Thoughts on later life

“…we believe a full life is one that gets richer with age … rediscovering lost passions and plunging headfirst into new ones … embracing new experiences … bringing joy and meaning to every moment.” This is a shortened version of the text on the website of Ryman Healthcare. Is it realistic to expect old age, whether or not in a Ryman retirement village, to be so idyllic? Or is it more likely to be dominated by adversities such as loss of health and vitality both mental and physical, lack of occupation, reduced income, bereavement, loss of status, social isolation, and the prospect of death whether feared or welcomed? I expect it depends a lot on individual attitude.

Quite a number of my own contemporaries have died before reaching old age, having for no apparent reason developed some fatal disease, usually cancer. Others are still alive and during my recent holiday in England I had the pleasure of renewing friendships with some of those I have known for a long time – from high school, medical school, or hospital jobs in Southampton and Oxford. Since coming back home I have also met up with my New Zealand friends. Our conversations often touched on the question of how to adjust to retirement.

Almost all of us, in our 70s or 80s, have the good fortune to be living in comfortable circumstances with reasonably good health, family connections and ample money, allowing plenty of choice about how to spend our free time after leaving paid employment. My friends described a wide range of activities including charity work, looking after grandchildren or animals, gardening, travel, socialising, entertainments, reading, writing, cooking, painting, crafts, sports, fitness classes, music, academic study, spiritual practice.

Everyone seemed fairly content, especially those who were pursuing some compelling interest, or simply enjoying the freedom to relax and do just what they liked. Others, more introspective, found their lifestyle pleasant enough but questioned whether they were making the best use of whatever time might remain. Some were missing former jobs which had involved contributing to society and being recognised for it. They had not been able to find a type of voluntary work which made full use of their abilities and experience.

One woman who is highly artistic stated that the most vital thing was to express creativity, if only for oneself. I agreed that creativity is very important but felt that the resulting products should be shared with others. There is an example of these differing views at home, where my husband and I both spend a lot of time writing. He does it primarily for his own satisfaction and does not care much whether anyone else ever sees it. In contrast, I like to publish my work in the hope that some readers will benefit from my medical books or enjoy my novels – while trying not to be too flattered by good reviews or too upset by bad ones, for the Stoic philosophers advised against seeking appreciation. They said that the best way to live – at any age – is by striving to be a good person, and focusing only on things you control.

Books I’ve enjoyed #11

Many books have been written about the Second World War, but there always seems room for more, and my two non-fiction choices for this post provide entirely different perspectives. The Splendid and the Vile by Erik Larsen is an extensively researched account of Winston Churchill’s first year as wartime prime minister, 1940-41. I found the book very easy to read, partly because the detailed information about political and military events is brought to life by personal insights from the diaries of Churchill’s daughter Mary, his private secretary John Colville, and members of the Mass Observation project. Even though Churchill had his flaws and made some decisions which proved misguided, it is impossible not to admire his tremendous energy and stamina, his optimism and determination, his skills as a leader and orator which inspired the British people during the darkest days of the war.

In complete contrast is the extraordinary book When I Was Someone Else by a French journalist, Stephane Allix. During a spiritual retreat in Peru, Allix had a vision of a German soldier dying on a snowy battlefield, followed by scenes from the man’s life, and including his name. Allix became obsessed with this vivid experience, and from military archives discovered that a soldier of that name had served in the brutal Totenkopf division of the Waffen SS, and been killed during the 1941 Russian campaign. Allix was able to contact surviving relatives of the dead man and discover facts which corroborated the content of his vision. Having first assumed that the vision represented a past life of his own, Allix later concluded this was not so, but that the soul of the dead soldier had contacted him in search of forgiveness and healing. I did not know quite what to make of this book, but it will be of interest to students of paranormal phenomena such as reincarnation and spirit communication.

