Why do we doubt ourselves?

What is it about certain people and I include myself in this observation that makes us second guess ourselves all the time. For a long time I thought it was a lack of confidence, but I don’t believe that to be true now, so what is it? Could it be that self believe is the problem. For years I have written reports, research papers, and other formal pieces of work. I have definite views on things and have never shied away from discussing them in informal settings but yet when it comes to a formal setting where I feel I may be judged for my views on a professional level, I refrain. It’s not that I worry what people will think about me, it has more to do with the fact that I was always representing an organisation and I did not want to do it harm by voicing an uncomfortable thought or viewpoint. I now realise that this has extended to all I do and now I seem to be living my life second guessing myself and my views, especially if I meet others who are very strong minded or blinded to other possibilities. Now after what I feel are years of conforming,  I want to break free but find I now can’t seem to find the words or the eloquence I once has – so what is one to do? For a while I have been writing this blog and yet would not advertise it to anyone for fear they might read my rambling thoughts. I now feel I need to take control over my life and thoughts and views and stop doubting myself. So instead of reading and re-reading and then getting at least two others to read (seems crazy when I write this) to check my work I am now simply going to post. So if you are like me and prone to personal self-doubt I challenge you to do the same, pick one thing in your life that you like to do and stop second guessing the consequences and just enjoy it. Let me know how you get on. 

Joe Duffy

Poetic licence evoked!

So on Monday - Anne Marie Hourhane wrote an article in the Irish Times "A medical conspiracy against patients", she went on Joe Duffy. I wrote a letter to the IT editor in support of the article. I then rang Liveline and was waiting to go on air. Deflated by three I cursed Joe!

On Tuesday, Joe takes up the mantle once more, I ring in again, Yes your definitely going on, 3 came and went- I was even more deflated. I should have lost some weight at this stage.

On Weds, my chairman rings and says you are definitely going on today they just rang me, now on Weds Thurs and Friday I am working in my other job, so I start to feel itchy and scratchy, red blotches appear on my face and neck, I listen into Joe really quitely, wanting the phone to ring but praying it doesn't  By 3 I am exhausted, I curse Joe and Liveline and resolve to hunt him down in Clontarf - I know where he lives!

By Thursday, I decide I am not even listening to Joe, I will read the IT, I open up the letters page and there I am as bold as brass in black and white - I ring everyone I know proud as punch. So happy I have forgotten Joe, who needs him anyway!

I have just take a bite of my cardboard sandwich in a very late lunch when the mobile goes, I half recognise the number and decide to answer it, I choke on the cardboard as the voice at the other end says "Joe is ready for you now", I panic, where will I go, I can hear Joe in conversation with two women, I decide to leave the office and head in the direction of the bathroom, spying the stairwell I head there, my phone starts beeping, someone else is trying to call me, then it whistles as the message jumps in, at this stage I am red, flushed like a tomato hiding under the stairs. I see the girl who thinks she is my boss, she is on the look out for me, I stay hidden under the stairwell but then I hear whistling and the lights go out, the bloomin porter is doing a fire check, god almighty is nowhere safe to speak to Joe. The he calls me in on the show, I feel like a rabbit caught in the headlights, Yes Joe, No Joe, three bags full Joe, I can't hear myself think, I love Joe now, he is so nice to me, now I am happy to listen I forget I am supposed to talk,  then its all over. Breathe  big tomato or someone is going to be picking you up. I run back to the office where my self appointed supervisor jumps through the door, shouting you were on Joe Duffy, I look at her and say "was I really, God I didn't know", I laugh to break the awkwardness and ask is this a firing offence, she smiles and says not quite, God what do you have to do around here to get noticed I think.

Finding my inner voice

So here I am the morning of the compassion conference in Cashel and I hear my colleague say we need someone to step up, a small voice from somewhere within me speaks up and to my own astonishment I volunteer. The speaker was to talk about compassion from a personal perspective that left with little room to manoeuvre, again to my internal surprise I found myself saying I would talk about my depression and the impact it has had on my life. If I even tried to explain why I felt this was a good idea I could not, for years I have kept this part of my life confined to those I love and trust, it is only in the last few months that I have voiced it in small circles beyond this, and yet here I was going to stand in front of over 100 people and tell them my life history. I had very little time to think about it all so maybe that was why the spur of the moment decision was not making me ill, in fact in honesty I felt little prior to my name being called.

