Why diabetes has made me detest clean eating even more

 

I bought a plumptious white peach on Sunday and perched it on the windowsill facing my desk so it could bask in my admiration. I tried to find pleasure in the anticipation of eating it but the important part – that a delay in eating must be voluntarily self-imposed to be truly enjoyable- has gone.

I was diagnosed with diabetes six weeks ago. My days of eating peaches without care are over.

These days I have to perform carb maths, tapping on my phone with fingers sore from multiple pinpricks. (How did people in the olden days cope without apps to help?) I conduct an internal dialogue with my pancreas and liver (please let me eat this!) in front of market stalls or  rammed up against a seething, hungry mass of humanity at food festivals. I hang around online food sites at 2 am in the morning when I am fitful from hypoglycemia or its hyper-odious sibling and torture myself with the Things I Cannot Have. It’s a form of self harm, I know, but it serves as a necessary part of accepting what has happened to me as I push myself up against my diagnosis. I can no longer leave any room for mistakes in a body that has become as confounding and wily as an old coyote.

The immutable reality of peach carbs (14-17g) meant it would have to replace the slice of wholemeal toast I prefer for breakfast and wouldn’t do at all as a mid-morning snack; I ensured I drank lots of water with it; I ate it slowly; I did ALL THE GODDAMN SENSIBLE DIABETIC THINGS.

By 11 a.m my blood sugars had shot up to ridiculous levels and what felt like a million tiny grains of sugar were needling me underneath my skin, prickling and itching and jabbing. There’s no drug on earth that can fully mitigate these sensations either; they take time to disappear, even after insulin or other diabetic medications return blood glucose levels to normal*. Not even antihistamine works (believe me, I have tried). It’s not itching in any sense that you might understand, rather it feels as if I am being pricked by a thousand needles from the inside. It makes me jump and twitch, my head pounds, my eyes and mouth become as dry as Dorothy Parker. By the time my husband came home I was about ready to burn the world down with fire.

I really, really hate the fact that fruit- and other carbs- have become loaded with problems. I am so resentful that I can’t just eat a piece of goddamn fruit. I have one overriding thought:

WHY WOULD ANYONE CHOOSE TO DENY THEMSELVES ENTIRE FOOD GROUPS IF THEY DON’T HAVE TO?

I am looking at YOU Gwyneth, Ella, the two Hemsley Sisters. Tess Ward and Madeleine Shaw (whose ‘chia seed egg substitute’ is about as appealing as toad shit) among many others. The fact that so many of you are women does not escape me. I’m calling it a form of dietary Stockholm Syndrome but you don’t get a feminist pass out of your self-imposed exile from joyful eating. Neither do I buy the argument that all clean eaters are psychologically unwell themselves. Some may well be, but does this also apply to the publishers and media organisations who make a lot of money from hawking dietary woo? Nope it does not.  You would take advantage of people like me if you could.

I don’t restrict carbs because I need to post photos of myself on balmy beaches hashtagged #blessed. I don’t restrict them because I erroneously mistake a full belly for bloat and I cannot cope with the idea of my body taking up more space in the world. I don’t restrict carbs because I have bought into a weird, sex ‘n death ‘n food vibe based upon quasi-spiritual concepts of denial and purity.

I CAN’T eat more than 40g of carbohydrate a day. Keeping to this is really difficult to do so I wonder why anybody would choose to live like this. It doesn’t hugely matter where the carbs comes from either which flies in the face of conventional dietary advice to diabetics, although carbs that take longer to be absorbed (brown rice, eg) are *better*.  I refuse to accept that anyone with taste buds will always think ‘oh yum!’ when offered brown rice over a piece of sourdough spread with good butter or a bowlful of cacio e pepe with a snowy covering of pecorino, or a tray of roasted root veg. A handful of cherries or juicy peaches are as damaging to me, blood sugar-wise, as a chocolate bar is at the moment. When it comes to sugar, my body doesn’t care if it’s the *worthier* fructose from whole fruit or the baddie du jour, glucose. It gets mighty pissed off if it’s lactose, too. My diabetes doesn’t give a shit about clean eating and prefers torture by a thousand sugar-needles over my old habit of negative self-talk if I over-indulged. If you want to get all biblical then let’s call it a damn hair shirt.

When you are told you cannot eat the foods you have always adored, it feels like part of you has died, never mind the dire warnings of actual death or blindness, renal and heart disease or the grim possibility that bits of you will literally start dropping off if you don’t maintain ‘good control’. (It doesn’t escape me that some of the language of diabetes care resembles the self-think of eating disorders**). I’ve not forgotten that time when as a HCP, I took a patient for an X-Ray and a blackened, diabetic toe rolled out of his sock as we removed it. I intend to die with all my toes- and toe rings- still attached to my feet because to paraphrase Kate Moss: “nothing tastes as good as having all your toes feels.”

I never did eat much white bread, white rice or pasta. I’m actually not a huge fan of pasta tbh. But when you can no longer blithely eat these sturdy workhorse carbs, by god you realise the fundamental role they played in your culinary repertoire. It’s really hard having to cook food for others that you cannot eat. It feels like an eating disorder that compels me to cook and serve my family with delicious food whilst I toy with a lettuce leaf and tedious lumps of protein in the next room.

To not be able to sneak a roast potato from the tray when serving up lunch unless you count its damn carbs like Scrooge on Christmas Eve? Horrible. Snaffling the end of the baguette on the way home from the bakers? No longer a spontaneous joy. Having to ask Leon or Pret for the carb content of everything you think you might be able to eat and having people look at you like you’re some kind of Gwyneth Loon-Disciple? Humiliating. Ordering drinks in pubs? Challenging because caffeine shoves me into hypos really swiftly and there are not many drinks that are sugar-free and caffeine-free. For those of you suggesting water, YOU try drinking it all night. I haven’t even addressed the joys of eating out in decent restaurants where it feels like an insult to ask the chef to accommodate you by leaving this or that from the finished dish. Yes I know I can just leave it but sitting in front of morsels of deliciousness knowing you cannot eat them is really, really shit.

Basically, when it comes to restricting food groups, the transaction will always be voluntary for clean eaters. They know they have a get-out clause. They know they don’t have to do it. If their resolve breaks and they decide to eat a slab of cheap chocolate or hunk of white bread, it ain’t gonna hurt them because despite whatever woo nonsense they believe in, physiological homeostasis really isn’t that precarious. Pretending that it’s a matter of life and death for them, that the food they willingly exclude is harmful to them (when it is not) is sickening. For those of us contractually obliged to no longer eat in abundance the kinds of food we love because our bodies have let us down, the exclusion is of a more permanent kind.***


* My diabetes is my diabetes. Yours may have different symptoms.

** That’s a whole ‘nother blog post on how diabetes can really mess with body image and food issues. Feel free to commission me on this.

***Yes I am angry I have diabetes. It’s rubbish.

Diabetes.org  

 

 

Why hygge and I are doomed to failure

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(Previously published in the print edition of the Bury Free Press.) 

It’s early October and already it feels more like a fresh start than New Years Day ever did. The latter’s odd meld of forced bonhomie, melancholy and lassitude from over-indulging never feels fresh to me.  New Year has instead, the air of the last day before we’re packed off to some dreary wellness rehab/ resort where they torture you with pints of daily tea made of moss and old twigs, foraged by a hippie with a manbun. January resolutions inevitably require us to reflect upon our previous misconduct and Vow To Do Better meaning our Fresh Start is already tainted with guilt and dreary low-rent Calvinism. I’m predestined to fail under those circumstances.

October is better. October is the season of mists,  a mellow kind of fruitfulness and- most joyful of all- entertaining twitter hashtags. Already we have #GBBO (my hate-follow because the miked sound of Mary and Paul chewing is worse than what we’d hear if they went to the loo wearing them) and #Strictly which is going to be JOYOUS because we have Ed Balls and his later-life self actualisation. To date Ed has given us pantomime boy-style capes, Elmer Fudd checks and a potted lesson in how to let go of the painful stuff without, um, RESOLUTIONS.

(Want to understand my weird obsession with him?  Check out this post on the website ‘Put Up With Rain’). It’s all Jess’s fault.

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Paso Doble, Ed style (Photo: BBC)

 

October is a slight bite in the early morning air and a Titian landscape; it’s woolly tights in hedgerow colours and lining the shelves of the cellar with mulled this and damson that. There’s boxes of new pencils and Cash’s name tapes to buy and blackberries to pick in the slanting light of the early evening. It’s the best time to get stuck into period dramas and boxsets, Netflix binges and publishers’ autumn lists filled with chunky cookbooks and the latest novel from your favourite author. The memory of brand new school exercise books and writing my names on them in my best handwriting is still acute. Yes, autumn is a time for making plans but it is also a time to batten down the hatches and consolidate what we already have and despite my enjoying modern conveniences and a local market teeming with bi-weekly deliveries of fresh food, at this time of year my atavistic settler genes run deep and I feel the urge to lay down supplies for the coming winter.

Last week I was reading about a new book (Hygge, a Celebration of Simple Pleasures) whose author urges us all to adopt the Danish way of living snuggly. There’s been a rash of books published on the subject (whiff of bandwagon, apart from those written by actual Scandinavians) and a lot of (albeit pleasurable) guff written about a concept which basically means ‘cosy’ but I guess there’s something in it because the Danes took the top spot in the United Nations World Happiness Report in 2016. In the interests of balance I should also point out that the Danes also take more anti-depressants than many other nations although this may well be linked to better mental health treatment and an absence of stigma.  They also have a lot of bacon which is associated with great happiness in my house, too.

V.S Naipaul was being very harsh on the Danes when he said, after winning the Nobel for literature in 2002, that ‘”If you are interested in horrible places, I can recommend Denmark. No one starves. Everyone lives in small, pretty houses. But no one is rich, no one has a chance to a life in luxury, and everyone is depressed. Everyone lives in their small well-organized cells with their Danish furniture and their lovely lamps, without which they would go mad.’ I personally would go mad without a decent lamp in the winter, without which I could not see to read (and it won’t be anything by Naipaul, the old curmudgeon) and there’s nothing wrong with a well- organized cell which is pretty much the only size of home a first-time buyer can afford anyway.

