The Conversation: Poets of the NHS
Editorial Note: this Conversation took place between late November and early December 2020, prior to the second and third waves of COVID-19 in the UK, before the second UK-wide lockdown in January 2021, and before the vaccination programme commenced. The total number of UK deaths from this disease on the date of online publication now stands at 129,498. Behind every single one of those numbers are grieving loved ones and hardworking healthcare staff. This Conversation is dedicated to all of them.
2020 was an unprecedented year for everyone, but nowhere was the pandemic so keenly felt than among those who work in health and social care. March 2020 saw the publication of These are the Hands – Poems from the Heart of the NHS an anthology of poems by NHS workers and other poets, including Michael Rosen. Its appearance chimed with the public mood at the start of lockdown and excerpts were widely reported in print and broadcast media.
There is a long literary tradition amongst those who work in healthcare. In this Conversation, Gutter co-editor Colin Begg (himself a practicing doctor) talked (over Zoom and WhatsApp) to fellow Scottish NHS poets about the impact of the pandemic, their writing and how it relates to their other life in the health service.
THE POETS
Colin Begg comes from Ayrshire. He is a co-founder and co-editor of Gutter and also writes poetry and fiction. His poems have appeared in many anthologies and periodicals, from Poetry Scotland to The British Journal of Psychiatry. He is a previous recipient of a Hawthornden Fellowship and a Clydebuilt Poetry Apprenticeship. In 2013 he won the Basil Bunting Poetry Award. He is a Consultant in Paediatric Intensive Care at the Royal Hospital for Children in NHS Greater Glasgow & Clyde.
Craig Coyle lives in Bonkle. His poetry has been widely pubished in magazines including Stand, Verse and Gutter. He is a former Clydebuilt Poetry Apprentice. He originally studied English Literature and Philosophy before retraining as a nurse. He works as an Advanced Nurse Practitioner in Mental Health at NHS Lanarkshire. Czeslaw Milosz is his hero.
Vicky Husband originally trained in fine art before retraining in Occupational Therapy. Her poems have been widely published in literary magazines and newspapers and have been awarded prizes in the Mslexia Poetry Competition (2007), the inaugural Edwin Morgan International Poetry Prize (2008) among others. Her first collection, This Far Back Everything Shimmers, my first collection of poetry, was published in May 2016 by Vagabond Voices and shortlisted for The Saltire Society Poetry Book of the Year 2016. Occupational Therapist with the North-West Rehabilitation Team at NHS Greater Glasgow & Clyde.
Andy Jackson, Originally from Salford, is a Dundee-based poet and editor. He recently retired from his career as a medical school educator and medical librarian at NHS Tayside. He is the author of 3 collections, most recently The Saints are Coming (Blue Diode 2020) and has (co-)edited 8 anthologies including Scotia Extremis (Luath 2019). He is on the board of Lapidus Scotland, an organisation which promotes creative writing for wellbeing.
Sarah Janac originally studied Human Sciences at University College London and is now a final year medical student at the University of Edinburgh. She finds poetry useful in pointing out the unspoken difficulties of healthcare and in helping to cherish moments of success. Her poetry was recently featured in These are the Hands.
Ross Wilson was raised in Kelty, a former mining village in West Fife. His poems and stories have appeared in many magazines and anthologies, including Gutter, New Writing Scotland and Northwords NowHis first pamphlet collection, The Heavy Bag, was published by Calder Wood Press in 2011. In 2013 he was credited as a writer on The Happy Lands, an acclaimed award winning feature film in which he had an acting role. His first full collection, Line Drawing, was published by Smokestack Books in 2018 and shortlisted for the Saltire Society’s 2019 Scottish Poetry Book of the Year. He works full time as an Auxiliary Nurse in the Intensive Care Unit at Glasgow Royal Infirmary.
THE CONVERSATION
COLIN BEGG: So, NHS colleagues, how did you all become poets?
CRAIG COYLE: I started writing poetry age 15, after reading in an old anthology of British and American Verse my Aunt Marge gave my mother as a farewell present when we were leaving America for Scotland. For the first 6 months I imitated Wordsworth, right down to the early 19th century syntax. But then I found in my local library George MacBeth’s anthology for The Longman English series, Poetry 1900 to 1975, which, very confusingly, introduced me to Dylan Thomas, Ted Hughes, Seamus Heaney, etc. At this point I became infected by the voice of Sylvia Plath, which took me 3 to 4 years to counteract, mainly through finding a box full of East European poets in a house in which I was living as an Undergraduate studying Philosophy and English Literature. The house was owned by the head of the English Department. The volumes included Vasko Popa, Zbigniew Herbert, Miroslav Holub, Paul Celan. Since then, I’ve tended to be more interested in translated poets, and am not very up to date with contemporary English language poets. After I graduated from university I worked in Belfast with a housing aid agency. All the time I was writing, but without any intention of sending to publishers. I think, in common with many ‘poets’, I was writing as a way of engaging in a dialogue with those who I was reading. More recently, I’ve endeavoured to bring my work as a nurse into closer alignment with my writing, and to better ground my poems in my experiences as a nurse.
