Hospital

Padua Children’s Ward, at the William Harvey Hospital in Ashford, Kent (UK), exudes a sense of permanence.  There is a parents’ room with comfy sofa, a TV, fridge, microwave, kettle and sink.  In the early evening parents are playing with their children in the side rooms, some with the radio on softly in the background.  A couple of hours later the little ones are asleep and all is quiet.  The place feels unhurried – to me anyway; staff are friendly and the other parents respectful.  For a place that is transient by its very nature, the ward has been made to feel like a home of sorts.

While I worked as a microbiologist at London’s Great Ormond Street Children’s Hospital (GOSH), I never saw the wards.  I saw plenty of little patients in lifts and corridors as I moved between labs in my white coat.  As GOSH takes only the severest cases, I knew that every adult I passed who wasn’t staff was the parent of a seriouly ill child.  This awareness was enough to sober me during my daily rounds.

So it was also a sobering experience bringing my son to Padua Ward two days ago.  We were assigned a “cubicle”, actually a tiny room with just one bed.  On our way there we passed a woman in tears outside another room where a baby squalled.  “She’s been like this for hours,” she explained to a nurse who was doing her best to comfort her.  Behind this ward’s calm façade lies the hidden drama of sick children, of parents condemned to spent long periods here, waiting, worrying, suffering.

I felt humbled as my son began to rally.  With his headache, fever, weakness and dehydration from nearly 24 hours of vomiting, he really did look terrible.  But as the time passed and he continued to keep his fluids down, I knew he was improving, and that we’d be home later that night.

Film goes where print cannot follow

Books that are made into film are rarely better in that form.  Too often a film races through complex networks of action and relationship, keen to get the story in a straight line and tell just enough of it to make sense.  In some the story resembles a series of ticked boxes as familiar events are assembled like hooks on which to pin the visuals, while the real sentiment is left out.  In others the action and characters are so altered that readers who have loved the books barely recognise their old friends.

The Lord of the Rings trilogy is especially guilty of this latter sin, distorting the Elrond into a jealous father who wants to draw his daughter away from Middle Earth and leave its allied peoples to their terrible fate.  The stately Aragorn becomes lovesick and doubt-ridden, and even Treabeard the Ent withholds his help until he is brought face to face with the destruction of his forest.

But the Lord of the Rings has moments of filmic splendour that manage to transcend even Tolkien’s breathtaking vision.  One such is the moment of despair in The Return of the King when, just before the turning of the tide, all appears lost and hope seems at an end.

Denethor, steward of the city of Gondor and an angry and embittered man, sends his second son Faramir into a hopeless battle to punish him for the death of his more favoured older brother, Boromir.  Sadness and fear accompany the departure of Faramir and his army.  The wizard Gandalf watches in shocked silence while the women of Gondor strew the  men’s steps with flowers.  From this battle none will return save Faramir himself, gravely wounded.

As the army rides out Denethor is shown shut up in his great hall, occupied with peeling red fruits which he does not share with Pippin, the hobbit who has sworn him allegiance.  Instead he orders Pippin to do something that seems tragically inappropriate to the hour: to sing.  Pippin, while Denethor tears at the fruit with his teeth and lets the red juice run down the corners of his mouth, produces a song of melancholy sweetness that becomes the soundscape of the doomed fighters lining up to face the orcs.

The scene ends with Pippin in tears, unable to continue, while Gandalf sits in the courtyard weighed down with foreboding.

As an expression of injustice and despair, it takes some beating.

Church Tower Abseil

I hadn’t intended to take part.  It’s a mad way to raise funds and I hate heights anyway, so I planned to take pictures of those who were brave enough to attempt it.  But then I had reckoned without the atmosphere on the day.

