The joy of dogs

For three years after the death of Khymer I was without a regular canine companion to walk, but am now having daily adventures on the beach with Ireland – a big black bouncy Labrador.

There is plenty of evidence that dogs are good for the wellbeing of humans. They provide loving companionship, a stimulus to take exercise, and opportunities for social interaction. Dog owners tend to have better physical and mental health than those without a dog, for example lower rates of cardiovascular disease and depression. These benefits as reported in many research studies are undoubtedly real, although they may be over-estimated to some extent because less healthy people are less likely to get a dog in the first place. Dogs have an established role as therapists: guiding the blind, visiting residents in care homes, supporting disabled children and adults, predicting the onset of epileptic fits or hypoglycaemic episodes, even sniffing out the presence of early-stage cancers.

Dogs can also present hazards. Falls are one danger, as I know to my cost: on one occasion when Khymer was forging ahead along an uneven pavement I tripped and broke my arm. Over-enthusiastic dogs often want to run up to strange people, or other dogs, and can easily knock them down. Constant vigilance is required during off lead walks.

Dog ownership is a significant responsibility. Leaving aside the dreadful cases of neglect and cruelty I have seen at the SPCA, many otherwise well-meaning owners leave their dogs alone at home while they are out at work all day, never realising how much they suffer from the lack of company and exercise. An ideal solution, as promoted through charities such as the the Dog Share Collective through which I met Ireland, is linking up such owners with people like myself who would love a relationship with a dog but for various reasons cannot have one of their own.

 

Ireland digging on beach

The building blocks of fiction

There are said to be seven key elements in fiction: character, plot, theme, point of view, setting, conflict and tone. Which comes first when writing a novel? My own current fiction project is based on a theme: how personal identity relates to family background. Though the story is not autobiographical, my interest in this topic was prompted by some recent events in my life which lead me to consider such questions as: How do people respond when faced with a stranger claiming to be a close relative? Or when their own parentage is called into question? Is personality shaped more by heredity or early environment, and can either of these influences be overridden by the exercise of choice and free will? Now that DNA testing and online genealogical databases are so easily available to anyone with an internet connection, more and more people are being faced with questions like these. I am finding the writing process quite hard going, probably because tackling a theme is not the easiest starting-point for a novel, at least not in my hands. It is best for themes to emerge subtly, rather than being thrust down readers’ throats, and sometimes even writers themselves are not aware of them.

There is no right or wrong way to begin creating a book. Some writers are inspired by the setting: a geographical location, social community, a historical period or imagined future. For some the plot is key, whether they work out a detailed outline in advance or see how it evolves as they go along. Some focus on the personality of their characters and the relationships between them. Others pay most attention to style and structure, aiming to create a sense of suspense, conflict, mystery, excitement, romance, wish-fulfilment or whatever is required by fans of the genre concerned.

My own six previous novels were inspired by personal experience of real-life settings: for example my first summer in New Zealand (Carmen’s Roses), and working with patients in an old mental hospital (Overdose). I did not consciously set out to explore particular themes when writing them but, looking back, several themes did emerge: the conflict between orthodox and alternative medicine, illicit romances, and later books contain a hint of the supernatural. They do not fit into conventional genres and were not designed to have mass market appeal, but some readers have enjoyed them enough to post nice reviews online. I have no idea when, if ever, my new novel will be ready for publication but meanwhile details of my earlier books can be found on Amazon.comAmazon.co.uk or Smashwords.com.

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Choice at the end of life

A bill to legalise voluntary euthanasia and assisted suicide is currently being considered here in New Zealand. Passionate campaigners both for and against have put forward compelling reasons to support their case. At one extreme are those who believe that human lives are sacred and only God can determine when they should end. At the other extreme are those who believe that each individual has the right to control the timing of his or her own death. Logically it is not possible to agree with both views, but perhaps there is scope for some compromise between them.

The term euthanasia, according to its Greek origin, means a “good death”. Much as I dislike the idea of deliberately ending a life, I do think there is a place for assisted dying for patients who are already finding their situation unbearable, or who wish to avoid likely suffering and loss of dignity in the future. But such cases are a minority. When I was in medical practice I got to know many patients with terminal or incurable conditions, mostly advanced cancer, and I do not believe that most of them would have wanted euthanasia or assisted suicide even if these options were legally available – though I remember a few who did. Similarly, recent surveys have found that many people with severe permanent disabilities have no desire for euthanasia, and are often worried that they might be pressurised into having it if the bill becomes law.

There are some strong arguments against euthanasia, but I think they need to be qualified. Looking at some of them in more detail:

“Euthanasia goes against the sanctity of life and the will of God.” This is the position of the Catholic Church and many other religious traditions. While respecting this belief myself, I do not think it justifies withholding the option of euthanasia from those who hold a different view. For this reason, when an anti-euthanasia submission was recently presented to our local congregation after Mass, I did not sign it.