Turning to fiction, as usual I’ve been reading mainly mysteries and psychological thrillers, and I’ll mention two of them which were written by health professionals. Deadly Cure by Mahi Cheshire is about the rivalry between two young female doctors competing for a job at a research institute developing a vaccine against cancer. When the successful candidate gets murdered, suspicion falls on her rival. Some of the medical content is not credible, as the author – herself a doctor – would no doubt admit. But dramatic licence is allowable in fiction, and as light entertainment I found this short book quite gripping.

More grounded in grim realism is The Family Retreat, by clinical psychologist Bev Thompson. The story is narrated by a burnt-out GP who, with her young family, rents a summer holiday cottage near the Dorset coast. She makes friends with another woman who has children similar in age to her own, and they share some pleasant seaside picnics until a dark secret is revealed. This is a rather sombre read, with much reference to mental disorders and troubled relationships, and constant soul-searching by the narrator raising such questions as how far doctors should take responsibility for their patients’ lives, and why so many women submit to being imposed upon by men.

Two countries

With New Zealand’s borders open again I have been able to make another trip to my home country of England, after a gap of over three years. Being in London when the Queen died, and during the subsequent period of national mourning, was a truly remarkable experience.

Sadly there wasn’t enough time to see all of my relatives and friends living in various parts of the kingdom, but I did visit a lot of places, too many to list here. I stayed several days in Oxford, where I did my medical training and spent much of my career, meeting some old colleagues and exploring the riverside and surrounding water meadows.

Grandpont, Oxford

One day I took the train to Malvern, with its memories of Elgar’s music and my time at the College of Healing. The town features in my novel “The Windflower Vibration”. I walked up the hills and had tea at St Anne’s Well.

On the Malvern Hills

Another highlight was staying with an old school friend who lives in a converted farmhouse in Wharfedale, Yorkshire. We walked the dogs by the river, and ate fruit from the orchard where 250 apple varieties are grown.

Washburn river
Apple orchard

For the first few years after I moved to New Zealand in 2000 it seemed easy enough to make frequent return trips to the UK. But international flying has become much more complicated and expensive since the pandemic, and attracts increasing criticism for its impact on the environment. Also, having reached a later stage of life, I wonder how much longer I will be fit to travel. So although I hope this latest visit to England won’t be my last, I am aware that it might be.

Knowing this I do sometimes feel torn between my two countries. But my present life in Auckland is a very happy one, and over the years I have enjoyed the best of both worlds.

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“No good deed goes unpunished”

Actions intended to benefit other people sometimes backfire. They may be perceived as interfering and controlling, or even have tragic results.

I’ve been thinking about this since watching a brilliant performance of Verdi’s Il Trovatore by NZOpera and the Auckland Philharmonia Orchestra. In the melodramatic plot, set in fifteenth century Spain, Count di Luna is obsessed with the heroine Leonora. But she is in love with Manrico the troubadour, and spurns Luna’s advances. There is bitter rivalry between the two men and eventually Luna gets Manrico imprisoned and condemned to death. Leonora, in what she sees as a noble sacrifice, offers herself to Luna if he will spare Manrico’s life. But when Manrico learns of Leonora’s plan, instead of being grateful he is disgusted and appalled, and denounces her. Meanwhile, rather than give her body to Luna, she has taken poison. Manrico is executed, and Leonora dies.

The old adage “No good deed goes unpunished” often applies in real life. During 2020 and 2021, the New Zealand government responded to the pandemic by imposing a strict system of lockdowns, mandates and border closures to protect the health of the population. These well-intentioned policies did limit illness and death from Covid in the short term, and gained admiration from around the world. But were they justified when weighed against the long term costs? Businesses failed, unvaccinated workers lost their jobs, other diseases went undiagnosed and untreated, old people were confined indoors and prevented from seeing their relatives even when they were dying. Despite continual exhortations to “be kind”, ugly rifts developed between those who supported the restrictions, and those who resented losing the freedom to direct their own lives.