VICKY HUSBAND: I’ve written for a long time but in more concentrated fashion 10 years ago when I did the creative writing MLitt at Glasgow University. I’ve written a few poems inspired by my work role, a few of which went into my first collection. For the past year or so I’ve been trying to write a sequence or longer book length piece about the people and the patch of Glasgow that I work in, about isolation and connection about the city and health. But I’ve always been wary of confidentiality, about not appropriating others’ stories, and how to avoid my default narrative approach so it’s taken me time to find a voice/oblique angle on this.
ROSS WILSON: I've been writing since I was a child really but only started taking it seriously in my mid-teens in the mid 1990s. I was writing novels and short stories initially and had a short story in New Writing Scotland in 1997. That was a big boost to a teenager with no confidence! I was never academic and left school not knowing the difference between ‘there’, ‘their’ and ‘they're’! University was never an option (or felt like it wasn't) so I became an autodidact, reading and writing in a remote former mining village in West Fife. I left school at 16 to work as a Youth Trainee in a warehouse, then wi the local council. I read a lot and switched to writing poetry around the age of 26 or 27 when I wrote an elegy for my boxing trainer (I was a schoolboy national champion and internationalist.) Since 2016 I've worked as an auxiliary in ICU in Glasgow Royal. Being close to a city for the first time I have probably met more poets in recent years than ever before, including Craig who I met on a Clydebuilt Scheme, which is about the only poetry group I've been too (not including informal pub gatherings in pre-Covid times.)
ANDY JACKSON: I started writing poetry about 15 years ago. I had moved to Scotland for a job in 1992 and then moved to working for the NHS a year later. Like most people in poetry, I did a bit at school then drifted into university, job, marriage, mortgage and so on. My NHS role transferred into the University of Dundee in the late 90s and I worked in the Nursing School and then the Medical School for most of my career - teaching students to access clinical research and assessing its quality, and also managing Library services to the NHS in Tayside. As part of the extra-mural activities of the University, Colette Bryce (the Writer-in-Residence at the time) set up a group to read and write poetry, primarily aimed at staff. I went along because I was looking to do something with my enthusiasm for writing, although I was very poorly equipped in terms of technique and influence back then. After a year or so of labouring on doggerel, Colette offered to look at some of the more serious-minded pieces I’d been wrestling with, and made it clear that I should start to take the craft more seriously if I was harbouring any thoughts of sharing them more widely. I did a lot of reading on form and technique and tried out a few competitions and magazines, and was fortunate enough to win a competition hosted by the National Galleries of Scotland in the ‘previously unpublished’ category, the prize for which was a week at an Arvon course. I was tutored on the course by Sean O’Brien and Alan Brownjohn, and I learned more from them about the writing of poetry in a week than i had learned in my entire life up to that point. I had a few lucky breaks in terms of being in the right place at the right time, and also got involved with the Medical School at Dundee in running sessions for undergraduate on using creative writing to reflect on their experiences as doctors in training, and maybe use the vocabulary of creative writing to help them understand those experiences. This was incredibly satisfying. I retired in 2020 (very early, I should add) and am now involved in a number of poetry-related activities to keep me busy - I’m on the board of Lapidus Scotland, an organisation concerned with promoting creative writing for wellbeing. I’ve also been accepted as a Fellow of the Royal Literary Fund, which will get me some work supporting students with challenges in writing skills and essay form. I may even write some poetry of my own again if I get a minute to myself! Poetry to me is an opportunity to do interesting things with language, though I have no illusions about posterity or legacy - I’m just one of hundreds if not thousands of writers who are having a good time without worrying too much about relative success. I do write quite a bit of stuff that might derive from experiences in my professional life, and it has opened up a few doors - the Hippocrates poetry umbrella, for instance... encouraging poetry specifically in the field of health and medicine.
SARAH JANAC: At school I took a lot of courses in arts and humanities, and really enjoyed them. I also was quite interested in biology, so I went on to study Human Sciences at UCL, which is basically an interdisciplinary degree combing medical/biological sciences and social sciences. I did quite a lot of essay writing there, and also did courses in science communication which involved writing media features and some creative texts. I did finally go on to study medicine, and I found that I enjoyed all the aspects of the course that other medics didn’t – things like ‘health, ethics and society’ or reflective tasks or the discussion section in case reports. I started writing poems about being a medical student and about medicine in general. I feel like, through writing about them, I have rediscovered a bit of myself that I had neglected for quite a few years now. It’s also really good to see that medicine and humanities can be combined after all, and it is definitely something I want to keep doing in future.
