Friday, 22 October 2010
PATIENCE (press release)
Wednesday, 22 September 2010
Book Launch at Stepping Hill Hospital
schools of nursing
In response to our new book Patience, Advance Nurse Practitioner, Fiona Roscoe has written:
The stark honesty and desperation expressed by a stroke patient in 'Ever' provides a frightening insight into her world. I would advocate that schools of nursing examine their curriculums and ensure that students are given an opportunity to experience the art produced from this project as stopping to listen to what patients are telling us is key to knowing what needs to be done to help them.
waiting and waiting and waiting and waiting
a cancellation
put me back again
a slight stroke
couldn’t move my arm
so I lift it with the other one
don’t let it lie dead
rub the back of your hand
keep it going
and then it’s un-frozen
waiting and
try to keep moving
haul yourself
with a walking stick
to your exercises
tried, tired and knackered
they train you, so
if you fall in the house by yourself
trapped
but only in part and some remains
waiting and
trying to open the door
try to get to the phone
try to climb a step, up four inches
(one bad leg, two arms, nothing 100%)
terrifying thinking about it
don’t think, try to
get on, to stand
on ice.
Anonymous
24-31 July 2009
Tuesday, 21 September 2010
Patients reading PATIENCE
"It brings a new outlook from my point of view, reading this book. It makes you think of something else in life, apart from yourself. You cheer one another up." (Madeleine)
"It's terrible in here, impossible to describe. You have to live it to understand. It can help a little to hear other's experiences. A little. Please come back again and read more poems." (Douglas)
"Very good that, very true. Pass it on... It's openness. You bring things out in people, so people don't close to you... a book like this is useful to read, helps with the patience, you need a lot of patience in here." Jean
We also shared the book with staff, many of whom remembered particular people featured in the collection. As so often happens, they said that they wished they still had time to talk to the patients as we are able to do.
"The emotional side gets overlooked. Without that, you are not treating people in depth. If a patient is in the process of getting better and they have psychological or emotional problems, they won't get better as easily. To verbalise and express their problems, they feel lighter, better... If it's repressed it affects them.
Conversing with them helps. They are away from their environment, in fear. Time is a factor. Take a minute or two, take time to listen and reassure them. Reading them this book will give them an idea of what a patient can expect to go through."
(Staff Nurse Mioji Baloguh)
On E1 the Stroke ward, we read poems to patients Madge and Marjorie, they commented:
"You feel very shaky and that, not kind of with it, you can't vision yourself. This book, it gives other people something of what you feel like."
A daughter, visiting her mother who'd had a stroke two weeks ago, said:
"The book would be nice for when they start recovering and can start reading - if they can't put their feelings into their own words, they could use the book to help." (Amanda)
We hope that PATIENCE will be helpful on the wards, a conversation opener, a comforter and perhaps a communication aid as Amanda describes. There's a point when a book, having been published, starts make its own way, separate from the the makers. As we put PATIENCE out into the world, it is now starting to do just that, to have its identity inscribed by its readers.
Thursday, 16 September 2010
Images of Patience
Wednesday, 15 September 2010
The Art of Nursing
There were times when I was reading this book that the hairs on the back of my neck stood on end and I felt my eyes prick with tears. With over 20 years clinical experience I value and embrace those qualities which we consider as a profession to be 'the Art of Nursing'. What this book does however, is give you 'the Art of patients'. Connecting with the meanings of the pictures and words has been profoundly humbling.
Fiona Roscoe RN DN MSc BSc(Hons) is an Advanced Nurse Practitioner (Primary and Urgent Care)
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Tuesday, 7 September 2010
Close-reading PATIENCE - by Matt Dalby
Margaret Hargreaves’ Be Patient includes the line ‘was a dressmaker’. There is a sense here that Margaret may no longer be who she was, or at least may feel she is no longer who she was. But it is not a sentimental, nostalgic, ‘when I was younger’ reverie. It is a lot more interesting than that. Here are skills and experience, here is something that makes the loss or impairment of capabilities with illness become more real. Here is something that is often hidden.
Anecdote. An elderly Muslim man in Trafford walking slowly around two parks supported on either side by two young women who appear to be his daughters. The sight is only striking because it is so unusual.
But this is to make assumptions. The assumption that ‘was a dressmaker’ refers to Margaret Hargreaves herself. The assumption of impairment through illness. The assumption that the women supporting the elderly man are his daughters. The only assumption for which there is any evidence is the first of these:
‘I call myself
a quiet person
was a dressmaker
if a stitch went wrong
I set it right
in two words, two small words’
But without knowing the author, and without knowing how the poem was put together it is a dangerous assumption to make. And even if it were a simple statement of fact about the author it only provides limited information. Many people could say ‘was a shop assistant’ and it would tell you precisely nothing about them.
