Catharsis?

It has been too long since I put pen to paper – so long that even that statement is outmoded!

 Today, I want to share with you a thoughtful sadness.

About two years ago I relocated to a quiet northern suburbs area, where I now have a small practice.  I’ve slowly got to know many of the folk, their children, parents and life stories.  Some with chronic conditions need more regular medical attention than others, often with the help of specialists and other professionals. As a doctor-patient relationship is forged and developed, I am constantly reminded of what a privilege it is to be allowed to walk this intimate (and often difficult)  path with another human being. Dealing with pain, anxiety, treatment side-effects, incurable conditions, heartache, terminal illness, or even just the effects of ageing – these are intimate things, not  easily shared with just anybody.  This trust is humbling, and is something to be respected and treasured.

Human suffering of every kind or degree is all around us – just scratch the surface and you will find some kind of pain, physical or emotional, in almost every individual. Sometimes the hardest part of all is knowing that for some people, there is nothing you can do to help, except to be there for them, and share their burden.

And this brings me to the sadness.  This week, two of my aged patients died, and I found myself as moved as if they had been close family, even though I had known them for only a short time. One dignified gentleman in his seventies had for years bravely fought his way through a difficult heart bypass operation, kidney failure, prolonged immobility, diffuse arthritis, and just recently needed to have a pacemaker inserted. His wife, children and grandchildren are loving people, all of whom constantly rallied around him, full of help and encouragement. His sudden death has totally devastated this family.  The other patient was a delightful lady in her eighties who spoke only a few words of English, but had a twinkle in her eye and a smile that only a grandmother seems to have. She had survived breast cancer and a heart bypass operation, and was lovingly cared for by her family. This lady developed a stroke after a fall at her home, and died a few days later.

Neither of these two people was a close relative or personal friend. My interaction with each was infrequent, and only as their family doctor. And yet their death left me with a sense of personal loss. As professionals, we must remain objective at all times, but this is often difficult when dealing with another human being who has come to you for help at their most vulnerable moment. Many doctors are completely objective at all times: they are often exceptionally good in their field, but equally often disliked for a lack of “bedside manners” which seems to be the price demanded for this objectivity.  Finding the right balance between cold objectivity and warm humanness seems to be the answer. This is easy to do with a difficult, uncouth patient (there are many), but can be very difficult with a patient who for some reason touches your heart.

Perhaps this is an inner battle we doctors must contend with, and might explain why psychologists often have their own psychologist : they surely must need to unburden themselves of the huge load they carry from dealing with their patients’ problems.

Sometimes, the proven technique of writing something down can help. Yet I know that this catharsis is not erasure, and each patient lost along the way will remain with me forever. And on reflection, I think it is right.  I do not want to be untouched by another’s life: that would deny me one of the most enriching experiences a person can have.

This one’s for you Dad – I miss you.

Cats, Dogs and Dad

I’m adopted. It’s official. I only realized this last week when he followed me to a friend’s house and bashed against the door demanding to be let in. Once in, he gave me steely look, sat down with us, said not a word, and proceeded to wash.

Oh, did I forget to mention “he” is a cat?

In our complex, small pets are permitted, and the residents who choose to have a pet seem to prefer cats. There is one little dog, who is kept out of sight, and is not allowed to romp in the communal garden – perhaps because of the potential results should he encounter one of the cats . 

 There is quite a selection of cats here. No high-falutin’ Siamese, only local pavement specials or SPCA editions, who are generally far more interesting anyway. One unit had six cats, now down to two – both spayed females, beautifully cared for and groomed. Both cats are equipped with flea collars and little bells as an early-warning system for the hapless doves, so we’ve had no fatalities yet, and the cats’ diet remains sans fresh dove. The long-haired one seldom ventures out, but when she does, seems to spend her time unsuccessfully stalking the doves gathered around the tall cypress tree in the communal garden. The other one is quite a friendly cat, but spends most of her time in quiet dignity atop the wall of her back yard, surveying her domain – or that’s the impression she gives.

 But then cats are like that, aren’t they? Someone once commented that dogs have owners whilst cats have staff : how true. There are exceptions of course, but most cats will come when called only if they choose to do so, or if food is obviously on offer. Mostly, cats are competent, lithe creatures, seemingly in total command of everything they do and every move they make. On the rare occasion when a cat stumbles or falls off a wall, it usually recovers with an air of “Sowhatchulookinat?  I meant to do that complicated landing manoeuvre -  been practising for weeks, see?” Their air of supreme indifference makes it easy to understand why some ancient cultures worshipped them as gods.

 Another cat here is Jinx, a white cat with black patches, who seems always to be in trouble – in a fight, injured, sick, clawing his owner’s upholstery or just otherwise getting underfoot. He has calmed down over the years, and seems to stay close to his home lately. Then there’s Flapjack, so named because he survived being run over by a car. Amongst the other cats whose name I don’t know, was an older, thin cat, who kept a low profile,  always just sitting in the garden, and who would regularly drink from the swimming pool. This puzzled me, because the pool has a salt-water chlorinator, so the water can’t be very palatable. But there he was, every day, lapping at water near the steps at the shallow end. One day I found him sunning himself in my back yard, but he wouldn’t allow me near him, and fled in obvious terror at my approach. Over time, our encounters progressed to the point where he would let me stroke him, and I got my first good look at this cat.

 He is one of the Tuxedo variety – black, with white paws, bib, tummy and moustache. Poor cat. Stroking him, I could feel his ribs, and he was covered in scabs under his thinning hair.  He seemed so neglected, and yet must have been a pretty cat once. Having overcome his initial fear of me, he seemed an affectionate, pleasant animal.  The speed with which he finished the saucer of milk left me in no doubt that he was starving. Not wanting to entice away someone else’s pet – if he had a home, that is – I chose not to feed him, but watched him carefully, only offering the odd saucer of milk from time to time. His reaction to sudden noises and certain movements made me think that this old man might have been abused at some time, and was apparently abandoned, or at least fending for himself. It is a sad reflection on our society that people so readily abandon their pets when they move house. Considering the flux of tenants in the complex, it is quite possible that he was one of these unlucky cats.   

 Before long, he learned to wait for me – as soon as I arrived home from work, he would appear at the back door, waiting for his milk, and the inevitable day dawned when I could no longer ignore his obvious hunger. The bowl of cat food disappeared at the speed of light, and he came up for air, asking for more. This poor cat was famished! Well, you guessed the rest.  He is now lord of the manor, with his own kitchen window left permanently open so he can come and go as he pleases. His range of food bowls includes some for water, dried cat food, and a special one for his evening meal of brown rice mixed into a sachet of meat and gravy. He has filled out, and is now a solid specimen of cathood, with the scabs nearly all gone, and his coat soft and shiny as it must once have been. He has had deworming and anti-flea muti sneaked into his food, so his odd sleep on my bed is not a disaster. The result of his constant grooming has already left my kitchen floor littered with hair-balls and their accompanying gastric contents, and I watch his continued licking with a feeling of incipient doom. Next time it may be the bedroom carpets, and not so easy to clean up! He is still a nervous animal, and I have no illusions about cupboard love, but his purr and rub routine are most heartwarming.

