All Posts by Chris Whit

1 See the whole person, not just the impairment: Reflections on a good medical appointment

Hello! Regular readers of the blog may recall that over the past 4 years (yes 4!) Fran has been working her way around the NHS in various ways in the search for an improvement to her day to day life. Let me rewind a little dear reader so I can give you an overview.

Four years ago Fran had a fall and unfortunately broke her foot. She was then taken to Accident and Emergency. Rather than waiting, the usual ‘patch and mend’ approach was taken at A&E to put Fran’s foot in a cast. However. As someone with Cerebral Palsy, Fran’s body doesn’t fit the standard presentation or course of action, or react in the same way to treatment in a way that is typical.

In a conventional situation, a cast is a response to a bone break, to both ensure it is immobile and/or to correct the position of a broken bone. As Fran was in significant discomfort, the quick decision was taken to put the foot in a cast.

The problem with this was that the foot was cast in an inward position, which caused ligament damage. What should have happened in this situation is for the medical professionals involved to recognise the particular nature of Fran’s circumstances, have a specialist called and leave well alone.

So work was needed to correct the original ligament damage and the pain caused as a result. This has taken literally three and a half years as various people have tried to find some sort of solution that improved things. Fran has lost the little mobility she had before the fall, and we had to very quickly move house as a result of what happened.

It has been four very hard years with a lot of lows along the way. During this time Fran has had some awful experiences and lost a lot of confidence and faith in the medical professionals she has seen, to the point where she now asks me to go with her to make sure she is listened to.  That it requires me to go with Fran at all is a damning reflection on some of the encounters she has had.

Fast forward to last week.  We had finally seen someone who ‘got it’ – someone who took the time to listen to Fran, to get to know her, see her and work with her.  You see, because of the Cerebral Palsy, a lot of the standard medical ways of dealing with things simply don’t work.

Fran also has a very detailed understanding of the way her body works, and what her impairment means.  In this sense, she is the expert, and will always be uniquely placed to understand what is likely to work.  In this sense, Fran needs to be an active participant in her treatment and work with the medical professionals together to find what is often a pragmatic solution.

I highlight and italicize the above words as this is exactly what happened in our previous appointment.  I will keep doing so in order to highlight the good practice in what was, for me, was the best appointment we have had during these difficult four years.

Firstly, the doctor came out to greet us and had clearly read Fran’s notes to remind himself of the case and where we were up to.  In the previous appointment he had seen the whole picture and taken a holistic decision to pause proposed treatment, allowing us time to take a much needed holiday which did Fran’s body a lot of good.

During a wide ranging discussion in which Fran was listened to and given the time and space to express her views we jointly discussed treatment options and the relative merits of them.  This led to an improved decision which aims to maximise the beneficial impact of treatment as a result of a collective discussion and Fran’s views being heard.

In the appointment, Fran’s background and circumstances were included in the notes for the benefit of future people that may see her and a copy of the notes sent to Fran shortly after the appointment.  The bold highlighted elements may seem like obvious things but are those which stood out because of the number of appointments where Fran had not been heard.

Fran and I came away from this appointment feeling elated and with faith and trust in the person we are working with and feeling more optimistic about the future. The proposed course of action will mean a long few months, but hopefully ones which will see an improvement. In words that left me with a huge lump in my throat after the appointment, Fran exclaimed ‘they saw me, they saw me!’

Above all, my key messages about working with someone who has an impairment are:

  1.  See them as a whole person. Don’t just see the impairment. Take the time to get to know them and see all the aspects of their life.

 

  1. Understand that in relation to their impairment they will often be the expert, and that in order to get the best outcome, you will need to work with them.

 

Seeing a patient, not the impairment shouldn’t be that hard, or that novel, should it?

The importance of relentlessness

I write this sat in the middle of our hotel lobby in Portugal, as we have reached a little over the halfway point of the first Football for All Leadership Course in Lisbon.  Over the past few days, we’ve had the privilege of hearing from some fantastic speakers at the top of their respective games, and bonding as a diverse group with much to learn from each other.  Thus far, the course has provided an invaluable space to critically reflect on my current practice and continued professional development.  We have learned about a vast array of things from the personal to the technical.  I raised a rye smile when my animal based leadership profile came out as..an Owl!

