Month: August 2016

Folding Stars – a blog about loss

Tomorrow is a promise to noone

I would do anything for another minute with you because
It’s not getting easier, it’s not getting easier

I hope that you’re folding stars

Simon Neil from Biffy Clyro sang these powerful words about the death of his mother, Eleanor, in the song Folding Stars (I’ve always assumed the title is a reference to her doing patchwork). And this week I’ve been thinking a lot about people who have died myself.

I think it started because I watched the songaminuteman videos and read their facebook page in which a man about my age, Mac, is singing with his 80 year old father, Ted, who has dementia. Mac described on their justgiving page (which has nearly reached £100,000 for the Alzheimer’s Society) how difficult it is for him and his mother to cope with Ted’s aggressive and disoriented behaviour, and how singing has been a great reprise from that. Ted has been a club singer and Butlins host for much of his life. Singing is clearly something he loves and shares with his son. You can see from the videos that as soon as the backing music starts, it is something he immediately connects with, recalling the lyrics of a huge range of songs, and the banter and demeanor that used to accompany it.

That reminded me of my paternal grandfather, Jack, who died in 2009. He was also a talented singer, who had the opportunity to make a professional career from it had he been willing to emigrate to America, although he chose to remain in South Africa and have a more conventional lifestyle, running a shop and later working in commercial real estate. I didn’t ever get to know him very well, as my parents had emigrated to England before I was born, and so we would typically spend two to four weeks per year with my grandparents, alternating visiting them in South Africa with them visiting us in England. After I was twelve and needed an adult seat on the plane, the cost of flights became prohibitive and we only visited South Africa once when I was a teenager, and I can only remember them coming to visit twice more. When I got married in 1997 they were unable to come to the wedding as my grandfather had recently had a stroke, so they sent us the airfare to come and visit them the following year. I took my husband to see South Africa and meet my grandparents, and my parents overlapped with us for a week during the trip to show us some of the places they had grown up. We also visited Cape Town and the Kruger Park.

After that trip I heard about their decline  through my parents. My grandmother sank gradually into Alzheimer’s style dementia, to the point she is now almost non-verbal and needs constant nursing care, and my grandfather had the stepwise decline of multi-infarct dementia, with Lewy body type hallucinations, until his death 7 years ago. I don’t have a very clear sense of Jack as a person from my childhood. I can recall his wry smile, the habitual sequence of cleaning out and restocking his pipe with fresh tobacco and the pungent smell of him smoking it. I can recall the paranoia and acceptance of racism that years of living in South Africa had normalised contrasting with the fact that they had been very much ahead of their time in how they had supported Ben, their black “garden boy”, to have accommodation and paid employment in Johannesburg, rather than having to commute from Soweto (the nearest “township” or black slum). I can recall the taste of sugar coated dried fruit sweets in various colours and flavours, and the enormous avocados that would fall from their tree. I remember trying to explain how to use their new video recorder and remote control. I can picture the pale blue of the air letters he used to send to us regularly, and the way we would all take turns to talk on the phone to them when it was the birthday of any member of the family, long before the internet and skype made the world seem smaller. Overall I remember him being a bit of a grumpy man, who was anxious about single lane country roads, and didn’t like my grandmother’s religious rituals.

I also remember being unkind to him once as a child, and being told off by my parents. The memory is of being quite young and making a den with my cousin out of blankets hung between furniture in my grandparents’ back room. We would have been about seven or eight years old, and we were pretending to be cats. I don’t remember what my grandfather said exactly, but I remember that he said something mean that implied he thought our den was stupid. We wrote him a note that said it didn’t matter what he thought because he was a big rat who wasn’t welcome in our den, and signed it “the two cats”. As a kid it seemed like a fair response in kind, but my parents said that although he was grumpy it was a mean thing to do because he was old and had arthritis, and I remember feeling ashamed. As an adult I gained another layer of empathy, as I learnt about how much happened during my grandfather’s lifetime. How as an infant he had to flee persecution in Eastern Europe with his parents and move to South Africa where they had to learn English as a third language and live in a single room. He used to study by torchlight so as not to wake his father who worked night shifts. As my grandparents reached adulthood and got married, Jack had to do military service, and there is a photograph from when he was a fitness instructor in the army. They lived through the second world war and heard about how two thirds of the Jews in the world were murdered in the holocaust, including 91% of the Yiddish speaking Ashkenzim to which they belonged. They saw the inaction of the world turning a blind eye for far too long. Then after the war, as they became parents, they saw the survivors return to their community with tattooed numbers from concentration camps. Having been brought up as a British atheist I have no idea how that must have felt, but it can’t have been easy.

