Saturday 24 September 2016

Work smarter not harder

Everything has changed in the last three and a half years since Ruby died. There are many things I will now never be able to do, there are new obstacles I will need to traverse forever (depression, mainly) and there are new considerations that demand necessary psychic work. 
I have had to be much more flexible in many aspects of my working practise and have had to deeply consider not only how I do what I do but whether I have wanted to continue being a nurse at all. It was disconcerting to scrutinise the initial reasons for choosing nursing as a career, reasons I have barely examined for twenty years, but it was one of a thousand corners of my current life worth reconsideration. In the last three and a half years I have critically looked at other ways I may be able to make money- baker, writer, bicycle maker, plumber, fireman- and will continue to consider these and others over time. For now though I will continue nursing and working with homeless people in the city as I have for the last ten years. 
I used to have a very clear work/life border. The second my work phone was turned off, I was not working. My work brain would easily disconnect and then it was time for real life, for my family, for me. 
But now the boundaries are blurry. The old coping mechanism of creating an obvious dichotomy began to break down after Ruby died and have been gradually replaced with a stratification of work and "mainly not work". There is less separation now. 
Objectively it makes perfect sense- I enjoy nursing, it is a vocation, the qualities one needs to do it well are qualities I naturally have or have consistently cultivated over the years, I am a nurse and also a Nurse- but it took the trauma of losing Ruby to subjectively understand the importance of appreciating that me, the nurse, is the same as me, Ben Dench and not a separate "other" attached to a job. 
The pragmatics have changed too. I see fewer patients face to face than I had previously, much of my contact is now via telephone, text or email. For many years it was an unquestionable demand of my work to see all patients in person for as long as they needed, regular meetings lasting one or two hours. This way of working, for who I am now and the way I work, is not constructive. 
My work is now less face-to-face and more by telephone, email or sometimes a text. This can be as supportive as face to face but keeps me in greater control of my caseload and relationships and, quite simply, keeps me at work. A two hour face to face meeting with a client can sometimes be replaced with a ten minute phone conversation if very well timed and if the subject matter is closely planned (with obvious flexibility within the subject matter of course). A well-placed text message can sometimes be more galvanising than a tear-filled hour together.
My clients were most often were my priority. Now it is my colleagues. If staff are well supported and cared-for almost any difficulty can be dealt with. I have had no pay rise since the day I started ten years ago- an issue for millions of people of course- but I continue in this team for two main reasons- the interesting patients and the lovely people I work with. Every team has its drama-queens, it's cliques and its tensions but these are simply one of the many chemicals in the compound glue that bonds every group. I put psychic effort into encouraging the warmth and relationships in the team to facilitate these bonds. 
And it does take great effort at times. I am not naturally sociable, generally preferring my own company, and coping with depression and grief means constant endeavour. But when my team works together, supports each other, volunteers their time and minds, it feels we can deal with any difficulty from terrible salaries to patients' threats to the death of a colleague. And my grief. 
As always in my grief navigation is key. Putting the effort into navigating these new pathways through work and life have resulted in a stable coexistence which, in turn, feeds into my own abilities to cope. Work works and life is easier. 


Monday 19 September 2016

Ruby's 15th birthday

It was Ruby's 15th birthday last week. On the last two birthdays that Ruby has not been here Claire and I used our time as constructively as we could by raising money for charity. The first year we cycled around Belfast and the second birthday we hiked across the hills and very muddy fields of Antrim. We have planned a fund-raising hike in a month or two and so decided to keep this birthday for ourselves. 
We had plans for the day, we always do, and I would advise anyone in a similar position to do likewise. Prior to the day we realised how useful it had been for us to be physically active, using our time creatively for the good of others (the genuineness of this "atruism" needs questioning, of course, as we also gained so much from the activities) and being distracted with company from friends or strangers. We never lose the feelings of loss, how can we, but on her birthday we think of her happiness and aliveness.
But grief is predictably unpredictable. This year we had few plans. I managed a short jog in the morning. We went to her favourite park, Crawfordsburn Country Park, and put flowers on "Ruby's Bench" which we had made and placed in a beautiful remote spot of the park a few months after she died. We went out for a quiet lunch at her favourite pizza restaurant and had a glass of wine at home in the evening. We weren't very active, we weren't sociable, we didn't feel like being creative or proactive or supportive of others. We were quiet and barely reflective. We were together though and this was the only thing we knew we definitely needed. 
The most affecting difference this year is the exhaustion. I have not been tired- I have jogged twice, 10km and 20km, I have been for a long cycle ride in the lovely warm sunshine, I have been for a number of walks here and there- but my grief has had a deeper sense of fatigue, dulling my focus, disconnecting me from others. Last week either side of Ruby's birthday, just for a few days, I lived in a cloud of unreality. I could only consider aspects of base survival- eating, exercise, sleep and Ruby- and nothing else mattered. 
This sense of acute and incongruous introversion is not new as I deal with my grief, I have felt it many times before and it has its place in my list of unconscious coping mechanisms. It is a common and very successful method of defence in coping with trauma and grief for many people. The surprise is not that it has happened but that it happened now, after three years and as I was trying to prepare to cope with Ruby's birthday. Grief's predictable lack of prediction. 
This week I am not drained of energy. I am now off work for a day or two because of a bug and high temperature not because of my grief and weariness. Now I am simply tired, achy and sore, a normal and natural physical reaction to a normal physical illness. My treatment is paracetamol, fluids and rest. Visible, conspicuous, empirical, easy. 
I would rather have this physical ill-health with all its treatments and inevitable cessation than the wretched and difficult surprises of never-ending grief. 



Saturday 10 September 2016

A big long list of nice things to do for yourself

Bake a cake
Prepare
Play with a child
Learn how to use your water stop tap
Copy your front door key
Have salad
Walk
Say no
Know who loves you
Write a letter
Be randomly kind
Make a positively critical complaint
Do something new
Exercise your brain
Listen to an entire album- preferably sweeping and classical- from beginning to end
Appreciate animals too small to usually notice
Stare at the sky
Play
Dance alone 
Read non-fiction
Be a feminist
Write a poem
Drink posh water (bottled, ice and a slice)
Grind fresh spices
Listen
Know a great joke
Be body-positive 
Smell good
Have a movie night at home with popcorn and all the trimmings
Give someone a compliment
Look people in the eye
Go to bed, and rise, early
Watch no screens for one day a week
Fantasise
Learn the rules to a complex card game
Note wild flowers
Ride a horse
Run on the beach
Watch sunrise
Ring your mum
Carry a photograph
Go for a walk in the rain
Stare at a painting for more than three minutes
Randomly flick through a paper dictionary
Appreciate shelter, sanitation, readily available food and antibiotics
Note anniversaries and birthdays
Make pizza from scratch
Breathe deeply and stand straight
Stop apologising
Speak out when something is wrong 
Eat less meat and more plants
Paint a fence
Question all authority
Be kind, always









Thursday 1 September 2016

Mary

My friend and colleague Mary died last week. She had been unwell with cancer for some months but was very tough and very resilient. She remained unangry and full of love until the very end, wishing only beauty and kindness for everyone she knew and also for those she didn't. She was an atheist in a foxhole, free from self-appointed courage, lacking in uncouth stoicism and utterly honest. She was 59. She didn't drink alcohol, didn't smoke, took no drugs, didn't eat meat, she ran, climbed mountains, lived outdoors, hiked hills and lived as healthy a life as anyone could. Only weeks before she died she asked "why me for Christs sake?" and then she answered her own question "I suppose the answer is banal- why not me? Cancer does not discriminate". 
She was a social worker for decades. In that time she had helped vulnerable children at risk from abusive adults, homeless drug and alcohol addicts, people with severe mental health issues and physical disabilities in need of assistance, ex-offenders who, although were among the most reviled members of society, she treated with a great level of regard and as having unquestionably redemptive qualities. She helped young people cope with the stress of unexpected parenthood, she helped refugees settle into their new, unfamiliar country, she helped the most scared and frightened women who had the courage to leave violent men. She was an advocate for those without a voice, a hand to hold for those weakened by fear, a crutch for those crippled by illness. She was the only worker I have ever had the fortune to watch in action who had maintained the supposedly unacheivable goal of counsellors and support workers- that is, unconditional positive regard. Along with empathy, warmth, genuineness and a few other qualities, positive regard is seen as an unacheivable goal to be constantly aimed towards, without condition. It is near impossible- we are all prejudiced and we set conditions for all relationships, professional or otherwise. But Mary was the one worker who got the closest to this ideal- she only ever saw the potential of clients and the unfortunate reasons they ended up in need of assistance, never dwelling their lack of love or appropriate behaviour. When we discussed the kind of help we might offer someone who had done the most violent, awful things to other people, to young children maybe, she would say "The things he has been through would have to be so traumatic to have made him this way". 
Mary reminded me how far you can go with love, with respect, with tenderness, and how well other people respond to it. She once told me that to facilitate other people's level of trust you had to trust them and let them trust you. She was so charismatic, without being overbearing, anyone who had met her would remember her forever. 
She would have helped thousands of people over the years. Some of them would have been very young, would have children and maybe grandchildren by now. All those initial contacts by Mary would have helped them and then their friends, then their relatives, their neighbours, their community. Also their relationships, their autonomy, their self-determination would have positively affected. Thousands of lives have been transformed by Mary's intervention. 
She will receive no accolade, no prize, no recognition. No MBE for her (although this is also impossible as she was a republican and staunch anti-monarchist). As the poem below states "everywhere life is full of heroism". Mary is the epitome of the everyday hero without whom society could not function. It is likely I will think of her every day of my life. 
Her funeral was yesterday and she had asked me to recite this poem which I was honoured to do.



Desiderata

Go placidly amid the noise and the haste, and remember what peace there may be in silence. As far as possible, without surrender, be on good terms with all persons.
Speak your truth quietly and clearly; and listen to others, even to the dull and the ignorant; they too have their story.
Avoid loud and aggressive persons; they are vexatious to the spirit. If you compare yourself with others, you may become vain or bitter, for always there will be greater and lesser persons than yourself.
Enjoy your achievements as well as your plans. Keep interested in your own career, however humble; it is a real possession in the changing fortunes of time.
Exercise caution in your business affairs, for the world is full of trickery. But let this not blind you to what virtue there is; many persons strive for high ideals, and everywhere life is full of heroism.
Be yourself. Especially, do not feign affection. Neither be cynical about love; for in the face of all aridity and disenchantment it is as perennial as the grass.
Take kindly the counsel of the years, gracefully surrendering the things of youth.
Nurture strength of spirit to shield you in sudden misfortune. But do not distress yourself with dark imaginings. Many fears are born of fatigue and loneliness.
Beyond a wholesome discipline, be gentle with yourself. You are a child of the universe no less than the trees and the stars; you have a right to be here.
And whether or not it is clear to you, no doubt the universe is unfolding as it should. Therefore be at peace with God, whatever you conceive Him to be.
And whatever your labors and aspirations, in the noisy confusion of life, keep peace in your soul. With all its sham, drudgery and broken dreams, it is still a beautiful world. Be cheerful. Strive to be happy.

by Max Ehrmann (1872-1945)


Mary Ozanne 1957-2016