How curious is the power of words

Regular readers of this blog will know I have a fascination with words, particularly the written word. One of my long-held ambitions has been to write a book; a novel that is. Despite having written, and had published, hundreds of academic papers and two reference books, I know I’m probably still not clever enough to write that novel that is meant to lurk inside us all. These days I content myself by writing these weekly blogs. To date, I have posted 767 weekly blogs, and as each one tends to be around 750 words, I guess I may indeed have written a book!

My fascination with words saw me looking last week for the origin of the phrase ‘to eat humble pie’. All will become clear as to why later. It turned out to be an interesting search that fuelled my curiosity over the meaning of different words. The phrase itself has been in use since the mid 19th century. The word humble, appears to have been derived from the term ‘numbles’ (or sometimes ‘noumbles’, ‘nomgblys’ and ‘noubles’). These were all words used to describe what we now call offal; such things as animal heart, liver, entrails and so on. Over time these words evolved into ‘umbles’ used to describe pies where the filling was made from offal.

Although sounding similar, the word ‘humble’ has a different etymology, and is derived from the Latin for loins. Interestingly loins (girded or not) are described in the Oxford English Dictionary, as the ‘parts of the body that should be covered by clothes’. It is perhaps that the similarity of both words ‘umble’ and ‘humble’ and the fact that umble pies were eaten by poorer folk that lies behind its current idiomatic meaning: that is, to eat humble pie is to admit you were wrong.

Last week I ate a large slice of humble pie. In a recent blog, I mentioned that I was to appear before a national review panel who, I suggested, would be ignorant about mental health services, mental health nursing, and measuring the real impact of our improvement journey on service users and colleagues. How wrong I was.

The panel were informed, were appropriately curious and very supportive. This made our discussion constructive, helpful and a real privilege to be a part of. It also had a very surprising outcome. At the end of the review meeting, I invited the NHS England Board panel members to visit our Trust to see for themselves what we were doing and where we were going. Two of the panel took me up on my invitation last week and came up to Manchester to visit our Trust.

It was wonderful to be able to show them around some of our services, and let them see the improvements we had made to many of our clinical environments. More importantly, it was great to introduce them to colleagues and to let our colleagues relate their own experiences, their journey so far, and the confidence they had in our future. I think that it was far more powerful for my NHS England colleagues to hear the words directly from my colleagues than any report or PowerPoint presentation I might have provided. 

My GMMH colleagues did themselves proud in the telling of their stories and doing so in their own words. We were also able to have conversations with some of the service users we met during the visit. Again, it was a powerful opportunity to learn about the services we provide through service users describing. in their own words, their experiences and hopes for the future. I hope last week’s visit is the first of many, and so yes, I was happy to eat that great big slice of humble pie and admit I was wrong.

On a lighter note, there are some words I would never eat. These are the words to be found running through the great British seaside tradition of a stick of rock. I can’t actually recall eating any rock in my childhood, although I know back then I did have a very sweet tooth. These days less so, and I would never consume such sugar-filled confectionary today. The seaside rock we have today comes from the 19th century ‘fair rock’ which was sold at fairgrounds during a time when sugar was both cheap and plentiful. 

It was Ben Bullock, an ex-miner from Burnley who is credited with inventing a way to put words through rock. You can see how it is done here - just go to the 12th minute of the video. It is said that only 30 people across the UK have the skill these days to put words through rock. What I didn’t know is that most of the rock sold at seaside resorts across England is made in Blackpool. Sadly, it appears that the seaside rock industry is currently under threat by cheaper (and some say inferior) imports from China. Blackpool rock producers want their product to be given geographical protection like Cornish pasties or Lancashire crumbly cheese. In this context, the protection afforded by such descriptive words is important. When you pick up that ubiquitous stick of rock at your next visit to the seaside and I’m sure you will, just have look as to where it was made. Look for the words Fylde, Blackpool or Lancashire.

My fascination and love of words has, over time, helped me realise that the importance of words comes from their ability to shape our thoughts and behaviours, help us connect with others, evoke emotions such as love, anger, sadness, but can also engender hope, and perhaps ensures new ideas are valued as much of stories from the past. Words can have a powerful impact, both good and bad on the lives of others. However, I always keep in mind that, sometimes, not speaking can say more than all the words in the world.  

The art of conversation lies in listening

Just three and a half months into my new role as Chair of Greater Manchester Mental Health FT and I have started to reclaim my diary. Don’t get me wrong, I’m not complaining, but working full-time in a role that is definitely meant to be part-time takes it toll. So last week I was able to enjoy my Wednesday completely free from meetings, phone calls and reading work-related reports. With the whole day stretching out in front of me, I thought I might go for a long walk. Unlike me, I couldn’t decide where to.