A further striking feature of the course has been that despite our truly global background, with over 10 countries represented on the course from across the world, is the common issues that we all face.  A big part of the solution comes from the shared learning of our experiences, drawing from the different contexts we have, and strategies we have used to make progress.  During the course we have had a couple of visits, including to the Portuguese FA and we are heading to the home of Benfica tomorrow!  Each class has raised thought provoking questions for our current work, and how we get better in the future.

On top of all these things, just one stands out – the importance of relentlessness.  It is clear that such are the nature, scale and stubbornness of the issues that we face, that only the highest levels of determination to address them will result in a difference being made.  Sustaining such relentlessness is of course far from easy, and requires a seemingly endless supply of energy that it won’t always be easy to find.

Such relentlessness should also not be mistaken for a blunt instrument.  Moreover, part of its success will be marked by the subtlety and judiciousness of its application.  Relentlessness does not mean indiscriminately shouting from the rooftops, nor tackling every cause.  It means the deliberate application of effort in a co-ordinated away to tackle problems, with the goal of making a positive societal difference for all.  Time and patience is also required, for the gradient of progress may be a shallow one, with a few bumps on the way.  Relentlessness and resilience will go hand in hand.

The rewards are also huge (and quite possibly the stakes too!) for the progress made will help society will be a better place and contribute to solving the collective issues which will make all our lives better. I am of the view that, in times where it is arguably easier to find what sets us apart than what brings us together, it is vital that we find common ground.  Locating such territory will not always be easy, and entail the negotiation of some really tough and sensitive issues.  For me though, inaction is not an option.

We must also celebrate our successes and learn from where things don’t go quite so well, taking the opportunity to learn and improve wherever we can do so.  As time passes, we must continue to innovate and not be afraid to be bold in our approach (a point which the course has emphasised throughout) and share our progress.

I am acutely aware that I may sound idealistic at this point.  We can and will make progress though…and that is the relentlessness talking!

Narratives, solutions and disability

How disabled people are represented is really important.  The stories, or narratives, we see about disabled people do a great deal, having the potential to impact on attitudes, thoughts and feelings in relation to impairment, for disabled and non-disabled people alike. Earlier this year I wrote about the contested narratives surrounding the representation of disabled people.

In this blog, I return to this topic with an updated theory, with reference to recent events.  I believe there is a battle going on at present to shape how we think about disability and.  The results of this battle, and how we choose to negotiate it, will have a critical impact on the lives and prospects of (and for) disabled people.

Policies

Recent events serve as a microcosm of this battle and the associated conflicts.  This month, the Department of Work and Pensions are holding a month of events to celebrate the value that disabled people bring to the workforce, via its much promoted Disability Confident scheme.  On the face of it, all appears positive.    The battle continues when a narrative is presented and projected.  The Sun reported that disabled people were getting jobs in record numbers because of the scheme.  A news search reveals a wave of events to promote the scheme and a variety of positive headlines.

However, scratch a little deeper and it all gets a bit more complicated.  In short, all is not as rosy as it would appear.  An indication of this comes via Work and Pensions Select Committee Report on sanctions.  This report found that sanctions, which are deductions from benefits paid to claimants, were ‘harmful and counterproductive’ for disabled people.  There appears to be a yawning gap between the policy rhetoric and the policy reality.  On the one hand, disabled people are being celebrated, whilst simultaneously subject to harmful measures.

Further evidence comes from a recent house of commons research paper.  This shows that the difference between the employment rates of those with impairments and those without is over 30%. The ‘disability employment gap’ remains a huge one.

Polls and Solutions

A further frontier of this battle is social media.  The disability community can be vocal about its struggles here, particularly in terms of disability benefits and welfare reform.  I too have been open about the difficulties I have encountered as a result of the PIP process.  It is here, on media platforms, where narratives are constructed.

I ran two twitter polls to ask people, if based on their personal, professional or voluntary experience, life was getting easier, harder or remaining the same.  Clearly there are limitations with Twitter polls, particularly as you can’t verify the respondents or ask them about the reasons for their answers.

What was clear from the polls was that both sets of respondents were of the view that life was getting harder and by some margin (70% of disabled people and 80% of non-disabled people.)

Stating the problems is in one sense the easy bit. This is where moving away from the battles needs to happen.  Towards solutions.  It is finding the solutions that is critical to moving everyone forward. This is where there is a need for an inclusive dialogue about how best to move forward, which involves disabled people in a meaningful way.

