Thank you

Content warning: Suicidal intent, Overdose, Self-harm

I remember a long time ago, I encouraged a friend to stop apologising so much and start using “thank you” in it’s place. She told me that it made everything sound so much more positive, and that less apologising really helped her get her gratitude across properly, instead of everything sounding like an expression of guilt.

After publishing my post this morning, which was entitled ‘I’m Sorry’ and contained a letter of apology to my partner, I recalled that ‘thank you’ is sometimes more suitable than ‘sorry’. So this blog post contains my letter of apology, transformed into a letter of gratitude. 


To my partner,

I’m sorry. Thank you.

I’m sorry about my mental illness. I’m sorry that my struggle has caused life to be so tiring for you, especially over the last few months. Thank you for supporting me whilst my illness has been particularly challenging. Thank you for helping me through my struggle, particularly as it must have been tiring for you. 

I’m sorry that you’ve had to take on so much – I’m sorry that the upkeep of our home, the laundering of our clothes, and the payment of our bills, all became things that I couldn’t face keeping on top of. Thank you for taking on the household chores that I couldn’t keep on top of. I’m sorry that you’ve had to do all of the work to look after our cats, when I was the one who was so desperate to adopt them. Thank you for feeding and looking after our cats, even though it was me who so desperately wanted to adopt them. I truly believe they’ve been therapeutic for me whilst I’ve been ill, so I hope you still agree that adopting them was a great idea. I’m sorry that making important phone calls, organising my sick notes, collecting my prescriptions, and filling in the paperwork associated with my leave from work all became solely your responsibility. Thank you for making important phone calls for me, even though you find making phone calls difficult yourself. Thank you for signing my paperwork as my carer and for emailing my work about my sickness leave. Thank you for going to the pharmacy on your way home from work to collect my medicines, even though it’s a significant diversion from your usual route. I’m sorry that my income has dwindled down to nothing, and your income has had to become ‘ours’. Thank you for supporting the two of us financially whilst I’m not well enough to earn money myself. I’m sorry that on top of full time work, you’ve spent hours by my side in various hospitals, and almost as much time travelling to and from said hospitals on public transport. Thank you for travelling a lot just to sit with me in hospital wards, playing scrabble or doing puzzles with me. Thank you for listening to me tell stories about the patients on the ward with me, and for holding my hand to comfort me when I’d had a bad day. Thank you for bringing me chocolate to cheer me up, and fruit to satisfy my ‘vitamin cravings’. I’m sorry for the amount of nights you’ve had to sleep in our bed, cold and alone, with no one to keep you warm. Thank you for waiting patiently at home whilst I was in hospital, keeping the cats company until I was deemed well enough to be discharged. 

I’m sorry that when I’m not in hospital, you have to spend ages looking after me, checking that I’m OK, making sure that I’m as safe as possible. I’m sorry that sometimes, I’m impossible to keep safeThank you for doing your best to keep me safe, even when it’s very difficult to do so. Thank you for always checking whether I’m OK, and for looking after me. I’m sorry that you went from just being my boyfriend, my lover, to being my next of kin and my emergency contact. I’m sorry that you involuntarily had to take on the role of my ‘carer’Thank you for being my carer as well as my partner and my team mate. It means more to me than you’ll ever know. 

I’m sorry for lying about how I felt sometimes. I’m sorry that I didn’t always tell you when I felt unsafe and suicidal, or when I was stockpiling spare medications ‘in case I wanted to use them in an overdose at a later point’.  I’m sorry that you now know the process of phoning for an ambulance better than the back of your own hand. I’m sorry that I disappeared in the middle of a suicide attempt whilst you were out of town, and I’m sorry that you had to call the police that day to report me missing. I’m sorry for the times I took overdoses whilst you were in the flat with me, instead of talking to you about how I was feeling. I’m sorry that I once stole the keys to the medication safe whilst you were sleeping, so that I could take too many pills. I’m sorry I lied and said I didn’t have any medications stored in secret places, when in actual fact I did. I’m sorry I sneaked out when you were at work, to buy painkillers from the corner shop only to hide them in my sock drawer. Thank you for understanding that my mental illness sometimes causes me to behave in an undesirable way, and for seeing that I don’t always have full control over my actions. Thank you for seeing things from my point of view, and for getting why sometimes I lied or held back the truth. Thank you for always forgiving me for the poor choices I’ve made, and for being on my side no matter what. Thank you for being on-the-ball and calling the emergency services whenever it was necessary. You always seemed to know when I was in danger, even when you weren’t physically anywhere near me.

I’m sorry I ran away from home late at night several times and made you worried sick; I’m sorry you then had to come to collect me from the railway bridge in the cold wind and rain to bring me home, when you had to be up at 7:00AM the following morning for work. Thank you for calmly and reassuringly talking to me when I got myself into a state and ran away from home to stand on the railway bridge. Thank you for understanding and never being cross with me. Thank you for giving up time that should have been spent sleeping just to make sure that I was safe. I’m sorry that you’ve had to come home from work to find me unconscious (or near-unconscious) repeatedly. I’m sorry that the responsibility for saving my life fell onto you so many times. Thank you for saving my life, even when I said I didn’t want you to.

I’m sorry you’ve had to ride in an ambulance to A&E with me so many times. I’m sorry you’ve had to sit in A&E whilst they ran tests and decided what treatment I needed. I’m sorry that you’ve sat with me, bored, lonely, whilst I’ve fallen unconscious from the overdoses I’ve taken. I’m sorry if every overdose felt like deja-vu for you. I’m sorry you’ve had to call your manager at work and book urgent unplanned leave from work, just because I’ve fucked up and needed you with me. I’m sorry for the states you’ve seen me in. Thank you for repeatedly keeping me company in the emergency department for hours upon hours. Thank you for fetching me water when I was thirsty, for helping me to the bathroom, for helping me to get changed into comfy clothes and for going to buy food when I was hungry. Thank you for packing my hospital bags for me and always including something that would comfort me, like one of my cuddly toys. Thank you for holding my hand during ambulance rides. I’m not sure if this is the case, but having your hand there to hold has always been very important to me in those situations; it felt like you were reassuring me that even though the situation my illness had created was a bad one, you didn’t resent me for it. 

