I treated Sam for minor complaints. I didn"t see the domestic violence victim

Sam* started attending my GP practice at the same time I joined. She had no extensive list of medical conditions yet she had frequent doctors’ appointments for minor complaints – in summer she would come with a cold, in winter with hay fever and all year round with tiredness.

She startled easily if someone spoke too loudly or the telephone rang. When she once arrived five minutes late for an appointment, she had volunteered that there were no clocks in her flat, since they were a reminder of time spent away from loved ones.

Sometimes Sam would roll her fingertips on the old scars that spanned her wrists. I asked about those scars (and traced their criss-crossed pattern with my eyes) but Sam would shake her head and hide her arms.

We went on in this fashion for some years. I was no longer the new doctor. I stopped looking for things that probably did not exist. Then one year a medical student came to us on a placement. He was in first year and this was his initial encounter with patients. He was given the task of researching and writing about a patient’s journey. He spent the day with me: we saw people with heart disease, diabetes, headaches, depression and dementia. Somewhere between these 10-minute appointments, there had also been Sam, who had come in with “not a particularly memorable” sore throat. To my surprise the student chose Sam.

Sam was taken aback that the young student doctor wanted to write about her but bit by bit she told him her story and with her permission he wrote it down. A while later Sam and I read it together.

Samia was brought up in a small village in the Indian subcontinent. Her life was busy yet carefree. She wished that time could stop there – she was happy. But her parents felt she had crossed a marriageable age and were worried – perhaps even more so because they had other children and dowries to provide for.

By a quirk of fate, in the nearby village a man had come from the UK in search of a bride. Samia’s parents hoped their daughter might be considered because she was beautiful and they belonged to the same caste as this man.

Samia was chosen and the date was fixed for the marriage – a few days before the groom was to fly back. Forms for her passport and visa were secured to start the process of her leaving for Britain. The procession came and the marriage ceremony was performed, with Samia’s father spending a substantial part of his savings on the wedding.

The groom returned to Britain and Samia to her parents. She was happy because she would travel by plane for the first time. She dreamt of a beautiful place where lambs grazed on lush green hills. Her only sadness was that she would move so far away from her family, friends and even her animals.

Her husband did not ring her, but Samia and her parents assumed he was busy in his job. Eventually, she got a plane ticket and all of the family arranged a van to go to the airport to see her off.

Her husband’s parents received Samia when she arrived in the UK – he was not there. Her father-in-law told her that he was at work. The days passed, with her seeing her husband rarely. It was a big family. Eventually she learned he was living with someone else.

She was soon introduced to the work she was to do, which included cooking and cleaning. Her life back home was tough, but here it was hundred times worse. When she complained it was decided that she should be sent back but Samia could not go back. She would not be the cause of pain and disgrace to her beloved family, no matter how much she needed them in her despair.

Her refusal made the situation worse. The hatred became visible. Her husband hit her sporadically. On one or two occasions other family members slapped her too. She was humiliated repeatedly with bitter remarks. Samia’s father-in-law had incurred business losses since her arrival and she was blamed for that too. In the end when there seemed to be no way out, Samia attempted suicide.

Someone took her to the local hospital. From there she had gone to a women’s refuge, and then moved from city to city, refuge to refuge until she had come to us.

Samia tried to put her life back together. She got a divorce, found a job, a place to live and even made a few friends. But home was still several thousand miles away. She longed to be with her family but lacked the courage to turn up alone, divorced and with nothing to show for her parents’ efforts.

Samia and I both finished reading. That is how the story would have ended – except that it didn’t.

Our student left but Samia had started talking and healing. She told me about her scars, her childhood, her siblings, her parents and even her pet goat. She told me of her aspirations for a better life when she had come here and her disappointment when her hopes had come to nothing. But after despair had come fortitude and courage. Then I did not see Samia for a while – she had gone to see her family. That had been her happy ending.

Samia had needed space and time to open up and heal. At the beginning I had asked the questions but she had been too traumatised to talk. I then focused on her medical problems and fixing only what was apparent. Samia’s story made me realise that sometimes we all need a fresh perspective on the same problem, perhaps even more so when some time has passed. It can occasionally lead us to question our initial diagnoses.

*Sam is a composite of this GP’s experiences of patient care

• In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here

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 treated Sam for minor complaints. I didn"t see the domestic violence victim

This Medication Doubles The Risk Of Suicide & Violence In Healthy Adults

Unfortunately, almost half of the American population uses a prescription drug daily. The third most usual prescription drugs used are antidepressants. This is according to Centers for Disease Control and Prevention. Although the population is somehow used to taking antidepressants, they aren’t aware of the side effects it causes. Unfortunately, manufacturers of psychotropic drugs are fully conscious of how their products can affect the user’s brain. However, they are not willing to share that information, or they just choose to give limited information. According to researchers in Denmark, people who take antidepressants risk from twice the increased chance of suicides. They suggest that this applies to the two most commonly prescribed antidepressant classes, i.e. SSRIs and SNRIs. These are the drugs containing these types: Fetzima, Effexor, Prozac, Celexa, Lexapro, Zoloft and Paxil. Patients need to take care of themselves better. Especially when it comes to the addictive usage of these drugs, they need to consider alternative ways.

Reasons

Although antidepressants are made to help people who already suffer from suicidal thoughts, they are not helping them in a long-run. According to Dr. Ann Blake Tracy, Prozac causes the human brain to stop the production of serotonin. The drug may make the patient feel a little better. Nevertheless, it causes the patient to experience a lot of different emotions. These emotions lead to more suicidal thoughts and greater risk of violence, on a long-run. However, due to their short-term effects, the patients feel the need to take even more of the prescribed drugs. Therefore, this way pharmaceutical industry flourishes.

Patients need to be aware of the side effects of the drugs they use. There are so many medications that list the side effects which, in many cases, are a contradiction to the main purpose of them.

How To Treat Depression Without Medication

People who are already taking an antidepressant and notice their side effects should consider other alternative ways for healing. Becoming aware of other choices alternative medicine has to offer is the first step towards helping themselves. Meditation, sleeping schedule, going for a walk, relaxation exercises are ones of the known ways to boost energy, mood, and love for life. Yoga helps a lot for depressive thoughts, too.  They need to seriously consider these, if they want to stay healthy in a natural way and with positive attitude.

Source:

Cdc.gov

MayoClinic.org

This Medication Doubles The Risk Of Suicide & Violence In Healthy Adults

Debt, homelessness, domestic violence: the GP practice acting as a one-stop shop

Lisa Baxter*, a mother of three from Oldham, was trapped with a violent partner, difficulties controlling her children, threats of homelessness and frightening debt. Her only ways of coping with her desperation were by abusing drugs and alcohol, and frequent appointments with her GP for antidepressants – until she was referred to community nurse, Ruth Chorley.

I don’t know what I would have done without Ruth. Without her, I think I would have had my children taken off me

Since the 28-year-old started seeing Chorley five years ago at Hill Top surgery, in Fitton Hill, Oldham – as part of a groundbreaking scheme aimed at helping the most deprived families – she has stopped abusing drugs and alcohol, is securely rehoused, her ex-partner is in prison, her children attend school and she manages her finances with only occasional support. Her mental and physical health are transformed and her GP attendances are a fraction of what they once were.

Baxter says: “I don’t know what I would have done without Ruth. Without her, I think I would have had my children taken off me. I would not have been able to cope with social services. Before I started seeing her, I was just being seen by the doctor, given tablets and sent away, but it wasn’t any help, so I would be back again.”

Chorley is a focused care practitioner – one of four employed by Hope Citadel Healthcare, a not-for-profit community interest company, to lead a pioneering approach to delivering healthcare to the most needy families in its four Greater Manchester NHS GP practices, by filling in the gaps between health and social care.

