Growing Into Medicine (25 page)

‘We looked at it from all angles, then prodded it with a stick. It didn’t move. Should we go on and tell Mrs Hickson? Or just run home? In the end we decided the right thing to do was to take it to the police station. I had a piece of string in my pocket so we tied it to the end of a stick to keep it as far away as possible in case it exploded.’

The vision of these two small boys, solemnly walking through Chippenham High Street, arms outstretched with what was probably some sort of empty cartridge case tied at the end of a stick, was a good story to take back to my mother.

By the time Daisy died my mother had moved into the rooms she had added to the back of our house in Bath. It had been built in the late 1950s of imitation Bath stone and is a plain rectangle with two projections on the back. The cupboard under the stairs has been extended to make a study in which I still write at my computer with a view of the garden, enclosed on two sides by an ancient wall. I was told that it had been part of an orchard belonging to an old monastery. In the corner where the two walls join, a shed contains a small
stone grate. Half the floor of the shed is raised a few inches above the rest. Could it have been a bakery, or was a fire used to heat one of the walls, which shows the remains of coping-stones and whitewash, suggesting greenhouses? The ground is full of broken glass and clinker. When we first viewed the house its simple style combined with the site’s long history made it irresistible.

The other addition at the back was a large playroom. With some trepidation we had invited my mother to join us. She turned the playroom into her living room and built on a bedroom with a kitchen and bathroom beyond, creating a ‘granny annexe’. She applied the same principle of building it round her furniture. In her eighties she continued to be in charge of her own affairs. But she was living in my house and I had a growing sense of responsibility for her wellbeing. She had given up her car and although she could, for several years, get to the town on the bus, I drove her to visit friends and family who lived further away. From the passenger seat in my car she could see the rev counter, hovering between 30 and 40, which she mistook for the speedometer. I never enlightened her for she would have been horrified by my speed. Adjusting to the faster speed of all traffic was as difficult for her as getting used to the rising cost of everything as the years passed.

My mother matured with age, like a good wine, becoming less tart. To my surprise we were able to live together in peace. Sometimes I could even share some of my inner feelings without fear of being shattered by her temper in the way I had been as a child. On one calm day in June, when lupins and delphiniums were flowering against the backdrop of grey stone, I told her that the garden felt like a space where I could face whatever life threw at me. So far that has proved to be true – though I have not been required to suffer the devastation of untimely death or serious illness among my younger loved ones. The loss of a child or grandchild must be the ultimate horror.

During that time, when my mother was living with us, I edited my first psychosexual book. For several years the proceedings of the
IPM leaders’ workshop were recorded and transcribed. I was no longer editing the family planning journal and I missed the task of trying to sort ideas. I began to pick out themes and to choose extracts as examples. In those days I worked with a pair of scissors, cutting out relevant pieces, stapling them onto plain paper and then photocopying them at the local paper shop. After a few months I sent a sample to Tom Main, fearful of the scathing comments I expected. His reply included the following: ‘. . .
I had no enthusiasm for the idea when you first mooted it. . . but your headings make the discussions punchy and even exciting reading. . . if the fumbling is plain and the occasional errors or superficialities also plain these accounts have one virtue
–
They have an authenticity, unpolished and even crude, that makes them a model of reportage
.’

His letter lives in that envelope marked ‘Some of my most precious things’. This package contains a number of other messages of appreciation, including a postcard of a stylised cat and kitten with the words:

Dear Mum

One kitten safely weaned! Thank you for a wonderful wedding
.

Lot and lots of love

Helen

Although I do not often take out these small tokens I still value them. The need for appreciation never dies.

I discussed the edited transcripts with Jimmy Matthews, Ralph’s longstanding friend, who worked as a small-time publisher producing a directory of legal businesses. He became intrigued and we decide to continue the project that eventually became the book
Psychosexual Training and the Doctor/Patient Relationship
.

The text was divided into three main sections: the individual doctor and psychosexual training, the group and psychosexual work, the leader and the group in psychosexual training. To my great delight Marshall Marinker agreed to write the forward to the book. He described the three levels in the following terms. ‘In the distance we may catch a glimpse of a man and a woman locked in some
personal unhappiness. . . Nearer and less muffled we hear the voices of doctors talking in their training seminars. . . Closer to hand is the Workshop where the leaders meet to discuss their leadership of these seminars. . .’

I have been surprised at how much I learned about group behaviour and the technique of helping the group to work. Many years later I was on a course at Schumacher College in Devon, sited in the grounds of Dartington Hall, where they run courses relating to the environment and sustainable living. All sorts of different people attend, including those from abroad and businessmen who want to conduct their affairs in a more ethical way.

The particular course I joined lasted for three weeks. The experience was not a happy one for me. The emphasis on a holistic approach to life’s problems was set in opposition to ‘relativism’ where things were divided into small pieces in order to study them. The members of the group seemed to equate that word with scientific method, in which I believe with passion. I became the token ‘bad’ scientist, castigated for not knowing all the details of the sheep dip that poisoned farmers back in the 1970s. However, towards the end of the time we were broken into smaller groups to work on some project. Our discussion was becoming heated and going nowhere when one member left the room. The others immediately started attacking her. We had no leader but without thinking I suggested we should wait until she returned and try to find a way of airing these views in her presence. When we did, she was able to put her points more clearly and we produced a result of sorts.

I experienced a very badly led group on a weekend course at the Tavistock Clinic, where I had expected them to be experts. My small group had only one man. When the discussion turned to sexual abuse he was attacked and, not surprisingly, became defensively aggressive. Tom was not in favour of making group interpretations and always took the discussion back to the doctor and the patient, the work task. Perhaps the trouble with the Tavistock group was that we did not have a well-focused task – I don’t even remember what it was.

