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Wednesday, June 29, 2016

Haiku on Trophy/ Fine/ Angel/ Pressure


You are my trophy
Impossible to keep you
Sitting on a shelf

Tom Jones' trophy wall
It's not impossible he
Collected knickers

The blessing of gods
An impossible trophy
For scoundrels and thieves


Fine lines from my pen
Curl themselves into letters
Words for my haiku

Nothing be finer
Than loving Carolina
Early one morning
A Fine Arts degree
Sounds so much more important
Than one in science

The angel of death
Not exactly best of jobs
But someone has to
She was beautiful
With such an angelic smile
Nasty piece of work
In Satan's workshop
The angel grinder starts up
All the tools screaming

Pressure to succeed
Goes against human nature
Fount of human ills
Low pressure weather
Cyclone over the east coast
Gale force winds and rain
Blood pressure rising
It's not really surprising
Certainly Can Can

Making of a Child Psychiatrist: (41) Settling Down Sort of… (4)

As I remember it, Christmas 1965 was a rather fleeting time because Jan had now become an employee subject to rosters; being one of the newer employees, she was down the hierarchy a bit in terms of taking leave.
So we travelled down to Westgate on Christmas Eve on our blue Vespa, with a case full of clothes and carefully wrapped loot for the families. It was freezing, and although we were both dressed as warmly as we could, we did not have leathers to fend off the chill; we were ‘mods’ rather than ‘rockers’. We did have woollen gloves inside sheepskin gloves, and Jan had taken the precaution of wearing thick tights under her ski trousers, and tucked herself in tightly behind me. But we froze. I know that when we arrived in Kent having negotiated the road out through Blackheath, the newly completed M2, and then the Thanet Way, the day was fading, and we were immensely relieved to reach dear old Westgate-on-Sea in its seaside town winter emptiness.
As it must be for all newlyweds, it was complicated having to satisfy two families. My recollection is that we stayed at Kingsmead Court with Jan’s family and its extensions, and that Christmas Day was shared with my parents and Andrea coming for Christmas lunch and the afternoon. On Boxing Day we went to my old family home, now re-occupied by Ted and Eve and Andrea after their return from Australia. We certainly have black and white photos of a delightful day showing us all in smart clothes and silly hats, standing around a Christmas tree as tall as the room, and stacked with more presents. We look happy, and I am sure we were. I was delighted to have my family back again, and reachable. The three years of absence in Australia had made me self-reliant, and that was never to change. But it is important for all of us to have that readily accessible emotional connection, and the potential for support if it is needed.
Having said that, at that time my side of the family were in many ways very different to Jan’s side. The vast majority of the Martin side of the family migrated to either Australia or to America in the years after the Second World War. As I noted in an earlier chapter, my mother’s side of the family (the Mays) have been a bit thin on the ground. Her paternal grandmother Charlotte (May, née Hirst) had died in January 1923 (aged 55), when my mother was only 4, and only two years after her own father Harold (aged only 26 in 1921) had died from tuberculosis after being gassed in the First World War. The other grandmother (Hannah, née Howie) died in 1924 (aged 69). These three deaths must have left my grandmother (Louisa née Barrett, then in her 30s) reeling, grieving very much on her own while trying to survive with two small children. Life must have been emotionally very hard, as well as stressful with little income except that from her war pension and her dressmaking. Her father (John Henry Barrett) was to die in her house in Feltham in July 1938, when my own mother was 18. Then Grandad May had an argument with a London trolley-bus in 1941, and died from his injuries. Admittedly, both were in their 80s, but Louie must have felt surrounded by death with so many over those twenty years.
Louie had developed a close supportive relationship with an aunt Emma (born in 1864), who lived in Twickenham, looking after her tobacconist father Thomas until his death in 1912. But travel was sometimes hard on public transport, and the correspondence between the two reflects Louie’s somewhat desperate need for closer support.
Admittedly there were supports. There was an uncle Ernest, younger brother to her father Harold, and a City of London policeman. He and his wife May had two daughters born in 1925 (Barbara) and 1928 (Dorothy). They lived in Feltham,  and became close. Uncle Ernie was to become the family patriarch, a role he filled vey well. Eve’s brother Harold (born a month after their father had died) was later married to Ruth, and they had a son, Brian, born in 1947, also living in Feltham. Even so, I sense the ongoing sadness that permeated the extended family, and this filtered down to my mother, and was amplified when her own mother died in 1945. Eve was not aloof, but despite her apparent gregarious nature in company, she was always a loner with few close friends, and sometimes a bit distant. Even when at her happiest, there was a self-protecting wistfulness. And her happiest was when she was painting or sculpting, somewhat solitary pursuits.