A visit to Hill Top surgery overlooking the former mill town of Oldham, perfectly illustrates how this transformation in Baxter’s life has come about. Chorley emerges with Baxter, having been on the phone for more than an hour on her behalf. She has arranged food vouchers and funds to pay for three school uniforms, and has prevented the cancellation of Baxter’s child tax credit. She has also helped Baxter write a letter of appeal against the cancellation of her housing benefit.

Chorley: ‘How can you expect patients to look after their health, when they don’t know where they will be living next week?’ Photograph: Jason Lock

Passionate about her work, Chorley says: “How can you expect patients to look after their health, when they don’t know where they will be living next week? You can not separate people’s physical health from their psychological, social and spiritual health.”

The reality of doctoring in Oldham is stark. Oldham is the most deprived town in England, according the Office for National Statistics, with 65.2% of its local areas in the most deprived 20%. Men and women in these areas can expect to die more than 10 years sooner than inhabitants of Trafford – Greater Manchester’s most affluent suburb.

Clinical director of Hope Citadel Healthcare and GP at Hill Top surgery, Dr John Patterson kick-started the Focused Care scheme from a belief that social conditions determine heath and that those in greatest need are the least likely to receive it. Patterson says: “In areas of deprivation you need more multifactorial medicine and psychosocial support.”

He asked Chorley – because of her reputation as an energetic champion of families in poverty – to design a scheme in 2010 operating from the Fitton Hill practice, to support frequent attendees at the surgery with complex problems.

Recent figures show something of the scale of human need she and her colleagues face. Of the 120 families on Focused Care in 2014-15, 92% presented with mental health issues, 58% of households had housing problems and 17 women disclosed domestic violence.

The scheme took off and Patterson was astonished by the two-year figures. Of the initial 50 to 60 households dealt with by Chorley, 24 had stopped using A&E inappropriately, 25 no longer had parenting problems, 10 had stopped abusing alcohol and 12 homes no longer had a domestic violence problem.

Seven years on, Focused Care has expanded into eight practices.

Chorley has supported a man through insolvency and encouraged him to stop smoking and drinking. Photograph: Jason Lock

Audits of the 160 families receiving Focused Care over the four Hope Citadel surgeries show that they visit A&E 57% less in the year following intervention. Smear rates over the four practices have rocketed from around 40% to 94%, while at Hill Top surgery alone, 91% of over 65s have had their flu vaccine, outstripping the target of 80%.

A patient can be referred to Focused Care by health staff, social care workers or even police. In each case a patient is seen, problems identified and a care plan drawn up, tackling anything from immigration to parenting and benefit problems. The practitioner then contacts or visits the family on a regular basis and supports them in whatever way is most appropriate for their wellbeing.

It’s usually a painstaking task unpicking the problems. Chorley has supported Baxter through the trial and jailing of a former abusive partner. In another case, she helped a man through insolvency and encouraged him to stop smoking and drinking, enabling him to become a mover and shaker in his local housing association.

Just occasionally Chorley’s job can be short and simple – accessing £20 from a Hill Top practice fund to pay the taxi fare to enable a woman refugee to leave her violent husband with her children.

Hope Citadel is now working with Shared Health – a charity centred on identifying good practice and using the Greater Manchester health devolution agenda to roll it out into the most deprived parts of the conurbation.

Patterson says: “We call Focused Care the ‘Macmillan Service for deprivation’. We want to have an impact on the whole community – not just our patients.”

*Name has been changed

Doctors Working in Deprivation will be held on Wednesday 28 September at Gorton Monastery in Manchester from 8.30am to 4.30pm. To book a free place please register.

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Debt, homelessness, domestic violence: the GP practice acting as a one-stop shop

Depression, violence, anxiety: the problem with the phrase ‘be a man’

The most dangerous phrase in the English language is “be a man”. To be a man today, says film-maker Jennifer Siebel Newsom, is to fight for success and sex, to reject empathy, and to never, ever cry. The result is depression, anxiety and violence.

Siebel Newsom’s first documentary, Miss Representation, explored the way the media contributes to the under-representation of women in power, and premiered at the 2011 Sundance Film Festival. When she was touring with the film she was pregnant with her second child, a son. And as she discussed the need for positive female role models, she inevitably heard from audiences asking: “But what about the boys?” Some $ 100,000 of Kickstarter donations later, she premiered The Mask You Live In. It has just arrived on Netflix, a fast edit of men talking wearily, and boys confused; an attempt to speak to what she calls the “boy crisis”. As a child, one young contributor says quietly, he used to have a group of close friends. Now he’s a teenager he struggles in “finding people I can talk to… because I feel like I’m not supposed to get help”. “If you never cry,” says another, “then you have all these feelings stuffed up inside you and then you can’t get them out.” In this film, Siebel Newsom calls for a whole new masculinity.

If you never cry, then you have all these feelings stuffed up inside you

The day I spoke to her, I passed three boys sitting at a bus stop. One was describing how gorgeous his wife would be when he grew up. “She’s going to be so hot… and I’m going to cheat on her like crazy.” At 42, Siebel Newsom has recently given birth to her fourth child with husband Gavin, former mayor of San Francisco, current lieutenant governor of California, and the man best known for greenlighting same-sex marriages long before US courts had sanctioned the practice. She deftly juggles our interview with her son’s insistent attempts to pull her away to play – what this means is she gets to the point. When she started researching, she found boys were more likely than girls to be diagnosed with a behaviour disorder, more likely to be prescribed stimulant medications, more likely to binge drink, more likely to be expelled from school, and more likely to commit a violent crime. At university entry level in the UK, women outnumber men in two-thirds of subjects. Three to four times as many men take their own lives than women; men aged between 20 and 49 are more likely to die from suicide than any other single form of death. “Knowing all this,” says Siebel Newsom, “and being pregnant with a son, I knew that not only did I want to make sure he didn’t become one of those statistics, but that I had to help change this culture for everyone.”

Life lessons: educator and youth advocate Ashanti Branch discusses feelings with a group of teenage boys. Photograph: Courtesy of therepresentationproject-org

It’ll take more than a film, she admits. Her nonprofit organisation, The Representation Project, works alongside the films, campaigning to challenge stereotypes. The most persuasive element, though, is Siebel Newsom herself who, in her previous life as an actor, was told to remove her Stanford MBA from her CV because it was “threatening”, but who still has that actorly skill of talking in a way that will make people listen.

Experts link the repression of growing up male with mass shootings and murder

In one scene in the documentary, a teacher gives a group of boys each a piece of paper. On one side they write how they are seen by other people, and on the other what they are feeling. Then they scrunch it up and throw it into the circle. On the outside of all the notes were words like “tough”, “fearless”. Inside, “lonely”. It’s with awkward agony that one boy rests a hand on his friend’s shoulder as he cries into his fists. The shock comes with the realisation they all feel the same. Experts swiftly link the repression required when growing up male with mass shootings and murder, which makes the film particularly poignant today. But while Miss Representation featured talking heads like Gloria Steinem, Jane Fonda and Condoleezza Rice, there are no recognisable faces in her second film. She pauses when I ask why. “It was largely because they didn’t exist,” she says. “Men are not speaking publicly about these issues.” The implication is that their silence is part of the problem.

Is masculinity really a mask? The film is compelling – her experts in neuroscience, psychology, sociology, sports, education and media are obviously knowledgeable and passionate – but the idea that the manliness they discuss is purely cultural isn’t questioned. In Time magazine, Christina Hoff Sommers (author of two “meninist” books about boys) worries Siebel Newsom is less concerned with helping boys than with “re-engineering their masculinity according to specifications from some out-of-date gender studies textbook”. She suggests talking about emotions might have less “value” for boys, that men’s stoicism is protective. She says the film is misleading, giving the impression that boys are severely depressed, stating contrasting figures showing clinical depression is much lower than in girls. Hoff Sommers’s most persuasive suggestion is that instead of simply critiquing masculinity, Siebel Newsom’s first objective should be to help mental health services to adapt to better meet the needs of men, conditioned or not : to harness that competitiveness, aggression, to reflect the energy back and use them for good. To defeat an enemy, like Captain America with his reflective shield.

