Love & Masochism

Fee-males, fee-lines,
he thought he ought
by now a lesson learned
as he felt the scratch from chin to eye,
yet still bewitched he yearned,
itched for the stealth of those
who ate his soul with lapping lick
slinked as they slyly stole his heart.

“Cats, cats, cats,
everywhere cats,
but then stepping
out from the crowd,
a single crab.”

And much to his surprise
he found fascination in her flapping flab
and grabbed lustily at her heaving thighs
as she sexily sidled up to him
and punched him meanly
clean between his eyes.
She grouched as he ouched
and yelped in pain,
moaned that he groaned,
punched him again and declared
if he wished to exist in her domain
he should irritate her not,
be grateful for what she gave-he got,
and he submissive for the want of her
discarded those cruel cats
whose pain made him purr,
knew true in his heart that he,
he did
prefer
her,
his sexy snapping brachyura.

 Anna :o]

What is this strange thing called love, that despite its potential to cause great pain, it brings out the masochist in us as we enter the uncertainty of it again and again in our search of a life partner or maybe a ‘just for now’ relationship?.

We profess love of our family and friends – but others interpretation of offered love can be suffocating, stifling, downright cruel.  Of course we cannot chose the family we are born into and may not like them very much at all and may teeter on the edge of near-dislike or dislike itself.

I guess we all have our own interpretation of what love is – is it a basic human need to be needed or is it a protective emotion that binds us together as a species, brings cohesiveness to our particular tribe and thus societal stability? If the latter – it is clearly not working.

Nevertheless, despite its potential to cause pain I am in love with love, love being in it – although I am not quite certain what it is. Can you love someone every minute of every day or do levels of love fluctuate? 

Looking at my handsome one now as he dozes on the settee, do I love him at this very moment in time, is there a passion of emotion there or do I view him (?)only as my chosen (and very likeable) partner? At this moment of time I would say the latter, yet he may wake and utter some words, do some deed and I will be overwhelmed with emotions that pleasure my mind and fill my chest to almost bursting point – and this I think is part of loving, love operates at many fluid levels/depths, love is societies binder - and indeed sometimes a bind…

As the Bishop said to the Actress “How do you interpret Love?”

Today’s post is the result of Isadora’s prompt post at Real Toads in which she asked us to write a post based on the Hamilton Cork's first lines – my chosen: “Cats, cats, cats, everywhere cats, but then stepping out from the crowd, a single crab."

La via che va tra la perduta

       

“Per me si va ne la città dolente,

per me si va ne l'etterno dolore,

per me si va tra la perduta gente.”

(Dante’s Inferno, Canto 3.1-3)

La via che va tra la perduta

There is no warmth here;

the inner glow of being me

is somehow elusive

and I can’t (quite) remember

why I’m here...

There is no warmth here;

the inner glow of being me

is somehow elusive

and I can’t remember…

It is cold here,

a numbing emptiness,

a loneliness,

a chill permeates

my every screaming fibre. 

Fear is cold as ice,

splitting,

exploding      every atom;

fear                        fear

excites the torment of,

the dread of tomorrow,

the dread of things… (forgotten)

as I desperately

try to grab,

to hold

to keepsake

memories of today

that disappear

with every fleeting moment,

disappear into the grey.

Something

(I can’t quite get hold of what it is)

is drawing me

like moth to candle,

something

cold and dark and uninviting,

yet it draws me,

draws me

like a spindly beckoning finger

and as I linger at its gate,

foreboding tells me

I should not enter

yet strange longing urges me to stay

and I can’t quite remember why I’m here...

Lasciate ogne speranza, voi ch'intrate.

 Anna :o]

Fred at dVerse asks us to write in a language which is not our own.  Although some of the above is drawn from Dante’s Inferno, that written in English is not my own.  It is based on the language and thought process of someone (I was privileged to know) who was a dementia sufferer. 

There is no pleasure to be achieved from dementia, no yearning to earn its tag – for the sufferer or the carer –and following diagnosis worlds begin to disintegrate, friends gradually cease to visit, even relatives – loneliness, isolation and fear ensue.  There is very little – and I mean very little - community support, perhaps a six-monthly visit to your psychogeriatrician, an annual review from your GP, an occasional visit from CPN or social worker and that is it – and they do mean well, they really do – but until you are diagnosed with dementia or care for someone who has – until you live this life - you really don’t know a thing - you may think you understand and can reel off wisdom acquired through the requirements of your profession - but you don't understand at all.

