Friday, July 8, 2011

Farewell

This blog no longer has legitimacy, because - as mentioned in my last posting - I've resigned as chairman, and having given up my trusteeship, I have no official standing with the Trust, and I'm not likely to have any future involvement in its affairs, unless my counsel or advice is sought on any matter, in which case I shall offer it; or unless my services are required to carry out some exercise or other, in which case I shall respond as circumstances allow. So this is my last post, to say farewell, after twenty-odd years, to an institution that has played an important part in my life, and absorbed some of my energies too.

I have no regrets about leaving, I've run my course, and it's time for me to go.

I wish the trustees well in whatever future undertakings they plan, and a fair wind to carry them in whatever direction thay steer their course. Although they must have a free hand to choose their own path and ways of working, I hope they keep the aims and purposes modest, the organisational structure loose and affiliative. I shall be glad if they continue on an inclusive and non-dogmatic path that allows and encourages wide personal interpretations of buddha-dharma; if the concept of unfettered spiritual friendship remains central to what is offered; and if the links to modern hospice principles and practices for end-of-life care are retained and occasionally refreshed.

I intend to continue my modest involvement as a healthcare chaplain in a few Essex hospitals and healthcare institutions, working in conjunction with Kalyana Mitra, the Buddhist Chaplaincy Support Group to establish an engaged Buddhist 'presence' across a wide chaplaincy 'front'; and I am urgently concerned - via Essex Mind & Spirit and Basildon Borough Forum of Faiths - to help address community health and welfare issues thrown up by the increasing alienation, dislocation, disbelief and deprivation amongst our people, especially the young, the poor, and the very old.

But for now, to my occasional followers, and to friends everywhere, I bid you all an affectionate "Good-bye!"

Sunday, June 26, 2011

Swallow Squabble



(Photograph "Swallow Squabble" by Barbara Scoles)






Verse 33 from The 37 Practices of a Bodhisattva



When you squabble with others about status and rewards,
You undermine learning, reflection, and meditation.
Let go of any investment in your family circle
Or the circle of those who support you -- this is the practice of a bodhisattva.


There comes a point at which you know you have to take practice seriously.

Maybe that moment comes when you realize that no amount of meditation is going to stop you from dying. Maybe it comes when your heart breaks, perhaps for the first time, at the destructiveness that pain and struggle wreak on people. Maybe it comes when you see that all your reactions to the ups and downs of life serve no purpose at all and there is nothing to do but open to what life brings you.

Your personal agendas suddenly seem small, petty and irrelevant, being, in effect, no more than efforts to avoid the challenges and vicissitudes of life. Or your idealism and other preconceptions about how the world should be may strike you as overwhelmingly grandiose, arrogant, and pretentious.


At that moment, your concerns about status and your desire to be rewarded fall away. You continue to do what is needed to earn a living and provide for those close to you. You continue to work and enjoy art, music, or writing, the joy of nature, and the warmth of family. But you see that all efforts to gain attention or recognition just undermine your efforts to be awake and present in your life. They are, in the end, mere compensations for a fear of death, unmet emotional needs, or the desire to be someone.

Take a moment right now and imagine that you are going to die in one minute. Wherever you are when you read this, stop. You are going to die in one minute. What do you do? One minute. You don't have time to call anyone. You don't have time to settle your affairs. You don't have time to resolve any problems. However you are, right now, this is it. Wherever you are, right now, this is it. You have one minute and then your life is over. Tick, tick, tick, tick.... Done.

How did you spend the last minute of your life? Were you consumed by anger, jealousy, greed or pride? Were you racked by pangs of regret? Did you think about conversations you wished you had had? Did your mind run around trying to figure out who to call or what to say? Probably not. You probably just sat there, in shock, possibly awe, and a little wonder, and perhaps at peace. Isn't peace, and the freedom that peace brings, suddenly very important?

