Tag Archives: angry

Happily Ever After: a Disney concept or reality?

I am a huge Disney fan. My late grandmother Mamie introduced Disney to both my sister and I early. Every time she travelled abroad, she would return to Yola bearing delicious large variety boxes of chocolate and Disney Videos. She would watch the animation movies with us and being an adult, she got some of the more subtle humour and would chuckle away to herself. For us, it was about the songs and the princesses, about the girl finding her prince against all odds and getting that happily ever after. My sister and I knew all the songs and when we drew pictures, it was always of the beautiful Disney princesses with their tiny waists, long hair and dainty feet. It is not hard to see why I wholly believed then that every little girl would grow into a beauty, find her soul mate, fall in love and live happily ever after with lots of happy children. To make it worse, I was also an avid reader and there was nothing I loved more than fairy tales, all with their happily-ever-afters and when I became a teenager, I read numerous paperback romances.

Unfortunately for me, reality intruded at some point during adolescence. I was witness to women who had been beaten by their husbands, those who were practically enslaved and could not leave their homes on their husband’s say so and those who were in forced marriages, mostly young girls like me. I went from thinking that every little girl was destined to be happy to believing it was all a fairy tale and that there was no such thing as a happy relationship between a man and a woman. I still believed in romance but I believed that romance didn’t tend to last beyond the ‘honeymoon’ period of a relationship. I also learnt about the widespread deceit being enacted by adults who seemed blissfully happy in their marriages.

I could not find any aunties who could say to me that their marriages were truly happy. Even those who at face-value were living a fairy tale. I found out that many came to be content with their lot having gone through a lot of heartache and choosing to put up with the husband they got as opposed to looking for Mr Right. Most had considered leaving their marriages but on balance thought the security of a marriage outweighed their hurt and betrayal. Many had been cheated on, more than once. A good proportion were the main breadwinners in their household yet were still treated as secondary to their husband. They took the lion share of responsibility, financially and socially. They fed and clothed their children, they made sure the children attended school and did their homework. They sent the children to Quranic School and made sure they learnt to say their prayers and how to fast when the time came. They were the nurturers and disciplinarians. They did it all for little appreciation in many cases.

Unsurprising, I was quite cynical when it came to love. I had very few relationships that lasted longer than a flirtation over a week or maybe one date. Before I met my husband, I had two ‘significant’ boyfriends. I think it is pretty telling that both of those are guys I met on holiday and only gave them a chance because I was on holiday and in the mood to have some fun. The first one lasted about 7 months but the last 2 months wasn’t really a relationship. The second lasted about a year and I really did consider a real relationship with him but I had my rational hat on throughout and I could see how bad he would be as a potential life mate. It was clear to me that we were not in the same place in our lives so I broke it off, difficult though it was.

I was single for 4 years before I met George. By the time I met him, I was happy being single. Loving my space and the freedom to do what I wanted when I wanted, unlike many of my friends. I was happily alone and not at all lonely. The only thing missing in my life was children – I had always been sure that I would one day be a mother. I even had a plan for that. I wanted to take a year out to see the world then come home and work on my career for a few years. Then when I was comfortable, I would find myself a gay bestie who wanted children without the ties of a relationship and we would have a couple of children raised in harmony. Plan B was to go to a sperm bank and find myself some quality swimmers. The only concern I had was explaining to my extended family back in Nigeria who the father of my children was.

Of course, best laid plans and all. I was making plans and God had plans for me. Just before my year of travel, I met George and I was suddenly in a real relationship. George says he knew within a few days he wanted to marry me. It took me a little longer to be sure but I was pretty sure within 3 months that this was the man I would risk getting my heart broken for. We have been together for over 4 years now. We have, like everyone else, had some ups and downs. Some of the best times in my life have been in the past 4 years. Some of my worst too. Some of them because of the relationship, a good proportion nothing to do with personal life but for which I was glad I had George to lean on. I have grown up and learnt a lot about myself. I have found that I have infinite patience I could have sworn I didn’t possess. I am capable of much love despite hardship. I am capable of trusting a man. I still can get really angry but yet my capacity for forgiveness has grown immensely.

Question is: does happily ever after exist? I don’t have an answer. I wish I did. I know there are couples out there who give me hope. My grandmother and grandfather were not a perfect couple. I know Mamie (my grandmother) had to put up with a lot through the years and her patience had to have been great but I also know that Baba (my grandad) loved her and that she knew he did. He never forgot her birthday or their anniversary. He never passed on a chance to show her off. He loves all of his grandchildren lots but he has a special spot for the 3 of us named Aisha, after my grandmother. When she died, it was clear he was lost without her. She died just before their 50th wedding anniversary. He went into deep mourning and we were all worried for the first year after that he would self-destruct. He couldn’t bring himself to mention her name or talk about her for many months. When the raw wound finally began to heal, he would mention her with reverence and such love that it made me well up. Theirs was definitely a till death do us part affair. I cannot attest to how happy they were but I like to think it was happily ever after, at least for Mamie who died secure in her husband’s love.

