Things We Don’t Want To Talk About

Things We Don't Want To Talk About - Menopause

I’m sure there are many things we don’t want to talk about. But the ‘thing’ I’m referring to is menopause. It’s not exactly a sexy subject. More often than not, it’s referred to as a kind of joke (Google ‘Menopause jokes’), oh the horror of a menopausal woman. And those of us who are going through it often try to pretend it’s not really happening, an embarrassed flap of hands when a hot flash occurs, Let’s move on. I don’t want to be a bother, I don’t want to be considered ‘past it’. Old. Et cetera.

Essentially there is a culture of silence regarding menopause: a report by the British Menopause Society found that half the women going through menopause haven’t visited a doctor, as many are ‘too embarrassed’. And yet the symptoms can, literally be catastrophic. I know, because they were for me. I’m writing this blog in the hopes it’s a small step to help break this silence.

I actually started menopause about 6 years ago. I experienced mild hot flashes (or ‘flushes’) – quite pleasant for someone who is usually cold, and I put on weight, which was a blessing as I’m underweight. The most debilitating symptom was breast pain, so extreme I had difficulty sleeping. I tried bio-identical progesterone bought from the USA, but it didn’t make any difference, and then symptoms slowly improved and I’d only have the occasional, mild hot flash.

About a year and a half ago, the hot flashes began to increase in number and intensity. At the time I was working with a herbalist to treat my 22 year-long chronic immune system dysfunction (possibly as a result of contracting South African Tick Bite fever). We were not sure in fact if the hot flashes were viral in nature or hormonal, as they were not responding to herbs that commonly help. I was also working with my GP and he was taking a slew of tests. I saw an infectious diseases specialist, an ENT specialist. No tests showed anything wrong. I asked about hormones, and he told me blood tests would just show I am post-menopausal.

By March of 2016, my symptoms had rendered me almost completely housebound. I’d have 8 – 14 hot flashes a day, a few at night. They did not last more than a few minutes, but for those minutes I was incapable of doing anything at all. Generally I’d have to lie down. Hot flashes were not just ‘sweats’, they were like having sudden onset jet lag, being dunked in far too hot bath and having a panic attack (racing heart rate, dizzy, pressure in my abdomen) — all at once. Sometimes I couldn’t even talk, or open my eyes. In between hot flashes I was OK. I’d begin to do a little work on my computer, and then, wham, another one would hit and I’d have to lie down on my office floor. Or I’d think , it would be nice to go out for a walk, and ten minutes into the walk, I’d have to hunker down on the sidewalk until the flash was over. I felt ambushed by my body, unable to function for any length of time.

I stopped going out. I stopped exercising. I got very depressed. I didn’t know what was going on. I tried other herbs. I tried cold packs. I tried to ‘think’ myself cool. I did deep breathing exercises. The hot flashes were worse after eating and so I thought perhaps I had histamine intolerance, and I radically changed my diet. I did experience an initial improvement, I think simply because I was eating better. And then the flashes just got worse, and worse.

I thought about trying bio-identical hormones again. I found a private doctor who would prescribe these. I mentioned it to my GP and he agreed it might be worth a shot. Neither of us mentioned “HRT”. I didn’t know much about this other than the muffled but clanging alarm bells. Didn’t it increase the risk of cancer? Although I had not researched the facts, it seemed clear HRT was NOT something to even consider. And clearly my GP thought the same thing.

So, in February this year, I booked an (expensive) appointment with the private doctor. Blood tests showed I had rock bottom levels of oestrogen, progesterone, testosterone and DHEA. I had expected the doctor to prescribe perhaps one or two transdermal creams, instead I she sent me away with 2 transdermal gels (testosterone and oestrogen), a vaginal suppository of estradiol and a micronized progesterone pill to take at night. I felt a little overwhelmed.