Reaching across the divide: Siebel Newsom during the production of her documentary. Photograph: Courtesy of therepresentationproject-org

But perhaps that’s next – Siebel Newsom says this is just the beginning. Since premiering the film, she sees the results of the boy crisis everywhere, from misogynist responses to Hillary Clinton’s campaign to the recent Stanford University rape case, where the father of an athlete convicted on multiple charges of sexual assault said his son should not have to go to prison for “20 minutes of action”. “The way the father and the judge protected that young boy showed again how we privilege white males and star athletes,” says Siebel Newsom. “As a society, we need to take a real look at that and recognise the damage that is being done when we continue to privilege those classes, those communities, and blame the victim.”

After screenings, Siebel Newsom says men approach her, crying. “There were men in their 70s saying, ‘That was my life.’ Men in their 20s and 30s who’d tell us they no longer feel so alone. And men in their 40s who have children who go, ‘OK, I’ve got to raise my own sons differently.’” She was moved. “That is where we have to inspire the good men, the brave men, the courageous men, to stand up to those who are trying to belittle them. We’re not going to move the needle on gender parity, on violence, until we have more men entering the conversation and using their platform to support those of us who are trying to do good.”

When making the film, she says she was taken aback. “What really surprised me was how pure and gentle and confused boys were,” she says. “How they felt so much pressure to become someone they felt they weren’t. ‘I don’t want to date girls, I just want to be friends with them’; ‘I don’t know why I only have to play football.’ It’s in those school years where they start feeling this need to disconnect, and you see the pain, anxiety, the alienation that results from them denying their true selves. It’s heartbreaking,” she says.

I hear her son calling for her again. “Because, at the end of the day,” she adds, “nobody wins.”

Matthew Ryder: ‘My dad’s notion of being a man was flexible’

Photograph: Courtesy of Matthew Ryder

When I was growing up, my father’s explanation of ‘being a man’ could be bewildering. ‘It’s not about what sex you are,’ he would say, before adding even more confusingly, ‘Your mother can teach you more about being a man than anyone I know.’

Eventually I understood. Unlike many fathers in the 1970s, his concept of being a man was not the opposite of being feminine or emotional. It was the opposite of being childish and immature. It meant having the courage to face your fears and responsibilities, but also not being afraid of your emotions or weaknesses. It was about being a trusted friend and an equal partner.

He could have just said ‘be a good person’ rather than ‘be a man’. But it wouldn’t have had the same effect. He knew that, as a boy, I would one day be interacting with the rest of the world as an adult male – a man. I was going to have to understand what that meant in my dealings with women, with other men, and with society as a whole. If he did not give me a positive identity of what it was to be man, he knew that one of the many negative ones would quickly fill the vacuum. He was giving me an identity that would prepare me for life.

Over the years, that identity grounded me through my successes and failures. It also meant that, despite my youthful love of hip-hop, reggae and sports, I was never really seduced by the cartoonish, misogynistic versions of manhood –black manhood, in particular – that they often offered. It inoculated me from the worst excesses of testosterone-fuelled nonsense.

My father’s notion of being a man was also flexible. As I grew from a child of the 70s to an adult of the 90s, it grew with me. I learned that sometimes a man should back down from a fight; that real men are also feminists; and that not being seen as a ‘sissy’ is meaningless, while not being homophobic is important.

In a modern, gender-fluid world, is the notion of being a man still relevant? Are we not all just people? Yes and no. The philosopher Jerry Cohen wrote: ‘There is no way of being human, other than a way of being human.’ Being a man is one of those ways.

Matthew Ryder is a QC and part-time judge. Follow him on Twitter here: @rydermc

Erwin James: ‘Cowboys were real men. They never cried’

Photograph: REX/Shutterstock

If my father had asked me when I was six years old, ‘What does it mean to be a man, son?’ – I’d have smiled broadly and said: ‘cowboy’. I was never happier than when I was sitting on his knee watching westerns like Wagon Train and Rawhide on our tiny black-and-white TV.

My father was cowboy mad and so was I. After I said my prayers for all the people I loved, my mother had to wait until I was in bed and fast asleep before she could gently relieve me of my beloved cowboy suit. Cowboys were real men. They were tough and they never cried.

But when my mother was killed in a road crash less than a year later, I cried. My father had to be cut from the wreckage and, when he came home, I cried again. In place of my funny, loving, playful dad was a grieving, selfish, violent drunk. He beat the women he lived with and he beat me. I loved him still, but learned to hate him just as much. The care home I was sent to at 11 was full of boys like me. No aspiring train drivers or astronauts among us – we told each other that, when we grew up, we’d be gangsters and crooks. No crying allowed.

My teenage years were punctuated by spells in prisons that lionised toughness and frowned on cry-babies. Lifting weights and being ‘hard’ was what counted, what got respect. At 20, I should have been a man. Instead, like my father, I’d become a selfish, violent drunk.

Self-loathing took me down a dark road, leaving in my wake immeasurable pain and grief. At the end of it, an Old Bailey judge called me ‘brutal, vicious and callous’ and jailed me for life. Two years in, a prison psychologist told me, ‘We’re all born lovable.’ I said, ‘Even me?’ She said, ‘Even you.’ Contrition almost destroyed me. For the first time in a long time I cried again. I was desperate to be a man. I just wasn’t sure what that meant. In the end, I decided to try to just be a decent human being. Trying to be a man had been catastrophic.

Erwin James is the author of Redeemable, a Memoir of Darkness and Hope (£13.93, bookshop.theguardian.com)

Horatio Clare: ‘Being a man is being kind when frightened’

When we are boys, we believe we must study Dad and be like him. I had the great fortune of a lovely father who was rarely observable: my parents divorced. Watching him was a hopeless guide anyway. He had ‘problems’, according to Mum, and he married four women before he settled down. But he is kind, peaceable, slow to anger, very funny, and skilled.

I was quite funny but otherwise hopelessly unlike him. I loved speed, spending, girls and guns. Over the decades of my ‘manning up’ I accrued convictions for arson, taking without consent (car), ditto (boat), ditto (milk float) and all sorts of decorations for dope. Change my background and I would have been a suicide bomber. No question.

You could apply the same criminal record to my relationships with women. Not in the manner of loving them, for I think I am gentle, too, but in the leaving. Porn, piracy, hijack, honeytrap: in my pursuit of love I have committed and been had by all these. And the frightening thing is, however special I thought I might be, in my teeny ravings, which are ongoing in the male part of my lizard brain, I’m not. The blindness testosterone causes accounts for much, we know, and being a man is being blind, ‘sand-blind, gravel-blind’ as Shakespeare had an old man say, and frightened. That’s the job, I think – to be kind when blind and frightened.

The only teacher I had, really, who lived with the knowledge she would watch us go wild into a wild world, was my mum. Her favourite birds are wood pigeons, which handle relationships with a religious purity, so it follows that a good man, to her mind, is a good pigeon: alert for crumbs and shoots, devoted, on watch but not panicked, and given to singing the same song as his partner. If he has one.

And he does. We all do. Like good sailors, we boy-men have our shipmates and all the world to help us, in this ‘man’s world’, this tramp ship in time and space. The rules of seafaring, I think, are: smile, work hard, trust in the Lord/Lady and remember – the sea is equal to all men, and no man is equal to the sea.

Horatio Clare is the author of Down to the Sea in Ships and Running for the Hills

Depression, violence, anxiety: the problem with the phrase ‘be a man’

Astronaut Mark Kelly On Gun Violence, Wife Gabby Giffords

Next Following week (Aug. twenty) it will be 28 years considering that postman Patrick Sherrill opened fire in an Edmond, Okay, submit workplace, killing 14 and wounding 6 prior to committing suicide. The event is observed as the origin of the pop-culture phrase “going postal.”