That is the problem with narratives.  They don’t always either a) tell the complete story and b) allow for stories to be told in a nuanced way.  Having narratives effectively serves to obscure and amplify problems by the creation of false positions and often dichotomies (e.g. deserving v undeserving.). The power of narratives lies in their ability to enhance understanding – by opening up our capacity and space to communicate with each other.  We need to do this more so than ever before, by recognising what can unite us and not divide us, in a way that respects our differences and celebrates them.

What is needed in my view is a greater focus on solutions and a greater emphasis on understanding.  Perhaps taking the politics out of things will help too.  Call me hopelessly idealistic if you like, but I think people’s lives are too important to be ‘spun.’

In short, what we need is not battles and polarised narratives, but solutions as to how to make life better. For everyone.

The Final Straw

In this blog, I focus in on current developments around the proposed ban on plastic drinking straws.  I look at this both as an issue in its own right and relate it to wider, more general matters.  In summary, I think the straw ban illustrates how the needs of disabled people are increasingly marginalised, and how this can be responded to.

Without being able to effectively convey their views using the right channels, hooks and levers, there is a risk that the views of disabled people will continue to be marginalised in policy making.

Why it isn’t ‘just a straw’

Simply put, straws are an essential for a lot of people.  My wife is one of those people. Without a straw she cannot drink at all for any purpose from the every day cup of coffee to when she needs to take tablets. Such is the importance of the straw that the availability of them (or otherwise!) has been known to fundamentally alter plans. Now I never leave home without them!

On occasions, we have been supplied with non plastic straws, especially paper ones. The paper ones in particular have almost with exception been very poor substitutes. I often think that people who suggest using them have never had to actually do so themselves.  There are other options, such as reusable straws, which have not proved to be hygienic or practical (using a public sink to rinse them out is not fun!) or comparatively very expensive and themselves impractical (see bamboo straws and metal straws.)

It frustrates me when people refer to them as ‘just’ straws.  Imagine going to a restaurant to be told you had to bring your own cutlery.  Its inconvenient and another barrier to accessing an environment which can already be difficult enough in and of itself.  For me, it is a further example of how medical model based thinking is increasingly reestablishing itself as the default position.  You have an impairment, and it is down to you to provide the solution.  This is a regressive position in my view.

Symbolism

There are also broader symbolic aspects to how the straw issue feels as everyday matter.  ‘You can just ask for a straw the conversation goes.  Of course you can, but it is how it feels to experience that which it is important to grasp.  To ask for a straw after having to ask for help to get into premises, a lower level of or a specific type of seating and/or booking may just be one step too far.

Feeling multiple layers of self consciousness due to the adaptations needed to an environment is not fun – and can deter you from wanting to bother from venturing into places in its own right.  Asking for a straw is like placing the final one on the camel back in some situations, and those layers of complexity and difficulty can lead to not wanting to bother to access the environment in the first place.  Elsewhere I have referred to this as the ‘war behind the door‘ and that struggle is a very real one!

Straws and the policy making process

I see the straw issue as being reflective of a more general set of issues about the policy making process in general, and how the views and interests of disabled people are represented.  Or more to the point, about how they are not.

On the impact assessment of the proposed ban on plastic straws the impact on the people who need to use straws is given minimal reference.  A medical exemption is proposed for those who need to use straws for ‘accessibility needs.’  The consultation continues as follows:

‘It is proposed to provide for these exemptions by allowing wholesalers to import and stock plastic straws for distribution to, pharmacies and pharmacy departments in both hospitals and retailers for supply to those that need them. We will be seeking views on whether online pharmacies should be allowed to supply plastic straws. It is also proposed that we allow catering establishments such as pubs and restaurants to provide plastic straws to customers on a specific ‘on demand’ basis.’

The framing of this exception is both interesting and problematic.  Defining the problem in medical terms means that disabled people will potentially need to have a prescription to buy their straws!  For me there is also a reductive element to this framing, neglecting the wider social aspects to these issues.  There is also a ‘slippery slope’ aspect to framing such as this I think in that disabled people are cast not as autonomous beings, but merely as patients to be dealt with in medicalised terms.

There is also an accessibility issue here.  To be able to respond to, engage with and correct such views, disabled people and the organisations that work with them have to be able to engage with the policy making process to make their views heard.  This may be difficult and daunting for many, and raises a need for training in how to work with policy making processes such as this one to ensure views are heard.