I felt even more overwhelmed when, after doing the research I should have done before making the appointment, I discovered bio-identical (or ‘body-identical’’ hormone therapy (BHRT) is actually not that different to taking HRT. There are still risks associated. I worried: was I doing a terrible thing to myself? I worried even more when after two weeks things just seemed to be getting worse. And then at the three-week mark, there was a sudden change. Instead of 14 hot flashes, I had 3 or 4. At the four-week mark, I had none.

Was I celebrating? Yes I was. And, what if I’d received treatment last March?

In the process of getting my blood tests I discovered there was a nurse at my GP practice who specialised in menopausal issues. The female NHS doctor who ordered the blood tests the private doctor needed – my regular GP was not available – who told me this, also told me in the past HRT was overprescribed, but now, due to the cancer scares, it’s under-prescribed. She told me there are now different kinds of HRT available on the NHS, better tolerated kinds. She told me that in fact in addition to alleviating symptoms, there are health benefits to HRT: it can increase bone density and some say it can protect one from  Alzheimer’s.

I had already booked – and paid for – my appointment with the private doctor so I didn’t pursue getting treated at my GP practice.

Actually, once my catastrophic symptoms stopped, the first thing I felt was rage. Rage that I had not been given adequate information or care by my GP. I changed practices, and now have a female GP on the NHS who is prescribing BHRT (all available on the NHS…) and who is monitoring my progress and symptoms, so I don’t need to fork out buckets of money to a private doctor. I have also learned that starting BHRT or HRT earlier rather than later is safer, and increases the benefits to bone-density. It might have been better if I had started a year ago. Or even 6 years ago.

Perhaps if I had been more vocal about what was going on (I thought I had been), perhaps if I didn’t ‘present’ with a complex case, perhaps then my now ex-GP would have said, Have you thought of HRT? and talked me through the options. I don’t know. What I do know is that what I went through was entirely preventable, and that after a year of near total inactivity, I’m still very debilitated.

If you are a woman ‘of a certain age’ please don’t suffer in silence. If you are a man who loves a woman ‘of a certain age’, help her find support. This is an excellent online forum on menopause and all things HRT / BHRT: Menopause Matters.

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We All Need Good News…

It’s been a challenging time for me recently, so it was lovely to receive two bits of good news this week. I was awarded a travel grant to help towards some of the costs of travelling to Crete for research on a new work this year, and I heard that a story of mine will be published in Hobart, a literary journal in the US (http://www.hobartpulp.com/).

(The image is a photograph of a photograph – of Chania port when I lived there in 1969.)

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Fish Listing

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It’s a long short list, but nice to know my piece ‘The Bird’ was on it: Fish Flash Fiction Prize 2016, judged by Nuala O’Connor. And, another piece was on the long list for the Fish Short Memoir prize 2016, judged by Carlo Gebler.

Thank you Fish!

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Losing My Mother

Berrell Jensen as a young woman, South Africa

Berrell Jensen as a young woman, South Africa

My mother, Berrell Jensen, died on the 25th of July at Mercy University Hospital, Cork, Ireland. Nine weeks ago, today. She was 83. Losing her has been profoundly devastating for me, perhaps all the more because we had a complicated, often estranged relationship.

In the last years of my mother’s life I would sometimes wonder how I would feel when she had gone. I imagined relief, mostly. She was physically suffering and lived reclusively. I felt, for the most part, burdened by these facts. Although I admired and appreciated the extraordinary things she’d done in her life, I could not locate feelings of love for her.

Perhaps I ‘lost’ her when I closed my heart to her, aged 13. Perhaps it began earlier. At critical times in my life I felt my mother failed, betrayed or abandoned me. Although being a rebel and a feminist, and a role model for many people, she did not prepare me for the challenges of becoming a woman. When my first period came, I thought I was dying. I waited for her to come and ‘make it all better’ but she did not and I washed my sheets in secret, and from this moment viscerally felt myself shut her out. But the seeds of this process started earlier, when she unwittingly – or uncarefully – exposed me to her sexual life and to her brief but violent second marriage. The list goes on. Her inability to help me through depression and bulimia, although in her work as a community centre director, she was instrumental in assisting others who had mental illness; her subtle chauvinism in her behaviour towards me; her endless and lengthy advice on what I should be doing with my life, without asking me what I thought; her rage when I wrote to her about a deeply transformative experience I had which concerned my father’s death in a family car accident.