Even so, this is a relatively straightforward poem in comparison to a poem like Doreen Jones’ Thee Thy Summer, which is much more fragmented. Thoughts are abandoned partway through, broken into fragments, and revisited later. The kind of fractures recur throughout the collection. Numbers play a large role in the text, as if they are fixed points within a generalized confusion:
’21 x pills a day’
‘fell 4 x times’
‘7 in morning’
Some numbers, especially 21, recur in the poem. So too does 7. The poem itself is arranged in six stanzas of seven lines in pairs across three columns, which might be read as three sonnets. But there is an ambiguity introduced by fragmenting the poem that means the poem need not be read down each column in turn running left to right. It is also possible to read each line across the columns, or the first stanza of each column in turn. Both of these reading give a poem in two halves of 21 lines each.
The first stanza gives a good sense of how the poem is constructed, and contains words and phrases that recur in the rest of the poem:
’21 x pills a day
make sweet thy beauty
parkinson’s you see
started vertigo
dizzy all the while
fell 4 x times = smashed face
started parkinson’s’
’21’, ‘make sweet’, ‘thy beauty’, ‘parkinson’s you see’, ‘started’, ‘vertigo’, and ‘parkinson’s’ all appear again. Even while broken into pieces the poem circles itself, its own areas of concern, giving it a unity and coherence it might initially seem to lack.
This does not seem designed to imitate any particular mental confusion so much as it feels like an act of resistance. Illness is defined more by medication than by symptoms, and both are an inconvenience. And here and there some aspect of a person (the subject of the poem? the author?) keeps slipping out. This is not loss but an ongoing negotiation with life and illness.
From the four sections I have read this idea of an ongoing negotiation with life and illness is a consistent theme throughout the book. For me this allows for a far greater human interaction and identification with the experiences of the authors than some sentimental veneration of their wisdom and remembrance of things past. To acknowledge the frustrations, pain, anger and limitations of age-related illness is surely more healthy than a vague sympathy. It does not make for a comfortable read, and the poetry is not instantly recognizable as the personal reminiscence and anecdote in conventional forms you might expect from a project of this nature. To my mind this is a good thing. It is more interesting and compelling for the reader.
It would be interesting to know whether the experience of creating the book was more satisfying for the participants than just writing a set of conventional personal reminiscences. Certainly one of my initial thoughts in response to being approached to comment on the book was that experimental approaches, being less codified, less familiar, might be more accessible than more conventional poetry. We all have an idea of what conventional poetry should look like, and that it has a number of rules that we do not understand. These preexisting ideas can limit what we feel is possible, and therefore what we ultimately produce. Whatever the truth, the more experimental approach has led to a book you are actually likely to read and return to, rather than pick up out of sympathy and never open again.
Matt Dalby is an experimental poet whose works take shape within multiple approaches and mediums, including sound and visual making. His blog Santiago's Dead Wasp is a key journal of experimental writing and related events in the North West of England, as well as a document of Matt's ongoing project. His extraordinary communal Mutapoem is world-embracing.
Friday, 3 September 2010
Reading PATIENCE - by Scott Thurston
‘take pills like new ideas’
(acceptance, chpt 5)
This latest offering from arthur + martha is a collection of poetry, text and artworks based on older people’s experiences of ill-health and hospitalisation. Divided into five parts, its structure is based on the five stages of the ‘cycle of grief’: denial, anger, bargaining, depression and acceptance. What is remarkable about a+m’s approach is that they use a whole host of techniques associated with innovative and experimental writing in order to frame people’s experiences. The results are simply extraordinary. In these works, the notion of writing and creativity as ‘therapeutic’ does not do justice to the seriousness and the ambition of the project, which is experimental in the truest sense. The diversity of the approach is key. In one strand of the project, creative work emerges from the charged objects of the everyday: medicine boxes getting a makeover by acquiring new labels like ‘take one glass of sunshine a day with water’ or ‘all’s well that ends well’ – the latter on medication for trapped wind relief! In another strand, it is postcards – pictures of famous buildings cut out and stuck on the reverse, creating a new space for words – in another (‘Lost and Found’), text is appended to actual objects – poignantly the label ‘Lost – your husband or your wife’ is attached to a tiny, empty chair.