My problem with hygge is not based upon sweeping generalisations about an entire nation, although it can seem a bit Law of Jante at times. Charlotte Abrahams,  (the author of aforementioned book) defines hygge (pronounced ‘hoo-gah’) as ‘the absence of anything annoying or emotionally overwhelming’ which means that sadly I can never achieve hygge’s lofty goals because being emotionally overwhelmed by annoying things is my raison d’etre to be frank.

I have fallen at the first post.

Why?

Spiders.

Recently a news report on the FB page of my local paper, the Bury Free Press, struck terror into my heart. ‘At the beginning of autumn large male house spiders, gorged from a summer of eating moths and flies, start making their way indoors in search of a mate’ it told us. All I took from this was that OBESE SPIDERS ARE HAVING SEX IN MY HOUSE. My house, my home, my hyggelig-respite from the cruel world outside is full of spiders, entwined in the throes of eight hairy-legged passion and indulging in a bit of post-coital cannibalism too. (AKA the belts ‘n braces approach to GROSSING ME OUT.) Yes, yes yes I know its nature n’all but so are pustulant boils and who would want them pustulating in the corners of ones kitchen?

Greg Nejedly, a clinical hypnotherapist, offered some advice to those of us who don’t much care for spider promiscuity in the form of ‘taking deep breaths in order to…steer ourselves into a calmer state” which is probably less useful if you are reading this in Australia and a Sydney funnel web is bearing down on you. As someone who reacts very oddly to all manner of insect bites and forgets her epipen more than is good for her, I’ll forgo the calm breathing (and being a sitting duck) and rely instead upon good old-fashioned eviction techniques called a husband or anyone who is around except me basically. Another name for this is ‘you aren’t doing feminism properly’ from the mansplainers in the cheap seats.

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I feel a bit mean when I criticise hygge because it feels like I am kicking a particularly well-meaning puppy but there’s yet more barriers to ever achieving it in my house asides from my ability to shrink every pair of cashmere socks I’ve ever purchased. It’s called ‘living on one of the roads popular with homebound clubbers between 1-5 am in the morning’. Hygge embraces the concepts of togetherness and sharing which is why the inebriated residents of my fair town do love to share their loud voices with us in the early hours of the morning. Instead of being annoyed at the drunken sots arguing outside our bedroom window: the hapless men breaking up loudly with invisible partners on mobiles; the groups of weaving women who want to share with us, their rendition of some dire Taylor Swift anthem to friendship, I could go full-on hygge and seek to embrace and share too.

I could have a whole new career offering relationship advice (LTB) to wailing lovers via my open window or end them a bottle or she-wee so they no longer need to urinate against the house wall (yes, this happens). When my hyggelig deserts me I fantasise about recording what is going on and playing this lovely, mellifluous soundtrack at 6 a.m outside the homes of those club or pub owners who do not take seriously the problem of anti-social behaviour and continue to sell ridiculous amounts of cheap booze to already drunk people.  It’s impossible to feel cosy beneficence towards your fellow men and women when one is sleep deprived. Mess with my hygge at your peril.

 

A smell of apples- sense memory and anosmia

Public domain image, royalty free stock photo from www.public-domain-image.com

Bunny Mellon, the American socialite designer of the White House rose gardens and President Kennedy’s gravestone, kept pots of stewed apple bubbling away on the stove at her Virginia estate in tribute to the apple pies made by her mother. She understood the power of scent memory to create a sense of place no matter how vast the house or estate might be, taking visitors back to a simpler, less salubrious and more homely past, all the way back to childhood.

In her essay ‘Sense of Self’, Erin Byers Murray writes about childhood memories and of her mother and the many meals cooked by her, evenly divided between those cooked ad hoc with whatever was to hand, using a pinch of this and a dab of that, and the meals that were guided in like a plane via precise instructions in recipes torn from Southern Living magazine. Her mothers food tasted good but it was the functional ‘gotta get the kids fed’ style of cooking that was the bane of the lives of women, stripped of much of its sensual pleasure.

Then the accident happened that changed everything. A head injury stripped her mother of her sense of smell and taste (anosmia) when her olfactory nerves were damaged. Assessments determined that she was still able to differentiate between salty and sweet, albeit an ability which was now drastically reduced, and to a lesser degree, bitter and tart, but for some time, her mother put down the reins in the kitchen and the other family members took over.

Taste and scent memory is complex but this is what ‘saved’ Murray’s mother who, upon baking an almond angel cake by rote for a birthday some time after the accident- having made it hundreds of times before- realised that her mind’s ‘nose’ was being stimulated by the memory, imprinted deep within her psyche, of what this cake used to smell like. As almond essence dripped into the cake batter and was spun around the bowl by the beaters of the mixer, the scent that pervaded the warm fug of the kitchen might have been beyond her sensory reach but the recollection of it was as intrinsic to her as her ability to bake the cake from memory. And for Murry’s mother, it was enough- more than enough.

Her nerves didn’t magically regenerate and there was no wonderful TV movie recovery but she began to cook and that cooking was speculative and experimental, liberated from the constraints of sustenance cooking for children. What taste she did have could be challenged and stretched- made to work for her in combination with a new exploration of texture, appearance and mouth feel. The memories she possessed of the taste and scent of food commingled with this awareness of other qualities, ones she had paid scant attention to in the past. Her gustatory life became one of adventure and the stripping away of boundaries. It transcended the cultural mores of her native cuisine, took her to new places like Japan and Thailand and to many other lands with multi-faceted culinary aesthetics.

Take salt as an example of something we may use in a pretty straightforward manner even when our pantries contain several different types. Salt sharpens and delineates the flavour of other ingredients, uniting their parts into a whole greater than their sum. Salt is the bassline, the doo-wop, if you like, of our cooking and a useful facsimile of the world of the anosmic is to try to eat your food unsalted. You will be shocked by how blunted the different flavours are until, eventually, your palate adjusts. It does a remarkable job but how often so we consider what exactly that might be? Pure sodium chloride imparts intensity as its concentration is increased up to a subjective maximum above which no further saltiness is perceived. This ‘bliss point’, the stage at which the addition of salt ceases to increase our liking for a food varies from person to person- our salt preference is malleable. An anosmic would be at risk of adding increasing amounts of salt to overcome a blunted palate with the risk of distorting and overpowering other flavours in a way that a non anosmic wouldn’t be. However salt is of huge importance in sharpening a blunted palate too and many foods (soups, rice, eggs, and potato crisps), are pleasingly enhanced  by it. Salt is proven to heighten the perception of product thickness (texture). it also enhances sweetness, masks chemical off-notes, counteracts bitterness, and rounds out overall flavor whilst strengthening and intensifying it.

I imagine Murrays’ mother surrounded by heaping piles of salt: wafer-like flakes of Maldon from nearby Essex which melt instantly delivering a bolus of super saltiness and the pink chunky crystals of Himalayan which are the salt equivalent of time-release pills. Then there are the colours; an Indian salt stained pansy-purple, gritty as gunpowder, or the delicate Kala Namak- tinted ashes-of-roses pink. Vastly different is the dramatic Cyprus black salt resembling a miniature Giants Causeway in a jar with its basalt hexagons that are slow to melt, crunchy and charcoal-dank. I see her dipping a spoon into a jar of Le Petit Saunier salted caramel sauce in its Breton saxe blue and white livery, rolling its sea-sweet flavour from the sweet-spot on her tongue to the salty and back again. I think of her recoiling as the sting of malted vinegar and salt hits her nostrils when it is sprinkled onto searingly hot chips (fries) or running her fingers through the delicate and translucent crystals of Fleur De Sel from the Guerande, sold in beige calico bags, drawn closed with a string. I hope she can do all of these things.

We know that if we lose our sense of smell, we lose much of our ability to appreciate the taste of foods because the two are closely linked. If you don’t believe this, cut a lemon in half and bite into it whilst holding your nostrils tightly closed.  And we also see what we taste and smell as a unitary perception of flavour which is incorrect and is actually not a single ‘entity’ at all being made up of anatomically independent sensory systems.

There are psychological consequences to anosmia and what we can also lose is a sense of pleasure in life:  an anosmic can become disengaged, anhedonic, dysthymic. It is also dangerous- as Murray points out, her mother was warned never to live alone because leaking gas would not be discernible to her. Think of other warning signs- the sweet acetone of diabetic urine or a hint of smoke on the air from a fire; the hot and clean electrical whiff when an appliance overheats or the curdle of milk on the turn. Think of the fact that we all have our unique smells, imprinted on our own offspring within moments of birth and we all sense when a loved one (or a stranger) is nearby because of what our olfactory equipment tells us, a primal and instinctive alert system that helps keep us safe. Fear and heightened emotional arousal is often described in terms of scent (an acrid smell of fear), and we associate certain scents (and tastes) with comfort (vanilla is a common one). Indeed as the Tutorial on the Sense of Smell states:

“The uncus, phylogenetically part of the ‘smell brain’ (or rhinencephalon), is functionally associated with the whole limbic system (which includes such brain areas as the amygdala, hippocampus, pyriforn cortex and hypothalmus), which is increasingly recognised to be crucial in determining and regulating the entire emotional ‘tone’. Excitation of this, by whatever means, produces heightened emotionalism and an intensification of the senses.”

And anosmia can highly correlate with a risk of emotional lability, impulsivity and problems with adapting behaviour to the lessons of experience. It can leave sufferers derealised, as Dr Rachel Hertz explains in The Scent of Desire:

” I felt trapped inside my own head, a kind of bodily claustrophobia, disassociated. It was as though I were watching a movie of my own life. When we see actors in a love scene, we accept that we can’t smell the sweat; when they take a sip of wine, we don’t expect to taste the grapes. That’s how I felt, like an observer watching the character of me.”

