If you think Christmas is ‘right’ you’ve got it wrong

Contrasting cathedral Christmases conjure world-changing subversion.

Katherine Amphlett

Katherine is a counsellor based in the West Midlands.

A carol singer looks down while candles flicker.

Coventry Cathedral.

Christmas.

The very word is loaded with associations and memories and history and meaning. Just looking at it written down conjures up years of my childhood and particular feelings and impressions and smells. And for good or ill, it seems that that’s the case for most people. Ask any group of individuals for the three words that represent Christmas to them, and you’ll end up with myriad different answers – and an argument about why each person is right and everyone else is wrong!

Interestingly though, Christmas has changed in meaning for me in recent years. Ever since Covid in fact – that weird, strange, historic, awful-in-many-ways-but-unexpectedly-good-in-others period, that already feels like quite a long time ago. Christmas had one significance before it and another afterwards, and the latter is actually much more important.

It was a place that stamped it into my mind; two very different experiences of it, with the second one over-writing and enriching the first. It was Coventry Cathedral.

So. Every year for the 20 years before Covid, we went to the cathedral on Christmas Eve for an afternoon service called The Road to Bethlehem. My husband had been going nearly all his life, having been a chorister there from the age of seven. We gathered with a big group of friends and acquaintances into an enormous rag-tag choir, first for a rehearsal in the undercroft beneath the cathedral before going upstairs to join the equally enormous orchestra for a bit more practice before the service itself. Everyone was in Christmas jumpers and antlers and sparkly earrings, and the conductors of both choir and orchestra had to stand on boxes so we could see them and they could see each other. It was the only time each year that all the singers and players came together, many of them teenagers home from uni, and the whole atmosphere was buzzy and excited.

In addition to all the hundreds of musicians, gradually then the congregation began to pour in – masses and masses of children among them, nearly all dressed up in nativity costumes. There were crowds of shepherds and angels, hordes of wise men, smatterings of Marys and Josephs and a good crop of baby Jesuses, along with Batman and Spiderman and plenty of princesses who came along for the ride. And all of them during the service moved round the cathedral, from Nazareth at the start, via the nasty innkeeper who told them to clear off, no room in the inn (aka the Lady Chapel), to the hills full of sheep behind the altar, and fetched up in the stable down by the font at the end – with the choir and orchestra belting out appropriate carols at each stage. It was absolute mayhem, with babies yelling and small shepherds whacking each other with light sabres and our friend Mark – a professional tenor – singing sublimely overhead as Angel Gabriel. The cathedral was packed to groaning and at the close, when everyone was asked to light the candles they’d been holding throughout, it was also filled with light and heat and noise as everyone bellowed ‘Oh Come All ye Faithful’ at full volume, the trumpets and tubas giving it large and the kettledrums and cymbals thundering and crashing. It was exhausting, but so wonderful.

And then, 2020.

We didn’t think we’d get to the cathedral at all that year, but the decision was made to hold mini carol services – five of them – across two weekends, sung by small groups from the cathedral’s own choirs, with congregations being admitted by ticket to sit in household clumps, face masks on and no joining in please. It was dark when we got there, and raining, and the streets in Coventry were empty. The people attending the service, not many of them, were stretched in a silent line outside the doors, big gaps between them, masks on, no talking. Inside too, the lighting was low and chairs stood in lonely islands of two, empty acres of space between them (though my husband did firmly go and get a third chair so he and I and our daughter could sit together). I didn’t realise that the lady who let us in was someone I’ve sung with for years – her hair had grown and I couldn’t see her face or hear her voice properly, and when a small choir of girls filed silently in followed by the director of music looking extremely severe, I found it difficult not to cry. In fact for a considerable part of the service I did cry, which was such a pain as it misted up my glasses and I couldn’t wipe my eyes or nose because of the wretched mask.

