Tag Archives: control

Don’t Sweat the Small Things

Sometimes in life, we allow small things which on their own are not significant to add up and turn into a massive problem. I speak from experience.  I am a creature of habit so I like things to be a certain way. To a degree, I do have obsessive compulsive traits. That is not unusual in a doctor. It takes a certain type of personality to go through medical school and then to work in hospitals and face all the horrors that can come with the territory. When I was living on my own, it was easy to use those OC traits for the good. Everything had its place in the little space I had. No mess was left where it was. Everything was clean and orderly. My personal life was organised to a T. In direct contrast, my professional life despite all my best intentions often felt out of control and at best, it was an organised chaos. Dealing with humans and ill-health is by its nature very unpredictable. You do all you can do and things get worse in some patients. In some patients, you barely have to do anything and everything gets better anyway. Which sometimes makes me question exactly how much we as doctors are able to influence and if it has more to do with patients than us.

Anyway…my lovely ordered life was turned on its head when I met and moved in with my husband. He is the spontaneous type who makes ad-hoc plans and also changes them (or should I say ‘forgets’) without warning. He is so full of energy that he cannot be neat. When he makes a mess, he would rather clean it up later. Later being in a few hours, days, weeks or even months in some extreme cases. I used to get really worked up about these things and ended up cleaning up after him because it was too much of a hassle to nag him into doing it. Then I started to resent having to come home after a long day’s work to organise everything again or use up my precious days off sorting. Now I have swung the other way. I have become an expert at turning a blind eye. I refuse to see the mess and I will generally not tidy up if it is not my mess. So whilst I complain less and I try to let him get to it in his own sweet time, it hasn’t lessened the stress it causes in my mind. I will literally obsess about the mess not being there.

Whilst I generally get on with my fellow doctors and nurses at work, there is inevitably one who is like a thorn in my side. In my most recent rotation, there was one such nurse. I will call her Nadine. She is a senior nurse with a lot of experience – this is usually an asset but in her case, she thought she could tell me how to do my job. I am usually quite laid back and approachable at work but I am certainly no pushover. I can’t be because as a registrar I have to take overall responsibility for patients out of hours. Well, Nadine decided because I was a new registrar that she had to question all my decisions, mostly indirectly. This really riled me because the decisions that I made were either straight forward or those which were more complicated were discussed with the consultant as per usual practice. I found that lack of respect very irritating and at the start of the job, I had to avoid any contact with Nadine until I could detach myself enough not to care. Once I realised by talking to the other nurses that it was not unusual for Nadine to give rotating doctors a hard time, I was able to maintain professionalism by communicating what was essential and just tuning out the negativity. What Nadine (and I) felt in the grand scheme of things was insignificant as long as I did the job I was there to do and I did it well. By the time I left, I think she had gained a grudging working respect for me.

I guess what I am saying is that I have come to realise some facts of life. Main fact being that most of life is not within my control. Fact is that there are many small imperfections and it is not always possible (or maybe even desirable) to make them perfect. I don’t always find it easy to let those little things go but when I do, it is less stressful. As long as I control those things I can control and make life as good as I can within my little bubble, I can live with the little things. Life is hard enough without sweating the small stuff.

Advertisements

The Taboo of Domestic Violence

One of the great privileges of being a paediatric doctor is the frontline seat we have on humanity. Of course we only see this great variety of human life and get to share in their stories because the NHS is still at the point of need free. We get to see how the very poor live their lives and also how the more affluent live theirs. Stereotypes abound within medicine and on the whole they ring true but we doctors and other frontline staff are constantly amazed and shocked by the unexpected. Life is certainly unpredictable as a doctor in the NHS. This is one of the reasons why I love the NHS so.

