Throughout the land
And don’t criticize
What you can’t understand
Your sons and your daughters
Are beyond your command
Your old road is rapidly agin’
Please get out of the new one if you can’t lend your hand
For the times they are a-changin’”
A dream of a spirit,
Sweeping, dancing through the world,
Speaking a Word that is pure communication,
Comprehending and comprehended by all
Who are touched by its flighty, dancing flounce;
Flickering flames in the darkness
Lighting dusty, cobwebby, shadowy corners,
Where demons of inadequacy, pettiness and shame lurk,
Nightmares of hurt and hate
Blown into disappearing, dissolving, glistening dust
By a Divine Wind.
A dream of a spirit,
The breath of a god
Exhaling unity and harmony
And perfect understanding
Into a broken babbling world
Of economic competition and exploitation,
Of scrabbling for survival and advantage,
Of climbing to security with hard-nailed boots over all those perceived as threats
(Or who just happen to be innocently in the way),
Of man-made miseries and natural catastrophes
And nattering networks.
A dream of a spirit;
A chimerical paraclete
Sent from above?
The old, human, millennial quick-fix?
Veni creator spiritus.
Or the longing for that something more than we are,
But that we know we can be?
When we are serene
An empty bowl spilling over,
We are the Holy Ghost.
I’ve been in nursing, one way or another, for more than twenty years now. Given my somewhat complicated biography, it wasn’t my first choice of career and the decision to enter it at the end of my twenties was more a rational one, taken at a period of my life where (I felt) I had to put myself on some kind of steady job/career path – I found myself with a young family to support.
It’s a decision I’ve reflected on frequently since taking it, but one that I have never really regretted. However, I freely admit that I do not belong to that group of colleagues (who I really admire), who seem to have been born for the job and who never seriously considered doing anything else. In that sense, it has been more of a profession for me than a vocation. Not that there’s anything wrong with that; indeed, as the years have passed, I have found myself increasingly regarding the idea of professionalism as being very useful for the long haul in this kind of work, helping me to integrate it into my life in general, giving me the capacity to combine genuine empathy with the necessary distance to be able to carry on daily dealing with the (often shocking) human suffering, pain and misery with which nurses are confronted without burning out or going crazy.
That said, I want to sound off about the way people working in the nursing area are often regarded by and treated in what is frequently called the “health industry” and our society in general. Our high-octane, performance-driven, (selectively) cost-conscious culture has developed all sorts of mechanisms and instruments to increase efficiency, frequently given such titles as “quality assurance” or the increasingly ubiquitous “total quality management” (TQM). I don’t want to completely demonise such processes – they can be very useful in many ways – but we should remember their origins in assembly-line based production industries and be wary about giving them unquestioned supremacy in areas which have to do with people and relationships (and the nursing process is fundamentally about relationships), particularly when these have to do with people in extreme situations – and people who are in a position where they need nursing (of whatever sort) are generally in situations which can be described as extreme. You just can’t treat someone suffering from terminal cancer or dementia in the same way as you can a carburettor and then decide that the time a nurse should need to help such a person to wash themselves or go to the toilet can be computed in the same way as the time someone on the factory floor needs to connect the carburettor to the rest of the engine.
But this is, in fact, what is increasingly happening in the health care area. Some of it is understandable. In a world in which medical advances make more and more possible it is becoming increasingly clear to everyone that such progress is not cheap. The fact that a basic driving mentality in our modern culture is to see every difficult situation as a series of problems to be solved exacerbates this. The end result of all of this is that modern societies (particularly in the so-called “developed” world) are faced with continually increasing costs in the health area and the issues of how we are going to pay for all this and how we can be sure that we are really getting value for the billions we are spending already become ever more critical.
Nursing care is, by its very nature, labour intensive. And this is where the problems really begin. Faced with (frequently conflicting) demands for high quality and efficient costing, the easiest quick fix is to look at staffing levels and organisation. The easiest reaction for medical institutions of any kind coming under economic pressure is to try to reduce labour costs. For all sorts of obvious reasons, for example, a hospital confronted with a choice of not buying the latest sexy piece of diagnostic equipment or getting by with a couple of nurses less will almost always choose the second option. The basic view of those making the decisions seems to be that there is always some slack in the nursing care area; that more rational organisation will always lead to a situation where fewer people can do the same amount of work.