Acute awareness of our mortality, more vividly than any novel, poem, or movie, can free us from the pulls, the tugs, the seductions and squabbles that ordinarily consume us. Compassion and faith can also do this. Each of these paths reveals a way to be awake, aware and at peace in any moment in our lives.

What would it be like to live this way?

Yesterday I resigned the chair of the Buddhist Hospice Trust, a position for which I was ill-equipped and in which I was not effective, although I did my best. I shall continue to do my best to uphold its unperishable values, and to fulfil its noble aims, in whatever further capacity I am fit for, if there be any.

Quotation
Everything we hear is an opinion, not a fact.
Everything we see is a perspective, not the truth.
-- Marcus Aurelius

Thursday, June 2, 2011

Innovation without Change


This is the title of a book written 20 years ago by David Brandon (see portrait) to argue for radical improvements in what were described then as 'our extraordinarily impoverished mental health services'. Much of the content of this posting is drawn from Brandon's writings, interspersed by comments of my own on the current scandal exposed by the BBC's Panorama programme at a privately operated mental health facility for people with learning diability and autism near Bristol.

John Perceval was the son of a British Prime Minister assassinated by a psychotic man in the House of Commons in 1812. Perceval himself became 'deranged' in 1831, and he was admitted at the request of his mother and brother to an institution run by Dr Fox in Brislington, Gloucestershire. He was transferred in 1832 to a private madhouse in Suffolk where he remained until early 1834. A year later he married and went to Paris where he wrote about his experiences, publishing two volumes in 1838 and 1840 of 'A Narrative of The Treatment Experienced By A Gentleman, During A State of Mental Derangement.'

He describes in careful detail the physical abuse that took place in Dr Fox's madhouse: beatings, excessive restraints, forced cold baths and forced medical treatment. Perceval beautifully summarises the extensive differences between his needs and what was provided:

"I needed quiet, I needed tranquillity, I needed security, I needed even at times seclusion. I could not obtain them. My will, my wishes, my repugnancies, my habits, my delicacy, my inclinations, my necessities were never once consulted.....Then I hated, I despised, I was enraged, I became hardened, I was brutalised......I will be bound to say that the greatest part of the violence that occurs in lunatic asylums is to be attributed to the conduct of those who are dealing with the disease, not the disease itself.....Because I did not respect myself, they disrespected me, whereas they should have brought me to my senses by greater reserve and respect."

John Perceval was the first English 'lunatic reformer' His Narrative is a serious work of protest. Early in the first volume Perceval asks readers, "In the name of humanity, then, in the name of modesty, in the name of wisdom, I intreeat you to place yourselves in the position of those whose sufferings I describe". Over the next twenty years Perceval worked tirelessly to bring to the attention of legislators in Parliament and elsewhere the needs of the mentally ill in asylums and outside them, and to champion reform. According to Brandon,'if anyone should receive acknowledgement as the father of the mental health reform movement, it is Perceval'.

Well, isn't it a funny old world? If not a perverse, brutally savage, refractory and enraging as-well-as-funny-old-world? John Perceval's account of his treatment in Dr Fox's madhouse almost two hundred years ago replicates almost exactly the account given by the under-cover Panorama reporter at Winterbourne View; of needs for care, respect, tenderness and sensibility being met with Abu Ghraib-style torture, at the hands of men and women - young, well-fed twenty-first century men and women - unfit, it seems to me, to transact with any life-form at all, let alone some of the most the most vulnerable, and already-wounded of our kind.

So the grisly mental welfare wheel still churns to mangle more victims as it did in Perceval's day, and their cries (and the pleas of those who speak out for them to authority and power) are at best unheard, and at worst ignored - for it's my sense, born of fifty-three years as a nurse in several environments set up to care for the mentally ill or disabled, that managers and regulatory functionaries do sometimes wilfully ignore the whistleblower; they want the whistleblower to stop whistling; they want the whistleblower to shut up and go away; they want a quiet unproblematic life; they want promotion to a sinecure position in the quangocracy; they want a consultancy or a non-executive directorship on the board of a private care-provider; they want a 'gong' or a knighthood, or a damehood; they want whatever's going; and by Golly they usually get it.