The weather was perfect.  The 100ft-high medieval tower of All Saints Biddenden, Kent, was bathed in late summer sun.  There was not a breath of wind and all of nature, still green, seemed to cry out for celebration.  Among the onlookers, the tone was quietly jocular as the first batch of abseilers received their instructions.  Children played among the slanting grave stones, grown-ups rested their cameras on stone tablets where the dead were forgotten amid this profusion of colour and life.

As the morning wore on and triumphant abseilers, many of them novices, either stepped or sagged off the end of ropes, joining them became a matter of community spirit.  It looked easy too, I thought, as I watched the harnessed candidates crawl backwards down the wall like spiders: people of all shapes and sizes had succeeded.  If I didn’t try now I knew I would regret it.

At least that’s what I told myself as, duly trained, I stepped out onto the flat top of the tower.  The wind was no stronger up here but the sounds of people were much further; the tower exuded its own special tension.  Our mouths went dry and I began to wish there were a toilet nearby.  Jane, ahead of me, joked through gritted teeth about witches as she ascended the scaffold that would launch her into the void, tethered at the front but with nothing behind but a bit of harness.

My turn.  I am hooked up, twice, for extra safety.  My instructor is calm and reassuring.  As soon as I push against the ropes I am hovering over the edge, and then I can no longer see him.  Keep my right hand on the rope behind, my left in the loop in front, concentrate on loosening the right a bit at a time.  I am told to straighten my legs when all I want to do is curl up in a ball.

But I stand up straight and then the world goes quiet.  They are all watching me, the scattered matchstick-sized people I know are waiting below, but I won’t look at them.  There’s just a wall, a set of ropes, a lot of sunlight, and me.

Going down is harder than I thought.  I pass the landmarks made familiar by watching earlier abseilers: the windows, a couple of ledges, a bee’s nest in the rust-stained stone.  My weight is still supported by my gloved hand but I can’t reach the wall with my feet; instead of making a fluent descent I am swinging into nothingness, the ropes threaten to tip me on my head or spin me round altogether.

I reached the ground shaking but exhilarated, sound rushed back into my ears and time began to move forward again.  I felt I had earned my round of applause.

Moleskine mania

I wrote the following on 2nd September 2008, at 12.40 precisely:

“I have just bought my first Moleskine notebook and I can already feel the romanticism oozing from it. I’m sheltering in an arcade from the rain that has kept up all morning. Canterbury (Kent, UK) is a dirty grey and groups of bedraggled pensioners are forced to pause before launching themsleves on the weather, umbrella to the fore. I’m sitting on a borrowed café chair to eat my lunch and write, and I’m trying hard to keep the famous acid-free pages dry.”

After trawling the internet on the the subject of Moleskines, I have struggled to find something new to write about the little “cahiers” whose cost (£9.99 in WH Smith) is out of all proportion to their size, 9×14cm. Neither the sturdy cover, the closing elastic nor the back pocket would seem to justify the expense. It was even surprisingly tough to find, tucked away on a special carousel dedicated to travel notebooks and even that, said the sales staff, was an experiment. So why have I pursued this object throught the pages of Bruce Chatwin’s writings and several journalist blogs that have sung its praises?

The Italian manufacturers, Modo&Modo, declare to anyone who will listen that their product is the inheritor of Chatwin’s favourite notebook, despite a 12-year gap in production after the writer himself was last able to locate one, and the fact that the originals were made in France. They would even have us believe that the very same was employed by Van Gogh, Hemingway and Picasso for random jottings that became major works of art. These claims are dismissed by detractors as so much humbug.

It is a fact of modern life that marketing a product to a niche customer base is likely to involve the internet, preferably via an interactive website for users to exchange ideas. After endowing the Moleskine with a romantic pedigree no one is seriously in a postion to argue with, Modo&Modo must feel their attempts to do just that have succeeded beyond their wildest dreams. On their own website moleskine.com as well as others such as ‘SkineArt and even Flickr and YouTube, the artistic contents of the Moleskine, that epitome of private journaling whose symbol should be a writer hunched over in private concentration, are laid bare. The challenge seems to ring out: what can you do with this?