CB: So, COVID-19 first appeared on my radar via social media in mid-January 2019 with the first WHO situation reports and the Centres for Disease Prevention and Control alerts from Europe and the USA. We were preparing for a big trip to visit family and friends in Australia, New Zealand and Japan. At that point, I thought it was a worrying development but that it would probably be contained. The day we arrived in Sydney, they began screening travellers from China (it was Lunar New Year, so a lot of people were on the move for the celebrations), and two days later Australia had its first case in Melbourne. A week later the WHO declared a Public Health Emergency of International Concern. I used to work in Sydney and my former colleagues were being told to gear up. Over the past 15 years, I’d experienced the response to SARS, Swine Flu and MERS so perhaps I was a little too relaxed about our ability to cope. We arrived in Japan in late February and got screened at the border. We were staying with friends in Osaka; their kids’ school was shut down and a lot of the tourist attractions began to close. It was at that point I began to get very concerned. At what point did you all fully realise the threat that COVID-19 presented?
SJ: I first heard of COVID around January, but didn’t become too worried about it until the start of March. I remember being on my Haematology placement then, and the doctors in the hospital were getting increasingly nervous. Most staff meetings – formal or informal – seemed to focus on this virus. At first, it was more of a relaxed chit-chat, but with every passing day I could sense that people were becoming more nervous. I remember getting a notification from the medical school, before the national lockdown, that said some of our exams this year would be cancelled, and all international students could return back to their families if they wanted to. I remember being surprised by these measures, I felt that they were quite drastic. After all, I remembered the news on swine flu and SARS, which seemed to remain distant threats only. I guess this just shows that the world of medical experts – which I have access to but am not quite yet part of – understood the severity of this virus a good while before the public or politicians did.
CC: I first became aware of COVID following news reports regarding Wuhan. I didn’t really become alarmed until I did some background reading one night in late January on a night shift in the library at Hairmyres Hospital. The article related it to SARS-CoV (the 2004 one). With two differences: one, it was more infectious, but (luckily) two, it was also less lethal. I started hearing rumours of preparations being made within the NHS in February, and became increasingly concerned to the point where I remember spending a further period in the library one nightshift investigating if there were any practical remedies I could advise my family and friends to resort to in advance. I found a paper in the BMJ about Vitamin D supplementation to prevent acute respiratory tract infection. So I circulated the link, and ordered Vitamin D for my mother and some for my wife and kids. No one at this point was really sure how bad it was going to be, and what the true risk factors were. As part of my job I conduct Mental Health Assessments in Accident & Emergencies across three hospitals, and also in medical wards within these. I also cover adult mental health wards and functional and organic wards for the over 65’s in psychiatry. I worried about becoming a possible transmission risk across these sites, and particularly into the wards for the elderly.
AJ: I had picked up on COVID in January when news started coming in about the seriousness in Wuhan (a city that my university was doing a lot of teaching in, worryingly). I had thought it might be like the bird flu false alarm that popped up in Cellardyke a few years back, but the rhetoric being used about the epidemic in China implied it was a very real threat and likely to be more serious than the usual health panics. I laughingly thought we’d deal with it better than the Chinese health services what with being a highly-developed first world nation. Oh, the hubris! I lost someone close back in January – a chest infection that seemed not to respond to broad-spectrum antibiotics and quickly worsened. The health team in HDU and then ICU were mystified, but he died within 10 days of being admitted to hospital. This has retrospectively been thought to have been a very early case of Coronavirus. Then I knew it was serious beyond expectations.
RW: I forget when exactly I first heard of it (the whole year is a bit of a blur) but I was more concerned about it when news reports started coming in from Italy. Wuhan seemed so far away but Italy was closer to home and the photos of exhausted ICU nurses with PPE pressure sores was alarming to say the least. When we knew it was definitely going to hit us and we began to prepare it did feel a bit unreal. The whole environment was changing around us in ways I couldn't imagine weeks before. That was alarming, as were talks of some of us potentially suffering from PTSD down the line. We were bracing ourselves for a hard time but didn't know how hard it would be. So fear of the unknown was perhaps the biggest fear of all. I remember thinking it felt like a battle had started a few miles away and we were preparing for the influx of casualties, only the enemy was an invisible one and we could be casualties ourselves.
CB: We’re ten months in now, how’s your pandemic been going?
AJ: I had COVID in March just before lockdown, caught from students no doubt as I was teaching large groups most days. Just a 36-hour fever followed by loss of smell and taste, so I got it out of the way quickly. I retired in August - so I never went back to work after we started working from home. Very strange to shut down the laptop at 5pm on the last Friday in august and never open it again. I had a virtual leaving do. It felt like I was slipping out the back door and leaving colleagues in the lurch, but I’d decided to retire last year. I haven’t lost anyone from my immediate family, though a few people I know have lost their lives to the virus. I have colleagues and friends in hospitals and in general practice who have been really struggling and, in most cases, have had the virus. I’ve been able to do lots of exercise, and also get down to poetry projects in the time since retirement.
SJ: With the New Year starting, the medical school found ways to get us back onto wards. As final years, the medical school is really doing everything to get us up to speed so we can qualify without any issues in a few months’ time. However, I know that other years, especially pre-clinical years, unfortunately don’t get much time with patients at all. I am finding the second lockdown much tougher than the first one. It probably has a lot to do with the darkness and the cold. I think there is also less fear of and more knowledge on the virus, making it seem less threatening to my generation.