So Christmas 1965 was special, but even after our 1963 trip to stay to with my family in Adelaide, the relationships were never overly close, always a little reserved. On the one hand Jan and I were respected for developing professional careers and doing well at University (something both of my parents would have wished for themselves), but we were expected to live our own lives. That was fine but I always felt slightly guilty in having such a relaxed and comfortable relationship with Jan’s family. I guess at the time, there had been fewer deaths in their families of origin, they were consistently light-hearted, and their lifestyle as hoteliers reflected a naturally gregarious nature.
The difference in styles of our two families shows in several ways. When Jan’s parents were not running the hotel in what passed for summer in Kent, they were always looking for opportunities to get together with family, or spend a couple of weeks on holiday. In my teens, I was privileged over the years to join them in North Wales on one occasion, and the Lake District on another. I was always made to feel welcome as a part of their family. In addition there were two skiing trips – one when I was only 14, another when 16. The latter was a ten-day gathering of extended Hughes family in Saas Fee in Switzerland. Sadly, my own family never took the opportunity to go anywhere for holidays. I guess money was always an issue, but I suspect a ‘home body’ attitude was also in play.
Another example is an episode that occurred in about March 1966, when Jan and I had been married nearly a year. I had to do a month of intensive midwifery training, and allocations to various units were made without consultation or redress. You were placed, and expected to perform for the month. That is you had to be an active part of at least 20 births, attested to by a supervisor midwife. I was allocated to Derriford Hospital a large teaching hospital in Plymouth, in Devon. So, fairly recently married, I was going to be forcibly separated from my life mate. I found this irksome and irritating, but just accepted it was something I had to do, in that somewhat blind male way of my extended family not really considering it might have major implications for Jan. She fretted, despite frequent phone calls and the odd letter.
If my family had had to deal with that, I suspect my father would have said something like “Well, you just have to get on with. It will be over soon enough”. Jan’s family reacted in a totally different way. Admittedly they were free to travel given it was pre summer season for the hotel. But they arranged to bring Jan down to Plymouth for a week, and make it one of their active holidays. She managed to get some time off from work, and we were both thrilled about connecting. Unfortunately, it went slightly awry. Jan caught some virus, was not well for most of the week, and then had one of her extended migraines. She was happy to be there, but not very happy. In addition, I was on call for births. As we all know, babies decide their own time, so the time Jan and I had together was disrupted a couple of times. Life is like that.
There was one quirky event that happened in Plymouth at the Royal Hotel where the family were staying and we were having lunch. Behind us there was a table with a rather large and somewhat elderly woman holding forth. She had a strong Australian accent, and Jan and I looked at each other bemused, remembering our own time in Australia. After lunch we went over to introduce ourselves, and talk about our experiences in Adelaide. We ended up sharing afternoon tea. Turns out the lady had been living in the street next to the one in Adelaide where we were housed for our three months. And she knew the Davidsons, in half of whose house we had been living. Life is strange like that with coincidences in time and links made around the world; if you are open to them. And you wonder whether there was some reinforcement of our enjoyment in Adelaide as a city, given what we now know about our future. But those are stories to come.

While the majority of you will understand immediately why I have taken time to explore these matters, I know that some may be asking: “What has all this go to do with learning to become a Child Psychiatrist?” The first thing to say is that, while death is a universal fact of life, grief affects us all in different ways. I believe as a doctor I have had to work with grieving people all my professional career. Not only have I had to come to terms with my own losses, but also I have had to learn how to help others manage loss and grief and make some sort of recovery so that it did not continue to have an impact on both their emotional and physical health. More than that, I believe I have made a partial case for how grief may shape a family style of living in the world. As a general practitioner I always thought of myself as a ‘family doctor’, needing to be able to work fairly with all members of a family. As a Child Psychiatrist, I have always thought of myself as a child and family therapist. My hope is that this will become amply demonstrated as this narrative unfolds.

