Snippet
Comment
Trauma
War & peace
2 min read

Hospitals are home to the truth of war

Remembering what war really is.
A black and white photo shows solider patients and nurses in a hospital.
Christmas in a German military hospital, Word War One.
Aussie~mobs, public domain, via Wikimedia.

I’ve been re-reading Erich Maria Remarque’s All Quiet on the Western Front in the run-up to Remembrance Day. Remarque, born in Westphalia in 1898, uses his own experiences of the horrors of the Western Front to paint a gut-wrenching portrait of its futility and suffering, seen through the eyes of 20-year-old Paul Baum. 

It had been towards the end of this First World War that Hiram Johnson, Republican Senator of California, observed that ‘the first casualty when war comes is truth.’ This is precisely Paul’s experience. 

The newspapers delivered to the soldiers at the Front are hopelessly, naively, offensively optimistic. They present a painfully, laughably discordant tissue of lies that deny the most basic truths of daily experience. When Paul goes home on leave, truth is even harder to find. His remote father only wants to hear tales of glory and courage and well-fed soldiers. His blabbering former teachers - the very ones who had cajoled his whole class to sign up - are patronising, ignorant and opinionated on the best route to victory. They literally have no idea, and worse, they don’t want to know.  

It’s only when he’s taken to a Catholic Hospital after an injury that Paul stumbles on an agonising truth -  

‘A hospital alone shows what war is.’ 

Paul’s vivid description of life on the wards backs this up. He witnesses the unceasing production line of shattered bodies tumbling into every available space. He’s warned against ‘The Dying Room’ which is conveniently, practically, located next to the mortuary. He catalogues the surrounding wards - ‘abdominal and spinal cases, head wounds, double amputations, jaw wounds, gas cases, nose, ear and neck wounds … the blind … lung wounds, pelvis wounds, wounds in the testicles …’ He’s grateful for the gentle, joyful kindness of Sister Libertine, ‘who spreads good cheer through the whole wing.’ 

This hospital is more eloquent on the theme of the futility of the fighting than any newspaper article or speech, censored or otherwise. 

For much of my adult life grainy videos of precision-guided bombs and leaders pounding their fist in defiant rhetoric have been the go-to guides to tell us the truth about modern warfare. I trust these sources less than ever, as I recall my instinctive respect for the ambulance drivers, nurses and doctors on the front-line - wherever it may be - marvelling at their courage and truth-telling and even-handed humanity. 

Their voices are shamefully drowned out in the world’s conflict zones, dwarfed by propaganda as insulting and truth-lite as the newspapers that doubled as toilet paper for both sides on the Western Front. And I cringe at the thought of what Paul and his young comrades would’ve made of hospitals - those oases of truth - becoming the targets of today’s bombs, missiles and drone strikes. 

We, rightly, remember the First World War as the very epitome of futility - Paul and his generation saw this truth far more clearly than we do. But let’s not congratulate ourselves, as we prepare for Acts of Remembrance in 2024, on having made any real progress in the last 100 years - hospitals across the globe’s conflict zones still tell us what war really is, if only we could hear, if only we would listen. 

Article
Care
Comment
Mental Health
4 min read

Suicide prevention cannot be done in isolation

Community response is needed, not just remote call-handling

Rachael is an author and theology of mental health specialist. 

 

 

Three posters with suicide prevention messages.
Samaritans adverts.

Suicide is a tragedy that leaves devastation in its wake for individuals, families and communities - but it remains shrouded in stigma. Whilst those who die by suicide are grieved and mourned amongst their communities, those who experience suicidal thoughts or who survive suicide attempts are often dismissed as ‘attention-seeking’ or ‘dramatic’.  

The truth is, our response as a society to suicide is one which often ignores those who are most vulnerable until it is too late. According to the UK Office for National Statistics, the number of people dying by suicide has risen steadily since 2021, and whilst some of this can be attributed to the way in which deaths are recorded, it also represents a real and urgent need to change the narrative around suicide and the suicidal.  

As the need has risen, we have also seen that services seeking to support those struggling with rising costs and rising demand.  

Just 64 per cent of urgent cases and 72 per cent of routine cases were receiving treatment within the recommended time frames and the proportion of NHS funding being allocated to mental health falling between 2018 and 2023 highlights that the parity of esteem for mental health promised back in 2010 seems to grow further away. 

Against this backdrop, for over seventy years, the Samaritans have been synonymous with suicide prevention, working where the health service has struggled to be. It’s sometimes been referred to as the fourth emergency service and has been providing spaces, mainly staffed by volunteers, in person, on the phone and online for people to express their despair in confidence.  

And yet earlier this year, it was announced that over the next decade, at least 100 of its branches would be closing, moving to larger regional working and piloting remote call-handling.  

Whilst this might be an understandable move considering the economic landscape for the Samaritans, it risks not only a backlash from the volunteers upon which Samaritans relies but also reducing the community support that locally resourced hubs provide.  

Suicide prevention cannot be done in isolation; it has to be done in and with community.  

Even the most well-trained and seasoned volunteer might find particular calls distressing, and the idea that they would have to face these remotely, without other volunteers to support them, is concerning.  

I think this needs to be a wake-up call, not just for the sector - but society as a whole. Because when it comes to suicide, we need to work together to see an end to the stigma and a change in the way people are supported. 

Suicide prevention cannot be left up to charities, we all have a role to play. 

It matters how we engage with one another, because suicide can affect anyone. There are undoubtedly groups within society who are at a higher risk (for example, young people and men in their middle age).  

Still, nobody is immune to hopelessness, and even the smallest acts of kindness and care can help to prevent suicide.  

In the Bible story of the Good Samaritan, from which Samaritans take its name, Jesus tell the story of a man brutally robbed and left for dead on the roadside. A priest and a Levite avoid the man and the help he so clearly needs, but a Samaritan (thought of as an enemy to Jesus’ audience) was the one to not only care for his physical wounds, but also pay for him to recuperate at an inn.  

We need to have our eyes open to the suffering around us, but also a willingness to help. It probably won’t be by giving someone a lift on a donkey as it is in the story(!) but it will almost certainly involve asking the people we meet how they are and not only waiting for the answer, but following it up to enable people to share.  

It might require us to challenge the language used around suicide; moving from the stigmatising “committing suicide” with its roots in the criminalisation of suicide which was present before 1962 to “died by suicide”, and shifting from terms like “failed suicide attempt” to “survived suicide attempt” so that those who must rebuild their lives after an attempt are met with compassion and not condemnation.  

Above all, we need to be able to see beyond labels such as “attention seeking” or “treatment resistant” to reach the person whose hope has run dry, and allow our hope to be borrowed by those most in need, both through our language and our actions.

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