I heard about my grandfather dying two days before I gave birth to my twin daughters after a very complicated pregnancy, at a time when I had enormous other stressors in my life and I was caught up in a protective bubble. And I just accepted it as a fact and got on with everything that was going on. I don’t think I had cried about it before this week. But I am sad that I didn’t get a chance to ask him more about his life or to hear more of him singing. Nor did I express my thanks for how much he changed the path of my life before I was ever born. It is an impressive achievement to progress in a single generation from being immigrants in a single room learning English as a third language to owning a home and a business and funding your child to complete university and travel to England for postgraduate study. He was probably the reason that my parents were able to choose their own path as London hippies, and therefore a big influence on my sense of identity. I’d like to think he’d appreciate how badly my Dad sat shiva with my much more devout aunt, given his disdain for religious ritual.

I had also lost a colleague and friend who had died unexpectedly a week before the death of my granddad. Phil was someone I had worked closely with for several years, and had great respect for. He was in his fifties and had teenage children. It was a mark of my great trust in him that I had cried twice when talking to him – once about seeing a small deer get run over and killed on my way to work, and once when he told me about the death of a child I had been working with. And yet, like with my granddad, when I heard he was dead and I would never see him again I just processed the news as a fact, and felt no emotional response to it. As with my granddad, it has only been over time that I have been able to mourn his passing. I think of Phil each time I travel to a new country or walk on a beach, because of his habitual request to “bring me back a stone” if you went somewhere far away, and the pile of stones he would bring back from the most northerly beach in Scotland. I have often made stone towers or arches, written his name on a stone and thrown it into the sea or photographed the stones thinking how much he’d have liked them.

Death is an enormous topic to even try to think about, perhaps because it is connected with such painful experiences of loss, but also our own mortality and the inevitable eventual death of all those that we care about. As an atheist, I believe death is the end. Trying to imagine death is like staring into a black hole – somewhere in the uncomfortable abyss between terrifying and impossible to conceptualise. Having children has made me much more aware of my own mortality, and more fearful for theirs. I always text before takeoff whenever I fly for work, and I tell them I love them an extra time every night as they fall asleep, because I’d want them to be sure of that if I ever don’t return. But I remain of the opinion I expressed as a five year old to a babysitter, that even if a butterfly lives only for one day that isn’t a sad thing if the day was a happy day, because all they would have known is happiness. And I feel the same about my life, that I’ve already had a huge measure of happiness from a wonderful family, good friends, and amazing experiences, so even if it were to all be over tomorrow I couldn’t feel short-changed.

My Mum’s father died before she was born, and her mother died when in her late forties, when I was an infant. In my childhood my Mum felt it was likely that she would also die young, and I remember her having life insurance to protect us from the financial repercussions if that was the case. She was the only person I know to be grateful to have greying hair, as it was a marker that she had lived long enough to go grey. She is now retired, with fully grey hair and is thankfully still in good health, but she has been a good role model of appreciating the time you have got. And that is such an important thing, to savour the present. We are taught to invest for the future, in terms of putting our time and energy into long-term plans, focusing on building our careers, saving money, accumulating possessions. But as Alan Watts so neatly explains, we need to make the most of now, and dance while the music is playing. We need to have time for relaxation, creativity and fun. I’m trying to change things around a bit, so I do that more. I’ll give the last word to Biffy Clyro also (from Machines):

Cause I’ve started falling apart I’m not savoring life
I’ve forgotten how good it could be to feel alive

Take the pieces and build them skywards
and
Take the pieces and build them skywards
and
Take the pieces and build them up to the sky.