One of the greatest sorrows I have faced is when I come across a mother and or child who is being abused by the man who is supposed to love her and protect her from the rest of the world. One of our babies has been taken into foster care recently because the mother is being abused and has chosen that option for herself and her baby. I wanted to weep (still do) because I cannot imagine the horror that the mother has gone through and must be going through to carry a baby to term, labour to deliver her beautiful baby and then feel she must give that baby up. Heart breaking! In this case, the abuse is on-going and the father of the child not only threatened the mother with further abuse, he has threatened to kill the baby if she takes it home. Isn’t there something we can do for her I hear you ask? Of course there are ways in which we can help her. We have offered her every viable option including the one she has taken: giving up her child for fostering or adoption. She weighed up her options and came to a decision to give up the baby. Some of us are worried this is not a rational decision but unfortunately, within the law as she is an adult without any mental illness to cloud her judgement, we have to accept her decision whether it appears rational or wise or not.

Unfortunately, this case is not unique. In my 4 years of paediatrics, I have seen far too many cases of domestic violence and its many victims. 1 is too many but there have been dozens in my short time in the NHS. Bearing in mind that I have only worked in 7 NHS Hospitals and have seen but a tiny snippet of what is going on out there, this is a massive problem that is rarely talked about. Even within paediatrics and obstetrics where this is a major concern, we only talk about it when we get a case. Then it gets filed in the back of our minds until the next unfortunate case. Today I want to highlight the evil that is domestic violence and in my little way encourage anyone directly or indirectly affected to do something about it. What we need is more awareness and everyone who can do something to do a little bit so we can get some change happening.

As you may know, my mother is a feminist so I have always been aware of domestic violence in its many guises and how ugly it can get. As a young feminist, it was always one of those issues I was passionate about and I even wrote a radio drama aged 14 on the topic which got aired in Lagos in 2000. From a very early age, my mother taught me to have zero tolerance to domestic violence. I have always said that the minute a man raises his hand to hit me, unless it is in retaliation after I hit him first, that relationship is done and dusted. Some of you may think this is extreme but if you knew what I know, you would understand that zero tolerance is the best way to go about snuffing out domestic violence.

In medical school (here in Birmingham), I opted to do a module on Domestic Violence in my 4th year of study. It was a short module but the quality of teaching delivered voluntarily by the staff from the local Women’s Aid was fantastic. It was sobering to realise that the knowledge I had from what was happening in my hometown in Yola was mirrored in Britain. Britain may proclaim how forward thinking it is but just the same with Yola in Nigeria, their response to domestic violence is still inadequate and there is very little actual protection for the victims. Majority of the work is done by the voluntary sector trying to safeguard those who seek for help. By the very nature of this service provision, victims do not have access to help and unfortunately, many will continue to be victims until they end up in intensive care or even worse in early graves.

Here are some facts and statistics from Women’s Aid (http://www.womensaid.org.uk/domestic_violence_topic.asp?section=0001000100220041&sectionTitle=Domestic+violence+%28general%29) by way of introduction:

  • Domestic violence is any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality. It is not just physical violence. It can be verbal, sexual or neglect. It can be against a partner, a child or an older relative.
  • The vast majority of the victims of domestic violence are women and children, and women are also considerably more likely to experience repeated and severe forms of violence, and sexual abuse.
  • Women may experience domestic violence regardless of ethnicity, religion, class, age, sexuality, disability or lifestyle.  Domestic violence can also occur in a range of relationships including heterosexual, gay, lesbian, bisexual and transgender relationships, and also within extended families.
  • The majority of abusers are men, but in other respects, they vary: abusers come from all walks of life, from any ethnic group, religion, class or neighbourhood, and of any age.
  • Abusers choose to behave violently to get what they want and gain control. Their behaviour may originate from a sense of entitlement which is often supported by sexist, racist, homophobic and other discriminatory attitudes.
  • The estimated total cost of domestic violence to society in monetary terms is £23 billion per annum. This figure includes an estimated £3.1 billion as the cost to the state and £1.3 billion as the cost to employers and human suffering cost of £17 billion.
  • The first incident of domestic violence occurred after one year or more for 51% of the women surveyed and between three months and one year for 30%.
  • Amongst a group of pregnant women attending primary care in East London, 15% reported violence during their pregnancy. Nearly 40% reported that violence started whilst they were pregnant, whilst 30% who reported violence during pregnancy also reported they had at some time suffered a miscarriage as a result (Coid, 2000).

