The Ties That Bind

Sometimes perspective is subtly gained, and other times it crashes into view and simply obliterates the previous mode of thinking. The hospital which has been its stage - and my home - for the last week is a master of shifting attitudes; an arena so cacophonous with extremes of emotion that few are seldom fixed.

Being quite experienced in pain and complexity, I've struggled much less with the physical reality of this current unwellness than I have with some of the wider questions it has thrown into my path. The now-unavoidable gastric surgery carries with it substantial risks to fertility, the extent of which I am only just beginning to explore with the help of relevant specialists from the field.

Suddenly finding myself asking very big questions about my future has been made particularly jarring because I had never given much thought to it before. My mother was in her late 30s when she became a parent, and even as a child I had always presumed that the same would be true of me. As ever greater numbers of my peers have begun to have families of their own, and the quantity of nieces and nephews I've amassed threatens to overwhelm the world supply of Jelly Tots, I still felt under no pressure to consider my own reproductive responsibilities. It was a question for another time, another decade. Something that seemed so abstract and far away, and felt almost ridiculous to ruminate upon seriously when it was so far from being relevant.

It is a theme repeated, I suppose, by couples everywhere who find themselves actually having to think about fertility. It's an aspect of our health we take for granted in a more absolute, evolutionary sense than we might any other, and do not test until it fails us. I had been as naive as anyone, never questioning my ability to have a child of my own, and indeed focused more on the rights and responsibilities afforded me not to get pregnant than anything else.

Much as I adore the cheeky, sticky, noisy, lovable riot of children to whom I am Auntie, I have been perfectly content to postpone any thought of adding to that brood myself. I'm not the type who coos and clucks over other people's babies, and don't have much experience entertaining children. This awkwardness led to a general assumption that I am not a very natural mother and a much more intuitive Wicked Queen. (It may also have something to do with the tiara, but I still deny responsibility for those poisoned apples.)

Despite the teasing, I don't think I had really given the concept of motherhood much thought at all until I was twenty. When my grandfather died it was earth-shattering, but somewhere amidst the shock and the grief and the pain was a strange kinship and familiarity. That moment of devastation linked me to the past in a way nothing could have done before. The loss of that great man and all that he was to us, and the staggering realisation that from that point on he could be only a memory, was when it all fell into place. I have referred to it since as my "circle of life moment", because I knew, there and then, that our lives have power and purpose simply because we share them. As I felt both the privilege and the loss of having been loved so much by someone I so admired, I recognised my place in the order of things in a way I had not done before. I wasn't just a daughter, or a granddaughter, I was a link in a chain that stretched back generation after generation, and - most startlingly - would reach out just as far into the future too.

I've touched on the significance of that moment before, but have found myself remembering it so much more acutely in the shadow of this latest news. As I indulged the self-pity and allowed myself to sink a little deeper into what was becoming quite a comfortable sulk,  my whinge was interrupted by a whisper.

"Please let me go. Tell the children that I love them, but they must let me go."

An elderly lady in a bed across the ward is receiving only palliative care, and her lucidy drifts somwhere between remarkably keen and hopelessly lost, never certain which is cruellest. Tonight she has called alternately for her children, and her parents, earnestly seeking the comfort of those greatest loves as her life begins its end.

Her family is large and caring, guilty only in their eagerness to cherish the moments of respite from distress, despite - and because of - their rarity. It is impossible to watch life unfolding and untangling itself at such close hand without realising how small a part we each play. How insignificant the knots are in which we find ourselves tied, time and again, until there is no time. No "again". It isn't blood she calls to, or to which they cling, it's bond. A bond formed by loving as deeply, resolutely, and fearlessly as family demands, but which is not exclusive to genetics. It's the quality of the relationships that surround her which have brought the greatest joy to know, and are causing the most pain to leave, not their heritage.

As the spectre of their loss calls to the ghosts of mine, I find myself so very grateful for those in my life whom I would be most loathe to leave, family and friends, and equilibrium begins to restore. It's hard to be too dedicatedly self-pitying in the face of so much love, and life, and potential for more of the same. I may not know what shape my future will take, or how far it may deviate from the course I'd expected, but in this moment it is enough to possess the luxury of time to find out.

