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A Big Gay Week
The news headlines are full of news about LGBT issues today.
In England and Wales, the Marriage (Same-Sex Couples) Bill returns to the House of Commons for the next two days to go through its third reading, further debate, and a vote by MPs tomorrow afternoon. The main threat to it has been the attempted amendment to extend civil partnerships to opposite sex couples, which looks more like a stalling tactic than a genuine attempt. If the House of Commons votes in favour tomorrow, the next hurdle will be the House of Lords on Wednesday.
A little closer to home, the General Assembly of the Church of Scotland happens this week and today they have been talking about the ordination of LGBT ministers and particularly ministers-who-happen-to-be-LGBT-and-in-civil-partnerships. They voted a few minutes ago in favour of a convoluted neither yes nor no option that Kelvin has explained better than I can attempt to. This has been an ongoing debate in the Church of Scotland for over a decade, but particularly since 2009, when Scott Rennie was appointed minister of Queen’s Cross Church in Aberdeen.
On the radio tonight, I heard a lesbian minister in the Kirk tell the General Assembly that this is painful for her because for two decades she has had to listen to the Church debate whether or not it accepts her as part of it. This is quite often how I feel about the Anglican Communion. Justin Welby shuddered theatrically a couple of weeks ago during an interview with the Financial Times when presented with the idea of two men kissing. The General Synod of the Scottish Episcopal Church meets in a couple of weeks and we will be faced with more of the stalling and the delaying and the refusal to actually talk about any of it. The churches forget, sometimes, I think, that this is not an academic exercise but a conversation about actual people who are caused real pain by it.
And not in the news headlines but a lot closer to home, Professor John Curtice, who is professor of politics at Strathclyde University and our resident expert, as well as the resident expert of the BBC – you may know him from such niche programmes as Newsnight – on public opinion in the UK, will be speaking at St Mary’s on this coming Sunday at 12.15pm about public opinion on equal marriage.
It’s all go, here.
The New Generation
*blows cobwebs away*
Are you all still out there?
My absence from the Internet has been mostly because I’ve had some annual leave. I’ve not been away or done anything particularly, but I’ve caught up on a lot of sleep and read books and baked things and spent time with the cats and gone to the seaside, and altogether had an agreeably lazy couple of weeks. It was a sign that I’ve been away for longer than I usually am when I went back to work on Monday and had forgotten all my computer passwords and the phone number for the biochemistry lab.
I am not built to be a permanent lady of leisure, though, and it is good to be back at work.
Today, I was given my very own medical student.
As you may remember from when I did them, my medical school holds finals in March, and the post-finals part of fifth year is taken up with classes on how to be a good doctor and then a final few weeks of hospital placement spent with an F1. There are a lot of useful things about doing that last placement. I think especially for students who have been more in the major teaching hospitals and less in the district generals way the heck out in the middle of nowhere, because for those students it might well be the first time they’ve really been much with juniors rather than trotting around after consultants. Hell, I did spend almost all of my fourth year in district generals way the heck out in the middle of nowhere and I spent a lot of time then with F1s, but, by the time Preparation for Practice rolled around, I had just spent the better part of six months hiding away in the library, which mattered a lot for passing finals and mattered not very much at all for learning how to actually do my job. And then there’s the other nice thing about doing a placement like this, which is that the students who are staying in this Deanery after graduation get to do it in the hospital that is going to be their hospital. There’s a lot to be said for having the chance to learn where the toilets are and where the coffee is and how to use the phones before you turn up to work.
My medical student is wonderful and I think, in so far as you can think anything after nine hours, that he is probably going to be a very good F1.
He kept me a jobs list during the ward round, which I missed a lot of because I spent most of it getting progressively more frustrated with a hospital in England, to the great amusement of my ward pharmacist (“His notes are on microfilm? Yes, I know it was 2007. It was 2007, not the Stone Age!”). And when he gave me the jobs list, he also said, “I’ve done this and this, and that hasn’t been done yet but I took it to radiology and they’ll do it this afternoon.” And then he chased all my bloods and wrote them in the notes. And he did it all without needing to be asked.
I like that I have someone who is competent and cheerful and eager to learn things, and not because it makes my life a bit easier for a few weeks, but because when I really thought about it, I realised that what I’m doing is training my replacement.
This is all very bittersweet in a way that I didn’t expect.
It’s weird, to start with, to look at someone else who is now where I was this time last year and to see that I really am a different person and a different doctor — a better doctor, I hope — than I was last summer. And to look at my SHOs, who were my F1s just after my finals, and to see how much they’ve changed, too, and to think about how much more I’m going to change in the next twelve months.
And then there’s the other part, which is that I won’t be here in August.
