Sunday, 14 July 2013

My blogpost on the feminist group blog

I wrote an anti-disablism, anti-cuts, intersectional, feminist blogpost for Hampshire Feminist Collective for Disability Awareness Day.

It can be read here:

Thursday, 7 March 2013

Here’s a toast… to abortion rights, on International Women's Day

I wrote this some time ago (this will become obvious given that it mentions a few news items that are now not so topical), and not got around to publish it. Today, International Women's Day, seems like an appropriate time to share it.

Here’s a toast… to abortion rights 
This is what a feminist doctor looks like

Ani diFranco’s song Self-Evident, which is mostly about the September 11th attacks but also about so much more, includes the line:

“Here’s a toast to all those nurses and doctors who daily provide women with a choice”

Today I provided a woman with a choice – her choice for an abortion. A termination of pregnancy. I administered and inserted the medication to end her early pregnancy. In practical terms, it was the same as what I often do for miscarriage, there was no difference in the procedure; the difference was that in this case, the embryo/foetus was alive. We were ending her pregnancy because she wanted us to.

I am really proud of this. I am pro-choice and proud of the fact that I can help make abortion accessible to women who want it (following appropriate counselling) and that we live in a country where this is available. I believe women* have the right to choose.

That’s not to say I think abortion is great; it’s a shame to lose potential lives especially when there are so many people in the world who would do anything to have a baby, but the right of the woman to have control over her body and her future trumps any right of some cells and tissue that are only a potential person rather than an actual person.

In a month where the news has been full of debate about Savita Halappanavar, the woman who died in Ireland, from septicaemia due to infected products of conception (infected pregnancy/miscarriage), after she was denied an abortion for a pregnancy that was failing anyway and making her very unwell. Although the Irish law is extremely restrictive on abortion, it appears that they could have ended her pregnancy, and increased her chance of survival, whilst still acting within the law, given that there was “real and substantive” threat to her life.

So this is how I express myself as a feminist doctor – I do the same job as other doctors would, I just get a bit more enthusiastic about it and about the opportunities that this job provides, opportunities for making the world a better and pro-choicier place.

I’d stiill do this even if we had vile campaigners, (such as Abort67, who have recently been targeting university campuses [graphic picture in link]) protesting outside the hospital, although I am very glad that there aren’t any. They’re probably not aware that we do social terminations in the NHS hospital, since it’s not an abortion clinic. The protest groups are deeply unpleasant, wildly inaccurate in the “facts” that they quote, and wave horrific pictures, which must be so traumatic for anyone who has ever miscarried a wanted pregnancy, to see – some of those pictures could bring back very painful memories.

In conclusion, I am glad I can do important things in my job, and please would Jeremy Hunt and vile Nadine Dorries (the jungle could keep her) back right off and leave me to do my job to the best of my ability with the best medical evidence available. Kindly stop spouting rubbish about abortions and throwing your political weight around, when we could be having sensible discussions about how to ensure reproduction rights for women, whilst also considering also the appropriateness of interventions concerning the foetus. Note sensible discussions.

Right, I’m off to a Reclaim the Night march and rally (gender inclusive).This is what a feminist doctor looks like!
(yes, it's not Reclaim the Night time of year, but it was when I wrote this!)

This is a picture I took of the badge display at the Women's Library in London, which I visited recently. It is a wonderful treasure trove of feminist history, I'd thoroughly recommend it! (Visit before 22nd March, when it closes and moves to a new venue in June)

As an aside, I recall a conversation amongst medical students when I was in my 3rd year of medical school (5 years ago – took the scenic route through medical school) about FY1 junior doctor jobs. We discussed that gynae might be good, and someone pointed out that you’d have to do abortions if you worked in gynae, and that really put me off. I remember thinking that I agree with women having a right to an abortion, but I didn’t want to actually do the abortion myself. I had a different, and rather inaccurate, understanding of what the actual process involved, but I’m very glad my opinions have changed since then. I’m glad the women I look after can have someone performing their abortion who’s not uncomfortable about doing it.

*women and any other pregnant people – people with various trans identities can have anatomy permitting them to become pregnant without defining themselves as women. It wouldn’t be the first time (e.g. the American Thomas Beattie, and the wonderful Jason Elvis Barker). I have frequently referred to “pregnant people” in a range of contexts, rather than “pregnant women” and almost every time, it gets me a funny look, but I maintain it’s more accurate and inclusive.