I’m sorry that I’ve locked myself in the bathroom to self-harm. I’m sorry you’ve known I was self-harming and had to just let me do it, because there was no way of stopping me. I’m sorry for the times you’ve had to help me clean and bandage the wounds I’ve inflicted upon myself. I’m sorry that I’ve made myself so grossly unattractive, covering myself in scars that will fade but never quite disappear. Thank you for understanding that sometimes, you can’t keep me safe from myself. Thank you for letting me learn my own lessons about how to express my pain, and for helping me to make sure my wounds are sterile and safe. Thank you for never judging me for my scars. I remember I had scars all over my legs before you ever saw me in few-enough clothes for them to be visible, and I’ve always appreciated that you’ve never looked twice or questioned them. Thank you for doing your best to ‘get’ it. Thank you for telling me that I’m beautiful, scars ‘n’ all. 

I’m sorry that you’ve stayed awake with me in the small hours of the morning whilst I’ve cried, and cried, and cried, and you’ve lost sleep. I’m sorry that when I was writing a part of this blog post at 4 in the morning because I couldn’t sleep, I started crying and it woke you up. I’m sorry for soaking your pillows and your T-shirts with my tears. Thank you for staying up late with me just to comfort and cuddle me. Thank you for not being grumpy when you woke up to the sound of me sobbing into a pillow during the early hours of this morning; thank you for instead just holding me close and trying your best to make things seem as OK as possible.

I’m sorry that I’ve made you cry.
I’m sorry I wasn’t there to comfort you whilst you cried.
Thank you for letting me know that you’ve cried about everything. It broke my heart to picture you crying alone, but in a way it made me understand a bit more how all of this has been making you feel. I feared you resented me, but the fact that you got upset and not angry reiterated to me that actually, you just care about me. A lot. 

I’m sorry I’m so withdrawn sometimes. I’m sorry about the days where I barely talk to you, because I’m feeling irritable or depressed, or because I just have nothing to say. Thank you for keeping a close eye on me whilst giving me the space I need when I’m feeling irritable or low. I’m sorry about the nights where I’ve refused a cuddle or a kiss goodnight, just because I’m feeling down. Thank you for understanding that sometimes, I don’t really feel like cuddling, and that my refusal doesn’t mean that I don’t love you. I’m sorry about the mornings and the afternoons that I’ve just spent lay in bed, unable to get up, incapable of wanting to ‘do the day’. Thank you for letting me rest when there’s time for me to, and for gently encouraging me to do what needs doing when there isn’t time for rest. I’m sorry for the times that you’ve reached out to hug me or reassure me and I’ve cowered away, refusing all physical contact. Thank you for understanding that me ducking away from your hugs is nothing personal. I’m sorry that I’m not the same as I used to be. Thank you for never losing confidence that the ‘real me’ is still in here somewhere, even though I feel that I’ve lost myself.

I’m sorry you’ve had to lie for me to my family because I asked you not to tell them how ill I am. I’m sorry that you’ve had to keep my friends updated on my condition when I’ve tried to kill myself and worried them all in the process. Thank you for letting me choose who to share information about my condition with, and for understanding the complicated reasons why I don’t want to tell some of those closest to me what’s going on. Thank you for keeping my friends who do know up to date so that they don’t worry too much. 

I’m sorry that I pulled you away from your home county when I got a graduate job nearer to my own home county, and I’m sorry I then ended up failing to cope with the job anyway. I’m sorry that you got a job near(ish) to here, too; I’m sorry that you’re so far away from all of your friends and your family. I’m sorry that you have to do a frustratingly lengthy commute on rubbish public transport to and from work every day, because there wasn’t any work for you in the town we live in. I’m sorry I’ve trapped you here. Thank you for moving away from your home county with me when I got work near to mine. Thank you for understanding that my long term sickness leave from work wasn’t planned or predictable, and for not resenting living in the town where my work was/is based. Thank you for getting up early and commuting to the next county over for work, so that we can keep living independently from our families, and so that we can keep renting our cute little flat with our two cats. I know that sometimes it feels a little lonely here for both of us, because we don’t have any friends that live locally, but hopefully we can resolve that somehow. 

I’m sorry I’m so erratic. I’m sorry for being incapable of doing anything anymore. I’m sorry that I’m boring. I’m sorry that I’m difficult to be around. I’m sorry that I’m ill.  Thank you for accepting my flaws, and understanding that I am poorly.

I’m sorry that, out of all of the humans on this planet, it was me that you fell in love with.
Thank you for choosing me when you could have had anyone. 

It’s bittersweet, really; every single day I spend time reflecting upon how lucky I am to have you in my life, and yet at the same time I question why you didn’t run a mile back when we were still ‘just friends’ in 2013. I tell myself that you deserve better. I wonder why you chose to be with me, despite knowing I had so many health problems. It says a lot about the type of person that you are, because not many people would stick around after all I’ve put us through. After all I’ve put you through. Thank you for sticking by me through all of my health problems and challenges, and reassuring me that those things don’t change the love we share. Thank you for reminding me that my opinion of myself is not the same as your opinion of me. Thank you for understanding, and regularly reiterating, that it’s not all my fault that we’ve been through more than our fair share of difficulties recently. 

I guess all of this is why they say that love hurts? Sure, it hurts, but I think we’d both rather feel the pain that love brings than never love at all. Right?

To my partner, my other half, my team mate; to the one I love

I’m sorry that loving me hurts so much sometimes.
I’m sorry that my mental illness gets in the way.

I love you, though, so much, and for now I can only hope that that’s enough.

Thank you for loving me back.

with love,
from your Sweetie-Pie x

I’m sorry

Content warning: Suicidal Intent, Overdose, Self-Harm.

This blog post is a letter to my partner. Over the last four months, I’ve spent around 60 days as a patient on several different hospital wards. He has always been there for me, be it physically or at the end of the telephone. My mental illness has always been present in our relationship, but since the start of December I feel that it has stretched our alliance to its limits.

Sufferers of mental illness sometimes feel the need to apologise profusely about their behaviour or ill state. Now, if it were anyone else, I’d insist that an apology wasn’t necessary, but when the ill person is me I feel as though I definitely need to. As usual, it seems I’ve set one rule for myself and another for everyone else. My partner surely deserves to hear the words ‘I’m sorry’ at the very least, after all that me and my mental illness have put him through? I’ve apologised a lot before, and he’s told me that it isn’t my fault and so I needn’t apologise. But a lot of this – it sometimes does feel like my fault. So here we go.

To my partner,

I’m sorry.

I’m sorry about my mental illness. I’m sorry that my struggle has caused life to be so tiring for you, especially over the last few months.