Berrell Jensen Netherlands Bank commission, Johannesburg 1962

Myself and my mother, as she worked on one of her copper ‘wallpaper’ commissions for the Netherlands Bank, Johannesburg 1962

The truth is my mother felt guilty for all these things. She felt she’d neglected me when she had had to work. She believed my father’s death was her fault: she should have driven, he had drunk too much. She blamed herself for my bulimia, and even, I suspect, for my decades long chronic illness. However she lacked the skills to talk to me – to anyone perhaps – about her feelings. In my 20s, during the worst stages of my bulimia, she wrote to me and said I needed to pull my socks up and get on with things, that I could not blame her or my father’s death for what was happening to me. Words that can only have been written because of her feelings of helplessness and remorse. I know this now, I have known it for some time. I went on to work on my issues with therapists and healers and spiritual teachers, and I learned so much: how to truly feel what was going on for me rather than rationalise it, how to talk honestly and directly with others. I learned how to take responsibility for my life.

But at no point did I choose to use what I learned when I was with my mother. I remained resolute in my early decision to exclude her from anything that was tender or vulnerable. Even in the few years I lived in the same country as her, I only made sparing visits, focussing on accomplishing any ‘jobs’ needed around the house. I gave her advice on nutrition, and made her monthly orders for supplements. I helped her out with her computer.

I would cry when I left her, acutely feeling her loneliness. Nevertheless, I did not choose to spend Christmas with her, which she spent alone for decades. She said she hated Christmas, and preferred not to do anything, and I pretended I believed her. I did not choose to visit her on her birthday, not even her 80th. Her birthdays were also generally spent alone.

I would cry when I left her, acutely feeling her loneliness… Now that she is gone, I understand this: we were close. So very close. I felt everything that was going on for her, and she me. Perhaps in this one way it is understandable that I found it so hard to spend time with her. It was too painful. She did tell me once, that she woke up in the night weeping.

Berrell Jensen, publicity shot, Santam Bank, Johannesburg, 1966

Berrell Jensen, publicity shot, Santam Bank, Johannesburg, 1966

My mother had much to weep about. She might have been one of South Africa’s most famous artists in the 50s, 60s and early 70s; she might have marched with women in the Black Sash against apartheid, she might have changed people’s lives with her social work in Belfast and London, but she was also a child of an alcoholic mother and she experienced her father as emotionally distant, a man who thought women should be wives and mothers, perhaps secretaries, but not activists or artists (she paid her own way through university in South Africa by driving a taxi). As a young child she was confined to her bed for a year due to meningitis. Also as a child, she was raped by a member of her family (now deceased), and fought off another rape as an adult. She dropped her aspirations to study for her Masters degree in order to support her family. She inadvertently witnessed one episode of her husband’s several affairs – this one with her best friend. She survived a horrific car accident that killed him, an accident that occurred the night of her son’s 11th birthday. She single-handedly raised her two children and supported her mother-in-law, often taking on work that was gruelling and very poorly paid. She lived frugally all her life and, in her last ten years, in difficult circumstances in a damp and isolated house.

She died in hospital, from kidney failure, lung congestion and heart-related complications. I was with her for most of the last two and a half days of her life, two and half days that changed everything I’d ever felt about her.

I arrived on a Wednesday evening, a late flight. The moment she saw me she tore off her oxygen mask and a monitoring device stuck to her forehead, and she opened her arms and said, “I just wanted to see you.”

The moment I saw her, my heart opened. The heart that had been shut for forty years.

Table glass covered, in copper, brass, enamel, created by Berrell Jensen

Table glass covered, in copper, brass, enamel, created by Berrell Jensen

During those short last days, we frequently gazed long into each other’s eyes. We talked little. Her mind had been failing and I don’t know what she was conscious of, but it seemed to me that she was in a state of grace, that the language spoken between us was deep and profound, there were no words needed. (She did once say loudly, “I love you my darling” – silencing a discussion of bodily ailments between two other patients in the emergency ward.)