Personally I’m a lot more comfortable with the term “woman” to describe myself than I was a few years ago (one can be both trans/of queer gender and identify as a woman without being a transwoman, they are not mutually exclusive) but even so, if I were to become pregnant, I might rather be thought of a pregnant person than everything being “woman” somehow. And my own identity and preference doesn’t make me any less of a feminist.

One day, I intend to follow up this post with another post looking into what happens when women are denied the right to abortion, and also what happens when they do have an abortion - there is some interesting research I'd like to collate. Watch this space.

Sunday, 30 December 2012

Christmas #2 - the depressing side of the season

Although I wasn’t working on actual Christmas day, I was working on Christmas Eve, and as mentioned previously, a 12 day stretch in the run-up to Christmas. Christmas around the hospital can be a pretty depressing affair, not because people have to stay in over Christmas and "isn’t that sad?" – it is, but family visiting can make up for it, and when patients are properly ill they seem content to be in the right place and receiving intensive medical intervention, even if the timing is a bit rubbish. It’s depressing because of the patients who want to be there, because hospital at Christmas is the best they’ve got.

I’ve come across a number of patients recently (it’s more of an issue in general surgery than it was in gynae) who are in hospital more because they want to be than because they need to be. I can imagine the outcries of “how is this possible, the NHS is stretched enough as it is!” but the difficulty is that it is very difficult to boot patients out, kick them out and onto the street. Discharge is a collaborative process, and requires the patient’s input, or if the patient has no capacity for this input, then the family or nursing home etc are involved.

There are the patients who were content at home, but came into hospital for surgery, and rather enjoy the multi-bed ward and socialising with other patients, the being cooked for, the lovely nurses and the nursing care, and suddenly realise that home is desperately lonely and they don’t like it anymore. This manifests itself as them realising, or proclaiming, that they need care at home, and it then falls to the hospital to try to organise this, which is a very lengthy process. 

The time taken for this is why many patients, particularly in an elderly care ward, will have days of “MFFD” recorded in the notes – medically fit for discharge, i.e. awaiting the social situation to be sorted out. Obviously sometimes this is absolutely essential, such as for elderly people with a very high care requirement and complex medical needs, which cannot be catered for in many care homes so it takes time to find the right one. But there are others for whom the care given is less essential, they coped without it previously and they are hardly less able to cope now, but it’s become understood that it is required.

A specialist nurse I work with believes the cuts to day centres have led to an increase in the number of patients who decide to stay in hospital because home is lonely. If they could go to a regular day centre, home wouldn’t be as lonely, and therefore hospital wouldn’t be as appealing. Yet another example of how cuts can lead to increased costs elsewhere…

There are the patients who can’t possibly go home because the problem they came into hospital with has not been fixed; they are still suffering with pain or sickness or whatever brought them in. As much as I love the idea that we can fix everyone who comes in the door, solve every problem, and make everyone feel better, that is sadly not how it works in reality, but sometimes is how it works in a patient’s head. It’s a sad thing, an unpleasant situation, to send a patient home still suffering, and with an end to that suffering not necessarily in sight – but sadly we are not magic. 

Explaining to the patient that our thorough and extensive investigations have shown no cause for their pain, there is no acute or life-threatening problem, there is no cancer, there is no obvious disease, there is essentially, nothing that can be fixed by a hospital stay, and nothing that can’t be improved by some pain relief, regular review with the GP, and community-based input such as physiotherapy, is not always a fruitful exercise, and some patients end up staying longer in hospital because they think they should be there. 

Those patients are slightly less likely to stay in hospital over Christmas, because they may eventually have somewhere better to be, once they have realised that there really is nothing more that the hospital can do to “fix” them, and being in hospital over Christmas is not the best thing that life has to offer them, and the benefits of going home start to outweigh the (perceived) benefits of staying in hospital.

The most depressing thing is the patients for whom staying in hospital, or even worse, being readmitted to hospital following discharge, is the best thing life has to offer them at Christmas. Their family either don’t want them, or don’t make it clear to the patient that they are wanted, so the patient has the sense of being a burden on the family, even if they aren’t (this seems to be a depressingly common occurrence amongst the elderly). So having a hospital bed over Christmas is the nearest they can get to seasonal happiness.

