Eric Sinclair – optimist, author, Stroke Association volunteer, occasional chorister – all views my own but fully endorsed by the whippet. "Being challenged in life is inevitable, being defeated is optional"
My Father had a stroke in 2018. Fortunately he got to hospital FAST which enabled him to get clot-busting treatment to reduce the disabling effects of his stroke – he was able to walk again. This treatment, ‘thrombolysis’ is now being used widely in Scotland and across the world thanks to research undertaken by many including world-leading Scottish stroke researchers.
As a result of the pandemic, the Stroke Association has had to halve its budget for stroke research. This is a concern as I know that research saves lives and improves stroke recoveries. No-one wants to have a stroke or live with its effects.
And as stroke numbers continue to rise, the need for stroke research has never been more vital.
I have seen the devastation of stroke as well as the treatment breakthroughs, and believe stroke research can and will let people live the best life they can.
Angie MacLeod is a stroke survivor who works for the Stroke Association in Scotland, but is writing here in a personal capacity.
‘Who’s at home with you?’ asks the ambulance man. We are bumping over the potholes on the outskirts of Aberdeen.
‘My wife and whippet.’ This gasped through the pain of another jolt.
‘Lovely dogs’
Through the pain, I think that the ‘Wife and Whippet’ could be the name of a Yorkshire pub. I picture a sign with a broad shouldered woman in an apron, her arms folded, and beside her a little lean, grey, miserable-looking whippet. ‘Ee, I’m off to the Wife and Whippet for a pint, luv.’ I check myself. This fantasising has to stop. Maybe it is a side effect of all those pain killers. Or maybe it’s a memory of all the fantasising you hear from other patients in hospital ‘I remember when…’ , ‘When I get home I’m going to….’ and saddest of all ‘I wish I hadn’t…’
It is always a strange feeling returning home after an absence. Some things are not quite as you remember them. And the ambulance men as they heft me through the front door see things with a stranger’s eyes. ‘Nice house, lovely garden.’ They are being polite, of course, but I suppose I’m seeing things afresh, too. That threshold at the bathroom, for example, the one I stumbled over a few days ago, when life was pain-free. That now seems deeper and more forbidding. Certainly if you’re negotiating it with a zimmer.
Some things are constants though; Johanna’s love, Archie’s tail-wagging welcome, the kindness of neighbours.
In order to give the thing a bit of humanity, I have christened my zimmer ‘Cedric’. Cedric belongs to the NHS of course, and I’ll be a happy boy when I can return him to his rightful owners. There must be thousands of Cedrics out on short or long-term loan throughout the land, and an army of their temporary owners wistfully remembering the days when they could roam free and didn’t require this metallic companion to accompany them about the place – slowly.
There I go, fantasising again. It must indeed be those painkillers. Which reminds me. It’s time to ask my ever faithful wife and whippet to bring some to me.
In the brief second before you hit the ground – the hackneyed phrase is ‘your life flashes in front of you’ – so, yes, in the brief moment after my toe struck the threshold and my body thumped down on to the hard tiles of our bathroom floor, in that moment, my life would, I am sure, have flashed in front of me, had I not been preoccupied with stretching out wildly for something much more interesting which might cancel the thump and its all too predictable consequences.
There will be many stroke survivors who understand that previous sentence horribly well. All the work you have put into recovery, those balance and strengthening exercises, the hours on the treadmill, the endless exhortations of physiotherapists to keep active, but to be sensible, all, all, put in jeopardy, by that one careless moment with your eyes fixed on the loo when you should have remembered that your left foot could misbehave at any time.
I lie on the ground, immediately realising that I have been a silly boy, and that being a silly boy has consequences, for myself and for my loved ones. Johanna is aghast; Archie is aghast; I am completely fed up. Kind neighbours help me to get to my feet. I stand, supported but shaky, but miraculously pain free. With help, I take a few steps. Bang. The worst pain I’ve ever felt, radiating from my hip and piercing its way into my torso and down my thigh. I hobble slowly to bed with help, fantasising that next morning I will waken and the whole event will be a fleeting, horrible dream.
