Who’s by your side?

It’s tough to watch A Good Person. Its laser focus and tenderness prompts Lauren Windle to recall her experience of addiction and recovery.

Lauren Windle

Lauren Windle is an author, journalist, presenter and public speaker.

An old man accompanies a young woman into a wood-panelled hall, both look aprehensive.

Morgan Freeman and Florence Pugh in A Good Person

Metro-Goldwyn-Mayer.

I don’t watch films about addiction. When I first got clean and sober almost nine years ago, I soaked in any piece of content I could find on drugs, drug use and recovery. At the time it was just YouTube clips of Russell Brand and the occasional memoir of a starlet who turned to cocaine before discovering yoga. After going to a 10:30am showing of Amy Winehouse documentary film Amy and bawling through the entire film, I decided to call it quits. I don’t need to see horrific stories of desperation – I’ve lived one. I am not a casual observer of addiction narratives; I’ve got skin in the game.

In 2018 I went to see A Star Is Born thinking I was watching a rags-to-riches tale of an unlikely popstar. I quickly realised we weren’t there to witness the female protagonist’s ascent, so much as the male protagonist’s decent. I got back in my car and had to wait a quarter of an hour for the fit of hysterical tears to pass before I drove home. I had the same realisation watching A Good Person.

Going in I knew that I had signed up to a film with Morgan Freeman and Florence Pugh. I knew that Pugh’s character Allison “had it all” before a “dramatic accident changed everything”. The ground here sounded so well-trodden that I thought I may need my wellies to navigate it. I knew that there was some element of addiction, but I envisaged a reasonably light touch depiction of a few too many nights on the sauce.

I knew I was wrong when, about half an hour in, Allison lay on the cold bathroom floor to soothe her withdrawal from prescription opioids. She was sweating, shaking and breathless and from then on, it all felt distressingly familiar. The trajectory of her decline was too quick, too obvious, too accurate. As Allison bargained, manipulated and begged for drugs, I saw myself. As Allison looked directly into the mirror and said: ‘I hate you’ to her own glazed reflection, I saw myself. As Allison was dragged out of a stranger’s house party unable to stand up straight, I saw myself.

The hopelessness, the false starts, empty promises and rare moments of lucidity rang so true, that I would find it hard to believe writer Zach Braff hadn’t experienced his own similar hardship. Either that or the recovering addicts they hired to consult on the project deserve a bonus of investment banker proportions.

When Allison eventually reached out for help and asked a woman to sponsor her, the loving directness that came back was reminiscent of those I was given by my first sponsor. It was virtually word for word what I remember being told when I, nine days sober, made the same terrifying request. The experienced mentor told her: “Some beat it, some die.” And she’s right.

Any of my friends who went to an in-patient treatment centre were told to look around because in five years a decent number of their cohort would be dead. And they were always right. Some people give up and let the tide of addiction pull them under. They feel exactly as Allison did when she told Daniel (played by Morgan Freeman): “I’m not sure I have the will.” And when she confessed in a Narcotics Anonymous meeting that: “Without [the pills] I want to die.”

In the 2015 film Amy, the one that convinced me to stick to rom-coms, there’s a scene that stuck with me. Amy had been invited to perform at the Grammy’s but was denied a visa because of her well-documented drug use. It was arranged for her to live perform in London and it would be broadcast on big screens at the event. When the date came around she was in a stint of sobriety. She performed beautifully and won five Grammys. One of her friends burst into her dressing room to celebrate the momentous achievement but all Amy said was that it wasn’t as good without the drugs.

You learn to love the cage you built around yourself and stop dreaming of more, because you are blind to anything beyond the walls you’ve created.

Getting into addiction means silencing that feeling in your Spirit that says that something isn’t right and you should go home. It’s consistently pushing through when you get a pit of your stomach urge to cut and run. Because you want the drugs, so you know you’ll have to take the chaos they’re packaged in. At some point you stop remembering that you ever felt uncomfortable, and you start to think you enjoy where you are, what you’re doing and the people you’re doing it with. You get Stockholm syndrome and life before your captor is a distant memory. You learn to love the cage you built around yourself and stop dreaming of more, because you are blind to anything beyond the walls you’ve created. You’re not happy, but what other options do you have? You could trade the misery of addiction for the misery of abstinence, but either way you’ll be miserable so you might as well do it with the drugs.

Except, that’s not true. When we’re living our lives right, we’re living them in complete freedom. Slaves to no substance or behaviour with the freedom to say yes to what we want and, crucially, the freedom to say no. It’s the present Jesus gave us in the resurrection but so many of us, myself included, hand it back like it came with a gift receipt.

I wish I’d known the dreams that would be realised, the friendships forged and the profound moments I would experience on the other side of those first, excruciating months of sobriety.

What I wish I could have told Amy at the Grammy’s, Allison in that NA meeting and myself when I first said the words: “I think I’m addicted”, is that there’s so much more than what you can currently see. I wish I’d known the dreams that would be realised, the friendships forged and the profound moments I would experience on the other side of those first, excruciating months of sobriety. I would have wanted to know that in time my grip would loosen, my knuckles would go from white back to their fleshy hue and I would be able to breathe again. It wouldn’t feel like a compromise or half a life or as though something was missing, but I would feel more fulfilled and alive than any drug would ever allow me.

A Good Person demonstrates the chronic and repetitive condition of addiction with a laser sharp accuracy that, for someone with lived experience, could burn. But it’s also a tender reminder of the power of unlikely friendships forged from a mutual understanding of adversity. It made me think of the woman who scooped me up as I backed away from my first ever support group meeting and said: “You can sit next to me.” It made me grateful for the woman who mouthed “it’s going to be OK,” at me across the table as I sat there listening with tears rolling down my face. It reminded me of the awe I felt the first time I heard someone speak about the insomnia, shame and self-hatred of drug addiction, and I realised I wasn’t the only one. The film showed the transformative effect of consistent community in a way that I hope encourages people to turn up to one of those meetings like Allison and I did. I pray that it is the turning point in many people’s lives.

Should you go and watch it? Absolutely. Just don’t ask me to go with you.

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.