going full circle

Today is a new day, and a new year.  Everyone I know has wished this day to come for most of the whole of last year.  I just want to keep saying to them all that today, just like every day, is a blessing, and wishing time away is all too easy.  It's nearly 8 months since I last posted here, and so much has happened in that time, for me, my family, my work, my colleagues, and the many many people I don't know and only see on TV or hear about through others.  And sadly all this time later we find our country in a worse situation that the first wave of the covid-19 pandemic.  It has undeniably been the hardest of years for so many, the world over, and to find that a mutant strain has infiltrated our population and is now filling our hospitals beyond the limits it saw earlier this year, is a worrying and hard way to see in the new year that everyone has been pinning their hopes upon.  So many feel anxious, disappointed, despairing again.  But maintaining hope and courage and strength and supporting each day remains so important, and many are forgetting that they have done this to get them to today.  

As I write, my own hospital this week has hit crisis point, 300 covid admissions compared to 125 the first time around, 15 on ITU, one of them being a young healthcare assistant. Christmas was a lonely place for many this year, as the situation forced our government to abolish mixing over the 5 days we had been "promised".   Yes I missed my family, but their health is more important to me so we can all be together next Christmas.  And I said all along that the virus doesn't go in to hibernation or on holiday over Christmas just because we were allowed a break in the rules.. and this week is telling its own Christmas Carol. It has been hard once again for me to hear the righteous and downtrodden opinions of the healthy and the sheltered and the well fed and the wealthy and the able bodied and those not reliant on the income that so many have lost from the closure of so many businesses, that they are so hard done by to have restrictions placed upon their usually gilded lives, no restaurants or bars, no holidays or shopping trips, as these people have no idea of the reality of the majority, nor the reality of the devastation that this infection has and still is causing so many.  And the ostrich mentality lingering in our midst still has some people not believing this virus is a real thing.. the behaviours of the individuals and crowds we are still seeing, mask wearing still worryingly variable, and secret mass gatherings still occurring.  I realise that hospitals really are setting the example and our vigilant practice outside of there remains.  We have got this far, and PPE has kept me well all this time, I won't be dropping my guard anytime soon.  

And as we enter the new year we have the hopeful saviour in the form of the vaccine-the most positive development to see us to a better situation we hope by this time next year and with luck well before that.  The UK was ahead of the rest of the world in developing the Pfizer and AstraZenica vaccines, and the first people to have them were the elderly on 8th December (my late grandmother's birthday-I wonder what she and all my other late grandparents would have thought of all this, but then they were alive in the time of the Spanish flu pandemic). We will have the Pfizer one rolled out at work from 4th Jan, and in the meantime may be called to assist with administering them as our elective and routine work is now to stop again, and we revert to urgent and cancer work only in dermatology.  Reminiscent of months ago, but this time with the experience of having muddled through and then successfully established our ways of working remotely, with our technology systems in place, we have nothing to fear this time around.  We have done it before and we can do it again. Echoes remain however of "I could be doing more", but I am reminding myself and my colleagues that we all have a place in this, the peace I came to and wrote about in this blog all those months ago when I had felt rotten for not being redeployable based on the care and attention of my colleagues who were concerned after having been a cancer patient.  But hard work still continued for me throughout, and as soon as we could open our surgical services again I doubled my days to be now working four days a week and we ploughed through our 200 on the surgical waiting list between May and August,  established a really fast pathway for patients coming directly for surgery following photo assessment, and never before have we had such happy patients seen so swiftly from GP contact to hospital treatment.  It has really worked, but has involved huge amounts of effort and adaptability in this constantly changing environment, and we should all be proud of what we have done to manage and cope and learn throughout this time, and continue to take forwards much of the good of what we have established now, even beyond covid. 

