29 Jun, 12 | by BMJ Group
Working as a doctor in Ireland has many positive aspects, particularly a warm human ambience and a remarkable love of the spoken word. On the debit side of the linguistic largesse is a leaning to the elliptical and the discursive, and a generalised tendency to soften the hard blows of life. A prime example of clinical Hiberno-Irish is the common use of the term “disimprove”: softer on the ear than “deteriorate” and suggesting a gradual slippage from the improving state rather than a grim decline, it caused much mirth on the wards in the early days of my very happy few years in the NHS.
A less happy aspect is the failure of Irish society to directly confront one of its greatest scourges, that of alcohol dependency. Despite the grim toll on family life and the health services, a great deal of sporting activity is sponsored by alcohol companies, and principled opposition from within the sporting organisations is rare. A heroic, if ultimately unsuccessful, stand was taken against alcohol by the GP Mick Loftus, a sporting hero and at one stage President of the association for the two national sports, hurling and Gaelic football.
Even more troubling is the persistence of sponsorship of Irish medical charities by the alcohol industry, from stroke to palliative care charities. This latter project involved a short story writing competition in an Irish newspaper (for which, in terms of a full declaration of conflict of interest, I write a monthly column on matters generally related to ageing) on the theme of celebrating what really matters. The word limit was a very manageable 450 words and winning stories are collected into a book, proceeds of which go to the Irish Hospice Foundation.
The competition is wildly popular, attracting 4,200 entries this year. Even my own fingers were twitching, yet how could I combine the creative impulse with a persisting concern over giving respectability to an unhappy proximity between the alcohol industry and the health services?
A chance showing of The Producers (where the producers develop the musical Springtime for Hitler with the deliberate intention of it being a failure) on television sparked inspiration. Why not write a short story about the tragedy of tolerance to alcohol with the aim of losing, even if only to nudge the conscience of the jury, which included a representative of the alcohol company? Happily, unlike the eventual wild success of the camp Hitlerian romp, the story was not even long-listed (that would have been embarrassing!) but hopefully might just nudge some of the jury to think hard about the project with which they were involved.
And so, was the story too obvious or too laboured? Reader, I will let you decide!
Celebrating what truly matters
Two rows of seats, three families and a constellation of grief filled the room. Peter hesitated at the lintel, catching his breath after running from the hospital car park to the intensive care unit. His wife and daughter sat motionless and dazed, their uncomprehending misery at one with the tears and mute heartbreak of the other families.
The planning meeting had been in full tilt, the storyboard for the new campaign unfolding, when the door opened. Usually he brooked no interruptions, particularly for a campaign this delicate. Sponsoring a short story competition in a respected broadsheet was controversial in a country so troubled by alcohol dependency: but to ally the brand to the buzz of creative writing with a people so besotted by literature was a tantalizing prospect.
One look at the distraught features of his secretary was enough. He quickly excused himself: once outside she broke down completely. The awkward young policeman in the reception area stumbled through his narrative. As if in a dream, Peter heard how his son had been knocked off his bicycle on the way to the university sports field and was on his way to the hospital. The driver was being held for questioning, having failed the breathalyser test.
The journey to the hospital was a blur, nausea and disbelief syncopated by frustration at the succession of red lights. Once in the room, the dissolving of his family into a tearful embrace, suddenly unconscious to the others in the room, confirmed his worst fears. A kindly nurse appeared and ushered them gently into the sister’s office.
Moving bundles of reports and schedules, she sat them down in the cramped space and the consultant in the surgical scrubs joined them. The contrast between the stark and horrifying message and her empathic and sensitive manner further heightened the sense of unreality. If Robert survived, his spinal cord and head injuries would leave him paraplegic and with a high likelihood of significant brain damage.
Stunned into silence, the room filled with loss, anger and despair, each unable to digest what had happened to this spirited and easy-going young man: son, brother and only months away from taking up his sports scholarship at an Ivy League university. The deathly stillness was suddenly interrupted by a ping from Peter’s Blackberry. His conditioned reflex outstripping his shame at obeying it, he read the text from their client enquiring about the progress of the short story campaign.
His misery was instantly amplified by the realization that his insouciance in lending respectability to the Achilles heel of Irish life would haunt his remaining days. With bitterness he reflected that we only learn to celebrate what truly matters when it is too late.
Des O’Neill is a consultant physician in geriatric and stroke medicine