Aside from these text-objects, there are many poems in the book – some co-authored and often produced using collage and/or cut-up techniques. Ron Miles’ ‘The Old Grenadiers’ is a particularly effective poem which opens:
'you’re 96 years
thy image
an old Grenadier'
(anger, chpt 2)
A stoic meditation on ageing, Miles’ narrator has ‘pain’s / red medal round my neck’ but is still able to conclude: ‘though new-fangled ill / this old dog’s prouder still.’ Elsewhere, Allan Whittaker and Frank Wigley offer a collaborative work, juxtaposing accounts of football history with a patient’s current predicament in a poem called ‘Football’ which is shaped like one on the page. Thus the story of the Busby Babes and their fate in the 1958 Munich air crash leads to some striking reflections:
'you’ve got to be determined to stay alive otherwise this world will see you off falling
into chaos somebody needs to mop the world nurse sort the ends out I’m sat in a
chair thinking literature I cant express god’s fire in the head'
(bargaining, chpt 3)
What is most impressive here is how the innovative techniques employed lead to a genuine creative opportunity. These poems show that an approach to creativity that recognises and utilises language’s physicality and malleability, immediately makes a connection between body and art object. By bringing creative practice closer to embodied experience, and breaking habits – of thought, of feeling, of experiencing – along the way, it is clear that these authors find new ways to express complex physical states that might be hard, or impossible, to achieve by other means. Illustrative of this, a group poem entitled ‘Now My Genius is Gone’ mourns the loss of creative autonomy but simultaneously finds the means for its recovery:
now my genius is some worthless song
I use a lever a little
and it comes back.'
(bargaining, chpt 4)
The personal empowerment resulting from this approach is testified to over and over again in these pages. Another group poem, entitled ‘A Kingdom’ argues ‘a body case / can’t case your mind’ and identifies the meaning behind the central pun of the title:
'when you’re in pain
teaches you something
teaches patience'
(acceptance, chpt 5)
Raymond West, the author of two excellent poems in the book, also comes out fighting in ‘Overcome’:
'have a bout with life
live to the full
with
an incurable disease'
(acceptance, chpt 5)
There is much more to admire in this beautifully-produced book: terrific photographs of the authors – including an impressive double portrait of Violet Gamble – and a series of text-images entitled ‘our needs are very small’ which link writing with images of wards. There are also several highly informative interview-articles from the perspective of various practitioners – care assistants, nursing sisters, a diabetic nurse, medical directors – offering insightful reflections on their experiences alongside more detailed accounts of working with dementia, Alzheimer’s and Parkinson’s.
A key message emerges in this book about trust – not only the trust to be won by care practitioners and creative workers such as arthur + martha, and to which end their creative strategies are invaluable – but also the trust to be granted to those older people in care contexts. As Stephen Watkins argues, the expectation of dependency that many of us have is one to be resisted, otherwise care can too often slide into control. As Watkins puts it:
'You mustn’t become dependent before you really need to – and also when you are dependent, you still should be allowed to make choices, be trusted to take risks.'
(bargaining, chpt 3)
It is clear from the breadth and verve of the work of this book, that a trust in risk-taking has been fully embraced by everyone involved – in this way fulfilling the experimental essence of creativity.
Dr Scott Thurston
Scott Thurston lectures at the University of Salford where he runs a Masters in Innovative and Experimental Creative Writing. He co-runs The Other Room reading series in Manchester, edits The Radiator, a little magazine of poetics, and co-edits The Journal of British and Irish Innovative Poetry with Robert Sheppard. He has published three collections with Shearsman.
Friday, 16 July 2010
Download Patience

Thursday, 3 June 2010
Pain and care
I think, correctly, people will find expressions of pain uncomfortable for the person whose hearing it, so that they don’t… maybe their protecting the audience. It’s a lack of faith, that people can deal with other people’s pain.
(some people will talk about nothing else but their pain/condition..)
That’s what I mean about support groups, letting something absolutely and totally dominate your life. Which allows that thing to define you.
A sense of humour is terribly important. It’s true that people mitigate difficult conversations with humour, and it may not be appropriate if their not in that place. I would say I have a pretty strong sense of humour and that helps.
I do believe in being upfront about whatever’s going on, and you’ve found that then promotes others to talk themselves. Maybe its having been in the caring profession, it’s no good hiding things. By bringing something out it makes things easier to cope with- that’s the function of art isn’t it?
(some peoples personality, you warm to and want to care.. I was thinking about Mary Hartin, she could hardly communicate with words, and yet you just wanted to be with her)
She was a very open person a very giving person.
(I imagine as a carer it would be very easy to care for her)
definitely
(in our sessions, she was life and soul, even though she had so few words, her body, her eyes her face communicated so much.)
Primo Levi had this concept, of hope, that he believed people survived the concentration camps because they maintained a sense of hope.
People have felt about the American positive thinking, about how you deal with cancer- leads you to either feeling if your not surviving as it where, then you are somehow guilty because you haven’t led a decent life, or you’re not thinking in the right way.
(putting the blame on the person, rather than the condition)
That somehow you can find this magic formula in life, and going to live forever…It puts a blind fold across you, shutters up. Being tested is interesting, living is interesting- so will dying be I imagine.
Alison Creed in conversation
Tuesday, 11 May 2010
Caring and dementia

Anne Sadler and Anne Parry interviewed at Bluebell Ward Dementia Day Centre, The Meadows, Stockport, 2009
Ann Parry
Our job? Making life a little better, making it fun.
Anne Sadler
Treating people as you’d wish yourself or yours to be treated – as individuals. People aren’t a condition, it’s individualised for all of us. As health professionals we are in a privileged position to be with these people. Carers are often talked about as the ones who have to give their personal lives, their time, their caring, and so on. But the flipside is what we get from it- we get people’s histories, lives, wisdom.
Ann
We also get their trust. Making them feel wanted, because they might feel they don’t fit in anymore and they need reassurance. We can give that, among other things. You feel better about yourself because you have given something. I’ve never wanted praise, just that the patient feels settled and enjoys the group. If I can give that, I feel better.
Anne
You might not be having a great day, but if you catch glimpses of people, it brings you back to where you are and what you’re doing. It grounds you.
Ann
What we’re doing is caring for someone. We give life. We give choices, so they can make their mind up about things. We give them our attention.
Anne
Compassion fatigue can happen, I’ve seen it. The only thing I hope for is that if I burn out that I’m able to realise, because that is the time that I give up this job. If your compassion goes, you should go. A partner can lose compassion. They have to deal with it night and day, but we can go home at the end of the shift.
Anne
We try to keep sight of the fact that these people are made up of their own lives, which they can articulate and feel, despite the dementias. We need to keep listening, maybe listening more intently to people who are unwell. I liken it to day-to-day conversations where I will listen with half an ear. At work it’s very important that I give my full attention, truly listening.
Ann
Otherwise you make assumptions and they get frustrated.
Anne
The way people behave is explained partly by knowing their history, it helps you piece together what they’re saying now. I remember 30 years ago in residential care a lady with fists clenched, shouting. It didn’t make sense at first, but then it transpired that she was bothered about something that had happened from years gone by. That was the essence of it.
People cope with dementias the same way that people cope with physical issues. They get the strength from somewhere, faced with any illness.
Ann
With dementia, as with any illness there’s some who fight and some give in. Some want to be looked after, dependent. If the carer is fed up and doesn’t want to give care then these people have problems.
In the poem written in the workshop I liked the image of dementia being a bit like getting off a bus in the rain and not being able to tell where you are.
Anne
I like images of dementia to be more than just confusion. I like them to be lighter and brighter, that it isn’t all a dark journey. That’s what I’d like to get across to the general public. TV images of dementia as sadness I don’t agree with. You always get this awful chamber music and shots of gravestones. There is happiness too. It’s not all the time, but it is there. And are any of us happy all the time? No!
If we can help channel the happiness – and the anger too - that’s our job. If we can take some of the anger it helps them. It’s not always pleasant, but it isn’t about us it’s about them. There’s a balance to be struck and people who attend as staff are aware of this. People’s emotions change as their illnesses progress. Some kind be insightful at times which can bring comfort, but at times can make them angry. “Why me?”
Ann
In the early stages a dementia can be awful, especially in young onset. People giving up jobs, big effect on the family.
Anne
Part of our job is to help people with that understanding. People can be angry, seem nasty, threatened. But it’s up to us to look beyond that. When I do home visits, very often it’s my job to help them maintain independence, not to take it. People worry about independence going.
When we talk about independence going, we often talk about this big whole. But there’s fractions of independence and they are important, little flags of independence. So for example, self-care might be very important to one person and not to someone else. Social independence – just the ability to socialise – can keep people going. If you chat to someone, that’s your choice and you’re exercising independence. A lot of it comes down to choice. It’s the same with our help. If we explain what we are doing and they give assent, then they are still showing a sign of independence.
Wednesday, 31 March 2010

Tuesday, 30 March 2010
golden lads and girls
Friday, 26 March 2010
Switching your thoughts

Whilst drawing with a patient last week, I asked for her response to the terms:
Anger
What’s the use of being miserable? Am I being frivolous? Just plod on and take what comes… get a bit uptight but not angry. If you get a bit uptight, it affects other people, you get snappy with them.
