Sunday, 25 September 2011

Burnout II: Getting Back on the Horse

Over a month ago I published a pretty personal post here about the unpleasant experience of going through burnout and the practical measures I was undertaking to deal with it. As a number of things have happened since, I thought it was time to write an update.

After six and a half weeks on sick leave, I went back to work last Monday. It wasn’t an easy decision to make. The enforced pause certainly helped me to clear my head – to an extent, at least – but the renewal of energy, a “recharging of the batteries” which I had hoped for, didn’t seem to be happening. I spent much of the time sitting at home, reading a lot and the normal, unthinking energy which was available to me for so many years for doing all the myriad things from housework, to visiting friends, to managing all the basic affairs of everyday life, to writing didn’t really kick in. Oh, I did manage to do the most necessary things and even a number of other things which weren’t strictly necessary but everything was still shaded with a heavy patina of effort; the old lightness which I had realised I had lost and the loss of which had so shocked and pained me didn’t appreciably return.

Very well, I thought to myself, taking time out hasn’t been the panacea I had hoped it would be. Panaceas rarely are all they are cracked up to be anyway; cure-all nostrums are usually the province of snake-oil salesmen and the treatment of suffering in something as complex as the human psyche is also likely to be complex – a process involving various elements in dynamic relationship with each other and needing time and space to develop. I had started taking medication, I’d begun a process of therapy which will (if all goes well and my health insurance can be given the proper signals to get them to finance it) grow into a longer phase of classical psychoanalysis, I had discussed my situation with professionals, family and friends and had productive talks with my employers concerning certain negative aspects of my concrete work situation. Now the time had come to take the next step, to climb back on the horse from which I had fallen.

And so – not without a large dose of trepidation – I went back to work. One of the changes I had negotiated with my employers was that I will, for the foreseeable future, be exclusively assigned to work in the new project we are developing; a middle-term residential group for the care of very sick children (sometimes accompanied by their mothers), who are in need of continual, often high-tech medical support in order to continue their healing process, or just to go on living. At the moment, the group is composed of four children (aged between six months and eleven years) and two adults (who are only there temporarily, these places to be ultimately available to children as well) in temporary, provisional accommodation. Permanent, custom-built quarters are presently being completed and we will be moving in there before the end of the year.

Six patients all in need of extensive, complex, permanent, time-consuming intensive care, with two nurses always on duty; there is plenty to do. The first twelve-hour shift saw me exhausted at the end but it was a good kind of exhaustion – that kind of tiredness which comes from having worked hard doing tasks which offer a sense of immediate value and worth. In the course of the week I found myself quickly adjusting to the physical demands of the job. And I realised that the enforced pause had, in fact, done more for me than I had thought. I found myself better able to cope with the various time-consuming idiocies enforced on anyone working in any of the over-developed, over-regulated, under-staffed, under-paid, misfinanced lunatic complexities which are a characteristic of health-systems all over the world. The senseless bureaucratic and administrative hurdles which independently uncontrollably burgeon in any system beyond a particular level of complexity, which would have had me seething with frustration a few months ago (this itself a symptom of the fact that I had gone way beyond my own tolerance levels), I could now accept with a lot more serenity as part of the inevitable Catch 22 reality in which all of us in our mad modern society are more or less caught.

I am not cured – this will be a long journey, and relative health and sickness are always just a snapshot of an instant in the constant complex dynamic interactive process which is life anyway. But I find myself seeing things more positively and see grounds for hope that my basic levels of essential energy will increase in the doings of things rather than waiting for them to grow so that I can do things.

I decided to be basically open with my colleagues (without going too much into details) about the reason for my absence. I received unexpected support for this during the week. The manager/trainer of one of the most prestigious Bundesliga soccer teams, Schalke 04, Ralf Rangnick, resigned his position last Thursday with immediate effect. The reason he gave was the spectacular, honest admission that he was suffering from an exhaustion and burnout syndrome. While, as with most news items in our high-speed, media-driven world, it will be a seven-day wonder, such public announcements do help the process of bringing various manifestations of mental suffering and illness into the realm of more serious open discussion and further the process of dismantling taboos, clichés, speechlessness and misunderstandings about such issues which are widespread in our societies.

Returning to work, I discovered that others had very different difficulties to deal with. I have written about Jenny a number of times here before. To recapitulate: Jenny is a three-year old girl, who is deaf and dumb, suffers from a partial facial paralysis, a dangerous weakness of her respiratory musculature, an inability to swallow and some balance and coordination disturbances. As a result, she has a tracheotomy tube in her throat and spends long periods daily on a respirator. She is also very intelligent and extremely lively.

Complicated gene tests have confirmed a couple of weeks ago that Jenny suffers from something called Brown-Vialetto-Van Laere syndrome. This, of course, means nothing to her, but it tells us that her prognosis is very bad as the general course of the illness is progressive.