As I look back and summarise since I last wrote, the second half of the year has seen the country in varying states of lockdown, the second wave no doubt having been catapulted by the summer holiday travels and laissez faire behaviours of people happy to bury their heads in the sand about covid, but not in the sand on the beaches of their holiday destinations.  Schools stayed open second time around, but children and teachers have been regularly dropping out like flies due to covid contacts and outbreaks, so education and parental home care thrown into disarray all too often.  The airline industry and many businesses large and small have been folding quietly, high streets and shopping centres, hair salons, entertainment, theatre and film, dining, hotels, and countless more suffering under the weight of the gargantuan but invisible viral load that covid has implored upon them.  The world will never look or feel the same, maybe ever again.  And the economic fallout is yet to be fully known.  Our airports and ports and the lack of stringent policy, testing, tracking, policing, have undoubtedly allowed our country to be the worst in Europe for infections.  We are an island. We could have prevented this.  We have to look at how some countries have managed it so well and repeat this.  I still can't understand that a problem affecting the whole world hasn't meant a single policy for all, closure of borders, and containment from the outset.  It has been each to their own, and this has been a deadly price to pay.

In my world, I have thrived, as has my husband, remaining hard at work and remaining sensible and careful to protect ourselves, each other, and our loved ones.  We haven't been to a restaurant, a bar, and social event, we have seen family or friends from a distance, we haven't had an urge to travel, although a week long break in a small cottage in Norfolk in August with much cycling and running as well as resting, was very valuable given that we have have otherwise had no time off.  Him more than me-football has continued, without fans, and games across all borders and tiers now (we were put into highest tier 4 before xmas) still continues. They still test all of them weekly, and some nearly 50 negative covid tests later I see that he is my measure of being covid negative when I'm not having testing myself. Low accuracy lateral flow covid tests have only just been delivered to us at the hospital, although I'm aware that a positive test by me at any time would mean he can't work.. So this is a current dilemma.  Football has somehow been justified to continue right now, even as this new wave grips the country, as this week has seen him travel to Southampton and Liverpool already, and positive tests turning up more and more in their circles, it's wonder if it can continue as it is. Travelling out of tier 4 is not allowed for anyone, but football seems to manage to swerve this, which is hard to understand.. But of course it is my husband's livelihood, and neither of us wants to be out of work, but his safety is priority.  Having him home for Christmas Day for the first time in 20 years in football was a gift, especially in the year when we couldn't now mix with our families for Christmas.  And seeing the empty streets on Christmas Eve on our impromptu drive to town after work that day to see the lights was a magical moment.

My Mum remains furloughed from her teaching English job, as language schools have suffered the loss of travelling students.  But her experience of retirement has suited her well, she walks on the beach, she reads, and she has played tennis when able and as with all my family has remained upbeat and understanding of what is important.  She has still been caring for the health and welfare of my Dad, who has had a hard year with his health.  He had three non covid related hospital admissions this year, first from campylobacter gut infection leading to sepsis, and then twice from urological sepsis, resulting in AF and a number of scary moments when he became acutely unwell.  But in true Dad style, and with the usual  tenacity of an ox that all our family, generations gone by have had, he bounced back, albeit slowly, and has taken his place in his room downstairs now, which he has found a comfort.  He has so far been declined home oxygen for his COPD following assessment (he has an incredible GP who has allowed me to openly communicate my concerns, and questions, and always emails me back.  I don't wish to be the interfering doctor daughter, but I approach with respect and care and we have collaborative communication about dad, all with his consent). He has had a ruptured cyst on his leg more recently, and swollen legs and some venous eczema which has been a new but predictable problem given his general immobility, and we believe some early heart failure, but all is being managed well, and I have been in very close contact, although hard from an enforced distance.  I have been careful to visit my family a couple of times, and touch wood we have managed this without hiccups too.  My older brother has been in the UK for a few months now, after leaving USA, and his girlfriend, and his work has been curtailed in many ways as travel is so integral to him as a photographer and videographer, but his creative ways have seen him still capture amazing things as he remains safe in the family home by the coast.  His long distance relationship has continued to grow, and that is a wonderful thing given the disruption that this year has caused otherwise.  We have at times found it hard to understand each others' stresses, him with his work and his inability to travel to be with his loved one, and me with the full on pressures of my work which I have been eternally grateful to have, and the initial fears of covid at work put to rest for the most part as I realised more and more that my PPE and my care with my practice has been protecting me and I gained trust of the practices we were employing to keep ourselves and our patients safe.  My brother and I had an unexpected and uncharacteristic falling out, and I have still found it hard to truly understand why some of it happened, but over time the situation mellowed, and we became friends again.  My younger brother has been in and out of work in the film industry, and we of course worry for him with the ongoing restrictions being what they are for his work.  We had some lovely bonding time over the summer, and spent quite a bit more time together than we might have otherwise, and bringing him to our home, in the surroundings of where Harry Potter was filmed, a film he has worked on more than once, was lovely-we just couldn't show him inside the Great Hall where it actually happened, as it was locked due to covid! Sometime soon we hope.  But contact has waned again, and my unannounced visit to see him and take some things to him ahead of Christmas was something I needed to do.  Pinning him down to get a response can so often be so hard, and finding him at home in tier 4 lockdown (same tier as me don't worry) was my only hope! A few minutes at his doorstep was enough for me (even if too long for him!). I hope we can again find the emotional and physical space to see each other more this year too, it's mainly in his hands, and we all live in the hope that he will come back into the family fold, at his own will, in time. 