It is not, of course. The next morning – a glorious sunny Deeside day – but not for me. For me, the telephone wrestle with NHS 24 and its tortuous journey through the ‘If you have… ‘ menu, the inevitable covid questions, the human who needs to know your symptoms, but doesn’t know where you are geographically, her colleague who asks the same questions, then passes the details to the local health board, who phone me back and tell me to dial 999 and call an ambulance, which I do, painfully exasperated that I should just have started with that option and why couldn’t they have done that for me, and, and…. But, of course, it’s much worse in India, and possibly worse in much of the world, though the pain of injury is identical wherever you are.
Sunday morning, therefore, spent in an ambulance. An hour’s journey and a 90-minute wait till we are admitted, the ambulance crew courteous throughout, though I’m sure they could be doing better things with their time than waiting stationary outside a hospital in the Aberdeen sunshine. The same courtesy when we are finally admitted despite all staff being occupied continuously and masked to the hilt. Bloods taken, blood pressure measured, canula inserted for liquid Paracetamol. Huh! This pain laughs at Paracetamol. More questions. Finally, an x-ray to be arranged. Another hour passes. The pain increases with time and immobility. X-ray completed and – great joy – they can find no fracture. It’s ‘soft tissue damage’. So how to get home? I can’t stand; I can’t walk; but I can sit – and wait. The staff are endlessly patient, so I should be too. Behind the scenes discussion. They struggle to find a bed, but by 9 p.m. I am in a ward. I am finally assessed by a doctor at 11 p.m. – 12 hours after I left home, more than 24 hours after I fell over, which, of course, is the point at which I should have called for help, but Saturday evening? You don’t like to call them out. Silly boy.
And now I sit here – Tuesday morning – listening to the chatter of nurses, the endless call of buzzers, the rings and beeps and musical notes of phones. The distant cries of ‘Squeeze your buttocks’, ‘you’ll need to stand up to get your bowels moving’ and ‘how do you transfer normally?’ It’s like returning to the stroke unit, except I have a single room and it’s more painful. It’s deja vu.
Today, Tuesday, clutching a zimmer frame, I can at least shuffle to the toilet, and that’s progress. Now, there is a sentence I thought I’d never write in my life.
Update Wed pm – it’s a fractured pelvis, picked up on a scan today.
I was recently preparing a piece of short fiction for my next MA assignment (see earlier post), when I found myself using the word ‘buff’ in the following sentence: … it was a very small book, which had lost its cover slip, and, shorn of this, was buff coloured and lightly dimpled to the touch. There is a picture of the very book at the head of this post. I had placed it on the desk in front of me for inspiration.
Even as I typed those words, the thought crossed my mind that somewhere I had heard the word ‘buff’ being used by a younger female person in a totally different context. In case I had made a terrible and suggestive mistake, I referred to an on-line dictionary and, sure enough, discovered that the word ‘buff’ has acquired a very specific and different meaning from the ones I was taught at school.
There it was in grey and white on my computer screen:
Buff– Adjective (of a person or their body) in good physical shape with well-developed muscles. (Originally North American)
An example of usage was given – ‘the driver was a buff blond, named March’
It was then that I remembered the context in which I had heard the young lady use the word. I will spare her blushes and maintain her anonymity, but she was referring to a male colleague at the time. I thought hard about my own recollection of this male colleague, then I checked my writing again to make sure that there could be no hint of double entendre in the way I had used it. I could see none, but you can’t be too careful. This was an assignment, after all, and you don’t want tutors laughing for the wrong reasons when they have power over two other four-letter words – ‘pass’ and ‘fail’. On the other hand, they probably get too few laughs when marking assignments, and might appreciate a bit of a titter from time to time.
Anyway, the whole episode got me thinking about the rather wonderful way in which the English language works, when you can have a short four-letter word like ‘buff’ mean so many different things. To me, these are some of the longer standing meanings of the word:
Buff (adj) – a beige colour, as used in my sentence
Buff (noun) – an expert or enthusiast, as in ‘he’s a computer buff’
Buff (verb) – to polish
Buff (noun) – a pad used for polishing
There’s the phrase ‘steady the buffs’ where the word has military connections rooted deep in history
And now, I suppose, there is Buff (adj) – fanciable, with well-developed muscles
I am sure the bright and informed readers of this blog knew much of this already and will be able to think of other, perhaps many other, meanings for the word. I am not implying, by the way, that readers of this blog are ‘buffers’- don’t let me get started on six-letter derivatives as well.