As a relative newly-wed, of course I want to believe it will be a happily ever after affair. I only agreed to say I do because I had hope that it would be forever. No one goes into a marriage wanting it to fail. However, the facts speak for themselves a bit here. These are from the Marriage Foundation and the Office of National Statistics:

‘The Social Justice Outcomes Framework reports that 45% of children already see their parents separate. Unless trends change dramatically, nearly half of all children born today will not still be living with both natural parents on their sixteenth birthday.’

‘34% of marriages are expected to end in divorce by the 20th wedding anniversary.’

‘There were 241,000 marriages in 2010, near a 100 year low. Cohabitation rose from 2.1 million couples in 2001 to 2.9 million in 2010.’ Maybe because divorce rates are so high, people are opting more and more not to say I do?

There is a lot of good news though:

‘Those who marry have a far greater chance of survival as a couple than those who cohabit. 93% of parents who are still together when their children complete their GCSEs are married.’ In other words, couples that choose to marry as opposed to just living together are much more likely to stay together, have children and watch them grow to the age of 16 or older.

60% of marriages are expected to survive to the 20th anniversary.’ Isn’t that an amazing statistic?

‘16% of marriages reach the 60th wedding anniversary’ and ‘the average marriage is expected to last for 32 years.’ I think those are awesome stats, don’t you?

‘Among natural parents, 31% of those couples who were cohabiting at nine months had separated when the children were seven compared to only 12% of married parents.’ Meaning that married parents are nearly 3 times as likely to stay together for 7 years or more compared to those just living together.

‘Cohabiting couples make up only 19% of parents but account for half of all family breakdown.’ In other words, married couples tend to stay together more than couples who have chosen just to live together.

I will end with this quote:

‘Quite clearly getting married does make a difference to your life chances and your children’s outcomes.’ It has been shown to be socially advantageous. Married people are more likely to be happy than their co-habiting or single or divorced counterparts, despite the shocking divorce statistics. So let us look beyond those stats and go into marriage putting our best foot forward. Sure it is hard work but we all know that anything worth doing is worth doing well. So I remain a realistic optimist. I will work hard at my marriage and I will pray for my happily ever after. I think I deserve it.

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What does a Junior Doctor Do Exactly?

A letter written to Jeremy Hunt by a consultant currently working in England.
An excellent illustration of how indispensible ‘junior’ doctors are to the NHS and the public as a whole. I couldn’t have put it better myself so I haven’t tried to 😀

…………………………..

Dear Mr Hunt,

My name is Philip, and I am a consultant physician. Not so long ago, I was a junior doctor and like many others I am outraged and angry about what you propose to do with ‪#‎juniordoctors‬ and their ‪#‎juniorcontracts‬.

I thought that maybe, given you have not worked in healthcare, you might not understand what it is that doctors do (much like if I was made, say, head of Network Rail) so I thought maybe I can help you by shining a light on what I used to a few years ago as a medical registrar.

The medical registrar is the most senior medical doctor in the hospital out of hours. In explaining to my friends what we do, I tell them everyone who doesn’t need an operation right away, or doesn’t have a baby falling out of them, above the age of 16, is our business (and often we have to look after those too). We were the ubiquitous shirehorses that carried the hospitals medical workload day and night. And here’s a typical night shift I did at a general hospital. (all details changed and adapted from real cases to protect patient confidentiality).

I arrive at 8:50 PM for a 9:00 PM handover. It’s been a busy day and the emergency department is full. The outgoing medical registrar tells me there are no beds in the hospital. There are 10 patients waiting in A&E for the medical team, and a lot of patients need reviewing on the wards. He’s already admitted 36 patients during the day, and the consultant is still there seeing some of them with the daytime doctors. I wave hello at her as I head into the fray. I know the consultant and she’s not seen her kids since her on call week started. She waves back wearily.

My first patient for review was a young man with abdominal pain. My first thought as I walked into his cubicle, he looks sick. This is a skill you develop after years of training, when you look at someone and know that they are minutes from death. He’s grey, clammy and shocked. I immediately set about treating his shock and assessing why this has happened. Does he have a bad infection? Is he bleeding? Does he have a blood clot on his lungs? A quick bedside test confirms he’s bleeding badly, likely internally, and my surgical colleague (another junior doctor) and I urgently arrange for an operation. He hurriedly talks to his parents and completes a inacapacitated patient consent form as his condition deteriorates. I leave him in theatres with the anesthetists and surgeons as I have other patients to see.