As the last of the ward lights are dimmed and the day's visitors reduced to a cluster of empty chairs, so she whimpers to the night and asks it to take her; eased of the pain her illness delivers but wracked with the agony she knows awaits them. She quietly asks the nurse if she can have something to cuddle, and they give her a pillow. As she falls asleep with it cradled tightly to her chest my heart breaks for far worthier tragedies than my own, but this single bed has never felt quite so vast.

Keep Kalms and Carry On

This blog began its life as a repository for all the nonsense burbling through my brain during a prolonged bout of insomnia. I've revisited it on occasion since, but never with the same committment. Some of that was because it became a victim of its own success; as more people confessed to having read it, the less about my life I could actually share for fear of upsetting or alienating those I am much fonder of than it might appear in print.

I find myself back here now not because I have anything more to say, but because I once again appreciate having a place to say it. Somewhere to unburden my mind of some of its turbulent tangle of thoughts and tangents. (Beginning with the excess of letter T's it seems.)

For the first time in a life that has grown steadily less ordinary, I've been unable to wend my way through that troublesome tangle of inner turmoil on my own. The blitz spirit indoctrinated by the grandparents who raised me failed in its robustness, and the moment came when I couldn't keep calm, and had no idea how to carry on.

That sounds terribly melodramatic but, momentarily, it was. I have long counseled others that we each have a point at which we break, but I had never expected to find mine. It's conceited of me, I suppose, to think myself immune to the stresses and psychological hardships that afflict others. I observed patterns of distress and depression in friends, family, and in my capacity as a peer counsellor. I have always believed that no one should be ashamed of asking for help, and that it is normal to feel overwhelmed sometimes. I offered support to others in the fullest sincerity of that belief, and have tried to learn from, and better comprehend, the processes involved with recovering and moving forward. As I write this, a University prospectus sits beside me with a page folded down to a counselling course I had hoped to pursue, while a leaflet for MIND volunteering opportunities is pinned to the noticeboard. I've championed the services available and actively sought to help others access them because I believe in the real, tangible value they offer to those who are struggling.

Yet, despite my vainly assured tolerance and experience, I not only failed to recognise the approach of my own crisis, but have reacted very reluctantly to the idea of treating it with medication and therapy. I have had to accept that not only am I human, but also a hypocrite. In a rather roundabout way, however, that admission may just be what gets me through it.

After fifteen years of ill health and disability, I first began to struggle when the prospect of further surgery was raised. I have, very fortunately, never been one to suffer from depression, but recall returning from hospital that day utterly exhausted and dejected. Defeated by a battle against my own body that I had thought was coming to an end. I lay in the garden as the disconcertingly beautiful sunshine slowly dimmed and the blaze dipped below the skyline. As I rested, I listened to Neil Gaiman's "Ocean At The End Of The Lane" audiobook, escaping into benign fantasy and letting the words swirl and cleanse as I railed against the bitterness and self-pity that kept trembling through my stiff-upper-lip. I will always be grateful to Gaiman for sending me a friend like Lettie when I needed her - almost as much as his ponderous protagonist did.

Over the following days I did what I always do, and 'got on with it'. Having been a sickly child I've come to be defined by the ability to cope. "She's a trouper!" "She's always so strong." "She never let's it get to her." How much of it I can claim was true I don't know, but it has become an important part of how I saw myself. It gave some sense of achievement and purpose to all the suffering I suppose, thinking that it was character building, and made the struggle less distressing for those around me who were helpless to improve my circumstances.

So as time moved on and other distractions presented themselves, I brushed the growing anxiety aside. It wasn't my way to indulge it, and I'm not sure I would even have known how to express it, or to whom. Then a spate of issues with uncertain consequences for my future left me feeling very anxious about the direction my life might take. I noticed it properly for the first time, like something moving from the corner of my eye into sharper focus. Yet still I dismissed the persistent, niggling, fear and busied myself with other things, and almost a year after the initial conversation about further surgery my consultant raised it as a much more immediate concern.

Suddenly I was forced to confront even more unsettling decisions about my future, including having to answer queries about my practical and emotional support networks, the stability of my relationship, and whether or not I wanted children. Contemplating the various alternate realities left me reeling and rudderless in an unforseen storm.