The commonest question people who have not been victims ask is ‘why doesn’t she leave?’ To understand the answer, you have to try to understand how they become victims in the first place. The typical victim starts out as a happy vivacious young woman, often pretty with very social personalities. They meet and fall in love with a man who at first glance is perfect. Often these men are older, more experienced who charm the girl with their confidence and assertiveness. Once the young woman/girl is ‘in love’ and moves in with the abuser, he (often he but not always) will begin to isolate the girl from her friends and family. It often starts innocently but becomes more pervasive. Often the man will complain about some character flaw in one friend and systematically will find a way of making her cut ties with majority if not all of her social support network. He will often start with small acts of violence like physical restraint if she wants to go out and he doesn’t approve, seizing her shoes so cannot leave the house or calling her ugly when she dresses in a way that she would normally and in the way he would have previously approved. Then once he starts to isolate her, he will chip away at her confidence and withhold praise so that she begins to modify her behaviour to please him and to get approval. To please him, she often has to isolate herself from her friends and family and cater to his every whim. Despite that, he will find fault with all she does and he will start by criticising her. Eventually, he will physically punish her for not doing what she should. Mentally, because of the slow insidious way of grooming her into becoming a victim, she starts to believe that whenever he abuses her verbally or physically it is because she has failed to do something.

Eventually, she is truly a victim and she stops to see herself as a victim and him as an abuser. She begins to blame herself for everything that befalls her and see him as her saviour. Most will come to believe their abuse is an act of love. What it often takes for her to begin to see her thinking is faulty is either when she ends up in hospital because he has lost control and beaten her so badly that he ‘allows’ her to seek medical help or she has children or other family members she feels responsible for and they get harmed. Even then, these victims will often go back time and time again. Sadly, some will go back one too many time and end up dead. Or their child will end up dead or permanently damaged. Here are some statistics to back that fact:

  • Women are at greatest risk of homicide at the point of separation or after leaving a violent partner. (Lees, 2000)
  • 60% of the women in one study left the abuser because they feared that they would be killed if they stayed. A further 54% of women left the abuser because they said that they could see that the abuse was affecting their children and 25% of the women said that they feared for their children’s lives. (Humphreys & Thiara, 2002).
  • The British Crime Survey found that, while for the majority of women leaving the violent partner stopped the violence, 37% said it did not. 18% of those that had left their partner were further victimised by stalkingand other forms of harassment. 7% who left said that the worst incident of domestic violence took place after they had stopped living with their partner. (Walby & Allen, 2004).
  • 76% of separated women reported suffering post-separation violence (Humphreys & Thiara, 2002). Of these women:

– 76% were subjected to continued verbal and emotional abuse.

– 41% were subjected to serious threats towards themselves or their children.

– 23% were subjected to physical violence.

– 6% were subjected to sexual violence.

– 36% stated that this violence was ongoing.

Lest I forget, I will mention the even more invisible group: male victims of domestic violence. I was heartened to see a poster the other day in a public toilet (female) offering male victims some help. This is just as important because we know that many perpetrators of (domestic) violence were once victims their selves. The man might be the victim in some cases. Learn to expect the unexpected.

So what do I suggest? For anyone who reads this, please share so that we can raise some awareness. If you suspect anyone you know might be a victim, please talk to them and point them towards the Women’s Aid website for help. Do not allow your friend or sister or mother to isolate herself. If you feel you are being pushed away and this is out of character for your friend, please persevere and remain friends with them even if it is only from a distance. Do not cut all ties as you may be tempted to do. Lastly, be watchful. Personally and for everyone you love. If you suspect something is amiss, draw them closer and be there so that if they need help, you might be that link that keeps them real and potentially saves their lives. If you are with a partner who is exhibiting some of the behaviours above, talk to someone you trust about it and ask for help. This help could come from Women’s Aid or even a trusted friend. If you are in a place where Women’s Aid or similar do not exist, turn to friends and family and seek for help early. No man is worth losing your dignity, sanity, health or life for.