The average human being may recognize up to 10,000 separate odours but our language to describe those odours is nowhere near as intricate. It is very hard, near impossible to explain what something smells like to someone who has yet to smell it and when we describe a taste, it is informed very much by its scent and how this marries with taste in our noses and mouths.

At a basic biological level our responses to smell and the anticipation of taste aren’t that much different to that of a Labrador dog with its Pavlovian reactions- a set of responses that prevent the dog (and us) from dying of starvation or developing malnutrition due to disinterest. We want to seek food out, prepare it in a safe manner (because scent and taste is potentiated by cooking methods that also effectively kill off bugs), digest and utilise it effectively. But as humans we also possess full and sub consciousness; the free will and layers of cognition that allow us to transcend that basic stimulus-response mechanism and interpret, manipulate and filter the messages we receive from our senses.

In the first few months of independent life (as in independent from our mothers placenta) we display a predisposition towards the inherent sweetness of breast milk and all human babies show some aversion towards bitter foods (eat brassicas for a day while breastfeeding and see your newborns reaction) which is most likely an evolutionary throwback to when we needed discouragement from eating poisonous foods. The ever changing nature of breast milk, which is in part a result of the mothers diet, also primes an infant to cope with our human omnivorous diet and as their kidneys develop, a taste for salt emerges which roughly correlates with the time at which many babies begin to be weaned and are, as a result, exposed to higher salt levels. All other preferences are learned behaviour and that learning is so strong that unlike a Labrador, we may not overcome our dietary taboos and predilections, no matter how hungry.

Along with those dietary taboos, aversions, phobias and fads we develop strong gustatory and olfactory memories where time, place and food meld in such a way as to transport us back decades in time through our senses. This confluence functions as a way of reinforcing family bonds and developing new ones, as a way of heafing us to our territories (no matter how wide ranging or compact) whilst also encouraging us to fan outwards towards new people and places- a handy way of discouraging genetic overfamiliarity when we decide to breed. We learn to guard against foods that don’t suit us and help reinforce affection and attachment to the foods that we can easily grow and eat. We learn that food is love.

It is possible for us evoke the past so viscerally because of our ability to build emotional content into what we sense; conjured up by what we hear (the clink of Sheffield steel against a china cake plate, the sound of boiling water being poured into a teapot, the paper dry rustle of a corn husk as we wrap a tamale), by sight and via our tactile encounters.  These memories and experiences are multi sensate, multi causal and have layer upon layer of meaning. Taste without context does not exist and I’m not sure we are capable of unpicking all the strands. Nature is not more complex than we think. It is more complex than we can think.

And the power of these memories! Walking along the banks of a Sardinian river one unusually hot late spring day, a sudden drench of rain penetrated the clay of the path. The air became sodden with water vapour and impregnated with the unmistakeable smell of the clay goblets and jugs used by our housekeeper in Mexico. As a child I was mildly obsessed with this roughly glazed pottery and I would nibble away at the gap between the top of the glaze and the rough clay rims. Bordering upon pica, the earthiness permeated the contents- water sharpened with a squeeze of local limes. All our drinks tasted of clay and were imbued with the love we felt for Maria and the bridge she created between two worlds, Latina and European. As I stood by that river I felt the heaviness of the goblet, so large in my five year old hands and my vision narrowed to what I could see over its rim. The clear light of the Sardinian mountains turned heavy, dusty and straw-yellow as I went back to our Saltillo kitchen and a light that shot in through the gap at the base of the heavy blinds, which had to be kept drawn in the day to keep out the vicious desert sun. It was confusing and surreal.

Erin Byers Murray’s mother instinctively knew what she needed to do to live fully in the world rather than continue to tolerate a gustatory existence diminished of colour, sense and the opportunity to make fresh memories. That almond cake was her Proustian moment in a far more significant way because it guided her towards a new future as opposed to Proustian wistful musings about a lost past. It is also a less frivolous example than that a stratospherically wealthy woman able to afford to keep pots of apples bubbling on the stoves of her many homes, but it is no more or less touching. Both women were negotiating the tricky present and future by invoking their sensory past.

Fifth Sense.org

Parosmia Diaries

More reading: The Poetics of Smell as a Mode of Knowledge on Brainpickings and The Science of Smell: how the most direct of our senses actually works, also on Brainpickings.

Why do we struggle to talk about menstruation?

Many of us still struggle to talk about menstruation and when it is discussed in the media, there is often a hostile response from men and women who clearly find the topic uncomfortable. However when this results in discrimination and additional pressures on girls and women in developing countries and war zones where their access to sanitary protection and toilet facilities is limited, women and men in the west have a duty to speak out. 

When Heather Watson crashed out of the Australian Open she coyly alluded to the reason why her game was sub-par, ““I think it’s just one of these things that I have, girl things” breaking what many commentators describe as a taboo in sport- the discussion of how the menstrual cycle may or may not affect performance and resulting in a few press articles.

White running shorts and periods...a no no?
White running shorts….

Is there a taboo about discussing it in real life or is it a case that the real life situation isn’t reflected in the media coverage and if this is the case, then whose ‘fault’ might that be? The British hockey player Hannah McLeod, in an interview with the Guardian where she talks about her own team-mates attitudes, claims that “we talk about it all the time…it comes up very frequently” then elaborates further, stating that on day one of their period, each member of the squad has to email their strength and conditioning coach, Ben Rosenblatt.

It is refreshing to learn that Rosenblatt creates training programmes that reflect the menstrual status of each hockey player in McLeods team but research into the effects of menstruation and the cycle itself on performance offers inconclusive and variable results. The Melbourne-based sports physician and Chief Medical Officer for Netball Australia, Dr Susan White stated:

“World’s best performances have been recorded at all stages of the menstrual cycle, including the pre-menstrual and menstrual phases.” She added, “There is one study in Italy that indicates female soccer players may have a greater injury risk before and during their menstrual periods. It is unclear whether it was because of physiological or psychological factors or a combination of them. There are no other studies at this stage that support this research.”

New research in the European Journal of Applied Physiology (2011), investigated the effects of the menstrual cycle phase using eleven rowers, concluding that not only was their endurance performance not influenced by a normal menstrual cycle, their energy expenditure, oxygenation and heart rate were also not significantly different during the menstrual cycle phases.

These studies are focusing upon ‘normal’ menstrual cycles though and are not concerned with the psychological and social impact of menstruation either. It is fair to assume that elite sportswomen pay as much attention to the fine tuning of their reproductive health as they do to all physiological functioning and it is also reasonable to assume that the assessment and evaluation of their cycles would be a normal and unremarkable aspect of their lives. The pitfalls of menstruation and any inhibition about discussing it must surely lie with the school playing fields, the changing rooms and everyday sporting lives of women at non-elite level. There is also the wider implications for women performing in any work place and public sphere where scrutiny is high and easy management of it is limited or complicated, What do women in the forces, women who live and work in poorer nations or isolated parts of the world (Antarctica) and beyond (the space station) do?

"Houston we have a problem. I've just come on"
“Houston we have a problem. I’ve just come on”

Remember those days of coyly approaching the (often male) PE teacher before swimming or cross country to tell him that it was ‘that time’ and therefore you might need to be excused ot have close access to a toilet? Remember the anxieties of using sanitary protection under skimpy and stretchy gym-knickers, leotards and skirts if you were yet to graduate to tampons? Remember the fear of accidents when wearing tennis whites? British tennis No5  Tara Moore does, and has spoken out about the nightmares she has about getting her period during Wimbledon, not just because it might affect performance, but add in the horror of white skirts, blood and the banks of press photographers there to capture the moment. Moore is not the only woman engaged in an open dialogue about menstruation and leakage. Check out the instagram feed of Mayan Toledano ( @thisismayan) for the image, below, which caused many complaints- that of a woman wearing underwear stained with blood. Mayan owns a company that makes underwear and clothing with a strong feminist ethos.

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Image by Mayan Toledano of @its_meandyou / http://www.itsmeandyou.com

It is hard to unselfconsciously tumble across a gym-mat or upside down on a trampoline when you fear all eyes are on your crotch. Girls and women who suffer from excessive bleeding, severe pain or unpredicable cycles face even more problems and when you remember that the menstrual cycle can take a few years to regulate itself in a young girl, we can see that the problem is not a rare one, and something that teachers or care givers would encounter frequently. So what is the impact on ‘ordinary females?’

Researching this article and soliciting requests for comments led to multiple requests to use ‘first name only,’ especially from younger women. Many said they had no problems asking fathers, brothers and boyfriends to buy sanitary protection for them, they also had no problems letting the males in their life know they were having a period. But they all baulked at being identified in this piece. As Emily (19) who is a keen runner, said,

“I don’t think I am ashamed of having periods but it is embarrassing and I don’t want to become the local poster girl for it.”

I spoke to girls competing at county and regional level in gymnastics, ballet, boxing and contact sports, horseriding and long distance running and while all of them applauded Heather Watson,

she has opened the door to a more realistic conversation about how women manage when they work or compete at a high level or in difficult conditions” (Sarah, dancer in her late twenties),

they were reluctant to identify themselves. As Louise explained,

“I am happy for my boxing trainer to know that my abdomen is tender and bloated and ‘yes I do need a toilet break every twenty minutes because my stomach is upset’ but I don’t necessarily want the whole world to know that, let alone my opponent.

Sarah spoke of the proximity of ballet and dance, of being lifted by her male dance partner who has “his hands in my armpits, my crotch, between my legs (during lifts). Your partner odten touches your stomach and because we are so attuned to each others bodies and how they move and perform, they can feel when I have pre menstrual bloating.” She laughs and agrees at the suggestion that they are more in tune with her physiology than her husband:

“I am not embarrassed about that but…the audience, the stage hands seeing any leaks..then I have seconds to change a tampon in some of the more demanding ballets when I am rarely off stage. I’ll let you imagine what dancers end up having to do and those costumes, the classical ones and all in one body leotards do NOT come off easily or swiftly.”

Sarah is keen to get the point across that dancers tend to be very earthy about their bodies,“they are tools” but despite this, she still feels anxiety about her ‘tool’ letting her down and bleeding visibly in public.