I’m sorry that you’ve had to take on so much – I’m sorry that the upkeep of our home, the laundering of our clothes, and the payment of our bills, all became things that I couldn’t face keeping on top of. I’m sorry that you’ve had to do all of the work to look after our cats, when I was the one who was so desperate to adopt them. I’m sorry that making important phone calls, organising my sick notes, collecting my prescriptions, and filling in the paperwork associated with my leave from work all became solely your responsibility. I’m sorry that my income has dwindled down to nothing, and your income has had to become ‘ours’. I’m sorry that on top of full time work, you’ve spent hours by my side in various hospitals, and almost as much time travelling to and from said hospitals on public transport. I’m sorry for the amount of nights you’ve had to sleep in our bed, cold and alone, with no one to keep you warm.

I’m sorry that when I’m not in hospital, you have to spend ages looking after me, checking that I’m OK, making sure that I’m as safe as possible. I’m sorry that sometimes, I’m impossible to keep safe. I’m sorry that you went from just being my boyfriend, my lover, to being my next of kin and my emergency contact. I’m sorry that you involuntarily had to take on the role of my ‘carer’.

I’m sorry for lying about how I felt sometimes. I’m sorry that I didn’t always tell you when I felt unsafe and suicidal, or when I was stockpiling spare medications ‘in case I wanted to use them in an overdose at a later point’. I’m sorry that you now know the process of phoning for an ambulance better than the back of your own hand. I’m sorry that I disappeared in the middle of a suicide attempt whilst you were out of town, and I’m sorry that you had to call the police that day to report me missing. I’m sorry for the times I took overdoses whilst you were in the flat with me, instead of talking to you about how I was feeling. I’m sorry that I once stole the keys to the medication safe whilst you were sleeping, so that I could take too many pills. I’m sorry I lied and said I didn’t have any medications stored in secret places, when in actual fact I did. I’m sorry I sneaked out when you were at work, to buy painkillers from the corner shop only to hide them in my sock drawer.

I’m sorry I ran away from home late at night several times and made you worried sick; I’m sorry you then had to come to collect me from the railway bridge in the cold wind and rain to bring me home, when you had to be up at 7:00AM the following morning for work. I’m sorry that you’ve had to come home from work to find me unconscious (or near-unconscious) repeatedly. I’m sorry that the responsibility for saving my life fell onto you so many times.

I’m sorry you’ve had to ride in an ambulance to A&E with me so many times. I’m sorry you’ve had to sit in A&E whilst they ran tests and decided what treatment I needed. I’m sorry that you’ve sat with me, bored, lonely, whilst I’ve fallen unconscious from the overdoses I’ve taken. I’m sorry if every overdose felt like deja-vu for you. I’m sorry you’ve had to call your manager at work and book urgent unplanned leave from work, just because I’ve fucked up and needed you with me. I’m sorry for the states you’ve seen me in.

I’m sorry that I’ve locked myself in the bathroom to self-harm. I’m sorry you’ve known I was self-harming and had to just let me do it, because there was no way of stopping me. I’m sorry for the times you’ve had to help me clean and bandage the wounds I’ve inflicted upon myself. I’m sorry that I’ve made myself so grossly unattractive, covering myself in scars that will fade but never quite disappear.

I’m sorry that you’ve stayed awake with me in the small hours of the morning whilst I’ve cried, and cried, and cried, and you’ve lost sleep. I’m sorry that when I was writing a part of this blog post at 4 in the morning because I couldn’t sleep, I started crying and it woke you up. I’m sorry for soaking your pillows and your T-shirts with my tears.

I’m sorry that I’ve made you cry.
I’m sorry I wasn’t there to comfort you whilst you cried.

I’m sorry I’m so withdrawn sometimes. I’m sorry about the days where I barely talk to you, because I’m feeling irritable or depressed, or because I just have nothing to say. I’m sorry about the nights where I’ve refused a cuddle or a kiss goodnight, just because I’m feeling down. I’m sorry about the mornings and the afternoons that I’ve just spent lay in bed, unable to get up, incapable of wanting to ‘do the day’. I’m sorry for the times that you’ve reached out to hug me or reassure me and I’ve cowered away, refusing all physical contact. I’m sorry that I’m not the same as I used to be.

I’m sorry you’ve had to lie for me to my family because I asked you not to tell them how ill I am. I’m sorry that you’ve had to keep my friends updated on my condition when I’ve tried to kill myself and worried them all in the process.

I’m sorry that I pulled you away from your home county when I got a graduate job nearer to my own home county, and I’m sorry I then ended up failing to cope with the job anyway. I’m sorry that you got a job near(ish) to here, too; I’m sorry that you’re so far away from all of your friends and your family. I’m sorry that you have to do a frustratingly lengthy commute on rubbish public transport to and from work every day, because there wasn’t any work for you in the town we live in. I’m sorry I’ve trapped you here.

I’m sorry I’m so erratic. I’m sorry for being incapable of doing anything anymore. I’m sorry that I’m boring. I’m sorry that I’m difficult to be around. I’m sorry that I’m ill.

I’m sorry that, out of all of the humans on this planet, it was me that you fell in love with.

It’s bittersweet, really; every single day I spend time reflecting upon how lucky I am to have you in my life, and yet at the same time I question why you didn’t run a mile back when we were still ‘just friends’ in 2013. I tell myself that you deserve better. I wonder why you chose to be with me, despite knowing I had so many health problems. It says a lot about the type of person that you are, because not many people would stick around after all I’ve put us through. After all I’ve put you through.

I guess all of this is why they say that love hurts?

To my partner, my other half, my team mate; to the one I love

I’m sorry that loving me hurts so much sometimes.
I’m sorry that my mental illness gets in the way.

I love you, though, so much, and for now I can only hope that that’s enough.

with love,
from your Sweetie-Pie x

Smile, and pass it on 

In a previous post, entitled Life and Death, I wrote a lot of praise and positive words about one of the ward sisters on the medical unit I was a patient on at the time. The day after the events that Life and Death focused on, I went to the PALS (Patient Advice and Liaison service) office within the hospital. Through PALS you can ask for advice, make a complaint, or pass on a compliment, and it can be addressed to the hospital as a whole, a particular ward, or even a specific member of staff.