Be Your Own Yardstick

I will start by admitting that I, like most other people, did not like the way I looked for a long time. More accurately, I had insecurities about some parts of my body, some of which remain to date albeit in a very passive way. So I understand that as humans, we always want what we don’t or can’t have. I have worked very hard not to measure myself against people who bear no resemblance to me. I realised very early on that my genetics are out of my control so wanting to be someone completely different was a futile aspiration.

I have always been skinny or more politically correctly slim. I used to hate the word skinny when I was a teenager because to me, it represented a person who was gawky, awkward, boy-like and unattractive as a young woman. I realise that most girls put on weight around puberty and looking at the stick-thin waifs gracing runways, magazines and Hollywood movies, it is easy to see why they would aspire to be skinny like I was. I was completely oblivious to this as I was quite the tomboy and did not have any time for magazines when I was around puberty. The movies I loved were mostly animation and even if the girls/women portrayed in most Disney movies were on the smaller side, they all had the beautiful curves I adored. My mother has lovely feminine curves and so does my glamorous older sister. Perhaps being African where the culture predominantly celebrates curvaceous women had a bigger influence than I was conscious of too. My celebrity role models were Halle Berry, Julia Roberts, Jennifer Lopez and later Beyoncé and Alicia Keys all of whom have (and celebrate their) curves. All of those things meant that instead of the usual Western ideals of being a size 6, I was self-conscious. I wanted to be bootylicious and packaged in a short petite perfectly proportion frame.

The worse part for me was having to go shopping. Again, another aspect where I differ from the norm. It probably started out because I used to accompany my grandmother to the market in Lagos and she used to take her time visiting stall after stall finding the best quality food for the best price. I would follow impatiently, wishing she would speed up and within an hour, I would develop a painful ‘stitch’ in my side, making me want to sit on the ground (a massive no-no as it was rather murky in Lagos markets).

As I grew older and had to start participating in shopping for my own clothes, it was okay because my mama like me is impatient with shopping and she used to be quite military with it. When I became an adolescent, my mama decided to give me money for clothes shopping and it became my responsibility. The shoes, underwear and bags were easy enough because it was just a matter of looking to see what caught my eye. Clothes on the other hand was a nightmare! I vividly remember days coming back dejectedly after 6 hours on Oxford Street in London and trying on top after top and jeans after jeans and none of them fitting well. I would look in the mirror and see this anorexic figure staring back at me. Some of those days, I would be so demoralised that I would cry. Thankfully, although I haven’t put on much weight over the years, I have acquired some (slight) curves which means that I am now a proud standard size 6 or 8 depending on the shop. I can confidently go out to buy new clothes knowing now I will find things that fit. It is just a matter of finding the style I want for the price I am willing to pay for it.

The lesson I taught myself early on was that there is no use aspiring to become curvaceous like J-Lo overnight. Rationally I knew I was going through puberty and it would take time before I developed curves. Also I had seen pictures of my mama in her 20s (pre-children) and she didn’t have much in the way of curves back then. I also looked around my family and realised that most of the young girls were rather skinny. Fulanis in general are skinny folk anyway (think Masai-like physique, same ancestry). I would tell myself that just because Britain was predominantly British and it catered to the genetic makeup of that population did not make me unattractive. Many of my friends and family told me countless times that they would rather have my body than theirs but I thought they were lying to boost my confidence. I only started to believe them once I grew my curves and became more body-confident and got strangers complimenting the way I looked.

I am still not a massive fan of the mirror and often forget to look at myself in it. I still find some of my features surprising and often when someone mentions something about my facial features, I have to go and look in the mirror to work out what they are talking about. I’ll give you a classic example of my lack of self-awareness. I was 14 years old when my sister and I went into a shop I had never been too. I turned a corner and caught sight of a girl who I thought looked vaguely familiar and I mentioned that to my sister casually. It probably didn’t help that at that age, I was still in denial about my short-sightedness so did not have perfect vision. My sister looked at with a smile like I had made one of my endless jests. I was confused. It dawned on her in seconds that I genuinely had seen myself and did not realise it was me staring back from the mirror. Oh well!