Health Secretary Jeremy Hunt has proprosed that GPs should screen all those considered at risk of developing dementia and those over 74 when attending a routine visit – with no warning of the intention to screen.  There are so many dangers here of over-diagnosing and over-medicating – please DO read two excellent post by Dr Martin Brunet regarding this here and here.

Please watch the video above – brought to my attention on Margaret McCartney’s blog and read her post here.

NICE has concluded that there is no accurate method of identifying people through screening – please see ‘Basis for recommendation’ so why are the government pressing ahead?  What will happen to the folk who may have to wait up to nine months for a Memory Clinic appointment?  They may be diagnosed with early dementia and then what?  Certainly very little helpful support and definite stigma attached – they may be found to have mild cognitive impairment that will not progress to dementia – but oh the worry while waiting (for the appointment) and the stigma will remain. They may be found not to be in the early stages of dementia at all – but oh the worry while waiting and the stigma will remain…  

 What are your thoughts on dementia screening?

Image: courtesy of Wikimedia Commons, author Luca Casarteli 

Peace

image by Daniel Murtagh

They say   when asked,

your dog-collar friends

that you must suffer;

                 anguished
as you slowly

drift towards the end.

They say that He is testing you,

giving you the chance to make amends,

and I wonder if you always knew

you’d writhe

in most exquisite pain

to bring glory, glory to His name.

I am not ready to give you up,

would do all to keep you alive

and strive with prayer

to plead

too soon too soon

please don’t take this man  

who shared Your flesh,

drank Your blood from precious Cup,

but no man is from death immune

and from life’s first breath we begin to die

and Lord you will not hear my cry

lest he should not come unto Thee.

I weep as I watch you wounded,  writhe

and change my plea to that of sweet release

for *nothing ‘gainst times scythe

can make defence

and entreat the Lord to grant you peace.

Tis twilight now

and I gaze as cirrus thin-wisp

the vast expanse of reddened skies,

and in awe of it,

want so to believe

that Heaven does indeed exist,

that when life doth finally cease, 

in death your soul will gently rise

and you will sit with Him

splendid

in Eternal Peace.

Anna :o]

I first began writing the above in response to dVerse's prompt of Peace and distracted by other things it fell by the wayside.  Then I saw Tess’s prompt at The Mag and the woman looking out of the window reminded me of the evening I looked out of the window – the day after my dads death – and the beauty of the skies made me think of the possibility that Heaven may exist.

The poem is of course about my dad and I should give a bit of history.

I was raised in a religious household – but a home where religion was a comfort and by no means oppressive – no Hell and Damnation.  Despite this warm atmosphere I cannot ever remember believing in God.  I spent periods of time in hospital as a child and saw a lot of suffering there.  I can remember my mum and dad saying – when comparing my relatively minor problems with those other children – “You have so much to thank God for Anna” and my response was “But what have they got to thank God for?” and they could not answer this.

My brother ran away from home when he was nine – he too conflicted between his ‘need’ to honour his parents beliefs and the lack of his own.  Upon his return much talking was done and my parents said they had realised a long time ago that I did not believe too.  My brother and I never attended church (with my parents) again after that.  It must have hurt my parents deeply – but wonderful good souls as they were – we were never treated any differently.

When I was ten my dad gave up his job in Law and devoted his life to his God – becoming a ‘missionary’ and a lay-preacher – not the Bible-bashing kind rather a man who gently wished to spread the love of his God.

Some twenty or so years ago – across weeks – he died an agonising death and I asked his colleagues why his God was treating him so.  They responded with the usual platitudes’ “God works in mysterious ways” and “He is testing him” and when I asked why He was testing him – a good kind man who had devoted his life to Him – they could not come up with a satisfactory answer.

So it is fair to say I have never believed in God – but for my mum and dads sake – I truly truly truly hope I am wrong and they exist in eternal peace with their God in Heaven.

*”nothing ‘gainst times scythe can make defence” – wonderful words borrowed from Shakespeare – Sonnet XII.  (It’s okay – he says so and he and I are good friends!)

Signatures

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.

Tobacco-kissed,
dog-end DNA

remains of you among the ashes. 

I see you 

on the lips of long-emptied glasses,

whisky-scented,

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! 

Innocence

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

Come 
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.

Storm Brewing

photo by Andy Magee

Rain streams

in never-ending rivulets,

blurs,

obscures vision.

The unremitting

rhythmic wurr, 

               wurr,  

               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

hate-faced

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.

It's Always You, You, You!

You say my drinking makes you miserable;

that you don’t know what to do when I’m ‘this 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

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.

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]

References

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

Squall



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.