Writing a medical memoir

Regular readers of this blog will know that in 2015 my husband Brian had a near-fatal heart attack, and that this was followed by a whole series of medical and surgical emergencies affecting our family. I had spent many years working on the medical staff of hospitals and hospices, but experiencing serious illness from the perspective of patients and relatives was very different.

After recovering from the traumas I decided to write a short memoir about them, and this is now available on Smashwords, Amazon US and Amazon UK under the title Across a Sea of Troubles. The first part tells the story of what happened, and the second part is a review of various topics including life event stress, the mind-body connection, post-traumatic syndromes and the role of  the carer.

I wrote this partly for myself as a way of coming to terms with things. Whether it has actually been therapeutic I am not sure – revising the manuscript involved rather too much focus on painful memories. So even if it still not a perfectly finished book, I have decided to publish it and move on. I hope it will hold some value for people who are coping with illness, whether as patients or relatives or health care professionals. But as always when publishing something new, I feel apprehensive about its reception: have I revealed too much personal information about myself or others? does it come across as morbid and self-pitying? is the medical information accurate?

A memoir can be defined as “a record of events written by a person having intimate knowledge of them and based on personal observation”. In contrast to an autobiography, it describes one particular aspect of experience rather than a whole life. Naively perhaps, I have always tended to assume that both memoirs and autobiographies are historically accurate. So I was a little shocked to be advised on one on-line site that it is acceptable, even desirable, to alter the facts to make them more interesting or inspirational for the reader. Although I did wish there were more positive aspects to my own story I resisted any temptation to embroider the truth, and wrote it exactly as I remember, checking all the dates from my diaries. So, rather than one of those books about “illness as a precious gift that transformed my life” it is an honest account of a rather gruelling sequence of events. Here again are the links for Smashwords, Amazon US and Amazon UK. I will share a short extract in my next post.

ast-smashwords-cover

Why troubles never come singly

Just as our lives were beginning to settle down, with Brian recovering from his heart surgery and its subsequent complications, our household was hit by another health crisis. A few days ago Clare, my 91-year old mother who lives next door, developed acute abdominal symptoms. For the third time in recent weeks I called the emergency ambulance, and for the third time spent most of the night helplessly keeping watch by the hospital bedside of a desperately ill relative. The surgeons were doubtful whether Clare could withstand the operation which would be necessary to save her life. I pressed them to try, for the alternative would be an agonising and undignified death, but they were reluctant to attempt such a major procedure in the middle of the night. Meanwhile repeated large doses of morphine and other drugs were failing to control Clare’s pain, nausea and distress, though eventually the anaesthetists performed an epidural which brought her some relief.

There was better news next morning. The surgeons did decide to operate, and Clare survived the removal of large sections of necrotic bowel. So far – though it is very early days – she is making good progress in hospital.

It seems incredible that our lives, so contented and well-ordered for the last few years, have been suddenly disturbed by this sequence of traumas. Sayings such as “troubles never come singly” “it never rains but it pours” and “bad things come in threes” suggest that negative events do have a tendency to cluster in time. I noticed this when I carried out my own research study to investigate “Life events and breast cancer prognosis” which involved repeated interviews with over 200 women over a three year followup. While some of these women reported very few happenings during the study period, there were others who experienced a whole series of disasters. Sometimes it was possible to identify a chain of events leading on from one another. Sometimes all the events seemed to stem from one single cause, which in some cases appeared to involve the personality and behaviour of the person concerned. Few of the events could be considered totally independent from those who experienced them.

Were the recent misfortunes of our own family linked, part of a cascade of events beginning with Brian’s heart attack? I have always tended to be sceptical of the theory that most illness is due to “stress” (the results of my own study, cited above, gave no support to the popular notion that stressful life events promote the growth of breast cancer). But there is no doubt that psychological stress can lead directly to imbalances of the body’s neurological, endocrine and immune systems, as well as to impaired self care due to missed meals and lack of sleep. I have no doubt that anxiety, overwork and exhaustion since Brian became ill have contributed to my own recent health problems of high blood pressure, sinus tachycardia, a posterior vitreous detachment of the eye, and delayed healing of biopsy wounds.