Jenny was dealing with two much more urgent problems. A month ago, my colleague Jan, who was the member of our team who had the deepest relationship of us all with her (in a very real sense, a replacement father-figure), suddenly and completely unexpectedly died in his sleep. He was two years older than me. At exactly the same time, Jenny contracted a very serious case of pneumonia, which necessitated a stay in the Intensive Care Unit in our local hospital. Given the fact that she is living with a hole in her windpipe where nature never intended that a hole should be, this is the kind of thing which can happen; it almost certainly won’t be the last time. When she returned, it had to be explained to her that Jan would never be coming back.

She has understood that and – we think – she has accepted, according to her own categories, that he has not abandoned her. But she misses him and suffers from his absence.

She greeted me like a long lost friend (which, I suppose, I was to her) and seems to have transferred some of her fixation with Jan to me. She stuck to me like a burr all week long, appointing herself my assistant nurse and accompanying me when I went to the other children to take care of them. This has been made somewhat more complicated by the fact that she needs extra oxygen all the time at the moment, so that I spent a lot of time lugging her oxygen tank with me.

For the events of the past weeks have weakened her. After a maximum of four hours, the effort of breathing independently has so exhausted her that she has to be put on the respirator for a couple of hours. Her continence – which she had achieved shortly before the illness commenced nearly a year ago, lost then and won back again in the past six months – has taken a hit. This annoys and embarrasses her, but she’s got enough determination to get it back once more. And she retains the capability to put all of her intelligence and creativity into continually working on marvellously extensive and sophisticated communication, despite her deafness and lack of speech.

Given her confirmed diagnosis, we are haunted by the dark suspicion that she may have already seen her physical zenith. Perhaps. But we shouldn’t write our prognoses without figuring in Jenny’s determination and stubbornness. They are part of a complex, fascinating personality which makes her occasionally amazingly frustrating but more often supremely rewarding to care for – sometimes simultaneously!

Engaging with Jenny has, at any rate, done me good. It is an intense, positively strenuous relationship which, in the way which children determine, takes place primarily on the emotional level of the ever emerging now. A condition which leaves very little room for depression. And for all that I am deeply thankful to my young friend. Having climbed back up on that horse, I sense that I am not alone; Jenny is there too, sitting in front of me.

Though the song seemed appropriate to me anyway, the fact that David Coverdale celebrated his sixtieth birthday this week makes it even more so.

Pictures retrieved from:

Monday, 12 September 2011

Dancin' in the Moonlight

Sometimes I feel the urge to try a different kind of writing to that which I generally publish on this blog. Regular readers will have noticed that in such cases I tend to make use of, the platform my friend Chris Jenkins has created. For those who do not know it, here’s the basic statement of the philosophy; “ is a loose collection of writers, artists, gadflies and trolls. Our purpose is to entertain and enrage in the quest to make you think.”

So it’s over at that I let my nasty alter-ego, Frankie, out of his cage every now and again. And where I try out other things as well.

So when my muse wagged her ass recently and seductively suggested that I might try my hand at a little fiction, it was clear to me that – if it worked – I should publish it over there.

In my teenage years in a small town in the west of Ireland, Thin Lizzy were one of my favourite rock groups; something I believe I shared with the majority of my contemporaries. Along with Rory Gallagher, they were the first to come out of Ireland and make a really serious impression on the international rock scene. Their first, and probably greatest hit, Whiskey in the Jar (1972) served to give diddle-ee-eye traditional Irish music real credibility for my generation and has become a classic rock standard often covered since; most notably perhaps by Metallica, winning a Grammy for their performance of the song in 2000.

Thin Lizzy saw many great musicians as part of their line-up over the years, including Snowy White, Midge Ure and the incomparable late Gary Moore, but the front-man and the soul of the band was their bass player and singer, Phil Lynott. Phil was an amazing, larger than life character, that most seldom of phenomena, a black Irishman, whose singing was always characterised by a broad Dublin accent. His childhood was not easy, growing up as an illegitimate mixed-race kid with his grandmother in very modest circumstances in Dublin in the 1950s. But he came out of this background with a suave, piratical coolness, which he projected on a level comparable with Jimi Hendrix.

And, just like Hendrix, he lived the rock and roll life in the fast lane, dying as a result of drink and drugs at the age of only thirty-six. His native city of Dublin commemorated him with a life-size bronze statue in 2005.

This little story was inspired by a 1977 song by Lizzy, Dancing in the Moonlight. It’s a modest homage to the group, especially to Phil and Gary, who are now rocking the angels.

So here’s the link. And while you’re there, check out There is some very good stuff over there …

Picture retrieved from:

Friday, 9 September 2011

9/11 - Ten Years On

Like most of the world, I presume, I find myself this weekend remembering that Tuesday in September ten years ago when we watched with horror as the hijacked planes crashed into the Twin Towers and the world was changed. If nothing else, the media won’t let us forget it; for the last week or longer we’ve been bombarded with specials, pictures, analyses, talking heads, etc., a phenomenon which will reach its peak on Sunday.