 

Rape culture and blame

I blogged a couple of months ago about the Brock Turner sexual assault case, and intended to write this post then, but I left it as a draft for some time – perhaps out of discomfort for the personal disclosure involved, or a sense of distance from the incident that made me want to post about my own experience. But it has never really gone away, because it is so prevalent, both in the tip of the iceberg of individual rape cases, and the massive underlying mass of the pervasive cultural acceptance of male sexual coercion of women (eg the horrifying statistics about misogynic beliefs and rape myth acceptance amongst male college students, particularly those involved in sports that I shared in a previous blog). It seems that just as racial tension has come to a head in America over police shootings, rape has come to a head with the Brock Turner case – with 1.3 million signatures on the petition calling for the judge to be sanctioned for his decision to go for a sentence well below the ordained minimum. And this week debate about whether the olympic diver proposal was romantic or inappropriate*. It seems that themes of sexuality and gender have become fault lines, showing wider problems in society.

Of course there have been many other cases making headlines since my previous blog on the topic, and rape and sexual assault are rarely out of the news. A woman who was raped in Qatar was found guilty of the crime of having sex outside marriage and given a suspended prison sentence and fined (I suppose we should be grateful that she didn’t get the 140 lashes that her rapist got, given they were nominally convicted of the same crime), whilst a woman in Argentina was convicted of murder for possibly having a miscarriage (though the only proven miscarriage in the case was the miscarriage of justice). Here a photographer lured young men to his home for photoshoots where he drugged and raped them. Another victim of campus rapists from athletics teams. This man used a woman’s desire to protect her children as leverage to stop her resisting his rape. This 7 month pregnant woman was raped at gunpoint. The list goes on and on and on. And there is evidence of systemic problems in how US police handle rape cases. Meanwhile lots of people have been brave about talking about their own experiences of “rape culture”. For example, this one, and this one.

I thought I might share some of my own experiences, to talk about both what it says about the culture, and the blurry line around consent. To give this some context, I’m not an extraordinary woman. Nowadays I’m a middle-aged mum. Non-smoking, rarely drinking, overweight and a bit of a workaholic, with that boring but comfortable lifestyle that many families fall into of school and work and supermarket shopping and homework and swimming and weekend outings to parks and historic places, with the occasional family visit or trip to the cinema. I’ve been happily married for 19 years this month, and I lived with my husband for 3 years before that. But even before that, I wasn’t extraordinary in appearance or behaviour, and I wasn’t reckless.

So when I say there were two occasions in my life when I felt I was at significant risk of rape, I’m pretty sure that other people have had similar experiences.

The first was when I was sixteen and had just started at sixth form. I would go out socially drinking with a particular group of friends from school most weekends, but I usually just had two or three single shot drinks with a mixer to make them last longer (vodka collins was a favourite, and much like a Smirnoff Mule now). One night I was with a group of friends outside a pub and one of the lads bought a bottle of “Thunderbird” fortified wine from a shop. He was pretending to drink himself and with nothing more than encouragement and peer pressure, he effectively persuaded me to drink more than I wanted to. I was a very innocent 16 and when he walked me away from the group and down the dock road out of sight I hadn’t expected more than a snog and a fumble.

However I suddenly became aware of my own vulnerability once we were away from the group. I was wobbly on my feet and nearly fell over, and in an amazing demonstration of both his strength and sobriety he practically picked me up and walked me firmly down the street. A minute later he put me on some concrete ground up a few steps from the road, hidden from sight by a lorry. It was then it became apparent that he was very determined to have sex and started taking my clothes off. I was putting them back on as best I could, but I didn’t know him well and didn’t want to risk him becoming violent (he was a foot taller than me, and I was too drunk to run away) so from his point of view I didn’t give a clear ‘no’. I was still kissing him to buy time to pull my clothes back up and trying to figure out whether anything else would appease him or whether there was a means to escape. But there was nobody in sight, and he was bigger and stronger than me, and this was in the days before mobile phones, so I felt completely on my own. Thankfully after half an hour or so he gave up and walked off. He left me dishevelled and alone, down the dock road of a town that was closed up for the night, having missed my lift home. But even as I stumbled back to the phone box, called my parents for a lift and made excuses about being drunk, I was feeling relieved that things hadn’t gone much worse. I look back and feel it was a lucky escape as no form of penetration occurred.

It was a frightening but in retrospect enlightening experience. Firstly, I learnt never to be drunk enough to lose my ability to run away or plan an escape with my full faculties. Secondly, I realised that from his perspective he was just trying to persuade me to do with him what another guy had lied and said we’d done at a party. He thought that it was just a matter of persuasion and persistence, which are socially acceptable aspects of the interplay between potential sexual partners – and importantly I never said no. Maybe if I’d have said “look Chris, I don’t want to have sex, stop it” he would have. However, maybe he’d have been angry that I was leading him on. Maybe if I’d have said “stop it, I don’t consent, if you force me to have sex it will be rape” he’d have been horrified and reconsidered his behaviour. I have no way of knowing. If we’d have been interrupted or I’d escaped and I hadn’t experienced him leaving of his own volition without sex, I think I would have felt it was a near miss. I don’t know if I’d have ended up reporting an attempted rape, but I certainly felt that repeatedly pulling my clothes back on was a pretty clear indication of lack of consent that he should have respected but didn’t.

Finally, I learnt that within that group of mutual friends he had done nothing wrong. They saw me leave willingly with his arm around me, and therefore everything that followed was presumed consensual. When I tried to steer clear of him they wanted me to make up with him as he was part of the group, despite the fact that I found his behaviour pretty sinister. However, for a teenage boy, plying a girl with drink, getting her to go somewhere private, trying to take her clothes off and ignoring the signals that she did not want to participate seemed a legitimate strategy, both to him and our mutual friends. He wasn’t a stranger, or someone menacing, and he was accepted within my social network. This made him very hard to avoid (and meant that on a later ocasion he cornered me at a party, put my hand on his genitals and used it to masturbate). Yet to everyone else was an ordinary guy who was above average in appearance and intelligence. He has gone on to have a successful life and now manages IT services for a bank.

The second time I felt at risk of rape, was after the tragic abduction and murder of toddler Jamie Bulger. A friend of a friend at university came to my door and said he was from Bootle and really distressed about it and wanted to talk. Although it was clear he had been drinking, in light of his distress I let him in, and we went up to my room as other people were in the sitting room of my student house. We later heard them leave, and after that his topic of conversation changed to how, despite having a girlfriend, he wanted to have sex with me. He tried to kiss me, but it was unpleasant and unwanted so I moved away. He started to undress, and try to grab at me. I realised I was cornered in the attic room of a house by a drunk man of substantial build with nobody else within shouting distance. However, this time I was sober and a bit more streetwise, so the balance of power was different. I told him that I wasn’t interested and wouldn’t be taking any of my clothes off. I suggested he get dressed and go back home, and I kept myself out of reach until he acquiesced. He knocked at the door the next day to nominally apologise in order to ask me not to tell his girlfriend.

Again, when I told my friends (and this time they were my friends, as opposed to mutual friends) they didn’t really see it as a big deal. I’d guess they didn’t see the story I recounted as having any bigger emotional connotations than “Drunk guy embarrassed himself. Assertive girl put him in his place”. And that wasn’t an entirely unreasonable perspective on the story, particularly given they were male friends and this was back in 1993, long before the days of #metoo. But it’s never quite as simple as that. Because even if it is only for one moment, the awareness that somebody else in your social network could force you to have sex against your will is a pretty stark realisation, even for an extraverted assertive girl. And however you think about it, it has an impact.

Whether by coincidence or subconscious drive, I put on weight after those two events, adding 40% to my bodyweight over a four year period that has stayed with me ever since. At the time I didn’t connect the dots. I thought it might be due to the contraceptive pill, or a less active lifestyle at university. But it seems more likely looking back that I just didn’t want unwanted sexual attention, and a fat suit is quite good at narrowing your appeal and not conforming to the socially accepted norms for attractiveness.

But it does feel like the psychological equivalent of wearing anti-rape pants. That sucks because anti-rape pants are a terrible idea that I object to in the strongest terms**, because they place the responsibility for not being raped onto the individual women. Rather than stopping a few men being rapists and a heck of a lot of men feeling so entitled that they act like overcoming the woman’s resistance is a normal and acceptable part of the process of dating, it makes women take the responsibility for not being raped. Why should it be that we need special pants to indicate we are not accessible for non-consensual sex, rather than the default position? And why should I feel that being a more attractive version of myself would make me more vulnerable to unwanted sexual advances?