She would smile if I smiled, but otherwise there was no need. We both felt our love for each other, of this I am certain. And I told her I loved her, often. Words I had never said before. She would nod, and smile, and I knew she was telling me the same thing.

On Saturday afternoon she started to fail rapidly, and the nurses and doctors made me leave the room while they ministered to her. I had only one wish at this point, which was that I would be with her when she died. I was not.

And so began the grief. I felt as if someone had taken a hacksaw to my chest. The pain was unbearable. Is still, when it visits. When a dear friend told me, It is unbearable, I knew she understood.

Pain made greater by remorse, by regret.

Totem, in bronze, Berrell Jensen

Totem, in bronze, Berrell Jensen

I regret not listening to the voice inside me that said, I should be there now, I should be there now, for the five days prior to my actual arrival before she died. I regret not listening to the intuition that told me, also five days prior, she would die on Saturday and so stopping the doctors from putting the feeding tube down her nose on Friday. I regret not removing a suction tube on Saturday morning from her other nostril, a tube that caused her so much discomfort. I regret the hours I did not spend at her bedside in the hospital. I regret the many things I did not tell her during the hours I did.

But these are small compared to my remorse for not overcoming my decades-long resistance to being with her, talking openly with her; my remorse for not spending time with her in her last years when she suffered so much and was so lonely; my regret for not doing the many things I could have done to make her life a little easier, a little less lonely. I needn’t have done anything drastic, but on my infrequent visits I could have sat quietly with her, asked her gentle questions. I could have given her the space to share with me, if she so chose. Or we could have just sat, and gazed out the window at the birds she loved.

Perhaps those two and a half days of precious connection have put into sharp focus what I have lost, what could have been, had I managed to set aside my list of accusations.

Commission for public building in Capetown, aluminium, by Berrell Jensen

Commission for public building in Capetown, aluminium, by Berrell Jensen

Many have said my mother was always a difficult woman, independent and stubborn, and so I should not blame myself for her situation. I have been told that had I taken more time to truly be with her, it probably would not have made a difference. Perhaps so. But knowing these things does not change how I am feeling.

I have been told I shouldn’t be feeling regret and remorse. For me I sense these feelings as a kind of teaching, a way to deeply remind me again and again to be truly present to what is, to live my life in such a way that I never again cut off emotionally as I did with my mother; to remind me to keep my heart open. I thought I was protecting myself from pain. I know the pain I feel now is all the greater because I closed myself to her.

There is more to write. The grief that we die at all. The incomprehensibility of this fact, still tearing me to pieces.

Berrell Jensen, late 60s or early 70s

Berrell Jensen, late 60s or early 70s

More mundanely, the utter catastrophe of what is expected of next-of-kin when someone dies. The amount of work involved is so contrary to what is really needed at such a time, work which brought me to my knees. The first thing one nurse said to me after my mother died, was: “You have to contact a funeral director.” I could barely breathe, let alone begin to know the steps involved in just this one thing, let alone navigate what was required for probate (the meaning of which I only learned after my mother died).

I am sharing my experiences and process (if you are still with me!) to encourage others not to make the mistakes I made, to be prepared, if just a little, for the death of someone close. To prepare for your own death.

I ask you now: think of those you love, are close to – in spite of difficult or complicated or estranged relationships. Is there anything you would regret not doing, not saying, should they die? Do it now. Do not wait. Do it now. It might feel too uncomfortable, it might feel it would cost you too much – financially and emotionally, it might feel as if it would take too much time, but please, do it now.

And, if you have not yet had to handle the post-death affairs of someone, find a friend who has and ask them if they might be on stand-by should and when the time arises for you to do it.