Interestingly, discussion around the management of menstruation pointed out issues with the rules on the use of medication and herbal aids which means that many painkillers and drugs that affect prostglandins (a useful way of reducing cramps) may not be part of the box of tricks available to them. As Emma said, 

“The drugs that work best on pain and stomach cramps make me woozy and disinclined to get off the sofa. And the nature of my sport (roller derby) means that I compete all the time so taking the pill to postpone or stop my periods would mean I’d probably never be able to have one. Which makes me worry because I think it is healthy to have periods ” Her conclusion?  “I am left having to manage it and hoping that the world won’t stop turning if I accidentally leak because things are at the heavy stage- I think I’d take a few weeks to feel I could show my face in public again if that happened and that there’s always the risk that I’ll be all over the internet, being laughed at.”

Emma echoes a lot of women in her belief that it is not ideal to prevent menstrual periods over long stretches of times. A period offers a woman a mini health-status report every month. Regular menstruation that is not overly painful or troublesome tells us that our system is balanced, that we are neither too underweight or overweight. It is a good indicator that we are not becoming overly stressed, that we are not pregnant, that our uterus can prepare for implantation and that we are not yet approaching menopause (important to know if you are planning a family in the future). Take them away and despite their nuisance value, we might feel something is amiss.

Those white shorts again.
Those white shorts again.

The euphemisms about menstruation don’t help an open and frank discussion though. Girl thing, time of the month, Aunt Flo, getting the painters in, wading through the Red Sea; they are many and varied. Same for assumptions, sterotypes and misapprehensions about the physiology of the menstrual cycle and its effects, some of which were mentioned by other elite sportswomen in their reactions to Heather Watson’s statement. Here’s former tennis player Annabel Croft: “It was quite sweet, the way Heather said it…you are quite emotional at that time.” Not all women experience heightened emotions during menstruation and her words had that weird undercurrent of unintended infantilism and internalised stereotypes common to the way the behaviour of menstruating women is depicted. Hence the scene in 30 Rock which saw Amelia Earharts disappearance whilst attempting to fly across the Pacific being blamed upon the unexpected arrival of her period. Go down that road and you arrive at the ‘menstruating women are unpredictable and unreliable’ belief that keeps us out of the boardroom and the sporting field.

Many religions and cultures codify elaborate rituals and rules about how a woman must behave during her menstrual period. For Orthodox Jews, the Old Testament stipulates a woman is unclean during menstruation but the Talmud goes further, stating that her period of uncleanness lasts for an additional week after menstruation has ended.

“And if a woman have an issue, and her issue in her flesh be blood, she shall be put apart seven days: and whosoever toucheth her shall be unclean until the even.” Leviticus 15:19 (KJV)

Niddah is the word used to denote the menstruating woman and her period of uncleanness which defiles everyone and everything she touches. She may not have sexual intercourse with her husband either. His existence is the perfect state, the default setting for cleanliness and a woman risks contaminating that. Only the ritual bath (“mitweh”) at the end of the period can render her fit to return to family participation.

Islam emphasises the normality of menstruation whilst regarding its blood as unclean (najis) although this inpurity should not prevent the woman from leading a ‘normal’ family life. However entry to the mosque and touching the writings of the Qur’an, the names and attributes of Allah, the names of the Prophet, the Imams and Fatimah (the daughter of the Prophet) are forbidden. The Qu’uran has this to say about sex during menstruation:

They ask you about menstruation. (O Muhammad) tell (them that) menstruation is a discomfort (for the women, it is a period when they pass through physical and emotional tension. Therefore,) do not establish sexual rela­tions with them during the menses, and (again you are remind­ed that) do not approach them (sexually) until the blood stops.”

In Uganda and Nepal, teams of people are tackling the challenges menstruation has for local girls, both as a taboo and the resulting issues of hygiene and social exclusion which sees school attendance plummit. The cultural tradition of Chhaupadi in Nepal, believes menstruation to be polluting and harmful to others, meaning females must remain isolated, abstaining from contact with other people, often in what are called ‘menstrual huts’ with their attendant poor hygiene, risk of disease and horrendous stigma. In Uganda, many menstruating girls are prevented from cooking food and banned from carrying newborn children. Girls in Uganda face less social restriction during their periods, but for them the fear of the consequences of inadequate sanitary protection means they avoid school and social activities. Teasing from peers and even teachers is a common occurrence.

The same problem has been reported in other African countries and across India too where school attendance past the menarche drops off drastically in poorer, more rural communities. UNICEF reports that “in countries where menstrual hygiene is taboo, girls in puberty are typically absent for 20% of the school year,” with many girls dropping out at around 11 to 12-years-old. They may also miss school because they are not educated about their periods, and neither is the school which thus fails to provide secure, discreet and clean toilet facilities for them.

The word ‘blessing’ is derived from the Old English for ‘bleeding’ and indeed the menses were once regarded as a sacred mysterious event being as they were then, unexplained, linked to the even more mysterious moon and part of a cycle of fertility that begat life. In the Americas, some Native American tribes celebrate and revere them- Apache tradition calls girls at menarche “Changing Women”, and later on, “White Painted Women” whlst Navajo girls run towards the rising sun. However the Sundance ceremony sees menstruating women segregated to their own dancing area so as to act as counter balance to the energy flow of the main dance.

Some women are reclaiming this worshipful attitude yet I am extremely wary of what I call the ‘woo’ side of menstruation activism: all that Mother Earth and menstrual goddess rhetoric; the worshipping of the menarche as a sacred rite of passage, elevating its status as culmination of the fertility cycle and the sole ability of the female to bring forth a new life tend to leave me cold. Yes, when you consider the odds, the fact that women get pregnant at all can be awe inspiring (so many ‘if’s and variables) but the whole of our fertility has an easy biological explanation; our uteri are not ‘mysterious.’

Elevating the status of menstruation is one end of a spectrum that sees the less celebratory rituals that isolate and shame women at its opposite end. They take what is actually a biologically practical solution to a product we no longer need-the spongy endometrial build up- and imbue it with a spiritual ‘woo’ side that cloaks it in layers of ritual and cultural rules, albeit women friendly ones. Seeking to make the explainable more mysterious in order to reclaim it from misogyny and misunderstanding is not the way to break away from taboo as it risks alienating women who wish to shrug off their embarrassment but who do not want to publicly discourse about the nature of their menstrual blood or celebrate something which can be significantly physically debilitating. No matter how positively you embrace or re-frame menstruation, it is often inconvenient, physically uncomfortable for many and downright painful for some. There are women (and men) who want to tackle the taboo of menstrual talk without attaching any special spiritual significance to it.

Reclaiming the celebratory ‘woo’ side will, I fear, allow men to cop out of trying to understand (‘womens stuff’) and also encourages the idea that hormones and periods cause us to become unpredictable, mysterious and capricious. I do not wish to give the impression that I rise with my red hair and eat men like air at certain times of the month. Nor do I wish to be defined as a woman who is prone to eating loads of chocolate, throwing tantrums or requiring special treatment because I am some kind of menstruating goddess creature. More seriously, imbuing menstruation with a spiritual and celebratory aspect is not very different to those menstrual huts and ritual baths which after all, are the sum total of men and women trying to explain and then contain what is/was to them, the mysterious and the indefinable.

What we do need however, is greater equality in sports commentary, reporting and representation. We will not get a practical and objective evaluation of the ways in which a womans fitness and sporting ability can be affected by her menstrual cycle when the world of sports media is, in itself, so male dominated. We will not see intelligent and sensitive sports reporting that understands the impact of female biology- something that is simply not on the radar of most men. Do young girls risk losing an interest in sports at puberty because of fears about their appearance and the difficulties of managing their periods? We need to research this and make a space for their experiences to be heard and by doing this, we will help prevent this from happening. Oh and we might end up with more than one toilet break per set for female tennis players at Wimbledon and better designed sanitary protection too.

A NOTE-

Donating money to charities, blogging and tweeting about the issue all helps frank discussion too. Please check out the links below. In addition, women in Syria and similar war zones face added privation. Please read this article which tells you more about their plight and what you can do to help.

 Think Africa Press

Luna Pads

Donatepads.org

 Afripads

Sanitary Pads downloadable patterns

The Indian Man behind a sanitary pad revolution

The ‘This Girl Can’ campaign is still about our bodies

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‘Sweating like a pig, feeling like a fox‘ goes the latest Sport England campaign designed to encourage women to take more physical exercise and feel better for doing it. Did I say feel better? What I, or rather the ad appears to suggest is that even during sport and physical exercise, we women apparently never escape the confines of our sexuality and the (presumably) male gaze – even when we are sweaty and really really busy doing something else. Women may feel free in the gym but really we are still in chains.

Some of the words and images used suggest that a womans sense of self must incorporate an awareness of our sexual attractiveness as we participate in sport. This surely runs counter to an important goal of physical exercise-  transcending the limitations of body and psyche caused by our conscious and subconscious thoughts. I cannot see any other explanation for the use of the curious term ‘fox.’ Surely sports should allow us to walk away from the travail of worrying about how we appear to others and we should only be judged, if any judgement is required at all, on our sporting prowesss and achievements and nothing else?

This Girl Can, a campaign launched by Sport England aims to encourage more women to take up sport and physical exercise and is backed by celebrities including Clare Balding, Dame Kelly Holmes and Sally Gunnell. It kicks off with a TV commercial peopled by women of all shapes, sizes and ages participating in a raft of sports and physical activities. Created by the ad agency FCB Inferno, the 90 second ad only uses ‘normal’ women set to Missy Elliott’s Get Ur Freak On and is backed up by a nationwide poster campaign with said same women from all walks of life with banner slogans such as the aforementioned pig/fox and ‘I jiggle therefore I am.’

Back in the late eighties, even misogynistic anti semite Mel Gibson, or rather the character he played in ‘What Women Want’, working on a sporting ad campaign with costar Helen Hunt, came to the conclusion that sport should allow a woman the time to shrug off her self consciousness and psychological chains. We appear to have moved on very little from this (albeit imaginary) scenario.