RW: The first two months were manic, then there was a lull through the summer before things started picking up again. I had a pressure sore on my nose early on (the bridge of my nose hasn't felt like that since I was boxing) but thankfully I got fit-tested for a more comfortable mask. The PPE has been effective if uncomfortable, especially in the heat. I wasn't confident it would be as effective early on though, so that was another worry at the start. I haven't seen my parents this year and my Dad now has COVID though he seems to be coping with it well, thankfully.
CC: The Pandemic has not disrupted my time at work: I have only missed 2 days this year, when I had to await test results for my son who had been socialising with a friend who tested positive. In terms of my writing poems, Coronavirus is a bit of a moving target. I remember many, many years ago writing sonnets when HIV/Aids was still a newsworthy topic, embedding the genetic sequence for HIV-1 into each sonnet as a way of infecting each, the conceit being that each sonnet represent a cell, a traditional form infiltrated and rewritten from inside by a retrovirus. But the only ‘formal’ response to Coronavirus I could conceive was to write a ‘crown’ of sonnets, and which ranged more freely over hotspots of my own anxiety. I got as far as 18 sonnets interlinked, ending with the death of my father in law in September this year. He had been in Wishaw General for 9 weeks following a subdural haematoma secondary to a fall (he was diagnosed with Parkinson’s). Due to COVID restrictions, my wife and kids never got to visit him prior to his suffering some kind of catastrophic neuro-event that rendered him comatose and from which he never regained consciousness.
CB: I’m really sorry to hear that Craig, that must have been awful. My parents, their siblings and friends are in their seventies and eighties. They are well but the past 9 months have been frightening for them. I think that was my greatest fear in the runup to lockdown last March.
CC: On a happier but surprising note: when Coronavirus eventually did break into one of the elderly wards I look after (in October), all 13 patients contracted it. Only 1 died. Everyone else made a full recovery. By this point, treatment had incorporated Dexamethasone, Oxygen, and Apixaban. I had been convinced that when the day came, the entire ward would be wiped out, as many of the patients are in their 80’s and even 90’s, and all have underlying medical complications.
AJ: I was worried by the uncertainty of how long it would last and how much of my social life would have to be postponed - very selfish, yes, but it felt like it would soon be over because surely society would quickly get back to normality, wouldn’t it? I soon stopped worrying about a social life... very quickly it became clear that we would all be making a new and less ambitious social life for ourselves.
SJ: Everything seemed to go so quickly. Countries across Europe were imposing lockdowns, and I had to make a decision about whether to stay in Edinburgh or go and stay with my parents, who are living in Germany. I can’t remember being particularly scared at the time, I remember feeling quite overwhelmed and confused though as life had changed so unexpectedly.
RW: My greatest fear in the run-up was passing COVID on to my partner who is a Type 1 Diabetic. I can't imagine how terrified I'd have been if children were badly affected too (our daughter turned three in September.) I was also concerned about my colleagues becoming ill and us burning out, not knowing how long it would all go on for.
CB: My wife has a rare form of Type 2 Diabetes so I can relate to that worry given how badly diabetics were being affected by it. I stopped reading the medical update reports for a while as it was making me anxious.
CB: Do you find the pandemic has triggered a creative response in any of you?
SJ: I did more writing and painting during the first lockdown. I also went for quite a lot of walks, in which I listened to storytelling and poetry-themed podcasts. These activities definitely made me reflect on some aspects on lockdown and life in general. Like most other people, I also got quite good at making bread/chutney/cakes/jam, etc, etc! So I am unsure whether the pandemic triggered a creative response, or whether creativity was just a way to fill time and reflect on difficult aspects of the situation (or maybe that’s the same thing?!).
AJ: I run a social/political poetry blog with Bill Herbert and we ran a series of daily posts for 3-4 months entitled ‘Postcards From Malthusia’ – every day a new poet with a poem responding to COVID-19. My own work crawls on – I’m not prolific – although I did have a book published in September and there’s always a lull in productivity after a book is published, so I haven’t by any means been in a fever of creativity. And I haven’t written about COVID either... I’ve read so many good poems responding to it that I don’t feel I can add much to the canon of great work that already exists. I did write a pandemic poem though – three years ago!
RW: I have produced what amounts to a sequence of poems that often start with me and my daughter Rosie going for a walk but usually have some darker undercurrent. Throwing sticks and stones in a burn, for example, becomes a lesson where Rosie learns how some go on while others go down. One day we found a mask and glove hanging from a tree and I told Rosie a story about the Liter-a-chewer, a strange creature with a bookshaped face and teeth like sharp-edged paper who basically recycles the rubbish Hugegerms (as it calls humans) throw away, into art. I recycled that one into a wee fable.