In the nursing/care area this kind of thinking is made easier by the fact that it usually brings results – in the short term. These has a lot to do with the fact that people who work in such jobs are generally conscientious, highly motivated and are driven by an ethos which makes them try to ensure that their patients don’t suffer as a result of such efficiency drives. So they work harder, put in more (frequently unpaid) overtime, etc. Often the pressure becomes too much, some become ill and have to take sick-leave. The resulting gaps are filled by their colleagues, who have to do even more as a result. And almost everything they do has to be done almost immediately, whether that’s at night or on Sunday afternoon. The pressure increases. This increased pressure can – and sometimes does – lead to mistakes being made. But there are ways around that too, you just have to make sure that every step of the work done is adequately documented so that in the case of a mistake being made it can be quickly identified and rectified. Of course, this obligation to document everything also increases the work-load further. In an iconoclastic mood, I sometimes ask fellow health professionals the question; what is worse, to do something and not document it, or to document something and not do it? Ethically, the answer is simple but, in terms of basic self-protection, it is often better to be sure that your documentation looks complete.
And, should an institution or a department do their job really well, then that’s a sign that there’s obviously more potential for savings there. And so the screw is turned a bit more …
So, the next time you’re in hospital, in pain, and you ring for a nurse, don’t be surprised if it takes her/him a quarter of an hour to answer your call. Chances are there are only two or three of them on the shift responsible for around forty patients. The next time you see a couple of nurses drinking a cup of coffee on duty, consider that they may just have finished changing the dressing on a stinking open tumour, or that a patient may just have died (probably when they weren’t there, because the amount to be done in every shift doesn’t allow them to simply spend twenty minutes just being there for someone who’s dying). Of course, it’s also possible that they may simply be a bit burnt out – too many night shifts, too much suffering and pain witnessed, a relationship failed because their partner couldn’t deal with them being frequently exhausted or stressed out during their irregular free time. And the next time you hear a discussion about the costs of health care, think about what the managers of health insurance or pharmaceutical companies earn compared with a nurse. Or consider what you paid the electrician per hour the last time you had to call him/her because your washing machine was broken. Nurses would be very glad to work for that kind of money
I’ve been on holidays. Two weeks, and, at some time during the first couple of days, I decided to switch off a lot of routine and just relax. Which I’ve been doing and, for the record, it’s been very nice – among other things, I’ve been able to catch up with a lot of planned reading (including Parts 2 and 3 of Stieg Larrson’s Millenium trilogy, but that’s a subject for another post here). One of the things I’ve let fall into this switching off routine is posting here but now that my holidays are almost over it’s time to slowly find the way back to normal and pick up some strands of my ‘regular’ life again. Besides, I didn’t send any postcards and that just won’t do – so here they are!
I spent a week on the Dutch North Sea coast in Zandvoort. The weather was the way it can be at the beginning of May in
It’s easy to find the Museumplein in
That Vincent was increasingly plagued by mental illness is generally known, it finally led to his death two days after shooting himself in the breast in July 1890. The question which arises is, of course, how much his private purgatory can be traced in his works? A standard approach would be to see the artist’s growing mental conflict and confusion reflected in his paintings, the problem is that the pictorial record doesn’t allow us to easily do this. Vincent’s final years saw him at the pinnacle of his artistic achievement; technical and compositional mastery, unerring choice and working through of themes, productivity, visions of sublime beauty, a procession of awesome masterpieces. And at the same time, this artistic outpouring was accompanied by a continuing deterioration of his own subjective, inner balance, a deepening descent into the pit of personal misery and confusion which we helplessly call ‘madness’ (and the experts today still argue about the precise label for the mental disturbance under which van Gogh suffered), leading finally to his death.
Back to the pictures. Shortly after moving to
The Harvest is a detailed work of ordered composition, a picture of a world in which humans have tamed and regulated nature; reaped fields, ordered haystacks, fences, carts and farming equipment ready, diligent peasants finishing off the job. Even the hills in the background take a disciplined, bordering role in the whole work.
A year later, following a period sharing a house with Gauguin (during which the famous episode with the amputated ear also took place), Vincent was hospitalised in Saint-Remý, a small village near
There are better reproductions of other versions of this picture online, but this is the version of the Reaper in the Van Gogh museum and I prefer it because of the almost painful intensity of the yellow-golden colour used. There is less of the obvious compositional order than in the painting above, but this has given way to depth, above all, the depth of the luminous, burning yellow of the ripe wheat and the storm threatening in the greenish hue of the sky around the relentless late-summer Provencal sun. The circular swoops of colour, used to depict the ripe grain, are familiar from other works around the same time, above all Starry Night (http://en.wikipedia.org/wiki/File:VanGogh-starry_night_ballance1.jpg). Vincent’s own comment on the work is revealing, “In this reaper – a vague figure laboring like the devil in the terrible heat to finish his task – I saw an image of death, in the sense that the wheat being reaped represented mankind. […] But there is nothing sad in this death, it takes place in broad daylight, under a sun that bathes everything in a fine, golden light.”
