Monday 31 December 2012


Image by R. A. D. Stainforth

Candle flickers,
gramophone spins old 45,
                brings you alive,
see you dancing in the shadows. 
Old sweater hugged
smells of you,
fills me up,   arouses
excites atmosphere.

dog-end DNA
remains of you among the ashes. 
I see you 
on the lips of long-emptied glasses,
cold breath whispering 
I was here.

Anna :o]

With thanks to Tess at The Mag for the inspiration, also entered Poets United Poetry Pantry – thanks Poets United!

Oops!  Nearly forgot!  Hope you have a wonderful New Year!

And also - (grand)baby Theo arrived at 1.37am on the 27th!  He is delightful

Saturday 22 December 2012


Newborn in blanket by Bonnie Gruenberg

Golden, soft, gentle, innocent,
safe in liquid amnii,
in utero.

Listen to my heart beat,
it beats for you,
it longs for you

be my world.

Anna :o]

My special present this year will be that of the gift of a new life – the life of my first grandchild.  Seems he is a bit of a procrastinator – must be an ‘in the genes’ thing – as he is a little late of his due date.  Ah well, he will come into this world when he is ready.

I really can’t wait!  Thank you my lovely first son and dear daughter-in-law for my soon to be present – can’t wait to hug him and kiss his soft warm cheeks and gift him with my love, my heart (forever).  Oh precious little thing – hurry up!

Have a wonderful Christmas everyone!

Thanks to Karin at dVerse~Poets Pub for today’s prompt of 'The Poetics of Presents/ce' and many thanks to all the good folk who hosted there throughout this year.

Image: courtesy of Wikimedia Commons, author Bonnie Gruenberg.

Tuesday 18 December 2012

Storm Brewing

photo by Andy Magee
Rain streams
in never-ending rivulets,
obscures vision.

The unremitting
rhythmic wurr, 
of wiper blades
irritates, marks time
as you sit behind the wheel
fix-gazed on anything but me.

This is an oft travelled road,
I anticipate the coming storm,
sense the thunder,
wonder what will precipitate
the squall.

I watch the blades
raise the tempo
as they swish to and fro,
aggravate existing fury,
heavens darken, heighten fear
and you begin to glance at me
and I know the time is near -
tis not only skies that will blacken.

Anna :o]

With thanks to Tess at The Mag for the inspiration.  Also entered at Open Link Night at dVerse, hosted by the excellent Joe Hesch.

Friday 14 December 2012

It's Always You, You, You!

You say my drinking makes you miserable;
that you don’t know what to do when I’mthis way.’ 
Why is it always about you, you, you?  
It doesn’t take much imagination
to figure out why I’m like this – it’s you, you, you!
Does it never cross your stupid mind
that you drive me to such depths of despair
with your moan, moan, moaning,
drinking is my only solace, my only way out? 
You shout and scream I make you unhappy
and you wish things were like they were before,
that this ‘sheer hell’ (moan, moan, moan)
is not you what you (moan) married me for. 
Do you honestly think I care? 
I wish you’d just leave me alone
and go and kill yourself,
cos you’re killing me with your nag, nag, nag.

Oh surprise, surprise! 
Here come the waterworks,
tears spilling from your stupid eyes
as you wail that life is so unfair,
that you can’t live like this anymore. 
Well piss off then you stupid whore. 
But you won’t, will you? 
You always say you’re gonna go -
but you always stay. 
Don’t you know I know why you won’t,
cos no-one else
would have a moaning bag like you? 
No wonder I bloody drink to drown out your
moan, moan, moan. 
Well Mrs Moanybag
I wish you’d just piss off and leave me alone.

Moan, moan, moan, moan, moan.

Anna :o]

Although my work involves caring for alcoholics and ex-alcoholics, I, as many ‘health professionals’ did not understand, did not know of the circumstances of the families of alcoholics as their story is not often told as it is hardly ever considered.

For the most part, families live their lives without any support whatsoever – unless that of Alcoholics Anonymous or similar agencies.

Without Addy’s blog Alcohlic Daze and Linda’s The Immortal Alcoholic – I would still not know.

A long-term alcoholic living with his/her family often blames his/her partner for the problem - unjustly.

This poem was written in response to the challenge to write in the second person at dVerse 'Meeting the Bar' hosted by Victoria C.Slotto.  Thanks Victoria.

Image: courtesy of Wikimedia Commons, author Steven

Monday 10 December 2012

I Am

I am.

Discover me,
chart me, map me out. 
Climb my mountains,
ford my streams,
swim my seas. 
Love me,
let me live inside your heart. 

I am your world.

Anna :o]

With thanks to Tess at The Mag for the inspiration.   Also linked to the Poetry Pantry at Poets United.

Tuesday 27 November 2012

It's Not Cardiac

It’s not cardiac it’s pleuritic pain,
you utter in a most kindly tone.
Heart leaps ten feet high! 
Phew!  Sigh of relief
as I press face into waiting hands. 
But you’re still saying things,
Urgent referral, I hear you say,
I say I don’t understand,
you explain it's your lung (draw breath);
there is a shadow in the left upper zone,
and all  the red flags I’ve suppressed
shoot up flap wildly on the pole,
and if my throat wasn’t so goddammed sore,
my voice so goddamn hoarse
I would scream my loudest scream
to vent this chaos in my brain.

Can’t stop thoughts racing
but can’t think at all;
why did they send me home?  
Can’t think doc;
you flit, flit, flit in shadow land, peripheral,
voice drones in monotone,
monotonous distant buzz, buzz, buzz.
Mind scrambled egg,
like I’m watching me in some old silent movie
(flit, flit, flit)
watching me going through the motions,
mechanical, perfunctory
(can’t even hear what I am saying).
Christ why me, why me, why me?
Why me?

The above was written following the experience of a colleague.  General malaise of two to three weeks duration had been followed by intermittent chest pain and a particular episode – which concerned her by its intensity - resulted in her presenting herself at A&E.

Chest Xray, bloods, etc. were done and she was told that there didn't appear to be a problem with her heart, she would be referred for further investigation and was sent home with a course of antibiotics (for a ‘chest infection’).   She was relieved – no heart attack then.  However the problem persisted and she soon sought the advice of her GP and the outcome of that appointment was as written.

Her account of her experience - not receiving enough information from the hospital doc -and the terror that ensued reminded me of similar cases of friends, relatives etc. where it appeared a communication breakdown had occurred between doctor and patient resulting in unnecessary pain and anguish (and sometimes false hope). 

The doctor-patient partnership is an unequal relationship and in a sense always will be so – for the patient is reliant on his doctor to provide him with an answer (to his problem) from his extensive knowledge base.  The patient can only offer his symptoms (and sometimes fears) and is dependent on his doctor to diagnose and treat (if required).

Traditionally the patient adopted a passive role, confident in his doctor’s expertise to diagnose and treat and the patient (generally) accepted the mode of treatment offered without argument or discussion, for he viewed his doctor as a specialist, a professional who carried with him a certain authority and commanded respect and thus adhered to his orders.  (I realise this paragraph is a generalisation in that all patients were not good obedient patients.)

Times have changed and the patient is - via the internet and other sources - more health literate and expects his views to be considered in shared-decision making.  However there exists the problem that the patient cannot recall all information given to him at the consult and indeed, at times, he is not given enough information to make sense of his situation.  It is not surprising that this problem exists for the patient is not grounded in the art and science of medicine and recall is (to some extent) dependent on understanding.

The paternalistic approach by the medical profession to its patients has changed too, no longer is the patient expected to blindly follow doctors orders and the ideal is that patients should receive all available information regarding their illness, treatments available, risks involved etc. and the doctor-patient partnership be a true partnership of shared decision making.

For the purpose of this post I researched in an attempt to gain knowledge of what we as patients actually remember of information given to us at our GP/hospital appointments but found the results rather contradictory/confusing such as, in interactions between doc and patient only 50-60% of info is recalled (by the patient) or 80% of info is forgotten directly after leaving appointment or 50% is remembered incorrectly and so on.

In view of this I sought the help of a good doctor who informed that when he did his GP training it was a good rule of thumb that most – if not all – patients only retain one third of what is said to them during consultation and as said previously – this is not surprising for patients are not doctors.  So it is important that doctors make sure the patient retains the important third and should ascertain this is so.

How can this be done and what influences are at play during consultations?  A little insight from a Pubmed ‘meta-study’ article (1) Abstract:

“RESULTS:  In a model of external influences on information exchange within healthcare consultations, practitioner influences were: receptiveness to informed patients and patient choice, lack of knowledge of cultural difference, patient centredness vs. stereotyping. Patient influences were: motivation to seek and engage with information; the appraisal of information before a consultation, expression of cultural identity, and ways of managing the risk of poor information. Shared influences were: differing illness notions, role expectations and language. Empowerment, disempowerment and non-empowerment were outcomes of information exchange and health literacy was a mediator of external influences and empowerment.”         

I would also recommend whether you are patient or doctor you read this excellent article (2) ‘Patients’ memory for medical information.’   (Roy PC Kessels. PhD). Please DO click the link!