Nobody is under any illusion that female athletes are judged solely on their sporting ability and we have only to look at the bile directed at Rebecca Addlington regarding her looks to see that. And the way they are spoken about in the press is still very much predicated upon their looks and sex appeal as are some of the endorsements and contracts they attract. Any pride in their physicality, hard work and the success it brings is marred by constant reminders that it is female physicality and therefore it must be appraised sexually and aesthetically.

This Girl Can continues our obsession with female flesh, encouraging us to disregard the fact that we wobble and jiggle, have cellulite and uncontrolled flesh spilling out of our clothing. The fact that we are depicted as casting off our shackles- our Spanx, control tights and body taming underpinnings, to let ourselves take up a bigger unfettered space in the universe is undermined by the drawing of attention to those perceived flaws, whether or not it is us that sees them as so, or a sexist society.

Jennie Price, chief executive of Sport England talked about some of the barriers to the participation of women in sport:  “One of the strongest themes was a fear of judgment. Worries about being judged for for being the wrong size, not fit enough and not skilled enough came up time and time again. We want to address that.” Yet the video, despite being beautifully shot, still worships at the cult of the body, objectifies the bodies of those filmed and makes those gazing upon them passively complicit with this. Whatever the intent was to redefine what kind of female body is acceptable, the campaign is still concerning itself with parameters and makes no attempts to defy convention.

If female flesh mattered not one jot in the gender scheme of things it would go unmentioned as it does in sports campaigns aimed at men which tend to highlight the skills, prowesss, work and effort required. A mans appearance is related very closely to utilty and functionality, ideas rarely associated in advertising about or aimed at women. They don’t use male flesh to tell men they want them to not focus on their flesh and they do not invoke an unwelcome gaze. Even more importantly, campaigns aimed at men do not tell them they need to disregard their physical flaws, either imagined or actual. By saying ‘disregard’ you are stating that there is something TO disregard and the psychology of self consciousness, of shyness and body unconfidence will hone in on that like a javelin.

Equally important is the worthiness and higher moral purpose that must come attached to many female activities, including what we’d imagine as something relatively uncomplicated- sport. Where is the argument for exercise for the sake of exercise? Exercise that is enjoyed purely for the simple pleasure in physicality it generates? Instead of a pure and uncomplicated relationship with their corporeal selves, women are encouraged to take part in order to strengthen friendships, manage and reduce the stress caused by work, parenthood and caring whilst improving our emotional and physical strength. There is no strong case made for pure unfettered, unintellectual and unanalytical pleasure, no case made for total abandonment to the testing of ones body against standards that have nothing to do with how it looks to others. There is no permission for women to exist solely for themselves nor are we permitted to exist in the moment purely for that moment, free from intrusion.

This campaign has good intentions but at the end of the day, it is still reminding us that we women have a mountain to climb when it comes to equality in sports and it is not handing us the best equipment with which to climb it.

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#BackOff- why women seeking a termination need a safe space

Watch the clip below which shows a pregnant woman taking umbrage with anti-abortion activists standing outside a BPAS clinic in London. The activists are filming women as they attend consultations, and they wear recording equipment around their necks. Initially they denied filming when she challenges them but watch their capitulation. The clip by  helpfully illustrates the need for the BPAS recent #BackOff campaign which seeks to protect women from harassment and filming by anti abortion groups on British streets.

 

Aside from taking a moment to marvel at her general awesomeness, we need to stop and think about some of the wider ramifications of allowing people to harass women in public spaces and whether the law should indeed be amended to make this either a criminal act or more easily dealt with through a civil claim.

The British Pregnancy Advisory Service have recently launched a campaign to address this issue:

“The government is being urged to take action to protect women attending pregnancy advice and abortion centres amid an escalation in anti-abortion activity. The Back Off campaign calls for the establishment of zones free from anti-abortion activists in the area directly around registered clinics and pregnancy advice bureaux. 

“Women attending these centres are now regularly exposed to groups of anti-abortion activists standing immediately outside. Many of these people bear large banners of dismembered foetuses, strew pathways with plastic foetuses and graphic images, distribute leaflets containing misleading information about abortion, and follow and question women as they enter or leave. Often, these people carry cameras strapped to their chests or positioned on a tripod. Women report feeling intimidated and distressed by this activity as they try to access a lawful healthcare service in confidence.”

The frustration of BPAS with the current laws on harassment and public order is apparent:

“The police have made clear that the legal options to counter this activity are limited, and attempts to use the Public Order Act to curtail their activities have not been successful. Appeals to the churches who support these people to reflect on the impact on women have failed. We echo the recent comments of the judge in the case of harassment outside the Marie Stopes centre in Belfast, who made it clear that it was entirely inappropriate “for anyone to be stopped outside this clinic in any form, shape or fashion and questioned either to their identity, why they are going in there and being forced to involve themselves in conversation at times when they are almost certainly going to be stressed and very possibly distressed”.

Ann Furedi, chief executive of the British Pregnancy Advisory Service, commented further:

“One in three women will have an abortion. These activists don’t stop women needing abortions, they simply make what is already a difficult day that much harder. Women should feel confident that they can approach centres for pregnancy advice and abortion care without fear of intimidation, or anxious that their identity will be compromised by protesters filming outside. Establishing zones free from anti-abortion activists around clinics would provide the reassurance and security women need. There is absolutely no need for the space outside clinics to become a battleground. Wherever one stands on abortion – pregnant women deserve better than this.”

Whenever I butt heads with people claiming to be ‘pro-life’ (or anti-abortion as I prefer to refer to them) what I find most astonishing is their belief that their right to demonstrate trumps a woman’s right to obtain medical and nursing care, unmolested and with dignity maintained. Any supposed concern for the sacred vessel of the pregnant female form does not extend to caring about the effects their intimidation might have upon her and her pregnancy. As far as they are concerned (and I draw my conclusions about it from their actions) her rights will always come second to their right to challenge her.

People should be able to express their views but what anti-abortionists are doing in this case does not constitute an appeal to politicans or even a show of hands. It is not intended as an entreaty to those that make the law. What it actually is attempting to do is frighten, humiliate and bully a pregnant woman into doing what the protestors want her to do. Women attending the clinics cannot feel assured that these strong-arm tactics with their undercurrent of aggression won’t erupt into outright hostility and they run the gauntlet of these protesters in the knowledge that medical staff at American clinics have been murdered by anti-abortion activists.

The protesters intend to make accessing health care (which may or may not include a termination) such a perceived and actual risk to a womans privacy and dignity that she would rather not do it. And if she does, the emotional and psychological damage from this harassment may be far greater than any residual effects of the termination. The threat of public exposure is NO basis upon which to make a decision to have a child or not. It is a particularly vicious form of blackmail that says: use a clinic that offers terminations and we will put the film of you walking up its steps online.

Research into Post Traumatic Stress Disorder (PTSD) has shown a positive correlation between severity of symptoms and the perception of threat during the trigger event(s). PTSD has also been diagnosed in the people who work in these clinics because of the threatening conditions they work in. The development of mental health problems may thus occur in women who eventually decide against a termination after using the clinic, flying in the face of the apparent concern these protestors claim they have for women and their unborn foetuses.

The anti-abortion protesters claim that they are not harassing women ( according to our current laws), because each individual episode does not constitute the course of harassing action required for successful prosecution. They claim that the freedom of speech is an inalienable right. and it is, but only if that speech is not seen as harassing, threatening, intimidating and a deterrent to seeking lawful treatment- an abortion. These individual ‘actions’- all the separate women approached and harangued over the course of the day by anti abortionists- should be cumulatively aggregated so the offenders could be prosecuted through the courts.

As things stand now, should a woman decide to pursue a claim of intimidation against her, current legislation requires making a complaint to the police about each individual instance or episode by each individual harasser. So on top of the breach of privacy endured by a woman, further invasions of privacy is incurred through the necessary reporting and subsequent legal action. She will have to make a statement, identify those involved, engage legal representation, attend court, possibly be questioned and endure any media exposure that might result. And the activists know this.

Let me describe some of the harassment that women are exposed to as they try to access advice, support and possibly a termination through a clinic such as the ones run by the BPAS. These tactics also impact upon staff working there or in nearby clinical facilities:

  • Having leaflets and graphic images of dismembered foetuses thrust into their hands, pockets and bags. Or waved directly in their faces;
  • Pregnant staff require escorting into and out of the clinics by police, private security or other staff members;
  • Staff are verbally intimidated and harassed. They are identified to passers by in a pejorative manner;
  • Women are given incorrect information designed to frighten or trigger guilt;
  • Having bibles and religious tracts thrust into their faces;
  • Being screamed at, shouted at, asked intrusive loaded questions, asked about their pregnancies;
  • Having to find their path through a gauntlet of people all seeking to make it as hard as possible to find a way into the building.;
  • Being confronted with graphic large posters that line the street leading to the clinic, making it impossible for them to maintain a low profile;
  • Being filmed and recorded by cameras and video recording devices;
  • Having to fear the footage of their entrance to the clinic being put on a public viewing platform such as Youtube;
  • NHS staff on premises where a clinic is located have felt so intimidated by the protestors outside they have asked for the abortion service to be withdrawn from the facility where they work;
  • Losing their anonymity, something enshrined within NHS policy and the policy of private health care providers.

The anti-abortion protestors will again maintain that they operate within the law. Claiming that it is ‘legal’ and therefore permissible is a facile argument because the law is fluid and changes all the time. It used to be legal to send ten year old children to work in cotton mills but that does not mean that it was right and fair at that time. The rules and legal conventions of a society may be created in a post-hoc kind of way because, (as is often the case), they are preceded by the acts that make them necessary.  Amazingly enough, there is no definitive legislation that stops people filming members of the public as they use health-care (with or without their knowledge), even if it might be an offence to publish those images without their consent. Filming under these circumstances needs to be stopped and women (and the men who respect them) are demanding change as a direct result of their own lived experience.