In this painting perhaps, most of all, we sense a correlation between the painting and the inner life of the artist – thoughts maybe of death as the clean conclusion of burning light, consuming everything in a conflagration of inexpressible clarity and purity, the transformation of pain and confusion in a cataclysmic, cleansing ending.
Vincent’s inner torture grew and he moved to Auvers-sur-Oise to be nearer to his doctor and his beloved brother, Theo, both of whom lived in
There are also signals here of his inner conflict. Writing to Theo about the series, he said; “They depict vast, distended wheatfields under angry skies, and I deliberately tried to express sadness and extreme loneliness in them.” Are we justified in seeing the stormcrows rising as some kind of prophesy concerning the immediate future? I don’t know. What I do know is that I spent a considerable amount of time last week walking between all three pictures and renewing my admiration and awe for Vincent van Gogh. And, just perhaps, taking a tiny step in understanding him better. Not that the understanding is so important, mind you, viewing the pictures and being moved by their wonderful beauty and artistry is far more important anyway.
Yesterday was the first of May; May Day. It’s a public holiday in many parts of the world, celebrated as International Workers’ Day or Labour Day. A bad deal this year for most workers this year, since it fell on a Saturday, but that’s just the luck of the calendar. Or maybe it’s also some kind of symbolism too; I have the impression that the position and status of workers all over the world have not been advancing particularly in the past twenty years, ever since the Soviet system collapsed and so-called free-market capitalism became globally (with a few exceptions) the only game in town. The increasing economisation of all walks of life has led, in many areas, to work being basically defined as unit labour costs, a component of general costs which the experts see as an area where rationalisation and cost-analysis (pseudonyms for cost-cutting) can lead to increases in profits and shareholder-value. Oh well, the events of the past few years – apart from all the misery caused – have at least shown that those who told us that all we had to do was to deregulate the markets and let business and finance just get on with magically making more money and prosperity for everybody frequently don’t know what they’re talking about. Yes, it does look like, having being bailed out by the public purses all over the world, they’re trying to move back to business as usual. Until the next time. Which will come, unless societies globally realise that maximising profits is not the panacea for all the woes humanity is heir to and force the economists and managers to factor in some values other than growth and profits into their computer models. Values like justice, honesty and decency. Otherwise, the final rallying cry at the end of Marx and Engels’ Communist Manifesto (1848), “The proletarians have nothing to lose but their chains. They have a world to win. Workers of the world, unite!” may well echo once more around the world.
The celebration of an international workers holiday on May 1 was inspired, ironically, by an incident in the
But May Day is not just a day of celebration of class struggle, workers rights and left-wing politics – it’s much older than that. May 1 is Beltane, one of the two great annual Celtic-Germanic festivals, the other being Samhain, exactly half a year later on November 1. It’s therefore no surprise that fairies, sprites and witches are particularly active on the evening before each festival. While Halloween is the festival which remained more strongly in folk memory in the Anglo-Saxon world, Walpurgis Night, the witches’ Sabbath, is a stronger tradition in many parts of Northern Europe – with German legends telling of witches gathering on the Blocksberg, the highest of the
Fertility rites, phallic symbolism, a celebration of rising sap and new growth, of the blessings of the fertility Goddess at the beginning of the merry, merry month of May, tricking and dancing, love and sex, surviving in the memory of ordinary people over hundreds of years, even when frowned on by the official (and believed in) religion of the Christian Church. Oh, the Church tried to Christianise May Day, as it had successfully taken over other festivals such as the midwinter one. May was proclaimed the month of Mary – an attempt to sublimate the old Goddess-worship. It worked to some extent but the old customs also remained.
I find it fascinating that the old, slightly subversive celebration of Beltane was taken up by the new, highly subversive workers’ movements of the 19th. Century. Popular memory is a powerful thing. How much of it survives in our technically dominated, commercially exploited, media networked global village remains to be seen. Somehow I have the feeling that, despite all our cultural and technological sophistication, we are not as far removed from nature, the march of the seasons and the turning of the year, birthing, growing, decaying and dying as we like to think. And that’s a good thing too.