I’m doing my F2 year in a different hospital. I chose that. I chose when I applied to FPAS to not stay in the same place for two years, and I think that was the right choice. I also think, although this isn’t wholly relevant, that I chose to do it the right way around. But even though I know that I chose to do these things for good reasons — I love my hospital.
And that’s it, right there, that’s the hard part.
I could dispense lots of advice about how to sweet talk radiologists and how to present someone on a post-take ward round versus on the phone at three o’clock in the morning and how to not leave an on-call weekend with worse renal failure than the patients, and I will. I will dispense all of that advice.
But I’ve loved my job and I love my hospital, and all I really want to tell any of them is that I’m handing over my baby and that I’d really rather they didn’t break it.
Running For Boston
I’m at home, getting ready to go out for a run.
It’s only going to be for a couple of miles, but I can’t not go, not today.
I am not the fastest member of the running community. I can’t run the furthest. I am not the most loyal or the most dedicated, even. I will never, probably, except maybe in my wildest dreams, qualify for the Boston Marathon, that Everest of all distance runners.
But I am a runner.
The words of Melissa Etheridge’s song, written eight years ago for a different kind of race, are ringing in my ears.
And someday if they tell you about it,if the darkness knocks on your door,remember her, remember me.We will be running as we have before,running for answers, running for more.
I’ve jumped up and down on a start line.
I’ve put in the training.
I’ve talked about the state of my bowels with people whose names I’ve never learned.
I’ve run in the footprints of Wilson Kipsang and Liz Yelling.
I’ve watched hundreds of thousands of pounds raised for good causes.
I’ve been given chocolate buttons and orange slices by people who have never met me.
I’ve run off bad days and I’ve run on good ones.
I’ve been spurred on by the cheers and the high fives of the kids who come out to support the people whose daft hobby has forced a shutdown of their roads for a whole Sunday.
I’ve known the agony and joy and exhilaration of finish lines.
This community is my community. These people were my people.
The streets of heaven are too crowded with angels tonight.
I am a runner and today I run for Boston.
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Doctors and The Right To Privacy
I had a bit of annual leave last week and I spent a lot of it messing around in a cassock – last week, not being at my day job didn’t mean not being in the business of fear, death, and, occasionally, if we’re very lucky, resurrection. But I didn’t have to go into work and for the first time in longer than I can remember, I had ten days when I didn’t check my work emails or look at ePortfolio or blog anything about medicine.
But even I, buried under my Holy Week shaped rock, could hardly have failed to notice the heehaw brought about by the new GMC guidance on doctors’ use of social media, which is part of the 2013 update to Good Medical Practice and will come into effect on April 22nd.
It is my view that this is not entirely a bad thing.
My guidance on the use of social media as a doctor came from the person in my Trust who is in charge of Information Governance and the advice she gave to me was: “I think that social media is dangerous. I don’t have a Facebook. I don’t have a Twitter. I think that you shouldn’t have them either.” This was patently ridiculous.
So, always with the awareness that the GMC were both entitled and willing to discipline doctors who they judged to be doing inappropriate things with social media, most of us have been left to judge what they might consider the appropriate use of it through the potentially dangerous combination of hearsay and common sense. It is good to have some clarity. It is good to have some uniformity. It is especially good to have those things from a body that acknowledges within their guidance that there are many benefits to the use of social media.
And most if it is exactly what we might have expected – don’t breach patient confidentiality, don’t accept friend requests on Facebook from patients or their families, don’t bully or harrass individuals with whom we interact online, etcetera, etcetera.
Then, this slips in:
If you identify yourself as a doctor in publicly accessible social media, you should also identify yourself by name.
It is that sentence which has caused most of the heehaw.
Some of the best blogging and Tweeting on the Internet is done by medical students and doctors who choose to blog and Tweet under a pseudonym.
I don’t write under a pseudonym. The decision to shake off my anonymity was one that I made years ago, and it was one that I made entirely for myself. I did it because I was frankly never that good at being anonymous. My medical school flatmate figured out who I was and my priest knew who I was the first time he met me and my choral director, well, he thought that I was the lovely and far more talented Margaret McCartney and so I was compelled to admit to him that I was not — and those are just the ones who told me about it. And then I realised that there were things that I wanted to write about but hadn’t been because I was worried that they would make me too easily identifiable. I had become trapped behind the veil of anonymity that had been supposed to liberate me.
But those are all decisions that I made for me.
I have no wish to make that decision for everyone, nor for the GMC to make it for them.
There are a great number of pseudonymous doctors and they are pseudonymous for a vast array of reasons. There are doctors who identify with racial or sexual or disabled minorities, and who would prefer when applying for jobs for those things about them not to be easily accessible. There are doctors who have revealed deeply personal things about themselves and are understandably wary of having everyone in their real life and the whole Internet automatically attach those things to their real name. There are doctors who would prefer patients not to discover through the power of Google what we do when they aren’t being doctors, not because the things they do are illegal or immoral but because a personal life is meant to be just that.