Many of the British based anti abortion activists are supported by the even more virulent American organisations who have the right to free speech enshrined within the First Amendment, which has no literal legal equivalent in the UK. Unfortunately the protestors appear, at times, to conflate free speech with hate speech, and the latter is something the UK does legislate against. It is up to the law to clarify this in relation to what is said to women by protesters in the public spaces outside clinics. As it stands now, a woman can pursue individual claims of harassment under the Public Order Act but these would have to be multiple named claims (same as before) against each individual which (again) further reduces her right to privacy and anonymity. Anti-abortion organisations must not make the mistake of believing a lack of pursuance under harassment laws means that women do not feel harassed by them. Claiming that women aren’t that ‘bothered’ about their protests and using this as basis to justify their continuance is disingenuous. Women are not going to use an equally troublesome and archaic legal system that makes is near impossible to gain adequate sanctions. The same limitations apply to the clinics themselves. Each one has the option of taking out restraining orders against individuals or a group, but this is costly, time consuming and the protestors merely circumvent this by reorganising themselves under a new organisational name.

The right to protest is a legal right, enshrined in UK law by the European Convention on Human Rights. The European Convention on Human Rights recognises a right to peaceful assembly in its article 11. It also recognises a right to freedom of expression, allowing individuals to express their opinions. In the UK, by law an organiser of a demonstration must inform the local police of their intentions, six days prior to the event and the police have the right to make any changes to that demonstration that they deem necessary. However, anti abortion activists circumvent the law on protests by organising themselves as a gathering (legally called ‘an assembly’) in a single location and they do not move from this location. In addition, they organise multiple single gatherings at every clinic in a region that offers termination of pregnancy.

These protest assemblies are different from marches because the organisers do not have to notify the police but the police retain the right to impose conditions on an assembly, if they feel they are necessary to prevent serious public disorder from taking place, or if they feel that the purpose of the gathering is to intimidate others. As with the law on protests, the police have the right to amend the location of an assembly, limit the number of attendees and shorten the length of time any protest runs for. It is this part of legislation which could be made more appropriate for anti abortion protests outside clinics.

Adopting a ‘buffer-zone’ will not fully protect pregnant women from people seeking to impose their views upon them and it will not stop those people from demonstrating in the street or in the vicinity of the clinics. But what it will protect against is pregnant women having their actual personal space invaded: it will protect them from being filmed and photographed and the subsequent placing of the film online; from having literature pushed upon them; from having people questioning them at a distance of less than several feet, jostling and acting as a barrier between the woman and the care she seeks out. It may be feasible to enshrine new legislation in a similar fashion to that which exists for research facilities where animal experimentation takes place: clauses were included in the Serious Organised Crime Act and Police Act 2005. These did not ban all protests or free speech but provided a corridor of protection where women and employees could move in and out of the vicinity free from harassment and infringements of personal space. It also made it easier to protect their cars from attack from people placing incendiary or other devices underneath them, an act of issue- terrorism. (These attacks have also happened in other nations where abortion is illegal.)

It is an incontrovertible truth that the abortion rate remains pretty stable and similar whether abortion is protected by a countries laws or not. It is an incontrovertible truth that making abortion illegal correlates with a high maternal morbidity and mortality rate. Making abortion illegal will NOT result in more women choosing to give birth or hand over their newborns for adoption. Instead they will seek out an illegal abortion and they will seek it with the same determination, courage and strength that sees them successfully negotiating the threatening hordes of demonstrators outside clinics in order that they retain reproductive autonomy and body agency. What DOES reduce the rates of abortion is excellent and early access to education in contraception, in relationships, sexuality and autonomy alongside easy (and inexpensive) access to contraception. It is not a coincidence that many of the groups opposing lawful access to termination of pregnancy also oppose sex education in schools and the provision of contraception to teenagers.

What I find especially arrogant about the act of foisting anti abortion literature on women whilst they attend clinics is the presumption that the women actually need that information at that moment in time or are receptive to it. The act of gaining permission for a termination under British law involves plenty of opportunities to inform oneself as one goes through the legal and clinical protocols. Women talk of the hours of thought expended in coming to a decision to terminate their pregnancy or not to. Behind the anti abortion lobby lies a profoundly anti women rhetoric, built upon paternalistic ideas of women being undeserving of full agency; of displaced jealousy over their ability to conceive and gestate children; of needing male input and control of their decisions. This rhetoric is usually underpinned by a religious justification- religion being the ultimate in patriarchal systems. Women are NOT coming to these clinics to engage in a debate and if they had doubts in their mind then this is a conversation to be had, not in the street with a total stranger, but with trained professionals or  with family in a protected and confidential space.

One in three women will choose to have a termination of pregnancy and I feel a measure of quiet pride that I live in a country that is still supportive of that right. I also value the right to protest but this must NEVER take precedence over a woman’s right to obtain advice, support and the treatment of her choice in an anonymous, discreet and protected manner. The right to protest is not harmed by the womens right to not be protested at directly outside a medical facility. There are plenty of opportunities for those against abortion to make their feelings known, both online and in the larger world. We must not become a society where decisions are fueled by fear of exposure and approbation by those who do not have to stay and face the consequences of those decisions.

For more information and support, contact the British Pregnancy Advisory Service

 

Guardian newspaper infographic

Here come the #HeadClutchers – images of mental illness in the media

If you are thinking of writing an article on mental health and illness, why not use our handy guide to some of the most popular and predominate images of this in the media- the ones that are the symbolic and metaphorical equivalent of a brick over the head in their subtlety, bearing little accuracy to the lived experience of people.

Clearly media folk are super important and very busy so we’ve decided to save you having to think at all about how you depict mental illness and mental health problems. So let us help you with those important editorial decisions.

The first one is the most critical. It is vital that all images of people with mental illness convey the levels of their despair in the most terribly obvious manner and the easiest way to do this is by use of the #HeadClutch. The only decision you need to make is about how many hands the person uses to clutch their face-

(1) Is it a one hand kind of article:

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(2)or a double hander?

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Once you have made this decision, we need to consider the surroundings and remember that people with mental health problems-

(3) appear to spend a lot of time in alleyways.

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(4) Or on the floor in the dark.

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(5) They also appear to like to sit on the side of an unmade bed. Never a made one.

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(6) If they are male and have ever had a mental health problem then they will invariably be unshaven.

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(7) And spend a lot of time clutching their heads on a park bench.

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(8) If it is raining or too cold outside, then the alternative is the corner of a room.

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(9) Or on the floor by open doorways with light streaming out of them. To convey, you know, a light at the end of the tunnel in an artistic manner. See too- the Venetian blind backdrop as that’s very popular, especially with picture editors who grew up listening to Japan in the 80’s.

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(10) Or maybe they prefer to spend time in weird never ending corridors?

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(11) Which is enough to turn anybody to drink.

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(12) When there is light in the world of mental health imagery, it is often a light not seen in nature. We like this pink shade to ring in the changes.

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(13) And when things get really bad, there’s no longer any need to even see their face. And a bit of fog never did any harm- go that pathetic fallacy!

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(14) Although sometimes articles are illustrated by photos of people with mental health issues doing extra weird things like playing ‘Ring a Roses’ the wrong way around..This symbolises hope apparently.

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The MOST important thing you need to remember though is the #HeadClutch because without it, how will any of your readers know that the article is about mental health problems?

Every single one of these images was taken from an article in the mainstream press about mental illness or how to regain mental health. Google those terms and see what images come up.

Here are some other images of people you could use who may or may not have mental health problems, the point being it is not a fixed state or something that necessarily shows-

(1)  People with other people. Talking.

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(2) Or just people.

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(3) Or finding comfort in the coping strategies they have developed to manage their symptoms.

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(4) or follow the example of the IAINews and use images like this to illustrate the themes of your piece on the future of psychiatry:

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(5) Or get really creative and use photos showing groups of four people to illustrate the one in four stat that any one of them could have a mental health problem. Here’s four people doing regular stuff. Like eating and drinking.

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(6) Or images that show just how strong people with mental health problems can be and how strong they HAVE to be to cope with all the stereotypical crap in the media.

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So- editors, photo editors, journalists and copy writers….Are you going to settle for one of these same old stereotypes or maybe, just maybe, you might decide to be a little more careful and creative with the images you choose to portray mental illness in your next copy?

 

 

 

 

 

 

 

 

 

 

Food Inglorious Food: or how our government continues to fail the poorest.

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Next week I will be visiting The Gatehouse in Bury St Edmunds, a local food bank to explore how they are planning for the influx of extra users during the Winter, a time of greater poverty due to the competing needs of heating the home versus feeding those that live in it. In the meantime, here’s a reminder that the need for food banks continues as does the need for us to support them. Please donate- links and information as to how can be found at the end of this article. 

The amount of people using food banks continues to rise despite the much heralded ‘economic recovery’, trotted out by the government in an attempt to deter us from believing what we see with our own eyes. The cost of living coupled with insecure work contracts and slashed benefits that fail to keep pace with the demands on our wallets have conspired to send even those in full time work in search of their nearest food bank, a fact the government would like to obscure because it contradicts the ugly message that to work is to reach the economic promised land. Indeed, the inability of people to feed themselves adequately has been described as a breach of international law by violating the human right to food by a coalition of anti-poverty charities, including the Trussell Trust. who have described the Government as “increasingly harsh” in its use of sanctions against people attempting to claim benefits. Half of those referred to food banks in 2013-14 were as a result of benefit delays or changes with 8 out of 10 of food banks seeing more cases relating to benefit sanctions over the past year. Tougher punishments for those on jobseeker’s allowance were introduced by the Coalition last October (2013) raising the minimum sanction from one to four weeks. Benefits can now be stopped for up to three years.

The latest figures from The Trussell Trust show that in 2014, a total of 913,138 people were given three days supply of emergency food compared to 346,992 between 2012- 2013, 423 food banks have been launched and 8318 thousand tonnes of food was donated to food banks over the previous year.