“Stress” is not the only possible explanation for the clustering of events, and maybe there are also metaphysical causes. According to the Law of Attraction, negative thoughts and feelings in response to adversity are likely to result in more of the same. And an astrologer friend, who like me was born under the sign of Aquarius, has cited “the ghastly Saturn square Pluto events which have befallen Aquarians of late”. I am trying to “take one day at a time” and appreciate good things like the spring roses blooming in our garden.

big pink rose

Bach flowers for life event stress

Distress about an ‘adverse life event’ is among the most common reasons that people seek help from the Bach flowers. Besides major events such as the loss of a job, a divorce, and the death of a loved person or pet, many other kinds of traumas, disappointments, irritations or deprivations can happen in life.

During my former career as a research psychiatrist I carried out a study about life events in relation to health. This involved following up a sample of women over several years through a series of detailed home interviews. Adverse events were reported much more often than pleasant ones, and the number of events varied greatly between different people. One event often set off a cascade of others and there were usually accompanying long-term difficulties, such as financial problems or unhappy relationships.

This is not the place to discuss that particular study but I would like to mention some personal observations I took from it. These points are not often emphasised in the academic literature, but they may be helpful to people dealing with life event stress themselves.

1. The impact of an event varies a good deal depending on individual personality and circumstances. The same experience, for example being made redundant, might be variously perceived as a loss, a punishment, an insult, a challenge, the hand of fate, or a blessing in disguise. It could give rise to different emotions such as sadness, guilt, resentment, anger, resignation or relief. There is always potential for ‘reframing’ personal attitudes and emotions around an event.

2. Although adverse events usually lead to emotional distress, and sometimes act as the trigger for a mental or physical illness, ‘every cloud has a silver lining’ and often there are compensations in the longer term. The person who was made redundant might, for example, benefit from a much-need rest before going on to improve his or her skills and presentation and eventually finding a better job.

3. We are responsible for much of what happens in our lives. Although some events such as bereavements and natural disasters do happen independently, they are the minority. Most events do not arise ‘out of the blue’; personal choices and behaviours have usually played some part in the chain of causation. Some also believe in metaphysical aspects, for example that our thoughts and emotions determine our life event experience through the Law of Attraction, or that the Universe presents us with the experiences required to advance our spiritual development.

Here, in alphabetical order, are some suggestions for Bach flowers which can assist coping with stressful life events and difficulties. The statements in quotes are taken from The Encyclopedia of Bach Flower Therapy by Mechthild Scheffer. As always, the choice of remedy or remedies depends on the current emotional state of the individual. Please visit the Bach Centre website for more details.

Chestnut bud ‘from superficiality to experience’: if the same type of adverse event keeps ocuring in your life, this may indicate a failure to learn from past actions.

Gentian ‘from doubt to trust’: if you feel negative and discouraged following a setback, delay or disappointment.

Gorse ‘from giving up to going forth’: if you feel completely hopeless, and can hardly see any point in trying to overcome long-standing difficulties.

Holly ‘from hard-heartedness to generosity’if you feel consumed by hostile feelings such as anger, jealousy or suspicion towards other person(s) whom you hold to blame for what went wrong.

Star of Bethlehem ‘from shock to reorientation’: for shock and grief, for example after an accident or bereavement, even if it happened some time ago.

Sweet chestnut ‘through darkness to light’: if you feel unbearable anguish and have reached the end of your endurance. 

Willow ‘from resenting fate to taking personal responsibility’: when the predominant feelings are those of self-pity and being a victim, Willow can encourage a greater sense of empowerment.

Adverse life events are always upsetting but there is often something to be learned from them. For example, having an accident – especially more than one – might indicate the need to be more patient, to curtail an overload of commitments, to maintain better safety standards for your home or car, to pay more attention to the present moment, or to avoid going too long without food. Or, experiencing a series of relationship breakups might indicate some kind of imbalance in your own psychology.  There are Bach flower remedies to cover some of these issues too, but details would be beyond the scope of this post.