What's Going On

 I think about writing all the time. 

I think, what would I write?

I um....

I....

There doesn't seem to be any way to corral my thoughts into any cogent order. And for why, anyway? It seems unlikely that putting words down will make any difference to the kerfuffle. 

There is grief and anger and sadness and emptiness, alongside fear and worry and anxiety. Guilt and remorse are shouldering their way in, next to hope and wonderment and anticipation. 

Mundanity and sparks. 

Boredom and peace.

Emptiness and contentment. 

Who knows?

Out Foreign

We've been on holidays. 

Real ones. In an airport. On a plane. Queueing at passport control. Blast of heat outside the terminal. Heavy bags. Light sweat. Steering wheel on the wrong side. Olive trees. Brown earth. Weird insecty sounds. Indecipherable signposts. 

It has all been there, waiting for us, all this time. People have been living their Covid lives in these towns and villages all over the world, in places we have been dreaming about going to and they have been dreaming about leaving. Once we got there, we broke the spell. What we thought was gone, unattainable, vanished forever, was actually just there all the time, doing its own thing. Swimming pools with splashing children. Evening beaches with cooling sands and light lapping Mediterranean waves. Supermarkets with huge peppers, bright red watermelons, giant hanks of jamon, massive jars of olives. Cava so cheap it feels like a mistake. Searing heat on the roof terrace, cool breeze in the leafy shade of the restaurant canopy.

Of course, I was absolutely terrified. Packing bags with extra masks and sanitiser, printing boarding cards so that I wouldn't have to hand my phone to the airport staff. Shrieking at the children to stay away from the next person in the line. But passing through an airport that has 30% or less of its usual passenger numbers was actually (obviously) an absolute dream. No queues. Plenty of seats. No hustling or bustling. Plane row to ourselves and empty rows in front and behind. New rules about cabin baggage mean you can check in your luggage for free, so no fiddling around with decanting the suncream into 100ml aliquots. Online catering choices reduced to tea, coffee, fizzy pop and chocolate, which made it feel like a school tour pitstop in a backwater garage. 

It was another story on arrival into Palma de Mallorca airport, with gazillions of people everywhere and so much noise, even though it too was probably only at 50% of its normal July traffic. We had all our important pieces of paper ("digital" covid passports being about as digital as a bus ticket) and an antigen test result for the over-12 child. It all worked. The people took our details and our temperatures (imperceptibly) and shooed us on. We were in. We had made it. Arctic expeditions have had lower expectations of failure than this. 

Our trip was booked in October 2020, when it seemed like a reasonable expectation that maybe the world would have returned to normal by the summer. By May, things were looking up; July 19th had been announced as the likely date of resumption of normal EU travel, and the case numbers were coming down. General practice felt a bit more general. It was possible to eat food prepared by someone else, and not have to wash up afterwards. You could walk into a clothes shop without an appointment. 

Then the Delta whispers started to get louder and louder. Countries that had thrown their doors open scuttled to slam them again and lock the shutters. The rumours of double-vaccinated ICU inhabitants gained pace. Stories of tourists locked in or out of their home countries, spending fortunes on mandatory hotel quarantine. My siblings and their families were travelling from four different countries, gathering together after 18 months of separation, to celebrate my father's 80th birthday. The odds of us all being permitted and able to travel at the same time seemed remote. In the few days before our scheduled departure, my cold feet turned even icier. It seemed like complete folly to be leaving our bubble that had kept us safe for so long. And for what? Sure couldn't we just have a family Zoom? The temperature in Ireland was tropical. We had a badly inflated paddling pool in our back garden. The beaches were packed. Why would we need to go anywhere else, and expose ourselves to a miasma of insidious greek-lettered virus particles?

In the end, after changing the flight (ridiculously easily and for free) to allow a few days for the icy feet to defrost a bit, we wheeled our dusty suitcases into the courtyard of the apartment complex where my family were scattered in various swimming pools and balconies, three days of sun and swimming and barbecues already under their belt. I wasn't able for hugs just yet, but within a few minutes it was as if the last 18 months had never happened. We were able to sit and chat and eat and drink together, and rehash old jokes, and rekindle old banter, and catch up on a couple of years' worth of news. Another batch of PCR tests before our departure reassured us that we were all still relatively safe, and 10 of my dad's 11 grandchildren were able to clamber around him to help him to blow out his birthday candles. We were very sad to be missing one from that generation and two from mine, but to have succeeded in getting that many of us in one spot after all this time was a minor miracle. 