Our relationship is realistic, without being non-committal. I recognize that he will come and go as he pleases, and may choose to ignore me for a day or two. But I must admit that it is rather comforting to be met at the door by a welcoming purr, and to have him sit on the desk watching me work. In a way, it’s almost like when your kids leave home: you miss them, but are actually quite okay on your own, and yet always pleased and grateful when they do visit.

As far back as I can remember, there was always a cat in the family. When I was very little, around four years old, I can recall that we had a large black cat. We lived in a tiny flat, but both my parents worked, and I was in a day care quaintly named “The Little Children’s Hotel”.  Needless to say, the cat soon found a retired couple in the building who were home all day, and though he came home in the evening, he spent each day at his other home, sitting in the sunbeam on their window-sill, and generally enjoying the benefits of dual citizenship. He stayed on with the couple when we moved away into our own home, so we acquired a new cat to go with the new house.  Chippy was a black tuxedo cat, whom we got as a tiny kitten, and had the pleasure to know for almost ten years. Then came Chippy II, whom we found in our garden as an abandoned newly-born.  I have photos of me as a teenager, feeding a straggly scrap of a kitten with a glass dropper. Pronutro had just been invented, and we hit on a mix of this with egg and milk which the kitten seemed to like, and clearly thrived on. Today I wonder what it must have done to his metabolism, but it seemed to work, and he survived, growing into the most wonderful family member. Hand-reared from birth, I’m convinced he thought he was human, and had no idea that he was supposed to be a superior being of the feline variety. Chippy lasted for nearly 18 years, surviving two house moves.

In all of this, the most amazing thing to emerge, was the cats’ relationship with my father.  Dad came from a very poor home, with a background of parental alcohol abuse and desertion – so bad that he faked his papers and joined the army at the age of 14, choosing to go to war rather than remain at home. Despite – or perhaps because of – his experiences, my Dad was a gentle loving soul, and had a particularly soft spot for animals. And animals responded to this, sensing, I’m sure, that they were safe with him. Over the years, we had several cats and dogs as pets, and Dad seemed able to communicate with them in a unique way. He could get them to do almost anything, and they seemed to want to please him, thriving on his words of praise and affectionate touch.

Once we children had left home, Mom and Dad set about building themselves a new house, but the inevitable builder’s delays meant that the house was only half built when they had to vacate the family home they had sold. Their only solution was to live temporarily in a caravan park near to where the new house was being built. Luckily, we had been a keen caravanning family, and already owned a large 6-sleeper caravan. So, with most of their belongings in storage, Mom, Dad and the cat moved into the local caravan park, where they lived for 9 months while the house was being built. The cat, though old by now, didn’t turn a hair at the move – after all, he was a human was he not, and didn’t need the butter-on-the-paws-when-you-arrive routine used for cats!! His diet changed dramatically too, as the bird population dwindled much to everybody’s disgust, and as did the mouse population, to the camper’s relief. On balance, they decided that he was earning his keep, so he was allowed to stay on.

Every evening, Dad would take a stroll around the park, and Chippy would stroll along with him, tail held high, stopping here and there to check on a spot he had found earlier in the day. Sometimes, he would climb a tree, and when Dad got tired of waiting for him to come down again, he would call out “Let’s go home now, boy.” At that, the cat would shoot out from the foliage like a launched missile, seemingly unstoppable as he galloped ahead. Getting back, Dad would find him waiting at the caravan tent, looking intensely bored with a “What took you so long?” attitude.

My parents’ new house was built on an acre of pristine bush hillside, overlooking the golf course. The bush was alive with hitherto undisturbed mice, lizards, and birds of all description. This was Chippy heaven. Mom and Dad moved into the half-finished house, completing the rest in stages themselves over weekends. And then came Bino. Our 20year-old maltese poodle, Chippy’s lifelong companion, died just before they moved to the caravan park, and my parents felt that both they and the cat would benefit from another dog. They returned from the local SPCA with the tiniest scrap of ginger fur I have ever seen. This creature was allegedly a dog,( breed unknown and obviously very mixed) and had a stubby, almost triangular tail, nothing like any dog we had ever seen. However, he was chosen from the litter because of his friendly nature, so home he came. He was called Bino because Mom said his facial expression reminded her of her cousin in Italy – I don’t know what cousin Bino thought of this, but Mom felt it prudent not to tell him.

Bino’s little legs were too short to negotiate the staircase, so for the first few months he had to be carried up and down the stairs. Fortunately (in view of the adult size he reached) he grew tired of this, and his adventurous puppy streak soon saw him racing up and down the stairs at will. As he grew, he changed shape, and was soon the size of a sheep, and just as wooly, but with straight ginger fur, which exploded into a lion’s mane around his head and neck. He looked utterly ferocious, with his loud bark at anyone daring to venture within a few metres of his property. Even the postman refused to deliver mail until the wall and gates had been erected. What they could not know – and my parents were not going to let on – is that the worst fate that could befall them was to be knocked to the ground by this huge dog, and suffer being licked to death by his warm, smooth tongue.

Although Mom did the feeding, Dad and Bino were inseparable. Whilst my Dad still worked, Bino made no attempt to join him in the car in the mornings. Once Dad retired, though, no car trip was possible without the brown furry passenger in the front seat. He became a familiar sight around the town, sitting bolt upright, staring straight ahead, and leeeeaning into the corners as Dad drove to the shops and back. If Dad pulled over under the shade of a tree to read his newspaper, Bino would jump into the back seat for a quick snooze, resuming his co-pilot seat when the car started up again.

No matter if Dad worked in the garage, house or garden, Bino was just quietly there with him. He would even wait outside the bathroom door while Dad showered – no matter what, Dad was seldom out of visual range. Bino loved to sit on the hillside and look out over the golf course way down there. Rarely, if it was too hot, he would choose to stay in the coolness of the verandah while Dad worked right down at the bottom of the steep acre plot. During the morning, Mom would tie a little bundle around his neck, and send him off: “Go to Daddy!” – and down the hillside Bino would go, bearing Dad’s morning snack, flask of coffee and packet of cigarettes, returning half an hour later with the empty flask. The other thing Bino loved to do was to bring in the post, especially if there was a nice fat newspaper to carry. The first few attempts yielded a rather soggy newspaper, but he somehow learned to make a dry delivery.