I should perhaps state the obvious here. I’m not a man hater, and I’m not tarring all men with the same brush. I don’t think of men as Schrodinger’s Rapist or at least, I don’t want to, because the vast majority of men I know are lovely human beings who care about other people. But yet, our survival instinct is a powerful thing. One fall down the stairs 20 years ago, and I am still careful about stairs and escalators. Two situations in which I felt vulnerable to sexual assault (and a fair few clinical cases in which I have heard stories of rape, sexual abuse and/or domestic violence) have made me see risk in men that I don’t know well, and to view being perceived as sexually attractive to those outside my trusted circle as a potential vulnerability. It is a troubling conclusion, and one I don’t know how to resolve.

*We’ve got men today saying it is ridiculous that people have questioned the romantic gesture of the Chinese diver proposal, even when the recipient of that proposal looks uncomfortable about it. They’ve been led to believe every woman wants to get married and is just desperate for her long-term bf to propose, rather than that deciding to get married and how to tell everyone about is should be a mutual agreement, or recognising that there could be duress involved. For me, the seed of doubt is in the body language and facial expressions when I watched the video. Of course, it might be a cultural difference, or the amount of adrenaline and anxiety about being in the spotlight with cameras all around her, but her face doesn’t suggest delight. It suggests hesitation and uncertainty. Quite the opposite of the rugby player and stadium manager involved in the proposal the previous day. From the silver medal diver’s reaction you could imagine the subtitles of the whisper in her ear, or the sentence after holding up the ring being “I don’t want it to be over, please say yes, don’t shame me in front of all these people” just as easily as you could imagine it being “I love you so much I want everyone in the world to know it, please forgive me for doing this in public”. And her response involved no grins, no kisses, no seeking physical closeness, just discomfort, tears, a delayed nod and then acceptance of his actions. Whilst we may never know the answers about the specific example, the themes have echoes in how gender roles are perceived across the world. So I believe the discussion is worthwhile and should not be shut down.
**I should also add that there is no evidence that these pants are effective. Instead it seems likely that a man motivated to remove the underwear of a non-consenting woman would play out in other forms of sexual assault or violence if he was thwarted by her pants. They also add to victim blaming of anyone who doesn’t use the product; “but if you didn’t want to get raped why didn’t you wear safer pants?” Similarly, a rapist might threaten the woman to get her to remove the pants, and this might then be twisted by defence lawyers to imply consent. I think this product shows a profound mis-reading of the problem. Most rape is by someone known and trusted by victim, not the kind of opportunistic attack by a stranger that will be thwarted by her wearing lock up knickers. Some thought about who will buy them, and how they will change behaviour suggests problems too. It seems to me that their main customer base will be women who are anxious about being raped who probably won’t put themselves in a position where stranger rape is possible, whilst women who buy these pants to mitigate a risky lifestyle might have false faith in their ability to prevent negative outcomes (eg if they wear them so that they can drink to unconsciousness they probably aren’t addressing why they are making themselves so vulnerable, or the risk to physical, emotional and financial well-being that this might lead to). It made me wonder about when you would wear the pants? Every day to reinforce helplessness and anxiety or just when you feel likely to be raped? If the pants are a means to say no to a partner when sex is not wanted that says something very disturbing about relationships that needs to be addressed in more than just her choice of underwear. Finally, would another person such as a partner or controlling relative ever make the woman wear the pants like a chastity belt?

Spreading too thin

In general I’m a frugal person. I buy foods that are reduced because they have reached their best before date and most of my clothes and shoes in the sales. I collect coupons and shop around for good offers. I try to waste as little as possible, and to recycle as much as I can. So I can understand wanting to get good value for money.

On the other hand, I like doing things properly. For example, when it comes to a sandwich, I like a thick slice of granary bread, fresh from the oven, with generous amounts of toppings. As it happens I’m not a big fan of butter or margarine, perhaps a symptom of being overweight in the 1980s and 90s when fat was literally seen as a cause of fat, whilst the carbs underneath were seen as relatively healthy. But whether it is soft cheese and cucumber, avocado and salad, cheddar and chutney, hummus and roasted veg, or toasted cheese and banana, the topping needs to cover the bread, with sufficient depth to make the sandwich proportionate. If the cheese has nearly run out, I’ll have half a cheese sandwich that tastes good rather than a mean whole.