CC: No, not spontaneously. I did feel almost obliged to undertake some kind of structured, formal response, which resulted in the sonnet sequence I mentioned before, a crown of sonnets. I had a line, paraphrased from one of what have come to be known as the Lachish Letters, where a military officer is reporting back to a superior on the course of the Babylonian invasion: ‘Tell my Lord we can no longer see the signal fires of Azeqah.’ Because Azeqah had went under, it was gone. There was a sense of encroaching darkness. That line stayed with me, and one Thursday morning in Wishaw General coming out of Ward 2 it became the starting point for a sonnet, and then a sequence, a Crown of Sonnets, the rules of which can trigger what is almost like a chain reaction that can unfold in surprising ways. Beyond writing sonnets, I also adopted the habit of writing stripped down unrhymed short poems whilst at work, about things directly arising from work. I have for years composed directly into an old iPad, having given up writing when my wife bought me a second generation iPod touch. I discovered that ‘writing’ poems on this iPod touch was easier than doing so manually with pen and paper. The whole process was less anxiety provoking and more directly connected to what was going on inside my head. I upgraded to an iPad for use in the house, but even now I will compose on my phone when out and about and sync documents for review and revision at home. I have been attempting to bring these two things, writing poems and working as a nurse, into closer contact over the years, sometimes as a deliberate push back against the increasing institutionalisation of creative writing, within universities. Soon no one will take you serious as a poet unless you have an MA in creative writing. Otherwise, how can you be qualified?
RW: Craig, I wrote a rough draft of a poem a while ago about a janitor fixing a conveyor belt in a creative writing factory! Good point about how continuing to work and feeling appreciated by the public was a good thing. However weird work got just by going in and having a routine provided a semblance of reality as well as job security many lacked. I was and am grateful for that.
CB: The institutionalisation of creative writing in Masters programmes is a good point (although perhaps material for a whole other Conversation). And I’m speaking as someone with an MLitt. Thinking back 12 years to why I did it, I think a large part of it was due to a serious case of impostor syndrome and feeling that it would validate my claims to being a writer. Partly this is my upbringing, which viewed artistic pursuits as valid only in terms of their social utility or aesthetic/technical worth. Art for art’s sake is suspect. Yet there remains that connection between health professions and writing - why do you think that is? And do you personally find your creative practice useful for your wellbeing at work?
AJ: I think working with lives and illnesses brings into focus questions of mortality, wellbeing, what it means to be alive. These are things poets have always been interested in. Health professionals are encouraged to use scientific language - unambiguous, measured - so much of our experiences is lost when we deal in absolutes and whole numbers. Poetry is the opposite - abstractions, degrees, ideas rather than proof. Maybe creativity is a way of connecting these two ways of thinking/seeing.
RW: I'm not sure about a connection between health professionals and writing to be honest as I haven't come into contact with many writers through work. I remember being told about a nurse opening a window to release the soul of a patient who had just died and a doctor said something about that being a lot of superstitious rubbish. Perhaps poetry is like that window in a way? For all our wonderful advances in technology and science (I'm in awe of the machines I see in ICU!) but for all those wonders and the essential need to keep our bodies working, none of that helps us emotionally or spiritually or however you want to word it. Poetry can be a window into what's going on in our minds the way an x-ray might show what's going on in our bodies. And, of course, some will always dismiss that as rubbish while others will keep reaching for the window.
VH: The best learning I got from art college and a creative writing course was during the rigorous critiques of each other’s work and in making connections with likeminded people who wanted in depth discussions about art/writing. But this could and should happen elsewhere, outwith institutions (though it is difficult to find). I also dislike making things unnecessarily academic. It is a form of exclusion, and that fact that universities now are businesses is problematic. A similarity to Occupational Therapy is that I learnt much of my work from on the job experience working with patients (also as an auxiliary nurse prior to OT training). Now I find that the best students are certainly not the most academic, in fact on the contrary. I like the window /soul metaphor, Ross.
CB: Do you think it is harder for writers with ‘real jobs’ to be regarded seriously at the present time?
AJ: I know some writers who have lived lives which are so filled with drama and unconventionality that they have an endless stock of personal experiences to draw on. I have a wife, a mortgage and a white-collar job (well, I did up until September) so my poetry is full of made-up stuff, fake emotions and imaginary situations, so I often feel a fraud when I write about such things. If I just wrote what I knew about from personal experience it would be of no interest to anyone.
