Don’t Mention the NHS

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Northampton General Hospital

“To be a good doctor, one needs to be involved with patients (capable of empathy and humanity); yet to remain objective and survive emotionally, one needs to be detached from their pain and suffering.” Support 4 doctors 2016

Don’t Mention Her follows the story of Connie, a woman doctor. The idea for the novel started with her husband, Liam, walking through a gate, in 1963, into a convent garden in the middle of England. I knew the mood of that scene – he was grief-stricken, was in mourning and couldn’t express it. I wanted to know why, and what happened to that family over the next 50 years. The novel was inevitably going to describe quite drastic changes, not only for Connie and Liam, and for their Catholic family, but more crucially in the practice of medicine.

None of it is actually true, no five-year-old died, no characters are based on people I knew. I had no family history to call on, apart from parents who were doctors in Northampton. But I did have a sense as a child of a deadening, of loss and of secrets. Looking at Don’t Mention Her with its fictional characters I realise that despite all the invention it is full of something that is very familiar, something that was around the house in my childhood and un-named.

It might have been a fear of failure, of blame, or anxiety about either. It might have been the much more present threat then of death. My parents both started in practice before regular use of penicillin, when TB was a constant threat, before vaccination for polio.

In the fifties the ‘family doctor’, or GP, worked alone or with only a few others; there was no practice nurse, there were no hospices, more mothers delivered their babies at home. I would hear the phrase when I temped for the receptionist: ‘I’m under Dr X, we all are.’ Dr X had looked after that family from birth to death, day and night, with the occasional trip by the patient to the General Hospital for surgery.

In The Guardian recently the report of a GP’s suicide mentioned not just that she was being treated for bi-polar disorder but her ‘work-related stress’: she was dealing with the ‘death of a patient’. And, interestingly, she’d had to retire because a patient complained about her blog mentioning her disorder.

As children, there were no conversations at meals about patients. And it wasn’t just silence about work, both my parents’ lives had been marked by siblings dying and had said nothing. My father rarely spoke. My mother had switched to working full-time in public health and was more communicative but she was always rushing. Occasionally she’d talk about polio, pleased that the sugar lump removed the need for an injection, of her experience when pregnant of taking chest xrays for TB; of the prevalence of rickets before the government started handing out Vitamin D in orange juice.

District hospital, Swinford, Mayo; formerly the Fever Hospital, formerly the front of the workhouse.
District Hospital Swinford, Mayo, formerly the Fever Hospital, formely the front of the Workhouse.

But on some things she was less forthcoming: she came from a part of Ireland that within her great-grandparent’s memory, within their stories, was fatally damaged by years of famine. She was angry, and at the same time had no desire to go back to Mayo. There had been too much death, mostly from TB, even within her memory.

But probably it was my father’s silence that marked us most profoundly. His first wife died in childbirth as did the baby. It was their second child; he was left with a toddler aged two. And none of this was ever mentioned. We didn’t know that our oldest sister had a different mother, and neither did she until she was twelve. Years after he died, and shortly before her own death, my mother talked about it briefly. She believed that my father had felt responsible. But he’d refused to say a word.

Various relatives lived with us while they were assistants in the practice. I remember eavesdropping on a cousin taking a phone call about some tests; he reported the results to my mother – the patient was a girl I’d been friendly with since we were four. I could tell it was serious from their muted voices and expressions. Kathleen was an only child, adored by her Catholic parents; soon after her funeral, her parents split up.

Medicine has changed, Clare Gerada in the BMJ describes the new stresses on medical staff: ‘The NHS is exposed daily to negative stories in the media. Its staff are accused of being lazy, cruel, and uncaring, and the service is blamed for failing to meet necessary standards. Doctors, nurses, and managers are seen as villains and are berated by journalists….. who overlook the fact that the NHS still tops the list of what makes the public feel proud about being British.’

Well, the NHS, as we knew it, is disappearing into Virgin Care etc; they allegedly don’t even pay taxes on their profits. Soon the health service might no longer be part of our heritage. And no one mentions it.

Jane Kirwan

 

 

 

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Inventing Art For Taking In Water

 Olafur Eliasson

Weather makes a potent subject for artists, from Turner’s watercolours to the work of conceptual artists. The Weather Project, Olafur Eliasson’s installation in Tate Modern’s turbine hall, attracted a record two million visitors in 2003/4.

Given the starting point for Taking In Water I knew weather had to feature in the artwork that my characters, Luc and Layla, would make together. In imagining their work, I wanted to avoid anything over-Romantic. Since the post-war break from traditional painting and sculpture is something I’ve explored in non-fiction writing and in curating, I decided to go back to the moment when new ways of working as an artist were beginning to emerge.

For many artists in the Sixties mass-media became their subject matter. With the Luc character I wanted someone who was paying attention to both directions – the natural world and the manufactured.

It was around then that Yuri Gagarin’s first manned space flight changed our view of the world; Earth was seen for the first time as a planet orbiting in space, mainly composed of water. Gagarin’s mission contains both senses of the sublime – to be in awe of nature and the awesomeness of space technology. Luc, I figured, would want to explore the conflicted relationships between the natural world, technology and the human body at a conceptual level. Lydia, on the other hand, would live out the effects of a personal encounter with natural forces that had overwhelmed her. Her understanding would be much deeper. Lydia, as Layla, provided the emotional context for the work.