But something interesting happened as I sat there struggling with all of this. Because, I think, of the quietness and the emptiness, I started to notice the cathedral itself – to feel its presence around me, to see its bones. There is an enormous tapestry there behind the altar, a vast portrait of Christ – strange and distorted and Picasso-like, full of symbols and odd colours – and it is very cleverly lit so that nearly all of it is in shadow except for Christ’s face, with piercing eyes that seem to look directly at you wherever you stand. In front of it are flights of highly stylised wooden doves fixed to the tops of the choir stalls, silhouetted against the tapestry as sharp crisscross shapes. There were lines and lines of tea lights on the ground along the steps, around the base of the pulpit, across the altar rail – like twinkling necklaces of light, reflected in the polished stone floor and casting strange upward shadows on the faces of the choir. And not singing and not joining in the spoken stuff meant I really began to listen – to the quietness of the building, to the sounds from the city outside, to my daughter breathing next to me, to the words of carols I know so well that I stopped hearing them years ago. It was like a sort of warmth creeping over me – I could almost feel it coming up from the floor and gradually making me feel better.

One of the canons gave the address. She looked as if she had been crying herself. ‘It’s not right, is it!’ she cried passionately. ‘That we’re separated from the people we love, that so many are afraid, or sick, that millions have lost livelihoods and now fear for the future, that our young people are missing out on friendships and education, that there’ll be empty places at so many tables.’ But, she went on to say, Christmas has never been ‘right’, not from the beginning. ‘Think of Mary’, she said. ‘So young and so vulnerable – having to give birth to her first child without her mother and aunties, not even with a proper roof over her head or a bed to rest on. Just a pile of straw and a man who wasn’t sure he even wanted to be with her at that point.’ I thought of my colleague, about to have her first baby, with her birth plan and her ‘nesting’ and her husband spending half the night wrestling with the new pram – so loved and precious, not lonely or homeless or disgraced.

‘And what about the shepherds?’ the canon continued. ‘Outcasts, forgotten ones, the lowliest of lowlies, poorest of the poor – but it was they who the angels visited. And it was only common sense that took the Wise Men to Herod’s palace. They were seeking a king after all… but they couldn’t have been more wrong, could they!’

Christmas is always all wrong, in other words. It’s meant to be. It’s meant to subvert the order of things, to teach us new lessons, to get us to think differently. So in many ways, the horrible upside-down 2020 Christmas with the world in disarray was just like the first one. And as with that one, there was light and wonder to be found, which darkness has never quenched yet.

It doesn’t matter, I don’t think, whether you believe or don’t believe in the existence of God: the fact is that the nativity is an extraordinary story that has guided millions of people for centuries, and inspired and comforted and influenced them in all kinds of ways. Even by itself, that is amazing. And the miserableness of Covid and upset and disruption and spoilt plans were – weirdly – the reason that I heard the story differently that year.

It is all right for things to be all wrong.

And because of hearing it like this, I have found that it’s given me a new kind of resilience – a higher capacity for tolerating wrongness; a cheerfulness that is not entirely centred in everything being fine and everyone behaving beautifully. Which, let’s face it, is just as well… and probably the very best gift that Christmas can give to anyone.

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Article

Care

Change

26 July 2024

6 min read

Are we forgetting how to care?

The profound act at the heart of nursing.

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A nurse bends beside a bed and talks to a patient

Marie Curie.

Recently, at a nursing leadership programme in Oxford, attendees focused on the fundamentals of care. Have we forgotten how to care? What can we re-learn from those who pioneered an ordinary yet profound act that affects millions?

Anam Cara is an old Gaelic term for ‘soul friend’, a person with whom you can share your innermost self, your mind and your heart. It is a term that Tom Hill, former chief executive at Helen House Hospice in Oxford, used to describe the relationship between his staff and the thousands of children and their families who passed through their ‘big red door’ in its first twenty-five years. The hospice (or ‘loving respice’ as it became known) had been founded by Sister Frances Dominica in 1982.

Other care in this country can also trace its religious roots. Between 1048 and 1070 in Jerusalem, the Order of St. John was founded for the purpose of helping pilgrims (“our Lords, The Sick”) who had become lost, weary, or beset by other difficulties while on their way to the Holy Land. Today, in the United Kingdom, the British Association of the Order has extended care to older people first in almshouses and later in care homes. A trustee for ten years was John Monckton, a man of ‘considerable talent, enormous integrity and deep religious conviction’; his tragic murder in 2004 led to the creation of the John Monckton Memorial Prize, which recognised and rightly celebrated commitment to care by care workers.

Today, across the world, seen and unseen, nurses, carers and families continue to provide compassionate care. “Assisting individuals, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge” is the very essence of nursing, captured by ‘architect of nursing’, researcher and author Virginia Henderson in 1966. Meeting more than basic needs such as breathing, eating, drinking and eliminating bodily waste (which are of essential importance), Henderson recognised the role of the nurse in enabling humans to communicate with others, worship according to their faith, satisfy curiosity and sense accomplishment.