That doesn’t reflect well on us as a society. Look after your old people – if only for the sake of keeping the hospital beds free for the people who really need them.

(I realise this may come across as hypocritical following my complaints about my grandmother in my previous post, but she has never spent Christmas alone. The responsibility is shared between my relatives, not because she is a burden, but because we have a sense of duty to ensure she feels welcomed and as happy as possible each Christmas, and regularly throughout the year.)

Wednesday, 26 December 2012

Bah, humbugs. Minty!

(NB This was written around the 22nd, but not finished and edited til Boxing Day)

I am not really feeling Christmas this year. I am never a massive Christmas fan, since it often involves my granny, who is acceptable in small doses but beyond that her sickly sweet manipulativeness and inability and unwillingness to cope with my sister's complexities (mostly her autism/Asperger's) get too much. Or it involves balancing my family and my other half's family so that we see both families and still see each other (one of the rare times I'm glad our families live near each other). Or it involves going mad getting stressed out on the high streets trying to buy EVERYTHING.

On the day, I do enjoy it, that I get to spend time with my family (parents and sister) and the other half, and there seems to be a Christmas tradition that a load of my home-friends, from the various schools I attended, go out on Christmas eve so there's a general catch-up which is great. So there are good bits. And I enjoy the proper time off - always at least two weeks, as a student, even though last year that was spent stressing about finals, and most years it involved a couple of days working in my wonderful job in my wonderful museum, which even though it was work, was still a break.

This year I have two days off, Christmas day and Boxing day, and since I've just worked a very difficult and draining 12 days in a row (someone insert a joke about the 12 days of Christmas here please) I'm not going to be the life and soul of the party. That takes more energy than I have! I'm just hoping that I get to the party/Christmas eve gathering in the pub at all, and that I don't finish work so late that I've missed everyone by the time I get there.

Today, 22nd, is the first time I've done any proper Christmas shopping - I've picked up the odd thing here and there, the first was in June (be impressed) but I haven't had any time until now to actually shop for anything. It's rubbish that not having time for Christmas shopping is such a big deal - Christmas shouldn't be about the shopping. Or the presents. Or the commercialism which is massive and horrific and all-pervasive.

This year, having seen something on facebook a while ago denouncing the commercial nature of Christmas and encouraging shoppers to support small businesses in their Christmas shopping. It was only a facebook thing but I took it to heart. I have bought three things from a chain shop, the rest from festivals or Christmas market stalls or Amnesty International online shop, and it feels wonderful. My money has gone to small and independent business, who actually pay their taxes (Amazon, you aren't getting any money from me, tax-avoiding scumbags, even if it is legal!). I'm really happy about this, and I like the idea of continuing this in future years.

Work, being a very junior doctor on a new rotation where I know nothing yet do everything, means that my energy for doing and enjoying Christmas is at an all-time low. The first time I actually have money and might therefore be expected to buy decent presents, I have no time or energy to do so. On the plus side, it means my expectations for Christmas are non-existent. All I want is a break, and the chance to spend some proper time with my family, time when I'm not meant to be busy doing something else. I am so, so looking forward to that. I don't care about the turkey, it's too much effort and takes time away from just spending time together.

I feel I've neglected my family - the last time I spoke to them was on day 1 of 12, and day 12 was yesterday. So two days where it's just me and my folks, and some of the time the other half, and maybe some friends on Boxing day, sounds amazing.

So on the one hand, I'm not in the Christmas spirit in any way. On the other hand, I am massively looking forward to it. And to getting some proper sleep for a night or two. Father Christmas better not wake me up.

A post-script: I did get out of work in time to travel home and get to the pub on Christmas eve, although the older we get the more people have moved away and the fewer friends are there, but it was fun nonetheless. I then fell asleep on the sofa after the pub, and my mum had to wake me up and make me go to bed. I woke up late on Christmas day. My sister and I made a dedicated and concerted effort to spend all of Christmas day in our pyjamas, because we could, so we did. I was knackered and had a head-cold (still! stupid virus) but that was no big deal. Working 12 days in the run-up to Christmas, with the weekend off being busy and full of Christmas preparations, clearly took its toll.
But Christmas was pretty much everything I had hoped for. Lovely.

Tuesday, 20 November 2012

Remembering our Dead

Today is Transgender Day of Remembrance, and we remembered our dead. We remembered and celebrated the lives of 265 people who have been killed due to having a gender identity or gender presentation perceived to not be “normal”. 265 in the last year.

