At the beginning of October I spent the most amazing week as writer in residence in the Royal Hospital, Belfast. A huge thank you to the wonderful Paula McHugh, arts coordinator in the Belfast Trust who conceived the idea and made it possible and worked tirelessly all week to ensure the staff and patients got the most out of the project and I had a wonderful experience. I won’t pretend I wasn’t primarily drawn to the idea of being a writer in a hospital because of my ongoing Casualty obsession. I had a vision of myself wandering round the wards in a white coat and stethoscope, handing out stories and sound medical diagnosis, based solely on years of watching BBC medical dramas.
I only got to wear a white coat once, (big thank you to the blood lab for making this dream come true), but I did have the most wonderful week in the hospital reading to staff and patients and writing some tiny little microstories which have been posted throughout the hospital. (I’m ashamed to say it’s taken me almost a month to get these stories blogged. I’d intended to do this right after my residency, but got swept up into lots of travel and book deadlines). The residency gave me an awful lot to think about and I can honestly say it’s been one of the most challenging and simultaneously rewarding experiences of my writing career so far.
Firstly it served as a timely reminder in the midst of this season of frantic travel and getting on like a literary type, that I still love and believe in community arts and can truly say that I haven’t felt as much like myself in months as I felt drinking tea and swapping stories with the wonderful people I met through the Royal’s Dementia support team. Thank you for reminding me that my soul needs to be around non-literary people every so often and that I need to continue contending for space and time to keep working on community arts projects.
Secondly, I left the Royal hugely convinced, (and I was already a strong believer), that the arts needs to play an integral roll in our health and well-being provision. It didn’t take more than a few hours on the wards to see how both patients and staff, responding positively to very simple arts activities, (reading and writing exercises, storytelling and listening), appeared more relaxed and generally positive. I met so many people who’ve spent a really long time in hospital and these little windows of creativity and imagination can really break up the monotony of their day, whilst staff members taking half an hour out of the pressure of ward duties or caring responsibilities, all said how much the arts activities helped them to relax and focus. We need more of this kind of stuff; not just as a token add-on to healthcare, but as a carefully thought through integral part of how we care for vulnerable patients and over-worked staff members.
Finally, the main thing I took away from my time as a “pretend health care provider” was an enormous amount of respect and admiration for the actual professionals. These people are amazing. They seemed to be relentlessly optimistic and enthusiastic, often working in difficult and truly distressing situations. It was such a privilege to get some behind the scenes snapshots of exactly what their jobs involve and I just hope my time on the wards and the little stories I wrote have served as some kind of small encouragement and a token of the appreciation I have for the people on the front line of the NHS.
I hope to get back on the wards again at some stage in the future. Until then, I am, if anything, watching Casualty even more keenly. Here are ten of my favourite microstories from Write Around the Royal. We hope to work on putting together a small collection in the future so the staff and patients might have access to these stories.
- The Small Hospital
Back in the days when nurses were still starched and formal in pinned caps and aprons, my mother was a theatre nurse in the Royal Victoria. I was barely old enough to understand the difference between a real hospital and the make believe ward I kept for poorly dolls and teddies. My charges slept patiently in shoe box beds, waiting for toilet roll bandages and elaborate operations I’d perform with kitchen cutlery. I was doctor, nurse, surgeon, anaesthetist and concerned relative all rolled into one. I was also God; killing my patients as I saw fit, resurrecting them five minutes later to begin the diagnosis process all over again. I had a plastic stethoscope. I took this as a symbol of authority.
On the other side of the city, my mother tended her patients with similar devotion. At night, while the ward swam with silence, she sat under a desk lamp listening to their laboured breathing and knitting tiny sweaters and hats from scraps of leftover wool. She’d bring her creations home to me in a prescription bag and watch as I dressed my patients in their swanky new gear. In these small moments we were both caregivers. We were both giving care.
2. Shrinking Stories
Before my stroke I was a furious reader of novels. I read all the classics: War and Peace, Moby Dick, everything Dickens had turned his hand to. The bigger the book, the more I managed to draw from it. Reading was like excavating for treasure in a vast and splendid desert. Now my storied world is shrinking. I can no longer manage a novel. I have digressed from short stories to poems and finally sentences of the smallest stature. Even then, I often find my fuddled brain cannot make it from one full stop to the next.
In telling you this, it is not my intention to evoke pity or even quiet concern. Small is large to me these days. Recovery has taught me this and other hard lessons. The least little step of progress now seems a mighty leap and while, for the moment, I have lost my ease with novels I have instead, discovered the comfort which can be found in a single word held in the mind and slowly savoured: ‘home,’ for example, or ‘family.’
I only came in for a cappuccino. I didn’t even really want a cappuccino. I wanted something stronger or perhaps something which would make me feel stronger, something like scaffolding, for I was in danger of falling apart. I came in for a cappuccino, but the cappuccino was really just an excuse to leave the ward for ten minutes. I needed an excuse. I’d been there all night, sitting by his bedside, not daring to leave and all the time wishing to be sat anywhere but here, holding his hand as I tried to imagine him grown up, years from now, in a place that wasn’t here. I didn’t even really want a cappuccino. I wanted something that would make me feel older and braver, more like a proper mother, less inclined to keep glancing at the door, waiting for a real adult to appear and take charge.
This was a lot to be asking of a takeaway coffee but the woman at the till seemed to understand how much was riding on this cappuccino. “Are you alright, Love?” she asked, as she slid my cup across the counter. Our hands touched briefly. She smiled. Though I could not have explained why, I knew that this, and the cappuccino, would be enough to keep me going for a little while longer.
It is not difficult to spot a resident of Pyjama-Land. They walk amongst us every day. They sit in the Coffee Doc, sipping small Americanos and Lattes whilst devouring the morning papers. They congregate in small groups by the front door and can often be seen in the shop, scanning the magazine rack for something they’ve not yet read. They are slow on their feet and often unsteady. Drip stands, oxygen tanks and concerned relatives trail behind them like leashed pets.
The residents of Pyjama-Land look just like regular people. They have faces and hair and speak our words. They would be almost impossible to spot if it weren’t for their outlandish dress sense. It is unclear why they insist upon sporting nightwear at all times, in all settings, no matter how public. They seem overly fond of dressing gowns and bathrobes. They prefer slippers to other, more practical forms of footwear. They sport pyjamas in every conceivable cut and pattern: tartan, fleece, cartoon print, satin, onesies for the younger contingent, M and S button-ups for the more sedate. They look like they’re always heading to bed.
It is possible, with practice, to see past the pyjamas. If you are brave enough to look a resident of Pyjama-Land straight in the eye, you will notice that they are peering through you to the hospital doors and the world beyond. You will see a kind of hunger in the way they stare at the road leading away from this place. You may even begin to imagine them slightly inclined as sunflowers incline towards natural light. You will want to lead them outside, one by one, in a gentle manner. You will want to say, “on you go. The world is waiting for you.” You should not say any such thing. It is easy for you in your jeans and trainers. You are dressed like an outside person. You know how to brave the cold. There is no heat in a pair of pyjamas and these people aren’t ready for real world clothes.
5. Healing Bell
Beneath the Healing Bell an elderly lady stops me to ask directions. She is looking for the ninth floor. She shows me her appointment letter. It definitely says Floor Nine. We are both confused. The lift behind us clearly states there are only six floors in this building. Later, I will wonder why I didn’t say to the elderly lady, “maybe your appointment is in heaven?” We could have had a laugh together. Later still, I will realise that telling an elderly lady her appointment might be in heaven would not have been a good idea.
We stand together, this lost lady and I, in the shadow of the sculpture’s downturned funnel. It is like being captured beneath the open end of an old-fashioned hearing trumpet. I listen to what she has to say. She has seen my Writer in Residence badge, (a makeshift affair run off on a computer printer and hastily laminated). She has taken me for a proper staff member; someone who can navigate the maze of these corridors. She couldn’t be more wrong. I tell her that I’m just a writer. “I feel a bit lost here too,” I say. The elderly lady sighs and says she’d better look for someone who can actually help her. I point out a nurse wearing the sort of badge you can’t make at home on a laptop.
I feel disappointed with myself. I am used to being able to help older people. Here, it is different. Here, I am still learning how to help when I can’t prescribe antibiotics or remove stitches or say with any great certainty, “everything’s going to be fine.” I walk over to read the gallery notes for Healing Bell. Apparently, this sculpture is to do with feeling vulnerable, human and, somehow, messy in these kind of spaces. I might go get a coffee and stand under it for a little longer.
6. Car Park
The queue for the visitors’ car park has now reached Lisburn. In a Vauxhall Astra, six vehicles from the front of the line, Albert McKeown has been waiting to enter the car park since last February, shuffling slowly forwards once car length at a time. He has been surviving on a diet of cereal bars and orange Fanta, listening to nothing but the Now That’s What I Call Dance Musiccd his daughter left in the stereo the last time she borrowed the car. He has not yet lost hope. Albert McKeown is made of sternish stuff. In the past he has completed two marathons, one triathlon and a single last minute Christmas Eve grocery shop, which was, in his opinion, more harrowing than all three endurance events combined. Albert McKeown is reasonably confident he will gain access to the visitors’ car park at some stage in the next few weeks. Patience is not Albert’s problem. Since his retirement, he has all the time in the world. The problem is, Albert McKeown’s been sitting here in his Vauxhall Astra, with the dance music thumping, and the rain coming down in sheets, for so long, he’s forgotten why he came to the hospital in the first place. He should probably just turn around and leave, but he knows he won’t. Such a move would feel a little too like admitting defeat.
7. The Letter
They told me I should write to you. Now, the transplant’s over and she’s getting better. They said it might help to write things down. I’m not sure whether it’s me or you they meant. Maybe this letter will help us both. I’ve begun to write it a dozen times, but I’ve not yet made it past the first line. You see, I don’t know what to call you and how can I begin such an important letter, if I don’t know who I’m addressing it to?
The transplant team won’t tell me your name or anything about your loved one. I say loved one, because I don’t know if it’s a child you’ve lost, a partner or sibling; whether they were a boy or a girl, a man or woman. I have my suspicions -a mother knows- but I can’t say for sure. It’s not my place to speculate. I don’t know the shape of your loss; whether it was sudden, or slow and blunt like a pressing bruise. I can’t speak into your sadness either. Every loss has its own sore song. Everyone copes in a different way. I choose to write this letter. You can choose to read it or not read it; to respond, or leave things be. Either way, I understand.
If I could get past the first line, I’d write, “I also know what it’s like to watch someone you love disappear. How you’d do anything to hold them together but your arms aren’t strong enough.” And I’d try to say something like thank you, though thank you’sfar too small a word for what you’ve given us. I’d say, thank you, with a photograph if I could: my baby girl, eight years old now, riding a bike for the very first time. I’d say thank youwith a list of all the things we thought she’d never do. Thank you, I’d say, and also sorry. But I don’t know who I’m writing to.
Dear Stranger then. Dear Friend. Dear Saint/Angel/Superhero. Dear Brave Soul who gave my child a heart which did not belong to her. Dear Heart, which is what Aslan whispers to Lucy in the Voyage of the Dawn Treaderwhen she’s much afraid and failing. “Courage Dear Heart,” Aslan says, and I’d also whisper this to you, hoping my dark days might speak to yours. If no one else has said this yet, let me be the one to remind you Friend, you are stronger than you think you are.
Tonight, on my way home from the wards I thought about the tunnel which runs beneath the Westlink, joining the Royal Hospital’s pharmacy department to the City Hospital’s pharmacy department. Picture this tunnel if you can. It is approximately twenty centimetres in diameter and round, like a Pringles’ tube. It is not unlike the chute system used to shuttle receipts, banknotes and small change from the cash desk to the accounts department of the old-fashioned department store where my mother once took me to buy my school uniform. Picture it. Imagine also, the noise made by this system when in use: a gentle whoosh, similar to the noise made by automated revolving doors. (Do not imagine the revolving doors at the front of the Royal which are more likely to sound like trapped patients swearing than anything gentle or whooshing). Note, that the distance between one hospital and the other is a matter of less than a mile. Walkable? Yes. But how much more efficient to fire prescriptions backwards and forwards in sealed canisters, each one equipped with its own ward-specific microchip.
Tonight, stuck in traffic on the Westlink, I began to imagine all the prescription canisters whizzing about, like plastic bullets, beneath my wheels. (This analogy holds well in regards to size and traction, though the bullets in question are more inclined to heal than harm). I could not keep from speculating on other things which, on slower days -when the need for penicillin or ibuprofen is minimal- might be transported from one hospital to the other in a similar fashion.
Love notes from pharmacy students enduring placements on either side of the ring road. Sandwiches. Mix tapes. Bookies’ tips and baby photos. Poetry. Halls Soothersor Locketsintended for colleagues afflicted with tickly throats. (Perhaps, falling closer to prescription than kindly gesture?) Wallets and mobile phones left behind at corporate training events. Traybakes. Biro pens branded with the names of drug companies. (Also, similarly branded post-it notes and mouse mats). Invitations to the Christmas shindig. Charitable donations and sponsorship forms. Cheese.
I found it difficult to stop imagining items which might be shoved inside a twenty centimetre tube and fired across the city. The whole system felt both futuristic and antique, like something which might sit easier in a fairy tale story than a hospital pharmacy.
9. Forgetting and Remembering
They will try to tell you that Dementia is a forgetting kind of illness. They will draw your attention to all the things which have become lost or misplaced. Words. Memories. Simple everyday acts such as boiling a kettle or reading a paperback novel from cover to cover in the correct order. They will say it is the sort of illness which is only ever, always, sad and sometimes they will be right in this.
They will not bother to tell you that the same illness can take with one hand and give with the other. That you might find yourself in a room with several brave souls gathered round a coffee table, grinning. That you will swap stories about childhood picnics, discuss pudding for breakfast and quote tiny mis-remembered snippets of Rabbie Burns poetry. None of these diversions will have been asked for or anticipated in any way. They will make no ordered, reasonable sense. You will nonetheless find them both wonderful and welcome; just the ticket for a drizzly Friday afternoon. You will look at these strangers; their minds made loose and generous by this bad disease. Your face will ache from too much smiling. You will realise you have forgotten to feel sad for them.
The pharmacy robot is actually two robots. They are best described as elaborate vending machines: self-stacking, self-sorting, self-serving. Their twin arms dart backwards and forwards across the aisles arranging tablets, creams and medicines of all sorts by bar code alone. Each robot lives in its own glass room, one shelved wall pressed up against the other so there is not even a centimetre of spare air separating them. They are Siamese twins these pharmacy robots. The first is named Wallace, the second Gromit, though their names badges have long since fallen off and none of the pharmacists can remember which is which.
The lady who keeps watch over the pharmacy robots is called Catherine. Catherine has been with the robots for years. She knows all their smooth moves. She can even tell when one or the other is in a mood. Though it might sound daft to an outsider, Catherine thinks of the robots as children and sometimes talks softly to one or the other when they’re having an off day. The pharmacy robots find the sound of her voice soothing. They try to talk back to Catherine. They say, “we love you, Catherine,” and, “some days, your smiling face at the window is the only thing keeping us going.” They say, “please don’t ever leave us,” for they can’t imagine the world without Catherine in it. She is the only kind of mother they’ve ever known. Unfortunately, the pharmacy robots do not speak human. They cannot understand Catherine when she talks and, when they try to talk back, all Catherine hears are clicks and gentle, metallic whirrs.