Foreign travel might never be the same again, but it still felt so good.

One I prepared earlier

I've been neglecting this blog. 

I write a column in a medical newspaper every couple of months, and that absorbs my writing energy. So I am going to double-job, and post my most recent column here, to keep you distracted until I get some time to write something else.

(First published in the Medical Independent on 20th May 2021)

Today I “attended” the IMO AGM, by which I mean it was transmitting from my laptop while I pottered about tidying up after breakfast, reorganising the knives in the dishwasher, and putting on the fifth load of laundry. I glanced at the screen occasionally to watch the wonderful new President Dr Ina Kelly and her colleagues deliver their speeches. The CEO, Susan Clyne, began to present the findings from a recent survey about doctor’s wellbeing. She told us that 70% of the doctors who took the time to participate in the survey showed signs of burnout. I stopped moving the plastic plates from the bottom shelf to the top one, and looked up. 66% of GPs had been unable to take time off due to difficulty finding locums. 85% of doctors had 9+ hours added to their working week during covid times. 87% had to cover out-of-hours shifts on top of that.

What the actual fork.  

I abandoned the Weetabix-encrusted bowls and sat in front of the screen, head in hands. Of course I knew all of this to be true. Of course. But I thought about my friends and colleagues, my daily contacts and the faceless names on the hospital letters, and I thought about the pain and hurt in each of their hearts. 

Later on in the day, a panel discussed the mental health issues that covid has triggered in the general population, and in doctors. I asked what is the main barrier which prevents doctors from seeking help for mental distress, and the answer from Dr Íde Delargy was “stigma”. We are too ashamed to say we are struggling. 

I have suffered from anxiety since I was a teenager. My first panic attack happened on the way home from Mór Disco one night in First Med. I lost my shit, as they say, but put it down to the €2 Tequila Sunrises. In fact I was scared, and worried and uncertain, and it manifested in physical symptoms of dyspnoea, tachycardia and headrush. I had subsequent panic attacks in my sleep which frightened the bejaysis out of me. 

It wasn’t until I had a miscarriage in my late 20s that I decided to proactively seek some help for my anxiety symptoms. I looked up the Health in Practice Programme page on the ICGP website and found a therapist who worked nearby. Her house had a red door. I sat on the chair and cried. Occasionally I sobbed, and the breathlessness and heart pounding was exactly the same sensation I had felt during the panic attacks. 

I had another miscarriage and it happened again. I went back to the Red Door. 

When I was diagnosed with advanced cancer it was easier. You’re supposed to lose the nut then. I went to ARC House and sat on the couch, and sobbed. A huge lump of fear gathered at my throat and stopped my words from coming out. The kind lady didn’t mind. She waited. And then the words came. 

There was a Milligan-esque relief in these counselling sessions – “I told you I was ill”. It was as if my once-silly fears were now legitimised and I had Real Problems to talk about. And yet it wasn’t the imminent death that worried me. It was still the niggling doubts about my social interactions, the internal struggles with my personality foibles, the guilt and doubt about previous behaviours. The desire to be a better person in my dying years, clashing with the fundamental truth that sometimes I am simply mean. 

I had a month or two of very low mood after I completed a shedload of chemotherapy. I have developed a number of tricks for combatting anxiety, but I was totally caught short when it came to dealing with depression. It was terrifying, but thankfully it lifted. I attended a Mindfulness-Based Stress Reduction course for people with advanced cancer, which helped. I needed to move away from cancer, though, so I haven’t gone back to ARC House for therapy. The Red Door has been painted blue by its new owners. My wonderful GP has died, but I am building a relationship with my new one. I try to cultivate my self-awareness, and keep track of the ups and downs of my mental wellbeing. 

I am never ashamed to say that I don’t feel mentally well, or that I am having an off day. I make myself do the right thing when it comes to going to my GP for bloods and prescriptions (a massive 40% of doctors who completed the IMO survey said they had no GP). I try to talk to other doctors about looking after themselves. What I really want though is for us all to be able to say, without shame, “I don’t feel well”.