On a more everyday level, think of the dinner guest who volunteers to do the washing up, only to put things away in the wrong place and break the host’s favourite mug.

My conclusion? It’s good to offer help to other people – but only if it’s done with unselfish motives and if they want to be helped.

Buddy the beautiful Cavoodle

Buddy aged 8 weeks

I’ve just met my new dogshare puppy, Buddy. I will be helping to look after him on days when his owner cannot take him to work. He is a lively, cuddly and confident little pup and I fell in love with him at first sight.

A Cavoodle is a cross between a Cavalier King Charles Spaniel and a toy or medium Poodle. Such dogs, weighing 4-12 kg, are said to be very affectionate, energetic and intelligent. Apparently they love human company, being prone to separation anxiety when alone; are not especially keen on food (what a contrast to my Labrador dogshare, Ireland); and are good swimmers.

Buddy is a 2nd generation cross, from two Cavoodle parents, and through the genetic lottery appears to be more Spaniel than Poodle. He looks very like a Blenheim Cavalier King Charles Spaniel – chestnut and white, with a “Blenheim spot” on the top of his head. According to the Wikipedia site about that breed: “The Blenheim spot is also known as the mark of the Duchess Thumb Print, based on the legend that Sarah Churchill, Duchess of Marlborough, while awaiting news of her husband’s safe return from the Battle of Blenheim, pressed the head of an expecting dam with her thumb, resulting in five puppies bearing the lucky mark after news that the battle had been won.”

Buddy aged 9.5 weeks

Dogsharing involves dividing both the joys and responsibilities of dog ownership between households, in a flexible way arranged on an individual basis, for the benefit of both the humans and animals concerned. Within New Zealand, matches can be arranged through the Dogshare Collective.

Memoirs of an Oxford medical student 1967-70

Osler House, Woodstock Rd

More than 50 years after graduating from Oxford University Medical School, I found a boxful of letters and diaries which I had written during my clinical course. To a naive 20-year-old from a rather sheltered home background, whose first degree at Leeds University had involved more work than play, life in Oxford was a revelation – intellectually, socially and emotionally. My memory for the past is fairly patchy and though I clearly recall some of the people, places and events described, I have forgotten many others which were obviously significant at the time. I was known by my maiden name, Jenny Collins.

The course was mainly based at the old Radcliffe Infirmary in Woodstock Rd. For some attachments we visited the Churchill Hospital, where I would later become a junior doctor and eventually a consultant, Cowley Road Hospital, and the Nuffield Orthopaedic Centre. The Radcliffe Infirmary was closed in 2007 and its site is now occupied by university offices. The hub of student life was Osler House (not to be confused with the present clubhouse of the same name on the John Radcliffe site) an 18th century listed building in the hospital grounds. Downstairs was a lounge, bar and kitchen. Morning coffee and afternoon tea were provided free. Upstairs were bedrooms for use when on call. There was an attractive garden with a croquet lawn. Each student also had an attachment to an Oxford college – mine was Somerville – but being postgraduate did not live in. My first few months were spent lodging in Summertown with the mother of a family friend, the widow of a bishop and a keen supporter of Moral Rearmament. After I had moved into my own flat, my former landlady continued to invite me for dinner on Sunday evenings.

Our intake contained only 18 or 20 students. Being divided into even smaller groups for clinical attachments, we got a great deal of individual attention from our teachers. For me, as one of the few women in a male-dominated environment, this was often of a kind which would not be tolerated nowadays. As well as clerking patients we were given considerable responsibility for practical procedures such as taking blood, putting up drips, lumbar punctures, delivering babies, and assisting with surgical operations.