Finding a form for the book that linked the 1960s with 2002, when the novel is set, came from work I have done interviewing artists for the Artists’ Lives project in the British Library’s National Sound Archive.

Going back to the Sixties made sense for other reasons. Given Lydia’s tragedy – having lost her family in the flood of 1953 – it was very likely that her teenage years in the 1960s would be turbulent. And, the Sixties was a decade in which visual artists became celebrities. I also wanted to look at fame as a kind of deluge that swamped Lydia for a second time. What had it been like for the two artists to suddenly find they were a media spectacle?

And finally, the exciting thing about inventing a work of art for fiction is that, though you need to enable the reader to envisage the artwork you don’t have to make the piece.

Don’t Mention Her – how it began …

 

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Several years ago, thinking up the plot of a novel, I wrote a paragraph about a man walking through a gate into a convent garden. All I knew was his name was Liam, it was 1963. I had a sense of his wife, Connie, a doctor; she was somehow dark and dangerous and would be the focus of the story. That was it for a while. I wrote other things but Liam’s character kept popping up, standing inside that gate. I knew that the convent garden was under threat and he would try to restore it, but not why.

Liam’s gate, and the garden he was walking into, were both links to my life from 4 to 17. I went to a convent school, was taught by nuns. My convent and its garden were demolished a few years after I’d left. I was terrified of the building, dreamt about it regularly. The original garden has never cropped up in any nightmare; I’ve invented it instead into an overgrown sanctuary.

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Today, from my window, I can see the cupola on the local church in a village in Central Bohemia where I spend half of the year. The church is rarely used, stucco is peeling off. Visitors to it are few. That view brings memories of a Catholic world I once knew and wanted to write about. I wanted to meet Connie, to see how she dealt with issues that had fascinated me all my early life but now felt far away: the whole business of believing in something so illogical, and why at fourteen I was anti-abortion, yet a couple of years later fiercely pro-choice, joining protests heckled by terrifying people from SPUC.  But, above all, I wanted to see how both Liam and Connie dealt with grief. Throughout my childhood nothing had ever been mentioned about close family members who had died.

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Characters from previous fiction projects that I’d finished – especially two women from a second novel – kept visiting. I liked them, they had lives, were getting on with their own stories. Liam had been a niggle at the back of my head for ages; he was left walking through a gate all those years ago and I had to find out what happened to him and Connie.

Having finished writing the book, at the very least, Liam has closed the gate behind him, started the rest of his life.

Taking In Water – how it began …

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Taking in Water began with weather. I’ve always been fascinated by ‘big nature,’ for years I’ve clipped articles on extreme weather events. Three times I’ve been lucky to escape the wind and the waves.

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Aged ten, I came within seconds of being swept over a waterfall. We were picnicking by a Pennine stream. The waterfall seemed innocent. It wasn’t a long drop, about five feet, the stream was inches shallow and sluggish. The stepping-stones across to the other bank were tempting. I was mid-way when my father ordered me to turn back.

‘NOW!’ There was urgency in his voice. For once, I did as I was told.

He’d heard the roar of water and knew what it meant. If I’d ignored him I’d have been swept away by a powerful river in spate. Seconds after I reached his side, a torrent of white water swept past. We all stared in silence as it tumbled over the waterfall at great speed, churning and swirling below.

I couldn’t swim.

In my twenties a hurricane-force wind felled the tree opposite my flat missing my window by a whisker, falling instead into the flat below and crushing the car of a friend who was visiting.

Then there was that time when my children were small and we were caught in a flash flood, trapped on a train, with a tunnel just ahead filling up with water. You couldn’t see out of the windows for the curtain of rain that kept on falling. We were stuck for ten hours through the night. This was in the days before trains had sockets where you could charge your mobile. Most people’s phones were soon dead. The only information we had came from a passenger with an FM radio who told us that the police were appealing for anyone with boats to come forward.

That day on the waterfall I understood for the first time that the awful disasters you read about in the newspapers could happen to anyone, anytime, without warning. In Taking In Water I wanted to explore what it would have been like if things had been different.

Among my collection of ‘weather’ cuttings was one about the Holbrook Hall Hotel, Scarborough, that fell into the sea as the cliff beneath it collapsed due to unprecedented rain. Researching the Scarborough landslide I came across information about the 1953 storm that devastated the east coast. Why wasn’t this part of the national story like the Blitz or the Battle of Britain? It was the worst peacetime disaster in Britain in the Twentieth Century. One explanation might be that we are too afraid to acknowledge our powerlessness when faced with the force of nature. But there was a practical element: there weren’t any photographs of the event as it happened. The images and newsreels that do exist are of its aftermath.

I soon had the character of Lydia. All I knew was that, as a child, she would have survived the 1953 storm but lost her family. I wanted to explore what happens to someone after such an extreme event and so the story is set in March 2002 as Lydia faces the up coming fiftieth anniversary of the storm. How had that storm shaped her life?