A Most Curious Detour

ES pictureThe Stroke Association is sponsoring production of a play by stroke survivor Stuart Hepburn. It’s called A Most Curious Detour, and is based on his book of the same name, which recounts the experience of suffering a major brain-stem stroke eight years ago and his subsequent life lived with locked-in syndrome. There is  an article in The Daily Record  of 15 February which summarises the background to all of this.

Stuart and I crossed paths in the Mitchell Library in Glasgow a few years ago and, meeting him in the flesh, it is difficult to fully comprehend the problems he has to overcome everyday – he is an articulate, intelligent and impressive human being. There are several things that resonate with me from his experience as a stroke survivor receiving treatment from the NHS.

First, there is the difference between the medical professionals who treat you as a job to be done and those who make a genuine connection with the individual to be treated. The latter are the “gold nuggets” I refer to in my own book. Another is the suddenness with which “treatment” comes to an end and “living with the condition” begins. For most stroke survivors, this transition takes some getting used to. Many medical professionals do not seem to be trained to take time to help stroke survivors with that transition – though the best provide help instinctively.  Often it is other family members who are forced into this role – sometimes putting an intolerable strain on relationships.

Perhaps most telling of all is Stuart’s comment that if we provided a more accepting, understanding world for people with his condition, then fewer would wish to beg for assisted suicide – as in the case of Tony Nicklinson, the stroke survivor from Wiltshire who took his own  case through the courts, before his untimely death some months ago.

Stuart has re-learned the habit of meditation as a key part of his ability to live with the restrictions of his condition. Thanks to his own perseverance and strength of character, and the legacy of this play, I hope that more people may learn understanding and acceptance of the long-term implications of living with stroke.

Stuart’s play is being staged on Saturday 2 March by the Scottish Youth Theatre in the Tron Theatre, Glasgow.

Posted in Uncategorized | Tagged , , , | 1 Comment

Horse and King displaced by Pontiff

ES pictureHeard on BBC Radio Scotland this week:

“A horse walks into a pub.

‘Sorry. You’re too late,’ says the barman, ‘We’re making jokes about the Pope now.’

‘He’s quite right,’ says Richard 111.”

Headlines are well named as such because they are often “lines that remain in the head” and not just because of their role as the header for a newspaper or website. It is a comment on the speed with which headlines change that six months from now we may have forgotten three things that seem significant today:

1. why we might do well to pause before biting into that burger

2. why the Roman Catholic church made history one cold, rainy February day

3. why the large, white “P” on a blue background in the car park might actually stand for “Plantagenet” rather than “Parking”.

Some headlines may be destined to remain with us for a long time this year, however – the economy, Syria, Africa and compassion (or lack of it) in the NHS, perhaps.

Friends of mine – retired medical professionals – have recently returned from a visit to Nepal where, apart from trekking, they spent some time at a leprosy hospital. Before they departed from the UK, they had raised several thousand pounds from our generous local community here on Deeside. These funds would apparently be enough to enable that hospital to function effectively for six months.

Amongst the photos they brought back home was one of a hand-written notice, a kind of “mission statement”, I suppose, from the hospital, which said something like this (I paraphrase and summarise) “The patient is the most important person in this building. It is the patient who provides us with the opportunity to serve”.  A doctor or nurse here in the UK  in the middle of a long hard shift on a rainy February afternoon might understandably want to scream at such sentiments; but it is almost certainly these beliefs that brought them into their profession in the first place.

In the light of recent events such thoughts might not be so bad as “lines that remain in the head” for our NHS as a whole.

Posted in Uncategorized | Tagged , , , | Leave a comment

Nigeria by Train

ES pictureYesterday was almost spring-like. We walked along the Deeside Way in Slewdrum Forest. This forest is managed by the Birse Community Trust, a local charity, and is situated on the south side of the River Dee. There are some beautiful open views of thickly forested hills and the river.

On the way home, by way of contrast, I listened to an item on Kate Adie’s radio programme, From Our Own Correspondent. This described a journey the narrator had made on the railway line that runs across Nigeria from Lagos on the coast to Kano in the north.  The line was built by the British over a hundred years ago and has recently been upgraded by the Chinese, who nowadays seem to be everywhere in Africa.  He said that he had taken the sleeper train from Lagos, which involved a journey of some thirty hours. Apparently many people now use the train because it is much safer than travelling by road, where there is a constant risk from armed bandits as well as groups of Islamist militants who have committed a number of atrocities in Nigeria in recent years. Even the train carries armed guards.