Bino was great pals with our two border collies. They were much older, and one was clearly top dog, but our visits saw the three dogs playing together like old chums. And because Bino was used to Chippy’s successor, one crazy cat called Elvis, and our dogs were used to our cat, the cats were also included in the games regardless of who was visiting who. Dad could watch the dogs playing all day, and he would often join in, getting more fun out of it all than they did.

When they moved to a smaller suburban house, and Mom succumbed to the physical and mental ravages of Alzheimers disease, Bino became even more special to Dad, especially as Elvis – the cat – had died, and Bino was now like an only child, and often Dad’s only real companion in the silent house. Now, Dad had to rely on Bino to safeguard Mom while he went out to do the essential shopping, so Bino’s car trips became fewer, and each one more special when he could go along with Dad. One awful day, Dad felt the huge lumps in Bino’s abdomen, and was devastated when the vet confirmed that it was a cancer, so far spread that surgery would not help. When Bino became obviously in pain, Dad and I went to the vet, where we held Bino in our arms for his final sleep. The look on my father’s face that day is permanently etched in my mind, and I felt his loss as if it was my own.

Now totally without a companion, and having to care for a bedridden wife,  Dad aged very rapidly, as all the spirit seemed to have gone out of him. We got him a kitten, but she never settled in and ran away when they moved into a retirement centre. Not to be put off, we got him another one, and we watched as Dad came to life again with this young playful kitten to liven up his days. Sadly, three months later, Dad died in his sleep. I hope he’s with his precious Bino, Chippy and Elvis now, walking under shady trees, and sharing the strips of biltong they all loved.

Grandpa’s relationship with his animals was a source of joy to him, and a wonderful experience for my children. He taught them little secrets of how to really love and care for their pets, how to handle animals gently, how to talk to them, and how to listen to them. Somehow, coming from their beloved Grandpa, this was special information, and it has made them better human beings all round.

Now, as I deal with my latest cat, I am slowly relearning the joys of pet ownership. I can appreciate what Bino meant to Dad, when he lived alone (my mother’s presence at that stage being physical only). I too have someone to share my day’s news, or can have the pleasant surprise of a sudden visitor to the study, black tail up and purring. Dad would have loved this cat, and I know he would have made it a fulltime mission to “de-stress” him, and that he would have succeeded. Somehow, every time I see the cat, I think of my Dad, and that makes him even more special. While he chooses to visit me, I shall enjoy every minute, because he may not be back tomorrow. After all I’ve been through, it has taken a stray cat to really bring that lesson home.  

One day, I may even get around to naming him, once I’m sure that he will stay. For now, he is just Kat.

Mom

I can hardly believe that five years have passed since Mom died. Recalling her last few years as she slowly lost the battle with Alzheimers is always so sad.  Like so many others in the grip of dementia, she underwent a total personality change, that the person who finally stopped breathing that awful night was not really my mother anymore. The body, the grey hair, the roughened hands – yes, all that, but the person, no, nothing like the person she really used to be.

This is for my Mother – I know you have a story too. I’d love you to share it with me.

Mom

 Mom. What a character. The epitome of dynamite coming in small packages.

 My mother came from a village in north Italy, where her parents had a small farm, and ran a trattoria. They lived in quarters above the trattoria, which was the hub of village life after work and over weekends. The main produce of this fertile valley was rice, which grew with little effort in the warmth and abundant water from the Po river.

 She and her elder sister were not involved much with the farming – that was their Dad’s domain- but were always roped in to help with household chores, and to work in the trattoria in the evenings. Mom was a stubborn, but likeable and lively child, always up to mischief. She hated school, and left as soon as she could. She eventually settled into a career of sorts studying midwifery.

 When she was in her teens, a farming accident claimed her father’s life, and she and her sister left their jobs to help their mother run the farm and trattoria. The farm was sold, as it proved too much for them to manage, and they concentrated on the trattoria instead.

 Then came the war, and the village fell under German occupation. Life became very difficult, with food rationing, and the constant threat of spies in their midst. Her mother was middle aged by then, and in poor health, so the young Pina passed her food rations on to her mother, whilst she made do with whatever she could. Trade at the trattoria dwindled of course, and there was precious little to live off.

 When the Allied troops entered their village, they were warmly welcomed by cheering crowds lining the streets. Soon, the villagers were being helped by gifts from the soldiers – food, medicines and basic supplies. Some of the soldiers began frequenting the trattoria, amongst them a shy but handsome young man. Soon Mom and her guy were head over heels in love, much to the amusement of the villagers who knew Pina as a tough nut, not easily swayed or fooled by sweet talking young men.

 At the end of the War, they were married in the village, and Mom was brought out to South Africa with her young husband to start a new life here – one she hoped would have better prospects than that possible in war-ruined Italy.

 Now Ben, my father, spoke fluent Italian, but Mom spoke not a word of English. Arriving here in 1946, with no family for support, the young girl felt totally isolated and incommunicado.  However, this was a girl who had survived the War, in an occupied town, so the small matter of language was certainly not going to put her off.

 Every day while Ben was out looking for work, Pina would take her few pennies to the market to buy food. What a job. Many of the vegetables she had never seen before, and couldn’t even enquire about, so for the first few days she bought only those few things she recognized: potatoes, onions, tomatoes, and beans. She got by with hand signals (fortunately this was second nature to ebullient Italians), but she never knew if she was being cheated out of her change. A kindly stall-holder recognized her plight, and began teaching the pretty Italian girl the English names of the fruit and vegetables. Mom had brought with her an Italian/English dictionary, and this now accompanied her every day on her lesson-cum-shopping.  

 The currency was strange to her as well. The Lira of Italy was pretty straightforward, and based on a decimal system, but here there was a very odd system indeed. Four farthings to the penny, twelve pennies to the shilling, two of which made a florin, or twenty of which made a pound. Two shillings and six pence made a half crown, five shillings a crown, and one pound one shilling made up a guinea. Oh for the simple lira! Trust the English to come up with a confusing system like this! It took her a long time to realize that five bob meant five shillings, and she gritted her teeth daily in annoyance at all of this.

 But the English lessons from the market, added to every night by my father, soon paid off, and Mom was able to communicate in a very basic way before too long. Fortunately too, Cape Town had many demobbed soldiers who had served in Italy, so there were many people who had a smattering of Italian and could help her out.

 I often wonder at the courage of this young woman, who left her homeland for a strange country, and an uncertain future, knowing that she could not speak a word of the language.  Would I have had the courage to do that?  This was how Mom was – if she was afraid of something, she didn’t show it, and she was always ready to at least try something. Giving up was simply not in her vocabulary, and I remember being intensely frustrated as a child by being told repeatedly: “There is no such word as “can’t”.”

