Coping with Covid

I've just spent  another six days of my life in hospital; a gut infection causing sepsis which sucked down my blood pressure to dangerously low levels and sent my anti-bodies into such over-drive that they started to 'eat' my blood-clotting platelets and red blood cells. (I have Antiphospholipid Syndrome, similar to Lupus/SLE. )  When  I was thirty-one a similar process occurred, alongside having pneumonia, MRSA and mega clotting and bleeding issues; I was in hospital for seven months and given ten hours to live at one  point. I've been an in-patient many times since then, sometimes talking weeks to get out, so I can't tell you how relieved I am to have been able to leave  hospital so quickly and relatively unscathed.  

I wasn't feeling relieved on my way to hospital; as soon as I was lifted into the ambulance last week the familiar flashbacks began, along with the  terror. My life was now in the hands of a bunch of total strangers; I was powerless and helpless and that, let me tell you, is terrifying and the ultimate in    vulnerability.   

Is it any wonder that we patients make our doctors into gods and our nurses the perfect parents?  We have to believe they'll be our shield against death, that they're infallible, totally there for us and beyond mistakes.  Beyond Human. 

And how can the doctors and nurses not identify with these  projections? A doctor, chosen for her super-human qualifications,   must be perfect or face annihilating self-criticism, and a potentially  thwarted career,  litigation,  shameful investigation or even the devastation of  being  ousted from her 'tribe' after so many years of study, stress (which she's not allowed to acknowledge) and self-sacrifice.  Yet  of course it's impossible to be perfect and medicine isn't the exact, magical  science we all like to believe, as I  first learned with a shock at 31 when six doctors were huddled near my bed on the  High Dependency Unit,  unable to figure out  where my infection was coming from and why my blood was clotting up and my organs failing. 

A nurse must be the perfect compassionate parent; he  signed up to be kind; it's his identity (let's face it, he doesn't do it for the money) and he wants to be a font of kindness and reassurance but he also has a thousand  tasks to get through or his job will be on the line - and someone might die.  As a patient I want him to listen to my fears, to tuck me in when the lights go out and I feel the overwhelming isolation and terror of a five-year-old;  I want him to get to know me as an individual and care deeply about who I am. I want him to put his own problems, aches and emotional pains aside and focus on me!

I've spent thirty years observing GP's and hospital doctors and nurses - and physio's , radiographers, domiciliary staff, porters, and the rest of those amazing people  - as they've worked like Trojans to keep me alive.  And mostly my care's been incredible - but there have been mistakes such as the mis-diagnosis' of a DVT and internal bleeding, a 5kg drip box being knocked onto my head,  being given medication which made me ill (eg Heparin Induced Thrombocytopenia) and being almost given drugs which may've killed me  despite my telling the doctors I was allergic to them . It's a good job I'm on the ball, bringing what I know about my own body and medical history instead of just absolving myself of all responsibility for my own heath the minute I enter a hospital.  The good doctors have allowed me to come to the table. and heard me. The god-doctors who needed to maintain total control, in the face of their massive pressures, didn't. The good nurses heard me when I told them I was in pain or they were hurting me;  the 'parents' who wanted patients to be seen and not heard didn't .

So what to do about the power-crazed gods and the controlling parents?  I could've complained and sued them but that didn't seem like the right thing to do when I knew the mistakes weren't deliberate - and were made in the context of mostly excellent care and the millions of pounds being spent to keep me alive.  I guess I  was also too scared to complain; I might have been resented and given less enthusiastic care...   

Many mistakes made in my care were , I imagine,  a lot to do with stress, exhaustion  and having impossible demands due to too few staff and unreal expectations. When we're stressed out and in 'fight/flight/collapse mode we lose connection to our brain's front cortex - the grounded, compassionate, calm and rational part of our brain and become overtaken by our 'reptile' brain which is all about dealing with immediate danger; in this psychological state the  patient may become 'the enemy', the pain in the arse who's being 'non-compliant ' because she forgot to take her morning tablets; a  source of grief and stress.  You feel irritated with her... and as a patient I pick up on your vibes and feel  an idiot, a burden, afraid and shamed and  in my fight/flight mode I may become argumentative and critical or slightly hysterical because I can't flee...

So here we are, a stressed god-doctor/nurse/physio etc and a pain in the arse patient  and a scared patient and pain in the arse doctor, all stressed out and in direct opposition.  No way can we work collaboratively.

So again, what do we need? I can't do anything now to keep myself safe and I'm freaking out...or can I do something? Well I guess I can take some deep, breaths,  right down to my belly  which will help me re-connect to my front cortex and get back to a place of being able to ask questions, be more assertive and regain my compassion. Then I  can  reminding myself that this staff member is a human being too; they may have just lost a loved one, been ill themselves,  be worried about their child or elderly parent...I  can try to soften my heart and re-connect to the person behind the uniform.