Now J always reminds me that we should try and walk with a purpose in mind. Perhaps to take in the view or perhaps to do a little shopping, or some other chore. I had a long list of jobs that had been mounting up, so I decided to do a 10-mile ‘round robin’ walk that would help me tick off some of those jobs. First stop, the vets to pick up Dylan’s flea and worming medication. Then it was on to the Timpson’s in our local supermarket to get a key cut for the wardrobe in our French Room (don’t ask). It is the same Timpson’s where I get my shirts and suits cleaned each week, and I like it that they remember both my name and phone number. Coincidently, and I’m not sure it adds to the story, but Andrea, the assistant at Timpson’s has just left to be a receptionist at our vets. Continuity of care maybe?

Key duly cut, it was a bit of a stroll into our next-door seaside town for a halfway lunch stop. The town is one of the reasons I like living here. It’s right on the sea front, has lots of interesting shops and a surprising number of café bars with outside seating. Great for people watching. My favourite is a microbrewery called The Shipwreck. While it serves a wonderful selection of original beers, it also has a fair range of wines, my preference. I took my seat outside, ordered a glass of red and a bowl of skin-on-chips, smothered in melted cheese, and prepared myself to enjoy an hour of people watching.  

I wasn’t disappointed. First up was a trio of older ladies who came in for a coffee and immediately started talking about how they would love to get married in the stunning wedding dress seen in the window of the local charity shop. The conversation soon moved onto the other benefits that being married might bring, a conversation far too risqué to reproduce here. Grandmother Denise made a slice of toast and a coffee last 40 minutes, during which she had a constant stream of folk coming up to say hello. Then there was Ernie.

He and his wife Irene were sitting at the table beside me. As they got up to go, Ernie asked me if I was in the rock business, and did I play in a band. It’s a question I get asked often. I once got free gins all night long from a group of folk who swore blind I was ‘that guy from Jethro Tull.’ I played along. Anyway, it turned out that Ernie had once played with Cliff Richard and with the Shadows (when they were the Drifters). We talked (actually Ernie did much of the talking) about rock and roll, guitars we both owned, how the world had changed and more or less life, the universe and everything. Irene was the personification of patience; I had another red wine and finally after nearly an hour’s conversation we parted company. It was an unexpected, but a very welcome diversion.

I had a similar experience the following day. We were due to have a visit from the NHS England Deputy Chief Nurse; however, she unfortunately had to cancel at the last moment. Colleagues had mounted an exhibition showcasing a range of activities and programmes they were involved in. I was asked to take a look and upon my arrival, I was asked to make a small speech, which I was happy to do. I then spent an enjoyable 90 minutes walking around the room talking to colleagues at each stand. It was an amazing opportunity to meet folk and learn more about what we were doing across the Trust.

There was much to find out. I didn’t know we had the only speech therapy service in the NHS working with homeless people and rough sleepers. There was a group of colleagues that work at recruiting nurses from overseas. I was impressed with the care they provided to people coming into a very different culture and health service. We had an interesting discussion over what we were doing to help develop mental health services in the countries we were recruiting from. It was clear we could and should be doing more in this regard. I loved spending time with our nurse researchers and hearing how they were using their research to transform services and increase access to care, particularly with children and young people. I met up with someone whom I last worked with 40 years ago, when she was a staff nurse at the Trust. She had enjoyed a fabulous career, working her way up to being a Consultant Nurse. She had since retired but had returned to support our Advanced Nurse Practitioner programme. It was a lovely reunion and an opportunity to say thank you for her service too.

Finally, I got around to talking to our educationalists. These were folk supporting continuous professional development, and who had raised the lifelong learning bar to a new level. I was really impressed with a couple of colleagues who worked on our preceptorship programme. We have been fortunate to buck the national trend in recruiting mental health nurses. However, many of these are newly-qualified nurses and need to be supported though an effective preceptorship programme for the first 12 months of their journey from novice to expert. The team’s determination to be there and work with these new nurses was positively tangible. They had a real passion for what they were doing and it shone through in their conversation with me.

I’m not sure therefore why I was surprised a day later to find out that last week we had been awarded the NHS England National Quality Mark for our Preceptorship Programme. It is an award that recognises our commitment to supporting new registrants and making the Trust a great place to work. Apologies to The Rolling Stones, being Chair is not all rock and roll, but on days like this, I like it.  