 Realizing that they could not exist on Dad’s meager earnings as an apprentice spray-painter, Mom intensified her efforts to learn English. Without it, she stood no chance of finding any kind of job, as she soon discovered when she went job-hunting. Jobs were scarce in post-war society, and would certainly not be given to someone who could not even speak the language.

 At the market, Mom had met another woman who had come to South Africa as a war bride. This woman, Vera, could speak a little English, and had managed to get a job at Woolworths. When a vacancy occurred, she told her boss that she had the perfect person for the job – my Mom. As Vera had performed well, it was decided to give her friend a chance, and Mom was put to work at the sweet counter.

 This was a mixed blessing. Mom was used to serving customers from her days at the trattoria, and had begun to master the odd local currency system. The different sweets were displayed in compartments, and Vera taught her how to describe to customers what each type was. All that was relatively easy, but what Mom was totally unprepared for was the imperial system of weights. Why have 16 ounces to the pound, when 10 was so much more convenient? Not to be outdone by mere numbers, she quickly sorted things out, and proved a success at her sweet counter.

 With one of her first pay packets, she bought a little radio, so she could listen to more English. Poor Dad had to face a barrage of questions and give many explanations every night when he got home from a hard day’s work, but Mom was relentless in her pursuit of language.

 After a while, Mom was entrusted with filling in order sheets for her sweet counter, and delivering them to the supervisor in the administrative offices upstairs. She had never been in an office before, and was very taken with the tidiness and businesslike atmosphere. This, she decided, would be her next move. She soon made friends with one of the office workers, and when she heard that one person was resigning, she quickly applied for job. It was company policy to promote from within their ranks, so she knew she stood a chance. Except for one small thing: she had no clue how to do the work. But, she decided, how difficult can it be if this other woman could do it? She knew this was one huge gamble, as she in desperation bluffed her way through a short interview.

 Her gamble paid off, and she was given the job, starting the following week. Impressing her bosses no end, Pina was in the office at every tea break and lunch hour, so that the person leaving could “show her the ropes”. Like parched soil in the rain, she drank in every word, in reality trying desperately to understand what the job was all about. She had no clue what a costing clerk did, and would have to learn very quickly to avoid being caught out and fired. Her innate intelligence soon figured out what had to be done, and her first few mistakes were ascribed – fortunately – to a language problem, giving her time to learn the tricks of the trade.

 Before long, Mom was handling her job comfortably. A fast worker, and always keen to learn something new, she soon caught the eye of her supervisor. Whenever her work was done, Mom would help other slower clerical staff with their work, and by the end of the year, she had obtained a working knowledge of all the different jobs. She was thus much valued as a stand-in whenever someone was unexpectedly absent due to illness, or if there was a sudden increase in a workload. Mom was soon promoted, and given a small salary increase. Whilst this was very welcome in those difficult times, what she really valued was the knowledge acquired of the different aspects of business in general, and retail store management in particular. This was to stand her in good stead later.

 After many years, Mom realized that she could progress no further in the company. With her experience she was offered a better position in a smaller company which manufactured luggage and handbags. Her experience in cost analysis especially was invaluable here, and she was soon being consulted on feasibility projects for new products, and revisions of older ones. The job of wages clerk was added to her duties, and she was made responsible for handling the weekly and monthly wages of all the 300 odd employees at the factory. The young girl with only basic schooling and no English had come far indeed.

 Handing out the wages each week, she got to know the workers, and was appalled to see the debt-collectors waiting outside the factory gates, to collect installments of what was owed to them. Very little was left of the weekly wage after that, pushing the workers even further into debt. Their debts were not for luxuries (though there were a few such debts) but mainly for staples like food, basic toiletries, clothes and the like. Mom’s astute mind saw a chance to do some business for herself and help these workers at the same time.

 This was in the early 1960’s, when there were no Factory shops or reject outlets or mass direct sales. Through her contacts made at her previous work, she had got to know many factory owners and managers, and other wholesale suppliers. Within a few weeks, Mom had set up her small business with the approval of management.

 Mom had a range of samples at work, from which the workers could buy if they so choose. Her range consisted of what would today be called “rejects or seconds” from different clothing factories, and included basics like underwear, socks, pyjamas, children’s school clothes : the defects were minimal yet unacceptable to retail outlets, but the prices were about a quarter of that charged in the shops. The factories were only too pleased to move this “dead stock”, and kept her well supplied. She also had a small range of basic toiletries like soap, shampoo, toothpaste etc, which a local pharmacy had agreed to supply at a much reduced price. The staff were happy to support Mom, as they could place an order with her, have it delivered to their work saving them time and transport costs. Also, Mom was willing to offer them limited interest-free credit, so they could pay their debt off weekly. Naturally, Mom made a (very) small profit on each transaction, but was happy to follow the small-profit-large-turnover principle, as she was on a good wicket. Not only could she run the business from her workplace, but the staff would pay their weekly installment to her as she handed them their wages.

 In retrospect, she could add to her achievements that of pioneer businesswoman!

 The little business grew rapidly, and became the mainstay of our income, as my father’s ill-health lost him many working days. Within a year, our spare room at home had become a store-room for the weekly deliveries, which now included men’s clothes, fancy lingerie, perfumes, shoes etc. The whole family became involved in the sorting and packing of orders, and in the paperwork involved in all of this.

 One amusing spin-off was church bazaars. Our family had a close friendship with the local parish priest, and Mom was able to persuade her suppliers to donate some items for a stall at the bazaar. This was so successful, that the parishioners kept asking for more, their main request being, oddly, for underwear. Soon, the parish priest became an agent for Mom, who let him keep the profits for the church. But the really funny part for us was seeing dear Father C collect his stock from us. He got so good at sorting bras, that he could sort them into their sizes just by looking at them, and he was never wrong! We never knew how he had learned to do this, or what the Pope thought of all this.

 As her client base grew, not all the customers were from Mom’s work. To ensure payment, Mom undertook to collect payment from their homes each Friday night. This was an eye-opener for us. My sister and I were bundled into the car, and went along with my parents as they did their rounds of the poorer, sub-economic districts to collect their weekly installments. In the riskier areas, Dad would accompany her into the buildings, which meant that we had to go along too, as it was too dangerous to leave young children in a parked car at night in those areas. In this way, we were exposed to a side of life and society that not many got to see.

 The vast majority were decent, working folk, just trying to do the best they could for their families, and paid regularly. If there was a genuine problem, Mom would defer payment for several weeks, and despite all this, had hardly any bad debt at all. Other homes had such abject poverty that even as a child I felt embarrassed to have to witnesses it. Another aspect of life we got to know was that of crime and alcohol abuse: so often we would find a mother in tears as her drunken son staggered around verbally abusing anyone in earshot, or because she had just heard of his arrest for a crime or of his admission hospital for a stab wound.  