Friday, June 24, 2016

Haiku on Rinse/ Matter/ Homework/ Sliver


Pale left over clouds
Rinsed by all the passing storms
Morning's memories

Old salmonella
Best to rinse all vegetables
Even when pre-packed

Saw him lathered up
Then again in rinse cycle
My poor teddy bear


He has the patter
So funny; no real matter
A real mad hatter

There are dark matters
So much that can't be measured
Like integrity
What really matters?
That at the end of the day
I will still love you


The caring mother:
"What do I have for homework?"
Breeds entitlement

Improve love-making
Read that naughty hidden book
Sensual homework
And now for homework
You will complete things from work
Phone interrupted


Painful injury
Sliver of wood under nail

Sliver of pork pie
With low alcohol pub beer
Anorexic lunch

Dark meditation
A sliver of light appears
Mindsight peace of mind

Making of a Child Psychiatrist: (40) Settling Down Sort of… (3)

We moved into a flat at 190, Camberwell Grove, a gracious Edwardian three storey semi-detached with a basement. The house had a ground and first floor where the mid 40s owner/ landlady lived. The second floor, reached by a rather noisy staircase clad in brown linoleum, was all ours - a kitchen, a living area, quite a large bedroom with an en suite bathroom.
Basic furniture was supplied from various family sources, and carried up the stairs with family help. Of course we had the loot from our wedding, unpacked awaiting our return from honeymoon, and were bemused to find we had ended up with 13 casseroles, very welcome bed and table linen, and several decorative ashtrays. My parents had given us a rather posh tea trolley that we used on most days. It had an amusing but somewhat odd habit of rolling independently across the kitchen, given a slightly sloping floor. Like most events in our lives at that time we just thought it was funny. These days it would have been a serious reason to call in a builder.
We realised we had collected rather a lot of books between us, and had nowhere to store them. They were piled unceremoniously while we sorted the rest of our meagre belongings. But one Saturday I went to a builder’s yard, and organised a couple of 10 foot long pieces of pine planking, and a number of bricks. When they arrived home, with considerable pride we built a simple 60s bookshelf to take the lot, as well as a stack of records and my old player (good for 45s, 33s, and older 78s). Later we bought some garish winged bucket chairs. We were home.
In amongst the muddle, Jan studied for her finals in the coming June, and I tried to avoid too much study by beginning to work studiously on my stamp collection. As part of my life long self-analysis, I have realised I am a collector. I understand that at times of stress, or times when I want to avoid hard work, I bury myself in an activity. More simply, when Jan was revising three years of study, I could have been doing the same, preparing myself for my own finals just under two years hence. My first stamp album was bought by an aunt and uncle as a gift for a four year old being a frilled, velveted pageboy at their wedding. This thin red album had very few stamps, and had simply languished as part of my baggage for many years. Now, I developed a passion for British stamps, and spent hours organising several new albums around a miscellany of stamps purchased cheaply from local dealers and others. I became fascinated by variations, watermarks, franking, and first day covers. It kept me quiet.
There were times of relaxation and freedom. Above us was a tiny rooftop flat rented by a couple very much at our age and stage. Bob Stebbings was an architectural assistant, and his wife Chris a receptionist. They were young, also newly married, happy go lucky, interested in the world around them, and very funny. We became great friends. At some stage in my past I had been allowed to borrow an 8mm camera from Jan’s father, who taught me the skills of editing and splicing celluloid. I cannot remember how I acquired a camera, but the four of us began to create a film of us around London doing crazy things. The first attempt was a picnic in the local park one Saturday. We had no children, but between us we did have a collection of soft toys, and we filmed a teddy bears’ picnic with silly interactions. An example was a big blue blow-up ‘teddy’, filmed as the plug was pulled and it slowly deflated. We all fell about laughing. On a later occasion, we went into the city on the underground and visited The Tower of London, Horse Guards Parade, and The Embankment, with Bob parodying guardsmen, emulating silly walks, us sitting on bronze cannons, or using the glass of shopfronts as mirrors and lifting one leg as if we were puppets. Over time I edited the film down and came up with an appropriate title. The Stebbings, who were great smokers, became ‘Stubbings ‘66’. We still have the reel of silent film (amongst a now large collection of other films and videotapes of our family history); and every four or five years we replay it, just to enjoy the silliness, remind ourselves of simple times, and wonder how Chris and Bob’s lives evolved.