I can't be sad about what's happened, I feel enraged, and that's more appropriate. Apologies from corporate or political suits, glib mendacious nonsense about 'lessons being learned', and 'never again' set my teeth on edge, expose raw nerves in me. I've seen it over and over, this scandalous bullying, this dehumanising criminality, and it seems to be spawned by the institutions themselves, as if there is some intrinsic flaw to them, as I believe there is. And I've tried for five decades to exorcise it from within, to keep myself free of it, to mitigate its worst effects, through training, through writing, through whistle-blowing, through personal example, and I've paid a price for those efforts; with the currency of capitulation, of craven cowardice, of self-doubt, even - there have been times - although it's an agony to admit it - of complicity and concealment to protect my self-interest: in a career, a salary, a tied-house, the security of my family, the well-being of our youngest son, whose own mental afflictions, psychiatric neglect and ill-treatment I have sometimes - God help me! - interpreted as retribution for my personal weakness and folly. So shame, and remorse - and that's appropriate too. But I don't know that it supplies any kind of solution, and I don't know what can.

Wednesday, May 25, 2011

Essex Mind & Spirit Networking Lunch

REPORT – NETWORKING LUNCH

That's the Spirit!

This lively title captured the mood of the twenty-five participants who met for a networking lunch at the Basildon Centre on 24th May and a presentation by Peter Goble and Reverend Fr Jo Delfgou on spiritual resilience and recovery in mental health, part of Essex Mind and Spirit's on-going programme of public engagement across the County. The event and the two presenters were introduced by Sidra Naeem, Hon. Secretary, who outlined the organisation's mission and structure, and invited participants to free membership, so as to be 'linked-in' to future developments and events.

Father Jo spoke movingly to participants from his experience as a mental health chaplain of spiritual journeying with people with serious mental health problems in secure environments. He made an impassioned plea to mental health staff to look beyond the stereotypes of religious delusion to the authentic spiritual struggles that patients undergo, to listen to their true voices, and – where possible - to advocate with colleagues about the spiritual dimension of recovery. Our religious language can betray our erroneous assumptions, he said, and convey the message that to others we don't want to meet them where they are, so we need to be sensitive, and listen with skill, patience and compassion to help tease out meaning in what is said. This instils the hope and confidence people need on the journey back to wholeness, and honours their autonomy. But spiritual care in mental health is full of complexity, and we need to carry on a continuing dialogue with each other – even those who may be hostile to our views - if we are to make sense of it.

Peter's approach was experiential, inviting participants to explore their own unique resilience to challenge, through a series of reflective and meditative exercises, drawn from his own spiritual tradition of Tibetan Buddhism, and his experience as a mental health nurse-practitioner and teacher. Participants were surprised and intrigued to be invited to “Stand Like A Tree” for up to ten minutes, in an exercise for which Peter claimed personal resilience-building benefit, by expanding and deepening awareness of bodily alignment with the earth, and the capacity for 'resting in attention'. Peter's guidance on unclenching the teeth, dropping the jaw, and dropping the belly caused some amusement, but by “standing like a tree” participants began to recognise how stress builds up unconsciously in the body, how bodily tension distorts alignment, perception, thinking and emotion, and how this reduces our capacity to respond skilfully to challenge.

Over a buffet lunch, participants were able to network, to meet new colleagues, exchange views and share experience. Many said that the event was worthwhile for this reason alone, apart from any other content. Most participants had been tasked to develop spiritual resources or to investigate spiritual approaches to care in their varied work, and all said that the event had furthered those objectives in one way or another. Peter, as chair of the South West Essex cluster group, invited participants to join him in growing the local cluster, through occasional meetings at the Basildon Centre or some other easily-accessed venue, to develop an agenda for local engagement in line with Essex Mind and Spirit's mission. Peter can be reached on 07951 869265, 01268 775521 or by email at pgoble@buddhisthospice.org.uk, and will be delighted to hear from anyone interested in joining the cluster group.

