There will be no public enquiry

I am two months away from the fifth anniversary of Ruby's death.
Claire and I received the final decision from legal entities involved in investigating the circumstances around that fateful day in Scotland- the final legal decision is that there will be no public enquiry.
There will be no public enquiry.

This side of Ruby's death- the investigation of what happened before, during and after her death- is an aspect of grief I have found too hard to bear. Claire has lead and managed this throughout our grief with the help of her family (this is one of many unexpected aspects of grief- how personal it is and how each of us vary in our resilience and coping strategies from one incident to the next) and I have remained very much on the side, observing and occasionally contributing, but generally finding it too painful to grasp all the details about these investigations.
There have been three major aspects- the NHS Trusts involved in her care from birth to death, the education board that manage her school and the legal powers in Scotland that support the police at the scene and the subsequent management of all investigations.
As usual the NHS were as efficient as they could be and were transparent and exemplary in their actions. All carers for Ruby throughout her short life- cardiac surgeons, consultant paediatric cardiologists and others- convened and reflected on every detail of her medical history from Claire's 20 week scan when she was pregnant with Ruby, Ruby's major heart surgery at four days old (transposition of the great vessels) and thereafter her yearly follow-up appointments with cardiologists keeping an eye on her progress in London and then here in Northern Ireland. The medical team, with agreement from Claire and I, concluded that they had done everything they knew at the time was possible to do to look after her as best as medical research knew how. Some changes, new tests, have now been implemented for other children having similar cardiac follow-up to reduce the risk of this ever happening again (after Ruby's death the pathologist discovered that Ruby had been slowly developing a very unusual, and nearly undetectable, heart condition as a result of her surgery as a baby- it was this that caused her fatal heart attack). In other words, the medical staff reflected and reassssed their approach and implemented the findings. This happened within a few months. An apology was offered and accepted, counselling was offered and accepted and Claire and I continue to hold up that team, and the NHS in general, as being a sentinel guiding us through these extraordinary times.
The police that investigated Ruby's death were intensely thorough and diligent (and mercifully brief) and the protracted legal process kept us informed of all processes and developments.

The dissatisfaction I feel is aimed squarely at the education board who runs the school she attended. I have deflected my anger over the last five years which could have been (rightfully) directed at her school and the education board because to not do so could have destroyed me. I will continue to deflect and mange this as best as I can.
There is no one individual to blame for Ruby's death, this is true. There were no suspicious circumstances surrounding her death, this is true. What is true is that more than one person made a mistake in her care on the night she died which resulted in her not being given the opportunity of survival. Her death was barely avoidable, as was agreed by the pathologist and others, but due to lack of thought, management skills and appropriate risk analysis we, her parents, will never be able to know whether she might have survived that night and thereafter had subsequent surgery to allow her to live and thrive.
It was a heart attack, incompetently managed, that allowed her to die.

We wanted a public enquiry to show the world that mistakes were made. We wanted to show that her school were not as blameless as everyone thought and that may other parents, who were relying on Ruby's school to look after their children and keep them safe, were misguided in their beliefs.
One year after her death the school went on another week-long trip. And the parents, who know of little else, let their children go. These trips continue even now, after little change in policy.
We wanted a public enquiry to clarify, with absolution, the potential for avoidance of such a tragedy again.
We wanted a public enquiry so that certain people and organisations involved would apologise. And would apologise unequivocally after reflecting on their poor practice, learning from their mistakes, knowing how they went wrong and then unambiguously say sorry without exception before changing policy and actions.
We wanted a public enquiry to give us some closure. But, as is the way with grief, there is of course no closure, just a series of small doors closing an exit to a dark corridor.

How to...

‪How to empathise:‬
1. Imagine how they feel- weigh and consider their experience and picture yourself there
2. Extrapolate from your own experience- eg. you may not know grief but you know loss. Use those feelings to connect
3. Be warm and genuine- it is obvious if you are not

‪How to listen:‬
1. Be quiet. You should be able to silently recite and review what someone has just said
2. Allow the space between you to be the 3rd participant in your relationship (silent, angry, reflective, etc)
3. You are not a passive recipient, you are an active participant

‪How to manage grief:‬
1. Embrace it. It is a normal reaction to a universal experience, you will survive
2. Practice self-care. Do what you enjoy and what helps
3. Make no big decisions for a year
4. Be honest about how you feel

‪How to find nice people:‬
1. Practice unconditional self-regard - your relationships are a reflection of how you feel about yourself
2. Be flexible and tender
3. Know that you see the world how you are, not how it is

‪How to live well:‬
1. Consider how you want to live- in fear, with love, playfully, intensely, etc.
2. Disregard that which is out of your control
3. Be kind, always. You will never regret this
4. Contribute
5. Connect with others

‪How to have courage:‬
1. Adjust your parameters. Sometimes it is courageous simply to get up on a morning
2. Make achievable small steps.
3. Slow down, even to a crawl, but don't stop
4. No pressure. Goals are not necessary but may be helpful to some

‪How to feel safe:‬
1. Appreciate that your perception may not be the same as reality
2. Know that you will get through adversity. Always.
3. Hone your bullshit detector
4. Look for helpers, they are always there.