I wrote a letter to the ward sister whilst at the PALS desk, expressing my gratitude for the amazing compassion and kindness shown to both me and the patient next to me. I told her that her actions that night had directly made a positive difference to how I coped with the situation and that she had really helped me. I said to her that I was certain the patients’ family would have been grateful that such a kind ward sister was in charge of their loved ones’ care on her final night. I thanked her sincerely for her wonderful attitude towards me and all other patients. When handing in my letter at the PALS desk, I wondered whether it would ever actually make it to the individual that the letter was about. People are more inclined to make complaints about poor services; were the compliments deemed less important, less constructive? I hoped not, but I tried not think too much about their protocols and just quietly wished for the ward sister to find out how grateful I was.

And she did!

In unfortunate circumstances, I found myself once again a patient on the acute medical unit just under a couple of weeks ago, which was probably around a month following the hospital admission during which I’d written Life and Death. I was upset one afternoon, when I noticed the lovely ward sister from last time was on duty. She approached my bed and told me she’d just seen I was on the ward again, and that she’d come to find me because she’d received my complimentary PALS letter the previous week; she was really grateful for it and it had nearly made her cry. I was so incredibly pleased knowing it had gone through PALS and actually reached her that I smiled for probably the first time that day. And the fact that she had remembered my name and taken the time out of her busy schedule to come and say thank you to me personally, at my bedside, was enough to cheer me up from my ill, upset state. Being able to tell her after that I truly believed it was completely necessary and well-deserved positive feedback was lovely.

I suppose that little moment just reinforced to me how important it is to focus on and compliment the positives, no matter how small, of any service – particularly a healthcare service. The ward sister made things feel OK for a moment during a very difficult time for me, and the least I could do was say thank you, if not face to face then via a small statement through PALS. But that seemingly tiny expression of gratitude via PALS allowed for the ward sister realised how special and important her actions were on that night, which in turn made her smile and realise the positive impact that she had on the hundreds of people she cared for in her role. And the fact that I could see her again, and be told directly that she’d really appreciated my letter, just continued the sense of warmth generated by her caring attitude in the beginning.

Compassion really does make the world go around.

I found out the next day that the ward sister was leaving, that this was her last shift on this ward and that she was going to work at a different hospital in the palliative care services. From the wonderful nursing practice I’ve witnessed, I’m confident that she’ll do fantastically in her new role.

Let’s talk about malpractice – at my local psychiatric hospital

[Found this in my drafts timed and dated 00:50 21/02/17]

Content warning: Suicidal intent, Hospitals, Malpractice

I feel better at home than I did in hospital today, but that’s probably only because of how incompetent that psychiatric ward are. It was the same place that discharged me too early in December, the place that let me walk away whilst I was a massive risk to myself. I could have died that day, I tried to make sure I did. I’m lucky that I didn’t require a large amount of support during this last week’s admission to this ward, and that I was just having a bit of a rest and rehabilitation in a “safe” environment there after a big overdose, because they literally didn’t offer me any support or help and there were no activities or groups to go to.

There was a patient there that they were sending home this morning, who was expressing clear intent to harm herself when she got let off the ward. I questioned the doctor, told her that I was in the same position as that patient back in December, and that the wards’ negligence nearly (and could have easily) led to my death. I warned that the patient really, really didn’t seem OK to go home and that if this happens as often as it seems like it does, they’re going to be directly behind someone’s suicide very soon (if they haven’t been already). The doctor then twisted it around and used my understanding of another patients situation AGAINST me, and said “See, you get too concerned about other patients, this is why hospital isn’t helpful for you.” (She’d accused me of wasting a bed last week when she said that psychiatric hospital admissions ‘clearly weren’t helpful’ for me. I told her outright that admissions to an incompetent ward like this one aren’t helpful, but that I spent three weeks of last month on the ward just next door to this one who genuinely helped me SO much. It’s atrocious, the difference between these two wards that have the same number of bed spaces and the same amount of resources and funding.) And I couldn’t believe what I was hearing- she basically said that my empathy towards the distressed patient was a reason that I shouldn’t be a patient. What, because I’m a human being with capacity and I can see what they’re doing and how they’re mistreating people? I suppose looking at it like that, they have an incentive behind discharging me: I’m too clued up on their bullshit.

I was already in the middle of a formal complaint against this ward after their malpractice in December, so I kept my head very low during this admission. Quiet, observing everything; judging them really, but keeping myself safe and occupied and trying to rest. But I have so much more incentive now to complain and demand answers on how and why they can be so incompetent. I am sickened and shocked by the way in which they practice, and in a weirdly twisted way I’m glad I survived what was a very determined suicide attempt last Monday, because it means that I can maybe ensure – through my serious complaints – that patient care gets reviewed on this ward…In December, not only did they essentially allow me (watched me and let me) abscond from the ward to attempt suicide – They also lost my possessions, they refused to inform my carer (my partner) of my state despite me consenting in writing to him knowing, they made decisions about my care without me, they made changes (reductions and omissions) to my medications without telling me, they refused to involve my partner OR myself in developing my care plan… They even missed a huge part of my diagnoses and as such didn’t treat me properly; if anything they made me more poorly… They fucked up and I was helpless, and they’re doing the same to other helpless patients right now.

This morning I also witnessed the nurse practitioner LAUGH at a patient who was crying and upset and distressed. She made a gesture to the other nurses pointing down the hallway (to where the patient was crying) and she LAUGHED. I felt sick. I wholeheartedly believe that the large majority of nurses are absolute angels but… Not this one. She is horrific.

I (used to / am off sick from) work as a management trainee in the NHS, at this very NHS foundation trust. And the fierce, passionate-about-change version of myself – the determined Rachael that I thought I’d lost in this full blown mental health crisis that has gone on for over 3 months – is definitely coming back out after what I’ve experienced and what I’ve seen. If I can’t find reasons to live that are just for me and my life, then I have to find reasons to live for others. And maybe one of those reasons can be so that I can share my experiences of this terrible psychiatric ward and get some changes made. I’m lucky that I now have the capacity to understand what I’ve been through and what the ward have done to me and others – and I need to use that capacity to help those who can’t fight for themselves.

At the time of my writing this, it’s just gone half past midnight and I’m a ball of furious energy. I can’t ignore my anger, and I can’t sleep because I’m worried. As soon as I am physically and emotionally capable of doing so, I need to get to work on formally complaining about this awful practice and ensuring this doesn’t happen to indefinite numbers of vulnerable people.

I wish I could say this is an isolated incident, but if this is happening at an NHS Mental Health Trust that is deemed by the CQC to be a “Good” trust, then I dread to think of the occurrences at hospitals within trusts which have a rating of “Requires Improvement” or “Inadequate”.