I would highlight this (from the above) ‘…first, factors related to the clinician, such as use of difficult medical terminology;’ for indeed this often presents a barrier to doctor-patient communication as much as (for some) the physician resorting to abstract conceptual thought in an effort to aid the patient in understanding his situation.

Research tells me that doctors who are uncomfortable with, have difficulties in ‘breaking bad news’ may sometimes resort to the use of medical terminology in an effort to draw the consult to a speedier conclusion.

Patients (in receipt of bad news) will probably cease to hear much or anything after the diagnosis is revealed and will probably enter the scary worlds of depersonalisation, derealisation  and it is important to (us) patients docs that we are seen a few days later once the shock has worn off a bit.  (Sorry docs – this sometimes does not happen as all docs are not necessarily as skilled as you in the art of communication and understanding patients needs.)

(When depersonalisation, derealisation rear their ugly heads – boy do we need input for there is nothing more lonely, more scary than being on the outside looking in, as it appears (is?) – depersonalised or not - that we are left out of the information-loop and very much to our own devices and fears.)

Whether patients are in receipt of bad news, made aware of chronic life-changing illness or suffering acute but curable disease, etc. most of us – but not all for some of us are happier in our ignorance - need information to cope with to understand our predicament – and at times this need is not met as we fail to communicate (with each other) effectively.

Although taken out of context in which they were written these quotes from Balint (3) spring to mind:  ‘There is a dangerous confusion of tongues, each party talking in a language not understood and apparently not understandable to the other.’
                                      ‘One is the patients increasing anxiety and despair, resulting in more and more fervently clamouring demands for help.’

So what are we to do?  The apparent bane of a doctor’s life is the patients list (of symptoms) as if somehow the patients attempt to convey all information is, well, irritating, ridiculous.  (I have resorted to a list once as I wondered whether the symptom I had forgotten to mention – how often we patients do this – was the final piece in the jigsaw that would provide an answer - an answer that I desperately needed.)

Research of articles (authored by those in the medical profession) suggests that doctors should check patient understanding and if need clarify; provide patients with a personalised list highlighting salient points relating to their illness, supplementing this with a ‘condition’ leaflet/booklet.

I don’t know – would this effort make too big a dent (time wise) in the allotted ten minute consultation?   If so would it be time well spent in that patients understand their condition more and are more likely to follow doctors’ recommendations (changes to lifestyle etc.) and adhere to drug regimens and thus need fewer appointments as they have an element of control over their lives and well-being?  What say you?

All the above is a patient’s perspective and that is all I can offer but I would certainly welcome comments from the other end of the stethoscope.

And a question (or two), does a doctor who becomes a patient continue to see things differently (from a patient who is not) as he does not cease to be a doctor?   Do you think – as a doc (patient) – having all information to hand is as frightening as a non-doc patient having too little?

As a patient or doctor – what are your thoughts on this post?

Anna :o]

1)       What are the external influences on information exchange and shared decision-making in healthcare consultations: a meta-synthesis of the literature.   Edwards M, Davies M, Edwards A. (PubMed)
2)       Patients’ memory for medical information.  Roy PC Kessels (JRSM)
3)      The Doctor, His Patient and the Illness.  (Page 26)  Michael Balint.  (Churchill Livingstone)

Poem entered at dVerse~Poets Pub Open Link Night hosted by the lovely Claudia

Image: courtesy of Wikimedia Commons.  Author, Chikumaya

Tuesday 20 November 2012


Squall, 1986, by Andrew Wyeth
The fancy frocks and summer hats belie
the sorry tortured soul beneath the     surface cracks
as  on her hollow haunted face     mouth gapes 
as  she smiles that sorry twisted smile  she smiles 
revealing rotten teeth that stain
her muddled thoughts  with filthy words
and for a while she listens
as  the budgies  cheep inside her head
and peck away at fractured brain.

She whines  the wasps  within her chest
will stop her heart unless she gets
(‘just one tiny’)  cigarette and offers
passing males her drooping breasts
and  (filthy)  sex  (she hates)
just for ‘one tiny zzzig-err-raare-t’. 
(The men who live inside her head
deride say they’d rather die
than go to bed with her.) 
The men (outside) refer    (unkindly)
to her mangled pock-marked frame
and jeer at her, call her ugly names,
jeer  and joke as  she resorts
to the only way she can to cope.

She contorts that tortured face of hers
grimaces  to quell the pain
all for the want the need of nicotine
and black  clouds gather in her brain
and erupt into a sudden squall,
she yells and screams, head-butts the wall,
punches  hard her cheek and then returns
to (some sort of) (troubled) peace again.

She thinks for a while then smiles
that sorry twisted smile she smiles,
shows the males her drooping breasts
and offers  sex for cigarettes.

Anna :o]

In the good/bad old days’ institutionalism in psychiatric hospitals bred its own strange culture, some patients on long-stay and acute wards, to ‘self-medicate’ their symptoms, to stave off ennui, chain-smoked and within this culture existed tobacco barons and easy lays.

The tobacco barons need not necessarily be smokers rather those that saw (and grasped) opportunity, increasing their personal wealth and their status in the patient pecking order.  One cigarette ‘borrowed’ would yield a return of three-to-five, sometimes more and daily the baron was able to sell  (the equivalent of in returned 'borrowed' plus 'interest') full packs for money, the more vulnerable smokers sometimes ‘owed’ their next days ration of cigarettes and  in essence held a continuous debt.

The ‘easy lays’ – not necessarily women but mostly so – were of two kinds, one would allow men to have sex with her paying with cigarettes and the other pay for cigarettes with sex.

Acute and long stay (apart from the ‘elderly’) wards were ‘open-doored’ – these only being locked when trouble occurred and this freedom and the hospitals extensive grounds allowed this culture to thrive.

After the closure of psychiatric hospitals there existed the problem of where to place institutionalised patients who would never be able to rehabilitate and live independently in the community.

Added to this burden of unwanted institutionalised souls were the upcoming patients with enduring mental health problems who would have joined their ranks.  Initially some were placed in NHS ‘rehab’ community units – most (if not all?) have long since closed, the rest in private nursing homes and rehab hostels - or just hostels -and some, where attempts were made to rehabilitate to independent living, now are homeless or if lucky(?) bed down in doss houses, etc.

The lucky(?) few institutionalised ex-patients who found a (locked)nursing home prepared to take them, as well as losing the only (hospital) life they had known through much of their adulthood – some even earlier – are further restrained by new laws re coercive healthism (no smoking in the premises – unless in a tiny room devoid of ‘entertainment’ – have you ever tried to fit twenty men who want (and need) to smoke in a tiny room where friction will  occur as a result of this sardine-tin existence? – to the wonderful well-intentioned Safeguarding Vulnerable Adults (SVA)  (no grey areas recognised – the world is black and white.)

An odd tobacco baron exists here and so do the easy lays, but the easy lays (of either kind) are not allowed to engage in sex – well neither is anyone really – for under the SVA we have to protect one vulnerable adult from another vulnerable adult…and so their wants and needs are stifled…their new institution more a prison than the old asylums.

I hated psychiatric hospitals but their closure offered nothing in its place….

Rant over.

Thanks to Tess at The Mag for the inspiration for this post.   Also linked to dVerse~Poets Pub Open Link Night hosted by the excellent Brian Miller.

Wednesday 14 November 2012

Hell Cannot Be As Bad As This

Verdun, 1917 by Felix Vallotton

Hell cannot be as bad as this.

I dwell amongst; exist amidst
a stinking mound of fallen men
who lie dead-eyed
in bubbling broth of shit and piss.
Earth moves as worms writhe
and feast on human flesh,
rats gnaw deep exposing bones
and in this mess
the wounded soldier groans
and screams in unremitting pain
and longs for sweet release of death,
long lost his dream of      returning home.

Half-mad, I suck (the breath) in deep,
let it cling to chest lest it be the last I draw. 
Sometimes when morning breaks like this,
illuminates lights up the carnage spread before
or in the black of night
when imagination plays its cruellest tricks,
I think death much more preferable to this.

What price this place in human life is made? 
How many soldiers’ hearts must spill their blood,
lay still upon its soil its stinking mud
until its final cost is paid?


The assassination of Archduke Franz Ferdinand the catalyst for what was to become The First World War, the first mindless, global war brought about by the insanity of the treaty alliance system, the war to end all wars…

The Battle of Verdun was the longest and one of the major battles fought on the Western Front and according to modern estimations the casualty count is in the region of 976,000.

The poem is composed of eye-witness accounts of life in the trenches found here and at other sites dedicated to The Battle of Verdun.

With thanks to Tess at The Mag for the inspiration, also linked to the good folk at dVerse~Poets Pub Open Link Night.

Sunday 11 November 2012

Remembrance Day: Anthem for Doomed Youth

Wilfred Owen's Grave:
 Ors Community
Cemetery, France
Anthem for Doomed Youth

What passing-bells for these who die as cattle?
 ---Only the monstrous anger of the guns.
 Only the stuttering rifles’ rapid rattle
Can patter out their hasty orisons.
No mockeries now for them; no prayers nor bells;
 Nor any voice of mourning save the choirs,---
The shrill, demented choirs of wailing shells;
 And bugles calling them from sad shires.