So what do I think about it? Expensive it is, but classy and highly portable. It opens well and has a pleasant feel in the hand while writing. Now I’ve got it, I’m already using it for brief notes written on the move, to develop later. Whether I’ll buy another one when this is filled is a different question.

At least Chatwin’s belief that “the Moleskine is no more” is no longer true. The Moleskine, or a version of it that may or may not be recognised by him, is here to stay.

The holiday conundrum

I’m trying to understand why I resent discussing my holiday plans with people I barely know. After all holidays aren’t private information, are they?

It was at the church fête where I shared responsibility for the children’s tombola stall with an elderly congregation member to whom I had rarely spoken until then. We had hardly sat down before she wanted to know what our holiday plans were for this year. As I tried to evade the question, we embarked on a useful digression over the differential holiday timings of my daughter’s secondary school compared with the rest of the county. But later the lady returned to the attack. She hadn’t got her answer, and she simply had to know where we were going on holiday.

Am I the only person on earth who is reluctant to be drawn into this? Deep down I think it’s the dullest conversation topic among strangers, on a par with reminiscing about the children’s TV programming of our childhood – a last resort for people who have nothing to say. At the fete with the old lady, it seemed rather early to proclaim our social failure, since we had only just sat down. Or did she need the information to pick over with other grey heads later in the week?

It might be a kind of snobbery but I don’t generally find other people’s holidays make stimulating listening, or reading. When Christmas comes round and we have to endure an endless stream of generalised letters, usually two single-spaced A4 sides of self-absorbed prose, it’s the holidays that bore me most. Beyond the experiences of close friends and family, I really don’t want to know. So why should anyone want to know about mine?

Where my old lady is concerned, it might just boil down to the vicar’s family phenomenon. In a small village you’re a kind of local celebrity and everyone wants a piece of you. This might account for people asking where I met my husband after knowing me for five minutes. From strangers, this intimate question is prurient, voyeuristic and not always well-intentioned.

And so I bring down the shutters and respond to these questioners the same way I treat those who think they have a right to park in our drive on a Sunday: with the defensiveness their intrusive behaviour deserves. I might appear rude when I ask why a person wants to know such things, but sometimes that’s a risk I have to take.

When I turned the question on my old lady, she told me she had already been on holiday. And in case you’re itching to know, I’m sorry, I failed to ask where she went. It was a good fête by the way.

Haunted by a memory that isn’t mine

A girl called Susan has been a part of my life for the past year. In recent weeks, as I have been immersed in her history, I almost felt I really knew her.

Susan died more than thirty years ago, aged 22, of a rare degenerative brain disease called cerebral lipidosis. This is an umbrella term for a group of diseases, the better understood of which are named after the person who first described it like Tay-Sachs or Batten disease, though Susan’s was never definitively categorised.

Just over a year ago I was asked to help Susan’s father Les, now in his eighties, write her life story. The research was slow, mostly interspersed with other jobs, and there were false starts to negotiate and red herrings to dispose of. Les was convinced Susan died from complications of mumps and not from an inherited condition, as cerebral lipidosis is, and one that requires a defective gene from each parent at that.

Slowly I have built up a medical picture with the help of a few doctors and an awful lot of medical records. Now I’m working on the human story, based on memories from Les and others who were Susan’s friends and on the canon or writings left behind by her mother Norah.

It was not unreasonable to blame the mumps until this explanation was ruled out by medical evidence. Susan’s path downhill, from a happy, bright and high-spirited ten-year-old, appeared to have its root in a bout of mumps. As she recovered from the infection her parents saw her movements become jerky, her speech slur and her academic performance plummet. As the years went by she got worse, dropping out of school after school as she became more disabled.

