Monday, 28 January 2013

Going under the knife

Considering (or perhaps because of) the amount of time I have spent working in hospitals I am still rather squeamish when it comes to surgery. I think it's amazing that it's possible to drill a hole in a bone and then tie a tendon or ligament through it or whatever it is they do, replace worn out ear drums using skin from behind the ears, or reconstruct a breast using tissue from another part of the body, but I don't much want to talk about it and I definitely don't want to watch. The idea of having unnecessary surgery is as incomprehensible to me as playing 'chicken' on a busy road, especially when I've trawled through enough medical notes to know that those wielding the knife don't appear to have the fine motor skills required to use a mere pen. Cosmetic surgery I find frankly icky (technical term, as I'm sure you can appreciate), especially the type where they suck fat out of one place in order to put it into another. Consequently I was surprised to read that this is on the increase.
This morning I was reflecting on the Holy Father's message for World Communications Day and I was initially surprised at how positively he spoke about social networks. I have read and heard a lot of comments about the evils of facebook, twitter et al which destroy interpersonal relationships, as individuals seek virtual relationships in which they can pretend to be whoever they want to be. However, as usual, Pope Benedict is right: social networks are neutral in themselves, it is how we use them which makes them positive or negative, good or bad. (I know I look like I've gone off topic: bear with me!) Similarly, plastic surgery is not intrinsically bad. There are many good uses to which it can be put, such as reconstruction following accidents or surgery or to correct physical abnormalities which present health risks in themselves. I am glad to see from the BBC report, though, that the number of 'man boob' operations has decreased because people are going to the gym instead. The operation, whilst superficially resolving a problem, does nothing to address the underlying cause, whereas going to the gym requires commitment and taking responsibility for oneself. At root it recognises that our actions have consequences.
When I say that there are good uses to which plastic surgery can be put, I don't know that think that all the others are bad. What concerns me is why people feel the need to have surgery to alter their appearance. In the same way that we can create an alter ego online, we can also project a different image by changing our physical appearance. We all constantly use 'masks' to hide our fears and insecurities, to make ourselves more likeable, or employable, or attractive (on whatever level). In other words, we take steps which we think will make us happier. In the drastic case of cosmetic surgery, it would seem that many people think that looking younger, or thinner, or having a certain body shape, will have consequences which in turn will lead to happiness. I question whether this is true. If a life is built on something which isn't real, can it lead to real happiness? And wouldn't our time and efforts be better spent on trying to be more like the One in whose image we are made, rather than attempting to alter our exterior to conform with any other image?