Life and Death

Content warning: Death, Resuscitation, Suicidal thoughts



I mentioned in my previous post that on Monday last week I was admitted to hospital after an attempted suicide. I was a patient on the acute medical unit (AMU), which is usually the first ward that people get transferred to after being admitted to hospital via A&E. The typical patient on such a ward is elderly, perhaps with some respiratory or heart problems. There is a lot of noise – cardiac monitors bleeping, nebulisers buzzing, IV infusion pumps ticking – a lot of different staff members, and a lot of movement; the ward is bustling 24/7.

It’s very easy to get chatting with other patients if you’re in a bay with several bed spaces, because chatting passes the time, and time drags when you’re poorly and in hospital. I had lots of conversations with a lovely elderly patient opposite me, P. We entertained each other, kept each other smiling, and when it was time for me to be transferred from the hospital to the psychiatric ward, P said “I’m going to miss you.” I gave her a big hug, and wished that she would get well soon. “You take care of yourself, won’t you”, I said – a phrase I say when I probably won’t cross paths with a person again, but I know they’ll remain in my memory for a long time, and I genuinely want them to be well and happy.

On Tuesday afternoon, a patient was moved into the bedspace next to me. Gwen. Her daughter, husband, and 4 grandchildren all came to see her, concerned about their loved one but knowing she was in safe hands in the hospital. Gwen was having difficulty breathing due to a chest infection, and had to wear an oxygen mask as a result. She complained that wearing the mask was making her too warm, and kept taking it off to “get some air” – bless her. She really enjoyed eating some ice cream for pudding, which she ate before her main meal – this made me smile. Her family left at around 8pm, her grandchildren each saying “See you tomorrow, Nan.” Those four little words would later break my heart.
At about 10pm, Gwen started sounding very chesty, as though a big cough would bring up a lot of rubbish from inside her lungs. Her oxygen mask had been switched to a nasal cannula, so that she was less likely to pull the oxygen supply away, but she was definitely still struggling with breathing. The only way I can describe the sound of her breathing is by saying it was the same noise as when you blow bubbles into a glass of fizzy drink through a straw. It got worse and worse, and I realised that she couldn’t just cough it up – she tried to say something, but it was incomprehensible; it sounded as though she was talking from under water.

It sounded like she was drowning.

My memory is jumbled up, so I’m not completely sure of the order of events that followed, but the concerned words of the team of staff have stayed etched into my mind:

“Oh sweetheart, your chest sounds terrible doesn’t it”,

“We need to get a blood test”,

“Let’s sit you up a bit, Gwen”,

“I can’t get any blood from her”,

“Could one of you call her next of kin, now, please?”

Very quickly, it became serious:

“She’s arresting”,

“She has no radial pulse”,

“Come on Gwen, let’s try and get you back”,

“We have a carotid pulse, but it’s weak”,

“Have they called the next of kin?”,

“She’s crashing again”

“We can’t get in touch with her husband, we’ve left a message and we’re trying her daughter”

“I don’t think we’re going to be able to get her back.”
And then the final words:

“Are we all in agreement to stop CPR?”

“Yes.”

I’ve never witnessed death before. I tried to reassure myself that that wasn’t what had just happened; I listened out for the under-water breathing sound, tried to convince myself that I could hear it, but I knew I couldn’t. Tears had been silently rolling down my cheeks since I heard “Could someone contact her next of kin, please”, but after the agreement to stop CPR, I was sobbing. Silently – staff were clearly so busy and I didn’t want to distract anyone from more important duties – but I was doing the type of crying that takes your breath away so that your chest starts to uncontrollably convulse. I’ve imagined and wished for my own death plenty of times, and of course I’ve seen the dramatic deaths portrayed in hospital dramas on television, but I never thought death could be like this.

At 10pm, Gwen was struggling to breathe slightly more than she had been for the rest of the day, and staff were a bit concerned. By 11:15pm, she was gone. It happened so quickly. I didn’t think death could occur so fast.

The nurse in charge, the ward Sister, popped her head around to my bed space – all of the curtains around our individual bed spaces had been closed whilst the fight to keep Gwen alive took place, to protect us, to preserve her dignity. Sister was just wanting to check if I was OK, as I’d been suffering some chest pain earlier on in the evening. They’d done an ECG, and taken some bloods – and she’d come back to see how the pain was. I didn’t care about the pain any more, though, I was a blubbering mess thinking about poor Gwen and her family who probably didn’t know yet. Sister asked me what was wrong, though I think she knew already, and I just vaguely gestured towards my left – where the other side of the curtain Gwen’s body lay, lifeless. I just about managed the words “Her 4 grandchildren… they said… ‘See you tomorrow, Nan’…..” before I burst into floods of unstoppable tears. Sister grabbed a box of tissues and came to sit with me, a reassuring hand on my back, letting me cry.

“We don’t want you to know what’s happened, obviously, but you already do. She was a very poorly lady, and unfortunately tonight she just couldn’t fight any more”, Sister said.

I asked, “How is it fair that I’m sat in here, receiving treatment because I tried and failed yet again at willing my body to shut down and die? And right next to me, there’s a patient who fought so desperately until the very last minute, wanting to live and pull through, but she couldn’t make it?” Of course, there isn’t an answer to this question, because it’s not fair. “It’s just not your time yet, you’ve still got some life ahead of you”, was all sister could say to me.

“Nurse, how do you do this? How do you manage to get through this without breaking down every time it happens? How do your team come together like that, try to save a patients’ life, and just cope when it’s not possible to?”

“We have to”, she said, “I love being a nurse, but in doing this job we have to be prepared to handle both life and death. You must think I’m so cold, because I’m not visibly upset, but it does hurt us, too.”

“I don’t think you’re cold – you must have seen this so many times, and you’re all angels, you nurses and healthcare staff. I just can’t get my head around how you cope with it. I feel silly, for being so upset, when you witness this type of fight every week.”

“If I was poorly, in hospital like you are right now, I’d probably be broken down, too. You’re not silly for being upset, you’re human. It’s heartbreaking, and it breaks our hearts a little each time too.” She reassured me, making me feel less guilty for how much it had upset me. “But we have to carry on. We’ve got the rest of you to take care of, we need to make sure all of you are OK. So we cope just because we have to. We cope because we learn how to, in time.”