Bargaining
Switching your thoughts to suit other people, to get what you want.
Depression
I don’t get depressed, I get cross. Its hindering me and my nerves do this when things tidderling me. I get fed up but I’m not depressive. When you get fed up you get cross, when you get depressed you get miserable. All that’s making me cross is being stuck in here. Can’t be doing nothing.
Anon
March 2010
Monday, 22 March 2010
Stepping Hill Hospital at Night (after Vosnesensky)
coughing at night
other breathing at night
people tend
droning to sleep
quietly
nurses’
footsteps
low light faces
the television
an adventure
of dark blue glass
constant
quiet breath engine
in their beds
three or four
calmed
safe
people
moving that’s the thing
I want to hear
people
X-ray photos of the soul
lonely
speak to me with dark tongues
lone
night
yawning
Ralph Starmer and Keith Philips
Stepping Hill
Thursday, 4 March 2010
night pains

I feel tight
feel clempt closed
always thinking trying
nighttime terror couldn’t tell you
a bit of a trouble-ful night
pains
hospital comforts: the beds are alright
the nurses are alright
the specialist said, “I can operate but…”
furious winter is in our stars
all the time many a time
I m always trying to look up
a-wondering what
to think of life itself
a bit of a trouble-ful night
pains
they do damn good work
specialist saved my legs for me
he was practically dancing
hope is a lot of things
group
Cherry Tree
2007
Tuesday, 23 February 2010
a locker

a locker is a sort of miniature you
haven’t much room on-ship
roll your mattress rope around
hammocks slung sausage-like
these curtain rails carrying
a coiled rope and a heaving line
panic at the dock everyone swearing
doesn’t bother me a cramped situation
eight fathoms for your morning wash
around the beds in the ward
a rough bloody outfit
you was on the frontline
some of the roughest buggers ever
I’ll take you all
remind me of
a good rough house in the pub
was a favourite occupation
thorough gentlemen
below decks
hammock rails
remind: dear me you don’t half meet characters
limbs and bits of heavy engineering
the place exploding
you hit the floor
the clews as they call em
undo them strings beg a kiss
the nurses
stealing sailors’
hatbands for ribbons
Allan Whittaker
Cherry Tree
2007
Friday, 12 February 2010
phantom pain
from my sketchbook, 'Phantom Pain' © Lois Blackburn 2010. (Of course the Phantom Pain in question would be felt in the missing leg, not as illustrated here- in the existing leg!)started out cellulitis
like a rash creams and lotions managed
but you know how it goes
down the leg
on the foot
then they wanted to meet
can’t remember Christmas
my leg
could sit here and cry for eternity
wouldn’t put my leg back
occasionally I forget
roundabouts
going longer between spaces
I have phantom pains
like an itch a weird sensation
I want to scratch my foot
the foot’s not there
try to master mind over matter
can’t scratch phantom pains
sometimes it works
sometimes I still forget
Anonymous 8th July 2009
Tuesday, 9 February 2010
heart
Here's a page from my sketch book, based on the human heart, with selected lines from the poem 'Paracetamol Soup'. You can find more of my illustrations at www.loisblackburn.co.uk(what’s wrong with it?) can’t do without
home
the most important place
(love when I think of home)
love it’s true I daren’t say it
the bank writing me love letters
security, savings, minus, plus
my dad singing over the rainbow
throwing coins in the air
noisy
movement
my brother is bent double with arthritis
I am an expert in pain disabled incurable
backache we’ve all got it why haven’t you?
you’ve got to drink gallons and gallons of
paracetemol soup
we’ve all got it like income tax
there’s no escape
bloody hell, miracles
luck
love
October 2007
Monday, 8 February 2010
notable dates (a Kingdom)
has come to me in illness
in sickness
in my body
my mind
*
isn’t captivated
not shut in
here, but let’s face it
could be by the sea
walking on pebbles or moors in Yorkshire
surrounded by moors in happiness or anger
my mind is a Kingdom
although you’re in
*
the ward you
can take yourself out any time
some learn to live with poverty or riches
some with illness
if you suffer for very long
have to say: not going under
count your blessings one by one one by one by one
(a Kingdom: I like to think I’m by the prom
the noise of the pebbles
one by one by one)
***
you get an affliction
get very resentful
have to adapt to
ageing
those beech leaves just turning red
*
a body case
*
can’t case your mind
you adapt
see someone a lot worse
live with your limitations
when you’re in a lot of pain
teaches you something
teaches patience
*
Queenie Wall, Catherine Cannon, Irene Corringan, Mary Hulme
November 2008
Patience
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