RW: I disagree with Andy when he says no one would be interested in his experiences as I think it comes down to how well or badly you write (and that might come down to taste, of course!) But the most exciting dramatic life will not translate to poetry if the writing itself is dull. A favourite poet of mine, Dennis O'Driscoll, wrote a lot about white collar work but is always interesting to me because of the way he frames that world in the forms he finds and because of his wit and imaginative verve and clarity of vision. Is it harder for writers with real jobs to be taken seriously? I've no idea, though I do know I wouldn't take anyone with that attitude seriously. What matters is the writing. Philip Larkin was a librarian. Would he have been a better poet had he earned a living from poetry? A foot (or both feet) outside the academy can be a good thing as long as you read voraciously. I prefer to look at poetry as a craft rather than a career. I've been a writer longer than I've been anything else, though I've never earned a living from it or tried to earn a living from it. People often refer to me as a nurse and I'm always quick to correct them because I'm not a qualified nurse. I haven't studied or trained for years to earn that distinction. I don't feel I need a creative writing degree to say I'm a writer though as I feel I've earned that by putting the time in for many years. I've studied in my own way. However, self-taught doesn't sit well with me: autodidacts learn from the libraries they build for themselves over many years. I share Craig's concerns about homogenisation. I think a good writer should have a distinctive voice that can be heard, not one that sounds like a hoof in a herd. Obviously that can apply to an autodidact as much as it can to someone on a writing course if all either is doing is echoing favourite writers or imitating modish trends. I mentioned Larkin above. ‘Oh I adore Mrs Thatcher!’ he once said. Unlikely to get on with me then! But I get on with his poetry. I get the impression that kind of distinction is no longer fashionable. As an Auxiliary nurse I'm very happy to be part of a collective. Poetry brings out the stubborn individualist in me though. But tension can be a good thing in poetry!
VH: I am also a Larkin fan. I went to art college in Hull and lived near Pearson Park (many years ago), it was a weird place back then, and would drive anyone to drink, or poetry.
CB: I think you highlighted a fundamental duality in a lot of poetry there Ross, between those poets who give primacy to the collective or the individualist perspective. The most relatable are those who pluck at the tension.
CC: I find Larkin really interesting. Despite being a pessimist who lived in Hull, he wrote a handful of English poems amongst the greatest of the 20th century. But most interesting, it was almost despite himself. When you read him, you sense that his breakthrough moments happen against the grain of his personality. That in itself points to a mystery beyond craft. And Larkin was probably the most formally accomplished poet I have ever read in terms of his ability to balance tensions within whatever stanza he adopted.
CC: I do worry that the rising trend amongst universities to offer creative writing postgraduate courses may result in the creative act being downgraded to an academic discipline. To the point where it becomes a technical procedure, like scholarship. That brings with it a risk of homogenisation. But neither do I believe that the reverse will make you a better poet, in terms of having a job, or being anti-academic. I think most poets learn the technical side of their art by being attentive readers, in a very private, highly intense way, where the encounter develops into a process of internalising the other’s voice. It drives you to learn the technicalities that modulate that voice. A great poem can restructure your consciousness. It composes you. And when you encounter a poem in that way, you realise that writing a poem is a metaphysical act, or an attempt at such. But I realise not everyone sees it like that. I once met a junior doctor who noticed I had a copy of Dag Hammarskjold’s journals on my desk. We got talking, and it transpired that he wrote poetry. Very soon after he emailed me a bunch of poems, and requested my comments on them, including individual scores. I was nervous, but did what he asked. Then I asked him why he wanted my opinion, being curious, as I would not readily wholesale ask for an opinion on a stack of my own poems. He explained that he had sent the same poems out to various people he knew, asking for critical comments and scores, with the intention of carrying out a thematic analysis of the responses and a correlation of scores with the ultimate aim of thereby finding the formula to writing a successful poem. Something about that endeavour unsettled me. After all, if a poem could be reduced to a simple underlying formula in that way, would it be worth writing? How could you differentiate it from something by Stock Aitken Waterman? I pressed him for his results. Reassuringly, he said that none of the responses he got aligned in any way with any of the others, and there were no identifiable trends. The whole business of writing a true poem remained a mystery to him. Which probably increased his chances of actually writing one.
VH: I think there are many routes into learning & development that suit different people and all are valid but I’m curious that creative writing courses seem singled out for criticism & endless debate where art school and music academy courses are not.
CB: That’s a good point Vicky. Probably because almost everyone can tell a story it gives the act of writing the illusion of facility. Whereas being able to draw a stick man or hum a tune doesn’t make you a visual artist or musician.
CC: There is definitely a parallel. The fine arts have an apprenticeship model dating back to the middle ages, due no doubt to the technicalities that need to be learned. There are technicalities also in verse, but I tend to believe that what makes a poem is something that transcends these technicalities. It is useful to learn these technicalities, but adhering to them doesn't necessarily output a poem.
CB: Yes, well-made verse is not the same as poetry. Returning to the Pandemic, I wanted to explore a little more of its personal impact on you if I may? I was on shared parental leave when lockdown hit. My partner works for the NHS too in Emergency Medicine. She went back to work after maternity leave straight into the teeth of the first wave, which was very stressful for her. They had roughly ten days to completely reconfigure their A&E service into COVID and non-COVID units, plus move to full-shift working covering 4-5 shifts a day. So I found myself supporting her and being locked down at home 23 hours a day with our 10 month old baby and no external activities or childcare support. The upside is that I have an amazing bond with my daughter. How did the first wave of COVID change your day-to-day work in the NHS?