‪How to not feel guilty:‬
1. Know you have earned the right to be free of guilt
2. Let go of things that are out of your control
3. Be realistic about your goals and responsibilities
4. Be tender but firm with yourself when asserting your autonomy

‪How to have fewer regrets on your deathbed:‬
1. Work less unless it brings you immense joy
2. Connect more. The endeavour is worth it
3. Do stuff. You will regret inaction
4. Be yourself not the person others expect you to be
5. Allow yourself to be happy

‪How to feel a type of happiness:‬
1. Love
2. Be unafraid
3. Enjoy subjective beauty.
4. Contribute and create
5. Be silly
6. Question all authority
7. Advocate for, and empower, others
8. Take no bullshit
9. Take active steps to do good
10. Remember that everything passes

My grief at Christmas

I work as a psychiatric nurse with homeless people who have long-term mental health issues, physical disabilities and drug and alcohol problems. My patients are not suddenly removed from my thoughts when a season of enforced fun (surely the most woeful type of adult pleasure) envelops me like a leaden duvet. How can I allow myself to enjoy Christmas? 

I am told by social media and politicians to think about lonely people this Christmas (it is literally my job to think about the lonely. And if I didn't I am unlikely to be the kind of person whose behaviour will be positively changed by their message). I am told by capitalists to spend money because it will make me happy (and I know, from the enamel on my teeth down to the nails on my toe that this is bullshit of flabbergasting obviousness). I am bellowed at by advertisers with the nuance of a prison shank, their infantilising, saccharine, constant pre-watershed, radio-friendly drone eats away at the last warmth in me aimed at Christmas until, when the day itself arrives seemingly years after I am reminded that it is only round the corner, I have so little festive cheer left that I want nothing to do with anything other than my wife and my son and my own physical space. And I am told, as a vegetarian, that I need to eat lots of meat because nothing says compassion at Christmas time more than piles of pointlessly dead animals. I have become increasingly angry over the last few weeks at the disgusting consumerism that pervades Christmas, people buying shit they don't need and can't afford and getting poorer and poorer. It is rotten and ugly. 

It certainly isn't Christian anymore (a blessing in disguise, I guess. Spiritual connections to Christmas were eroded a long time ago not that they ever mattered to atheists like me). 

I think about Ruby every hour of my waking life and I hope, every single night when I go to sleep, that I will dream about her. Some nights I go to sleep and don't want to wake up and I want to be dreaming about her forever or, at least, not ever wake up to be reminded every hour that she isn't there. Christmas is a persistent reminder that my immediate family is missing someone and there is a constant gnawing of my resolve in the entire run up. I am told this is a family time but a quarter of my family doesn't exist anymore. 

Our Christmas cards don't have Ruby's name on them. We didn't buy her any presents this year. There is no stocking under the tree with her name on. Her brother Tom gets innappropriately expensive presents we can't afford to compensate for our "well, life is too short" explanations for being in debt. I spent the day with my in laws and they drink all evening and sing. Ruby is dead and they sing. On this "family" day. I made excuses that a recent back injury means I have to move around the house and keep mobile just so I can avoid their company to stop myself from crying every time a new song starts. I have found this Christmas to be alienating and lonely because I still get bewildered and squashed under the encumbrance of loss at times like these. There is no psychic weight like that of a gravitational mass beyond my control for which there is no pill, no treatment other than time (if that, even), to control its descent. 

My mum died a few months ago. My sister nearly died a few months ago and spent many weeks in a coma in intensive care. She barely survived. There were many aspects of my professional life that also contributed to 2017 being one of the worst years of my life and I'm glad to see the end of it. My Christmas was symbolic of the ugly mess and the chaos of the last year. 

Fortunately I have a genetic predisposition to optimism and, by lucky chance, I have an astute bullshit detector so I am staring intently at 2018 as it sidles over the horizon. It had better deliver. 

