If you want to laugh out loud then you should read this book, however if you recoil at rude words then perhaps it’s not for you. On the other hand if you seriously worry about the state of the NHS then you really need to see for yourself the problems that Adam Kay outlines.
I must admit I had never heard of this best seller until, recently, I had a short stay in Grasmere and was able to visit the small but very adequate book shop there. There seemed very good reason to select this little paperback when I saw that it had caused a number of celebrated commentators to actually laugh out loud. There seemed a very definite need to laugh as a remedy for the unremitting pain of two years.
Back to my search for laughter and the reasons for my search. Over the past few months, following a second knee replacement I had recourse to looking back once more at an old book by the late Norman Cousins. Cousins is interesting to me because he too suffered from Ankylosing Spondylitis, though he developed the illness in middle age, whereas I have suffered this chronic condition since teenage years.
Cousins appears to have cured himself of this alleged incurable illness by creating a better frame of mind through lots of laughter. Indeed, he wrote and published the book Anatomy of an Illness, from which a film was also made, telling of his miraculous recovery from chronic illness. After writing Anatomy of an Illness Cousins penned Head First: the Biology of Hope. He said that his former work had posed the big questions and this work would provide the answers. His quest was to find the proof, or help create it through research, that positive attitudes are not merely ‘moods’ but biochemical realities. It was claimed that this book presented the mounting scientific evidence that hope, faith, love, will to live, purpose, laughter and festivity could help combat serious disease. I was glad to be reminded that I could yet retain the feeling I could manage my chronic illness. Laughter might even help the process.
Many years have gone by since I first read Cousins’ original work with interest. I felt very much in control of the condition through ensuring that I carried out the exercises, including regular swimming, to ensure that I could manage to live without any medication. Two years ago, if asked what medication I took, I could truthfully have answered none. Now the case is very different; following the development of osteoarthritis in both of my knees, leading to full knee replacements, I need a full complement of medication.
My acceptance that I was rapidly losing the will to live also took any creative impulse that I may have previously possessed. A few weeks before our much-loved friend David Paterson passed away, I spoke to him, by telephone, in his hospital bed. He caught me through my mobile phone while I chanced a rare visit into my garden to look at growth and reasons to hope life might change. During our very long conversation I asked David if he had ever felt he was losing the will to live. He answered very honestly ‘yes’ – just that very morning. I guiltily felt both sorry and glad; sorry my level-headed and erudite friend had felt this but glad that he had rather normalised my feelings. However, you will guess my shock and distress on learning of David’s passing.
I do not fall into the category of persons who believe that everything happens for a reason, but I do tend to think that one can learn lots as one passes through life, and especially when confronted with difficulties. Of course, I had been regarded as disabled for many years. For years I was regarded with much suspicion as a person who had an undiagnosed illness. Ankylosing Spondylitis was thought to be an illness that only affected men and, specifically, young men. After 15 long years, my illness was at last diagnosed by one of the world leaders in the condition. The diagnosis took him all of two minutes. All he did was listen and then ask me to perform certain movements. He apologised very sincerely for the manner in which my illness had been overlooked seven years before at the same hospital. Armed with the correct diagnosis and the routine exercises that would help me to manage the illness, I never thought of suing, feeling myself as being in the powerful position of managing the chronic illness that had managed me.
During my twenties I went through agonies as the bones at the bottom of my back fused themselves without operation. Once the bones had fused, for some reason life slightly improved, though the symptoms persisted. I could not lift the phone off the cradle on my desk and relied on the member of staff opposite to lift it for me. For years I was a celebrated green card holder. I say celebrated because it was the only time personnel, now more commonly known as Human Resources, wanted to know I existed, so that they could claim, as a very large employer, to be carrying their full quota of disabled persons. The rest of the time I spent proving my worth by working my butt off and trying my best not to be ill at all.
I could not swim but would soon learn to swim and every day to perform routine exercises, which lasted exactly 45 minutes. I was a woman with a mission. But even though I did all this there still remained problems with sleep, so in the early days I was forced to take pain killers just to manage work. Most nights I was up twice and on a bad night thrice. In the end my new rheumatologist told me, after some considerable reflection, that if I continued to work full time and neglect the illness, I was likely to have a short life. I had no idea how I could give up my very good salary but as Winter rapidly approached, I knew that I had to find a way to manage my affairs. After a more concentrated effort to manage my condition, I could at last spend full nights in bed. I was able to add Tai Chi to my repertoire.
Then suddenly the curse struck again and osteoarthritis was added to the mix. I really trusted that knee replacements would easily be hurdled and indeed the surgery was a breeze. But the recovery was halted by the old enemy AS. One would have thought that a lifetime of this curse would prepare me entirely for this very common and straightforward procedure. I was daft enough to believe that all those bloody exercises would ensure a rapid recovery, but I have learned the lesson of a lifetime. With my condition my recovery would take at least a year.
Having been told at age 25 that I would probably be in a wheelchair by age 30, I had internally vowed I would avoid the wheelchair scenario. I did not, for one moment, envisage that one day I would happily get into my wheelchair, as the only means of getting out and about. It has become the way of doing the weekly shop with a basket on my knee and my other half pushing me around Morrison’s at his preferred speed of 90 mph. As a former runner and now cyclist, he knows no other speed.
The wheelchair also works wonderfully well to obtain the best means of travelling through airports and getting the best of attention on the flight, even if the staff continue to talk to anyone who accompanies you, without actually speaking to you, for you are the afflicted. In the end it even became something to smile and laugh about.
So back to Adam Kay and the book that made me laugh, despite the agony of my most recent surgery in December 2019. The book was in the form of anecdotal notes written by Kay on different days and in many different situations. Throughout the work, it was apparent that this highly-trained individual would be a huge loss to the profession which he was so proud to serve. By the end we find that Kay’s heart was eventually broken by his work and he walked away. Despite his sense of humour, he could no longer stay in the job. He was sad and, in the end, I was sad too. Sad that such an individual was lost to the NHS. Yet I looked back to the team of brilliant professionals, whom I met at the time of my major surgeries, and was immensely grateful to each and every one of them. Adam speaks of working 94 hour weeks and the fact that simple maths revealed junior doctors actually earned, per hour, less than the minimum wage. As is the usual custom, Kay had a string of acknowledgements for the folk who are helping him in his new life as an author. His final telling line read: ‘With no thanks whatsoever to Jeremy Hunt.’
Last year I was unwell and, as I have already remarked, rather under the influence of the type of drugs you need to sign for. Thank you to all who have given me, through two miserable years, Portholes, Sofia and the Annual Conference. I am indebted to all concerned. Thank you all very much.
Bobbie Stephens-Wright is a long-standing member of the SOF Network and ran the North East SOF Group.