What candles may be held to speed them all?
 Not in the hands of boys but in their eyes
Shall shine the holy glimmers of goodbyes.
 The pallor of girls’ brows shall be their pall;
Their flowers the tenderness of patient minds,
And each slow dusk a drawing-down of blinds.

Wilfred Owen.

Wilfred Owen (please read his biography and beautiful poems here at The First World War Poetry Digital Archive) was born on the 18th of March 1893 and aged twenty-five was killed in action on 4th November 1918, leading an attack  by the Sambre Canal, near Ors, France.  His parents learnt of his death on Armistice Day.

Like many before him and many after him, he died for this ugly thing we call war – his, a young life wasted but bravely given.

The First World War, the first mindless global insanity brought about by the idiocy of the treaty alliance system, the war to end all wars…

and still we return to savagery and play our deadly tribal games.

We remember and honour all those brave young men (women and children) who died in WW1 - whether they be soldiers or civilians - and all those who have died in the countless wars that have followed, on this, this Remembrance Day.  We must never forget. 

One day hopefully we will learn from our bloody past (and present), and our future will be bright.  But I fear we will not…


Wilfred’s poem: 'This item is from The First World War Poetry Digital Archive, University of Oxford (; © [Copyright notice]'.
Image: (also courtesy of the above) Reference URL

Monday 5 November 2012

The Muse

Charis, Lake Ediza, California, 1937 by Edward Weston
Searching for the stars
she found la Luna.
His muse, moonstruck
amuses him.
His art is science,
he cerebrates,
dines on word salad
washed down
with the want of her.

Urine soaked
(storm weathered)
she sleeps a sleep
beneath her dreams
as he watches in the shadows.

He has seen her naked,
soul bared,
knows every contour
every crevice.
he has been inside her mind,
penetrated every nook and cranny.

Obsessed with her
he documents, details
ever word she utters
(deleting his that thrust
her deeper into madness).
As she sleeps,
shutter speed prioritised,
he clicks,
black-and-white to lust on.

her vulnerability excites him.

(sitting in the shadows)
he thinks he needs to heal himself.

Anna :o]

With thanks to Tess at The Mag for the inspiration.

Wednesday 10 October 2012


Sick Woman, 1665, by Jan Steen
I gave true my faith to medicine,
did not wrap her up in sweet bouquet;
this mix to be the save of us
could not *miasma keep at bay.

Aquavitae, triacle, urine of virgin boy,
we drank of this across three morns,
drunk his receipt against this plague,
yet it stays with her upon this dawn.

She fevers so yet shivers yet,
cries with despair at paining head,
buboes puff pain at armpit, neck,
under skin bleed tokens,  black, purple, red

He feels at her pulse for well o’er an hour,
her plight fills me with awful dread;
he looks at me with sore forlorn
and I await the cry ‘Bring out your dead’

Anna :o]

The above is ‘work in progress’ and was inspired by Tess’ prompt at The Mag.

1665 was the year of The Great Plague, (also known as The Black Death or Bubonic Plague) which although affecting much of England affected London the most.  London was a filthy city (especially the slum districts) where household and human waste was flung into the street – an ideal breeding ground for black rat and its little jumping chums who infected their rat and human hosts with Yersinia Pestis.

The Bubonic plague presents with general symptoms of fever, vomiting and malaise, this followed by lymph gland enlargement (buboes) and the endotoxin of bacteria leading to bleeding manifestations which ultimately may lead to shock.

The above sounds pretty tame and for a better description read an eyewitness account by William Boghurst (an apothecarist and general practitioner) “Loimographia: an account of the great plague of London in the year 1665.  London" and for wonderful preventative and (supposedly) curative measures please read “A collection of seven and fifty approved receipts good against the plague : taken out of the five books of that renowned Dr. Don Alexes Secrets, for the benefit of the poorer sort of people of these nations. London
Both excellent insights into life in 1665 (and I am so glad I wasn’t alive then!).

The Great Fire of London finally brought to an end the ravages of the plague and life returned to its odd sort of normality…

…and if I wasn’t so damned tired (finished five nightshifts this am) I would write more but now need shut-eye and much zzzzzzzz, but would invite you to google and read more for looking back in history is fascinating stuff.

*Miasma: a theory that disease was linked to a noxious form of ‘bad air’ – hadn’t made the rat connection then...

This post also linked to the good folk at dVerse~Poets Pub.