"Biosphere" Approximately 1 1/2 feet in diameter, Berrell Jensen

“Biosphere” Approximately 1 1/2 feet in diameter, Berrell Jensen

Write a will. Make sure it’s legal and valid. Put it in a safe place, known to your nearest and dearest or lodged with your lawyer, along with a list of all your accounts and financial institutions and all important documents – passports, birth certificates and so on. There are a number of websites which outline what you should do to prepare for your death, things that will make it a great deal easier for whoever has to handle your affairs, for example: One Day, You’re Going to Die. Here’s How to Prepare for It

Last but not least, what do you do when a friend of yours is grieving? The thing most people seem to be concerned about is intruding. I am sure everyone is different, but for me, all expressions of concern or love were and are much appreciated. It means a lot to me, the hundreds of little notes, the ‘Likes’, I receive on my Facebook posts, the emails sent. I may not be able to reply, but believe me, I see and have read every one and have been comforted.

Other things to do if a friend is grieving: if you can, cook a meal and drop it by. Offer to clean the house, go shopping. Even just getting basic groceries seemed an impossible task sometimes. If you can, do these things without asking. Send cards, little silly gifts.

And ask questions about the person who died. Perhaps I am unusual in this, but I so desperately needed, still need, to talk about my mother. About everything – the horrors that happened at the hospital. Her last moments. My remorse for the things I didn’t do in her life.

I need to share these things over and over again, not to wallow, but to help the emotions flow through and out. To keep my heart open. I need to talk, to honour my mother’s memory, to tell the world how much I truly loved her, even though I only discovered this love in the two and a half days before she died.

Berrell Jensen

Note: I have been honouring my mother every Saturday on Facebook with posts about her artwork and her life. If you would like to see more please visit me there.

The Guardian Obituary: Berrell Jensen
Architectural Association Obituary

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Seagull Pie at Winchester Writers’ Festival Writing Competitions

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I was very pleased to hear that a first draft chapter of my new work, Seagull Pie, written this year at a Freefall Writing retreat in Portugal, won a ‘Highly Commended’ award at the 2015 Winchester Writers’ Festival Writing Competitions.

As part of the award, we receive feedback from the judges:

This was a very good account of a moment of departure told from a child’s point of view. The writing is full of detail and is extremely funny in places. I liked that this isn’t an airbrushed account. At times the experience feels uncomfortable and that is conveyed in the writing. This is a well told story that includes a real sense of tension and jeopardy. There are strong characters and complex family relationships are conveyed. I finished with vivid impressions of mother, Bonma, Michael and the dog. In a strong field this piece deserved its place on the shortlist.

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Michael Ondaatje on Writing

Screen Shot 2015-06-16 at 14.46.37The great Michael Ondaatje on writing. Well worth watching. I love his image of writing a novel being like holding 35 things while getting to the elevator. Also, how writing is discovery.  He is interested in finding out about something, through the characters and the time period; how he is interested in not relying on one voice, that in his later books 3 or 4 people who are not related who become a family by the situation. “It’s a community, as opposed to one voice.”

Michael Ondaatje | Louisiana Channel.

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Identity Crisis

22529144Last night I attended an event where Alexandra Fuller discussed her new memoir, Leaving Before the Rains Come.

Don’t Let’s Go To The Dogs Tonight, her earlier memoir of growing-up in Zimbabwe, Malawi and Zambia in the 1970s and 1980s, left a deep impression on me. It’s a powerful and powerfully written story, and my own life shares some similarities, so I was delighted to meet her in person. It was a wonderful, inspiring evening.

Alexandra talked about a lot of things. What particularly strikes me now is what she said about identity. She has in the past been criticised for subtitling Don’t Let’s Go To The Dogs Tonight “An African Childhood” – and for stating that she is an African, “first and foremost.” (I presume the criticisms were mostly because Africa is not a single country.) I wanted to ask her more about what she means by saying she has an African mind and soul, something I’d read in an interview in preparation for the event, but time was short and so I asked another question, one about the long-term consequences of trauma. Nevertheless, this issue about identity is an important one for me.