SJ: The medical school was quite quick to cancel all clinical placements, allow students to return to their families and rethink the end-of-year assessment. They decided to move the teaching online. It took a few weeks to set-up, but once it was running it meant that we had weekly self-directed learning material to cover, which was often followed up by a few tutorials run online. It was impressive that the medical school managed to set up such a radically different learning format in just a couple of weeks. I went back to see my parents in Germany and stayed with them for 4 months. I studied medicine remotely through online lectures and tutorials. I guess this online set-up kind of worked; my knowledge base is there. But I realised how useful clinical placements are providing focus and in consolidating my knowledge. And, of course, I never got to examine patients or practice clinical skills. It was a very different experience learning medicine this way and it reminded me a bit of the pre-clinical years. I covered all the relevant material, but my examination technique, clinical skills and communication skills got a bit rusty over the 4 months.
AJ: The first wave of COVID meant the closure of the University, so my Libraries all closed for a while. Working from home became the norm, and I found myself doing one-to-ones and full classes of teaching from my kitchen table. It worked better than I thought, though – but like doing a poetry reading, you lack that eye contact and feedback that says your audience is a) awake. And b) listening!
RW: The impact of the first wave transformed my working environment in many ways as our ICU expanded into other areas to cope with the increased number of patients. We also had a lot of staff brought in from other departments and retired staff returned to work. Social distancing signs were everywhere, as were staff support lines and booklets to help us cope with stress. Having to wear full PPE for 12 hour shifts in a warm environment was itself a challenge, particularly early on when I had some pressure damage to my nose. Proning and unproning patients became a procedure we were doing several times a shift. Washing goggles is not something you'll hear much about on the news but as an Auxiliary Nurse (or Healthcare Support Worker) washing goggles became a big part of working through the pandemic. As did stocking up our PPE. We also had to carry walky-talkies so we could communicate with staff outside cohorted areas if we needed equipment or had samples ready to be picked up. It's all a bit of a blur to be honest! I'm sure I'll be excavating things I've buried years down the line.
CC: As a consequence of COVID, the junior doctors working in Psychiatry were transferred to staff COVID Hubs. ANPs such as myself were asked to backfill on-call shifts that would normally be part of the junior doctor’s rota. At the same time, due to the numbers of staff within the Psychiatric Liaison Nurse Service who were ‘shielding’ from direct patient contact, ANPs were also moved to cover gaps in the PLNS rota. We were also asked to provide cover for cottage hospitals that previously relied on GPs, as some GPs were restricting their input to video calls. All of this eventually resulted in myself and fellow team members regularly moving across 5 hospital sites, in and out of A&E, medical and surgical wards, as well as adult and elderly psychiatric wards. No attempt was made to localise team members to certain sites, an issue which was raised with management on a few occasions.
CB: What were the impacts of lockdown on you personally outside of work?
SJ: Outside of work the most difficult aspect about lockdown was the uncertainty. I didn’t know when I’d be able to return back to Scotland, which is where my friends and my flat and most of my life was, and whether this would involve quarantining for 2 weeks.
AJ: More exercise and fewer meals out (none, actually) so I actually feel fitter and have lost a bit of weight even! I usually only get to cycle at weekends but lockdown saw me reignite my love affair with my pushbike. I’m lucky to live in the country so a lot of the minuses of lockdown were offset by the pluses of life closer to home. I didn’t miss traffic, fighting for parking spaces at work or the general banalities of being in the office. I did miss people though. Hasn’t everyone? Well, possibly not everyone.
CB: Yep it was lonely. I had a lot of father and baby activities planned for my parental leave. I ended up talking to my baby daughter a lot though and video calling with her grandparents. She was just starting to talk herself so I kept a diary of her language acquisition. Seven months later and she’s quite the blether. Initially I also kept an incredulous journal of the cack-handed UK government response but stopped as I found it was not helping my mental wellbeing. One day I hope to read it and laugh. I lost weight too due to lengthy daily pram walks around the park.
RW: Outside work was also a struggle as my partner is an Occupational Therapist, therefore also a key worker. Amanda had to work from home due to her Type 1 Diabetes. This was a problem as pur two year old (now three) had yet to start nursery and we’d no contact with grandparents who would usually have helped with childcare. So when we weren't working we were looking after our child as best we could under the circumstances. This involved lots of walks, in my case, to give my partner the space she needed to work from home. Fortunately we live in an area where there's plenty of open spaces to roam away from people. I remember getting up around 3am one night and, half-asleep, rummaging around my bookshelves for PPE as I thought I had to wear a mask to enter the next room!
CC: Minimal contact with family and friends was an issue I missed being able to wander round the bookshops in Glasgow, the game shops, and go for lunch and a good drink at night. I never felt depressed, I suppose because I was able to keep working and there was increased notice given to the work that those of us within the NHS do.
CB: The first COVID vaccine was approved by the MHRA today. That success was built on research begun during SARS outbreak 15 years ago. COVID won’t be the last respiratory pandemic, looking back at how the NHS responded, what do you think we should do differently next time?
AJ: Blimey, that’s tough. I think the Cummings thing didn’t help with compliance. More and better PPE in store, but it’s a virus and it can’t be reasoned with, so I think just listen to the professionals, medical and economic, and use the best evidence we have to make decisions that are human first and political second.