For now, just enjoy, if you can, the subtle, multi-faceted, ever-changing beauty of our language.
This, below, was the scene outside my window on Christmas Day 2020 at about 10.30 a.m.
and this was the scene on 1 January 2021 at approximately the same time
Spot the difference. Slightly different angle? Slightly more colour on 1.1.21 than there was on 25.12.20? Less snow in 2021? Generally brighter in 2021? Well let’s hope so. As we say goodbye to the dark year that was 2020, we must hope that 2021 will be brighter in many ways. The days are getting longer – an important plus, particularly if you live in the north of Scotland. There is the hope of vaccines, so perhaps 2021 will see an end to the worst of this pandemic. That’s a plus. But just as we know that there will be more snow in 2021, we also know that there will be challenges ahead.
In Scotland, there will be an election to the Scottish Parliament in May 2021 and amongst the final pieces of mail for us in 2020 were leaflets from two of the political parties encouraging us to vote for them in May. Both were of a predominantly yellow hue, and that is the only clue you are going to get. This is not a political blog – you may seek that elsewhere.
Between the taking of the two photos above, I ventured on to Twitter where a lot of election campaigning will be done, quite often in the form of ill-informed sound bites. I am the archetypal floating voter, so I will study all the information the various parties put out. I am reasonably confident that I know their key policies, so what I will be looking at is the tone of the information they provide. Idealistic maybe, but I’ll be looking for the parties that are likely to build unity rather than division; the parties that have a clear vision for the future of our country and the planet; parties that look as though they will continue to improve our health and social care, but above all I’ll be looking for decent politics focussed on ideas, not on personalities, and certainly not on attacking individuals who hold opposing views. As I said, idealistic, but you may as well aim high.
Anyway, back to that brief visit to Twitter. Amongst the various tweets on my feed was this from Hardeep Singh Kohli, who on Twitter describes himself as a ‘broadcaster/speaker/author/creative director/chef/journalist’. So, you would imagine, a reasonably intelligent man:
He is writing from Scotland. He is alluding to what may (or may not) become a key question in the election – should Scotland leave the UK or remain within it. I have no problem with discussing that question on economic, social, political or cultural grounds, but tweets like this are not the way to do it, not at least in the kind of Scotland I want to live in.
Let’s examine what he is saying. “Look South” – note his capital letter – presumably he wants us to cast our eyes towards England. “Do they represent us in any way?” Who is “they”? The English? The UK Government? I leave you to work that one out. Then his most chilling statement of all – repeated twice for emphasis: “They are not us and we are not them.” You think, this is racism, surely hatred at the very least. You think, where is the common humanity we share? You think, 1930s Germany. You think, any part of the world where groups of people are fighting one another. You despair. On the grounds of taste, I will not display the hate-filled Anglophobic responses he received on-line from those who agreed with his sentiments.
So, to new year and hope for the future. Selfishly, I want to see improved investment in stroke care in Scotland in 2021. Health is a key responsibility of the Scottish Government. But I also want to see an end to the politics which “others” people who don’t see the world in the same way as you. I am not alone in this and we have had enough of it in the UK since the Brexit vote. So, an end to that, please, in 2021 and a resumption of the “normal” civilised politics of debate, centred on ideas, and of a kind which should be possible in a mature democracy. After all, in the real world there are plenty of things that need to be improved, inequalities that need to be tackled.
This from a very occasional Facebook user (me). My post was referring to my decision in August of this benighted year to register for a postgraduate MA in Creative Writing with the Open University. I do not ‘need’ an MA, having already acquired one at St Andrews University many years ago. If I am honest, I am not even sure that creative writing is a skill that can readily be taught, at least beyond a very basic level. Did Shakespeare or Robert Burns attend formal creative writing courses? No, but they had talent and they wrote regularly. Repeat, they wrote regularly, developing a creative muscle that is there to be developed like any other. And I speak with the experience of someone who has had to develop and maintain lots of muscles in recent years.