Many of them will not have been remembered or celebrated on any other day, or by anyone else, except for the day of remembrance. Some didn’t even have recorded names, only recorded brutal manner of death.

We remembered, and acknowledged that those transgender people who are more likely to be killed are women, people of colour, those who don’t live in Western Europe, and particularly those who live in Latin America, and those who were sex workers – usually due to the above factors combining to make it very difficult for them to be accepted in any other line of work. Whatever the factors, none of them deserved to be brutally murdered.

Today I remembered with about 200 other people (a rough estimate – generally LOTS, the chairs ran out) in London. The last time I went to the service in London was four years ago, and we fitted into a much smaller venue then. To have a bigger service with more people paying their respects is significant. Sadly although the numbers of participants and audience in the service has changed, I think there has been little change in the number of names read out. Just to give an idea of the scale, reading out the name, age, and location of each person murdered in the last year, takes about an hour in total – no breaks.

It also required readers who were adept at Spanish and Portuguese pronunciation – a vast majority of those murdered had lived in Latin America, specifically Brazil and Mexico, and some in Venezuela. Countries further south in America, such as Chile and Argentina, were not represented in the names in any number.

I can’t help but wonder what on earth they must be doing to Brazilian boys and young men to instil a culture in which gender conformity is everything and anyone who disobeys society’s gender rules deserves to die, and it is their right to ensure this happens. What goes on in a society to cause that to be commonplace? And what can be done to counteract this?

I don’t imagine this blog has any Brazilian or Mexican readers, why would it, but just in case it does: look after your country’s trans people, and do all you can to create a culture in which gender diversity is not only not stifled with death, but actually accepted. Love each other – if only love could stop murder.

It sounds strange, but I found it almost difficult to be moved by the service. So many, many names, they start losing their meaning and stop being people, if you don’t engage your brain and emotions and register what’s actually been happening to them and what’s being said. Today’s service didn’t include mode of death – it did a few years ago and some of the youngest participants at the service were understandably very upset. But on the other hand, it forces people to acknowledge the horrors that have happened and not just allow the hundreds of names to wash over them. I forced myself to really think about it, and even then it’s impossible to fully comprehend the scale of systematic transphobic murder that’s taken place – I’m lucky and privileged enough to not be able to get my head around it.

I try every year to attend a trans day of remembrance service – I didn’t two years ago, I went on holiday, and it felt a bit wrong. That was one of the first blogposts I almost wrote (but didn’t quite) about how important it was to me, even though I hadn’t attended. The other half and I even attended the service in Berlin, six weeks after arriving there, and we added some words to our German vocabulary, that we had never wanted to add (e.g. geschossen = shot). Attending today’s service was one of the deciding factors in me taking today as leave and being in London. Even though I find some of the more upbeat parts of the service slightly difficult to swallow given the juxtaposition with the sombre nature of the service (some feel it’s also a celebration of life/want to ensure people don’t go straight from the service and into the Thames because it’s so harrowing), I’m glad I went.

Here’s to a shorter list next year. And every year thereafter.

Just to dispel some misconceptions, which I picked up on in the comments of this Guardian article from last year: TDoR does not commemorate trans people who have died by suicide. There are many – being trans is a significant risk factor for experiencing mental health problems, self-harm and suicide, but TDoR is specifically for trans people who have died at the hands of others, not their own.

It has nothing to do with Remembrance Day or poppy day or Remembrance Sunday at all, except that both are to do with remembering dead people. The trans people who we remember at TDoR did not fight for us or die for us, they simply lived their lives, tried to be themselves, and were murdered for it. Nothing whatsoever to do with soldiers and war and Remembrance Day.

Also, although I refer to “service” there is nothing religious about it. Some people may choose to bring a spiritual element to their remembering, but it is not a church service and is not religious.

To finish, because sometimes art speaks better than prose, and because it was such a poignant and appropriate piece to have in the service, I am sharing the poem Elaine read out, with her permission. It makes the reality hit home further.

It’s not about us.
It’s not about those of us sitting here, standing here, living here.
It is about those who cannot be here.
Those who should be here with us, somewhere in the world.
Those who are gone.
It’s about them.

