Article

Comment

Christmas survival

17 December 2023

5 min read

How to ruin Christmas

Actor turned vicar Natalie Garrett, recounts the perils of being a Christmas Pro.

Natalie Garrett

Natalie produces and narrates The Seen & Unseen Aloud podcast. She's an Anglican minister and a trained actor.

A nativity seen with wooden figures and hay, amidst which a cat sits in the manger.

Nativity cat, Warsaw, 2012.

Kacper Pempel.

So, during the years of my acting career, I always avoided Panto (oh yes I did). Not because I don’t like Panto, I love a good Panto. But because I didn’t want to work over Christmas. How God will have chortled at that great irony, knowing as he did that as of 2005 (the year I got ordained), I would be working every Christmas for the rest of time.

Christmas is different now. Not only am I ordained, I’m married to a vicar. I’m completely immersed in professional Christmas. And Christmas is a bit different when you’ve turned pro. I won’t go so far as to say that being ordained has ruined Christmas, but it’s certainly changed it. But so has (supposedly) being a grown up.

My “Proper Christmas” will always be the Christmas that I grew up with (is that just me?). I had traditional preparing-for-Christmas jobs that I did every year on Christmas Eve eve: polishing the special cutlery we only used once a year, making the brandy butter (which is a bit odd now I think about it, being that heavily involved with brandy from the age of six) and decorating The Tree. And having the annual argument with my sister about whose turn it was to take the present to our neighbours across the road. And eating a lot of satsumas. And chocolate. And seeing my cousins and playing Trivial Pursuit. All of which looks very rosy seen through the eyes of a child. Christmas is different when you’re ordained and you have to work, but it’s also very different when you’re the grown up.

I used to think my mother made a ridiculous amount of fuss about Christmas. I am now that same mother. I think it’s Michael McIntyre who does a whole routine about women starting to write their Christmas To Do lists in October and endlessly shrieking, “there’s so much to do!” That’s me folks. Christmas as a grown up – or at least for this grown up – feels like there’s so much to do!

I always imagine (unhelpfully fantasize) that Other People’s families are living the Christmas dream – the relaxed, cosy evenings drinking hot chocolate or eggnog in front of a roaring fire; laughing and playing wholesome games happily and peacefully with their angelic children, wearing matching Christmas jumpers. In the cold light of day, I realise that, actually, most people find Christmas stressful for a million different reasons. It’s not all twinkly and bright.

For many people, Christmas means seeing all the family that they avoid during the rest of the year. It means spending money they can ill-afford on presents that may not be wanted. Christmas means missing the people who aren’t with us anymore. It means endless advertising campaigns suggesting that you aren’t living the perfect life – but that if you buy a new sofa, you’ll salvage the ruins of your life just in time for a perfect, twinkly Christmas.

And so the life of the mythical twinkly, “magical” Christmas lives on. With little or no reference to its origin story.

I was the chaplain at a Church of England secondary comprehensive school for seven years. In my first term, putting together the carol service, I asked a class chapel rep if she would do one of the Bible readings. “Oh, is Christmas in the Bible?” Huh. Another conversation I had went along the lines of, “Miss, I don’t believe in Jesus and all that religious stuff. But I believe in the spirit of Christmas.” Huh.

There’s a song in the staged musical version of the film Nativity, which is to all intents and purposes a Christmas prayer. But instead of the prayer being directed at God, it is directed at Father Christmas;

Dear Father Christmas, make our wish come true

Dear Father Christmas send your spirit through

There are Children in the world who need you way more than we do

But Father Christmas, we still believe in you

Dear Father Christmas make our wish come true

Which brings me to a difficult moment in my Christmassy life. I have a parenting policy that demands that I tell my children the truth. Whatever the question, if I know the answer, I will give it to them honestly. So, when my children were around the ages of four and six, in the middle of Sainsbury’s, with both children piled into the trolley, in mid-November, surrounded by early Christmas-abilia, one of my children asked me, “Mummy, does Father Christmas really exist?”. (SPOILER ALERT!!). I had to give an honest answer. If the question had been less straight, if there had been any wriggle room at all, I would have fudged it. But a straight question deserved a straight answer. Which, wide-eyed, they went and shared with their friends. A crowd of angry parents from their Primary school came to church to complain that the Vicar’s children had ruined Christmas.

But my point was that if I were to tell my children that I believe Father Christmas exists and that he grants Christmas wishes, were they ever to find out that I had lied (ahem), how would they trust me when I say that I believe Jesus does exist and that he does answer prayers? The challenge has lived with me ever since: how to keep Christmas rooted in Christ without ruining the Christmas magic.

Well, my saving grace is that I’m still a sucker for a bit of Christmas schmaltz. The theologically sensitive part of me absolutely abhors Away in a Manger (“no crying he makes”? Really? He was a new-born baby, of course he cried!!) and Little Donkey (in the Bible accounts there is absolutely no mention of donkeys at all. Not a single one – not on the road, not in the stable. No cows, no donkeys.) But light some candles, get the children singing and I have tears pouring down my face with the best of them, loving every moment.