 After a few years, this weekly collection trip became too risky, and the business scaled down to only those at Mom’s work. By then, too, Dad had a more demanding job, and my sister and I were at University, leaving Mom to do most of the work, so the scaling down suited her fine. Once the financial pressures were off, Mom closed her business and took a job as a representative for another company, where she worked normal office hours, and had time for her family and her beloved garden.

 Throughout all of this, Mom was known as The Italian lady. Despite all her years of living here, she still had the odd problem with English. She would confuse the words shirt, sheet and skirt, and left many people wondering why she complained about having so many of her husband’s skirts to iron, or about why shirts (and pillow-cases) were changed weekly instead of daily.

 Many of her sayings have stuck with our family to this day. Often, when asked for advice about how to get a system going, she would answer “Try an arrow.” It took a long time before we worked out that her confused friends need not take up archery, but rather follow the intended method of “Trial and error.” She loved “honeypot” grapes, and would describe herself as a very down-to-earth person “who called a spade a shovel”. There were also many novel terms which only our family understood: her favourite plant was a Budgie creeper, so called because she didn’t know its name, but it looked a bit like a Canary creeper.

 Her foray into learning Afrikaans was a disaster. The only part she appreciated was that it is a phonetic language, like Italian, but she very quickly abandoned even trying to pronounce the guttural “G”, when those around her thought she choking and would rush to slap her on the back. She did learn one expression of condolence though: unfortunately the intended “Fooi tog!” got a bit mixed in translation, and she would wander around “Foegtooi”-ing anyone whom she felt needed it, much to their confusion.  This was the only matter in which Mom ever admitted defeat, where her usual approach of “If she can do it, so can I, and better!” didn’t work.

 She never learned Afrikaans, and never lost her heavy Italian accent. Right up to her death at the age of 82, she still spoke pure accent without a trace of English.

 She remains an inspiration to me. Where others would have buckled under the pressure, she faced almost insurmountable odds, and succeeded, with her only tools being her innate intelligence and sheer determination. Some called her hard – to me she was strong, and I know there were times when she held the family together. I saw my mother cry only twice: once, when my two-year-old sister went missing for four hours, and then when her own mother in Italy died. And this told what was really important to Mom – her family.

 No effort was too much – she did it all for us.

KIDS!!

Please bear with me today. Forgive the typos, atrocious grammar and excessive use of exclamation marks and ellipses.

I am still recovering from a brutal attack in which my consulting rooms were trashed by Attila the Hun and Helga the Horrible – each cunningly disguised as innocent, cherubic three and five-year olds. Mom made the appointment for herself and the two kids : Mom had a problem, but the kids came for routine checkups and referrals for hearing tests. That should have set alarm bells ringing at the start – these kids were not droopily sick, but healthy, energetic youngsters.

As I opened the door to admit them, there was this tornado effect of two young bodies sweeping past, running races with each other to see who could scramble onto the examining couch first. Mom looked on with a benign smile, admiring how healthy and active her children were. Having prised them apart from the fisticuffs (over who REALLY got there first) I sat them down in the patient’s chairs, glared at them, and tried to get started. Mom suggested we deal with the kids first – okay, let’s do that. Elder one first – fairly co-operative, got done quickly while younger one tore around the room pushing a doll in a pushchair making vroom-vroom car noises at full blast.

Then it was his turn: instant metamorphosis as I picked him up and sat him on the bed. Cute, smiling, impish, but with a twinkle in his eye that I should not have misread. Once done with him, I sent them both back to the play area in the waiting room where there are toys and other patients and staff: a safe area, but unfortunately, right outside my non-soundproofed door.

Two sentences into consulting with Mom, our ears were assaulted by screeching from the waiting room: fearing an injury of some sort, I burst into the room, only to find a battle raging between Attila and another child over who got which toy. Deep breath, retrieve Attila, bring kids back into my room for the sake of international relations, then try to proceed.

Okay, next tactic to try: watch them carefully and try to ignore the din. Nope, no good either.  As Mom went into the examining room, the terrorists followed. Take it from me; it is well-nigh impossible to conduct a rational, thorough examination in the presence of two whirling dervishes, who are everywhere at once, poking fingers into electric outlets (damn, the power was out!)opening and shutting cupboard doors, leaping up and down on chairs and literally throwing toys at each other.

I lost it when Attila tossed an expensive – and brand new – medical instrument on the floor, littering the carpet with its pieces. I doubt that any child has been so quickly grabbed by an adult, forcibly sat in a chair, and told that if he moved so much as a muscle he would be in deep trouble. Attila was suitably subdued – no doubt partly by the shattering sound of the equipment disintegrating and my swift – and loud, reaction to it. That lasted for about three minutes, when he slooooowwly slithered off the chair, and went to lie down on the carpet and stare out of the window at the passing cars. Yeah, or so I  thought. I overlooked the large, expensive pot plant near the window where he was parked.   

When Mom was ready to leave, she went to pick up her dear, quiet, well-behaved child. That was when we discovered that he had, handful by handful, emptied the soil out of the pot, and when the saucer under the pot could hold no more of the soil, he had silently smeared it all over the tiles, carpet, walls and his clothes. “Oooh, you are naughty today my son.”

 Shutting the door behind them, I took a deep breath, rendered the necessary first aid to the poor plant, then tried to reassemble my broken machine, which I soon realised would need more professional repairs. Deciding that by now I needed an urgent caffeine infusion, I headed for the kitchen …………..Mom and the children were still trying to restore order in the waiting room play area, under the “we-are-not-amused” stony stares of the patients who had been forced to endure the children earlier. How long they took I shall never know, as I fled the scene PDQ.

I have never come so close to infanticide as I did today, not even with my own hyperactive ADHD baby who never slept more than two hours a night or 20 minutes at a time during the day.

Parents, why are you so afraid to discipline your children?   I don’t mean physical punishment, spanking or the like.  I’m talking about teaching kids from infancy about boundaries, gentleness and ways to behave appropriately. Yes, let them shout and scream at play on the beach, in the park, or in the garden – that’s the stuff of childhood, and yes, nothing can come close to the sheer, gurgling delight of a child’s happy laughter.

But there is also such joy to be had from seeing a child who is happy within himself, comfortable in the presence of others, and who does not use banshee wailing to attract attention as he dashes from one scene of wanton destruction to the next like a windup toy. As irritated as one gets with the child, this sort of thing is the parent’s fault, plain and simple.

I’m not advocating CONTROLLING a child. I am saying “Love your child. Love him enough to show him you love him – give him your time and attention. Love him this way and he will be a happy child, who will become a responsible adult, who will one day show his children that he loves them too.” THIS IS NOT SPOILING A CHILD – THIS IS RESPONSIBLE PARENTING.