I enjoy writing – hence one reason for this blog, and, if you follow it, you will have your own view as to whether the effort put into it is worthwhile. But a two-year on-line course with a mix of formal teaching materials, occasional tutorials and interaction with other like-minded students had an appeal, particularly as a structure like this might encourage the naturally lazy and undisciplined scribbler within me to make more of a regular effort to put words on the page. Also, we are more or less in lockdown here, so there is at least potential human contact there, albeit of a digital on-screen kind.
The last time I was asked for proof of my formal qualifications was before taking up a teaching post with the British Council in Istanbul. My degree and teaching certificates still bear the scars and stamps of their postal visit to the Turkish embassy in London. The Open University asked for the degree certificate to be displayed once again. In the 21st century, a scan of the relevant document is all that is required, but the challenge for me was finding the parchment in the first place after many years and several house moves.
Having overcome this obstacle and been accepted on the course, I am now three months in. I have bought the OU hoodie. I have under my belt one on-line tutorial, a host of written exercises, much on-line interaction and exchange of work with fellow students and my first major assignment, with detailed and encouraging feedback from my tutor. I discovered early on that all the reservations you might have about disclosing your creative work to others are not only real but are also shared by your fellow students. However, you soon get into a rhythm of regularly sharing your work, and critiquing others’. It’s a bit like swimming in the North Sea: the thought of it and the initial few steps are worse than the lived reality once you are in.
Before you embark formally on the course you have to choose a principal and secondary genre from: fiction, poetry, script-writing and creative non-fiction. I am certainly no poet, so I opted for fiction as my main genre and creative non-fiction as the secondary genre. I have completed the first 8-week block on fiction and am currently into the first part of the non-fiction block, with my assignment on this due in February. After that there is one other major assignment before the final end of module assignment in May. The pace is gently gathering, I feel.
Perhaps I have been lucky in the members of the tutor group to which I have been assigned, but we seem to be mutually supportive and keen to improve as writers. A number of my classmates are also clearly talented writers, which is both sobering and challenging. There is a wide variety of backgrounds and ages, a fact that is comforting to me as a student of mature years. Having been on the other side of the desk, so to speak, for a long time, it is refreshing for me to be a learner in formal education once again.
What we are missing, of course, is the occasional or even regular face-to-face contact with one another – who isn’t these days? However, what is a strong counter to this potentially difficult isolation is the way in which the high quality course materials are presented and organised. For example, there are forums and workshops on which it is obligatory to exchange work and to post comments on work in progress and there is plenty of freedom to develop your own interests, with good support from your tutor.
Several years ago, I prefaced the final paragraph of a post on this blog with the words ‘words matter’. In these testing times perhaps words, spoken or written, whether in kindness or passion or anger, matter even more than usual. I suppose that is another excuse to myself for taking time to follow this course – that and the fact it is something I can still do while my mind is relatively intact, even if the body struggles.
All of this means that my blog posts may be relatively sparse over the next few weeks – that’s my excuse, at any rate.
Merry Christmas and better times to follow.
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Throughout the pandemic, the Deeside Stroke Group has managed to keep its exercise sessions going. Supported by the charity the Stroke Association, we are the only organisation on Deeside providing specialist exercise sessions for stroke survivors once they are discharged from hospital.
Led by our excellent physiotherapist, Anna, exercise classes have continued on Zoom over the last few months. We plan to continue classes in this way until it is possible to return to face-to-face activities – early in 2021 we hope. Although we get great moral and administrative support from the Stroke Association, we are largely responsible for our own fund-raising. In the past we have had generous grants from the MacRobert Trust, from NHS Grampian Endowment Funds, from the Stroke Association itself and from many local individuals and organisations.
I know personally how sudden and devastating a stroke is. You need as much support as possible on discharge from hospital, so the stroke group has always tried to keep charges to participants as low as possible, so that the kind of rehabilitation we provide is accessible to all who need it – there is no equivalent service locally available through the NHS or social care.
Like many charities, we find ourselves with our funds severely depleted as a result of the lockdown, but we are trying to keep this important service open to all stroke survivors on Deeside despite the challenges posed by the pandemic.
