LISTEN EB

Kathryn Mannix

• Publisher: William Collins
• Year: 2021
• Print ISBN: 9780008435479
• eBook ISBN: 9780008435455
• Topic: Medicine
• Subtopic: Medicine Biographies

'Powerful, humane and wise' JULIA SAMUEL

'Everyone should read it' NIGELLA LAWSON

'Beautiful … This is a book for everyone. You feel held by it' PHILIPPA PERRY

Most of us have a conversation we're avoiding.

From the bestselling author of With the End in Mind, this is a book about the conversations that matter and how to have them better – more honestly, more confidently and without regret.

A child coming out to their parent. A family losing someone to terminal illness. A friend noticing the first signs of someone's dementia. A careers advisor and a teenager with radically different perspectives.

There are moments when we must talk, listen and be there for one another. Why do we so often come away from those times feeling like we could have done more, or should have been braver in the face of discomfort? Why do we skirt the conversations that might matter most?

By bringing together stories with a lifetime's experience working in medicine and the newest psychology, Mannix offers lessons for how we can better speak our mind and help when others need to.

Kathryn Mannix's 'With the End in Mind' was a Sunday Times bestseller the weeks ending 6 January 2018, 13 January 2018 and 3 February 2018.

Where Are the Listening Spaces?

The world is busy. People are caught up in their own affairs. We move between tasks and places distractedly, rarely living in the present moment, largely preparing for (and often worrying about) what may lie ahead, and sometimes remembering about (and perhaps reproaching ourselves for) what has already passed. When life suddenly brings us up short through an event that is sad or shocking, we are tipped out of our distraction into the present moment. The world moves past us, unaware or uninterested; we are islands of presence in a distracted world.

Where is the space for sorrow and reflection in the busyness of the world? Who will listen to us as we formulate our sadness and make sense of our disappointments? Where can we express grief, explore anxieties or be consoled in our loneliness?

We are social animals. We are hard-wired for connection to one another. Yet community living becomes lost in urban anonymity and rural distance; it has become harder to make meaningful relationships; a loneliness epidemic has been recognised. Loneliness is not about lack of company but lack of connection. Surrounded by people but with no one to hear us can be a place lonelier than isolation.

How can we recreate connection? Where and how can we provide compassionate spaces in which people can meet and communicate, to reflect and recover equilibrium? Where are the spaces in which we can speak, where we will find ourselves heard, where we can experience connection, compassion and care?

Valerie’s ear is hot and sore. She has been holding the phone for twenty minutes, listening to tinny music interrupted by the insurance company’s recorded announcements about how much her call matters. She has a list of tasks and a cup of tea, grown grey and scummy as it has cooled. She tries not to think about things cooling. Irvin’s hand had been cold as she said goodbye. How can he be dead? The panic rises again, and she shakes her head as the music shifts, mid-phrase, from Mozart to Albinoni. Or not Albinoni, as she has recently discovered. She sighs.

Widow. What a word. How can she think of herself as a widow? She stares at the list before her, typed by Irvin as he was dying, listing all the things that would need attention after his death. The bank; the car insurance; the house insurance; the phone and power companies; the credit card; the library: all these organisations need to be told to cancel Irvin out of life. The charities they supported together will need to replace his name with hers, if she can afford to keep supporting them. First there is the matter of rearranging the bank account. The lady at the bank told her she cannot withdraw money from their joint account or use her bank card now Irvin has died: she should have taken out some cash before telling the bank. How would anybody know that? wonders Valerie. This is the first time my husband has died.

‘Ponchester Insurance, thank you for waiting, my name is Maxine. Please tell me your name,’ a perky voice suddenly interrupts Albinoni.

‘Valerie,’ she says.

‘And your surname?’ trills Maxine.

‘Anover,’ says Valerie. ‘A-N-O-V-E-R.’ No one has ever heard of Anover. She has spent her married life spelling her husband’s family name.

‘Is that Miss, Mrs or Ms?’ Maxine intones in a voice that could ask these questions in its sleep.

Valerie can’t think. Is she still Mrs? Is there a different title that says ‘My husband is dead’? She hesitates.

‘Sorreee,’ drawls Maxine. ‘Perhaps it’s Lady, Doctor or Reverend?’ Valerie is perplexed. How has it become so hard simply to state who she is? But who is she, now?

‘My husband just died,’ Valerie stutters into the phone. ‘I used to be Mrs. I don’t know whether that changes when a husband dies. What would you call me now?’

‘Oh, that’s still Mrs then,’ trills Maxine without a change in pace or breezy tone. ‘And what can I do for you today, Valerie. May I call you Valerie?’

‘I just told you. My husband has died,’ replies Valerie.

‘Yes, Valerie. You did tell me. And I told you that you would still be known as Mrs. Now, why are you calling me today?’