The Living Wage Campaign works hard to raise awareness of the problems faced by those in low paid employment citing a study by the Joseph Rowntree Foundation (JRF) that claims there are more working families living in poverty in the UK than non-working families for the first time since the birth of the welfare state. The JRF attributes this to a sustained fall in the standard of living, causing average incomes to fall by 8% since the 2008 peak and around 2 million people to live on an income that would be considered below the poverty line back in 2008. Working age adults without children form the largest group in poverty with 4.7 million people falling into this category and plummeting incomes over the last few years erasing all the gains previously made.

Despite a strong safety net being deemed vital in ensuring social mobility across all age groups, government cuts via the ‘Bedroom Tax’ and other housing benefit changes, ESA sanctions and delays in processing benefit claims cause further harm to those who are already barely managing to keep their heads above water. Millions of people are living in fear of one more thing going wrong- a car repair or broken washing machine, unexpected dental bills (because they do not qualify for free assistance), sickness, outgrown shoes, not being paid over a bank holiday because they are self employed or paid for work done (and their firm shuts down) or loss of working hours because the weather is too bad and they work outdoors- any of which will tip them over the edge into a financial abyss from which they will never claw themselves back out of.

The experience of food banks is that more of their users are unable to find reliable work because of a myriad of issues and users then go on to be further handicapped by benefit delays, sanctions and even benefit refusal. In The Guardian (Nov 2014) a report by Melissa Viney says: “The most recent government figures (to June 2014) show that only 2% of longer-term ESA claimants find sustained employment. Independent research by the Centre for Economic and Social Inclusion has found that disabled people are about half as likely to find employment as non-disabled people. Last week, a report suggested that officials were considering cutting ESA, which is paid to around 2 million people, by as much as £30 a week as the chancellor, George Osborne, seeks a £12bn cut in the welfare bill.” A DWP whistleblower claimed “ the majority of my ESA caseload of about 100 clients were not well enough to have been on the government’s welfare-to-work Work Programme, but should instead have been signposted to charities that could support them with their multiple problems.” Instead people were left to negotiate a system that could not effectively place them in work because it is trying to force square pegs into skimpy round holes.

In a job market that is over subscribed, the disabled (including the mentally ill) are not going to get the pickings. In addition, staff were not given copies of job seekers Work Capability Assessments (WCA) and so were unable to offer any kind of tailored support or advice. The DWP state that providers “have the freedom to design any work-related activity so it is appropriate to the person’s condition”, yet fail to address the issue of staff being unable to do this because they do not possess the right information on the person.

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The blasé cruelty of ministers such as Lord Freud, who slurred desperate families by claiming that people were turning up just because there was ‘free food’, and not out of necessity is breathtaking. He would be perfectly aware of the surveys that show many people wouldn’t consider turning to a food bank for help when they need it: they find the stigma attached to ‘asking for food’ too humiliating.He would also be aware that families need to be referred to local food banks; you cannot just rock up with a shopping bag and fill it at will. In a seemingly desperate attempt to smear the charities who run food banks (including the Trussell Trust), DWP department directory Neil Couling, gave evidence to a Scottish Parliament committee on food banks and questioned the motivations of the UK’s biggest supplier of emergency food aid by implying that a motivation for their growth was Christian “evangelism” and that the food banks were merely an “evangelical device”. This elicited a furious reaction from the chair of the Trussell Trust who wrote: “Please provide me immediately with the evidence you have to support this assertion. You are directly challenging the integrity of a registered charity and its trustees both past and present. If you are not able to provide evidence to support this assertion please write immediately to the Scottish Parliament Welfare Reform Committee to withdraw the statement.”

We all remember Jack Monroe’s bleakly truthful blog posts about her own food poverty, and the resulting desperate attempts by the right wing press and its sympathisers to discredit her. Failing to comply with the ‘feckless, fat and lazy’ stereotype that is ignorantly trotted out by those who should be chained to a food bank and made to listen to their users and their children (who surely do not deserve to go without) made her an articulate threat and not easily dismissed. Ms Monroe faced them down, providing researched, clear and objective rebuttals, trembling with well controlled, justifiable outrage. She continues to highlight food poverty in the UK and the structural issues underpinning this alongside imaginative and accurately costed out recipes that are based on ingredients that are truly inexpensive (or should I say not as expensive?). I have cooked from them, own both her books and encourage others who need cost effective, nourishing meal ideas to do so. (Her pasta flavoured with a jar of 19p fish paste that itself has no nasties in the ingredients is genius)

In the USA, Linda Tirado recently authored her first book ‘Hand to Mouth’  after posting an essay about the American poverty trap online whilst working two low-paid jobs, which went viral. Extending it into the now book, Tirado has similarly been exposed to the same slanderous much raking attempts to discredit her, resulting in her posting her welfare records online plus a devastatingly brave and honest video in which she discussed appalling access to dental care and the way this impacts upon a persons job worthiness in the eyes of employers. Poor dental care is not only an aesthetic issue either when you consider the positive correlation dental decay has with cardiac problems and what these cost the public health service of any country. As usual, a government is relying on short term measurable actions rather than investing more on the medium and longer term measures that will save more in the long run: the latter are unfortunately not as immediately impressive to a voting public with short term moral attention deficits. Tirado lays waste to the American Dream and the much bandied ethos that if you want it and work for it, you will have it, irrespective of social class or cultural background. The fact that millions work over fifty hours a week in minimum wage zero contract positions yet still cannot afford to feed or house themselves is terrifying and subversive proof that this is no longer true. No wonder the establishment seeks to silence her.

During the course of researching this piece I have met men and women who:

  • Wear glasses with a prescription out of date by years, lenses scratched and smeared because they cannot afford to replace them (again, you only get free eye tests and prescriptions if you are on a very low income or receive a higher level of tax credits);
  • Have to struggle on with painful teeth but do not qualify for or cannot find NHS dental care. (Remember that travelling to meet repeated appointments to an NHS dentist forty miles away is out of reach for people with little money for public transport or petrol.) I have also met people with badly fitting dentures because the NHS pairs are not adequate and they cannot afford to go private;
  • Go out foraging for fruit and vegetables not because they love to go back to nature of a weekend or have read Hugh Fearnley Whittingstall’s or Renee Redzepi’s latest tome on foraged cheffery but because they cannot afford to buy decent quantities of fruit and veg (and this includes stealth raids on fields of sweetcorn, cabbages and local orchards). They live too far away from local markets or discount supermarkets and having to spend a tenner on transport wipes out any monies saved;
  • Are teachers, buying breakfast and ‘snacks’ for their pupils out of their own pockets because they are clearly coming to school hungry-and  not because their parents are feckless either but because there is only enough for a tiny bowl of cereal or one piece of toast. And when you eat not quite enough cumulatively over days or weeks, it is much harder to work all morning on smaller rations- this despite Michael Gove’s accusation that ‘feckless parenting’ lies behind this;
  • Have to return some food items to the food bank because they cannot afford to cook them or have run out of gas on their pre-paid credit meter, instead relying on foods that can be cheaply heated or eaten cold;
  • Shamefacedly admit to taking toilet paper from public toilets because they cannot afford to buy it. They choose to spend the money they do have on what goes into their children’s mouths rather than what comes out of their bottoms;
  • Have had to stay inside for the best part of a week because they cannot always afford decent sanitary protection and feel too ashamed to admit this. Or they ration what they do have or use cheaper, less efficacious products.

I have seen the shame on the face of one father as he tells me about sneaking into schools lost property room in the hope of finding an unnamed school sweatshirt in the right size that they can use for their child. They worry themselves sick about birthdays and Christmas, about their kids being invited to parties and hiding from trick or treaters because they have nothing they can give them; about the school trips that they cannot afford and the fact that they forever window shop on life, faced pressed against the glass and not yearning for much, just the chance to afford a treat or a day out, something to relieve the monotony and exhaustion because being poor is so very tiring. Many had good jobs when they had their children, or were in good marriages that then failed. They tried to make good choices, didn’t live beyond their means and didn’t flash the plastic even though previous governments did their level best to encourage us all to live on credit and delayed consequences.

A recent poll by Kelloggs has also revealed that almost one third of teachers admit to bringing in food for pupils they think may have missed breakfast and  two fifths of school staff (38%) know of pupils who have not enough to eat on a daily basis. Teachers talk of lethargic children with 83% commenting that they had noticed that their pupils could not concentrate properly. Again, the blame was ascribed to breakdowns in benefit assessment, a living wage that is not a living wage and in some cases, parents failing to ensure children were adequately nourished at breakfast times.

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As Winter approaches, more people will be forced to choose between heating their home adequately and eating properly with a recent Which? survey for the Tonight programme revealing that 46% of respondents plan to cut back spending in other areas to pay their winter energy bills. In an ITV programme shown on Nov 6th, reporter Chris Choi put together a log of his experience in a cold chamber to simulate the conditions experienced by those living in fuel poverty, a room cooled to 12 degrees. Interviews with health and social care professionals discuss the problems this causes for the most vulnerable, exacerbating existing health conditions and rendering them vulnerable to a host of others.

The UK is supposed to be built on a bedrock of  christian principles but the fact is, if you object to your tax pounds being spent on the poor, you are not one. This government happily trots out christian ideology and mores when it suits, yet ignores its central tenets. I do not believe that the greatest goodness comes from being a religious person yet I do hold those that claim to be to higher standards, especially when it is used to justify moral and legal pronouncements on how we live and how the country is run accordingly. When those judgements are used to justify punitive measures against the poorest and whip up hatred and derision towards them we see the moral ugliness of those in charge.

The Trussel Trust– find your nearest foodbank

The Gatehouse Foodbank in Bury St Edmunds

East Suffolk food bank

Newmarket Open Door

Haverhill food bank

Suffolk info link

<Addendum>

In the Guardian on December 8 2014, the paper warns of impending Conservative party hostility to an all party report on food banks which warns that Britain is “stalked by hunger caused by low pay, a growth in inequality, harsh benefit sanctions regime and social breakdown”. The Conservative party is seeking to avert a damaging rift with the Church of England over this with the church-funded report describing voluntary groups as “courageously fighting “a social Dunkirk” without the assistance of the government”, and calls for urgent action to ensure ministers do more to combat hunger, including joining a new coordinating body and asking supermarkets to do more with surplus unsold products.