“There is no need for euthanasia because symptoms and suffering can be so well controlled with modern palliative care.” I disagree with this one. Only a minority of dying patients have access to specialist palliative care. Even with the best of care, there are a few terminally ill patients whose symptoms and suffering cannot be relieved. And what about old people who may not have any specific life-limiting disease but would welcome death to release them from weakness and frailty, aches and pains, failing physical and mental faculties, loneliness and lack of purpose?

“Euthanasia may be undertaken too lightly, and against patients’ real wishes.” This is a real risk. Some people will feel obliged to request euthanasia to avoid being a burden to others. Well-meaning medical staff can judge that some patients’ lives are not worth continuing, when the patients themselves might disagree. This can also apply to the withholding of life-sustaining treatment, which could be called passive euthanasia. I have just read It’s Not Yet Dark, a memoir by the late Irish film maker Simon FitzMaurice. He describes being discharged from a hospital without being offered home ventilation because doctors had assumed that someone with his diagnosis, namely motor neurone disease, would not want their life prolonged. In his case they were quite wrong, and he was able to obtain a ventilator and spend several more worthwhile years with his family. A less informed and articulate patient could not have achieved this.

“There could be deliberate abuse.” Going further down the “slippery slope”, legalised euthanasia could provide a cover for murder. Family members might want to dispose of a sick or elderly relative, in order to make their own lives easier, or to get hold of an inheritance. Euthanising incurable chronic patients, who require expensive and time-consuming care, could be said to enable the more efficient use of scarce health care resources. Recent history has shown the potential for mass killings by authorities in the name of racial cleansing or medical research.

“There can be psychological damage to the staff involved.”  The same applies to clinicians carrying out abortions, and veterinary surgeons putting animals to sleep. There is certainly scope for conflict and distress when those trained to preserve life are called upon to end it, depending on whether they believe they are doing the right thing, and on the method used. Prescribing a fatal quantity of drugs, for the patient to take at a time of his or her own choosing, would seem a less harrowing experience for a doctor than administering a lethal injection – although the end result would be the same. Besides affecting staff, unnatural deaths can have a deep impact on the family and friends of the deceased. Consenting to euthanasia of a sick pet, and hearing about the suicide of a colleague, have counted among the most distressing events in my own life.

In summary my own view is that euthanasia and assisted suicide can be justified occasionally, though literally as a last resort, on condition that the patients concerned have given informed consent; if other treatment options have been carefully considered and excluded; if clinicians with religious or ethical objections are not obliged to take part, and if there are safeguards against abuse of the system. I suspect that many people who support euthanasia in theory might sign up in advance when still in reasonable health, then decide not to go through with the option when it actually came to the point – but having a sense of control is a very important aspect of coping with illness, and I believe patients should be allowed that choice.

 

 

 

 

 

 

Medical cannabis

Access to medical cannabis is tightly restricted here in New Zealand, and progress towards a more liberal approach is slow. I understand that doctors are allowed to prescribe Sativex on an individual basis for such conditions as advanced multiple sclerosis or intractable epilepsy, but that many are reluctant to do so, and that patients have to meet the high cost of the product themselves. And following a recent law change, people with terminal illness can now use home grown cannabis without fear of prosecution for themselves or those who supply them. But using cannabis outside of these circumstances still carries heavy penalties; according to the police website, these range from a $500 fine for possession to a 14 year jail term for supply or manufacture. This despite the fact that cannabis, with its analgesic, anti-inflammatory, anti-tumour, anticonvulsant, antispasmodic, anxiolytic and sedative effects, has been used for healing purposes for thousands of years and is now legal in many other parts of the world. Cannabis oil can be taken by mouth, inhaled, or applied to the skin.

My personal interest in this topic began in an unusual way. Unlike many students I never tried cannabis at university, because I moved in fairly conventional circles and also had an aversion to smoking. Then last year I was intrigued when a homeopath suggested that Cannabis sativa would be a good remedy for me. Shortly after this I came across a series of online documentaries called The Sacred Plant promoting the value of cannabis for treating cancer, epilepsy, arthritis, multiple sclerosis, other autoimmune disorders, and AIDS. While this series was focused on the benefits of cannabis, with minimal discussion of any potential downside, it convinced me that this plant has huge medicinal potential and has been unfairly stigmatised. Heavy recreational use can certainly be harmful especially for adolescents, but it seems wrong to criminalise sick people who are seeking the plant’s therapeutic effects.