Forty years ago I undertook exactly the same journey, myself.

At the time, I was working as a volunteer teacher in a small Catholic teacher training college in the south of Cameroon. During the long rainy season holiday in July and August, together with a fellow volunteer teacher, I travelled across Cameroon and Nigeria by public transport. In West Africa, and in Nigeria in particular, public transport in those days meant either a cramped, uncomfortable taxi shared with nine or ten others or a “mammy lorry” – a Mercedes lorry with a rickety wooden superstructure on the rear capable of carrying several dozen passengers and animals in close sweaty confines and often an optimistic slogan above the driver’s windscreen – “Man No Worry”, “God is Love”, “Redemption” or the like.

By the time we had reached Ibadan in western Nigeria, the thought of exchanging hours of bumping along muddy roads for some 30 hours in a train seemed quite appealing. Doubtless there were bandits in those days too, but, being young, we never thought of them, though we did always give our taxis a cursory inspection before agreeing to be transported in them to the next destination on our trip. Uppermost in our minds, in our relatively poverty-stricken state, was how much the driver was going to agree to charge us for the privilege of travelling with him and our other companions. I say “relatively poverty-stricken” because compared to most of our fellow travellers we were financially and materially well off.

But, to Ibadan railway station. Our long, clattering train pulled in about an hour late, having left from Lagos earlier that day.  There may well have been a sleeper carriage, but we did not even consider that, knowing that we had to keep our costs to a minimum. In the early afternoon, we fought our way on to seats in any available carriage along with dozens of other travellers. Do not imagine the deep self-contained, polite silence that is typical of crowds travelling on long-distance trains in Britain. Our fellow travellers were a noisy, colourful crew – big mammies with small children, business men with cases, people on family visits, soldiers returning home or travelling to a new posting. The Biafran war had only been over for a few years so Nigeria was big on soldiers and policemen at the time. All of life was there in that hot, sweaty carriage.

As our train trundled north and west we gradually left the crowded, humid towns and cities of southern Nigeria, first for forest and then for more open, arid country, regularly crossing rivers in high, rushing torrent. Nigeria is a vast country with a host of different cultures and traditions within it.  As we dozed uncomfortably in our seats we crossed over one of the biggest cultural and religious divides in the country – that is the divide between the largely Christian south and the predominantly Moslem north.

This difference was brought most noticeably to our attention the next morning when we ground to a halt in apparently dry, empty countryside. From all along the length of the train, men emerged with prayer mats and water to kneel and pray beside the track. Some minutes later, as if from nowhere, dozens of women and children appeared from what had seemed to be empty bush, bringing with them pans and dishes of food and bottles of water and other drinks. For fifteen or twenty minutes this colourful, noisy human host traded with and served the culinary needs of the hundreds of passengers on the train. This short stop in the vast plains of northern Nigeria felt like a brief spiritual pause for all of us. The pause for reflection and sustenance was more important to all these people than any adherence to an officially designated timetable.  A blast on the train’s horn  brought proceedings to a close and we were on our way again, but this procedure was repeated several times as we snaked our way north to Kano and the dry edge of the desert.

Forty years have intervened, but the reporter’s account of his trip in the twenty-first century suggested to me that, Chinese upgrade apart, little has changed along this line.

Posted in Uncategorized | Tagged , , , , , | Leave a comment

The Miserable

HamishThis winter is interminable.

This morning, as ever, I was dragged out into a freezing gale, clad in the usual ridiculous outfit of blue coat and garish yellow neckerchief. I am now fourteen in human years – that’s ninety-eight in dog years. I would like some deeply thought out views to appear on this blog about the merits or otherwise of ninety-eight year old whippets being made to

a) go out at all in winter

b) being made to wear ludicrous clothing by their human overlords

I overheard Master talking about going to see a film called “The Miserables”, this morning. He seems to forget the fact that there is a “miserable” right in front of him – me!

And, there is a distinct shortage of my favourite bones in this house.

Posted in Uncategorized | 1 Comment

Inverness

ES pictureTo Inverness, to run two days of workshops on secondary school timetabling for Highland schools.

Many years ago a friend of mine told me that Inverness was an acronym: I.N.V.E.R.N.E.S.S. meaning It’s Not Very Exciting Right Now Especially Saturdays and Sundays. To emphasise his wit, he would utter the words in a strong Inverness accent.