Friday, 25 January 2013

Faith, hope and mental illness

This isn't about the news, although today the Mail apparently carries an article on how brisk walking prevents Alzheimer's. This is about me, my brain, and how it doesn't really work properly.
I am suffering from a severe episode of a recurrent depressive disorder. This episode has so far lasted around 18 months; it's difficult to pinpoint the start and the harder I look, the more I can see signs earlier than that. I'm a lot better than I was 18 months ago. I can walk, I don't fall over for no reason and most days I can get up and maybe be vageuly productive. Occasionally I can manage to apply the techniques I learned from CBT. But I still suffer from extremely low energy levels, lack of interest in things I enjoy (it's a bad sign if I don't want to read, I used to read in the bathroom, at school under the table, in bed under the covers) and a level of anxiety which makes me worry about answering the phone or even talking to my closest friends and family members. I can only concentrate on one thing, and if someone talks to me while I'm doing it I'll probably shout at them out of sheer panic. I can't remember what I just did, or whether I just did it. I am short tempered and impatient. Worst of all are the times when the "brain rubbish" floats to the surface and I hate myself, think I am worthless and conclude that the world would be a better place without me in it.
The first time this happened I was so terrified that I hyperventilated and collapsed. It doesn't happen very often now, or with such intensity, and I have learned how to deal with it. I am no longer ashamed of these thoughts because I know that they are a fruit of my illness and not of my will. I have discovered that the best way to deal with them is to share them, rather than hide them, (although one has to choose carefully who to share them with!). I struggle with my anger and impatience more and it is impossible to tell to what extent they come under lack of personal conversion, and how far they come under depression. I cannot simply fight, fight, fight because there is an element of chemical imbalance involved. I cannot attribute them entirely to my illness because I know that I was impatient before that. Now when I lose my temper, I see it happening and get so frustrated with myself that I am acting like a small child (yes, I am also lacking in humility) that I get even more stressed out and more grumpy, and so it goes on. All this isn't helped by the fact that I often can't sleep and that when I do I have crazy, but strangely real dreams which are hardly restful.
I say I am not ashamed, but I rarely tell anyone I have depression. I don't want to have to deal with their judgements. I don't look ill (except for being a little paler than usual on really bad days, and they are the days on which no-one sees me), and even I often have a hard time accepting or recognising that I am (sometimes I feel like it is a daily lesson!), so why would anyone else believe it? At the same time, as a healthcare professional and a Christian, I feel I have a responsibility to help end the silence and stigma which surrounds mental illness. I read this week that GPs are overprescribing anti-depressants. Similar stories about sleeping tablets have been in the news for weeks. And yes, they probably are overprescribed. People have this expectation that life is happily ever after and when something difficult comes up, or they aren't happy because they are looking for happiness in places where it cannot be found they think they have depression (I speak in terms of the illness, rather than  the emotion). They want a tablet to make them feel better and it isn't going to help. It annoys me: it reduces my illness to a lifestyle issue rather than a disease. But it also makes me really sad for them: they are reducing themselves to a merely biological level, they do not know the happiness that comes from loving God and I want them to: I want to tell them all. 
Faith in God, Christian life and frequenting the sacraments will not prevent illness of any kind, including depression. Christian life is not some kind of fluffy, light-hearted dream where everything us 'nice' and goes according to plan. It is a joyous battle, which has already been won. It is falling over and getting up again, over and over. It is a relationship with a real person. But happiness is not a feeling. True happiness is the peace which comes from knowing God and fulfilling his plan, being 'right' with Him, if you will. I may rarely feel happy, but I know I am happy and I can say that with all honesty. I may suffer from severe anxiety but I know that, with God, suffering transcends my daily experience of it, and can have meaning and even purpose. I don't just know that intellectually, I experience it regularly. I have hope that my life won't be like this for ever, but that even if it is, that God is with me in this suffering and that with Him, as a wise friend once said, the best is always ahead of us. And I am slowly learning that I can't be in control of everything (and this is a struggle which extends long before and after this particular episode of depression), that I have to allow God take charge in my life because I know and believe that His plan is the best plan. I have long believed that the difference between the saints and the rest of us is that they recognised suffering and mortification as an opportunity to grow in holiness, grow closer to God, at the moment when it was happening and made the most of it whereas the rest of us either miss them completely, don't realise until afterwards, or stay on the level of "poor me". So this is me, half way between a pity party and the foot of the cross, where my Mother stands with and looks upon her Son. That is the only place where any of this makes sense.

Monday, 14 January 2013

If we're going to do it anyway, should it be allowed?