Jan’s exams came and went, and she relaxed in that tense kind of way we do when waiting for results. Of course she had passed, and gained her Bachelor of Science degree in Biochemistry. She glowed, but I suspect her parents Reg and Bobbie were even more proud; to have a daughter with a University degree exceeded their expectations given the post war uncertainties they had survived, and their own educations curtailed by necessity. Jan joined a kind of elite in their eyes, along with cousin Monica who became an academic in plant genetics, and her brother Michael who gained his degree and joined a software engineering firm in the early days of serious computing.
I am not sure how the connections were made, but Jan applied for a laboratory technician job at King’s and was successful. She began her own journey of professional work, and I could see her confidence in her own abilities expand as she gained a varied skill set, became a well liked member of a team and learned the ever emerging techniques of hospital biochemistry. The bonus was that Jan was earning a salary working in the hospital at which I was a medical student. So I became a kept man, supplementing my £96 a quarter county council grant with moral earnings from my woman. Seriously, it made an immense difference to our lives, and our sense of security for the future. In many ways we had come to believe the dire warnings that it was crazy to get married while we were still students; at time we had lived on next to nothing, even combining our grants. We breathed more freely.
It dawned on me that I now had to live up to my side of the bargain, and do sufficient work to complete my own degree. I had to set aside the stamp collecting me, given my fantasy of making a lot of money selling special stamps had not come to fruition. I had to begin to study in earnest. But I found myself frequently falling asleep over textbooks. Clearly it was not for a lack of interest in my chosen career. But I now know from my later neurolinguistic training that I am a visual and experiential learner. As I have noted earlier, I am not good at following a logical plan. Throughout my life I have continued to be a voracious reader. But textbooks are for dipping into, not learning verbatim. I had been under the misunderstanding that, to emulate so many of my close colleagues, I had to read every textbook from cover to cover. I just have never been able to do that. I learn, and always have learned from my patients, and the subsequent supervision sessions or post clinical discussions. And once learned visually and experientially, I rarely forget. In terms of medicine, I am a collector with a fascination for remembering the work and names of historical figures and their contributions, minutiae of various diseases, all along with a clear visual memory of patients and episodes going back 50 years (even if I struggle to remember their names).
I did not know this in 1965-6, and struggled. I felt dumb, and thought I was stupid. From time to time I believed I was not worthy to become a doctor. Looking back, I know I became depressed, and found myself seeking out odd activities to prove I was not dumb. Again, I cannot quite remember the detail, but I came across some information about intelligence and, perhaps during my earliest student time in psychiatry, I was introduced to the work of Hans Eysenck, some of whose work I devoured (Sense and Nonsense in Psychology, 1956); Fact and Fiction in Psychology, 1965), and who had written a book in 1962 called ‘Know Your Own IQ’. I found a second hand, but clean, copy in a bookshop and devoured that as well, and seemed to do OK. So I challenged myself to do the Mensa test. The results proved to me that I was not dumb; so that was not the problem.
I now know that I was in an episode of depression with loss of confidence, confusion, irritability and self-blame. How could that be, when I was newly married to the love of my love, we had a bit of an income, we had funny friends, and a place to call our own. I guess we could factor in an episode of glandular fever, from which Jan and I both suffered in recent months. It is said that can leave you with depressed feelings. Whatever, I did what I have always done, which is to bury myself in whatever I was doing at the time, and just get on with it.

And what rescued me on this occasion, probably was the possibility of doing the pantomime ‘The Tempest’ described in an earlier chapter. I became so engrossed in the whole process, I forgot about being depressed and my inner conflict over studying. Well, it was Christmas, and the holidays loomed.

Thursday, June 23, 2016

Haiku on Multiply/ Obsession/ Faith/ Spin


Oceans of plastic
Fish no longer multiply

Can you multiply?
Special tables may help you
Chairs are not as good

Problems multiply
In number, seriousness
Unless you solve them


Obsession in film
The Butterfly Collector
Can Clegg find love

Obsession with words
I find I can win Scrabble
Against anyone

Finding my left sock
Has become an obsession
Others are not right


Did not learn one faith
I learned that loving kindness
Permeates the core

Faith in my teachers
Allowed me to learn each day
Now I teach to learn

To have faith in life
Needs predictability
Patterns we have learned


She was in a spin
Three hours to catch the plane
Could not find passports

Travel through your mind
Observe each moment's record
Take out all the spin

Wander life's byways
Avoid travel agent spin
Meet local people