The sentiments behind this acronym may have been true of the town at one time. I grew up as a child in Inverness, and his words always made me think of my parents reverentially laying out encyclopaedias to be read by us kids on quiet, rainy Sunday afternoons (after church). For years, I visualised Sunday afternoons, encyclopaedias and rain on the windows as a rather dreich collage of childhood weekends. There were happy, brighter memories, too, of course and, as an adult, I’ve always found Inverness quite a pleasant and friendly place to visit. I can still remember the attractive sandstone suspension bridge that spanned the River Ness in the centre of town when I was a child. This was replaced many years ago by a featureless concrete structure designed to handle the increasing levels of traffic. With its wide fast flowing river, its castle and cathedral, the centre of Inverness is very attractive for a bustling modern city, but I can’t help thinking the town’s appearance would have benefited from the retention of that bridge.

Anyway, to work – every time I run workshops like these for head teachers and their deputies,  I am reminded of the busy, committed and stressful working lives they lead. As with any profession involving people, being a teacher – head of a school or not – requires patience, energy,  a sense of humour and the ability to take the long view.  It can be frustrating, but it is a job that can be thoroughly enjoyable and stimulating. The best teachers  enthuse and encourage youngsters to challenge themselves and create a stimulating, welcoming classroom atmosphere.

The best head and deputy head teachers work as team members and support to the hilt teaching and non-teaching staff who are conscientious, prepared to adopt imaginative approaches to learning or who offer activities for pupils outside the classroom. You will have your own picture of what a head teacher is, perhaps based on happy or unhappy experiences at school.  A head, or deputy head, has to be many things to many people. To the staff, he’s the boss, or represents the boss.  To pupils, he is the ultimate embodiment of school authority and can be by turns an object of fear, annoyance, ridicule, respect or an appeal court of last resort, depending on mood or circumstance. If he’s any good, he is also someone who keeps popping up everywhere around the school.  “He” means “he or she”, of course, but for the sake of simplicity, in a quite disgraceful departure from political correctness, I am using “he”.  In a rural community particularly, the local secondary head is expected to have a presence, an authority, an articulate public voice in which that community can have confidence.  To parents he/she is required to be approachable, readily accessible, reassuring and a mine of information about all aspects of the life of the school and education generally, and in particular he/she must be seen to care about the individual young people for the quality of whose education he/she is ultimately responsible. He/she must also be able to agree a clear vision for the school and involve teachers, parents and pupils in realising that vision. On a daily basis, the head teacher can find that they are arbitrating between pupil and pupil, teacher and pupil, teacher and teacher, parent and teacher and occasionally between parents and their own child or between parent and parent.  He/she can within the course of a single day, or even a single hour, be the recipient of praise, abuse, lengthy harangues, political, emotional or spiritual outpourings, salacious gossip, adolescent tears, and any one of a thousand possible results of the circumstance whereby 900-plus adolescents are compelled to spend the working day in close confines with 100-plus highly-educated, opinionated, supremely stressed adults.

And it is in addition to all of this (and cuts in their budgets), as these Highland colleagues reminded me implicitly or explicitly during the workshops, that he, or she, has to organise a complex timetable for the school, or devolve that task with confidence to a competent colleague. And that timetable must work.

But at least there was plenty of laughter and humour along the way.

Posted in Uncategorized | Tagged , , , , | 2 Comments

Winter again

HamishWinter has returned.

I first became aware of this yesterday when Mistress dragged me out into the early morning gloom. Not only was I forced to wear my horrible blue coat, but added to that indignity, she hauled a garish yellow scarf round my neck. Apparently this is for my own safety so that I can be seen by other humans and dogs, but I suspect it is also so that Mistress can keep an eye on me in case I rush off to the edge of the river to feast on one of the several rotting salmon that have been washed up on to the bank in recent days.

There was the usual icy chill of snow and ice round my paws and the thick flakes of snow meant I had to keep blinking my watery eyes so that, to any passing dog, I must have looked like a weeping emotional wreck. What an embarrassment, for an aging literary whippet, with a manly white chest, etc etc.

Whippets were not designed for this weather – I turn fourteen next month (that’s 98 in dog years) and I am getting too old for winter here. To cap it all, my kitchen bed has vanished – apparently it was getting “too fruity”. Where is an old whippet supposed to rest his weary bones, let alone find the space and time to think up his literary gems?