There were periods of intense activity – on take for medicine and surgery, night deliveries in obstetrics, preparing for exams. But otherwise the pace of work was fairly leisurely and allowed time for a vibrant social life. Lunches, dinners, parties and outings were frequent and usually involved vast quantities of food and drink. I sang in the hospital choir and in my final year played a good fairy in the students’ pantomime, Tingewick. I must have done a certain amount of studying but most of my free time seems to have been spent entertaining friends for supper or afternoon tea, making my own dresses, listening to pop music, or walking around Oxford which was then a peaceful place with few cars. Several of my friends did have cars, and when they were driving north would give me lifts home at weekends. It was a privileged and mostly hugely enjoyable life which, I imagine, was far more relaxed and informal than for clinical students today.

Much of what I wrote is too trivial, personal or libellous to publish, but maybe I will adapt some extracts for a series of blog posts, a memoir of a novel. Meanwhile I’d be pleased to hear from anyone who remembers those times.

On the other side of the (medical) fence

Since retiring from medical practice I’ve exchanged the role of doctor for those of patient and of patient’s wife, and being on the other side of the fence has been an interesting experience. Between the two of us, my husband and I have needed to see a good many different healthcare professionals from various specialties in recent years. Most of them were excellent, but a few were unsatisfactory and this was usually because of their poor “communication skills”.

Following the retirement of the family doctor we had known and trusted for a long time, I saw a GP whose failings included a rude manner, ordering me to take a long-term prescription for a new drug without any discussion of its efficacy and side-effects, and – as I discovered later – referring me to a hospital clinic without telling me. After that I changed to a different practice and am very happy with my doctor there, but my experience with the previous one distressed me for a long time, illustrating the importance of a good therapeutic relationship not only for improving patients’ emotional well-being, but for influencing their compliance with treatment and the outcome of their disease.

I don’t remember having any guidance about how to relate to patients when I was at medical school in the 1960s, nor during my junior doctor posts. Senior role models varied greatly in their approach, ranging from the caring and compassionate to the arrogant and disrespectful. In the later years of my career this aspect of clinical practice began to be taken more seriously, led by specialties such as general practice, oncology and palliative care. Communication skills training is now included in the education of doctors, nurses and other healthcare professionals, though its long-term impact must be difficult to measure, and depend on the student’s personality. The skills may come naturally to those who have chosen their career for humanitarian reasons. Those who are mainly interested in the scientific and technical side, or whose prime objective is making money, may pay little attention to such “soft” subjects in the curriculum.

The basic principles should be obvious, simply involving courtesy, common sense and genuine concern for the patient. Giving a polite and friendly greeting. Meeting in a clean and tidy consulting room free of interruptions. Listening to the patient’s story with genuine interest and empathy. Taking account of the patient’s knowledge and preferences when discussing management of the problem.

Conducting the interview becomes more difficult in the case of a serious condition. The medical literature contains many studies about techniques of “breaking bad news”, usually in relation to a cancer diagnosis, and I won’t attempt to detail them all here. Key points include giving truthful information without destroying hope. And avoiding dogmatic statements about prognosis, because the outcome in individual cases can vary so much from the average. Negative predictions can be self-fulfilling as well as disheartening, whereas except in the most dire situations there is always some help to be offered, and some scope for improvement. Another point highlighted by our recent experiences is that illness can be just as stressful for relatives as for patients themselves.

Ireland visits Normanton Reserve (“not” Devonport Dog walks #5)

Ireland in Normanton Reserve

Although I’m including this post in the Devonport walks series, it actually relates to a different part of Auckland. This is because Ireland, the dogshare Labrador I’d been walking most afternoons for four years, has moved out of the city with his owners’ family. Contact is less frequent now, but our bond continues unbroken, and Ireland greeted me ecstatically when we met halfway for a visit to the Normanton Reserve in the Wairau Valley suburb.

I had driven around there many times in the past for business purposes, not for pleasure because it is a rather unattractive industrial area prone to traffic congestion. I had no idea there was a peaceful green reserve close by, hidden away at the end of a cul de sac.