The Long Run

I hadn't decided on a plan to run. Instead, I just consider the possibility of running and, inevitably before I've had the opportunity to reflect, I find myself pulling on the shorts and T-shirt and course through the mental check list- is my phone charged, the rucksack dry, the drinks bladder clean, have I got the electrolyte tablets, will I take a banana or treat myself to chocolate this time? 

After the commitment to the long run and its preparation comes the silent, reflective minutes, the hesitation, readying and steadying myself, reading my body and assessing my desires for a medium run, a medium/long run, a "proper" long run, maybe even a "long" long run (by this point there is no question that this is not one of my two short runs per week but is, unequivocally, "the long run"). Do I ache anywhere, recovering from any bugs, any blisters or sore areas on my feet from the last run?

Fluids and fuel in the bag (it is never "water and food" to us runners), GPS on, last thing before leaving the house is to slip on my minimal sandals- never trainers on the long run, only occasionally on a short run if it is dark or wet- which are as good as barefoot and provide the thinnest of protective layers against sharp stones and glass. The strongest reason for me to run near-barefoot today is that I will need to retain my energy levels for as long as possible which means running as naturally as possible. And that means relying on the depth of hominid history to help me use the tendons and sinew and muscle just as they have evolved to be used. 

I stare at the sky through the open front door trying to second guess cloud formations, wind direction, humidity.  I have no real idea what I am looking for but it always seems the right thing to do. Then I'm off, running immediately from the door. I don't practice any warm up exercises, I just go dead slow until my rusty hinges free themselves and my thigh muscles have eased their initial fear. It takes five kilometres before I am fully warmed up and they are the most difficult I will encounter today. 

By now I have left the local town behind and there will be no more right-turns or traffic lights until I am home again.

A few more kilometres and I am halfway through. My joints are free and loose, my blood is the colour of the Japanese flag, vitality floods my muscles, litres of energy fizzes through channels in my calves and thighs. I am in perpetual motion. I am "in" the run and will stop only when I die. I am fuelled, hydrated, in charge, in total control. 

Cars rarely use this road- there is an alternative and straighter short-cut from A to B, the beginning and end of this 10 kilometre section only 500 metres away- and the footpath is narrow and undulating at this mid section. It gently snakes left and right, respectfully leaving A-road pretensions well behind, providing just enough variable stimuli to maintain interest without feeling like an overbearing training session. The pavement is relatively new and in perfect condition, barely used. There are no walkers walking, no pushchair pushers, no-one popping out on foot. 

This is the long middle section (totalling three quarters of today's run) of expansive lawns, modest farmhouses and their fields of sheep, forest corners, nursing homes, edges of a golf course. My run is edged with thick hedges of blackberry- I imagine them to be teeming with tiny lives, insects and rodents racing through these animal motorways- and deciduous skeletons spiking the anthrocene sky. 

Running is essentially an introspective and lonely experience for me and these hours alone, in the flow, are some of my most valuable. My thoughts can drift and undulate with the path because my goal and my abilities are assured and because concentration is unnecessary. I think about the intrinsic versus the instrumental value of running, I wonder about homemade pizza and beer for dinner, I think about how my dad and sister are back in London, I wonder about Christmas presents, I wonder about that sore spot developing on my heel. Mostly I have no great depth or detail of thought which is a fundamentally intrinsic value of the run- any contemplation is shallow, dream-like and brief. I am free from intensity.

But every now and then, maybe one run in ten, a thought grows and develops and can begin to overwhelm me in its intensity. Today there started a flicker of an idea about Ruby and that last diabolical day of her life and her last few hours, not with me or Claire or anyone who loves her. Today these thoughts stole my breath like I'd jumped through broken ice into a wintry lake and I couldn't breathe or concentrate or escape and the only thing I could was stop and lean on a wall as if I was tired and cry and cry. Then, as is the way with seasoned grief, I stopped crying after only a minute, wiped the tears and sweat from my eyes, straightened my spine and shuffled on towards my goal. 

By now, in the last quarter of my run, I am cruising home, slow "marathon pace". The final two miles are downhill and I welcome the site of the beginning of the descent as I round the last gentle bend prior to a sharp right-angle at the first traffic lights for miles and on through the final straight-lined, red-bricked town and then my front door of the last house at the end of the cul-de-sac where I live. 

I don't stop running until I touch the front door. 

The shower after a long run is a shower like no other. 

And if my plan is successful I'll be celebrating with a guilt-free homemade pizza and a beer or two tonight. 