The initial Conservative reaction to leaks of the report – which is formally published today – was hostile, with one minister claiming the increased use of food banks was due to greater publicity about their existence. Read the article here.

 

 

 

 

 

Curly girl – my daughter and Scoliosis

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“The operation will consist of anterior release of the thoracic curve through double mini thoracotomy on the convex side of the right side of the deformity. Second stage will be posterior correction with multi segmental fixation system and two rods. The surgery takes practically all day.”

The explanation on this letter from my daughters consultant neuro-orthopaedic surgeon made sense to me because I have invested some of my working life in training to decode the mysterious and protective language of medicine. It deals in the measurable, the objective and the recordable, flying in the face of the vagaries of the human body and its messy emotions. Some weeks after receiving that letter, we had a last meeting with her surgeon and his specialist registrar at nine pm on the day before the surgery, down in the reception area of the X Ray department, my daughter safely sedated and asleep upstairs. This meeting dealt with the less objective- a promise to do their best and an admission that sometimes things could go wrong- two weeks before a young boy having a similar operation had died of post operative complications. Our surgeon and his specially trained team- handpicked by him to manage the demands of a surgical procedure that used to be two-stage and now, thanks to his hard work could be done all in one, were all deeply distressed by this loss. We shook hands and I remember focusing on his hand in mine, steady, dry-palmed and cool. I felt reassured. I did not have doubts.

Nearly seventeen years earlier and pregnant with my daughter (and first-born) I made a home and a garden and read Sylvia Plath- happy Plath, herself pregnant and writing about her upside down tumbling unborn child. In ‘You’re’, I homed in on her words: ‘Bent backed Atlas, our travelled prawn’ and this image of a curled spine, the bone traced pale in the darkness of the womb had come to life in the smudgy early scan photos I brought home. The lightness and brightness of my daughters backbone were illuminated on that little screen then captured in a photo, the dark walnut of a heart and her own moon skull just like Plath’s baby which carried the weight of her hopes, just as my own unborn child carried mine.

Our spines are our midline, fulcrum and linchpin.  They give us shape, hold us up and channel the electrical sparks that in turn give us motor, volition and drive, movement, or the ability to choose to be still. A spine guides the body as it grows and develops and is metaphor for all kinds of pep talks: “Hold your head high!”, “Stand proud” “Show some back bone!” and sometimes, self reproach “spineless”. As my daughter grew, her spine turned rogue on her and one evening as she leaned over the sink to brush her teeth, shortly after returning from a holiday somewhere hot where she wore few clothes and ran in the sand, straight-backed and carefree, I saw that had changed. Somehow in a few short months, it looked as if her scapula had been pushed upwards and towards her clavicle and the top of her shoulders. When she stood and straightened, it did not straighten with her. I traced the line of spine with my eye and it did not follow the customary route- the one my eyes wanted to take.

A deep breath and a call to the doctor the next morning started the process that led to our time at a regional hospital, home to the team that would change everything for her. And as two years rolled past, we watched her spine continue to curl, curve and twist, copying the name of what afflicted her- scoliosis with its S and ss, onomatopoeic and disliked with roller coaster twists of consonants and vowels. Her ribs twisted into a wing bulging out of her side, her shoulder blade reared upwards and she ached with both the effort of supporting a skeleton which was not supporting her and the physical discomfort of lungs restricted in their cage of twisted rib.

“The waiting is the worst” became her (and our) mantra. The repeat out-patient visits, the measuring with callipers and a series of acronyms that moved her in and out of dark tunnels (MRI) and moved around her (CT) and asked her to stand semi-naked and vulnerable in rooms empty except for large machines and strangers peering through a window in a lead-protected room (X Ray). Adolescence is a time when a child redefines their boundaries, asserts their privacy and develops their sense of impending adult self, but my daughter was being stripped naked and asked to offer up her internal and external self for examination and photography. “The waiting is the worst” moved from something thought to something chanted as she lay on the trolley, rolling down to the anaesthesia department, waiting to be ‘flown’ by a quietly assuring teddy bear of an anaesthetist who promised he would not leave her and did not- he stayed with her not only for the thirteen-hour surgery as was his remit, but also one to one’d her in the recovery room and ITU. His own memory of losing his last scoliosis-afflicted  patient was fresh in his mind. My daughter was the first surgical case after that tragedy as the team had taken a few weeks to reassess and try to learn from what happened whilst we sat at home and wobbled and worried.

We were and remain grateful to her surgeon who insisted he would not undertake the surgery until my daughter had done her research and could show she was fully cognizant of what it would involve, both surgery and the arduous and often tedious rehabilitation. A familiar pattern assumed itself- a visit to the surgeon for monitoring, a chat on the way home followed by research online supervised by us, then tears, anger and finally pragmatism. “I have no choice so I need to get on with it. The waiting is the worst.”. In the United Kingdom, Scoliosis and its variant forms affect 3 or 4 children out of every 1,000 and can develop at any age, but is more common at the start of adolescence. In very young children, Scoliosis may correct itself as they grow but in older children and adults, it is unlikely that scoliosis will improve without treatment and in some cases the curvature may get progressively worse. My daughter was one of them and she soon achieved a magnificent curve of 85%: a spine akin to the curviest roller coaster at Alton Towers- a double curve in fact (Kypho Scoliosis) as we watched in trepidation. Our fears and her spine appeared to spiral off in tandem.

“The patient will be nursed in bed for seven days. After six to eight weeks the patient is usually well enough to travel by car. The patient will not be able to sit for six to eight weeks and will have to remain flat on their back or upright for short walks to the bathroom. The patient will not be fit to travel home by car and will be transported in an ambulance.”

Seven days of chest drains and urinary catheters. Of morphine pumps and a ward filled with women twenty to thirty years older because she fell into the gap between child and adult services. Obtaining the menu from the children’s ward was reassuring- fish fingers and chips and teddy bear-shaped food allowed her to regress back to a time that seemed commensurate with her level of dependence. Yet the morphine also made her strangely adult and stoned; sage pronouncements came from this tiny, wounded creature in her bed. We pressed the PCA (Patient controlled anaesthesia) for her when she was asleep in those early days to ensure pain did not wake her and her sleep was our respite too. It allowed us to drop our adult guard and slump, show our worry on our faces to each other and the staff. Gradually though, this turned into a belief that it was going to be okay. Strange fevers from things growing in her bones would not come to take her away. MRSA was the monster under the bed we feared the most and as her incision healed strong and clean, we imagined the bone grafts in her spine becoming impervious and inviolate, merging with existing bone although in fact, the grafts take several years to become fully patent.

A trip to X ray to check placement of the rods resulted in a meeting with a radiographer who introduced himself to her by saying “I saw your beating heart”- her thoracotomy and coloplasty had left her laying opened up and exposed on the table while the radiographer was brought in as part of the team responsible for her spinal cord monitoring and preparation for placement of those rods. She was unfazed and deeply proud of the fact that two of her ribs now lay in the bone bank to help others. She was intrigued by what had gone on during her surgery. “What did you both do Mum while I was under?” Endless Scrabble games kept us sane plus a flat in the hospital’s staff accommodation. Buckets of ice-cream, walks, sleeping, time as a family, cooking in the flat’s  kitchen with other residents. We turned inwards and forgot about everything else. It was shocking to us to see the reactions of other relatives to her. Seeing the distress on their faces at my daughters temporarily bloated swollen face (oedema from being face down for hours on end) pulled us out of our self protective bubble. We found it easier to cope by not being told how well we were coping.

How can I explain how I felt upon my return to the ward after a walk, to see a straight-backed girl in pale yellow t-shirt sitting, her back to me, on the edge of her hospital bed, being supported by two physiotherapists? I had grown so accustomed to the brutal curve of her spine that it had become an identifying feature. Lazily, it had become easy to use that. It was gone and what replaced it was a success beyond the hopes of her surgeon and his team. The remaining curve was imperceptible to the naked eye and the twist to her rib cage was now hidden by clothing. She stood up carefully and briefly, crying from pain and my other marker of time passing had changed: she was four inches taller- although as the weeks went by this settled to three. We had plaited her hair before the operation and she had been kept so still that the plait remained, tidy and neat, following the livid scar that traced the now straight line of her spine from nape of neck to her butt.

“After six months following follow up in clinic, the patient can gradually recommence activities, including different functions, building them up to one year following the surgery.”

Her surgery was one week after the end of her GCSE’s. She missed out on the celebrations, she did not collect her results from the school. She missed out on the start of her drama course and returned some months after, guarded by a literal circle of friends surrounding her, as she walked slowly and carefully through the crowds of students. Health and Safety assessments guarded her in a more formal manner. A quiet space made available for her to lie flat, a plan for what to do if the fire alarm went off- she couldn’t walk fast and must not be jostled- a modification of drama classes, an awareness that her rods restricted her from bending fully. My daughter is flexible in spirit and mind, her body lags behind.

We live in image-heavy times and the messages we are given about what is beautiful and what is perfect are twisted and skewed. My daughters spine and ribs became master and servant for a while of this. At times it ruled her growth as a young woman and caged her with pain and embarrassment. She worried about it skewing her in the eyes of others although she has met men who have loved her for who she is and admire her courage and dignity in coping. Now, ten years on, she has her scars, the beautiful and striking faded line all the way south and the two ‘tiger slashes’ across the side of her torso. She has answered enquiries about these scars by joking that she was mauled by a tiger. A few people find that more believable than the truth.


My daughter has Kypho-Scoliosis and her treatment was specific to her needs and condition and may not apply to other cases, If you have any concerns about Scoliosis please see your GP or contact a relevant support group or source of information.

Scoliosis NHS Choices Website

The Scoliosis Association UK