Formal research on patient populations has been hampered by the legal constraints but there are some published clinical trials, besides many laboratory studies and a wealth of anecdotal evidence, supporting its use. The National Cancer Institute in the USA has produced an excellent review, including a detailed version for professionals and a simpler one for patients, not limited to the cancer setting. Cannabis can alleviate symptoms of pain, nausea and vomiting (including that caused by chemotherapy), lack of appetite and weight loss, anxiety and insomnia. Importantly, it also has potential for treating the disease which underlies these symptoms. Like any effective drug cannabis can have unwanted effects and interactions, but these usually seem to be mild in comparison with those of many orthodox medications.

Two main constituents of Cannabis sativa are THC (tetrahydrocannabinol) and CBD (cannabidiol). Both have medicinal properties but THC is mainly responsible for the “high” sought by recreational users, whereas CBD has minimal psychoactive activity and can be freely purchased over the counter in many countries including UK, Australia and many states of America. The plant also contains hundreds of other chemical compounds, found in varying proportions in the seeds, leaves and stalks and depending on which strain is used, and there is still much to learn about how its extracts can best be prepared and used medicinally.

My own health is reasonably good but I do have a few medical problems of a kind that could be helped by CBD, and am tempted to buy some on my next overseas trip. But I doubt it would get past the clever beagle dogs who patrol Auckland Airport to sniff out illicit drugs.

Cosy Crime?

Assigning their books to the most suitable categories in online databases is an important part of marketing for self-published authors. People looking for new reading material often search under these categories, but will be disappointed if the content of what they get is different from what they expect. Several different categories would often seem equally appropriate for the same book. Determining which of them will achieve optimum exposure on Amazon is a complex process, and there are websites giving expert advice.

In my own experience I have found that classification of non-fiction books is usually quite obvious, but finding the best category for novels – many of which could be described as “cross-genre” – is more challenging. Thinking back to my medical career, it reminds me of the difficulties faced by doctors who are required to give diagnostic labels to that large number of patients who are clearly ill but whose symptoms do not match any officially recognised disease.

Taking crime, mystery and detective fiction as an example, classification systems such as BISAC (an acronym for “Book Industry Standards and Communications”) include many different divisions and subdivisions. Both as a reader and a writer I find it somewhat overwhelming to have so much choice, though I realise the development of these subject headings is based on extensive market research.

A code I have avoided up till now is the one called “cosy” (UK) or “cozy” (US). I feel this term sounds uncomfortably twee and – given that books about murder are designed to entertain – that it goes too far towards trivialising such a serious topic. The phrase “cosy crime” is surely an oxymoron, though perhaps this is the key to its appeal. Some “cozies” – an even more irritating name – are far too whimsical for my taste. But a recent conversation with a writer friend prompted me to Google descriptions of the genre, and I found that it was broader than I realised. According to the entry in Wikipedia, typical features include:

  • an amateur detective, usually female
  • a closed community setting such as a village or a house party
  • murder by a non-violent method such as poisoning, often occurring off stage
  • murder motivated by greed, jealousy or revenge, often rooted in the past
  • little or no sex
  • emphasis on character and plot rather than action
  • a thematic element relating, for example, to pets or hobbies (BISAC has introduced the subdivisions of general, cats and dogs, crafts and culinary)

Most of the books by the great Agatha Christie meet these criteria, and they are now classified as “cosy” – though I think this gives quite the wrong impression, a view apparently shared by her great-grandson James Prichard, who administers her estate. What other term would be better – “traditional” perhaps?

My own novel Fatal Feverfew, a rather lightweight and old-fashioned murder mystery set in England’s west country, fits well into the cosy genre as described above. A while ago one reader gave this book a negative review, and I think this was partly because I had referred to it as medical fiction and it did not align with her conception of that genre; medical crime novels are usually more graphic and dark. I have now moved Fatal Feverfew into the cosy category on Amazon and Smashwords, and hope this will help it reach an appropriate target readership.

Top twelve books of 2017

Once again, with the help of the annual summary provided by Goodreads.com, I have looked back at the books I read last year and selected twelve of the best. It was a difficult choice because I had listed 44 books and these were only the ones I really liked, because out of respect for fellow authors I no longer post ratings of less than 3 stars or review books written by friends. Not having done much writing of my own lately I spent more time on reading books by other people, spanning a wider selection of genres besides my usual focus on mystery/crime/psychological thrillers, and including some that were heavy in more ways than one.  In alphabetical order:

A History of Loneliness by John Boyne: a powerful novel about the mental conflicts of a devout but somewhat naive Irish priest who is unwillingly forced to acknowledge the issue of child sexual abuse within the Catholic Church.

A Very English Scandal by John Preston: a “non-fiction novel” about the politician Jeremy Thorpe, who was accused of the attempted murder of his homosexual lover. Writing with brilliant dead-pan wit, the author manages to turn this sad and sordid story into a gripping black comedy.