Monday, May 16, 2011

Chaplaincy competencies



The 'competency framework' is a fairly new way of describing what used to be listed as the 'skills, knowledge and attitudes' expected of a professional worker. A good 'competency framework' has the virtue (perhaps) of helping the developing practitioner to visualise herself doing real-life things, so she can grow into the job in an organic way, rather than trying to bolt together bits of attitude, bits of practical know-how, and bits of theory when faced with an angry mum, a frightened child, or a patient vomiting blood.

Here's a list of chaplaincy competencies we were recently invited to dissect. I should stress that these were not proposed as THE competencies training was intended to develop in us; more a stepping-stone towards thinking through our own. I quote (and my musings are in italics):


"The chaplain can demonstrate.............."

Hang on a minute! Who is going to be watching this demonstration, and in what circumstances? Will the observer watch me over minutes or hours of performance, will I know I'm being watched, shall I have any warning or preparation, and how will the fact of my being observed affect what I do? More important, how may the observation affect my performance? Even more important, how may it affect the experience of anyone with whom I am transacting? By what criteria of competence will my performance be judged? Am I to know how they will be applied? And what assurances am I entitled to about the competency of anyone who judges me? Or am I just being my usual narky, paranoid and bloody-minded self? Some of these questions may be answered when we get to what it is I am supposed to be demonstrating competency in........


"1. Good grounding in one Buddhist tradition, with evidence of regular practice and doctrinal knowledge."

I wonder how one can demonstrate "good grounding" in a Buddhist tradition. Maybe one could ask a higher authority for a reference stating that "I hereby testify that So-and-so, whom I have known for what you will probably agree is a a respectable length of time, has a good grounding in the X tradition in which I am an accredited position-holder, as is suggested by my titles and honorifics, or you may just know by my name that I'm important enough not to have to declare them."


Evidence of doctrinal knowledge is another matter, although one may have written a book of doctrinal exegesis, or obtained a degree or other academic honour that fills the bill. Evidence of regular practice is a toughie, I would have thought. Leaving aside what constitutes practice, what are the acceptable criteria of regularity? This question has always perplexed nursing records, as it also vexes definitions of constipation.


Clinical evidence demonstrates that, although most individuals evacuate the large bowel regularly once or twice a day, for a sizeable minority a regular bowel-movement occurs once in every three or four days; and for a few, the call-to-stool prompts a trip to the lavatory weekly or at an even longer interval. As for height and formal intelligence, the normal range of regular evacuations is distributed on a Gaussian curve, rather like bell-jar. One might conjecture that regular practice (whatever practice means) shows a similar distribution. But does every observer of competency know that? Not many nurses are well-informed about bowel-movements. Some still expect everyone to "go every day" (or need an aperient).

"2. Knowledge and use of appropriate liturgy and ritual in healthcare settings".

Ah, ritual! Everyone knows that you have to squirt your hands with alcohol gel as soon as you walk into a hospital ward, and sometimes as soon as you get out of your car in the car-park, so that you don't carry germy MRSA into the clinical environment. Most people like doing this, as it helps to dispel the feeling of total uselessness that comes over us when we visit a hospital. There's something brisk and business-like about walking down the corridor rubbing your hands together, sniffing the un-germy smell of alcohol, feeling your hands cool and capable. One can almost imagine a junior nurse opening doors for one, holding out your surgeon's gown, passing the sterile scalpel, respectfully inclining her head and lowering her lovely gaze above the snowy mask.....

Of course, we'll get on to Buddhist ritual and liturgy on another occasion (to be continued).....