When I stood at the podium the fear gripped me. For a moment I felt like a rabbit caught in the headlights I could not see the people, the room seemed like a blur and I thought I was somewhere else. I tried to think fast I had nothing prepared, how do you begin your life story? Where do you start? What’s the first thing you say? All this flashed through my head and to be honest I don’t remember what I said to start, I remember flashes but not everything. My eyes scanned the audience to try to gauge if I was boring them, rambling or if they thought I was just plain mad. My eyes fell upon several of my friends who strengthened my resolve particularly when I could hear the cry in my own voice and I begged myself not to destroy me in front of all these people. The love and encouragement I received from the audience and my friends fuelled me to continue, I only dealt with the beginning of my depression diagnosis and the way that compassion was shown to me over the years. The kindness of a nurse in my local GP who recognised my pain and took me in. The cups of tea shared with my friends, breakfast at Dunnes, Sunday dinner provided courtesy of my friend every second Sunday who made sure my children were fed. I will never forget their kindness nor will its importance ever diminish in my eyes, they saved me from myself and they continue to do so as each day presents new struggles. The early years were hard and these years are just different and different people are caring for me and that’s for another day. 

It's a viral thing!

It’s a very Irish May day today, sitting here at the kitchen table I am looking out onto a lusciously green back garden, the apple trees are starting to bloom along the wall and for the first time I think we might get a decent amount of apples. The rain is so soft you can barely see it and every now and then it reminds me of a learner driver, stopping and starting. It’s Sunday morning and everyone else is asleep and this is my first day up since Wednesday when I collapsed through the hall door and went straight to bed. Yet again I had a viral infection, they seem to last longer and take their toll on me more each time, but what is really stressing me is the frequency of their untimely arrival. Viruses obviously have no appreciation of a mother’s life, and certainly not this mother’s life, it has truly left me in a bit of a pickle this time. Here I am trying to hold down my two jobs and still try to retain some semblance of a good mother and an inkling of a decent daughter, I can forget about the wife bit for now because that really has to stay paused, only allowing a slight trick forward every now and then when I have time to think. The last few weeks have been slightly manic but that seems to be every last few weeks, surely the end must be in sight. Anyway back to the virus, it came uninvited into our home, intruder alert should have sounded at the door, but no, it crept quietly hidden, first it said hello again to my daughter, who was already feeling a bit under the weather, then it crept to my youngest son, it hopped over to me while minding him while his fever broke, but I never saw it coming. I left for work on Tuesday feeling sore and tired, by Wednesday lunchtime I was shivering and needed to lie down in work. Now alarm bells should have started to ring out but no I only heard a brief chime and kept going. So what did my friend virus do, it took a sledge hammer to my mind, body and dare I say it soul and said “you’re not going anywhere”. By Thursday, in the very early hours I knew I mistaken the depths virus would go to, oh no, not for me the 24 hour or even 48 hour virus that the children had, no it had held firm for me and was going to make sure I lay down, and took appropriate notice. First it increased my temperature till my body could barely stick the heat, and then just as you think sure pretend you are in Spain on a very sunny day, it goes artic on you, two duvets later when you just fall asleep from shaking yourself blind to heat your body, it decides to give you a taste of the Caribbean Sun and you can’t seem to get those duvets off now. Eventually, it peters out and you think great we are moving forward, but no, then comes the throat, swallow what’s that, it must be the bird you are talking about because there is no way of swallowing here, but now I think I have you virus, no swallow = no food, no food = lose weight, hah, I found something I like about you now virus, but then you realise you are thirsty and virus wins the round. Now if all this is not enough, my sweet eldest decides to hurt his toe, he has a match and we try to bandage the toe and send him on his merry way. I really don’t feel well and can’t think straight, all I want is to go back to bed. Now I seek the advice of two lovely men and bought feel the toe is strained. The daddy says he can play but bandage the toe, so I try. Three socks and lots of screaming later I give up and decide both of us need to go to bed. I look at my son and get that cold feeling that virus is going to be making him a visit soon. By Saturday, I manage to get up a bit, after all I have three children to care for and they still need to be fed. To my lack of real surprise I find my eldest in pain, virus came froze him, scorched him and left him like a fossilised fish on a stony beach, his lips full of ugly crustations, flesh raw from the heat and body drained of all fluid. I ask him how his toe is and if he can walk, he has not the energy to get up. I drop the others off to the cinema and bring back a diet coke from McD’s, hoping he will be encouraged to drink it. He is tired, sick and sore. He eventually sleeps again. When I collect the others I pick up a milkshake, other than a bottle of water this is all he can cope with. Today is Sunday, he is starting to bounce back and yet here I am, I can still feel virus sliding up my back like the feeling you get when the hairs on the back of your neck stand to attention. My throat and head all still ache, I know by the time I finish this, virus my old friend will force me back into bed for a few hours, hopefully the children will stay asleep a bit longer. The fact that virus is coming to my door so often now is worrying me, I don’t do sick well, I know the key is rest and slowing down so that you can give the body enough time to recuperate but I hate that. The problem is that I think that the virus is going to win this round, I don’t have the energy to get dressed and do a full day’s work and then come home and be mam, and if I am honest I don’t have the energy to be mam let along work.  One day I am going to get the virus and before it ever gets a chance to even darken the door, it’s out, until then I think I will surrender the laptop and the view and head back to the sanctuary of the bed where virus and I can find a mutually agreeable location.