The Great Chicken Run Escape

Last week, aided and abetted by Hansel and Gretel, our two goats, the chickens made a bid for freedom. Their foray into the big wide world was short-lived however, and they were soon back in their run. The hens spend much of the winter in a large covered run, which protects them from the worst of the weather and helps the garden area, they usually run around in, to recover. For the last couple of weeks, they have been eyeing up the rapidly appearing green shoots of the returning grass with something reminiscent of circling hyenas waiting to steal some of a lion’s kill.

The other reason they have been in a covered run is to keep them safe from bird flu. It has been sweeping the world. Over the past few years H5N1, to give it its formal name, has killed millions of wild birds and domesticated poultry across the world. All our hens including Gregory Peck our beautiful cockerel, are fit and healthy. They all have bright red combs and we are getting around half a dozen eggs each day. We have managed to keep our neighbours in eggs since late February. So, while our hens might be keen to get back out on the grass once more, they are by no means suffering, more of which later. They certainly don’t have bird flu, which is a relief.

Worryingly the virus has started to jump to other animals, cats, foxes, sea lions, cows and even humans too. Last week it was reported that a man in Texas had caught bird flu from contact with a cow. Thankfully, to date, there is no evidence to suggest that the virus can be spread from one person to another. Globally, there have been 887 reported cases of bird flu infecting people. 462 of these folk died as a consequence of the infection. It is potentially a hundred times worse than Covid which, at the start of the pandemic in 2020, saw something like 20% of those infected sadly dying. There is no human bird flu vaccination available.

Interestingly, with echoes of the Covid pandemic, the UK government issued guidance last month that we should all stay 2 metres away from wild birds. I have warned the little robin, who comes looking for worms and watches me as I work in the garden. Whilst somewhat humorous as a piece of government advice, not all requirements regarding hens are as funny. From October this year, anyone keeping chickens will be required to register the birds with the Department of Environment, Food and Rural Affairs (DEFRA) and apply for a holding number. We already do something similar for our goats and J is, to her delight, registered as a “hobby farmer”. I’m not sure how the new regulations will be effectively policed. However, it is an administrative burden, in both time and cost, that will see many back garden hen keepers give up their birds.

The new regulatory burden is nominally designed to control bird flu. However, most responsible poultry keepers will ensure their hens are protected from contact with wild birds, who may carry the virus, in the same way as ours have been over the winter months. Indeed, last year when there was an outbreak locally, we had to keep our hens in splendid isolation for several months. Despite their covered run being large and spacious, towards the end of their confinement, they did start to get a little techy and were clearly upset they couldn’t run free, as they normally would during the summer.

Do hens suffer because of their lives being disrupted in this way? Well, the evidence from our small flock would suggest they do and they don’t. Some of our hens are two or three years old (with the exception of chicks hatched that are male, we don’t kill them) and they are quite familiar with the winter/summer cycle and only start to become twitchy, as the days get longer and there’s more sunlight. Yet when they were kept isolated during the summer, they clearly began to get upset. Last week, I heard an interesting discussion around the same topic.

Most days, I like to listen to Farming Today, a Radio 4 programme that airs at 05.45 during the week. Last week, there was a debate about the banning of poultry cages in the UK. These were not the horrible cruel small metal cages used in industrial scale egg production. Those were thankfully banned in 2012. Enriched cages were introduced and it is these that the UK government now want to ban. Enriched cages are much larger, have perches, scratching areas and proper nest boxes for the hens to lay their eggs. There were two elements to the discussion that resonated. One was the farmer being asked if he thought the hens suffered by living in these cages. His response was the hens knew no other existence, so he didn’t see how they could suffer. It was a statement that has made me ponder all week, but it feels a little like a metaphysical conundrum probably only Nietzsche might untangle, and we can’t do it here.

The second element was the farmer’s complaint that such decisions and changes in policy were made by folk in Whitehall, who, likely, would never have visited a poultry farm, would not be able to describe what an enriched cage looked like, and who probably would have a stab at the philosophical question of suffering. Not that I would want to intentionally draw parallels, but next week I’m to attend two regulatorily reviews of our Trust, which will be conducted by folk who likely, have never nursed someone experiencing severe mental distress, or run a ward for acutely ill service users, or had to ensure safe and quality services are consistently provided within finite and often shrinking financial resources. However, just like our chicken run, we have plenty of green shoots (of improvement) that I will be happy to share and hopefully, others will recognise too.         