Monday, May 2, 2011

The language of compassion


We are all pioneers of a sort - rough frontiersmen and women. The so-called helping professions are at the beginning of an exciting journey that attempts to explore and enlarge human awareness and establish new disciplines - echoing some of the experiences of sixteenth-century physics. It is a fresh form of alchemy. There is the same sense of arrant nonsense and profound wisdom jostling side by side - often very difficult to tell which is which.
David Brandon (1941-2001)

Here's a vignette from a (very helpful) training exercise at a Buddhist Chaplaincy (Kalyana Mitra) study day, intended to develop competencies required for the chaplaincy task:

'Helen grew up in a small market town, trained as a teacher, and started a family. She had always been used to walking in the countryside as a way of ensuring that her career and family life didn't become too stressful for her.

Following the birth of her second child, however, Helen began to experience some unusual phenomena related to her walks in the country. She started seeing patterns in that nature which she hadn't perceived before; believed certain trees were speaking to her, and felt herself and her two children being drawn towards the lake.

These experiences reached such a pitch that she became very unwell; there were concerns about the safety of the children, and Helen was referred to the crisis resolution team.

Helen has no particular religious faith, but her spirituality is very much linked with her love of nature, and her love of children, especially her own children.'


To encourage reflection and discussion, the exercise poses the following question:

How can the chaplaincy service assist Helen to continue with a spiritual journey without aspects of it leading her on a path which might endanger her and her children?

For me, this vignette is characteristic of the 'mental health' mindset: it proceeds from genteel, middle class professional inferences (assumptions) about class, aspiration and lifestyle; it travels smoothly and without hesitation or doubt towards a further set of description of Helen's experiences. These seem to be a further set of inferences, couched in language that is at once tentative and non-attributable (the authorship is vague) and, at the same time, both authoritative and vaguely threatening.

Such language, it seems to me, is carefully crafted to combine a dual purpose: to convey a message of well-informed concern and benevolence on the one hand; on the other to imply a perilous or dangerous situation, a potentially malignant state of mind, a pressing need for urgent for intervention, and a presumptive right to do so. The language, at first reading, seems to be sympathetic, even empathic, full of well-judged concern: the language of compassion.

I also detect an unchallengeable conviction of the rightness of the view expressed; and an implied warning along these lines: "you would do well to consider that it might be imprudent, reckless even, not to accept this assessment of the situation, not to align your own opinion with this reasonable paradigm. Specifically would you want to risk the possibility of, and take responsibility for, serious harm to defenceless children at the hands of a hopelessly deluded mother?" None of this is stated so bluntly, of course.

How is this murderous intent, and the need to forestall an insane crime, implied in a few lines of anonymous reportage?

"Helen grew up in a small market town, trained as a teacher, and started a family". Helen, the writer seems to imply, is of archetypally wholesome and uncomplicated rural provenance, of modest intellectual capacity and ambition, heterosexual, and defined at least in part by her wish to become a mother within a conventional nuclear family. So far, so unexceptional; the sort of person, perhaps, who has known her family doctor since childhood, and whose parents live in the same town and happily babysit their grandchildren when invited.

"She has always been used to walking in the countryside as a way of making sure that her career and her family life didn't become too stressful for her." Note that reference to her "always" being used to country walks emphasises her rural origins, although presumably she has only "always" used these walks "as a way of making sure that her career and family life didn't become too stressful for her" since she had a career, and had a family.

One might imagine that Helen herself had volunteered this information about stress-management, but there is no evidence of this; indeed, none of the information about Helen is corroborated by actual statements she made, included in her own words. They might as well have been from third parties, or even made up. But the overall effect is to show concern for Helen, as a likeable young woman who organised her leisure responsibly, so as to maintain her personal and professional equilibrium: an example of good-housekeeping in every sense of the word.