 These “wild” children are often simply bored, or desperate for a parent’s attention: the detached, bemused attitude of their Mom today spoke volumes. The more she ignored them, the harder they tried to get a rise out of her. Not only did that not work, but they were not reprimanded for their inappropriate and destructive behaviour, so how will they ever get the message that it IS inappropriate? And so they will naturally keep doing it, and trying even harder to be noticed.

The point that really saddens me though is that as maddening and disruptive as these children’s behaviour was today, this is the imprint they will carry. And one day, they will be adults…….with kids of their own…………………

TO DO LISTS & LIFE DECISIONS

Hello fellow bloggers,

Today’s post in a dear friend’s blog (http://eileensodyssey.wordpress.com/) is so true, and applies even more in these often pressurised times. 

I would like to add a few more decisions of my own to her very practical list.

So many of us think we are organised by having daily “to do” lists – often we spend so much time on these lists that we don’t have enough left over to complete the items on it, so back we go to craft yet another list for tomorrow, bearing the carry-overs from today. And so it continues, with a daily reminder, (the carry-over) of what we have in fact failed to achieve. Does such a list serve a positive purpose?  I say no, not until you decide to craft a list that serves as a reminder of what you have realistically chosen to achieve for this day in your life.

And it is in the crafting of this list, that so many other decisions subsist. The two quotes from Eileen’s blog pertain here:

1. Am I frittering away precious time in perfecting something that in fact does not doing at all? – can this once-in-a-lifetime chunk of time be put to better use?
2. Is my ladder against the right wall?

The old chestnut of “man’s reach should exceed his grasp” is meant to serve as a motivating force, but even the best intentioned motivators can backfire if they are unrealistic in the context of the specific person and his/her abilities and life situation. So I say, CHOOSE YOUR BATTLES CAREFULLY, MAKE THEM WORTHWHILE, AND SET YOURSELF UP FOR SUCCESS NOT FAILURE. This is of course not always easy to do, but the mere exercise of thinking a situation through can often clarify your thoughts – sometimes in very unexpected directions.

A quote I have often found useful deciding on priorities is ´Will this still be important in five years from now?”

So do I use to-do lists? Yes. Where would any of us be without diaries, Post-its, notelets and fridge magnets? An important trick of course is to remember to actually use that list – remember to take that shopping list with you to the shops, remember to look at it so you pay that bill on time, send that birthday card, etc..

The other – and to me most vital – decision, is how you react. Many life coaches say that we can decide what happens to us, can decide what our future holds etc. That is true in many respects. But, there are still many situations in life over which we have no control: you do not decide that your child be killed in a car crash, that you develop a rare cancer or that the stock market crashes and wipes you out financially. And here is where my decision comes in: the only real choice here is in HOW I CHOOSE TO REACT TO THE SITUATION. In reaching this highly important decision, once again, all the others subsist and must be faced.

As Eileen has done, examine each important issue in your life with the larger picture in mind, and then make your decision. Is it easy? At first not and there may be some very deep or thorny issues to be faced.  But it does become easier the more often you go through the exercise. So take that first step, start really thinking about what is important in your life – just for today. Then do it again tomorrow. After a while, your priorities will become crystal clear and your path to follow, highly visible. Then, somehow, the decisions seem so easy to make that they no longer seem like decisions at all, but merely “this is what I do and how I live”.

However, it doesn’t stop here. You cannot become complacent merely because you have reached this stage. If you don’t keep thinking and reassessing your life, your run the risk of becoming entrenched in a behaviour or response pattern that may become inappropriate as your circumstances change. So, constant vigilance and the ability to adapt remain vital tools: don’t pack them away, keep them handy, sharpened and well-oiled.

Remember: the difference between a groove and a grave is just a matter of depth.

TOO MUCH HOT AIR

This heat wave in Cape Town is becoming unbearable. The shortlived  thunderstorm last night did little to relieve things, and only succeeded in terrifying the neighbourhood cats and dogs.

Today, with the temperature well above 30°C, I closed all the windows and blinds against the baking sun (yes, you guessed it, my home faces north!!) turned on the fans, and settled down to a productive day’s work at the computer, all smug in my undies thinking of the poor folk out there facing a day at their office.

What an odd feeling it is to be “under house arrest”.  One phone call and a few e-mails have been my only contact with the outside world. This set me pondering again on how life has changed, and how dependent we have become on electricity. The blackouts last year very forcibly brought this home : no power = no computer, TV, microwave, kettle, sound system, heater, cooler, geyser, fridge, lights, (if you wanted to  *gasp* actually read a book).

In this weather, I can imagine that every aircon unit in the peninsula is working overtime. Maybe the guys who went to the office had the right idea after all.

And staying indoors for a day also drives home what a very small cog each of us is in this cosmos – life simply goes on. Doesn’t it? Granted, someone may have noticed my absence, but it didn’t make a significant dent in anything.  Keeps one humble.

As for the productive day ….well, let’s just say I’ll try again tomorrow! Apart from wilting like my poor pot-plants, my main problem is dry eyes causing blurred vision. The heat is a huge factor here of course, but there is the added affect of the fan circulating this hot dry air in its feeble attempt to improve things. The cherry on top is working at the PC : staring at a screen reduces one’s blink rate to almost half of the normal 10-30 times per minute. This leaves your conjunctiva dry and unlubricated. No wonder I can’t see clearly.

So on that somewhat defeatist note, I think I shall have to apply some tried and trusted conjunctival rescue medicine – an ancient remedy handed down by generations and fiercely guarded by my ancestors.        Wake me in an hour please.

© Anna G. Hall

CHILD ABUSE

Hello readers, It’s been a long time since my last post: so much has happened to turn my life upside down – future posts will expand on thoughts re that.

For today, I want to express my outrage and intense disappointment at what should be one of the basic principles of our civilisation: the safety of our children.

I have in my practice a little girl aged 3, whose extensive birth trauma has left her with probable minimal brain dysfunction, and definite behaviour problems. The child and her mother now live with another man, but the biological father has maintained contact. A few months ago, based on recurring bruises, the possibility of child abuse was raised. This led to an investigation at our local children’s hospital, which is internationally renowned for its work with children, and in particular for its involvement with child abuse centres and services. Whilst no child abuse could be proved, the case remains open.

This little girl is now in hospital with a broken leg. In view of this, yesterday morning I called the children’s hospital in question, to ask for some more background information . Well, I tried the listed number in the book plus five other numbers listed on the various child abuse websites : NOT ONE CALL WAS ANSWERED.

What is the point of raising public awareness of the problem, forming fancy dedicated units, pouring funds into them etc, if the entire system collapses because the phone is unmanned? What would have happened if I was calling to get help for a new emergency case?

Coming back to this little girl : was this truly an accident? Is this an escalation of concealed/unproven child abuse? Will she not be so lucky next time? Will it be rape, or even death?

A charge of child abuse is a very serious matter, and cannot be made lightly. Even if the charge can be 100% disproved, the fact that it was made at all has a huge psychosocial impact on the entire family. The question will always remain unanswered in the minds of those who know of the family, and the whispers will always be there. And the person laying the charge will never be forgiven by them, regardless of the fact it is done out of concern for the child’s welfare.

And so my dilemma remains : does this child need protection from abuse, and how can this best be done? I do not have the training or resources to do this myself and the advertised help centres seem “unavailable or unreachable”.

© Anna G. Hall

Trousseau troubles

My home and garage have become a repository for everybody’s cast-offs. Our entire family seems composed of magpies who cannot part with any item regardless of its lack of intrinsic value. Maybe that’s a little unfair. Everything has SOME value, be it monetary, sentimental, a spare of something hard to find, a “you never know when this may come in useful” item, or something just so pretty that it has to be kept. I’m sure we all have some of these tucked away somewhere. But my garage and cupboards – now they are in a category all of their own.

It is an old Mediterranean custom to provide each young girl with a trousseau (usually linen) for use when she eventually marries. My Italian mother proudly kept the few items of her trousseau she could transport out of WW II Italy, and was determined to do better by her own daughters. My trousseau was generous indeed. Over the years Mom accumulated towels, tablecloths, dish towels, blankets, sheets, pillowcases, pillows, serviettes, dustcloths, face cloths, cutlery sets, an entire range of stainless steel pots and pans, baking trays, brooms, buckets, scrubbing brushes – you name it, she had it! And all this in duplicate – one set for me, one for my younger sister. In honesty, all this came in very handy when I got married, as I was still a student, and my young husband had just started his internship, earning all of R200 pm, of which R90 went just for rent. My trousseau was proudly unpacked into the cupboards, and I got a warm house-wifely feeling seeing the shelves tidily packed with all these treasures.

Over the years, all the items were put to use, but more carefully than any others. It was as if they were somehow more precious. Even the plastic buckets were handled as if made of crystal, and were carefully washed and dried before being stored away after use. It must also be said that Mom always believed in buying the best she could afford, and she sometimes just bought the best anyway, even if she couldn’t really afford it. So, the trousseau items just lasted and lasted. Over the next 29 years, all of this stuff got packed, moved and unpacked to five different homes, the last one being my current home. 

During that same time, though, two lovely daughters made their appearance: yes, that meant two new trousseaux to start and store. I never reached the pots and pans stage, but did get quite a bit stashed away in the linen category. And all this got packed and moved around too. My elder daughter moved to another city when she married, but left her trousseau behind. With the beautiful linens and kitchen equipment available today, I can see that her trousseau things must have seemed dull in the extreme, so I joined her excitement at setting up her own home with her own choice of things. Then my younger daughter went into digs. As this was around the time of our divorce, it was easier to provide her with items for her flat from the “stock” of our home, which was being divided up anyway. So her trousseau also remained untouched.

Guess which parent got custody of the trousseaux?

At that time, my parents were getting on in years, and decided that they needed to downscale to a retirement village. They began rationalizing their possessions, and naturally wanted to pass on to me anything of potential use, rather than give it away to a stranger. I didn’t have the heart to turn down the boxes of surplus towels, table linen, bed linen etc which they decided they would never use. Some of these were still in their original wrapping, gifts from many years back. I dutifully thanked them and removed the boxes, sighing inwardly because I knew that I simply had no place to store them. And the boxes just kept coming. The squeeze was really on for me, as I had downsized of necessity after the divorce, and had my half of household goods, (some of which had formed part of my trousseau), the girls’ trousseaux, and now I had to find place for my parent’s off-casts as well. And just when I had repacked the cupboards to fit everything in, the next box of goods would arrive. I eventually learned to live with boxes jammed into every crevice, tucked under every bed (why DON’T they make beds on legs anymore – all that wasted space!), and some just stood around here and there like standby passengers at an airport hoping for a seat on the next flight. I began to dread birthdays and Christmases, when the family felt obliged to give gifts – where to store them?

I stumbled on in this mode until the unthinkable happened; my gentle, loving father died in his sleep. As he had always taken care of my Mom who was now almost bedridden and  incontinent in her advanced stage of Alzheimers, we had no real choice but to sell their retirement home and move Mom to a frail care facility down the road from me, where I could visit her daily. I couldn’t bear to toss out the few belongings they had taken with them to their retirement village, so these joined their erstwhile housemates in my garage. Mom had a cheerful private room in the frail care, with a huge clothes cupboard, bedside cupboard/dresser, even her own fridge. It was reassuring to her to be able to fish out of storage an item she would suddenly remember and ask for, and then I was pleased that I had not disposed of so many of their things.

As the months passed, it became clear that Mom’s world was shrinking fast. Her needs became less and less, until eventually all her life’s requirements could be accommodated on a few hangers, one shelf and a store of disposable nappies at the bottom of the empty cupboard. Even her wheelchair stood folded away gathering dust. The staff at the frail care had asked me to remove the increasingly superfluous items, rather than risk them being stolen. So this too, was added to the store at my home. My fun-loving, energetic, hardworking mother had been receding into the distance of memories over the years, and, one lonely night, the shell of this person-who-was, quietly slipped away. The day after Mom died, I emptied her room, and was again moved to tears by what her life’s possessions amounted to: two shopping bags of clothes, and another one with toiletries, medications and her portable radio.

Months later, I gathered enough courage to try to sort out her things, and was determined to give everything away – after all, there was nothing I could use. I managed fairly well on the whole, though there were some items I simply could not bring myself to part with. I never liked her black handbag, but she loved it, and used it every single day, even if was just to store her cigarettes or her favourite comb. Yes, there are now a few new boxes, with my memories of her carefully tucked away. 

How does one deal with this? The items themselves are not the problem, but they are a link to the past, a key to a treasure trove of memories which, once entered, explode with a domino effect. All the “remember when”s come tumbling out unbidden, with unstoppable tears and that deep ache that only irreplaceable loss can elicit. I have tried many times to rationalize both the situation and my approach to it, but have yet to succeed. Whenever I start to unpack a box, the memories sidetrack me so effectively that I land up just repacking it, resolving to deal with it another time. I am clearly not yet ready to let go, even though I know I shall have to at some time.

My cupboards and garage are still bulging at the seams with “not-my” stuff, and every day, in some part of my life, I am touched by the legacy of my parents. Perhaps I sharpen my kitchen knife on a real whetstone, something my father kept from his days as a coachbuilder on the old SA Railways. Mom had a pair of scissors with the tiniest points imaginable – they had come with her foot-treadle Pfaff sewing machine as embroidery scissors – and these are in regular use for stubborn stitches which simply cannot be removed with any other instrument. I have an old comfortable jersey I wear around the house ; it is baggy and discoloured but soft and warm, and was the last thing Mom knitted for me. Somehow these links keep my parents very real to me, and are a constant reminder of what they meant to me, and how they helped make me what I am today.