A series of fractures began to appear in the days preceding my first meeting with the surgeons, and instead of greeting the new challenges with the required patience and determination, I just...broke. The anxiety finally peaked, and the calamitous clash of thoughts and feelings that had been growing into a tight ball in my stomach welled up and out in incessant waves of anguish that I could neither hide nor prevent. I couldn't eat, or sleep. Couldn't stop crying, and was beset by a nervous shaking that would put Michael J Fox to shame. All the while the measured, logical voice in my head was curtly urging me to stop making such a fuss and pull myself together, but I failed to maintain my composure for more than a few minutes before the panic would take hold once more. Deciding whether I wanted toast or cereal felt like my whole life hinged upon the answer, which is entirely illogical for anyone who doesn't live in a low-budget, Serendipitous romantic comedy, or a medieval village plagued by ergotism.

Leaning heavily on the family whom I would usually endeavour to spare such distress, I ended up crawling into bed with my grandmother in the middle of the night, like a toddler hoping to shake off the monsters that have followed her out of a nightmare. I knew then that I had to give in and ask for the help I had so earnestly recommend to others. I made an appointment to speak to whichever doctor was on call and sat in the surgery fighting not to make a scene, lest anyone be more inconvenienced by my dismay than their own coughs, colds, or ingrowing toenails.

The young GP who eventually saw me was one of the few at our practice with whom I am not familiar. It relieved me greatly as it released me from feeling like I may be disappointing the others; those who had treated me for years and praised my fortitude for making all our lives that little bit easier.

She listened patiently as I explained what had brought me blubbering before her. I candidly confessed to the various triggers for my state - between profuse apologes for making such an abnormal fuss - and heard the reassurances it is usually my job to supply reflected gently back at me. I told her that my main objective was to regain some stability, as I had a lot of big decisions coming up - personally and medically - and needed to know that I was not letting them be governed by fear. She was far less surprised than I had been that the accumulative stress had reached an unmanageable peak, and recommended an antidepressant for the anxiety and counselling to try and better identify, and manage, its causes.

It has been a very odd experience, being suddenly so unfamiliar with myself, and one with which I am still coming to terms. A lot of time recouperating had previously allowed plenty of time for introspection, and as such I always felt quite satisfactorily attuned to my sense of the world and my responses to it. Now, taking pills to help dull the panic and awaiting a referral for therapy, I find myself overreacting to change and needing clear, stable plans and structures to avoid the lingering anxiety. It felt a little like going blind, in some respects. All of a sudden I could no longer rely on my brain to process information in the way it always had, and was left stumbling around in the dark trying to relearn how to function. How to interact with a world full of new obstacles that would have been much more easily negotiated before. (Blindness is probably far too extreme a parallel, but it was at least comparable to the helplessness of going on holiday and realising in the middle of the night that you need a wee and haven't got a torch.)

One of the driving factors in my resolution to pursue the prescribed counselling is the incredible strength in the face of adversity that has been demonstrated by those I myself have counseled. The people who bravely took the steps I directed them towards, despite being just as dogged by self-doubt, embarrassment, reticence, and reluctance as I am now. I owe it to them to practice what I preach, and perhaps owe it to myself to accept some of my own advice.

I want to better understand the process, and understand this new, fractured facet of myself better too. So I'll start by being more honest with the people around me for whom I have maintained the expected facade. Now that the tablets are kicking in and I have begun to regain a much healthier perspective, it is easy to pretend everything is fine simply because I'm uncomfortable with making a fuss about the fact that it isn't. I know I need to work on not viewing my own vulnerability as weakness, and trust the people closest to me to be strong enough to cope with the truth, even if it isn't pretty. Life will continue to present difficulties, and test the limits of my tolerance, but I believe absolutely - as I did even at my lowest - that things will improve. This will pass, and I will be "ok". As I take the first steps towards being truly, positively, content again, I'm very grateful to be so certain that it shall come to pass. I know how many others have to find a way through their darkest nights without the certainty that they will soon feel the warmth of the day. It is for those people whom I write this and offer some company in the darkness, as they find a way back to the light. (As long as none of them piss in the wardrobe again.)