Note that nothing is said or hinted at that might detract from or cast a shadow over the image offered the reader. No harbinger of a future sinister turn-for-the-worse. No hint at childhood trauma or a troubled adolescence; no problematic relationships; no major illnesses or accidents; no thwarted ambitions, no hidden fears, no repressed compulsions. There is an unsullied innocence about Helen, she is a clean slate. When she becomes "very unwell" we can derive some satisfaction from knowing that, because her life is otherwise so naturally wholesome, it should be possible to restore her quickly to health, to the bosom of her family, to the status quo ante of woodland walks, children busy in her classroom, primroses in a glass on the breakfast table.

After the birth of her second child, Helen "began to experience some unusual phenomena". It's at this point that the account begins to change style, and the clue is in the phrase given, which - rather than use Helen's own language to describe her experience, distances her experience from the narrative with the phrase "some unusual phenomena". The phrase is deliberately obscure and all-encompassing, and - if interrogated - could be (and almost always would be) re-expressed in terms that were incomprehensible to a layman: words such as "ideas of reference", "autochthonous delusions", or "thought insertion". These are psychiatric terms understandable to mental health professionals, but usually quite mysterious to lay-people.

Three examples are offered to give some substance to the unusual phenomena Helen is said to have experienced. First, "she started seeing patterns in nature which she hadn't seen before". Seeing new patterns in anything is not of itself problematic; indeed the opposite could be true, it might be a kind of awakening, a broadening and deepening of awareness. So what casts a shadow over it? Maybe it's the next phenomonen to be catalogued: Helen "believed that certain trees were speaking to her". We don't know whether Helen volunteered this as, "I believe that certain trees are speaking to me", or whether she used some other form of words.

It would be interesting, for example, to know whether she said that the trees spoke singly, in audible words, or together; and to hear from her what they said, in what tone or quality of voice. Did they utter cautions or commands, give advice or commentary, or offer reassurances? Did she recognise the voices in which they spoke? Or was Helen's use of "speaking to" a poetic metaphor? None of this seems to matter to whoever spoke with Helen; or if it did, Helen's possible meaning has been subordinated to the need to build a case against Helen's meaning, and in favour of a psychiatric diagnosis, within which meaning can be disregarded or set aside.

"And (Helen) felt herself and her two children being drawn towards the lake." It's a rhetorical device to combine three sentences or ideas to build emphasis, and this device seems to be used here to good, deliberately chilling, if understated, effect. Again, one would hope to find her own words on the page. Perhaps she said, "It would have been really nice to take the kids by the the lake, it was so pretty there with the trees and everything"; "I wanted to bring my kids down to the lake, I can't explain why really, but it seemed sort of important that I took them"; She might have said something like, "The way the trees seemed to lead down to the water, it was like an invitation, they were sort of pointing the way, and I thought of the girls, and that maybe the trees wanted us all to go down there together, where we could be peaceful and safe, and nothing bad could touch us...."

But one doesn't find this kind of personal statement in mental health reports, because it's too ambivalent, too open to interpretation, too full of idiosyncratic and contingent meaning, to close to the grain of human experience, in all its fury and its mire.

Tuesday, March 1, 2011

In the Doldrums - and coming out





My last post was about six months ago. I've been in the doldrums since then, a long dip into lassitude, sails limp, going nowhere. It seems there's a slight breeze stirring, so I'll reset my sails, and make way while the going is good. That's 'me' in the picture, the one with they spy-glass. The one with the tipped bowler hat in the smaller boat is the former 'me'.

I had a stroke in October 2009, and retired from my part-time nursing work in December of the same year. I wasn't fit for work, and I was relieved to give it up, having worked for 53 years - I felt proud of this achievement, fifty years a Registered Nurse. Now it seems distant, almost like something that happened to somebody else. Interesting how the mind works, weaving memories into stories, binding stories into books - books whose pages yellow and curl, whose stories seem quaint and old-fashioned in the telling; books with strange archaic indexes that seem to omit everyday words or concepts. Old books, with rubbed and faded covers.