Rest day tomorrow, no exercise allowed, and then back to a short run the day after. 

Left-libertarianism, corporate psychopathy and why women's corporeal autonomy is the answer to the world problems

Left-libertarianism is concerned with fair distribution of land and its (occasional) ownership, one’s relationship with that space and an emphasis on equal use of resources (hence the strong value placed on social welfare as a useful tool to assist in apportioning those resources). It works under the premise of equal, shared, mutual use of the world's content and places emphasis on humanist qualities as being the only ones able to do this. The state- capitalist and generally psychopathic- has little or no place in libertarian society and, if agreed that it must exist at all, does so purely to facilitate actions in the best interest of all living things (such as rare interventions to regulate financial markets, social welfare, etc).

Left-libertarians believe in self-ownership, autonomy as independence from authority and in socialist ethics. They reject capitalist teachings as being strongly competitive-based and authoritarian: a traditional ethos of the Right. Generally they are advocates of a free-market economy.
It is a common mistake of those with a capitalist stake to think that "anti-capitalists" simply believe in the opposite of capitalism (which has more than one opposite- anarchism, socialism, statism and so on). As with religious people believing that atheists are defined by what they are not ("a-theist") the truth is very different- anti-capitalism (and atheism) is the default starting point for normal human actions. Babies are anticapitalist, babies are atheist- the foundational human position is to experience an absence of economic greed and of religious belief and so one can become enlightened to all that one wishes to be, thereafter. 

A tenet of left-libertarianism must therefore be a general rejection of organised government and an active avoidance of as much of the states’ influence on the lives of individuals. 
For humans to flourish and to live a life rich in beneficence they need to be to be free of external negative influence (money, ownership, the state, authoritarianism, etc) so they can focus, unencumbered, on qualities most helpful for living things- empathy, decentralisation of power, worker-ownership, equal distribution of resources, fairness, working collectively with our individual identities. 

As an organisation grows, it distances its' relationship with the individual and it is this coldness, at first an inevitability of growth and thereafter a state being sought due to the corruptive abilities of power, that is self-perpetuating- the dehumanising nature of corporate power is directly proportional to its growth. As it grows, it finds its nature is to push away from the unconcious responsibilities of collective altruism as this is ineffective for competitive growth. Therein exists a remorseless grandiosity which it deems necessary to be able to sell itself over competitors. The larger a corporation becomes the greater its degree of guiltlessness due, in part, to its degradation of empathy. 

The financial addiction to gain capital transforms into a craving for stimulation and of change, of fluidity. Thereafter comes distrust, and eventual rejection, of reflective criticism as there is no time to stop and think. An inevitable consequence of this is the eventual loss of control over corporate behaviour, often paraded as an increase in creative impulsivity but, more accurately, as long-term irresponsibility. 

And there lies the crux of the matter- an entity without compassion or empathy, that exists entirely for its personal gain. It feels it necessary to have a massively inflated idea of self, is bereft of guilt and shows no remorse even after terrible life-changing abuses. 
Any human with these traits would be called a psychopath. This is the engine that fuels capitalism. 

So what then? If capitalism utterly fails to address any true sense of human proliferation of value, what counts? 

What is necessary, therefore, is to focus directly on human relationships as being the most relevant for human flourishing. 

Women do most of the worlds' work and earn less money than men while they do it. Women are less represented than men in most institutions, in politics, religions, educational establishments and other areas of power and influence. Women are not even allowed full control over their own bodies in many parts of the world including my home country of Ireland and this patriarchal oppression is the primary method of control over women. Contraception is sometimes difficult to get and abortions are not legal or safe (of course abortions go on all the time and, in countries where they are illegal, abortions have always occurred and continue daily). But I often think about the potential for the fair distribution of wealth, fair distribution therefore of food, of resources, of education, even of love and equality if there existed an absolute freedom of corporeal autonomy for all women, worldwide. It follows therefore that to have complete control over ones contraception is to likely have complete and international equality.

It makes sense to me that if all women had bodily liberty the worlds' population would be under control, food, resources and wealth would be distributed equally, international political influence would be relevant to individuals as well as countries and that life, on planet Earth, could be a type of bliss. 

My amazing wife, Claire. 

The death of another young man

There was a funeral today for a young man. Seventeen people attended, fourteen were professional support workers. He died from a heroin overdose but the naked truth is that he was close to dying from liver failure too. And he was close to dying by his own hand. And he was close to dying by being murdered by someone else. And he was close to dying from a blood clot caused by his reckless injecting technique. 