Have we created progress with gun violence in the U.S. given that that tragedy? You tell me. There have been massacres at Columbine (1999), Virginia Tech (2007), Newtown and Aurora (2012) – the list would seem limitless.

I had a possibility to chat with Mark Kelly, 50, an astronaut as renowned for his journeys to the International Room Station as for currently being married to former Arizona congresswoman Gabrielle Giffords. Giffords was shot in the head at a 2011 Tucson political rally and has been recovering ever because.

JC: Gun violence in the U.S. – what are your views?

MK: The gun lobby more than the final 30 years has developed enormous influence in Washington. My wife and I soon after the Newtown shootings determined to form Americans for Responsible Remedies as an powerful counterbalance. We want an surroundings where elected officials can make decisions on policy and not be concerned so significantly about politics. Hopefully in excess of time we can get away from a place the place we have 15 to 20 occasions the death charge from guns than any industrialized country. The debate is not about the Constitution. Nobody needs to consider anybody’s second amendment rights away. I often wonder if by not acting to supply a resolution that perhaps we’re placing people’s rights in jeopardy. Considering that that horrific Newtown event happened, the nationwide response has been practically nothing. We’re going to change that.

Astronaut Mark Kelly with his daughter. (Photo: Jim Clash)

JC: So you do assistance the Second Amendment.

MK: Definitely. I’m a gun proprietor, my wife’s a gun owner. Gabby has a Glock 9 mm – I have Ruger 9 mm, a Ruger .22, a thirty.06 rifle and a .45.

JC: How is Gabby carrying out?

MK: Excellent. When it first occurred you would see progress hour-to-hour, then day-to-day, then week-to-week. It slows – now it is more month-to-month. Gabby performs hard and continues to improve. We had been chosen as Glamour Magazine’s first “Couple of the 12 months.” She gave a very good speech. Some individuals get up there with notes – she had some, but did not really look at them.

JC: In 2003 when Shuttle Columbia broke up above Texas, you visited the accident site.

MK: I was the very first particular person on the scene. I was in the workplace early and when my boss acquired in I said, ‘We have a good deal of contingency programs on what to do upon dropping a Shuttle, but nowhere did we anticipate dropping one within a two-hour drive of Houston.’ I informed him I feel we need to send a person there now, and he stated ‘Ok, you go.’ I asked the neighborhood constable to get a helicopter ready, and myself and one more man flew up. It didn’t get long just before we recovered the initial remains of crew members. I recovered 3 – two the day of the accident, and 1 the next day.

JC: In 2011 you had the challenging determination about whether or not to fly aboard the Shuttle for a fourth time.

MK: We had just had this horrific occasion occur to Gabby, and I’m going to fly in area? It was a hard choice. At the time I couldn’t even communicate effectively with Gabby. But she’s a huge supporter of the space plan and my little ones are massive supporters of my occupation. In the end it wasn’t only about me, but the other crew members. We all felt it was in the mission’s greatest curiosity for me to go back and do that flight.

Astronaut Mark Kelly On Gun Violence, Wife Gabby Giffords

Government failing on violence reduction scheme by means of A&E departments

A violence reduction sheme involving A&ampE departments sharing anonymised data with police has not been fulfilled. Photograph: Bethany Clarke/Getty Images

Ministers are failing to fulfil a coalition pledge to roll out a violence reduction scheme that has been proven to reduce attacks by as much as 40%, top accident and emergency surgeons claim.

The Tories and Liberal Democrats agreed in 2010 to introduce the nationwide scheme, which involves A&ampE departments sharing anonymised data about violent incidents with police forces, enabling problem spots to be targeted.

But as handful of as a third of A&ampE departments in England have completely adopted the programme, which was pioneered in Cardiff 20 many years ago and has been copied as far afield as South Africa and the US.

Department of Wellness officials have created it clear that A&ampEs ought to share info with police, but a spokesperson admitted it basically did not know how a lot of hospitals have been working the model. It is undertaking a assessment this summer season to discover out.

Dr Adrian Boyle, chair of the good quality in emergency care committee of the University of Emergency Medication (CEM), said he was annoyed at the lack of progress. “The implementation is not functioning as effectively as we would have liked,” he mentioned. “It is aggravating.”

Boyle, an A&ampE consultant who has worked closely with the Division of Wellness and NHS England to get the system up and running, referred to as for the government to give hospitals incentives to introduce the scheme. He mentioned there was a wariness within hospitals about workers to liaising with experts “out of their silo”. The reorganisation of the NHS may possibly also have hampered the programme, he said.

An audit two years in the past discovered two-thirds of A&ampE departments were not sharing information to the standard advisable by the CEM. Boyle mentioned he did not feel the new audit would present any progress.

The architect of the unique Cardiff scheme, Jonathan Shepherd, professor of oral and maxillofacial surgery at the Cardiff school of dentistry, expressed concern at the slowness of the adoption of the model.

He mentioned there was even now as well great an acceptance of “schedule” street violence. “Folks grow to be immune to the concern and the social catastrophe it represents. For health-related personnel, police and local authority employees it becomes a schedule portion of what transpires when you’re on shift at the weekend.

“Pros are used to getting reactive, suturing folks up and arresting offenders rather than taking a a lot more preventative approach. I’m not shocked it is taking some hospitals so prolonged [to adopt the Cardiff model] and others aren’t doing it properly.”

Shepherd’s thought stemmed from research he did in the 1980s which located only a quarter to a third of violent incidents resulting in a journey to A&ampE come to the interest of the police. He realised that for forces to have a full image of what was happening they ought to know about all situations of emergency treatment.

His scheme – the Cardiff violence prevention programme – launched in 2003. Hospital personnel recorded anonymised information of where, when and how a victim had been attacked. This info was shared, making it possible for maps of violence hotspots to be developed and the organisation of operations to tackle the problem.

The outcomes were striking. Inside 5 years there had been an estimated 42% fewer woundings in the Welsh capital in contrast with similar cities.

There was a 35% decrease in the number of sufferers seeking emergency treatment method and one particular study place the savings in economic and social expenses at just below £7m a 12 months. For every £1 invested on the scheme, £82 was saved.

Shepherd mentioned he realised the scheme was working when the price of violence in Cardiff, a well-liked get together city, dropped to amounts noticed in towns this kind of as Eastbourne and Harrogate. Shepherd advised the government essential to do more to fulfil its coalition agreement guarantee. He explained: “In the runup to the 2015 election I feel people will want to be reassured that this government commitment has come to fruition.”

Shepherd’s model or variations of it are in place in Amsterdam and the Western Cape in South Africa. Milwaukee in the US has also been investigating it.

Alun Michael, a former Labour minister and now police commissioner for south Wales, was also surprised that a lot more hospitals had not adopted the model. “Analysing incidents which brought victims of violence to A&ampE has led to considerable and sustained reductions in the variety and seriousness of violent incidents,” he said.

Gary Smith, the director of Cardiff Street Pastors, which assists keep revellers safe in the city centre on Friday and Saturday nights, said he had noticed a big difference in the city in excess of latest many years. “It feels a secure, area to be now. I feel that’s partly because everybody performs collectively so nicely now.” Michael and Smith each explained the programme in Cardiff had led to a wider cultural shift with companies far more utilised to functioning closer and better together.

South Wales police created it clear it believed the scheme was worthwhile. A police spokesperson mentioned the scheme had produced a “important contribution” to the reduction in violent crime. “It is an superb illustration of how partnership perform in Cardiff is producing a genuine big difference to retaining our communities protected.”

There are examples that display the scheme has worked nicely in other places the place it has been adopted. In some, violent crime has fallen by 40%. In Cambridge, for example, analysts realised foreign college students had been being injured on Monday evenings after Addenbrooke’s hospital shared info. Officials found that drinks promotions aimed at foreign students were currently being offered by bars. The premises have been told they must end such promotions.

In the south-east of England, people began attending an A&ampE having been hit by planks of wood and bricks. The information was passed on and council officials realised an open skip had been left close to a nightclub. Such skips had been banned from the area.

Mark Bellis, who advises the World Wellness Organisation on violence prevention who has implemented a productive info sharing scheme in the north west of England, said there remained a reticence in some locations to take it up. “It can function phenomenally well but some are reluctant since of the investment and the time.”

Caroline Shearer, of the anti-knife campaign group Only Cowards Carry stated the government essential to do a lot more to tackle violent crime – like generating sure hospitals shared information.

“The government talks challenging, it demands to act difficult,” she said.

A spokesperson for the Department of Overall health mentioned: “We have been clear A&ampE departments should share details with police and we are about to assessment compliance ahead of the rollout of a new legal regular which all key A&ampEs will be obliged to meet. We’re also supporting hospitals to train nurses to specifically champion this.”

Government failing on violence reduction scheme by means of A&E departments

National Youth Violence Prevention Week: Brady Center To Prevent Gun Violence Launches "Communicate Up" Campaign To Conserve Lives

A targeted and revolutionary new public awareness campaign was launched by The Brady Center to Stop Gun Violence yesterday as component of National Youth Violence Prevention Week, April seven-11. The public awareness campaign, referred to as Talk UP, enlightens college students about potential techniques they can aid avert violence, and features posters and poster contests, public support announcements, interactive BuzzFeed-style quizzes, as well as pledge drive and action and resource kits.

According to data, in four out of 5 college shootings, the attacker informed somebody about their prepare. The truth that advance knowledge usually exists makes communication and transparency a key element of assisting to reinforce a sense of urgency among those who have the potential to end this kind of violence.

“I constantly wish an individual had spoken up if they saw any red flags with Eric Harris Harris and Dylan Klebold, explained Crystal Miller, survivor of the April 1999 Columbine shooting. “I really do not think in this day in age we can afford to be overly cautious. I want men and women to know that if there’s any hint of suspicion, they have a responsibility to speak up and talk to the authorities, even if it’s anonymously by means of a hotline.”

“I do think there are constantly indications and red flags. I believe people didn’t understand the place issues could lead in the case of Columbine,” Miller explained.

Placing this in point of view, Miller believes that “in the submit Columbine planet we are not able to afford to be overly overcautious, meaning that anything at all that we see that is out of the ordinary for a younger person should draw our consideration and be addressed.”

Speak UP CAMPAIGN

“SPEAKING UP”, which includes improving communication amongst teens and dad and mom, is the cornerstone of building and marketing security in our communities.

The Talk UP site revolves close to BuzzFeed fashion interactive super hero quizzes expanding upon speaking up narratives of other students who have spoken up prolonged with on-line, Television and print adverts. Adding to this hard work, an action kit put collectively by the Nationwide Association of College students Against Violence All over the place (Conserve), a founding spouse in the National Prevent Youth Violence Campaign contains a Talk Up pledge drive as well as poster contest.

“We are devoted to identifying true solutions that can assist keep our schools and communities safe”, said Dan Gross, President of the Brady Center to Stop Gun Violence. “When college students communicate up, they can save lives. This public awareness campaign is about something actual that students can do to assist make their schools and communities safer.”

“Forty little ones are shot or killed by guns each and every day in our nation. It is occurring in huge cities and small towns, in private homes and public places – even colleges. It is clear that guns in the incorrect hands are a main contributor to this violence, and this campaign offers college students with important equipment they can use do anything about it,” mentioned Gross.

“Signs,” one of the new public services announcements, focuses on recognizing and reporting threats as nicely as other warning signs of violence. The PSA, which will be run on cable television and key network stations and will be posted on You Tube and Facebook, encourages and empowers students to make anonymous reports about “signs of violence” by calling the hotline, one-866-Communicate-UP. The hotline, which was launched in 2002, has obtained practically forty,000 calls.

The shootings at Columbine 15 years ago have been a dark day in our nation’s background. Multiple other mass shootings including the tragedies at Virginia Tech, as nicely as Newtown, emphasize the want to empower our society to assist seek out techniques to avoid more bloodshed. The effects of mass gun violence on youngsters and families has led to alterations in how we method preventive techniques to identify signs of likely ideas to inflict harm on people in public settings.

National Youth Violence Prevention Week, especially in the context of the 15th anniversary of the Columbine High College shooting, holds unique relevance to the victims and survivors of this tragedy, as properly as to all Americans who continue to witness senseless gun violence.

The Mechanics of “SPEAKING UP”

Encouraging teens and youngsters to talk up about any indicators of prospective violence against other people is an critical facet of empowering our society to assault gun violence.

“There is powerful proof that an overwhelming bulk of younger people value the importance of speaking up to avoid violence and are inclined to do it if they are offered a protected, reliable and anonymous signifies to do it, ” explained Gross.

National Youth Violence Prevention Week: Brady Center To Prevent Gun Violence Launches "Communicate Up" Campaign To Conserve Lives

Call climate adjust what it is: violence | Rebecca Solnit

If you are poor, the only way you are likely to injure a person is the previous traditional way: artisanal violence, we could get in touch with it – by hands, by knife, by club, or possibly modern day hands-on violence, by gun or by vehicle.

But if you happen to be tremendously wealthy, you can practice industrial-scale violence without any guide labor on your personal element. You can, say, construct a sweatshop factory that will collapse in Bangladesh and kill more folks than any hands-on mass murderer ever did, or you can calculate chance and advantage about putting poisons or unsafe machines into the planet, as producers do every day. If you’re the leader of a country, you can declare war and kill by the hundreds of 1000′s or millions. And the nuclear superpowers – the US and Russia – even now hold the selection of destroying quite a whole lot of lifestyle on Earth.

So do the carbon barons. But when we speak about violence, we virtually often speak about violence from under, not above.

Or so I believed when I received a press release final week from a climate group announcing that “scientists say there is a direct link between altering climate and an improve in violence”. What the scientists really stated, in a not-so-newsworthy write-up in Nature two and a half years in the past, is that there is greater conflict in the tropics in El Nino years, and that probably this will scale up to make our age of climate adjust also an era of civil and global conflict.

The message is that ordinary men and women will behave badly in an era of intensified climate adjust.

All this helps make sense, unless you go back to the premise and note that climate adjust is itself violence. Excessive, horrific, longterm, widespread violence.

Climate modify is anthropogenic – induced by human beings, some a lot more than other folks. We know the consequences of that change: the acidification of oceans and decline of many species in them, the slow disappearance of island nations such as the Maldives, enhanced flooding, drought, crop failure top to foods-value increases and famine, increasingly turbulent climate. (Think Hurricane Sandy and the current typhoon in the Philippines, and heat waves that destroy elderly individuals by the tens of thousands.)

Climate adjust is violence.

So if we want to talk about violence and climate modify – and we are speaking about it, soon after last week’s horrifying report from the world’s best climate scientists – then let us speak about climate change as violence. Rather than worrying about whether or not ordinary human beings will react turbulently to the destruction of the really means of their survival, let us be concerned about that destruction – and their survival. Of program water failure, crop failure, flooding and a lot more will lead to mass migration and climate refugees – they previously have – and this will lead to conflict. People conflicts are currently being set in motion now.

You can regard the Arab Spring, in portion, as a climate conflict: the improve in wheat costs was a single of the triggers for that series of revolts that modified the encounter of northernmost Africa and the Middle East. On the one particular hand, you can say, how great if people individuals had not been hungry in the very first place. On the other, how can you not say, how wonderful is it that people people stood up against becoming deprived of sustenance and hope? And then you have to look at the techniques that created that hunger – the tremendous financial inequalities in locations such as Egypt and the brutality used to preserve down the men and women at the decrease amounts of the social system, as effectively as the weather.