She was only correctly diagnosed at the age of 18. Cerebral lipidosis is a death sentence – no one recovers even today. And even today, a diagnosis can take several years to obtain. The only option left to parents of such children is to prepare themselves for the worst possible outcome. Les and Norah’s experience illustrates starkly how this disease operates: it teases the sufferer as a cat plays with a mouse. Susan’s condition permitted her a stretch of normal existence and then cheated her, snatching her hard-earned gains, reversing her development and finally robbing her of life.

Norah’s diaries bring to life a short period covering the few months after the diagnosis. Everyday occurrences are meticulouly recorded in a small, neat hand: the timings of Susan’s waking, eating and sleeping, the friends who visited or rang and the family’s efforts to overcome the restrictions imposed by life with a housebound daughter.

And yet until she was nine or ten she could have been any child. I find it hard not to be haunted by her small face grinning out at me from drawings and photographs, eyes sparkling, mischief just out of sight. She might have been one of the school children performing songs in church yesterday alongside my son, himself ten. I thought I glimpsed her thin shoulders jostling in the childish throng, her arms shoving her friends as they swayed playfully in time with the music, her high voice taking a lead in jokes and pranks. She would have been watched fondly by parents in the congregation.

And by now she would have been a mother herself, like me. Except she wasn’t.

The twin problems of superbugs and climate change

While preparing an article on the spread of superbugs, I was struck by similarities with our response to climate change.

Superbugs travel mainly on the hands of healthcare workers (HCWs) who fail to wash them adequately between patients. Correct hand hygiene is considered to be the single most important means of preventing cross-infection. But HCWs, who are trained in hand hygiene and taught the consequences of non-compliance, just don’t get around to doing it often enough.

Where this has parallels with climate change is that researchers believe the key to improving hand washing habits lies in the psychology of behaviour change. This notion, described in more detail below, could extend to our attitudes to lifestyles when considering the threat to our planet. We are being asked to switch from our well-worn ways to a new and costly path, but this doesn’t suit us and so we don’t.

The reluctance surrounding hand hygiene has defeated efforts to overcome common objections, such as abrasive soaps, uncomfortable towels and too few sinks. Even where these problems are addressed the barriers appear to be deep-seated in the mind, hence the foray into psychology.

But the research in this field is arcane and difficult to follow. You have to grapple with terms like “cognitive dissonance”, referring to an erroneous rationalisation of poor hand hygiene by HCWs arguing that the patient will benefit from the time saved. “Unrealistic optimism” points to a belief that infection is so unlikely, HCWs don’t believe they can ever be perpetrators.There are also psychological models to get to grips with.

The “Theory of Planned Behaviour” was used by Elizabeth Jenner, principal lecturer in infection control at the University of Hertfordshire, to determine the factors that might predict a HCW’s intention to wash their hands. The Australian specialist Michael Whitby divided hand washing behaviour into two types, one employed when hands are obviously sticky or dirty, and the other carried out automatically after, erm, certain functions. Jenner examined healthcare poster messages to find out which are the most effective at reminging HCWs of their obligations – the ones that instil fear or those emphasising the benefits.

I don’t know whether anyone has applied this type of psychology to climate change behaviour. It has certainly been used on other aspects of health, for instance in persuading people to use suntan lotion. But the topic of superbugs has features in common with climate change that distinguish it from other health issues: it represents an invisible and apparently far-off threat. An infection developed by a patient has no more likelihood of being linked to a particular instance of poor hand washing than a flood in a developing country with an individual motorist in the privileged west.

Furthermore, as Jenner points out, HCWs do not directly benefit from their own hand washing. She has shown that the losses in terms of time and damage to skin outweigh the gains to healthcare professionals. Lifestyle changes inspired by a concern for the climate, such as giving up the car or the plane, are similarly chosen at a cost to oneself.

Jenner argues that an element of altruism will be needed if hand hygiene is to catch on as it should. Whitby suggests teaching very young children that washing their hands is about protecting others as well as themselves. The sooner we realise that the same approach should apply to climate change, the better off we will be. If no one is individually to blame, we are nevertheless all responsible and everyone must act.