So when it comes to services, I can see the motivation to get value for money, and to ensure that resources are being used in the most cost-effective way. I’ve developed pathways, clinics and groups to meet needs more effectively, and I’m happy to delegate less complex work to less experienced or less qualified staff. I can’t see the justification for paying psychiatrist salaries to deliver therapy, when a member of staff with half the hourly rate can be an equally good (if not superior) therapist. I can see the importance of capping the cost of agency staff, so that this money can be invested in increasing the substantive workforce. And when it comes to staff who are not pulling their weight (my record being a member of staff who had spent a whole year with a caseload of four clients, whilst colleagues in the same job had five times that along with other responsibilities) I can see the need for performance management.

However, there comes a point that too much pressure for efficiency actually makes services less effective. I saw this happen gradually over the 16 years I worked in the NHS. If we cut out all the conversations between cases, all the informal supervision, all the CPD opportunities, the time to bond as a team and to reflect and process information between appointments, then clinicians are less able to be empathic and individualised with clients. If you also give people tougher and tougher cases to work on, expecting faster throughput than with the more mixed caseload that preceded it, and couple this with cuts in admin despite there being more and more paperwork to do, you increase burnout and time off sick. Add some pay freezes, lose a proportion of posts, put people in smaller premises and tell them to hot-desk or become mobile workers and they no longer feel valued. Make it a set of competing businesslike trusts rather than one amazing non-profit organisation, tender out services like cleaning and home visiting to allow them to be done on minimum wage without the terms and conditions of the NHS, allow private companies to win contracts, and keep people in a perpetual state of change, then morale falls. Nobody has any loyalty or job security and it no longer chimes with the ethics of the people who work there.

The sandwich has been eroded down to bread and butter, and then to crackers and margarine, and then to a value brand version of the same that is 30% smaller. It might look like costs have been driven down, but the price is a reduction in the quality of services, and in the wellbeing of staff. It reduces the willingness to go above and beyond that has been the backbone of the NHS, and increases presenteeism – the tendency to feel that you need to be at work longer, and look like you are working harder, without this making meaningful impact on the work you get done. The UK has lower productivity than most other developed nations, perhaps because we have longer working hours, and work expands to fit the time available.

All over the public sector at the moment I see services trying to spread their resources thinner and thinner, and I’m acutely aware that this means they can’t do the whole job. Social Services departments have barely the capacity to maintain their statutory role, so supporting families in need goes by the wayside. Some good staff find other jobs. A proportion of the remainder go off long-term sick, leaving an ever bigger burden on those that remain. Teachers are forced to teach to tests that assess primary school pupils on aspects of English grammar that graduates struggle with that have little relevance to daily life, and squash the rest of the curriculum into less time. Children’s centres, youth clubs and leisure facilities are disappearing at a time when it is clear that parenting support and exercise are critical in improving well-being and decreasing long-term health and social care costs. We’ve been feeling the cost of ideological austerity bite, even before the financial shock of the Brexit vote, so I am struggling to see how things can improve in the foreseeable future, let alone once any steps are made to implement the extraction of the UK from the EU.

It is hard in this climate not to feel overwhelmed by pessimism. Staff are not pieces of equipment that can be upgraded or replaced at the click of your fingers. I can make a plan for how to cover a remit that needs 12 staff with 7, but I can’t then tell you how to do it with 5. I can only tell you that if you want the job doing properly it needs 12, and if you go below 7 it won’t be fit for purpose. If I sticky plaster over the cracks, you can pretend that paying for 5 is enough, and that it is the clinicians who are failing, whilst we burn out trying to do twice the amount of work each. But no matter how hard I work, I can’t be in four parts of the country at once, or do recruitment, service development, supervision and provide a clinical service in a part-time job.

Maybe the problem is that I am stubborn. I won’t just toe the line whilst covering my eyes and ears and going lalalalalalala when it comes to everything that isn’t being done. Like my exit point from the NHS, there comes a time where I’d rather leave than do things badly. And where the only efficiency available for me to recommend that fits the prevailing rationale is to pay two cheaper staff instead of my time. I’m teetering on the edge of the plank they’ve made me walk, and I’m increasingly tempted to jump. Maybe in retrospect they’ll recognise how much was getting done with such limited resources.