In general, I guess it is a good thing that I am not self-conscious about what others see when they look at me. I care more about presenting a professional look when I am at work and a ‘nice’ look outside of that. All my adult life, I have chosen an extra 5 minutes in bed over putting on makeup in the morning. Thankfully, being sexy or desirable are not issues I care about. My dear husband assures me that I have those characteristics in abundance anyway and it is only in his eyes that it is important I am those. To anyone else, it really doesn’t matter to me what they think of how I look as long as they see that I am a decent and caring girl inside.

My message is simple – I value what sort of a person I am inside more than out and because of that I do not compare my ‘beauty’ to others. I have simply learnt to embrace and even love the body I was blessed with. I see beauty in all body sizes and shapes, colour, height etcetera. As Christina Aguilera says in her song Beautiful and I paraphrase – ‘I am beautiful, no matter what they say. Yes, words can’t bring me down. I am beautiful in every single way. Yes, words can’t bring me down…Oh no! So don’t you bring me down today…And everywhere I go, the sun will always shine.’ Preach! Belief in your beauty, regardless of what people say because there will always be critics but that is their problem, not yours my friend.

The Expiry Date

This morning I read drkategranger’s blog regarding her expiry date (she is a doctor with terminal cancer who talks about death so candidly, it inspires. I would absolutely recommend!!!). The blog and some of the responses to it got me to thinking about death. I have already written about dying and the fact that I fear it not so much. As a Muslim, I tend to see death as just one of those certainties of life so I treat it quite matter-of-factly. This blog is will be further musings about my experiences of death. I will start with a quote from Hadith (Islamic teachings) which summarises how I generally see life and death:

Al-Hasan Al-Basrî said:
‘The life of this world is made up of three days: yesterday has gone with all that was done; tomorrow, you may never reach; but today is for you so do what you should do today.’ Al-Bayhaqî, Al-Zuhd Al-Kabîr p197

I am generally an optimist or more accurately an optimistic realist so I try not to be morbid and I am generally not one to dwell on death. However, I have had times in my life where the thought of dying has crossed my mind. Last winter was a pretty bad time for me. I was working in the hospital that inspired me to become a paediatrician (which still inspires me) but I was in a job with a particularly toxic individual who succeeded in poisoning the atmosphere. I became depressed after 6 weeks of this. So much so that I hated waking up every morning I was scheduled to work. It got to a point that I would lie in bed, sleepless and think ‘would it be that bad if I didn’t wake up in the morning?’ As soon as the thought came to my mind, I would feel guilty and terrible. Guilty because I knew that my life really wasn’t that bad and that there was so much for me to be grateful for. Terrible because I knew my death, although insignificant in the grand scheme of things, would be horrible for my nearest and dearest. My mama especially. I got through those 4 months because my husband was there and would not let me sink into the depths of depression that kept pulling at me. Thank you George!

I am now back to my normal sunny self despite some current work horrors. As a newly-qualified doctor back in 2009, I dealt with death day in, day out especially on my first job on gastroenterology at a busy inner-city hospital. After the initial shock, I got used to it. Not that I didn’t care or it didn’t bother me but I dealt ok with it. There are 2 patient deaths from those days that have stayed with me. Both died of alcoholic liver disease. Both men in their 40s.

The first patient died slowly from hepatorenal syndrome (HRS). Basically with chronic liver failure, if your kidneys too fail, you will die soon because that means 2 of your 4 vital organs are dead or dying, unless you get brand new organs (i.e. transplants). As things currently stand, you cannot be put on the transplant list for a new liver if you are still abusing alcohol because the new liver will get damaged just the same and it is considered a waste of an organ that is in high demand but short in supply. So with my first patient, who I will call Patient A, when his kidney function tests declined rapidly and nothing we could do medically fixed it, we diagnosed HRS and my registrars and consultants had a meeting with his wife to inform her of the diagnosis and what that meant for the patient. He too was told in due time but because of his liver failure, he was confused and did not fully grasp the fact that his condition was terminal.