The actions I witnessed from the staff following Gwen’s death will stay with me forever. I heard several members of staff talking to Gwen whilst they cleaned her body and made her as peaceful as possible, calling her by her name, calling her sweetheart, just like they did with every patient in their care. Just like they did with me. I suppose that must help the staff cope in a way, too, treating her in the same way as they would should she be alive. They showed more dignity and respect and compassion than I could ever have imagined, consistently talking to her: “Let’s put another pillow behind your back, Gwen, make you as comfortable as possible.” “That’s it, sweetheart, let’s lay you back down.” I sat listening to it all, sobbing, I just couldn’t get the tears to stop. I was awake for hours, I definitely remember seeing the clock hit 5am, replaying the events of the evening over and over again. Sister kept checking on me, making sure I was OK, asking me if I wanted hot chocolate, asking me if I needed to talk. She genuinely cared about how I was feeling, and it was heartwarming that even though something so tragic had just taken place, she was still the kind and caring nurse in charge of the shift who just wanted to make sure all of her patients were OK.

I got up to go to the bathroom, and I must have knocked the curtain slightly because on my return there was a slight gap visible between my bed space and Gwen’s. I instinctively looked through it – I didn’t have time to think – and I saw Gwen. I was shocked, I looked away, but then I realised that she looked comfortable. She looked like she was out of pain. I’ve never seen a deceased body before, and seeing her in the moment was absolutely accidental, but it was comforting that she looked at peace.

I think witnessing the death of Gwen awoke a feeling in my mind that I hadn’t felt for a long time: Life is fragile. It’s really, very delicate and it can be stripped from us at any given moment. At the click of a finger, or the drop of a hat. It seems terrible that I had to observe something tragic for me to remember this, but if Gwen’s death taught anyone anything, it taught me to be thankful – for the life of my friends, of my family, and my own life. I looked at my body, still recovering from the pills, still hooked up to various machines and monitors and infusion pumps, and felt a sense of gratitude. I’m still not sure about the future, and whether it exists for me, but I’m certainly aware that my body is sturdy. And for that, I should be grateful.

I can say with confidence that Gwen had the very best care from the nursing staff, right from the time of her admission until her last moments and beyond. The staff were fantastic, and I’ve passed on my compliments through patient services at the hospital, because their actions really were commendable. I’m almost certain that her family will have been grateful that the lovely ward Sister and the rest of the team were right by Gwen’s side at the time of her passing, because they handled it so perfectly. Nurses really are angels. The fact that it happened so quickly is a blessing in a way, because she wasn’t suffering terribly for a prolonged period of time. But the words “See you tomorrow, Nan”, spoken so reassuringly and with such certainty by her grandchildren, have truly broken my heart.

Observation

Content warning: Suicidal thoughts, Overdose, Hospitals.



I’m the type of person that sits in the corner of the room, facing outward, watching, silently observing. A people-watcher. Nosey?
I’m sat in the corner of the main lounge in the ward, and it’s dinner time so the room is busier than it is at any other time of day. I was a patient on this ward at the beginning of December as well, just a little over two months ago, and it feels uncomfortable being back here. Some of the staff double-take when they see me, recognising me from that brief previous admission. Others don’t recall me. I recognise a handful of the patients. A man, M, I would guess that he’s in his fifties, seems cheerful when he speaks but his eyes look dark and sorrowful when he’s quiet. A lady, T, who’s had a haircut since I last saw her but still wears the same big overhead headphones. A young lady around my age, K, who has needs slightly different to the rest of the patients and requires a lot of support. And a guy, D, who last time I was here was arguing with unseen stimuli almost all of the time but now he appears to be slightly more settled. I wonder how they’re doing; I find myself hoping that they’re doing OK, that they’re getting better. That they can be discharged soon, instead of remaining what I assume must be detained under section 3 of the mental health act. That their time here has been worthwhile, that they are recovering. I’m doubtful, because of my past experience of this ward, but I’m still hopeful. 

The rest of the patients are different. I don’t know their names, so I find myself involuntarily nicknaming them; there’s ‘second-helping guy’ who repeatedly checks whether he can have seconds of dinner and pudding (the answer: yes, as soon as everyone else has had their first helping). There’s ‘bald guy’ who has expressed distaste about the ward and the lack of actual help he has been offered in the 19 days he has spent here (a feeling I am far too familiar with, unfortunately, as this ward is sub-standard when compared to the adjacent ward in terms of the patient support offered – they are supposedly the exact same type of ward, but I was on the other one last month for 3 weeks and they are NOT the same; the other one is far better). There’s ‘Pokemon headphone girl’, who loves to talk and seems very kind, but I find it difficult to follow the conversations that we have, as though three quarters of the words don’t ever reach the air and so most of the meaning stays unknown. All of the other patients have been fairly quiet, so I haven’t named them – there are 19 of us altogether. 

I’ve observed within myself a sense of failure, due to being admitted back here again, but I know this is what is for the best at the moment. Just to keep me safe for a few days until they can put proper care in place in the community for me, because I’m not safe with the current (fairly low) level of care they have been providing me with. The doctor who reviewed me today looked at me as though I was an unsavoury character, and told me that hospital admissions were ‘clearly not helpful for me’ (my response: my previous admission to this ward wasn’t helpful, no, because you all completely ignored my needs – but my admission to the adjacent ward was a really successful three weeks in which we got my anxiety under control and my needs properly assessed and managed). So I’ll be going home in a few days, whether or not that’s a safe plan.

Another overdose, a determined one of about 90 pills at once, and a conversation with the psychiatric liaison service in which I was honest and stated I wouldn’t be able to keep myself safe if I went home, was what landed me here in the psychiatric hospital again. The overdose happened on Monday, and now I’m here. After a few days of bleeping monitors and IV treatment lines and too many wires and tests and not enough sleep, the doctors found my body had pulled through relatively unscathed. A few days of doctors worrying about my cardiovascular system, my digestive system, and my poor liver and kidneys, and it was confirmed that my blood results were back to normal, my lack of ability to walk was just due to weakness and I would be fine – physically – very soon. Onto the psychiatric ward I went, to pick up the pieces of my broken mind.