I was born in South Africa, but left when I was seven, so my time in Southern Africa was much shorter than Alexandra’s, and when I do visit, I don’t have a feeling of coming home, unlike Alexandra. I have three passports, South African, Canadian and British. I was educated mostly in England, but have lived many years in Canada and Ireland, and have lived for extensive periods in other countries: Greece, Germany, France, Australia. On ‘the road’ throughout Asia.

I have struggled to find ‘home’. I am not even sure what it means to feel ‘at home’ in a place – a town, a country, a house or apartment. In my body, even. I know they (who are ‘they’?) say “Home is where the heart is, but this has never been much solace or use.

As I grew up, I began to identify myself as European. I felt at ease in Paris, London. In Berlin and Athens. I loved sitting in cafés, people-watching. I loved to discuss art, philosophy and Life in General. The authors I read were predominantly English, French, German (in translation) and, of course, the Greek classics (my degree is in Ancient Greek). I thought I felt European. It’s what I told people when they asked. It was better than saying ‘English’ because I certainly didn’t feel English, and the English certainly seemed to think I wasn’t one of them. I could hardly call myself French, or German or Greek.

So European it was, until someone I respected laughed out loud when I told them.

You’re not European,” she said. “You’re North American.”

I instantly rejected this assessment. I’d been living in Canada for many years, and had a Canadian passport, and even a Canadian husband for a while (but he had Japanese heritage and was born in Buffalo, New York…), but me, North American? No, never. And definitely not Canadian (I had absorbed the usual (boring) judgements about Canadians: “boring”).

But as the years went on, and my little struggle for identity put on the back burner as there were so many other things to worry about, I realised that I felt more at ease amongst Canadians and Americans. I loved them for their (generalisation alert) friendliness. When meeting someone new, if they were North American, I felt as if was actually worth meeting. But when presented to a new person who happened to be English, the experience was vastly different. The unspoken phrase was the same: “Hello, and who are you?” but the Americans said it with bright, open friendliness and the English with a guarded suspicion.

So I re-aligned my compass: perhaps I had a North American soul, even though I was not born there and nor were any of my ancestors, as far as I knew.  If I include my reading habits, and indeed where I’m mostly published, my preferences in literature have become quite ‘North American.’

But still I wondered.

When I read about how Alexandra Fuller felt about Africa, I began to think perhaps I too had an African ‘soul’, that in spite of my few years in Southern Africa, and not feeling ‘at home’ there, I had been indelibly imprinted in some way.

umbrellapineI have a very strong (positive) emotional response to certain landscapes, climates, trees and sounds.  I love the hot, the dry, the subtropical, I love the umbrella pines of the Mediterranean. The sound of crickets has an instant calming effect on my body. I crave the gold and sand colours of the desert; I crave huge vistas and vast night skies. (I fell in love with Australia for all those things.)

My idea of heaven is a languid late afternoon sitting on a verandah watching the sun go down.

africantreeThe iconic tree of Africa is the umbrella thorn acacia, very similar to the umbrella pine. I was born in Johannesburg, which has a subtropical climate, but I remember it for its hot days and cool, ‘desert’ nights, night so pitch you can barely see your hand in front of your face, stars bright enough to hurt. My few trips back to South Africa have included many long evenings watching stars, listening to the night sounds (sipping something cold and alcoholic).

And then yesterday, I heard Alexandra Fuller say (I’m paraphrasing) “The trouble with having a national identity, is that you end up having to fight for it.”

A penny finally dropped. Yes, of course there are so many aspects of Africa, of Europe, of America, of the people who live there, that I love, that I identify with, that I yearn for when I’m not there.  But perhaps I don’t need to keep searching for one particular national identification.

In the past I have sat in meditation for hours, for days, in fact, asking the question: “Who am I?”

The answer to this question is unsayable. Not because I don’t want to say it, but simply because the answer is ineffable.*

Sometimes, when I’m feeling particularly awry, wherever I am, I whisper to myself “I am here.”

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*Think Walt Whitman: Do I contradict myself? Very well then I contradict myself, (I am large, I contain multitudes.)

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