The next patient was an elderly woman who has fallen. Although she has no hip fracture, she’s unable to walk and needs admission for painkillers and rehabilitation. I reassure her as best I can and stop many of her medicines potentially making her fall. There are no beds for her on the assessment unit or the elderly care ward, so the A&E sister arranges for a pressure support mattress and bed for her in the department overnight. She was lonely and depressed, and I spend some time talking to her about her worries and fears but after a while I needed to move on. She squeezes my hand and smiles, thanks me and settles for the night.

Next is a resus patient with an asthma attack. He is drunk and abusive verbally, though he’s too breathless to be too abusive. A blood test show his attack is life threatening and he he fights off attempts to treat him by myself and the A&E team, pulling off his nebuliser mask and oxygen. As I read out the blood test result to the intensive care registrar (another junior doctor) the man goes blue in the face, gasps and stops breathing. I drop the phone, run over and take over his breathing with a manual ventilator. He has had a respiratory arrest. Alarms blare, help comes running, we inject him with various medicines to help relax his airways and the intensive care doctor slips a tube into his windpipe to help him breathe. The consultant physician, still there, helps with what she could, running blood tests and helping to scribe in the notes. After a nervous period, he stabilises and we take him to intensive care.

It’s now midnight.

In the meantime I have reviewed five more patients, seen by the twilight team, and also my night SHO has discussed some patients with me. The consultant finally got home around 11PM. I’m now on the wards, a liver patient with severe cirrhosis is unrousable. I read through the notes. He has cirrhosis and is not suitable for a transplant. The team has tried everything. I sit and talk with his family, telling them I’m very sorry but there’s nothing more to be done. They cry, one of them screams at me that I’ve killed him, but I accept this as part of my job. With more assurance they’re calmer and I reassure them he’ll be kept comfortable.

My bleep goes off as I write in the notes. Is that the medical reg? The hospital is now totally full, can you please choose some patients to send to our sister hospital down the road? I groan, although I understand the necessity patients understandably hate it. I pick four stable patients and liaise with the registrar down the road.

2AM. I send my SHO off for a quick break as I review some more patients. A confused elderly man who might have a urine infection, a young man with severe headache, a diabetic patient with a very high blood sugar, a lady withdrawing from alcohol and hallucinating. The A&E sister makes me a coffee, lots of milk, lots of sugar.

3AM. I’m with a man in resus again, he is vomiting bright red blood in large volumes. He is jaundiced and looks unwell, very unwell. As the A&E team arranges for a massive transfusion to be set up, I ring the intensive care doctors and the gastroenterology consultant. He listens and says “I’ll be coming in”. I then slip a line into his neck under local anaesthetic, a practiced skill that’s hard at 3AM when you’re tired, but fortunately successful. We pour blood, clotting products, medications and antibiotics into him to halt the bleeding. The gastro consultant arrives at 3:40 and he’s taken to theatres where he performs a life saving procedure. The patient goes to ITU.

4AM. A brief moment to sit down for a quick break. I have reviewed three more of the SHO’s patients. This is the first time we’ve had a chance to sit down together, a quick chat and a cup of tea was interrupted by a cardiac arrest bleep. We run to the cardiac ward. A 54 year old gentleman admitted with chest pain by the day team has had a sudden cardiac arrest. The excellent CCU nurses are doing CPR and attaching a monitor. I ask them to stop as it’s attached, the rhythm is ventricular fibrillation.

“Back on the chest please, charge defib to 150, charging. OK, off the chest, stand clear, top middle bottom myself, oxygen away, SHOCKING.” The patient jolts. “Back on the chest please.” I heard myself say.

Two minutes later he has a pulse. We repeat an ECG, he’s had a full heart attack. I call the cardiologist at the heart attack centre 10 miles away. He’s accepted and an ambulance crew transfers him for an emergency angioplasty. I send my SHO back to A&E as I write a transfer note.

5AM. The resus doors burst open. Another patient, an elderly woman with breathlessness. The A&E F2 listens to the chest, pulmonary oedema. She’s given the emergency treatment but it’s not working. I decide to start her on positive pressure oxygen. Strapped to her face was a tight mask blowing oxygen to inflate her lungs, buying time for the medicines to work. The plan works and pints of dilute urine fills her catheter bag, her breathing improves and she says thank you through the mask. Despite the fatigue I smile and give the F2 a fist bump for a job well done.

7AM. Four more reviews. a patient with kidney failure due to medications, a depressed young man who took an overdose, an elderly nursing home resident with pneumonia, and an elderly man with a broken hip whom I assess with the orthopaedic surgeon. I start to round up the patients for the ward round. 18 patients overnight, five transfers out, one death. A relatively quiet night. I check with the clinical site manager and SHO that we’ve not missed anyone and click save on the list. No one is waiting to be seen, a good feeling.