I feel guilty, for doing this again – for putting my lovely partner through this again. I feel frightened, because my head is a shitty and scary place to be at the moment. I feel like a fraud, like I’m taking up a bed space when someone else probably needs – or deserves – it more than I do. I feel uncomfortable, being back on a ward that neglected me and my needs so terribly last time that I’m actually in the middle of putting forward a very formal, very serious complaint. I feel… Poorly. Anxious. Misunderstood. Dreadful. Tired
But I do feel fairly safe. I’m safe from myself, anyway, and they haven’t denied me any of my psychiatric medications (like they did last time, when they stopped 2 of my high-dose anxiety medications cold turkey – even though every guideline ever says to reduce them gradually to avoid withdrawal symptoms) so I’m probably safe enough in their hands too. It’s just a holding pen.  

I’ll give the mental health services – and myself – another chance at getting me well. I have to, because I experienced something three nights ago that changed my perspective, twisting it slightly, making me look at my life in a different light. I will write about that separately, soon, because it’s big and important but a terribly upsetting story. 

I still feel suicidal, but hopefully I can fight that feeling and get my life back on track. I will try – I am trying, I have been trying. I’ll be getting discharged early next week – they want me out of here and into community care as soon as possible. Obviously. So that I’m not their problem. I feels a bit like I’m a hot potato, being tossed between the general hospital and psychiatric liaison services and psychiatric inpatient wards and crisis services and the community mental health team. And no one wants to get stuck with me. 

But someone will have to be stuck with me. I hope things improve soon. 

Practice

Content warning: Suicidal Intent, Overdose.

My consultant psychiatrist and I decided last week that it would be useful for me to get some practice at remaining safe and in-control. One of the challenges we agreed on, that I’d need to successfully accomplish before being discharged from the hospital ward, was that I would spend a couple of hours by myself, be it an afternoon at my home or elsewhere.

I woke up on the day my ‘lone leave’ was planned for, and immediately my mind narrowed-in on one particular thought: “I can’t do this.” My new medication regime has been making me incredibly sleepy, and I wanted nothing more than to take a nap that lasted for the entire day. No. Instead I challenged my thoughts and sternly told myself, “if you don’t do this now, it will only become more difficult to accomplish.” I spoke to the nurse in charge, and we agreed that I would still be going out alone for a few hours that day. I’d decided it was now or never. I was going to take a slow, mindful walk into town, grab a coffee, maybe visit the book shop, and see how things went.

Mindfulness. Noticing, being in, the moment. Trying gently to push away any particular thoughts that come to the mind. It’s much more difficult than it sounds. It requires a lot of practice. But I was going to give it a go.


I scribble my name on the ‘patient sign in/out’ booklet, listening to the nearly-empty pen scratching on the paper. I receive a reassuring nod from both of the nurses in the office, who are seemingly impressed by my bravery. “Treat yourself to something that you really want”, one of them suggests, and I smile because it’s a lovely idea. I deserve a treat. I set off towards the ward doors before I get any chance to reconsider my plans; I push open one door, then the other, and I’m outside. It’s my first time stepping outside since being admitted to this ward over two weeks ago, and at that point I was being escorted by paramedics. I breathe in the fresh, crisp air – my nose feels cold almost instantly. Winter. A few more deep breaths, and I set off towards town.

A memory. The last time I walked on this exact path, it was the morning of 14th December ’16 and I’d just managed to talk my way out of the ward adjacent to the one I’m staying on now. Same type of ward, same ‘type’ of patients; very differently managed, though, and with a ghastly consultant (such descriptions are only my opinion, of course). Earlier that morning, I’d bravely spoken of my plans to end my life, and had expressed my intention to act on those plans as clearly as possible. “I do not feel able to maintain my safety, because I have a solid plan in place to end my life and I want to act on that plan as soon as I can.” I was slightly conflicted; I wanted advice on how to cope with such strong intentions, and my partner had begged me to tell them of my plans as he thought it would ensure that the ward kept me safe. It was very clear to anyone that I still needed to be in hospital; I was a risk and I wasn’t stable. But the ward were not going to help me; the consultant had already made the decision to discharge me that afternoon, and none of the staff were willing to take into account the obvious risk that I was to myself on that day. I don’t remember much of what happened, it’s all just a blur of pills and sirens and A&E. Essentially, though, I shoved my belongings from the ward into bags, and asked the nurse who’d told me I was being discharged that day to unlock the doors of the ward (who did so without even questioning my mental state at the time). I vaguely remember dropping my belongings at the door – I wouldn’t need them if I were dead – and running away. Along this very path. 

The path. It’s covered in salt grit; it must have been below zero last night, slippy. With every step I take the pavement crunches beneath my worn-out converse trainers, the soles of which are now so thin that I can feel the sharp edges of the salt digging into the base of my feet. I continue walking right off the hospital grounds with my chin held high, and I step onto the housing estate between the hospital and the town centre. My heart is pounding in my chest and my hands are clenched in the pockets of my warmest cardigan, but I’m feeling brave. I can do this. I can.

A thought. This used to be my route from work each day. My desk in the office, where I worked until I was signed off by my doctor as being too ill, was a mere 60 second walk from the hospital bedroom I’m now staying in. I used to spend some of my time looking at the statistics and performance indicators for the hospital, and the rest of my time project-managing the development of an online portal for hospital staff. Now, I’m a patient on the very wards I used to monitor the statistics for, I myself contributing to the patient data that my colleagues need to analyse as part of their day jobs. The sheer idea of that is unsettling, even though I know the confidentiality policies better than I know the back of my own hand. I’d gone from staff member to inpatient in the space of under a week nearly two months ago. The two identities aren’t necessarily mutually exclusive for everyone, but they seemed to be for me; I still hadn’t managed to get back to work. I’m doubting whether I’ll ever be able to do my job again, and that’s completely aside from the fact I’m uncertain about whether I even want to return.

A squirrel is standing on its hind legs, its pose similar to that of a meerkat on guard for its clan. It then hops along the grass, and I imagine in my mind the trace that it would make if its hops left a stream behind. Lots of little joined up arcs, like a dozen tiny rainbows in a line, each joined to the next by its base. I continue through the housing estate; two new play parks have been installed since I last paid attention to this route. A person – presumably a child – is sprawled like a starfish on the hammock swing, rocking back and forth.

A wish. I wish for the same sense of wonder and curiosity – and naivety – as that of a child. A memory. I remember myself as a child; I spent a fair share of my time alone, hanging far upside-down on swings such as the one I’m watching now. An awareness. I am aware that my mind is wandering again.