‘To tell you,’ says Valerie. ‘To tell you that Irvin has died. For the insurance. For the name on the policy.’

‘Oh-kay,’ sings Maxine. ‘And do you want to know the value of the policy? Do you have probate? Are you the executor?’

‘I beg your pardon?’ asks Valerie. What is this language? What do all these words mean? Is Maxine real, or is there a tiny silver robot at the other end of this phone, babbling words at her?

‘Do you have a policy number for me?’ the robot asks, cheerily. As it happens, Irvin has typed the policy numbers beside each company name. And the telephone numbers. He is so methodical. Was. He was so methodical. Valerie reads out the policy number and the inanely chirpy Maxine repeats each digit. Valerie can hear her typing them.

‘Oh, this isn’t life insurance, Valerie! This is your house insurance. Is that the right policy?’

‘Yes, it’s our house insurance,’ says Valerie. ‘That’s why I’m calling. Because it’s my house now. It’s not our house. Well, it is still our house … the house we lived in … but Irvin’s not … Irvin’s no longer … it’s his name and my house now, you see?’ Her voice is pleading please understand me but Maxine is still trilling.

‘Do you have a copy of the death certificate?’ she asks, cheerfully. ‘You’ll need to upload it on our website. Once you’ve done that we can change the names over. Got a pen? I’ll tell you the website.’

‘Upload?’ repeats Valerie. That sounds like a computer thing. Valerie doesn’t do computer things. She’ll have to get Irvin to do it. Except …

This scenario is both tragic and common. People like Valerie will encounter any number of telephone voices that work through their algorithms without regard for the story they are being told. People who listen without hearing, taking in information but screening out context. This is function and effectiveness without compassion. All bereaved people encounter it. Similar indifference to their difficult experience is reported by people notifying employers or statutory bodies about disability or illness, redundancy, mental health problems, legal issues, divorce and separation. There are noble exceptions, with companies who train their public-facing staff to notice the context and to express empathy when appropriate, but largely the business remains transactional rather than supportive.

Irvin, Valerie’s recently-dead husband, was an amateur motor mechanic. He loved playing with engines and machines, he built a computer from a kit, he liked hot chilli sauce, he was a tone-deaf but enthusiastic singer. There is nobody now to smile about these things. Since he retired from teaching, he had happily taken old engines apart and repaired them: sewing machines, washing machines, motorbikes, anything not too modern. ‘Nothing with a chip in it, except a chip butty,’ he used to joke. He had been a tech teacher at the local high school, and that is Valerie’s next call.

She is surprised to hear an automated voice on the school number. Her heart sinks. ‘For notifying student absence, press 1. For the exams office, press 2. For the lower-school admin team, press 3. For the upper-school admin team, press 4. For the library, press 5. For the pastoral team or special educational needs, press 6. For sixth-form enquiries, press 7. For all other matters, please hold …’ She holds. The music is better than the insurance company’s. It’s young people singing something about ‘Once in a Lifetime’.

‘Southside High School. How can I help?’ says a woman’s voice. Valerie has not prepared anything to say. After hours of being asked questions, she is surprised to be given space to say an original sentence.

‘This is Valerie Anover. I’m—’

‘Oh, Mrs Anover! I’m Gillian in the Big Office. We are all so, so sorry … We heard this morning. We all loved Irvin … I’m … we … oh … How are you?’

The relief of talking to a person who sounds sad, who uses Irvin’s name, who cares, is overwhelming. Valerie feels herself sinking from her brittle state of spiky anxiety into a formless puddle of sorrow. She is unable to speak.

‘I’m sorry, that’s a stupid question,’ says Gillian. ‘You must be really sad and shocked. We all don’t know what to say. But I’m glad you rang us. Mr Burton the new head, he didn’t know Irvin, but most of Irv’s old colleagues are still here and we are all very sad. Can we do anything to help you? Would you like the school to print any orders of service? Or to send musicians to Irvin’s funeral? We’ve done that for other people, and we like to help when we can …’ Gillian stops talking. Valerie takes a breath.

‘I don’t really know what I need just now,’ she says. ‘I was ringing to make sure you knew. I haven’t thought about the funeral yet. Thank you for those ideas, I hadn’t thought about orders of service, but Irvin’s left a list of the music. I think he’d like the school to be involved.’

‘Of course,’ says Gillian, kindly. ‘Give me your number and I’ll ask Mrs Green to phone you. You remember Amanda Green, the music teacher? She runs the school choir. They are very good. And the sixth formers will remember Irvin. They’ll like to help.’

Well done, Gillian in the Big Office. She isn’t following an algorithm. She isn’t sure what to say. But she is expressing compassion and concern, offering practical help and talking about relationships. These are hallmarks of connectedness, and although Valerie is sad, she is also consoled by this response. Compassion by telephone is possible.