People revolt when their lives are unbearable. Sometimes materials actuality generates that unbearableness: droughts, plagues, storms, floods. But meals and health care care, well being and well-being, access to housing and education – these things are also governed by financial signifies and government policy. That is what the revolt known as Occupy Wall Street was against.

Climate alter will improve hunger as meals costs rise and food manufacturing falters, but we currently have widespread hunger on Earth, and much of it is due not to the failures of nature and farmers, but to systems of distribution. Practically 16m kids in the United States now live with hunger, according to the US Department of Agriculture, and that is not due to the fact the huge, agriculturally rich United States are not able to produce enough to feed all of us. We are a nation whose distribution technique is itself a kind of violence.

Climate alter is not out of the blue bringing about an era of equitable distribution. I suspect folks will be revolting in the coming long term against what they revolted towards in the previous: the injustices of the technique. They need to revolt, and we ought to be glad they do, if not that they want to (though hope they will acknowledge that violence is not automatically in which their energy lies). A single of the occasions prompting the French Revolution was the failure of the 1788 wheat crop, which created bread rates skyrocket and the bad go hungry. The insurance coverage towards this kind of occasions is typically considered to be more authoritarianism and a lot more threats towards the poor, but that is only an try to hold a lid on what is boiling more than the other way to go is to flip down the heat.

The exact same week during which I obtained that sick-considered-out press release about climate and violence, Exxon Mobil Corporation issued a policy report. It helps make for uninteresting reading, unless of course you can make the dry language of organization into photos of the consequences of those acts undertaken for profit. Exxon says:

We are assured that none of our hydrocarbon reserves are now or will turn into ‘stranded’. We believe making these assets is important to meeting expanding energy demand throughout the world.

Stranded assets that suggest carbon assets – coal, oil, fuel even now underground – would grow to be worthless if we made the decision they could not be extracted and burned in the close to long term. Since scientists say that we need to have to leave most of the world’s known carbon reserves in the ground if we are to go for the milder rather than the far more severe versions of climate adjust. Under the milder version, many much more people – species, locations – will survive. In the very best-case situation, we harm the Earth less. We are at present wrangling about how much to devastate the Earth.

In every arena, we need to have to appear at industrial-scale and systemic violence, not just the hands-on violence of the much less potent. When it comes to climate alter, this is specifically accurate. Exxon has made a decision to bet that we cannot make the corporation keep its reserves in the ground, and the business is reassuring its investors that it will carry on to profit off the quick, violent and intentional destruction of the Earth.

That is a tired phrase, the destruction of the Earth, but translate it into the face of a starving youngster and a barren discipline – and then multiply that a number of million times. Or just image the small bivalves: scallops, oysters, Arctic sea snails that cannot kind shells in acidifying oceans proper now. Or yet another superstorm tearing apart yet another city. Climate adjust is global-scale violence, against areas and species as well as towards human beings. As soon as we call it by name, we can start off having a true conversation about our priorities and values. Simply because the revolt against brutality begins with a revolt against the language that hides that brutality.

Call climate adjust what it is: violence | Rebecca Solnit

Violence – A Side Result of Psychotropic Medication

http://www.hcbl.com/weblog/wp-content/uploads/2013/eleven/bullet_capsules.jpgThese days antidepressants, psychotropic medicines, and mood enhancers/stabilizers are becoming given out by doctors like Tic-Tacs.
Feeling sad? Have a pill. Feeling mad? Get a pill. Feeling something at all? – We have to appropriate that! – Here is a prescription.

When did we all cease dealing with our difficulties and begin believing that swallowing a magic pill would fix every thing?

It would be beautiful if it worked. The evidence is in the pudding though. More and far more individuals on these drugs are shedding their grip on reality and turning into actively violent.
Current shootings in the news – Sandy Hook, The Batman Film Shooting, Columbine, and others all have a common denominator : Prescription medicines have been all in their techniques at the instances these crimes were committed.

According to a review published in the journal PLoS 1 and based on the Meals and Drug Administration’s Adverse Event Reporting Method, the following mind-altering medication are most frequently linked to violence:

10. Desvenlafaxine (Pristiq) is an antidepressant connected with seven.9 instances much more violence than many other medicines.

9. Venlafaxine (Effexor) is relevant to Pristiq and is an antidepressant also utilized in treating those with anxiety issues. Effexor is eight.3 times a lot more related with violent habits than other drugs.

8. Fluvoxamine (Luvox) is an antidepressant that impacts serotonin (SSRI) and is eight.4 times much more most likely to be linked to violence than other drugs

7. Triazolam (Halcion) can be addictive and is a benzodiazepine that supposedly treats insomnia. It’s 8.7 occasions far more likely to be connected with violence than other prescription drugs.

6. Atomoxetine (Strattera) is usually prescribed to tread ADHD and is 9 occasions a lot more likely to be linked with violence.

5. Mefoquine (Lariam) treats malaria and at times goods bizarre conduct, and it is 9.five instances much more most likely to be linked to violence.

4. Amphetamines come in many varieties and are often used to treat ADHD (even to young children not diagnosed with ADHD). They are 9.six occasions a lot more probably to be linked to violence.

three. Paroxetine (Paxil) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. Several users expertise severe withdrawal signs and are much more likely to create kids with birth defects as properly as ten.three times much more likely to be linked to violence than other medications.

two. Fluoxetine (Prozac) is a household title for a potent SSRI antidepressant linked with ten.9 times far more violence than other drugs.

1. Varenicline (Chantix) is administered to smokers to supposedly assist curb cigarette cravings, but it is a whopping 18 instances more very likely to be linked to violent conduct than other drugs.

There is literally no accountability. Pharmaceutical medicines are killing men and women by the 1000′s through the two toxicity and behavioral side effects, but no 1 seems interested in banning these medicines or holding Massive Pharma and prescribing doctors accountable.

The FDA, which approves these medicines, recognizes that far more 100,000 adverse drug response deaths occur each 12 months. This is the fourth foremost cause of death, ahead of pulmonary disease, diabetes, AIDS, pneumonia, accidents and car deaths.

Drug businesses bribe doctors to prescribe their drugs and use fake research to create belief in their effectiveness and security.

The greatest way to deal with your emotions is to encounter them head on. Drugs are a crutch, and not a really excellent one at that.

They might make you really feel far better in the interim brief phrase, but they do not have the potential to appropriate anything at all. They can’t and do not make greater existence alternatives for you that will lead to happiness.
If you really feel you have a chemical imbalance, seek the advice of a Holistic or Naturopathic Physician who can aid you operate with not towards your physique in purchase to proper this.

Violence – A Side Result of Psychotropic Medication

One in 4 Afghans has misplaced a person to violence in past yr, says charity

An Afghan schoolboy injured in a bomb blast is taken to hospital in Helmand province, Afghanistan. Photograph: Watan Yar/EPA

Conflict has become so widespread in Afghanistan that one in four people have lost a relative or shut buddy to violence in excess of the final year, a leading medical charity mentioned.

The network of clinics and hospitals is also as well modest, weak and expensive to appear right after the victims of war and disease, and there, and there is a unsafe lack of respect for the neutrality of healthcare providers by all sides in the fighting, which is costing lives.

The findings seem in Among Rhetoric and Reality, a report by Médicins Sans Frontières on Afghanistan’s health care system following a decade of worldwide help.

Government troops, their global backers and insurgents all periodically seize clinics for use as temporary bases, although ambulances and patients are delayed and harassed at Taliban and government checkpoints in violation of global law.

The government also ideas to use medical centres as polling stations in approaching elections opposed by the Taliban, further politicising buildings that must keep neutral. They will also threat harm need to they come under assault from groups that have threatened to disrupt the election.