Bring on spring and the warmth of summer!

Posted in Uncategorized | Tagged , | Leave a comment

Andrew Marr

ES picture   Andrew Marr, BBC Journalist, has had a stroke. The headlines are everywhere.

He has the dubious pleasure of gaining membership of a club which includes approximately one in six of the UK population. Obviously, I do not know how severely he has been affected. What I do know is that, even if his recovery is complete, life will never be quite the same for him again.

There will be a sense of loss. It may be loss of physical ability or stamina or it may be a much more subtle loss of a life that could be lived spontaneously, with good health and fitness taken for granted. He will grieve for that past life. Stroke is sudden, unexpected and cruel. Jonathan Dimbleby, his fellow broadcaster, is quoted as saying: “I’m very shocked that someone so energetic, fit and young should have a stroke.” That is how stroke is – age is no barrier to that one-in-six club; nor is fitness and energy.

It is shocking indeed to think of Andrew Marr with his sharp mind, obvious humanity and wide range ofinterests laid low in this way. However, so much is known about stroke, that with professional care and modern medication in this acute phase and good support during longer term rehabilitation, there is every reason to be optimistic for the future.

The consultant who treated me in Norway smiled at me in my wheelchair and said: “You have youth on your side.” This is something not often said to 55 year old men, but it gave me hope at the time, and more than eight years later, with the wheelchair a distant memory, I am glad that he helped to encourage that attitude of mind in his patient.

I wish Andrew Marr and his family much hope and strength for the future.

Posted in Uncategorized | Tagged , , | 3 Comments

The Mystery of Edradour

ES pictureIn the press recently, there have been a number of reports of strange transformations that have taken place in individuals after  stroke. One example from a couple of weeks ago is that of the Englishman in his seventies who emerged from a stroke-induced coma speaking fluent Welsh. He had lived in Wales early in his life, and had been surrounded by Welsh speakers, though had never previously spoken the language himself. He has had to re-learn English, apparently. Then there is Dr Jill Bolte Taylor, a Harvard neuroanatomist who describes in her book, My Stroke of Insight: A Brain Scientist’s Personal Journey, how her stroke gave her completely new insights into the functioning of the right and left hemispheres of the brain.

In my view these examples simply reinforce the need for us to try to understand more fully the miracle that is the human brain so that when it is damaged, through stroke or other causes, we can apply that knowledge to improve the lives of those affected by brain trauma.

In my own case – apart from the obvious disabling effects – I can report  two unexpected changes that took place following the stroke I suffered in 2004. The first of these was a welcome end to the debilitating migraines I had suffered throughout most of the 1990s.  Whether these were in any way connected to the stroke, I know not.  What I do know is that – touch timber products – I have suffered only one migraine headache since 2004. That occurred shortly before I was discharged from hospital and caused our ward cleaner to lie down beside me and stroke my fevered brow, much to the merriment of fellow inmates and my own good fortune….but enough of that particular breach of health and safety law and free addition to patient entitlements. I most certainly do not recommend stroke as a cure for migraine.

The second, less welcome, unexpected effect was something I only became aware of some months after I’d been discharged from hospital. This was a total aversion to malt whisky. Where previously I had enjoyed a relaxing malt or two at the end of a long working week, now I found merely the smell of the stuff – even the mention of names such as Highland Park, Glenlivet or Tallisker, was enough to induce nausea. Now, you may say, “No bad thing”. And to that I say, “Moderation in all things”. Sadly, however, even moderation was no longer a realistic option. The thought and smell of the stuff simply turned my stomach. Friends would wistfully produce their treasured bottle of malt and say, Edinburgh style, “You’ll not be wanting a dram, I suppose.” While I worked my way manfully through a glass or two of mineral water or fruit juice, I would watch them savouring their glass or two of the golden nectar. I suppose reformed alcoholics and ex-smokers must feel like this all the time. The difference is that I had no desire to touch the stuff. You could have left me overnight locked in a room with a carton of fine malts and you would have found the stock untouched next morning.

Until now.

Just before Christmas we had a small party for friends, and one of them, who’d clearly forgotten, or perhaps never knew, of my aversion, offered as a gift a miniature of a malt whisky. At any rate, I suspected it was a miniature malt – it was wrapped in Christmas paper and was of the correct shape. “That’s destined for my son-in-law,” I thought glumly as I accepted the gift, all the while thinking enviously through metaphorically gritted teeth of my son-in-law’s joy.