Permitted to Pause has continued to grow, and I have met incredible people and kindred spirits through instagram, which has been like gaining a whole lot of penpals! I have enjoyed seeing the charity Doctors in Distress become more visible.  I was honourably asked to be a Trustee of the charity.  After much and agonised thought I felt it unfair to take on this role when I am already so busy and fearful that I couldn't give them the time they deserve right now, and being keen to expand of some of my own longstanding projects too (I have written five chapters of my book so far) which need the time I am already trying to find, I regretfully had to decline.  They understood, we remain in collaboration,, and I will continue to support as and when I can without question, and perhaps we can revisit this in the future.  But through these wonderful meetings on instagram,  between Sept and Dec I have been invited to be interviewed on four things with P2P I never thought I could or would do-a webinar, a podcast, an instagram live, and a video stream-I learned so much, and the conversations we had were enlightening and bonding and I am so grateful to each one of the hosts.  And this has given me a hunger to try to be brave enough to do my own thing in some way, to try to effect change in the culture of medicine and enable healthcare professionals to be healthier and happier in ways that are simple and are passed on at every level, and that self care in the profession will be seen as something mandatory, and not just by chance, or because it is "deserving" and that is becomes second nature, and remains guilt-free.  My Imposter Syndrome has gobbled me up at times, but I have been infinitely encouraged by my husband throughout.  I have bonded on ever deeper levels with my colleagues this year as we have worked thorough this unexpected journey together.  And I have continued to have the love and support of the incredible friends I call my sisters, and we have all grown and projected along this past year's runway, and we remain by each others sides. 

And my final reflection is on the view to the future, as this year we found a place in the New Forest that we hope to call home in the very near future.  The James Bond house as we have called it, the perfect idyll with so many elements of all the homes we have lived in before, in London, Wales, Montreal.  We are looking to a future which brings us more control, more security, more of nature, more time with family, and most of all more time with each other.  We have both grown as individuals, and as a couple ever more united by the life events that have surrounded us through the years.  We are not afraid of what lies ahead, we positively embrace it, whilst holding the health and good care of our family in  equally high esteem.  And we count our blessings every single day, and today is no different. 

I will end this blog post with the post I put on my instagram yesterday, and as I don't know when I may again be writing, but today I was determined to do so. 

Think Positive: I found this the other day-something I acquired during my cancer treatment (no idea how  but I think it was given to me having been pinned on the wall somewhere!) and I thought it a timely reminder to share these words as we enter a new year in just a few hours. 

Let's remember to make every hour count, in 2020 and in 2021 and beyond, and don't take your previous time for granted. And as you reflect on this year gone by, do so positively, and with gratitude, for getting to where you are now.  You have had strength and courage, more than maybe you knew.   Without reflection how can we learn and grow and figure ourselves out and gain the tools to figure out the next bit in the stages of this meandering life? Steps we have walked before are what bring us to where we are in the present, and take us onwards to our future-we don't have to have it all worked out, because we can't, and continuing through this year's constantly dynamic state can be an empowering reflection for us all. 

So onwards we go, and may 2021 be a healthy, nourishing, and ever positive year for us all. 

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