This alone makes me reluctant to write this – there’s more than enough being published on the subject. Yet, despite this, I feel a need to not let the day go by without reflecting on it myself. The first thing that occurs to me is how successful Osama bin Laden was with the diabolical action he and his followers planned and followed through. Terrorism has as its primary aim the spread of terror – fear – and confusion, the provocation of reaction in response to the initial act of terror; a reaction which serves to bring the agenda of the terrorists to the fore, to win attention for their cause, to help them recruit followers so that their agenda can be followed through on, to force those they see as their foes to act on their terms. In all of these goals Al Qaida was successful.

More of the long term goals of the Islamicist terror organisation have also been advanced. Ten years after 9/11, after a decade of war which has caused the deaths of thousands of western troops, the deaths of hundreds of thousands of Afghans and Pakistanis, and the spending/waste of hundreds of billions of dollars, Afghanistan is still not pacified and it looks like the Taliban (even if only as part of a very slightly more moderate coalition) are poised to return to some kind of power in a chaotic Afghanistan still dominated by warlords, corruption and fundamentalist Islam. Iraq has been wrecked; a brutal secularist-inclined dictator has been removed but fundamentalist Islam is several orders stronger in the country than it was ten years ago. And more hundreds of thousands have died. Fundamentalist Islam still rules in Iran. Nuclear-armed Pakistan – most frighteningly – is on the edge of falling under Islamicist control. Only Saudi Arabia, bin Laden’s primary goal, still remains fragilely under the control of the House of Saud but even here rich fundamentalist Wahabists, who do not belong to the clique around the king, continue to finance Islamicist radicalism globally.

While Al Qaida seems to have lost some impetus in the past few years, it remains as dangerous as it was ten years ago – if not more so. The group has fissioned, spawning dozens of autonomous cells worldwide, many of them composed of second or third generation immigrants who are completely at home in the countries of the west in which they are located.

The other major question is the effect the 9/11 attacks (and those following them in Indonesia, London, Madrid, Mumbai, etc.) and the “War on Terror” instituted under the leadership of the USA have had on those societies which see themselves as based on ideals of freedom and democracy. Here too the balance after ten years is sombre. It is understandable that security became an aspect which increased in importance for those societies under attack after the fall of the Twin Towers. What is questionable is the extent to which other values have been subordinated to the perceived demands of security and how high the price of this subordination has been.

There are values which belong to the fundamental building blocks of open, free societies, values which have developed and been achieved over the course of hundreds of years, often as a result of long struggles and suffering on the part of many brave people. Values like habeas corpus, due process, the right to a free trial and legal representation, the inadmissibility of purported evidence obtained under duress or torture, the rights of innocent, uninvolved civilians to integrity of life, limb and property, the presumption of innocence until proof of guilt, rights of privacy.

An Afghan child injured in a US bombing raid
All of these rights and values have been seriously compromised in the past decade, both in those democratic societies considered under attack as well as in those countries where various military actions have been carried out, countries like Iraq, Afghanistan and Pakistan. The Homeland Security Act, Guantanamo, Abu Ghraib, extraordinary rendition of suspects and their torture in countries like Iraq, Afghanistan, Mubarrak’s Egypt and Ghadaffi’s Libya, the treatment of many of those who have attempted to make abuses of the law public (whistleblowers like Bradley Manning), lies told to the world (Saddam Hussein’s possession of Weapons of Mass Destruction), the bombing and killing of innocent civilians in Iraq, Afghanistan and Pakistan (“collateral damage”) all represent betrayals of the values which Al Qaida was attacking on 9/11 and which the western authorities in various governments, particularly in the USA and the UK, have ostensibly been defending.

Those who wish to justify such things will claim necessity as their reason; the ongoing situation demands them, they are the lesser evil and, in such a war context, the end justifies the means. Yet all these arguments are questionable. Ten years after its inception, the so-called War on Terror shows no sign of being brought to a successful conclusion, even if Osama bin Laden was finally run to ground this year (on the territory of a putative ally of the US). Many of the actions justified according to this rationale have been counter-productive; one need only look at the negative results the pictures of the abuse and humiliation of the suspects held in Abu Ghraib had on Muslim public opinion worldwide.

The War on Terror is a dangerous and misleading misnomer. You cannot fight a war against an idea or a concept – and the Islamicist terror which found its expression in 9/11 is the expression of a (ghastly and horrible) ideology – wars are fought against people. Ideas and concepts can only be combated by other ideas. And the ideas at the basis of the open and (generally) free societies of the west, the values which the USA understands as the foundation of its democracy, are worth defending and proclaiming. Moreover, if we are convinced of their worth, then we must surely be confident of their power to prevail over the half-baked idiocy of those ideologies which are presented by simplistic fundamentalists (of whatever persuasion). But this cannot take place as long as our leaders and decision makers betray these very values in their proclaimed measures to defend them. The cynical saying regarding the destroyed town of Bến Tre in Vietnam in 1968, attributed to an unnamed US major by Peter Arnett, comes to mind; “It became necessary to destroy the town to save it.”

An open, free society will always be vulnerable, to an extent, to the attacks of those who reject its values. That is the price we pay for freedom. But we can only defend and spread that freedom by ourselves adhering to those values which are its foundation.

The victims of 9/11 deserve no less.

Pictures retrieved from:


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