He deteriorated slowly over a few weeks but in the meantime, he would ask me daily when he could go home and travel to India to be blessed in the Ganges River. I would mutter something non-committal and beat a hasty retreat out of his side room. Initially, it was clear that his wife knew his death was near. But even she began to belief he would miraculously recover from his liver and kidney failure. Every week, she would say something that made us worry we hadn’t prepared her for the inevitable. Every week we would remind her gently that although she couldn’t see it, he was in actual fact deteriorating judging from his biochemistry lab results and worsening oliguria (he was weeing less and less).

In the week of his death, he suddenly looked well again. If I wasn’t the doctor patiently doing bloods on alternate days and chasing those results and noting the relentless rise in his urea and creatinine, I too would have started to believe in miracles. His wife upon seeing the light return to his eyes and his demeanour brighten plunged headlong into denial and joined him in planning their trip to India to the Holy Ganges River. Less than 24 hours before his eventual expiry date, it was devastating for me to watch her grief as the light in his eyes faded rapidly and he shrunk back into himself. Within 12 hours of his final illness beginning, his strength was gone and his mind with it. His utterings became incomprehensible and he became completely disorientated. The look on her face said it all when we came in to see him on our ward round that morning. We returned the look and she ran out of the room to sob in the corner. He was anuric by then (had stopped weeing completely) with a creatinine of over 400 (in other words, his kidneys had packed up). His liver function tests painted an equally damning picture. We completed his end of life paperwork that morning and when we left work that evening, he was hanging on by the tips of his fingers. We came in the next morning to the news that he had died before the end of the day before. The side room he had occupied for many weeks stood empty, awaiting its deep clean before the next customer.

Patient B was a young alcoholic who had developed liver cirrhosis in the months before I started the job. He had just turned 40 and I don’t think had any idea how serious the consequences of regular alcohol binges could be. Reality hit when another patient who was his ‘neighbour’ on our ward developed HRS and died rather quickly. All of our words of warning had somehow not sunk but with this other patient’s death, his mortality was clear to him. He called me over urgently that afternoon and said ‘Doc, I am ready to change’. I was pleased and felt a sense of accomplishment when I referred him to the rehabilitation programme. His wife found me the next day before they were discharged home to thank me for getting through to him. I was honest to say it wasn’t anything I did.

Unfortunately, he came in a few weeks later unwell with an infection which caused his liver function to deteriorate badly. I was encouraged to hear that he had no touched a drop of alcohol since his last admission. He developed litres of fluid in his tummy and I had to put in a tube into the side of his tummy to drain out all that fluid. He was in a lot of discomfort and fearful for his life and he asked me ‘Doc, am I going to die?’ I hesitated over the words I used but in the end I made no promises. Just that I would do everything I could to help him get through this. At first, it looked like the drain and intravenous antibiotics were effectively doing the job and the next day, the fear was gone from his eyes. I was encouraged by his blood results and left having ordered some more routine bloods for the next morning. Coincidentally, at I was securing his abdominal drain, I carelessly dropped the needle I was using to suture and when I went to retrieve it, gave myself a needle-stick injury. I had to get a co-doctor to inform him and take blood samples off him to check that he didn’t have any blood borne infections I could catch. He apologised every day after the event like it was his fault I had stuck myself with a contaminated needle. He asked me about those results daily – he seemed genuinely to care for my welfare. This went on for over 2 weeks as he slowly improved.

I was doing the ward round alone one morning when I was called urgently to his side. He was in a great deal of pain and was writhing in his bed with his abdomen larger than before we drained him. He was pale and clammy and his eyes looked like a man staring down the barrel of a gun. I could barely make sense of his words and as I changed his prescriptions, called the blood bank for blood products and prepared to get a new drain inserted. I could see the life begin to ebb out of his eyes. In a panic, I called my registrars and told them I needed them on the ward ASAP because patient B had taken a turn for worse and nothing I was doing was making a difference. The registrar told me to leave the drain for the meantime and focus on reassuring the patient. After I asked the nurses to call his wife in, I went to him and I held his cold hand. I looked into those eyes and I knew in that instant that he was not long for this world. I remember saying a mental prayer that he could hang on for his wife to be by his side.