It’s not about us.
Yes, we have many things to say, and many things that need saying, and maybe our voices are often ignored but we can still speak.
It is not for us to put words in the mouths of those who have had their breath stolen from them.
Those who should still be able to tell the world who they are.
Those who were taken from this world for who they are.
It’s about them.

It’s not about us.
I stand here white, middle class, here in London with a warm bed to return to.
It's not about us.
Because this world finds so many ways to hate, to silence, to erase those it deems less worthy.
Their race is not incidental. Their work is not incidental. Their nationality is not incidental. These things are not incidental but integral as this is intersectional.
And did we pay them any attention before they were gone?
It’s about them.

It’s not about us.
We are still fighting battles, personal and cultural and political. And these are battles to be fought but
These people are not martyrs, these people did not die for a grand cause.
Their deaths are pointless, senseless, symptoms of violence and racism and misogyny and the ways we casually turn people into nothings.
Their deaths should not be our politics.
It’s about them.

It’s not about us.
We are not here for us.
We are here to remember and to mourn and to mark those who society finds so easy to overlook.
We are here for them.
These people are so much more than names, a photograph, if we even have those to remember them by.
These people deserve to be remembered but far more they deserve to still living their lives, telling their truths, laughing and crying and dancing and smiling but they are dead.
It’s about them.

And not just the people on the list, all 265 of them when even 1 would be too many.
It’s about those people who are not on the list because nobody noticed, nobody knew, or nobody even cared.
Those who were further erased in death, identities taken and torn apart from those no longer able to defend themselves.
Those who never even made a footnote in the paper.
Let us think of them.
It’s about them.

It’s not about us.
We can always have tomorrow.
It’s about them.
They don’t even have a today.

It’s about them.
And next year, may the list be shorter.

Monday, 22 October 2012

Once a faily student, always a bit faily (or ex-faily)

Was thinking yesterday* how my final exam fail (and other final exam near-fail) probably contributes to why I dont have as much clinical confidence as I'd like, and explains why I'm not as methodical as I should be. Or rather, my lack of logic and method explains why I failed.

Meeting with educational supervisor:

Supervisor: foundation years are a steep learning curve, especially when you've probably always done really well and never failed anything...
me: actually, I failed a final exam...
ES: really? Why on earth did we give you an academic job then?!?!
me: you gave me the job before I failed
ES: oh well, it's not the end of the world
me: it certainly seemed like it at the time!

I guess it's something that I'll never forget about, but the significance will hopefully fade over time. It should stick with me long enough to prevent me getting much too big for my boots anytime in the next few years- I know I could still be capable of screwing up.

However, some days after this conversation, I had a potentially good idea: I know, and documented extensively on the previous blog (here and here) how horrible it is to fail a final exam and to have confidence shattered and to get totally burnt out and have to find some way of picking yourself up and carrying on (or relying on others to pick me up and carry me on – I am still so, so thankful to the wonderful people who helped me prepare for my re-take).

Maybe I can help other faily students to pick themselves up and carry on, help motivate, help practice, help them realise that help might be there for the asking (if their fellow students are as wonderful as mine were). A little investigative work tells me the number of students currently retaking final year at the place where I’m working (I’ve got an academic foundation job – it should come as no surprise that I’m working at a hospital involved with a medical school) reaches double figures, so perhaps there’s a market for this concept, for want of a better word. I just need to work out who to contact about it, and see if the other openly faily F1 doctor (who has of course, now passed, that’s why they’re an F1) wants in on this.
I don’t have training in motivating people, but I think personal experience that would be relevant here. Watch this space…

* Not yesterday, actually ages ago, but that’s how long it takes me to write a blog these days.

I'm not dead, just being a doctor

Sorry it's been forever (well, 6+ weeks) since I last posted. Or not sorry (I did once blog about how I shouldn't feel obligated to blog... but then I also planned to blog three times a week).

I'm not dead, just been busy working. Which is very busy. Though apparently will get worse when I'm working in surgery and moved on from generally-reasonably-well-supervised gynae.

A three day weekend seems to have got my creative blogging juices flowing again, slightly.

Also, I STILL have lack of internet to blame, partially, for my lack of blogging - thanks Tesco totally rubbish Home Pho-one and Broadband (yes I still find it odd and mildly entertaining that the woman on their phone message pronounces phone with two syllables... I have spent FAR too much time listening to her!).

Here's to the blog. Or not.