I found a safe space on the Internet when I was fairly young where I could learn how to be the person I was becoming. I didn’t at that time identify myself by my real name. I don’t think that only teenagers need that safe space and I don’t think that people should be denied access to it merely because they happen to be doctors.
Do we require teachers who use social media to identify themselves by their real name? Do we require it of engineers? Or plumbers? Do we require it of nurses or of allied healthcare professionals?
And if we don’t, then why is it now required of doctors?
What do the GMC mean when they say that we should identify ourselves by name? Are doctors allowed to merely say publicly that they will provide privately their real name to anyone who asks for it? Or does their real name have to appear publicly on their website or Facebook account or Twitter? I don’t use a pseudonym, but, interestingly, while I’ve been writing this, I’ve discovered that the GMC website has no record of any doctor by the name of Beth Routledge. It is my real name. It is merely not the full form of the name on my birth certificate. I wonder how that fits in.
It is good to have some clarity and to have some uniformity.
But I don’t think I agree with this part of it and I am not convinced that it’s been thought all the way through.
Update: 16 April 2013: The GMC published this piece of clarification on 10 April (the link takes you to the GMC’s official Facebook page). Hat tip to Anne Marie Cunningham for directing me to it.
Jesus Is Laid In The Tomb
Reproduced with permission from Gwyneth Leech
“There was a good and righteous man named Joseph who came from the Jewish town of Arimathea, and was waiting expectantly for the kingdom of God. This man went to Pilate and asked for the body of Jesus. Then he took it down, wrapped it in a linen cloth, and laid it in a rock-hewn tomb where no one had ever been laid.” (Luke 23:50-53, NRSV)
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I believe in God, who died.
Where do we go from here?
It isn’t quite over for us. Not yet.
In every place on Earth where blood has been spilled, people remember. We remember in the battlefields of France and Belgium. We remember on the sands of the Middle East and the Gulf. We stand by the graves of the known soldiers and the unknown ones, of the martyrs and the heroes, of the people whose deaths have changed the course of human history, and we remember.
And now we bury our dead.
It is the last thing we will ever do for them. It is the last thing we will do for him.
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God of the grieving, we turn to you in our hour of despair.
As we lay your Son in his tomb,
we weep for the dead.
We pray for all those who have died in conflict.
For all those who have died as a result of ethnic cleansing.
For all those who have died on the streets of Glasgow.
For all those who have died violently.
For all those who have died with their names unknown.
For all those who have died alone.
For all those who will die tonight.
And we pray that they, with your Son and the souls of all the departed, may rest now in peace.Jerusalem, Jerusalem, return to the Lord your God.
Death On The Cross
Reproduced with permission from Gwyneth Leech
“At three o’clock, Jesus cried out with a loud voice, “Eloi, eloi, lema sabacthani?“, which means, “My God, my God, why have you forsaken me?” Someone ran, filled a sponge with sour wine, put it on a stick, and gave it to him to drink, saying, “Wait, let us see whether Elijah will come to take him down.” Then Jesus gave a loud cry and breathed his last.” (Mark 15: 33-34, 36-37. NRSV)
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I believe in God, who so loved the world that he gave his only Son that whoever believed in him would not perish but would have everlasting life.
There is nothing left for us here. There is a God-shaped hole in the world, and we are left with only an ugly raw wound in our souls where he used to be.
The darkness has fallen.
The light of the world has gone out.
As we stand at the foot of the cross, we think of all that we have loved and all that we have lost.
Jesus Is Crucified
Reproduced with permission from Gwyneth Leech
“The other rebuked him, saying, ‘Do you not fear God, since you are under the same sentence of condemnation? And we indeed have been condemned justly, for we are getting what we deserve for our deeds, but this man has done nothing wrong.’ Then he said: ‘Jesus, remember me when you come into your kingdom.’” (Luke 23:40-42, NRSV)
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I believe in God, who we crucify still.
So, this is how it will end.
A true and righteous man, too true and too righteous for his government and so they treat him as they do the common criminals. Crucified. Scorned. Abandoned.
He is nailed to his cross in solidarity with women executed under the Taliban, in solidarity with pacifists killed by firing squad, in solidarity with the victims of the IRA, in solidarity with Matthew Shepard and Damilola Taylor and Lucy Meadows.
And even in this moment, he will not back down. “Father, forgive them,” he says.
Father, forgive us.
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God of the repentant, your Son came to us with a message of love.
As we call to mind the promise to the thief,
we pray for ourselves.
For the faith to trust in an unending and unconditional love.
For the grace to accept forgiveness without limits.
For the hope to see beyond the cross
and to look to the day when we will enter with him into that heavenly city.Jerusalem, Jerusalem, return to the Lord your God.