Today I read health-related story with a much wider implication than health. Apparently, a cross-party inquiry concludes that we should decriminalise illegal drugs
Having skimmed through the 150-pages I have to say that the BBC report is rather misleading. Whilst the inquiry talks about decriminalisation, it also calls this depenalisation. It is no so much about letting everyone have all the drugs they want, but recognising that addiction is a disease (albeit one which starts with a choice) and that treatment is a better solution than prison (especially given that there are a lot of drugs circulating in the prison system). I have no problem with this. In fact it seems like a good idea. Where cannabis is concerned, the inquiry recommends that the government monitor Colorado, Washington and Uruguay where it has recently been legalised.
The BBC article implies an attitude of "people are going to take drugs anyway, so let's make it safer for them to do so". I don't think this is really what the inquiry's recommendations are getting at, but I will say that the committee's document does contain phrases such as, 'We accept that it is impossible to...' with unsuprising regularity.
There seems to be a lot of this around at the moment. From those who talk about 'reality-based theology' to strategies for dealing with drug misuse and abuse which assume that the user will never be able to stop, it would appear that whichever way we turn there are people saying that we should accept something because it's like that.
I saw a postcard the other day which proclaimed "I set myself incredibly low standards and aim to fall just short of them" or words to that effect. This is mediocrity in the extreme and I for one am not buying into it. Yes, I have a tendency to sin; no, I cannot conquer it by my own efforts. But we were created good and nothing is impossible for God. A little co-operation with grace goes a long way. I don't think that we should ignore the fact that we are going to fail, to sin, to take drugs, to commit crimes, and we should be prepared, and we should devise and implement means which help us not to, and which help us to pick ourselves up and start again afterwards, but that does not mean we should re-define objective wrongs as acceptable.
God sees that we sin, he sent his only Son who suffered and died for our reconciliation, and he continues to love us and is always there when we turn back to him. And we must show this same face of compassionate welcome to others. But he doesn't say, "OK, everyone, 2000 years on you're still sinning, so we're having a new strategy: it no longer matters what you do." If we have this pessimistic attitude of 'it's going to happen anyway' we will never be able to accept the grace to get up again when we fall, never draw any closer to God, never grow in holiness. If we consider the inevitable as acceptable we will end up seeing it as good. Up will be down and black will be white. It will become even harder to choose between right and wrong, good and evil, life and death, if we start calling them by the same name: "legal".

Monday, 7 January 2013

Keeping up with life

The Daily Mail (not my favourite source of healthcare/science, or indeed any other kind of news, but anyway) reports a worrying trend in the number of women taking stimulants in order to cope with life.

Aside from the fact that Ritalin and friends are not licensed for the treatment of ADHD in adults (ie their safety and efficacy in this group of patients is not proven) and that buying medicines on the internet is a stupidly dangerous thing to do there are some other concerning aspects.

The women taking these drugs are obviously experiencing extreme pressure to perform and conform, but more seriously still we can see a tendency to measure people by what they do. We are not ourselves, or what we eat, but what we do. This is massive problem because if you cease to "do" then you also cease to "be". In the case of the students using these drugs, their measure of themselves is how well they perform in exams: I am only as good as my exam results. Others struggle with the demands of juggling work and family life, or long hours and pressure to meet targets. But where is the weakness in admitting that something is hard? There is also, as so often with mental health, a reduction of the human person to the merely biological.

According to the article, women aged 25 to 34 are the most stressed demographic group in the country. No surprises there: we are the group who first experienced student loans, SATs at 7, 11 and 14 years, league tables, contraceptives for all, abortion virtually on demand... We have grown up being encouraged to turn down children in favour of career success, with the advice that giving up work for motherhood makes you a failure, that instant gratification is our right and we are also the generation whose parents lapsed in their religious pratices meaning that many of us have never stepped foot inside a church. We started life with the understanding that, as women, we would have to fight tooth and nail to be recognised as good enough and we have arrived at adulthood finding that most of the work has been done.We have moved on from the time where everything was blamed on our parents not giving us enough attention. Now we are our bodies. We have been formed by secularism and individualism and taught that an expensive pair of shoes can solve all our probelms.

We were promised the world, and the world turned out to not be worth the paper it was written on. Only God's promises are worth trusting, and the majority of this group have no idea what they are.

Sunday, 6 January 2013

Normal service will resume shortly

This post is more for self-motivation than anything else.
I think I got a little freaked out when I realised that people, other than myself, were starting to read this blog! Obviously that is part and parcel of blogging, and I will just have to get used to it, otherwise I might as well keep a diary. There were a few other little things going on as well. I don't want to turn into a person who uses the words "liturgical abuse" every other sentence, but when members of the congregation get up to give notices in the middle of the Eucharistic prayer and the 100 Club draw takes place inside the church immediately after mass, using the altar as a convenient table on which to place the necessary accoutrements, it is somewhat inevitable.
So tomorrow, when I get my email full of health-related news I shall blog about something which is going on. And who knows, there might even be a snippet about my 12 confirmation candidates who may not know where in the Bible to find the Gospel of Matthew but do now understand the meaning of "consubstantial".