If you think your plane might crash, Keep Calm, and see Mrs Perry

True confession time. I don’t often get blog inspiration by stories published in the Daily Mail. Last week I did. I habitually read the daily newspapers online; well at least those that are not pay walled, which is probably why I was skim reading the Daily Mail. A couple of stories caught my eye. These were stories about courage, coolness, compassion and care. The first of which was the story of Captain Eric Moody and his response, when, in 1982, all four engines of the Boeing 747 plane he was flying failed, while he was over the shark-infested waters around Jakarta, Indonesia.

Unbeknown to Captain Moody and his crew at the time, they had flown through the dust clouds thrown up by the Mount Galunggung volcano eruption earlier in the day. The dust not only damaged the windows, so the crew couldn’t see out, it also clogged up the engines, shutting them down and preventing them from being restarted. Once Captain Moody realised the engines couldn’t be restarted, he announced to the passengers, ‘this is your Captain speaking. We have a small problem and all four engines have stopped. We are all doing our damnedest to get them started again. I trust you’re not in too much distress’. Now I love flying and have travelled thousands of miles in planes. I’ve never thought about the risk of there being a mechanical fault. Likewise, I have never doubted that I wasn’t always in the safe hands of highly trained and highly regulated pilots.

I’m not sure how I would have responded to Captain Moody’s message. He was completely cool, and his announcement belied the fear and confusion on the flight deck caused by not knowing what had made the engines fail. There were 263 people onboard. Captain Moody had few options open to him to try and save as many lives as possible. He knew he could not reach the nearest airport at Jakarta, and although he considered landing in the sea, it wasn’t something he had done before.

The plane had a glide ratio of 9/1 – which meant for every mile it dropped, it would continue to glide for 9 miles. This gave them just 30 minutes to try and restart the engines or crash into the ground. The lack of engines meant the cabin could not be kept pressurised, and so passengers needed to put on the oxygen masks to breathe. Some of these failed, and Captain Moody was left with no option, but to rapidly descend thousands of feet, so that passengers could breathe without the use of oxygen masks. However, the lower altitude brought with it clearer, denser air, which blew the dust out of the plane’s engines. One by one they restarted and he was able eventually to safely land the plane.

Captain Moody died, aged 84, last month. His death prompted several stories being published last week, reminding us of his courage and coolness in what must have been an almost overwhelmingly stressful set of circumstances. The second story to catch my eye was of the compassion and care Ruth Perry showed to her pupils and their families during the long lockdowns of the Covid19 pandemic.

Readers will recall that, sadly, in 2023, Ruth Perry took her own life following an Ofsted inspection and their subsequent report. The report downgraded her primary school from its previous highest Ofsted rating to the lowest rating possible over safeguarding concerns. Ruth Perry’s death sparked an important and widespread debate about how public services should and or could be regulated. Reliance on one or two-word descriptors such as ‘requires improvement’, ‘inadequate’, or ‘good’ can never capture the whole picture of what and how an organisation provides its overall services.

The Ruth Perry story was once more in the news, as a video of Ruth talking to her pupils virtually during one of the lockdowns was played by her sister at the National Education Union’s conference last week. In the video, Ruth urges her pupils to ‘talk to the people you love, be kind to each other, be hopeful and to take care of yourselves and each other’. If you needed an example of compassion and care in action, this is a good one. You can see the video here. Have a look at the cushion behind her, it’s where this week’s blog title comes from.

Ruth’s sister urged the conference delegates to ‘get help’ and ‘think again’, if they were having thoughts about ending their lives in the same circumstances as her sister Ruth. She said ‘suicide is always a terrible, wrong-headed option. Ending her own life was the worst thing that Ruth could possibly have done’. I agree. However, I can see how some challenges in life might make one feel like that. The NHS Trust that I Chair is an organisation ‘in special measures’. At present, we are being scrutinised by every regulator possible. Last week, we were responding to four different regulators and for a moment, I felt totally overwhelmed by the scale of what it was we were being asked to respond to. It was just a moment. The moment passed and I once again became relentlessly positive. What made the difference?

Well, we had been given a very unhelpful deadline by one regulator to respond to a long list of information demands on the Thursday before Easter. Submission of our evidential response was to be by Tuesday lunchtime, the day after the Easter Bank Holiday. In response, a large number of my colleagues worked throughout the weekend; a long weekend, during which they should have enjoyed being with their families and friends, in order to deliver this information. There was no anger or resentment at the lack of any real recognition by the regulator of improvements already made. They all just adopted a professional cool, calm, compassionate and caring approach, and brought together the necessary information, and did so on time. To say I was overwhelmed by their commitment to doing what is right for our service users and their families, would simply be an understatement. It is unlikely that their efforts would ever be picked up by the Daily Mail, but acknowledging their story here is something I’m very proud to be able to do.