In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care?

An uncomfortable truth brought out in healthcare reports such as the Final Report of the Special Commission of Inquiry (The Garling Report) 2008, and the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (The Francis Report) 2013 is though that this type of nursing is too often done badly or even missed, leading to pressure injury, medication errors, hospital-acquired infection, falls, unplanned readmission, critical incidents and mortality. According to nurse scientist and scholar Professor Debra Jackson, “missed care occurs much more frequently than we might think”. She cites a systematic review in which ‘care left undone’ on the last shift ranged from 75 per cent in England, to 93 per cent in Germany, with an overall estimate of 88 per cent across 12 European countries’.

In one offensively-titled paper, “Shitty nursing - the new normal?” (in which the authors apologise for the title but not the questions raised), real-life pen portraits are drawn of patients lying for hours on hospital trolleys, immobile through infection or injury, ignored by staff. Whilst acknowledging contextual factors for poor care, such as a shortage of nurses and resources, the authors argue that circumstances cannot be the sole cause of missed nursing care.

A report published by the University of Adelaide, School of Nursing, has called for nurses to ‘reclaim and redefine’ the fundamentals of care. It asks whether the cause of the problem (of missed nursing care) lies “deep in the psyche of the nursing profession itself?” “Has something happened to the way modern nursing views and values caring?” it continues. “Indeed, is nursing in danger of losing its claim to care? In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care? Or is this a broader social pattern where individuals are less inclined to show kindness, compassion, and care for others even if it is a necessary requirement of the job?”

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness.

Writing in the British Medical Journal, Professor of critical care medicine Peter Brindley and Consultant in intensive care Matt Morgan wonder whether doctors also “too often default to high-tech and low-touch” when patients are dying – a time “when community and connection matter most”. They powerfully begin with a mother’s comment: “Humans are gardens to tend – not machines to fix.”

Professor Sir Al Aynsley-Green, the first National Clinical Director for Children in Government and former Children’s Commissioner for England, and past president of the British Medical Association, suggests that we as a society need a “momentum for compassion”. Struck by the extremes of compassion witnessed during his wife’s treatment in the last years of her life, Sir Al wants to see a cultural transformation in healthcare: for compassion to be a key operating principle in NHS and care settings, led by the Chief Nurse’s Office; for every organisation to promote the importance of compassion at the professional level; for the views of patients and families to be sought regularly; for much earlier and better focus on compassion in undergraduate and postgraduate teaching programmes for all staff; for compassion to be inspected against by the Care Quality Commission; and for a willingness to encourage staff at all levels to expose poor practice as well as celebrating excellent care.

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. “It’s putting yourself into somebody else’s shoes – and doing something about it.” Recently appointed the UK’s first Visiting Professor in Compassionate Care at Northampton University, at the age of 80, Sir Al certainly is doing something about it. He has made it his new purpose in life to “embed compassion into every aspect of care”.

Like Sir Al, Queen Elizabeth II, the UK’s longest serving monarch, espoused compassion, in word and deed. Living a life of compassionate service, the Queen made clear that her Christian faith was her guiding principle. She speaks of Jesus Christ as ‘an inspiration,’ a ‘role model’ and ‘an anchor’. “Many will have been inspired by Jesus’ simple but powerful teaching,” she said in her Christmas Broadcast, 2000. “Love God and love thy neighbour as thyself – in other words, treat others as you would like them to treat you. His great emphasis was to give spirituality a practical purpose.”

When nurses do unto others as they would have done unto themselves, and act as role model to colleagues, not only do patient experiences of care and their outcomes improve – but so does job satisfaction for nurses: a critical factor in nurse recruitment and retention – the biggest workforce challenge faced by healthcare organisations. Across the UK, there are currently more than 40,000 nursing vacancies, and thousands of burnt-out nurses are leaving the profession early. Whether nurses decide to stay or go is driven in part by their daily experience at work. The late Kate Granger, Consultant in medicine for older people, inspired Compassionate Care Awards in her name, envisioning that such a legacy would drive up standards in care - and surely also help retain nurses, through restoring a sense of pride, achievement and fulfilment to the nursing workforce.