Sadly the New Scientist didn’t want the hand hygiene article, for which I blame the curse of the psychobabble. Yet the World Health Organisation endorses the psychological approach o the global challenge of poor hand hygiene. It goes further: its guidelines booklet released in 2006 highlights the role of religion in this very personal human activity. The authors point out that some faiths encourage ritual hand washing while raise objections to clinical cleaning products because of animal or alcohol components. Buddhists favour clockwise movements and for Hindus, the left hand is dirty and fit only for cleansing oneself. Cue a whole new field of research into religion, superbugs and hands.

If the researchers involved were asked to advise climate changers, they would probably say there are no magic answers. Good hand hygiene examples set by senior clinical staff must be allied to state-of-the-art facilities and, in the opinion of some, a reduced workload on nurses who bear the brunt of patient care. A carrot-and-stick approach is advocated by Paul Elliott, senior lecturer in nursing and infection control at Canterbury Christ Church University. He proposes regular personal development sessions, during which HCWs can discuss the details of their work in a non-threatening environment, and greater disciplinary powers for infection control staff to deal with non-compliance.

And what of climate change? Solutions emerging from the grassroots include ecoteams to discuss one’s carbon footprint, information days and reminders in offices to switch off appliances and turn the heating down. These are countless tiny gestures whose cumulative effects cannot be calculated. But the real answers will have to come from above: redesigning our transport system, radical though it is, would be but a first step in a profound reorientation of our economy away from its dependence on oil. Climate change, like superbugs, may be with us for a while yet.

Journalists – wired or not?

All journalists of a certain age have had to learn the computer.  No, they’ve even been grateful for its forgiving nature, especially those who can remember when press day meant the clatter of thirty typewriters in a hot newsroom.  And we more recent entrants of a certain age have had to catch up on our own: we word process, we email, we surf the net – what more can be expected of us?



I seem to have joined the blogosphere at a time when debate is raging about the place of the internet in news.  Turn this notion on its head: those who long ago embraced blogging, social networking and image sharing are now questioning the place of printed newspapers in news dissemination.  Are traditionalists right to worry about the appeal of the screen to the next generation of their customers?  And is the gap between techies and luddites really getting wider?If so, howardowens.com has thrown down a timely gauntlet to journos to become fully wired up in a year.  Call it a new year’s resolution: we’re to blog, upload our videos, share photos online, launch a virtual social life, subscribe to news on RSS and reveal our favourite web haunts with a social bookmark.  Howardowens.com means to have us fluently mashing and twittering by the end of 2008.



Well, this humble freelancer might not be eligible for the prize at the end of it, but I’ve certainly looked around the ideas, thanks for the links.  First the blog: just created (thanks Katy!), this is only my second post.  I haven’t even decorated it yet so don’t get too critical; treat it like I just moved in.Next I visited YouTube and chose a video that refused to do anything but stare back at me.  My computer politely informed me I needed some new software which it promptly refused to download –  short, apparently, on Java-literacy.  So many obstacles when the spirit is willing but the hardware is weak.



On social networking, Facebook sounds good, it’s where many of my friends are and probably the logical place for me.  But the neophyte is rebuffed from the off by needing to be a member before they can look at anything.  ”Trust me,” the software seems to say, “the water’s warm and you’ll love it once you’re in.”I remain unconvinced by social bookmarking and even RSS.  Isn’t it all a bit addictive and time-consuming, I mean, when do I get the day job done?  or do you guys stay up all night?



So I’m going the slow road, gently blogging, learning html so I can build a website, oh, and perhaps a computer upgrade at some point.  Who knows, I might even make it on YouTube and Facebook by the end.  But hey, Rome wasn’t built in a day, or a year, was it? 

Stephanie writes:

Welcome to my first ever blog! There’ll be plenty more here in future, so watch this space… Meanwhile, happy new year to all my visitors.