VH: Unlike during the first lockdown, we should keep as many services going as possible, (obviously with safety measures in place and scaled back). The fallout is still to come from delayed/missed appointments/advice not sought and the backlog. In the community we kept a Rehabilitation service going but many community services didn't operate and we treated the fall out with older people become more immobile and falling and confused as a result of lockdown/not going out/seeing less people.
CB: Yes, I witnessed that deterioration in some of my own older relatives: lack of access to regular community exercise activities meant that they became weaker and lost confidence. My aunt had a really nasty fall and spent five days in hospital in May. She’s fine now, but not physically as strong as she was a year ago.
RW: I'm not sure what the NHS should do differently if we experience another pandemic as I'm still processing this one. It's all been a bit of a blur and I feel a bit frazzled by it all. Getting rid of the Tories would be a start! That obviously wouldn't begin to solve every problem but we all know the conservatives have been ideologically opposed to the NHS since its inception. If the NHS was a lifeboat, the Tories would be a mouth-shaped hole telling you the lifeboat is crap while trying to sell you a fancy lifejacket you can't afford.
CC: That’s a difficult one, because next time might be a completely different disease, not necessarily a sequel to a previous respiratory virus. But there definitely is a part of me that thinks we retreated too far and sacrificed too much in the face of the current virus, and I would question how much a difference our sacrifices actually made. The disruption within the NHS was (and is) severe, in terms of services being retracted. Meanwhile, a part of me thinks that this avoidance of face to face health care provision during an epidemic is like a fireman refusing to enter a burning building for fear of getting burnt. The risk comes with the territory. And as someone who worked right through the pandemic, in A&E, in various wards and in police custody suites, whilst adhering to PPE and other guidance, without (as far as I know) catching Coronavirus, I feel the risk was manageable. I am now assessing patients in A&E, and in medical wards post-overdose, who have community supports but have not seen their CPN (for example) or other support worker, for 10 months now. Or their GP. I fear there is now a culture growing within certain sectors of the NHS where face to face contact is regarded as burdensome. Some staff do indeed have an increased risk due to certain factors that have been identified. But that is not what I am seeing in the wholesale retraction of certain sectors from their routine work. An option that in-patient ward based staff were not given. Or specific community staff such as district nurses, who believe their work load increased to compensate, and who remained visible in their domiciliary work. Then there is the wider issue of the economic damage done, as well as the educational. I have a 14 year old daughter who has completely went off the boil in terms of her attitude towards school work. The structure that was once in place and regarded as mandatory has been shown to be optional. It worries me. I also think we did not target and protect those with a true vulnerability quickly enough, such as the elderly in care homes. And that a more focussed approach towards protecting those with a true vulnerability might have been a better alternative. On the other hand, if we did not impose lockdowns in the way that they were, maybe the death toll would have been much higher? It is difficult to answer these questions definitively ahead of all the analyses that needs to be done in the aftermath.
CB: Some of you alluded to this already but thinking more broadly, beyond COVID, how does your work as a writer interact with your work in the NHS?
CC: I am definitely making a more conscious attempt to write about my experience as a nurse in recent years. I wrote sonnets in response to COVID, and notational poems on the hoof throughout the pandemic. But even before then I tried writing narrative poems in terza rima that addressed some of my previous experience as a CPN and independent prescriber in addictions. I left addictions not long after a particular patient of mine, who I had nursed for 10 years, died of a drugs overdose. When I started writing the sequence, he quickly surfaced and became a contending voice in the poems, to the point where many of them broke out into dialogues that were surprising to me. It wasn’t therapeutic. But they were poems that someone without my specific experience as a nurse in that role might not have been able to write. So I suppose they represent an interaction between the two roles of nurse and poet.
CB: Do you think the NHS area where you work puts an emphasis on the therapeutic importance of creativity (for staff and patients)?
VH: In theory Occupational Therapy does value this however the theory of the profession and the practicalities of everyday NHS mean there is a huge gulf that we don’t have resources to fill. So many more heavily dependent people are ‘being managed’ in the community now that we’re often fire-fighting: safety and prevention of admission/readmission come first, basic transfers (on/off toilet/chair/bed) access to food and drink before working towards actual rehabilitation; practising daily tasks towards independence, before considering community access & leisure time such as arts activities. But I do, when possible ask about this aspect of people’s life, even if just to ask what they are reading.
CB: COVID-19 raises many questions around trauma and survivorship both for staff and bereaved relatives. How do you think the wider community should respond to this?
CC: I personally think that when this is all past, we should designate a day of remembrance with both local and national ceremonies to allow for a more connected process of grief to take place. Many people have missed the opportunity to be with and comfort dying relatives, or even to mourn them publicly in the way that would be customary. Whether that should be an annual occurrence, I am not so sure.
CB: I think that note of reflection, as we head towards 70 000 deaths, is a good place to draw this Conversation to a close. Thank you for your time everyone, and stay safe.