But that still doesn’t mean that the essence of Christmas is the twinkly magic. Because, of course, the first Christmas was neither twinkly nor magic. Nor did it involve a perfectly curated tablescape (which I also love at Christmas). It didn’t involve any the stereotypical Christmassy things that we all get stressed about and love in equal measure. The first Christmas was messy and difficult. But it was also the most real, most genuinely joyous event in human history. Apart from Easter. Don’t get me started on chocolate bunnies….

Article

Care

Comment

21 June 2023

5 min read

The healing touch in an era of personalised medicine

As data powers a revolution in personalised medicine, surgeon David Cranston asks if we are risk of dehumanising medicine?

David Cranston

David Cranston is emeritus Professor of Surgery at Oxford University. As well as publishing academically, he has has also authored books on John Radcliffe, and mentoring.

A doctor looks thoughtful will holding a stethoscope to their ears.

Photo by Nappy on Unsplash.

In 1877 Arthur Conan Doyle was sitting in one of Dr Joseph Bell’s outpatient clinics in Edinburgh as a medical student, when a lady came in with a child, carrying a small coat. Dr Bell asked her how the crossing of the Firth of Forth had been on the ferry that morning. Looking sightly askance she replied;

“Fine thank you sir.”

He then went on to ask what she had done with her younger child who came with her.

Looking more astonished she said:

“I left him with my aunt who lives in Edinburgh.

Bell goes on to ask if she walked through the Botanic Gardens on the way to his clinic and if she still worked in the Linoleum factory and to both these questions she answered in the affirmative.

Turning to the students he explained

“I could tell from her accent that she came from across the Firth of Forth and the only way across is by the ferry. You noticed that she was carrying a coat which was obviously too small for the child she had with her, which suggested she had another younger child and had left him somewhere. The only place when you see the red mud that she has on her boots is in the Botanic Gardens and the skin rash on her hands is typical of workers in the Linoleum factory.

It was this study of the diagnostic methods of Dr Joseph Bell led Conan Doyle to create the character of Sherlock Holmes.

A hundred years later and I was young doctor. In 1977 there were no CT or MRI scanners. We were taught the importance of taking a detailed history and examination. Including the social history. We would recognise the RAF tie and the silver (silk producing) caterpillar badge on the lapel of a patient jacket. We would ask him when he joined the caterpillar club and how many times he had had to bail out of his plane when he was shot down during the war – a life saved by a silk parachute. We would notice the North Devon accent in a lady and ask when she moved to Oxford.

The patient’s history gave 70% of the diagnosis, examination another 20% and investigation the final 10%. Patients came with symptoms and the doctor made a presumptive diagnosis – often correct - which was confirmed by the investigations. Screening for disease in patients with no symptoms was in its infancy and diseases were diagnosed by talking to the patients and eliciting a clear history and doing a meticulous examination. No longer is that the case.

At the close of my career, as a renal cancer surgeon, most people came in with a diagnosis already made on the basis of a CT scan, and often small kidney cancers were picked up incidentally with no symptoms. The time spent talking to patients was reduced. On one hand it means more patients can be seen but on the other the personal contact and empathy can be lost.

Patients lying in in bed have sometimes been ignored. The consultant and the team standing around the foot of the patient’s bed discussing their cases amongst themselves. Or, once off the ward, speaking of the thyroid cancer in bed three or the colon cancer in bed two. Yet patients are people too with histories behind them and woe betide the medic, or indeed the government, who forgets that.

With computer aided diagnosis, electronic patient records and more sophisticated investigation the patient can easily become even more remote. An object rather than a person.

We speak today of more personalised medicine with every person having tailored treatment of the basis of whole genome sequencing and knowing each individual’s make up. But we need to be sure that this does not lead to less personalised medicine by forgetting the whole person, body mind and spirit.

Post Covid, more consultations are done online or over the telephone -often with a doctor you do not know and have never met. Technology has tended to increase the distance between the doctor and patient. The mechanisation of scientific medicine is here to stay, but the patient may well feel that the doctor is more interested in her disease than in herself as a person. History taking and examination is less important in terms of diagnosis and remote medicine means that personal contact including examination and touch are removed.

Touching has always been an important part of healing. Sir Peter Medawar, who won the Nobel prize for medicine sums it up well. He asks:

‘What did doctors do with those many infections whose progress was rapid and whose outcome was usually lethal?

He replies:

'For one thing, they practised a little magic, dancing around the bedside, making smoke, chanting incomprehensibilities and touching the patient everywhere.? This touching was the real professional secret, never acknowledged as the central essential skill.'

Touch has been rated as the oldest and most effective act of healing.

Touch can reduce pain, anxiety, and depression, and there are occasions when one can communicate far more through touch than in words, for there are times when no words are good enough or holy enough to minister to someone’s pain.

Yet today touching any patient without clear permission can make people ill at ease and mistrustful and risk justified accusation. It is a tightrope many have to walk very carefully. In an age of whole-person care it is imperative that the right balance be struck. There’s an ancient story that illustrates the power of that human connection in the healing process.

When a leper approached Jesus in desperation, Jesus did not simply offer a healing word from safe distance. he stretched out his hand and touched him. He felt deeply for lepers cut off from all human contact. He touched the untouchables.

William Osler a Canadian physician who was one of the founding fathers of the Johns Hopkins Hospital in Baltimore, and ended up as Regius Professor of Medicine in Oxford, said: