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25 Ağustos 2016 Perşembe

I went to work a doctor – and returned home a stroke patient

It started with an innocuous drooping of the right side of my face late one Tuesday evening in January. While talking to Amy, my wife, I suddenly couldn’t match the thoughts in my head to the lip movements to make the words. Amy asked if I was having a stroke, to which I answered: “There’s no way, I’m too young and healthy.” When she questioned again, I uttered the immortal words: “I should know, I’m a doctor.”


It was so painless and gentle that I thought little of it at the time. I was tired and perhaps overstressed. Pressures of work and maintaining a life balance had perhaps been taking their toll. My first consideration was that this was a Bell’s palsy, which involves a virus in the nerve endings in the face causing them to go offline for a while. This can be brought on by stress and not looking after yourself, so I felt it fitted what was happening. As it was late and I had to get up early the next day for work I thought I’d sleep on it and reassess in the morning.


At breakfast the next day the severity of the situation hit. I read up on the symptoms over breakfast and saw that if your eyebrows were still working (as mine were), this was far more serious. The potential option list read: brain tumour, multiple sclerosis and stroke.


Four days, one brain scan and a battery of tests later at the hospital in which I work, I had been diagnosed with an embolic stroke. I was 34, a marathon runner, recently married, a junior doctor and had no risk factors. This wasn’t meant to happen to me.


The immediate aftermath of the diagnosis was a proverbial rollercoaster of emotion, an odd combination of a doctor’s curiosity about the disease process and a strange inability to think. The shock, interest and well wishes of the outside world contrasted with the suffocating moments on my own wondering if another would happen; the sense of bafflement that this could have happened to me and the painful realisation that it had. One memory I have is being struck by how life can literally change in a heartbeat, even when lying in bed.


I had gone into work a doctor on the Monday and returned home a patient on Tuesday. The transition was seamless. One day I was helping others, the next I needed help myself.


One of the greatest lessons it has taught me so far is something that no amount of study in medical school could have prepared me more – being ill is often a profoundly lonely process.


While we study and work hard to understand the objective reality of disease with its variety of pathology and manifestations, we can only ever understand what is happening with half the information. The other half is what that disease means to the patient.


A huge element that defined my own recovery from the stroke was the post-stroke fatigue. The tiredness was like something I’ve never experienced. Boiling an egg became an exercise in total concentration; I could only talk to people for 10 minutes before feeling shattered. Some days, getting out of bed was almost impossible.


Becoming a patient, but also retaining the identity of a doctor, allowed for a duality of perspective. One part of me was able to step back and observe and be interested by what was happening. Another lived and breathed the tough new reality I found myself in. No one could really understand what I was going through. Illness and recuperation became a lonely place, with some days much harder than others.


The desire to be listened to is powerful. One thing I learnt was how suffocating it could be to be given answers such as “don’t worry, you’ll be ok” or “it’s happening for a reason” when others perhaps didn’t know what else to say.


Among many things, this has taught me the value of just being there to listen and support, without the need to necessarily control the situation and only offer solutions. This is something that as often over-stretched doctors we do not always feel we have time for, but the value of it can never be underestimated. I hope to take this back into my own personal life and professional practice – both with loved ones and future patients.


Giles Dawnay has self-published a book about his experience on Amazon – Brushstrokes – Thoughts, poems and reflection on having had a stroke at the age of 34


If you would like to contribute to our Blood, sweat and tears series which is about memorable moments in a healthcare career, please read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.


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I went to work a doctor – and returned home a stroke patient

5 Ağustos 2016 Cuma

Two-year-old returned to UK from Guinea amid FGM concerns

A two-year-old girl thought to be at risk of being subjected to female genital mutilation has been returned to the UK from west Africa following moves by police and a family court judge in England as well as Dutch embassy staff, lawyers say.


Concerns were raised after the child – whose family have links to the Netherlands – was recently taken from her home in England to Guinea, a high court judge heard on Friday.


Lawyers said the Metropolitan police launched an investigation, a family court in London made a female genital mutilation (FGM) protection order and Dutch embassy staff made arrangements to get the girl out of Guinea.


Related: England had 5,700 recorded cases of FGM in 2015-16, figures show


Details of the moves made to ensure the girl’s safety were revealed by lawyers representing the Met at a private hearing in the family division of the high court in London.


Barrister Zimran Samuel, who led the police legal team, told Mr Justice Moylan that a man had been arrested and released on bail pending further investigation.


A judge is due to analyse the case again at another family court hearing in the near future.


Moylan said the girl would undergo a medical examination and that all evidence from police and family members should be gathered so that facts could be established.


The judge said details of the case could be reported – but that the girl could not be identified.


Judges began to make FGM protection orders in the summer of 2015 following changes in the law.


Samuel, a specialist in FGM litigation, said last year that the orders could “make a very real difference”.


He said they were aimed at protecting potential victims rather than punishing offenders.


They could put barriers in front of people who posed a threat and could give comfort and support to vulnerable females, he said.


“FGM protection orders, which were originally one of several recommendations made by the Bar human rights committee, can make a very real difference where the criminal law has historically failed. The criminal law is intended to punish perpetrators after FGM has happened,” Samuel had said.


“The new civil orders allow for intervention to prevent potential victims from being subjected to FGM in the first place.


“Further, the underlying thinking behind civil protection is to encourage girls at risk to come forward without feeling that the full force of the criminal law will necessarily be brought against those closest to them.


“A judge in the family court has a high level of discretion and flexibility in how these cases progress, with the fundamental aim of protecting those at risk.


“Importantly, the new legal provisions protect girls who live in the UK not only from FGM which may be committed in this jurisdiction but in fact anywhere in the world. It is an offence to breach an order, regardless of where FGM is committed,” he had said.



Two-year-old returned to UK from Guinea amid FGM concerns