I couldn’t help smile though, when I unpacked one of the boxes Mom specially wanted me to have. Inside, carefully folded, were items of Mom’s own trousseau. Her mother had hand made and hand embroidered, sheets and towels made of linen (no terry-towelling in a little Italian village in the 1920’s). These had been brought to South Africa in 1949 when Mom arriveded here as a war bride, and she had never used them, despite the grinding poverty she and my Dad endured. She kept them in memory of the love her mother had for her, and passed them on to me. She clearly had a trousseau problem too.

I predict that my garage and cupboards won’t have space to let for some time yet.

(c) Anna G. Hall

Alternative medicine, homeopathy & placebos

Alternative medicine – placebo effect?

 The best clinical trials are the randomized, double blind, crossover kind, where neither the doctor nor the patient knows whether s/he is getting the real drug under investigation or a dummy look-alike, a placebo. When results are finally analyzed and who-got-which is revealed, the most intriguing thing for me is the small but notable therapeutic effect obtained by the placebo. This is true of placebo no matter what drug is being investigated: a blood pressure drug, heart failure drug, pain-killer etc. This placebo must indeed be a wonder substance!

 So I decided that selling placebo would be a good business move – after all, it does work to some extent; contains no drugs at all; has, therefore, no unpleasant side effects, and is ridiculously cheap to produce. Safe, effective, cheap and profitable – an entrepreneur’s dream.

 Oops!!  Pipped at the post again. The market is already flooded with placebo, marketed under the blanket term of “alternative medicine”. As I understand it – and please would some-one correct me if I’m wrong – some of the basic principles of homeopathy include using a substance which reproduces symptoms similar to which the patient reports (using fire to fight fire), but in extreme dilution. A small amount of the substance used, often a herbal extract, is serially diluted with vigorous agitation of the container. The homeopaths also claim that the greater the dilution, the greater the effect. Now here is where I have the problem understanding.

 Maths dictates that eventually a dilution will be reached where there is not a single molecule left in the container. This, the homeopaths claim, is no problem at all, because the water molecules somehow retain a “memory” of the medication it originally contained, and that THIS is all that is needed for the medication to work. I have been unable to find a single scientific report proving this “memory” or any other form of alteration in the water molecule. Has placebo somehow crept into the bottle?

 Also, if water can retain a memory of substances in it, then what about the memories of all the other substances to which it must have been exposed along its journey from its source to your tap? All the naturally occurring toxic and carcinogenic substances, the radioactive elements in the earth, decaying animal and vegetable matter in the rivers, excreta from aquatic life, bacteria, excrement from human settlements along rivers – what about the memory of all this? Surely this must also have an effect? Or is this somehow mysteriously neutralized? Is this placebo at work again?

 My science background rejects this dilution/memory theory due to lack of substantive evidence. However, I do commend the homeopaths for having gained deep insight into the mysteries of placebo, and making it such a business success.  The alternative medicine in USA is now so huge that there is a move afoot to bring it under some form of regulation ( eg standardizing products, which is currently not required), leaving the consumer exposed to unknown doses of active ingredients. In the case of herbal medicine, this could be lethal.

 The human psyche is a wondrous thing, and it is here that placebo does its work. That does not trouble me at all: we all know the value of a reassuring hug, of comforting words to a child etc., so I in no way want to belittle the skilled and judicious application of placebo in any form. What I do object to, is it being marketed under the guise of scientifically proven fact, and possibly keeping a patient away from the benefits of another form of treatment which could be more effective.

 In the absence of scientific proof, the consumer is therefore being asked to accept homeopathy on faith. And that is where it falls squarely outside of any science at all, and enters another realm altogether.

© Anna Guiseppina Hall

Should we have a star rating for hospitals?

Hello folks,

The The best place for a microwave oven in a hospital is right outside the patient’s door! Time and motion studies show that this is the most efficient way to keep a whole ward full of patients from sleeping. In case the nocturnal half-hourly pulse and blood-pressure check are ineffective (plan B), plan C – the 2am fingerprick – is invoked.

Then there are the other subtle strategies to make one’s stay as uncomfortable as possible. The new soft mattresses come at a price – they have now stuffed the pillows with rocks to counter any thoughts you might have had of actually sleeping. This way you need a sleeping pill – Kaching! goes the pharmacy till.

The catering staff eagerly hands out slips for you to tick off your choice of meals for the next day – this at least looks promising. Your breakfast finally arrives – late – bearing the slip you ticked. Don’t ask me how it happens, but at least two of the four things ticked on the list are not on your tray. The two things you chose that do arrive, toast and porridge, are ice cold, and you know that there is absolutely no chance of actually getting what you ordered before next week at the earliest. So you eat what you’re given. And this is repeated at lunch and suppertime.

Now I have a few grumbles here. I realize that hospitals – even private ones- are understaffed. But the private hospitals are actually in the BUSINESS of healthcare, so you’d think that the customers (patients) would somehow be important to management. Not so. The emphasis is clearly on throughput, (next patient please) rather than quality care for the ones already in. There must be a hidden financial incentive somewhere.

The moans about food are not mere ramblings though: what about the patient who is diabetic, and can’t eat certain foods? And he certainly can’t wait for the tardy kitchen to send a replacement meal: he could become dangerously hypoglycaemic. And what about the allergic patient? He might be given the wrong meal, and consume what is sent to him simply because he is too hungry to wait another hour. Good nutrition is vital, and especially so in the immediate post-operative phase: what a pity hospital management doesn’t know this!

And the healing power of sleep – in silence, darkness and uninterrupted. Has no-one told them about this either?

I was lucky: my operation didn’t render me helplessly bedridden. Also, I’m a doctor, so I could see impending medical disasters and avoid them. But the average patient can’t defend himself against this sort of system – if he moans, he is labeled a “difficult patient” and gets summarily ignored from then on, making his life even more miserable.

Whilst a hospital is not a hotel, if management wants to claim that it treats its patients well, then hospitals could take a few lessons from the hospitality industry. Perhaps there should be a star rating for private hospitals too, so patients know what to expect.

Make no mistake, in the midst of all this there are some really good, efficient and caring nurses. But they are swamped by paperwork and admin, and  have no time to actually nurse patients. Gone is the nurse who fluffs up your pillow, or adjusts the curtain just so, to block the beam of light. The gentleness seems to have gone out of nursing too, drowned by “progress and systems”. Whilst we benefit so much from science and technology, I think we have lost the human touch along the way. I miss it.

© Anna Guiseppina Hall