Lower field
Playground

The large flat grassed field on the lower level of Normanton Park offers activities for both adults and children. On the path that encircles the perimeter there are a series of exercise machines – I did not try these. There is a playground, a small basketball court and a small skateboarding park, a picnic area and toilet block, all clean and well maintained.

On an upper level, reached by a short flight of steps, is a large field in a more natural state with plenty of room for a dog to run free.

Upper field

Ireland’s departure has been a loss but I will certainly keep in touch with him and meanwhile, with other local dogshare opportunities on the cards, have had the gaps in our garden hedge sealed off …

A puppy-proof fence

Waiheke interlude

Brian and I spent two days on Waiheke Island, staying in a comfortable and spacious holiday home surrounded by native bush and overlooking the sea. Though New Zealand’s summer is nearly over, the weather was sunny and hot. Waiheke has a semitropical climate, lush vegetation, sandy beaches, boutique vineyards and olive groves, a friendly and somewhat bohemian vibe, and feels a world away from the mainland.

Huruhi Bay viewed from the balcony

Except during Auckland’s lockdown periods we have often made day trips to Waiheke. The 40-minute ferry ride from the city centre, across a calm blue sea flanked by other small islands, always induces a sense of relaxation. Parts of my novel Cardamine are set on Waiheke and this extract contains some references to the history and geography of the island.

Waiheke Island. Source: Wikipedia

Waiheke holds many memories for me, some bittersweet. Stonyridge Vineyard has been our usual venue for birthday and anniversary lunches. Our group of local Bach flower remedy practitioners, now depleted by the loss of key members, has held weekend gatherings in more modest settings such as the Quaker meeting house. The sad story of my first rescue cat, Orange Roughy, had a happy ending when he was successfully rehomed on the wild far reaches of the island.

During this recent short holiday we went swimming at Palm Beach, climbed up and down a steep track for coffee and galettes in Bisou cafe at Surfdale, dined at Vino Vino and The Courtyard in Oneroa.

Palm Beach

My Author Bio

I have just turned 75, and it feels like the right time to review my long and winding journey to becoming an author.

Writing was my first love and as a child growing up in Kent I produced a variety of short stories and plays. These early works have long since been thrown away and their content forgotten, though I think they usually featured cats and dogs. I did well in English at school and was expected to take a university degree in that subject, but in my teens I developed an idealistic wish to heal the sick. The medical courses at Leeds and Oxford, then life as a junior doctor, absorbed so much time and energy that I never even thought about writing fiction again till years later.

It was after many changes both professional and personal that I decided on a career in psychiatry, and when studying for the postgraduate qualifications I compiled my notes into what would turn out to be my first book. A senior colleague suggested sending it to a publisher. It was accepted, and without any marketing on my part sold well and continued into five editions; by far my greatest commercial success. I moved on to academic posts, involving opportunities for research, writing papers for journals, and medical books relevant to my specialty of the interface between psychiatry and cancer.

In my mid-30s, when finally settled into a contented domestic life, I wrote three novels inspired by my earlier work experience in general practice and in mental hospitals. I enjoyed this tremendously, and given my earlier success with the psychiatry book, I assumed that I would have no trouble getting them published. I was soon disillusioned. Some rejection letters were encouraging but others were not, and I was so upset by one damning verdict that I put the manuscripts aside for 20 years. An overreaction, and I now realise that you can’t please everyone and that even the best of books gets an occasional bad review. Knowing how devastating it can be for writers to receive harsh criticism of their work, I will only review a book myself if I can give an honest positive opinion.

Fast forward to my 50s when, after a rewarding career as consultant in psychological medicine in Oxford, I came to live in New Zealand. Alongside many new interests, I focused on writing and editing. Twenty years later I have a variety of titles, non-fiction and fiction in a variety of genres, some traditionally published and some under my independent imprint of Overcliff Books, listed on my Amazon.com and Amazon.co.uk author pages. My current project is editing my husband’s autobiography. What, if anything, I will write next I don’t know.