Fast forward a few hours to that evening when we were all relaxing by the fire after the party. I had ritually humiliated my son-in-law by thrashing him at Scrabble and felt, therefore, unusually mellow towards him. “Fancy sharing that miniature, Alex?” I found myself saying. Alex, of course, winced at the inclusion of the word “sharing”, but half a miniature is better than none at all, and my generosity did not extend to donating him the whole thing, so a few minutes later the miniature was unwrapped to reveal a malt I had not sampled before – Edradour.  I invited Alex to bring a couple of glasses and poured a small – very small – measure into each. Adding a little water to mine, I said “I’m going to hate this, Alex, but cheers anyway.”  The tentative sip I took was not only palatable, it was distinctly, well, wonderful.

Edradour – whose advertising slogan includes the phrase “enjoy life’s small victories” had reversed the effect of a stroke.

I feel a research project coming on.

Posted in Uncategorized | Tagged , , , , | 2 Comments

Master to Master

To Banchory, to take Hamish for a follow-up visit to the vetES picture (the sore paw saga).

Though he doesn’t always think so, Hamish is lucky to be seen by a very caring vet who has treated his many spectacular injuries and various ailments over the years. Amongst his many skills are rendering wounds and scars virtually invisible to the naked eye. Several years ago Hamish tore one of his back legs quite severely on a skein of barbed wire which someone had left lying around in woodland close to our home. Whippets are notoriously thin-skinned and repairing those wounds was a delicate operation carried out with consummate skill. Today, no sign of those injuries remains.

The paws are declared sound (keep taking the medicine), Hamish is weighed as the vet feels he looks rather thin (would a human patient receive such care?) and we return to the small waiting area to collect the final supply of pills. There is a glass door out on to the street – Hamish rushes to press his nose against this in order to declare his wish to be gone from what he regards as a place of torture. In his haste to depart, he has swept past a bichon frise waiting with its Master. The bichon is emitting a low sound somewhere between a growl and a whimper, suggesting it is in some discomfort. We Masters exchange nods. A small dog and yet another Master appear at the door. Hamish moves aside as they enter. The small dog turns out to be a jackapoo – a mixture of jack russell and poodle. He is cradled in his Master’s arms. The dog looks nervous.

“It’s not going to hurt,” I say.

“Nothing hurt except Master’s wallet,” says the jackapoo’s Master.

There is a pause – all three Masters nod in glum agreement.

Hamish and I leave in silence.

Posted in Uncategorized | Tagged , , , | Leave a comment

Singing after stroke

ES picture  There is an article in today’s Telegraph which reports on research to improve speech recovery after stroke. Researchers have apparently discovered that singing can help regain better communication after severe stroke. For the sake of the many, many stroke survivors out there whose speech has been badly affected, I very much hope that this research can be translated into practical therapy.

Singing is a joyful activity and I confess to being a bit of a singer myself. I emphasise “a bit”, though in my time, I have sung in choirs large and small. Only once have I been required to sing solo publicly – this was when I played the part of the Dame in a pantomime in Orkney – in this role, holding a note was less important than holding together collapsing boobs and a ridiculous dress, while all the while dodging missiles thrown from the audience and resisting the temptation to wipe running make-up from my eyes. I now sing regularly in a small choir here on Deeside (no make-up required – no missiles so far). After the stroke, I found singing in a choir not only enhanced my social life – important for all stroke survivors – but the act of singing gradually strengthened my voice, which had become weak and squeaky. To begin with, however, it was a bit of a challenge simply to stand up without collapsing sideways into my fellow basses. I won’t even begin to describe the problem of holding sheets of music with one hand while hitting a note and finding the words.

I hope that as a result of this research, singing therapy can become yet another serious weapon in the fight against the chronic effects of stroke.

There is a wider point here, though, which comes up again and again in stroke research, and it is this: the amazing plasticity and resilience of the brain; its miraculous capacity to compensate for a weakness in one area by developing new and powerful synapses in another.

At the moment in the UK, for every £10 spent on research into cancer, only 75p is spent on research into stroke. We know so little about the brain and its fantastic powers of recovery, that surely we must invest more heavily in this area of research. Who knows what potential therapies we may discover and how much we may be able to help stroke survivors and others with neurological conditions as a result.

In an ideal world, the only limits to research should be the limits of our imagination.

Posted in Uncategorized | Tagged , , , , , , | 1 Comment