‘Doc!’ he cried. I squeezed his hand and responded ‘Yes B?’

‘I am dying aren’t I?’ he asked. I looked down and swallowed the lump in my throat. ‘I am here for you B and I will do everything I can to help you. Your Mrs is on her way in.’

‘Stay with me,’ he entreated fearfully. I nodded and again I had to look away because the fear in his eyes was too powerful for me to take in. The rest of it was a blur. His wife made it in before he died but not in time for him to know she was there. He was delirious by the time she got to the ward and as he was slipping away before our very eyes, there was little time to have ‘that conversation’ with his wife. The consultant whisked her away and broke the news to her. She could see that treatment was futile by then and knew that he was on maximal available medical treatment. We had no more to offer. She signed the DNAR (do not attempt resuscitation) forms and we set about making him less agitated. When we finally called it a day, he was less distressed, still mumbling incoherently and his eyes had started to take on that distant look I now associate with death. I came in the next morning to a request to come to the morgue to complete his death certificate and Crem forms so that his wife could lay him to rest. I got a call 3 days after his death to say his blood tests for blood borne infections had come back negative so I was in the clear. I cried in the staff toilets. He would have been relieved not to have put me at risk I think.

What did patients A and B teach me about death and dying? Firstly that when it is your time to go, it is your time to go. Life unfortunately doesn’t usually give you a clearly labelled package with an expiry date on it. Secondly, although death is scary for the person dying, it is actually worse for the person who loves them who has to watch them lose their battle to live and battle their fear of the unknown. Who has to go home and face life without them and rebuild their lives around the hole left by the dead loved one. Who for a very long time will think about their dear departed every morning when they wake up and every night before they fall asleep. Lastly, every human is unique. Despite having the same disease and modifying your risk factors, your body will do its own thing. We doctors can try to influence outcome but whether we succeed or not is not within our power to control. That is beyond science and medicine. That is life. That is God. That is reality. May we all depart this world in the easiest swiftest way possible. Amen

WoMD – Not in My Name Please!

I will start with a small apology for anyone who is reading this to get away from all the doom and gloom in the media these days. This story is about now. About Boko Haram and the Nigerian Government’s failings that have led to an unstable Northern Nigeria which threatens to destabilise not only the whole of Nigeria but all of West Africa. About poor Malaysia being caught up in Putin’s plot to regain USSR glory days. About the Israeli who are fighting darts with spears. About the US blindly refusing to do what is right in favour of protecting their own skin and financial interests. About the UK which though slow in its condemnation of  some of the atrocities on our (British) doorstep, has finally started to show some balls but are dragging their heels anyway so that by the time they respond, it will be too little too late.

I have signed several petitions to force the UK Government to discuss a response to Israel and Russia. I have added Tesco and Sainsbury’s to the list of boycotted companies/institutions which fuel much of the instability with the profits from my shopping. And fortunately, my husband (from a Christian Zimbabwean background) is supporting me to stand by my principle. My principle is simple. I do not sanction murder. In any shape or form. I hate weapons of mass destruction (WoMD): guns, mines and bombs (atomic or nuclear) and I really wish oil was not so intrinsically linked to murder. I always say if I were to be made King of All, my first task would be to gather all of those weapons created specifically with the intent to kill and burn them all.