“Active fighting, the occupation of wellness facilities by armed groups, deliberate delays and harassment at checkpoints, and attacks on health care cars and personnel all generate unacceptable barriers for sick or wounded people in need to have of health-related assistance,” the report says.

Virtually half of sufferers who make it to the four hospitals run by MSF in the north, south-east and central Afghanistan encounter fighting, landmines, checkpoints or harassment on the way, the charity’s director, Christopher Stokes, stated.

After a decade of foreign efforts to transform the country, hundreds of millions of dollars have been poured into every little thing from vaccinations to midwife training, but numerous Afghans say the programmes have brought little actual modify to their villages.

“The patients’ testimonies expose a broad gap amongst what exists on paper in terms of healthcare and what truly functions,” the charity says. It warned that money invested by commanders looking to “win hearts and minds”, or as element of counter-insurgency tactics, typically did not meet the most pressing demands of ordinary folks.

“In our area the canals are half-finished, the school buildings are half-completed, the clinics are half-finished,” 1 college principle from northern Afghanistan told MSF. “It means that we do not have appropriate healthcare in our location. A good deal of medical professionals also escaped simply because of the fighting and insecurity.”

The report also warned that though there had been progress since the fall of the Taliban, limited entry to the most violent and deprived locations has skewed data that looks to display dramatic improvement in situations.

“Health statistics from Afghanistan are notoriously unreliable … information from the most insecure areas are often excluded,” the report says. “This introduces a persistent bias that is most likely to contribute to overly constructive country averages.”

The research was carried out more than 6 months and incorporated interviews with more than 800 individuals. MSF provides all solutions free of charge of charge, as opposed to government and private hospitals where official and unofficial costs can bankrupt families. Two-thirds of the folks who seek help at MSF hospitals live in intense poverty, with their households surviving on about $ one a day, the report says.

One in 4 Afghans has misplaced a person to violence in past yr, says charity

Eve Ensler: "We need to be hysterical about sexual violence"

The last time Eve Ensler and I met, she was sporting a sleek black bob and shiny boots, and had Jane Fonda on her arm. It was 10 years ago, when Hollywood actors were falling over themselves to perform her hit play, the Vagina Monologues, in front of audiences who got a thrill out of hearing stars say “cunt” on stage. Back then, post-feminism was still the height of fashion, Sex And The City was still on air, and I was growing tired of celebrity froth and rude words being passed off as radicalism. Ensler recalls finding me “intense and scary, and hostile to everything we were doing”.

Since that interview, a great deal has happened. The complacency of post-feminism has been replaced by a new, much more indignant movement of grassroots groups such as Vagenda and UK Feminista. Ensler has very nearly died from uterine cancer. She has also created a global women’s campaign called One Billion Rising, which on Valentine’s Day last year brought close to one billion women out on to the streets to protest against violence towards women, and will do so again next Friday. This time round, we find each other so unrecognisably altered that the interview dissolves into unexpected intimacy, and by the time we say goodbye, I am quite shaken.

Link to video: Eve Ensler: ‘Women will rise up and take back the Congo for the Congolese’

The contrast is striking as soon as I arrive. Her Manhattan loft is done out in colourful drapes fashioned from Indian saris, and she bounces around it with an unselfconscious ease in her own skin that is arresting and compelling. Her pre-cancer bob has been replaced by a more haphazardly friendly crop, and the old angular severity and faint air of ambition have vanished. With less than three weeks to go, preparations for OBR are reaching fever pitch and Ensler is buzzing, because it looks as though its second year will be even bigger than its first.

The idea behind it is both simple and fantastically ambitious. According to UN figures, one in three women on the planet will be beaten or sexually assaulted. That works out at one billion women, so Ensler wants a billion to gather on 14 February outside buildings that represent justice – police stations, courthouses, government offices – and dance. That’s it. Where and how they dance is up to them; each gathering is organised at a local level. In Miami, they plan to stop the traffic, to highlight sex trafficking; in Peru, they’re getting construction workers to carry placards renouncing street harassment. The sole unifying principle is that they dance to end violence against women. Last year, women and men danced in more than 200 countries.

Ensler always says that when she first began organising Valentine’s Day events back in 1998, she assumed violence against women would by now be a thing of the past. Her V-Day movement was obviously going to stop men beating women, and eradicate rape and sexual assault from the planet. She never dreamed, she likes to say, that 15 years later she would have to come up with an even bolder solution, but I’d always taken this for rhetorical playfulness. She didn’t seriously believe she could end all sexual violence against women, did she?

“Well, that’s a good question.” Ensler grins. “Here’s what I think. Look at slavery. It’s utterly barbaric. How could a practice like that absolutely exist, ever? So, raping women? Same thing. How could that exist? So part of me goes, of course it has to end now! We have to have an idea that it’s possible to end this. Because if we all keep going around as if, well, it’s just part of what life is, it’s part of the human condition, it’s who men are, it becomes permanently normalised, right? So, yes, I do hold an idea that it’s possible. Absolutely. I wouldn’t keep doing this work if I didn’t. I’d be an insane person. Now, obviously it hasn’t happened yet. But at the same time, the world has changed. We are talking about violence against women, it is on the front page of newspapers. It wasn’t 16 years ago. So it has changed, and that makes me think, why can’t we end it? I’m going to believe it’s possible until I leave this world, because that gets me up in the morning. And if that’s a pipe dream, so be it.”

Ensler was always an idealist, but never planned on becoming a global activist. When she wrote the Vagina Monologues in 1996, she was a minor playwright just hoping to see it staged in a tiny downtown New York theatre. It has since been produced in 140 countries, in multiple languages, and Ensler discovered that audiences all over the world were laughing and crying in exactly the same places.

“So then I began to understand that this worldwide violation of women, this denial of desire or pleasure, this blaming of women for their sexuality when they are abused, is actually universal. When you’re fighting female genital mutilation in Gambia, or you’re fighting gang rape in Congo, or you’re fighting acid burning in Pakistan, you are in your world believing this is happening in your culture, because it’s specific to your local reality. But when you suddenly understand that violence against women is the methodology that sustains patriarchy, then you suddenly get that we’re in this together. Women across the world are in this together.”

Educated western women struggle to see parallels between their reality and an Afghan villager’s, say, so the concept of global patriarchy is a tough sell, isn’t it? “The so-called liberated women?” she blinks. “I’m not buying all of that. If we look at this country, 300,000 girls on college campuses in America are sexually assaulted every year. Is that an end to oppression? One out of three in the US military is raped by their comrades? So we’re not talking about an end to that violence, absolutely not.”

Ensler in The Vagina Monologues. Photograph: Robbie Jack/Corbis

Up to this point, I’m with Ensler. But I’ve always taken for granted that rational argument is the way to get change, whereas she says, “We should be hysterical. Yes, I really think so. I mean, look at what’s going on! Sometimes I think we’ve all learned how to be so well-behaved and polite, and there are many clever people, and we have access to so much information – but the world is still falling at its knees. We have 85 people who make the same amount as 3.5 billion. We have one in three women on the planet being raped or beaten. And all our best thinking – thinking – has brought us here. All this great information is just spinning more information. Where is the action part, which is about rising up to do something about it? Until that thinking is translated into the body, and we are feeling what is happening, nothing is going to get us to motivate to change. I mean,” she begins to laugh in amazement, “I love that people think theorising is stronger than dancing. I love that they think that’s a stronger way of changing the world.”

Isn’t it? I ask her to explain why I am wrong. “Where do I begin? Last year, close to one billion people danced, and here are the things that happened. In the buildup to the dancing, coalitions came together that have never come together before. They understood their body, they understood their sexuality, they understood love. They were able to see themselves working together in ways they couldn’t do before.”