There are many layers to the important debates around the straw ban, which go far beyond face value.

Notes from a hostile environment


I write this reflecting on a range of recent events, some personal, others more general to me.  I first came across the term hostile environment in relation to immigration policy.  An informative publication from Liberty outlines the sites where this hostile environment is in operation, ranging from education to employment to housing.  Of this, the guide says:

De facto hostile environment policies, designed to limit migrants’ rights and deter them from accessing services, have operated for decades

As I’m reading this I nod.  I nod because I think that increasingly the ‘hostile environment’ applies to disabled people.  It applies to disabled people who are denied education at an increasingly earlier stages of their lives.  It applies to the awful Bedroom Tax, which denies disabled people the space they need to store their essential possessions and forces them into unsuitable property.

The disability employment gap continues to yawn away, obscured by technical arguments about statistics.  Whatever the measure used, the fact is that people with an impairment do not fare as well as those without one in the workplace, and this has been the case for years.  As if to prove the point, Inclusion London have today released some research showing that disabled people are being pushed away from the workplace by the operation of the benefit system.

Which brings us to benefits, including PIP and Universal Credit.  Regular readers of this blog will know my thoughts well on the former.  On the latter, figures have emerged suggesting that people will lose up to £200 a month.

Yet still the hostile environment is allowed to continue.  The front pages dominated by Brexit and the antics of someone whose name I don’t even know in Strictly Come Dancing.  Every morning it seems, I read the newspaper headlines and shake my head.

Closer to home, I had to go to a hospital appointment with my wife last week. Without me she was greeted with comments such as ‘Where is your carer?’ With me, she was taken seriously and given time to have her questions answered by someone who actually made eye contact and shook her hand.

There are people who are out there who are making a difference, who are highlighting the issues, whose work I applaud and from which I draw strength. Much more of this is needed.  Much, much more.  Then there is also the notoriously fractious disability community, for whom consensus on the key issues seems to be illusive, to the detriment of so many.

The charges are too easy to sweep away.  A particularly pernicious feature of the hostile environment is its stealthy and subtle nature, its creeping norms steadily chipping away.  It also has a teflon like quality, armoured with an ability to swiftly and confidently dispel any critiques, stubborn enough to resist even the sternest of critiques.

So where are the solutions?  Unusually dear reader, I am not so sure at this point in time.  Something has to change though, and some new responses are needed which are effective in highlighting the numerous manifestations of this hostile environment.

Let us hope some counter measures can be swiftly deployed, and that the responses are forthcoming.  I’m tired of shaking my head.

PIP Journal- An Update

Dear Reader,

Hello!  I hope this finds you well.  I just wanted to give you a quick update on the PIP Journal as it has been a while and a few of you have asked me about this and where it has got to. To give some context, I wanted to do the best job with this I could, albeit on a budget of zero and a limited amount of time!  To that end, it was really important to me to have a draft of the journal put through its paces.

In order to do that, I reached out to a few of the great people I know to get a range of feedback, from the more technical to the views of those who this journal is aimed at.  It was really important to me to get a range of viewpoints so that the design of this journal could be as inclusive and as useful as it could be.  Though I cannot name the individuals at this stage (with their permission I will later!) I have feedback from:

  • Two disability experts
  • A disability focus group
  • A housing association and a range of staff

I’m pleased to say that the feedback was very positive and also reassuring across the board.  The people who I sent this to also made a range of suggestions and observations about improvements which will be incorporated into the revised draft which will be ready for release soon.

My next step will be to work on a draft for general publication as a working draft, which will have a more general consultation window.  This consultation window is designed for people who are using the journal to be able to give feedback on how they have found it and to suggest improvements.  I’m really keen that this is a journal that should be designed with disabled people at its heart, and their needs at the forefront.

I am also trying to write the journal in a style which combats the worst parts of the form. The below is an example of this in relation to toilet needs:

An extract from the PIP journal in relation to toilet needs

My hope is that through injecting some warmth into the journal it will make the form in particular a little more accessible and address what I think is one of the hidden barriers in the process in the way in which information like this is asked to be disclosed. 

Finally, a thanks, for your patience, interest and good will!  What this endeavour lacks in resources it is more than made up for the abundance of encouragement I’ve received, and I hope that by working together we can come up with an end product that will make a positive difference.

If you would like a copy of the journal to be emailed to you when it is released, please complete the following form:

Talking with my inner critic

As I pause to write this blog, I’m in two minds.  I know precisely what I don’t want it to be, which is the flip side to what I normally feel when I write a blog.  My inner critic is saying ‘you don’t want to write this blog, it’ll be rubbish and nobody will read it..’ and so it goes on.

I’ve written previously about my depression, because I believe that being open about mental health issues is a good thing, and that any remaining taboo around them frankly is in need of decimating in the swiftest way possible!  I think one of the impacts of this for me is that there is no real ‘cure’ as such, I have just got better at recognising the signs and deploying the constructive coping mechanisms that I have.  I quite often have to switch off, as overthinking is one of my favourite things to do (if you sort that one, then please do let me know!!!)

So a couple of weeks ago I had a real dip, began to really doubt myself.  I also think one of the skills I have developed is to distinguish between the ebbs and flows of every day life, where it is perfectly natural for my mood to fluctuate (often on a Saturday afternoon at about 5pm after my beloved Sheffield Wednesday have invariably lost) and what might be a bit more of something to keep an eye on.

When it is the latter, that inner critic of mine really gets going.  Though I can only speak from my personal experience, I think its particularly easy for the inner critic to speak up where my impairment is concerned. When you have the mind of a 35 year old, and the body of a pensioner, often the brain is willing, but the body is not.  The flip side of this is that I’ve become particularly adept at solving problems and finding solutions to this, even if its just not straying far from bed at the weekend.

The trouble with my inner critic is this: It is exhausting! When I was 21, I was lucky enough to get into Cambridge.  There was a myth that was particularly prevalent there (and to be fair, in lots of other places too probably!) which we called the ‘imposter syndrome.’  Someone would come up, tap you on the shoulder, and let you know that there had been some terrible administrative mistake, and you shouldn’t be here after all.

I took my imposter syndrome with me, and have only really got to grips with it a few years ago.  I had told myself for a long time that when I got my PhD, I would have all the validation I needed.  Truth is, it was only after then that I had a bit of a eureka moment and found that my certificate didn’t in fact come with a gold plated key to wisdom.  True validation was something that had to come from within and that I had to train myself and work on.

Which brings me back to a few days ago.  My inner critic wouldn’t shut up, and I knew I had to change things a bit.  My standards are infinitely high dear reader.  This is no bad thing, but I needed to change my approach.  I needed to be more compassionate with myself.  I needed to start to re-recognise the good things.  To take time to be grateful for them again rather than taking them for granted.

So I started each day with a list of the positives and ignored the inner critic.  I close each day with listing the things that had gone well, that I had to be grateful for, and which I was looking forward to tomorrow.  The inner critic is still there, and probably always will be, and has its place.  I need to use it to drive me on to better things, rather than coming up with reasons to help me stop from even attempting them.  It’s definitely a work in progress, but one that I feel better for having started 🙂 My questions for the day are now as follows:

  • Morning: What have you got to be thankful for.  List at least 3 things if you can
  • Through the day: Notice your ‘wins’ – what have you accomplished?  Write those things down and tick them off!
  • At the end: Think about what you have worked on – and what has been developed. What have you achieved? List at least 3

Still the trepidation as I hover over the publish button for this post.  As you read this, you know that my inner critic has taken a back seat on this one.

I offer this blog to everyone else with an inner critic that needs to be put in its place from time to time.  It can be done 🙂

The PIP Journal – A draft

Well its taken longer than I’d like, but better later than never hey.  I’ve been working on the draft of the PIP Journal for a while and I’ve given it to Fran, who is great at designing things and making things like this come to life.  I need to emphasise that this is very much a work in progress, and I have paused deliberately at this point to get feedback from the people who matter most, the people who hopefully will be using it!

The journal is designed to guide people through the PIP process in a supportive way, particularly with reference to the form and completing it in a focussed and relevant way. Samples of the draft content are as follows, just click on each image to view it in more detail:

The next stage for me is to get feedback on the full draft over the next few days, using a few people who have been generous (or brave!) enough to give me comments on this.  I will then look to publish the full draft, along with a full plain text version.

If you have feedback based on the above images, please use the following form to give your thoughts, and thank you in advance for your views.  I might not be able to include all of the feedback in the final version, but will read all the comments I get carefully.