The school had been told about Irvin’s death by his friend Albie, who was pastoral care lead when Irvin was the tech teacher. In emergencies they were a troubleshooting twosome. Albie came to the rescue when students fell apart, and Irvin when equipment failed. Their students referred to them as ‘The AA – emergency response team’[1] with fondness. After retirement Irvin missed access to some of the larger tools that had been available in the school tech department, and Albie just missed company. That is how they found their way to an organisation called Men’s Sheds, where men (and a few women) who like to make or mend things gather to use the organisation’s tools, to make and mend and ponder, and to chat or ignore each other in a companionable way.[2] It’s not about the tools, of course: it’s about connection. Men’s Sheds welcome those who want to use their resources to become members. Some come because they have heard on the grapevine that it’s friendly and there’s a lathe or a jigsaw or some other piece of desirable kit to be used. Irvin and Albie have met men who were referred to the Shed by their GP, too, as part of a social prescribing move in the NHS that helps people to become connected and active to enhance their wellbeing. Social prescribing is a national programme to connect people with other people in a life-enhancing way, and it includes referring people of all ages to outdoor gyms (exercise by working to maintain public outdoor spaces), walking groups, choirs, knitting circles, community gardening groups, sports clubs and many other activities. Social prescribing recognises that we are social beings, and that connection is good for us, boosts our mood and keeps us healthy.

What all these activities offer is Compassionate Space: a place to belong to, to connect with people, to tell our stories and to hear theirs, or to create new stories together. The rise in emotional ill-health during the Covid-19 pandemic was partly related to fear or sadness and bereavement, but mainly it was the impact of social isolation. Watching social groups reinventing themselves in a virtual setting has been fascinating: online choirs, quizzes, mutual interest groups; social media forums for people with shared interests or similar challenges in life; uptake of online yoga, meditation, dance or fitness training, with members discussing their classes online in much the same way they previously chatted in the car park after using the gym.

As a relative newcomer to social media, I have been astonished by the compassionate communities I have found online. There are communities of interest ranging from book clubs to charity supporters, grief circles to pet photos, locality residents’ groups, groups coordinating volunteers to shop for the house-bound; crafters and nature lovers and recipe swaps. A single comment from a stranger on my Twitter or Facebook accounts about feeling lost in grief will attract many responses from kind people willing to empathise, offer virtual companionship, answer questions or offer resources, often hours or days before I find the comment. These are self-sustaining communities and, despite the widely reported presence of some less positive influences in the social media world, my heart has been warmed by the compassion and willingness to listen to each other’s stories that I have found there.

What about our public spaces? Not everyone has the means or the interest to be online; where can people meet and connect in a physical space? There are public spaces in our hospitals, town halls, libraries: do they offer space for connection? There are some inspiring developments out there, as well as a need for more thought. We met Laura and Alan here, when they had just discovered Laura’s miscarriage. The compassionate team caring for them provided a room away from the other expectant parents to gather themselves and to begin to mourn their lost baby and expectations.

The privacy of the grieving parents’ lounge in Pete’s service represents an unusual resource in hospitals: a place to retire to away from the clamour and the discomfiting presence of other patients who may trigger, or be distressed by, another patient’s distress. Currently there are hospitals where newly bereaved people sit with other visitors in anonymous waiting areas when they arrive to collect their dear, dead person’s belongings and all the death-related paperwork; where women attending clinics for infertility investigations sit alongside other women there for termination of a pregnancy, each sensitised by the other’s suffering; where parents anxiously carrying a baby who will be born to struggle with physical and cognitive difficulties attend antenatal clinics with excited families carrying healthy pregnancies.

Sometimes hearing unwelcome news at the hospital is made more difficult because urgent decisions need to be made. For example, when someone is given a new diagnosis of cancer, an empathic recognition that this is a life-changing conversation is essential. The patient will have a deep, individual response to the news, no matter how much they may have been expecting it. The possibilities of a changed life or shortened life, of a future with an altered body, of shifts in the balance of personal relationships and rol...

Table of contents

• Cover
• Title Page
• Copyright
• Praise
• Dedication
• Contents
• Introduction
• Storytelling
• Opening the Box
• Getting Started
• Listening to Understand
• On Tenderness
• Curiosity
• Using Helpful Questions
• Getting Alongside: ‘Being With’ Distress
• Using Silence
• Finishing Safely
• Towards Change
• Listening, Noticing, Wondering
• Staying Present
• Giving Away the Power
• The Voice Within
• Building Bridges
• Thresholds: The Courage to Begin
• Anger
• Lessons in Listening
• In-Between-Ness
• Unwelcome News
• Revelations
• Cross-Purposes
• Last Conversations
• Listen
• Towards Connection
• Where Are the Listening Spaces?
• Acknowledgements
• Footnotes
• About the Author
• By the same Author
• About the Publisher