Special Offer only for readers of this blog: For the last few years, we have offered a cryptic quiz on sale through the kind co-operation of local shops and other businesses. This is a part of our fund-raising effort during the winter. This year the theme of the cryptic quiz is ‘Sea Creatures’ and to encourage you to take part, here is a tempter of the first five questions, after reading which you will probably say to yourself – ‘Yes, I definitely need more of this to keep my brain active and to keep me cheery over Christmas. Bring it on’:
We will make print copies of the quiz available locally after the new year, but readers of this blog can purchase an early copy of the complete quiz securely for only £1 (or more if you are so inclined). Here are our bank details:
Payment to: Deeside Group SA
Sort Code: 23-75-24
Account Number: 05969615
Important. Once you have paid please send a confirmatory email to the email address in the contact details for this blog – see link to page above – you should receive a copy of the complete quiz by email within 48 hours. The closing date for entries is February 28th 2021. Your donation will go directly to the work of the group.
Thank you for your support and a Merry Christmas to all readers and followers of this blog.
When I was at at school we were regularly encouraged by our excellent English teacher to write creative fiction. “However,” he warned us, “do not write a far-fetched tale that ends with the words ‘and then I woke up’. That is a cop out. Try to come up with a decent ending.”
Today is World Stroke Day 2020, no sorry that needs to be shouted above the coronavirus noise – TODAY IS WORLD STROKE DAY 2020 . You can read the thoughts of the Stroke Association’s director in Scotland about stroke care in Scotland here , so don’t just take my word for what follows.
Anyway, here is my piece of creative fiction dedicated to all English teachers everywhere. As you will see, I have not yet mastered the art of coming up with a decent ending – but then neither has the present Scottish Government.
29 October 2035
The First Minister of Scotland is standing up to address the chamber. There is a hushed silence as all members of the Parliament concentrate on listening to his* words.
*sorry, Nicola Sturgeon, in 2035 it may not be you
“Fellow MSPs, today we mark International Stroke Day 2035. I am delighted to tell you that members of Scotland’s stroke community – clinicians, other health and social care professionals, charity reps, stroke survivors and carers – are joining us today in the Chamber to help us celebrate this important day.
“We have a lot to celebrate, and I want to remind you briefly of some of the successes of the last few years.
“If you are unfortunate enough to have a stroke today, you can be assured that the technology of mobile scanning means that whichever major hospital you are sent to will already know the details of your condition by the time you arrive.
“Our door to needle times – by which I mean the time from arrival in hospital to the moment you receive thrombolysis or other appropriate treatment – those times are the best in the UK and amongst the best in the world.
“Our hospital clinicians have benefited throughout the 2020s from a huge investment in training and resources which has not only raised their morale but has also resulted in fewer fatalities and a fantastic service for patients. The greatly increased levels of staffing and staff training for our stroke units have significantly improved the service. Importantly, the investment in a comprehensive thrombectomy service has meant that there has been a very significant reduction in the number of patients whose lives are blighted by disability. This has also resulted in huge savings to the health and social care service. These savings have been re-invested in long-term evidence-based rehabilitation services for stroke patients who require it – especially younger patients. Once again, our rigorous measurement of rehabilitation has shown our service to be among the best in Europe.
“So, I can honestly say we have a comprehensive stroke service – responsive and quick acting at the acute stage, thoroughly supportive at the rehabilitation stage and spearheaded by dynamic forward-looking leadership here in Edinburgh (sporadic applause) – no, not me, colleagues. I mean the dynamic professionals who have led enthusiastically from the front, learned from experience and research across the world, and worked energetically in genuine partnership with stroke charities and a fully committed Scottish Government.
“I know that many of you will remember the coronavirus health crisis of 2020. We realised then that we needed an effective rehabilitation service for Long-Covid sufferers and moved quickly to put it in place. I am pleased to say that we learned from that and have transformed rehabilitation from its Cinderella status to being on an equal footing with other health service provision for people suffering from a range of neurological conditions, including stroke, as well as those recovering from traumatic injuries. Indeed, I was delighted to welcome a delegation from Scandinavia here last week who were visiting our recently opened rehabilitation centre in Inverness, the latest to join centres in Edinburgh, Glasgow, Perth, Dundee and Aberdeen housed in now redundant city centre offices. They were particularly impressed by the provision of psychological support, by the way in which stroke survivors and their carers were fully involved in the process of rehabilitation and by the excellence of communication with local hospitals.