As a staff member I might take a few breaths too, encouraging the soothing, parasympathetic part of my nervous system to pull me out of my  fight/flight mode,  calm me down and reconnect to my front cortex and my compassion.  I might also push for a different medical system where I'm not expected to be a perfect android who tries  to impossibly contain the massive amounts of stress and emotion I carry from working with the sick and dying month after month and year after year, being haunted by trauma and death every day.  I need structured, regular emotional support from my managers and my team; we need the space to talk, share, grieve and feel our terror and pain in order to work through and beyond it, in order to stay grounded and at our best.  In order to avoid depression, anxiety , misery and even death; we know doctors have a much higher than average  suicide rate.     

The  main thing we all need of course is our government  investing properly  in our amazing NHS rather than , it appears, running it down to justify privatizing it.  But while we're stuck with a system bursting at the seams our best bet is perhaps, as both staff members and patients,  to aim for reconnection when we've lost sight of one anothers' humanity; a mending of the ' interpersonal bridge ' of compassion so we can once again meet as two vulnerable humans who are trying to do our best in the face of stress and fear. We can notice our aggressive and judgemental thoughts, try to bring our stress level down with breathing and imagining our solid roots going deep into the ground and be strong enough to humbly apologise for any mistakes or harshness. We may even and share a bit about who we are to each other; meet as real - and equal - people who both just want to be safe, well and happy...

In my experience, when I feel seen and heard by my hospital carers I heal much quicker, physically and emotionally. Studies have suggested that the relationship between patient and doctor  is absolutely paramount to recovery, and it's not rocket science that a medic/nurse who feels seen and appreciated is  going to feel more energised and inclined to do their best for a patient.

So, here's to us seeing more than a pair of pyjamas or a uniform and connecting in our human-ness...   

( Please see my book 'Rocking with the Reaper' on my store page; my account of dancing with death for thirty years and a call for more human connection based on neuroscience's revelations that we are actually 'wired to connect' and be kind biologically - as exemplified in our amazing NHS. )

 
 


  




 
  
  
  

                                                                                                       Managing Devastation the Mindful Way

 

I became seriously ill in my early thirties and, after seven months in hospital, ended up pretty wrecked and unable to have children. I had a disastrous marriage in my late thirties and am pretty scarred from that. Needless to say, when I bought a beautiful sheep-dog puppy, Alfie, fourteen years ago, he became my world. He was from a farm in Yorkshire and could be aggressive but he was also very loving and helped me loads; he took weeds to the compost heap, shut the door, brought my remote control, shoes, bag etc and took me for lots of walks – which, as well as giving me great joy, probably literally saved my life. Alfie and I danced, he ‘gave me five’, hugged and 'kissed' (licked) me on request and when I asked him who the most beautiful dog in the world was he’d put his paw in the air. Sitting on the passenger seat of my campervan, if people looked over at traffic lights etc I’d ask him to wave, delighting strangers wherever we went.

Alfie was my best friend, protector and child and partner substitute. And then he reached about a hundred in human years, became arthritic, lost his hearing and developed tumours. A month ago, when he was struggling to breathe, I called in the vet to put him to sleep. He made a blood-curdling howl as he was dying.

Needless to say I was and am devastated. In the first week my brain tried ‘looking on the bright side’ - no more piles of dog-hair and muddy paws, sometimes getting up in a morning to pee and diarrhoea, fears of him biting people, dragging me out on cold rainy days and mega vet, insurance and medication bills. I tried distraction - sanding every bit of bare wood, painting my porch, obsessive gardening etc; I couldn’t save my dog but I could gain control in my home! I ate a ton of sugar  in an attempt to comfort myself.

None of these methods eased the pain and I began to feel depressed, anxious and grumpy. Then I finally did what I needed to do, just as I did when I came out of hospital - and as I do to deal with my ongoing health challenges. I put on some soulful music, faced the pain and cried and whimpered for three solid hours. I observed that my tears felt like a waterfall, that my belly and shoulders were ‘chugging’ and my heart  felt sore. Instead of thinking ‘Oh god my life’s over…I’ll never be happy again’ etc and making my pain even worse, I just allowed myself to be as I was and stayed with my bodily sensations, knowing that my tears were literally releasing sad and stress hormones and my ‘chugging’ massaging my organs, toning my stomach muscles and easing my shoulder tension. I slept that night for the first time in a week and felt calm, less despairing and open-hearted again.

In mindfulness there is no question that we hurt as human beings - that’s just life and the pain’s known as the ‘first arrow.’ The ‘second arrow’ we are seen to stick in ourselves – it’s the negative, catastrophic ’story’ we add onto the pain. The pain is sensations, the self-inflicted suffering is our thoughts about the pain.

Our culture encourages to avoid pain at all costs with medication, over-busyness and language (“Don’t cry now”). We seem to have equated sadness with some sort of failure.