Churchill: A Life by Martin Gilbert: the wartime prime minister Winston Churchill has been voted “the greatest Briton who ever lived”. This huge book is his authorised biography, and though I cannot claim to have read every word it is certainly a monumental achievement.

Daisy in Chains by Share Bolton: an intriguing if far-fetched psychological thriller about the relationship between an imprisoned surgeon, convicted of murdering some overweight women in and around the Cheddar caves, and an enigmatic female lawyer.

Eleanor Oliphant is Completely Fine by Gail Honeyman: Eleanor is an obsessional and isolated woman with a troubled past. Through a chance encounter on the streets of Glasgow, she gradually begins to relate to the world around her and make some friends. This perceptive and original novel is both funny and sad.

Floating by Joe Minihane: a memoir about the physical and mental benefits of wild swimming, as experienced in lidos, rivers and seas around the UK.

He Said/She Said by Erin Kelly: during a Cornish music festival at the time of a solar eclipse, a young couple witnesses what might or not have been a rape. The repercussions of this event will haunt them both for years. A complex psychological thriller with a shocking twist at the end.

Holding by Graham Norton: although I am not a fan of Graham Norton’s TV show I enjoyed reading this, his first novel. A gentle mystery story set in an Irish village, it is cleverly plotted and the characters are sympathetically observed.

If This is a Woman by Sarah Helm: a detailed and meticulously researched history of the appalling events at Ravensbruck, Hitler’s concentration camp for women. A harrowing but salutary read.

The Five Side-Effects of Kindness by David Hamilton: “Scientific evidence has proven that kindness changes the brain, impacts the heart and immune system, is an antidote to depression and even slows the ageing process”. In contrast to the dark character of some of my other choices, this is a positive inspirational book describing the ways in which everyday acts of kindness can benefit both others and ourselves.

The Ice by Laline Paull: an “eco-thriller” set in the near future. An ice-cave in the Arctic collapses, due to global warming, revealing the body of a man. The intricate plot revolves around the conflict between commercial and environmental interests.

The Student Body by Simon Wyatt: I wanted to include a New Zealand book, and this first novel by a former police detective describes the investigation of the murder of a young woman near a West Auckland beach. Plenty of local colour and procedural detail.

I hope you enjoy some of these recommendations.

2017

I sometimes regret not having consistently kept a diary during my life. But, better late than never, perhaps a blog is the next best thing. I started blogging a few years ago now and for a while I had several sites devoted to different categories such as writing, health, Bach flowers and cats. This became rather cumbersome so, even if it meant having fewer followers, I decided to combine them here. Most of my blog posts, while inspired by some recent experience of my own, aim to provide a brief overview of a topic that could be relevant to others. This present post summarising my past year’s activities is a more purely personal one, written as a record for myself and possibly of interest to a few relatives and friends.

The outstanding feature of 2017 was exploring the Irish side of my family. With the help of FinderMonkey, AncestryDNA, Rootschat and some extraordinary coincidences I discovered two half-siblings I did not know about, and had successful meetings with them both. To respect the privacy of those involved I won’t give any further details here, but it has been a remarkable experience.

Meanwhile life back in Auckland has continued on an even keel and I am happy to report that Brian has maintained a good recovery from his major cardiac surgery of 2015. He remains active physically and mentally, usually beating me at online Scrabble. My own less serious health problems are under control and I have kept up my fitness regime of Zumba Gold classes and daily cold water swims. Rather than move into one of the retirement villages that are proliferating around Auckland, we have decided to stay in our old Victorian villa with its large garden, ideal for our three cats, and pool. Following the sale of my mother’s house we have undertaken some repairs and improvements, so the inside is now ​warmer and more comfortable​, and renovation of the exterior woodwork will take place next year​.

I continue my involvement with SPCA, helping to raise funds for a Satellite Centre to care for abused and unwanted animals on the North Shore, though with regret I have given up doing regular sessions at the Animal Village because increased traffic congestion has made the commute so long. I am currently exploring other volunteer opportunities with the Heart FoundationInternational Bomber Command Centre and DogShare Collective. I ​am ​still in the alto section of St Patrick’s Cathedral Choir​,​ and attempting to sing soprano in a “Pop-Up Chorus” with NZOpera. I also see a few Bach Flower clients and recently had some success treating an anxious dog. ​

Inspiration for w​riting ​has been somewhat lacking since I published my short memoir at the beginning of the year, though I have made a tentative start on a new novel. Sales of my existing ​books trickle along slowly. Much as I dislike the marketing aspect I know I need to make more effort to stand out from the hordes of other indie authors, and have updated my profile pages on Smashwords.com, Amazon.com and Amazon.co.uk.
I am planning to visit England again in 2018. Brian no longer enjoys long haul travel so won’t be coming with me, but we have booked to go to Australia together for a medical conference and a trip on the Indian Pacific train.
A Happy Christmas to all my readers.

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