Despite my efforts not to get too politically involved and give myself a coronary, I have had this debate several times. First of all, it tends to be traditional men with a misguided sense of masculinity who think weapons of mass destruction are good. Because they can be used in self-defence. Right. My take on that is: if I was angry with my neighbour and in a moment of blind fury rushed over and slapped her, the likely response is for her to slap me too. Maybe harder, maybe multiple times but I am likely to be alive at the end of it all. So she might be high on narcotics and shove me hard, causing me to fall, crack my head open and die instantly. Chances of that are slim though because majority of neighbours are not on narcotics. Now lets imagine I have a gun for self-defense and she does too because we all want to protect ourselves. I might in that moment of blind fury grab my gun and because I am blinded, shoot randomly and get her in the leg. She goes to hospital and when she comes back, she is out for revenge. More importantly, she wants to teach me and other neighbours the lesson that I cant shoot her and get away with it, so she plots and comes over when she knows I will be defenceless and shoots me straight in the heart and I die instantly. Then all my neighbours freak out and rush out to buy guns. The vicious cycle has started with no end in sight except ever-spiralling obsession with protecting oneself.

The argument then turns to ‘but the Armed Forces have to have guns so that the law can be enforced’. I agree. Why not use weapons of control instead of murder? Why not give them all tasers instead to incapacitate criminals and lock them up until they undergo trial for their crimes? Why not resort to using pepper spray and tear gas? If we are so intent on killing everyone we perceive to be criminal, what was the point of the fight to ban death by guillotine/hanging/firing squads/lethal injection etc? Because lets face it, who really thinks a mass murderer, serial killer/torturer or serial rapist is going to be rehabilitated by a stint in jail? Rehabilitated enough that you would be happy to live next to them and allow your children to play out of your sight. I confess I don’t believe people who premeditate murder, torture or rape will ever get to the point where if they had the chance, they wouldn’t murder, torture or rape again. I would never knowingly/willingly live in the same street or even same neighbourhood as an ex-con like the Suffolk Strangler Steve Wright or more recently Ian Huntley who could be up for parole in about 15 years.

To those farmers/land owners who want to protect their animals/land and so have to own a gun, it is the same argument for me. Why not use a tranquiliser gun that is used on Safari to guard against wild animals turning, well, wild? And come to think of it, use the same tranquilisers on those who try to rustle your cows. My point is if nobody had guns, then nobody would need a gun to defend their person or property. I know this is a pipe dream though because lets face it, who is going to make me king? I am a girl. I have no royal lineage (well nothing that would make me big enough to ban WoMD) and I am anti-establishment most of the time. Better not!

I could write a whole book on why WoMD are evil but I think you get the gist. I hate them. And most normal people would agree. So why are we all so quiet in the face of irresponsible gun-loving idiots we have allowed to govern us leading us into war? I mean, the UK for the first time saw through the faked dossiers on WoMD in Iraq/Tony Blair/Bush conspiracy to invade the Middle East and get at the oil. The numbers at the anti-war demonstration were unprecedented and this was before the war began. I marched in London with my mom. I was 17 at the time and I could foresee the carnage we see today in the Middle east and the instability throughout the West as a result of their involvement. How could Tony Blair and Bush  with all their ‘intel’ not foresee it? How was it legal for the UK to go to war despite the fact that more people demonstrated against it than voted for the government. And what makes me laugh (because if I don’t laugh, I will cry for the shame of being British) is that Tony Blair now has the audacity to pose as the UN Peace Envoy for the Middle East. No wonder the ceasefire farce fell through! What a hypocrite!

These politicians, they all are hypocrites. They are not there to serve the people or improve what is already there. They are all blinded by their power and the need to serve their gigantic egos and leave a legacy in the world. And we sanction it by our inaction. By buying good from companies we know are sending a proportion of all their profits to places like Russia, Ukraine, Palestine, Nigeria, Israel etc. Those places that are already unstable and whose downfall might  benefit some rich or powerful little man in the West (and increasingly in the East). We sanction them by voting for them (I know we have no real choice anyway in the UK). We sanction them by paying our taxes and then silently watching our money being spent on murder of helpless civilians whilst our needs (NHS, utilities, education) are being neglected. What a farce! May we all wake up to the harsh realities and wield the enormous power we have. What we have is the power in numbers. A weapon of taking back control (WoTBC)*. I know which I prefer between WoMD and WoTBC!

 

*This is not a real phrase. It is my creation and no government has sanctioned its use. It in no way represents the views of the UK or Nigerian leadership.