Compassion

Recently I had call to stop and think about what compassion in healthcare really means. The Irish Society for Quality and Safety in Healthcare has never asked patients about compassion in its surveys about patient experience directly, but as I thought about it, I thought how the ISQSH ask lots of questions that centre on the whole concept of compassion and what it means to me.

When you are ill and in hospital you are vulnerable, even the most vocal amongst us can be silenced. Someone once described it to me as ‘white coat syndrome’ but it’s more that. I have to put myself into this picture to convey what I see every week or have heard so often or read in the comments I receive from surveys about patient experiences.

Imagine yourself sitting in bed in your pyjamas. Straight away there is vulnerability, I don’t know about you but clothes are my barrier. When I go to meetings where I need to show I am a strong CEO, I try to dress to impress; full battle make-up on. When I am collecting the children from school, the casual look; clean, tidy but nothing to embarrass the children. When on a night out; fashionable but age appropriate. Then when at home relaxing or sleeping maybe my pyjamas. However, would I want to be seen in public dressed like that? Despite current trends in Ireland, no. But here I am in a public place, a hospital ward in my pyjamas feeling sick – no protection. People I don’t know, nor am likely to meet again are sleeping in the same room and there’s no privacy.

Healthcare professionals who more often than not are so busy they forget or wont introduce themselves or when they do they use words like SHO Registrar, phlebotomist, cardiac technician, clinical nurse manager – all relevant titles but what do they mean to me sitting in my bed? I’m not feeling well, I don’t know really what’s wrong, I’m told I’m getting bloods done and an x-ray, but why? For what?  And when? What will it tell me about why I feel bad? Am I just another case to you? Or am I a person with a name?

I feel self-conscious.  I know people can hear our conversation so how can I tell you I’m afraid or I don’t understand what’s going on or that I can’t hear your hushed tones because I am losing my hearing. Nobody wants to admit they don’t understand. Or maybe yes I understand the blood test but what are you looking for, why is it taking place? What will it tell you? What will you be able to tell me as a result?

Now it is busy. You rush in. I’m up for breakfast at some ungodly hour considering I hardly slept will all the commotion of the night. The ward is a very busy place. Like in all jobs, there are those that are enthusiastic and love their work, those who are doing it for the paycheque and those who strive to do their best in highly resource constrained conditions. I’m still in bed watch the hustle and bustle. Maybe I am constrained to bed or told to sit in the chair beside my bed. If I need to use the bathroom I lay here to wait until someone can bring me or worse still to use a bed pan-the humility of it, can you feel mine? Needing someone to help me with something I have done for myself since I was a child – the tears sting my eyes but I try to retain my dignity and composure.

I am told I am going for a test but not sure when so I start the waiting game. Am I to fast? Who knows – ah sure lets fast then just in case. No sign of anyone coming to bring me for my test... everyone is eating lunch now, still no news.

 If I am lucky enough to have family, they have most likely rung me several times to find out what’s happening. They do their best to visit and spend time, but now I feel I am a burden. I watch the clock for visiting times to see will someone come. Can my husband get a bus here? Will anyone have the time to visit with everything that is going on? The children need to be looked after, they’re under 12 so no chance of seeing them for the next few days/weeks. I don’t spend much time apart from them so now I am lonely.

If I am elderly I think to myself it could be worse. My children will hopefully have a job and their own children and their own busy lives. Children or none, either way I might watch the clock tick slowly past visiting hours with no one coming to see me. Or sometimes in the evening one of my children will come straight from work and pass a few hours with me, most likely asking me what happened today, what tests, what news, was I told. How much do I say I don’t know? I didn’t know quite how to ask or understand what the clinicians were saying to me?