“Finally, a word to our stroke researchers. Without you there would be no progress and I know that many of you have benefited from the Scottish Government’s promise to quadruple action research funding, enabling researchers to work alongside patients and stroke professionals in stroke units and rehabilitation centres and not just in our universities.
“I want to say a heartfelt thank you to all who have helped us to achieve these successes.” (cue thunderous applause)
The name of this blog is Man, Dog, Stroke. Recently there has been quite a bit about the man, and quite a bit about the dog. Perhaps it’s time for a bit about stroke.
Last month, later in the year than usual, the Scottish Government published its annual review of stroke care in Scotland. You can read the details here. I am aware that this blog is read well beyond Scotland, but who knows? There may be something in this post that resonates with you wherever you live. In any case, I would like to give you a stroke survivor’s perspective on this report, which is optimistically entitled the Scottish Stroke Improvement Plan 2020. Despite its title, it relates to stroke care statistics for 2019 – i.e. prior to the Covid pandemic.
First the good news. In common with the rest of the UK, Scotland’s stroke care is provided by a host of professionals who strive to do the best they can with the resources, training and guidance at their disposal
However, after almost a decade of these reports we now have a depressing situation where:
there is a continuing post code lottery across Scotland in terms of acute and community stroke care and we are generally lagging behind the rest of the UK.
in terms of stroke bundle performance (i.e. the procedures to be followed for stroke patients immediately upon admission to hospital) no NHS Board in Scotland reaches the stroke standard expected.
thrombolysis door to needle times are variable across Scotland and below rates in the rest of the UK, despite this being an urgent treatment at the onset of stroke. (Thrombolysis is a procedure to dissolve blood clots in patients with an ischaemic stroke – a clot blocking a vein or artery in the brain).
while the Scottish Government has managed to produce in a matter of weeks a rehabilitation plan for covid-19 survivors, no such national rehabilitation strategy exists for stroke survivors, despite repeated requests for this from charities and professionals over several years. Rehabilitation merits only a passing mention in the audit report, despite being the key to maximum recovery for patients.
there has been no opportunity this year for Health Boards to respond to their statistics within the published audit. This had in the past been an opportunity for readers of the report to get some of the human and resource facts behind the dry data
there is still no measure of what a good stroke unit should look like – unlike the measurement of stroke services in many western countries.
finally, despite its potential to reduce disability for hundreds of Scots each year, progress on developing a national thrombectomy service is proceeding painfully slowly at the planning stage, although thrombectomy has been available for suitable stroke patients elsewhere in the UK for some time. Thrombectomy is a mechanical procedure to remove a blood clot. While it is only suitable for some patients it can significantly reduce the chances of patients having their lives blighted by chronic disability, speech or vision problems and many of the other results of stroke – to say nothing of the savings that it potentially brings to health and social care services.
All of these points are significant, but for me there are important ethical and equality (inequality) questions posed by points 4. and 7. above.
None of these shortcomings is the fault of our stroke professionals who, as I said at the beginning of this post, can only work within the strategies and resources they have.
This blog rarely strays into the zone of politics, which in its on-line form in Scotland can be an extremely unpleasant place. However, it is important to say that stroke professionals, stroke charities and stroke survivors were heartened to see in last year’s Scottish Programme for Government a mention of stroke as a priority. It is a small fraction of the health budget, but £1m was allocated to stroke in that programme, mainly to undertake the first tentative steps towards introducing a national thrombectomy service. One year on and…, well, you have seen my comments above.
Understandably, the pandemic has caused upheaval in our health and social care services, leading to the hasty redeployment of staff and resources, including staff who might have been available to treat stroke patients. There is anecdotal evidence at least of patients being discharged earlier than they might have been from stroke units, and discovering that it is difficult or impossible to continue their rehabilitation in the community. Some of this is understandable, perhaps, but it it does not bode well for how the annual review of stroke services will read next year.
If you wish to read more about how coronavirus has affected stroke services you can read an excellent report by the Stroke Association here.
I was recently preparing a piece of short fiction for my next MA assignment (see earlier 
Man Dog Stroke 