The relief of retiring gave way to a complex of other emotions, including those I understand are typical of bereavement. I don't recall being in denial, angry, or depressed, but I know I displaced a lot of energy into qi gong. This produced a deceptive state of calm and equanimity, a feeling of well-being. I remember laughing a lot, and being aware of this as a new phenomenon, I'm not known as a jolly person. I don't think those who knew me thought my laughing was an expression of jollity either. It's likely that I was angry, depressed, and in denial too.

I also found myself 'doing my rounds' in my head. 'Doing the rounds' is a nursing thing - you go round early in the morning (or late at night, depending on the shift you work) and greet your patients, many of them in bed or maybe getting up, and you check them out clinically, psychologically, making a note of any immediate or pressing needs they may have, for future action.

This doing-the-rounds happened 'in my head': I made a virtual tour of the people I had nursed before I retired, a small community of people with 'severe and enduring mental health problems' - the chronically mentally ill, refugees from long-stay asylums. I missed them very much. Each bedroom had a different smell. I missed the smells. Nursing is a very physical undertaking. I was taught as a nurse probationer to use my sense of smell as a diagnostic tool, it made a lot of sense too. Now I've given that up: I've given up a lot besides, and I know now that I was - and am - bereaved, and to an extent disabled.

But I'm 'into acceptance' now, or at least I feel I am. The journey isn't over, but the road under my feet feels more familiar, I have lengthened my stride, am making more sense of the terrain than at first, and am beginning to enjoy it.

I've also begun to let go of other things that defined me, or which I've used to define myself throughout my adult life. Too many unconsciously or fearfully assumed identities and roles to catalogue, and who's interested anyway? That's a glib question. Many of those whose identities and roles have been determined by my own, by my assumptions and presumptions, would claim a right to express an interest, intense and personal. Some have done so. I have encountered them on the road I mentioned; the encounters have been challenging. Loving as well as fierce. And they will no doubt continue into what remains of the future for me, and so they should.

While becalmed in the doldrums I stopped practising qi gong, partly because I thought that it had become compulsive, I was hooked on the feeling of calm and the illusion of control of my thoughts and feelings. Qi gong practitioners are counselled about suddenly stopping practice, but I ignored the warnings, and I've learned why: my energy-levels plummeted so that I could scarcely crawl around, feeling weak and lop-sided. I've recently resumed the practice, and - perhaps coincidentally - my energy-levels are climbing back. The other day I found myself jogging up the road, having seen the bin men looking for the bins I'd forgotten to put out for them. I hadn't broken into a trot since before my stroke, and I was surprised that I still could after partly losing my right-left-leg coordination as a result of it.

It's been a struggle staying 'on top of' the small heap of Trust issues that accumulates over a six-month period, and I missed an important Trust meeting earlier this year, a meeting at which a new Hon. Secretary - Willemien Hoogendoorn - was elected to give our affairs a much needed boost. Willemien is a Pure Land practitioner, a personal friend, a talented clear-thinking and logical woman, with the confidence of all the Trustees 'going forward', to use a brisk and breezy new term that seems to invest the more passive 'in the future' with an appropriately modern dynamism.

Some dynamism seems to be called for, not least in extending and strengthening the Ananda Network, which - through neglect of a means to maintain it - has become very attenuated and thin. Recently I've had to use the Internet to search for potential volunteers who might be willing to respond to urgent calls for support. Fortunately, this has done the trick, but not without effort and some difficulty: "cold-calling" established sangha for help in an emergency is leaving too much to chance, and not all sangha seem to be able to reach decisions without a lot of consultation; moreover, some sangha (or established Buddhist groups) seem to meet infrequently - for example during University term-time - and may have no contacts who can respond quickly to events. At any rate, it seems that the Buddhist Hospice Trust can still fulfil an important function in British Buddhist life - and death. In future - and more frequent - blogs I intend to report further on progress, and to comment on current affairs from a personal - idiosyncratic - perspective, as I've done in the past.