It goes on like this for a few days and you start to look forward to the small things sent your way; the smile from a nurse who arranges your bed and asks how you are? Fine you say. We talk about the weather; the catering  staff who come and give you a real cup of tea and the way you like it, with only a drop of milk, because they listened to you; the clinician who introduces themselves by their name first and then explains not their title but where they fit in in the scheme of things; the ones who sit and actively listen or who watch for the signs, like the hesitant pause I take as I wait to ask a question and the confused look on my face they rely on when I do understand. Those who give me the time to absorb and adjust – the ones who see me and not just as case A with conditions X & Y.

So what is compassion to me?

It’s the willingness to see me as a person, to understand I am here not because I want to be but because I have to be. It’s the seeing that at this time, this is not a true reflection of me. It’s the understanding that I am facing some of my fears, worrying about my dignity and respect, and above all when I am not well.

Compassion for me is summed up by the reassurance that you will do your job professionally and safely but whilst caring for me with dignity, respect and above all that you will treat me as you yourself would like to be treated if you were in my position.

Matriarch of Ferndale

On Monday, my friends, family and neighbours brought my mother’s best friend to the church for her last ever mass in Dublin. They have been friends since my mother and father moved into the house beside her 51 years ago. Her practical no-nonsense approach found a kindred spirit in my mother.

In the church with my parents I felt a sense of sadness but not the ache I had expected. I never noticed the tiny trail of tears running down my face until I felt my coat wet around the collar. I could not bear to look at my mother and see the sadness and loneliness I saw in her face on Saturday when we went in to say goodbye. Then my heart had fractured as my mother told me she had to say “Good night to Mary”. At 92 Mary had what people termed as a “good innings” but that does not soften the blow or lessen the loss. Sitting in the kitchen later drinking tea and eating lemon drizzle cake my eyes wandered to the shelf and the pot where the spare key to our house had stayed for all my life. Like Mary it too was gone –it’s always the small things that push you over the edge. We talked about how as a child one of Mary’s children called to my mother’s house to see if his mother was there. Pretending my mother told him “no”, where upon she was royally greeted with tears and she quickly told the truth. We all laughed but I stayed quiet, because that child was often me. I would arrive home from school and if my mother was not at home she was in Mary’s. I would call into Mary to see where my mother was and despite my mother’s best efforts to send me home, I would sit on the stool at the kitchen table and listen to their light-hearted conversation. They righted all wrongs at that table with kindness, pragmatism and the knowledge that only those who see clearly have.

On Monday another piece was chipped away by my mother’s sadness and uncertainness of what she could do at the funeral. During the mass, she dabbed her two eyes gently and discretely, she is not a crier, silence is her way. Just as I thought I was safe and that the tears would not envelop me, Mary’s eldest son spoke about his mother. He had her to a “T” and as he concluded he said how much she would be missed by her family, friends and neighbours and soul mate in number one; my mother. I now understand what a sucker punch is, I never got it before, but I felt my whole being crumple, the sadness that surrounded me was palpable to the point where what can only be described as a groan escaped my lips. It was not only the kindness of the words but also the realisation of the fact that my mother had lost her best friend, someone who could never be replaced.

When the mass ended my mother was reluctant to leave before her friend made her final journey home to Roscommon. She held my hand so tight I felt like I was a small child all over again, being protected by my mother from the sadness that enveloped her. Each of her friend’s children came to her and kissed her goodbye, each knowing that it would be a long time if ever they saw my mother again. Time passes and we forget people, lives take over and we neglect those that once meant so much.

A number of things came to my mind over the past two days. One is the love I have for my parents and the realisation that I might not have much more time with them and as such I need to tell them I love them and spend as much time with them as possible. The second is the value of friendship, as girls around the world forget their friends when boys arrive on the scene, I now more than ever, see the true value of a good, old friend. They know you, understand what you are saying, can see though you when times are tough, they just get it. You can laugh with them about things it’s not possible to laugh about with your partner; they finish your thoughts and sentences. Real friendships are a rare and valuable commodity, you can’t buy them; you can only make them. They are a fragile thing easily damaged but also as strong as an oak tree if you nourish, protect and respect them. You don’t need lots of friends, you just need a few where mutual respect is core and love flourishes as friendship grows.

Yesterday Mary went home, back to Roscommon, just as she had wanted to do for the past few weeks. In her death she was as practical as she had lived her life. No tears or sorrowful mysteries, remembrance, kindness and practicality were the messages left behind. The matriarch of Ferndale left her mark on all who had the good fortune to know her; she will be missed by many, but none more than my mother.

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