Mindfulness. It’s difficult to put into practice, but the most important thing is to not get frustrated when you find your thoughts wandering – instead just try to bring your mind back to the present moment. I tried to be as mindful as I could that day, even filling in a page in my “Mindfulness Moments” book by Emma Farrarons which suggested sitting in a coffee shop at the window and writing notes on any observations. But as we can see from this post, thoughts and memories (the italics) can easily disturb your focus and shift it from the present moment. I think it’s just as important to accept that it’s perfectly normal and OK for your mind to wander, as it is to try to reign in your thoughts and resume your focus to the present.

I’ve included a photograph of the page I wrote on in the Mindfulness Moments book below, not because it’s interesting to read, but because it shows my efforts at practicing mindfulness on my day of ‘lone leave’ from the ward. I was anxious and tense that day, and at first I felt very reluctant to even leave my hospital bedroom – but as soon as I made the commitment to just try to focus on things one moment at a time, things got a little easier.

image1-19780752265933mindfulness-moments

For those interested, my couple of hours off the ward went better than I expected them to. I went to Costa, grabbed a coffee, completed the aforementioned mindfully-noted passage of text in my book. I went to Waterstones afterwards, and noted down the titles of a books that seemed interesting (so that I could look into ordering them online for less than half the price later, because on statutory sick pay you aren’t exactly rolling in money). I did buy myself a journal, though; I decided that this counted as the “treat” to myself that the nurse had earlier suggested I buy. Whilst I felt a little guilty buying a present just for myself like that, I recognised that I’ve been through a lot and I’ve struggled recently so I decided that I did deserve it. The idea of the journal is to write down 3 joyful moments that happen each day, the moments can be big or small. I then went to Boots, brought some makeup for myself (I haven’t even worn make-up since Christmas day, and even then it was only because I felt I had to make the effort) and some tweezers (because quite frankly, my eyebrows are a disgrace). In the queue my anxiety spiked, a LOT, but I successfully managed to ground myself just enough to be able to complete my purchase. After that, I decided that I’d done plenty of ‘time alone’ that day and I was fast nearing the limit of my ability to cope, so I decided to head back to the ward. When I returned about 5 or 6 different members of ward staff asked me how I’d got on, and they were so pleased to hear about my successes. I was particularly proud when telling the ward psychologist that I’d used the grounding techniques she’d taught me to get me through that wobbly moment in the queue in Boots.

The first entry on the first page of my new ‘3 good things’ journal is “I discovered that Costa now put white chocolate ganache in the middle of their raspberry and white chocolate muffins, instead of just jam. It used to be a white chocolate chip muffin with a pool of jam, but now it has a rich white chocolate goo in the centre, too”. Because that genuinely made me happy that day, as small as it is. (10/10, would recommend that muffin!) The second entry is that I saw a tiny puppy on my walk back to the ward, a little black springer spaniel that was clearly out on one of its first walks on the lead. I stopped still in the street and smiled, watching the owner of the puppy patiently encouraging good behaviour whilst the puppy excitedly tripped over its own feet. Bless. The third and final entry describes a moment where I cried with laughter – something that I haven’t done in such a long time – whilst talking to a friend I’ve known since I was sixteen. We were just having a catch up, but we always have such a good laugh and I giggled in my hospital bed for a solid 15 minutes. The tagline on the front of the journal book is “A journal for tiny moments of joy”, and I’m going to do my best to fill it in whenever I can, because recognising the tiny joys in life will hopefully help me through its bigger hurdles.

You’re Alive 

Content warning: Suicide attempt, Overdose

Alive

By some weird twist of fate, you’re alive. You tried four times in three weeks to ensure that you wouldn’t be, but you are. You’re still alive.

Emergency

In total, you took over 200 extra tablets. You thought – hoped – they would finally end you, but they didn’t. You’re alive.

A seizure. Cardiac monitoring. Respiratory support. A GCS of 3.

You ‘woke up’, but you couldn’t move, you couldn’t see. Perfectly capable of hearing the bustling hospital bay, yet unable to respond to the two nurses shaking your shoulder and calling your name. You wondered if you were in a coma; you wondered if you were dead. You wished you were dead. But you weren’t.

Countless injections, dozens of tests, 11 intravenous infusions. Wires and tubes and noisy monitors. Prescriptions for tablets and suspensions to protect your stomach, your liver, your kidneys, your intestines. Days, no, weeks of abdominal pain – with your body completely unable to tolerate basic pain relief.

You’re still alive, though. You survived. All of the treatment worked exactly as it should have. You made it.

And despite every single ounce of you believing beforehand that you certainly wanted to die, you’re finding yourself feeling almost relieved that you didn’t succeed in killing yourself.

Past

Four months ago you were working. You started your very first full-time, high pressure, graduate-level job. It was wonderful, all shiny and new; it was your dream job. You were trying really hard, and you were determined to succeed. You were enjoying it.

At least, that’s what you tried to tell yourself – and anyone else who asked.

The reality is that you were struggling. The office you were based in was a toxic environment for you, and attempting to study for two part-time postgraduate qualifications alongside working full-time was just too much for you to handle. It wasn’t all that you’d expected it to be and you felt out of place, as though you didn’t belong. As a perfectionist, accepting that it was all beyond your capability was too hard. So you persisted. And then you cracked.

Six months ago, you walked across that stage in the biggest hall at your university, and wearing a cap and gown you received your hard-earned Masters degree. You were granted the title of “Master of Science”, and the world was your oyster.

Present

Now you’re an inpatient on a psychiatric ward – for the second time in the space of 5 weeks. You were brought here via ambulance, directly from the hospital that treated you for your final overdose. Last month, your admission to a psychiatric ward was a disaster, but you’re unable to keep yourself safe at home at the moment. You don’t have any other choice but to be here.

Contrary to your expectations, though, it’s going OK. The notion of a beneficial stay on a psychiatric ward is inconsistent with your past experience, but this time really is different. The consultant psychiatrist who works on this ward is the third one you’ve seen in the last six weeks, but he’s the only one that actually seems to want to help. He has listened to you, he wants to support you. He’s asked the ward psychologist to work with you to help you to cope. He has altered your cocktail of medications in the hope that things improve quickly. He has diagnosed you. And this time, you are in agreement with your diagnoses. They make sense to you.

A sigh of relief. A glimmer of hope. Tears not of sadness or frustration, rather, tears because someone has listened to you. They have heard you, finally. You thought it was impossible, but this time, they’re going to help.

And this time, you think that you might be in the right frame of mind to make the most of their help. It’s difficult; the road ahead is a very long one. But you feel you may finally be willing to work harder than ever to get better.