Even in the womb he was at a disadvantage- he came from a murky gene pool and had a high likelihood of inheriting many serious and life-threatening diseases. His young childhood was empty of parental love and, later on, empty of any parents at all. His teenage years were spent angry at the persistent rejection from everyone around him. He became addicted to alcohol at eight, cannabis, cocaine and other drugs by twelve, heroin by seventeen. There was still no love in his life except for that of nihilism. His life, all life, had no value. 

Then he developed bipolar disorder and spent many months deluded, paranoid, utterly secure in the knowledge that not only drug-dealers and the police but everyone else too wanted him dead. Through his twenties he dealt and abused legal and illegal drugs, he spent more time in prison, more time in hospital. His life was one of almost persistent detention. 

He never had the chance to develop a personality disorder or a psychopathic carapace to protect himself. He was always open. 

He never had a home of his own, never had the security of stability in any form. He lived wildly and was barely tamed by the institutions that surrounded him- he became institutionalised to the streets, trusting no-one, caring about no-one. He wore a sneer, on his face and in his heart. 

We all liked him. Everyone liked him. He was uncomfortably honest and upsettingly open about his life and his mind and his character. But he knew he had no chance and so did all the rest of us. We knew where he was from and how he lived. We all guessed correctly where he was going. 

Hundreds of professionals had contact with him over the years, me included, and we delude ourselves into believing we made minor differences here and there- I helped get a temporary roof over his head (until he attacked someone and had to leave), I gave him a few hours of my time as a listening ear (until he became abusive and rejected me). 

He died off the streets in a bed of his own. He hadn't taken his medication for weeks and had replaced it with vodka. He was twenty eight. 

What chances did he have? In 2017, in Nothern Europe, in a rich, major world city he had hundreds of chances. Some he took voluntarily, some were enforced, most he rejected. But the foundations were never set, his character waned and faltered and he slowly crumbled to death. 

We didn't save him we just cushioned his descent, the death of another young man. 

I wouldn't invite me to a party

Some months are extraordinarily difficult. It is September 2017 and am having one of the toughest periods since Ruby died. 

My mum, who died a few months ago, should have celebrating her birthday a fortnight ago. I am grieving her and her sister who died two weeks later. Ruby should have been celebrating her sixteenth birthday a few days ago. My sister nearly died recently from pneumonia and sepsis and she remains, five weeks later, in intensive care in a poor state (hundreds of miles away). My dad, in his seventies, has to cope with this too. I stopped my antidepressant medication two months ago and although the experience has been mostly positive I am always one intonation or one curt word away from tears. Always. 

Like many men I have a small number of friends and, like many men, I don't really know how close they are. Of course we discuss personal matters, how we feel, all those subjects thankfully now not out of bounds as they were only one generation before us. But other people's personal friends remember dates, seem concerned about their friend's relatives, know when their friends need loving most. I am not the best friend to have- I am terrible at keeping in touch, I go on about being a loner and about not needing other people- but I have been through some very difficult times and, although I am not demanding, need genuine support to keep myself well. 

I consider myself an optimist. Or as my Yorkshire mum would say, I am a "do-er", I get on with things, I try not to dwell. I consider myself a reflective person, looking into my grief, my depression, my life, embracing the potential for growth and for learning. But sometimes, thankfully very rarely, I just feel a bit shit and a bit lonely and I feel that other people around me can be a bit shit too. I know that my friends, professionals, even strangers will "be there" if asked but there are times when I don't want to ask and don't feel as if I should need to ask. 

I rarely wallow, I rarely feel sorry for myself. My job as a mental health nurse supporting homeless people with complex needs means that I meet and support the most vulnerable, most marginalised people in the country so I am therefore sensitively aware of my fortune and privilege. Although I have experienced most parents' vision of hell I have met hundreds of people who have been through much worse and continue to cope, to live, even to thrive. 

But today I am being selfish and indulgent and fragile and I am feeling sorry for myself. And I am thinking- what about me? What the fuck about me? Where's my random text? Where's my gift? Where's my invite? Where's my sympathy card? 

Sometimes I don't want someone to ask if I'm OK, sometimes I just want someone to say "I know you're feeling shit and that's normal". And then give me pizza and chocolate. 

Update: it's now the following day, I've given myself a kick up the arse and I'm feeling a little more grounded. I had been thinking of deleting this entire entry but decided not to for the simple reason that is it an honest and genuine expression of how I feel. Maybe it will ring true to someone and prove that even irrational nonsense, like feeling sorry for yourself, is perfectly normal once in a while.