Ensler is in good company, for if the new feminist movements have one thing in common, it’s an aversion to prescriptive ideological programmes. All this inclusivity has been good at bringing a new generation of women to feminism, but I wonder how far it can be sustainable once they get down to the business of working out what actually to do. Ensler knows that nothing will change until women are economically equal, which is both true and a tall order, but is she saying men are basically violent towards women because they have the economic power to get away with it – or do only damaged men damage women?

She sighs. “I’ve been thinking about violence against women for 16 years, and I wish I could tell you I was closer to an understanding of what motivates men to do it. But I have a few theories. One is that we bring up boys to be disconnected from their hearts at a very young age. What are the defining qualities for a man? That you don’t cry.

“Let’s just stay with that. If I had not been allowed to cry in my life, I would be either dead or in a mental institution. What is the one thing you can do when all else fails? You can cry. You can get rid of the trauma. What if you don’t have that? Where does it go? It goes into self-hatred, it goes into rage, it goes into shame – and somebody’s going to pay the price for that. When men get angry and frustrated, they beat up their wives. And once you are far enough dissociated from yourself, anything’s possible. Imagine a man on top of a woman who’s screaming no no no, and he’s continuing. Where is he, that he doesn’t feel what she’s saying? He’s gone.”

Ensler talks very quickly, often with a cadence not unlike a charismatic preacher’s, in sentences that build and rally and roll in a great rhythmic refrain. But when I ask why she thinks her own father raped and beat her senseless throughout her childhood, her face freezes, and the words come slowly and haltingly.

“I think, umm… I think my father wanted control. Control was a very big thing for my father’s generation. They were taught to be in control of their feelings, their family – in control.” She pauses. “And I think when anything felt out of his control – his emotions, maybe his feelings towards me, an autonomous being doing things he didn’t tell me to do – it was absolutely unbearable.” After another pause, she adds quietly, “There is an insane sadism that comes from believing you have a right to control other people. And when people don’t let you do that, it just gets deeper and more psychotic.

“The other piece was that my father didn’t know what to do with his sexual feelings. I think there are many parents who have sexual feelings towards their children, and we don’t have any discourse around that. What do you do with those feelings? People punish the child for evoking those feelings.”

Mexico 2004: Ensler, Jane Fonda and Sally Field on the frontline of a protest in Juarez. Photograph: Getty Images

Ensler was born in a middle-class suburb of New York 60 years ago, to a rather glacial housewife and a domineering corporate executive who began abusing her when she was a few years old. Her mother never intervened, and her younger sister witnessed the violence helplessly. As soon as she was old enough to leave home, Ensler took a lot of class-A drugs, had a lot of promiscuous sex, became an alcoholic, lived in communes and numbed her way through her 20s until she met her husband. She cleaned up, worked with homeless women, campaigned against nuclear weapons, got divorced in her mid-30s and became a small-time playwright on the beatnik downtown New York scene, until, at 43, she wrote the Vagina Monologues and the sexual violence of her childhood became the motor of her existence.

Fay Weldon once said, “Rape is not the worst thing that can ever happen to a woman, if you are safe, alive and unmarked afterwards.” Germaine Greer has argued something similar, claiming, “It is not women who have decided that rape is so heinous, but men.” Is it just possible, I ask Ensler, that we have accorded rape greater emotional power than it merits?

“That is just the most ludicrous thing I’ve ever heard.” She looks stricken, and speaks slowly and deliberately. “I know what rape does. What people don’t understand about rape – and it’s so hard to communicate – is it’s not an act, it’s a life. It robs you of dignity, agency, choice. It is an invasion that renders you incapable of trust, and makes intimacy one of the most terrifying things. A woman in Haiti said something brilliant to me – she said it makes sex something you’re obsessed with but can never enjoy. The sexual assault and the beatings by my father made me leave my body, and you know, I am 60 years old and it is only this year that I’m finally able to actually purge his negative and dark projections into me, and reinhabit my own body.”

Had I asked if she thought she inhabited her own body when we met a decade ago, she would have said yes without any hesitation. She’d done years of therapy and had just written a play, The Good Body, all about women’s relationships with their bodies. But when Ensler began passing blood five years ago, and her stomach distended, and she suffered terrible indigestion, and felt nauseous, she decided not to pay attention. By the time she finally saw a doctor, cancer had spread. It was stage III, nudging stage IV, and the odds of her surviving were bleak. How could she of all people have ignored what her body was telling her?

“I know, I know.” She smiles. “Cancer was just like a smash into the wall – like, ‘Girl, you are so not in your body, you are so not paying attention to yourself.’ But I had things to do! When my doctor called to tell me I had cancer, he said, ‘I have two things to say, and you have to listen to me. You cannot go to Haiti tomorrow. And you have cancer.’ He had to say them in that order because he was sure I would keep going, because my body was secondary to everything. I didn’t value it.”

Ensler believes she got cancer because her body became literally sick of the compulsion to keep proving herself. “I had to prove I wasn’t stupid, I had to prove that I was somebody, I had to prove that I could do it all on my own. And I think I had gone as far as I could go. I thought, what is the point of this – am I going to do this for ever? Am I going to prove myself to death?”

I’d been expecting a fairly straightforward conversation about Ensler’s work with OBR, but as she talks about cancer, I feel myself turn cold with fear, because the self she is describing sounds horribly recognisable. If that’s why she got ill, then I’m in trouble. Ensler is not the first person to talk about cancer in these terms, but the peculiar persuasiveness of her intimacy makes me blurt out: “The truth is, I’ve got no idea what ‘being in the body’ even means. I’ve only ever lived in my head.”

It’s true; for as long as I can remember, my body just seemed like a troublesome inconvenience, the least important thing I could think of. “I could have told you that about you,” Ensler says. “And it’s so important to get in your body. Can I tell you, it’s different in here [motioning to her heart]. And it’s really good.”

But I don’t think I ever really feel much about anything, I admit. I just think and do.

I’m amazed to hear myself telling her this, but she looks unsurprised. “Oh God, I so relate. I had a tumour the size of a mango and I didn’t even notice. And you know what, where are we going with all that fancy head stuff? We’re achieving and doing, but where the fuck are we going? When I sat there and they said to me, the cancer might be in your liver, it was like a new world. Wake the fuck up, sister. And I bless it. Because I don’t know what else would have taken me there. Can I tell you, I am now the happiest I have been in my life. Profoundly. I’m working from a different engine now; I don’t have to work, I want to. And that was the beginning of this life, which is so good.”

Is she saying she is glad she got cancer? “Are you kidding? Of course I am. I wasn’t in the beginning. But then I really got it. Because I realised I was disconnected from everything and everybody. And there is such a loneliness with it. Once you live in your body, you can just be.”

She studies me again. “How much are you living to prove yourself?”

Don’t we all have to prove ourselves? Nothing comes unconditionally.

“Bullshit. It’s all bullshit. I’m convinced that the core of everything that is wrong on this planet is people feeling that they are not good enough. But there is nothing to prove. You don’t have to do anything. You know, I don’t really give a fuck if you’re a good interviewer. I actually like you – not your do, but you.”

But we are what we do, aren’t we? “No. No. No!” Deep down I think I’ve always known this must be true, but Ensler is the first person who has ever made it sound believable. She grips my hand. “Let me tell you something, if you keep going on this path you will get sick, it’s inevitable.”

This doesn’t really feel like an interview any more. The last time we met, if someone had told me that our next encounter would end with me asking her how I go about getting back into my own body, I would have said they were mad. But she can get A-listers to perform a play about vaginas, persuade a billion people to dance, and believes she can end rape, so I don’t know why I’m surprised. She is one of the most powerfully magnetising personalities I’ve ever met.

We stand and she hugs me. “You don’t have to get cancer to come back into your own body, you really don’t. I got to do it so you don’t have to. You think your body is just an engine, a machine to move you along. Let me tell you, I love my body so much now, I adore this body. I’m missing seven organs and 70 nodes, and I’m functioning. How could I not love this body?”

Eve Ensler: "We need to be hysterical about sexual violence"