Thank you for your continued interest in the project 🙂

1 The PIP Process: The Journal

Hello dear reader.  Something I have always tried to do is to take positives from difficult situations.  Its one of the things that, at risk of sounding very old indeed, has got me where I am today.  So I have been reflecting on my experiences of the PIP process, and how best I can make a constructive contribution.  The feedback on my blogs has been very kind, but that doesn’t seem enough..I still feel the need to make a tangible contribution.

This particular idea has been inspired by Fran, who has been working really hard on producing journals of her own.  ‘Why not do a guided journal for the PIP process?’ she said to me one evening, and that really hit home with me in a good way.  Having done some research on it, there are lots of great guides produced by organisations, which this journal can refer to, but it struck me that there was something missing.

This something was a bit of a first hand perspective, and a guide that could effectively function as a bit of a companion to the PIP process, trying to break it down, and to help people record information on the form in particular, that was relevant when it came to completing the application form.  The application is long and complicated, but if broken down, can seem a lot more manageable.

So this is what I am working on.  Since talking about it on twitter over the past couple of days, this project has already taken on a life of its own, so I hope that it will be helpful when it comes to other people who have to go through the process.  I know that from my own experience, a voice of someone who had been through it and got to the other side was really useful, and I want to capture that.

I’m also looking to test early drafts and get feedback from people, so that this is something which hopefully hits the mark.  I’m trying to set up a bit of an informal testing group so that we can explore things together.  This project is a bit of a personal venture, so I won’t be looking to formally partner with any organisations to do it, and my intention is to make the product free of charge so it is accessible.  Unfortunately, this means I also can’t pay anyone for the time they take to feed in their views, but I am hoping that the promise of a useful product is enough.  What I will do is set up a mailing list, so that I can keep people posted about any updates

I’m not in a position to comment on timescales at the moment, as I’m concentrating on trying to get a decent journal out in an efficient timescale, as well as juggling a few hats in life (don’t we all!). The standard disclaimer applies, this is a purely personal project unconnected to any of those other hats, and the views expressed within it will be purely my own, but then you knew that already, yeah?

If you’d like any further information, please send me an email via the contact me page, and I’ll do my best to get back to you as soon as I can 🙂

6 The PIP Process: Part 6 – The verdict 

So after my assessment I have had a wait which has felt like forever. Thanks to the enduring support of people from Twitter, I knew roughly what range of wait there was to expect. It still felt like an endless one though, and I’ve got off lightly compared to some.

Recovery time was needed from an assessment which left me feeling fragile and insecure. I still do to a certain extent, which is part of the legacy of the PIP process which there isn’t really any formal mechanism for dealing with. The assessor leaves, with yourselves and those around you left to pick up the pieces.

For ages now Fran has been intercepting the post. We knew that the arrival of the verdict was fairly imminent as a couple of weeks previously, we’d had what seemed like an utterly pointless letter telling us that they now had enough information to make a decision. Given the assessment I’d experienced I wasn’t surprised about this, but I was also relieved.

I was in the shower when Fran banged on the door. ‘It’s here, and it’s ok. It’s ok. It’s ok!’ We were both in tears. I had got a result that was consistent with my DLA, and a long period of review. It was an outcome that I thought was fair, and I wouldn’t need to go to appeal, which I was very surprised about, as that’s what I was expecting all along.

There was a mixture of emotions. There was relief. There was reassurance that things were as I saw them and felt they should be. There was also a lot of guilt. A kind of survivors guilt. This is something I’m still experiencing. I feel so bad for those whose outcomes were not what they want them to be. I feel bad for the continued waiting that they are going through.

So whilst my own process is over in the short term (that is unless the goalposts are moved again as with DLA!) I am determined to keep raising awareness about the nature of the process.

For me, the right outcome has been reached, but by means which are totally wrong. The process is a damaging, inaccessible and costly one, which is still not fit for purpose. That a just outcome was reached in my case does not change my view on this. If anything, it reinforces my view, given the extensive process that I have experienced, and the extensive extra support (both practical and psychological) that I have needed to complete the process.

My own next steps are to use my experiences to hopefully help others in a personal capacity. As I write this, I’m fortunate enough to be going on holiday for a few days. When I return, I’ll do so with some further reflections and practical suggestions.

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