8AM. The consultant from last night arrives, she looks tired but asks us how we’re doing. OK we said. We start in A&E as most of our patients are still there, the site manager is worried as some of the patients from last night are coming up to 12 hours in A&E. We review each patient’s story and tests, and talk to them about their condition. We visit ITU for the two new transfers there.

11AM. The ward round of the night patients are done, and I have completed a death certificate for a patient overnight. I climb into my car and listen to the breakfast show as I drive home, an hour away. I’ll be in bed by 1PM , and back for the night shift after 6 hours sleep. A relative luxury from a relatively quiet night.

This would be a relatively quiet night for a junior doctor and I am sure many registrars would laugh at how easy I’ve had it! But the people doing this work are junior doctors, who show dedication, commitment and goodwill beyond belief. They do lifesaving work up and down the country, working hard without complaining and sacrificing time with their families.

Please, I beseech you, treat them fairly and with the compassion they treat others daily. The new contract is not fair, and the extended hours it’ll cause is not safe. ‪#‎notfairnotsafe‬

I hope this little story will give you some insight into the vital work junior doctors and the NHS do. If you like, please come and spend a night at our hospital, I’ll come in with you and show you around. Please talk to my junior colleagues and listen to them, you may be surprised what you’ll learn.

Best wishes,

Dr Philip Lee

When You Argue with a Fool

Have you ever had an argument that goes round and round in circles, never-ending with no point to be made? Where the person you are arguing with seems to be in a monologue? Where their comebacks are so off the mark that it feels like you are in a different time-zone? Where hitting your head hard against a concrete wall might be more productive?

I have and it used to annoy me so much that I’d get really upset and want to stamp my feet. And I used to try and reason with them and try to get them to see that the argument was entirely useless and was going nowhere. Now that I am older and wiser and my fuse less short, I deal with it in one of 2 ways. Either I say ‘look this argument is going nowhere and I don’t have the time for this’ or I just say ‘we will have to agree to disagree’.

I will confess something. I copied that 2nd response off somebody older who I admired when I was teenager. I remember the first time someone used it on me and back then, I couldn’t handle the maturity of it. Back then I thought everything was black or white. I thought every argument had to end with a winner and a loser. Now I know that there are many shades of grey in between (no, not 50 shades child!). Knowing that the world isn’t so binary makes arguments less upsetting for me.

I can now acknowledge what is fact for me is not necessarily fact for another because we are all shaped by different factors. We are shaped by our genes, our environment, our family, our friends, the media, our education, our beliefs, our religion, our culture and much more. Most important of the factors that shape how we view the world is our experiences. Hence, some of the things I would have argued successfully so passionately for 10 years ago, I am not so sure now are as I argued. Yes I enjoy a good debate but I am the sort that will not be dragged into an argument unless I have strong views on the subject and I have very solid reasons to back up my views. Fact is, I do not back away from an argument and I am often successful in getting my point accepted or at the very least acknowledged by my debating partner. But I choose what I will be sucked in by. And more importantly by who.

Which brings me neatly to the quote I have used as inspiration for this blog…‘don’t argue with fools, people passing by won’t be able to tell who is who’. It is my belief that arguing with someone who you know is arguing for all the wrong reasons is a complete waste of your life. This wrong reason might be that the arguer loves the sound of their voice and they are using you as a sounding board. Or they want to impose their beliefs on you because they do not think yours are important enough. Or they say things they don’t believe in order to shock or upset or entertain the passers-by. Or they want to score points. Or they are angry or upset or stressed about something or over someone and they want to take it out on a scapegoat. Or they are arguing for the sake of it, not because they believe in what they are trying to convince you is true.

These days, with my adult hat on if I spot the arguer with these wrong reasons and they ask an opinion so they can start a diatribe, I simply say: ‘oh good question but I am afraid I don’t know much about that. I’ll pass.’ Or ‘how about you tell me what you think’ or ‘I would be lying if I said I care about that matter’. Then I listen until my patience runs out and I find an excuse to not be in the same space anymore.

If it is a proper friend and they pick an argument over the littlest thing, I will usually get worried and ask if they are okay…really ok or if there is something they need to get off their chest? You know the saying ‘when you ask a woman what’s wrong and she says it’s nothing…’ Well fact is, when your sister/mother/husband/friend who you usually get on with great starts to conjure up arguments from the most innocuous conversation, then they are asking for help. Something is up and they want permission to spill. They want you to listen. So please, instead of entering into a slanging match, give them a hug and invite them to tell you what’s really bothering them. Chances are that they do not really think George Bush was a good president or Apartheid wasn’t all that bad.