Bion’s writing about small groups suggests they function in one of two modes, the
work group
and the
basic assumption group
where members act out unconscious strategies to avoid painful work. Tom never referred to any theories, but the workshop digests demonstrate many of the difficulties met in helping trainee doctors to belong to the former group.

Over the years I have led groups in many parts of the country. My travelling was comparable to that of many participants who, especially in the early days, paid their own expenses. I certainly paid for all my travel during training, only being reimbursed and eventually paid a fee when I started to lead. Like most of my contemporaries I was a woman working part-time with a husband who provided basic financial support for the household. We were happy to give our time and money for the unique training that grabbed our attention and filled a gap, not always recognised as more than a vague dissatisfaction, in our understanding of patients and their needs.

Now, most women doctors can get other part-time work and their households have been designed with the expectation of two salaries. Sexual problems are recognised as underlying much unhappiness and some illness. All doctors are expected to have some training in the recognition of such difficulties and to be aware of places to which their patients can be sent for help. Some doctors apply to the IPM for training because their employing authority has sent them or because they like the idea of another qualification – with such motivation they are unlikely to gain much insight.

The publication of the workshop transcripts was an important step in my working life. Although I was never an innovator, I had taken on the job of trying of capture the highly original ideas and method of training that was developing within psychosexual medicine. In both my family and my professional life I was on my way to becoming a member of the senior generation.

When my mother fell and broke her femur I was in London to present a paper at an IPM meeting. She was in her flat and managed to crawl to one of the panic buttons we had put in each room. Ralph
went through to find she had a bag ready packed for such an eventuality. The ambulance took her to a private clinic. I caught the next train home, to find she had been prescribed bed rest in the hope that the simple break would heal itself. During that time she appreciated being called Dr Hickson by the staff. She enjoyed the care, the tasty meals and the single ward with a view over fields, the flowers and letters from well-wishers. But a week later her fracture showed no sign of healing. Her consultant decided he must operate. I went with her to the door of the operating theatre where she looked into my eyes and clutched my hand. I reassured her that I would be waiting for her when she came out. I was, once again, the adult to the frightened child – as I had been for those few days following the death of my father.

Back on the ward she floated on the edge of consciousness. After twenty-four hours we were told she had sustained a massive heart attack under the anaesthetic and was not going to recover. Arthur sat with me by her bed while a nurse did everything she could to make her comfortable, keeping her mouth moist and every part of the body supported in a comfortable position. Half an hour before she died the nurse asked me what my mother’s first name was. When addressed as ‘Joan’ her eyes flickered. I was deeply moved. This passionate, powerful woman who had been my mother had regressed to the stage of an infant. I am comforted by my belief that hearing her name in those last moments ensured that she did not feel deserted or alone. I held her hand and Arthur held mine, a line of support I tried to extend across the Atlantic when I phoned Biz later. She, however, was in the middle of hosting a dinner party and with typical stoicism continued being polite until her guests had left and she could share the news with her husband and seek what comfort he could offer.

I mustered some words to thank the nurse for her sensitive care of my mother during those last few minutes of her life. She told me she had nursed her own mother to the end and that the personal experience had taught her the importance of adjusting one’s responses to the moment by moment changes in each patient as they slipped towards death.

Again, Arthur and I were faced by a funeral. Knowing our mother would hate to have even the simplest prayers said over her, we asked the undertaker how it could be done. He said quite simply that the coffin would be in the crematorium. We could go in and sit down. When we wanted it to disappear we should stand up. So we did just that. She always hated bought flowers, they were a waste of money, garden bunches were much nicer. So, after forcing the buds to open by putting them in a warm oven, I placed three Iris stylosa blooms on the plain wood. They only last a day so it was appropriate that they should burn with her.

As we drove back to Bath after the ‘non-funeral’ I told Arthur about the time, only a few months before, when our mother had climbed into one of my compost boxes, made of wooden planks, in order to paint them with preservative. She loved to help in the garden and I did not resent what I would have considered intolerable interference earlier in my life. I tried to suggest simple tasks that she could manage easily and had meant her to treat the wood from the outside. But she was determined to do the job properly. When I came home she told me, with a laugh, ‘I found myself wishing to die at that moment, in that place. Then you would not have the trouble of moving my body but could build me into the layers of compost.’

Arthur and I managed to laugh too, at our practical but impossible mother, whom we had loved despite her tempestuous temperament.

17

Surviving

After the publication of the workshop transcripts, Jimmy and I published a multi-authored book
Introduction to Psychosexual Medicine
under the same imprint, Montana Press. The name occurred to him one day as we sat with Ralph in the garden near a prolific clematis that had draped itself round a pear tree, one of the last of the monastery trees, not destined to live for many more years. Among my favourite photos is that of Helen and her new husband Simon, taken in front of that tree with its mantle of white flowers, soon after their return from honeymooning in Africa.

Ralph retired from the prison service when he was sixty, in accordance with the regulations. The year was 1984, appropriately synchronous with Orwell’s book. He would have found the prison service with its modern ethos of privatisation a difficult place to work. In retirement I had expected him to become a keen member of the Bath chess club for he had played by post for many years. However after attending a few times he stopped, preferring the distance of correspondence and the impersonality of a computer. In the hope of prying him out of his chair into the open air I acquired a replacement dog. Bess had died a couple of years before. Cassie was a collie/Labrador cross with her own problems. She had eczema and the steroid tablets needed to keep it under control gave her a ferocious appetite. She stole any food within her reach. If allowed to run free in the fields above our house she disappeared into the bowels of the skips at the back of the university, where they chucked waste food. I was not firm enough to train either of my dogs.