I have a grin on my face. I know the secret of the ‘Second Arrow’. I don’t ask ‘Why Me?’ or ‘Why my dog?’ I try to just cry when I need to cry (and have confirmed through my own experience the research which has found that intense emotions generally only last a matter of seconds or  minutes) and I quietly observe. Alfie’s death ‘is as it is’ and I can’t change that; all I can do is kindly process and transform the pain by facing it and letting it go. I don’t need to stab myself with the dastardly second arrow; rather I need to be kind to myself

A month on I can smile when I picture Alfie beaming his wide grin at me. I’m also still crying. Either way, I’m so grateful for the fourteen years I had with my beautiful, amazing Alfie-dog and also for having learned about the mindful way and that it’s ok to just calmly feel what I feel and watch the pain transform and pass…      

We have two ‘parts’ to our autonomous nervous system, which controls all the stuff we don’t think about - our heart and breathing-rates, blood pressure, digestion etc. The first part, our ‘accelerator,’ is our ‘sympathetic’ nervous system (SNS). In this mode our cortisol and adrenaline hormones are on the go, we’re wired, alert and ready for action. Which is great unless we're feeling under threat  -  no longer from sabre-toothed tigers but  from the need to meet work-targets, suffer traffic jams, meet the non-stop demands of  technology or being a parent or ensuring we  look and behave 'like the pack'  (without wrinkles )on TV -  we go into ‘fight, flight or freeze' mode . In this mode  our ancient ‘reptile’ brain, the fast-action, danger-sensing part of our brain,  takes over and  our focus becomes our safety. Blood is diverted from our organs, digestive system, brain, skin and reproduction system into our muscles (so we can run or fight). Our pupils dilate so we can see better and our blood thickens up,  just in case we get injured in an attack.

When we sense that danger has passed, we start to relax and breathe again and in kicks the parasympathetic (PNS) part of our nervous system. This mops up all the cortisol, allows our blood to flow from our muscles and reptile brain back into our guts, organs and the ‘thinking’,  grounded, compassionate part of our brain (the front cortex). Our blood thins down and our inflammation markers reduce; we’re at peace…

When we’re in our SNS mode for too long, however, our PNS gets exhausted, leaving ‘killer cortisol’ on the rampage. Cortisol can shred our veins, weaken our hearts, cause inflammation (a big player in many illnesses) whack our immune systems (sometimes leading to auto-immune diseases like fibromyalgia, Lupus and arthritis or cancer) damage our guts and reproductive systems (due to the ongoing low blood flow) and make our brains turn to jelly and unable to remember, concentrate, focus and be emotionally responsive to others.       

This is possibly why most of we Westerners are often stressed, grumpy, exhausted and dying from cardiovascular disease and cancers.

But all is not lost!

Mindfulness has been shown to be a fabulous anti-dote to the potential damage of long-term  anxiety and stress. With practices designed to both calm and sharpen the mind and relax and strengthen the body, it works on boosting the PNS and decreasing cortisol. Mindfulness is thought to have an impact right down to the genetic level, strengthening the ends of telomeres which hold DNA together, thus reducing ageing and potentially extending the life-span!

Can you devote a few minutes every day to some focused breathing and body awareness…can you afford not to?...

Compassion is absolutely central to mindfulness.  As we sit in meditation and stillness we inevitably face painful feelings and become aware of the not so pleasant parts of our human selves - the jealousy, selfishness, arrogance, malice etc. It's imperative that we hold those hard feelings and uncomfortable realisations with compassion - they're just part of the human condition and common to ALL of us. 

As we develop self-compassion and accept our sometimes painful and imperfect humanness, it helps us to tolerate and accept the pain and imperfectness of others. We learn to accept the whole of ourselves and no longer blame others for 'making us' act in not so great ways, we no longer see in others what we want to disown in ourselves (like seeing inhumanity in the Germans during the World Wars but failing to own our own).  We see that we're all just frightened, vulnerable human beings who attempt to cover our feelings of smallness, shame and insecurity with rage, blame, arrogance, greed,  the accumulation of material goods, botox etc. 

This was the first poem I wrote. I'd just bought a new 'doodle' book and just wrote 'The Wide-mouthed frog' for some whacky reason.  Then the next day this emerged...

  The Pond

The wide-mouthed frog

Sat on a log

And began some contemplations;

‘What it is it with these humans,  

Separating into nations?

We have a pond,

We share the pond –

That’s just the way it is

And yet these crazy humans

Get into such a tiz!

Bombs flying here,

Soldiers killing there

Everyone scared to death,

Half the world bloated

Half just bones

What a blooming mess!

 

And yet they show such promise!

They build us ponds

They feed the birds

And have smiles like supernovas!

They care for their kids

For twenty years

And then look after their oldies!

They can seem so kind,

So full of fun

- So what the blooming heck is it

That makes them act like a load of sheep

Having a mass communal hissy fit?

Maybe one day they’ll evolve enough

To see the great connection

And know that every other person

Is just their own reflection'.

        

A poem about us each taking responsibility for our environment and global warming instead of leaving it to an unspecified 'them.'

Reflections on the 'unique' US President and how his outrageousness could help to change things

A reflection and poom about awareness, socialisation and reclaiming our power as older women.

A foundation of mindfulness; we have a good heart at our core...