The long dark night of the soul in hospital

Note: I recently had to spend four night in hospital with a leg infection (cellulitis). I wrote this towards the end of my stay, when I was recovering, and it’s pretty much unedited from then. It seemed important to try and pin these feelings down, so I could learn from them in the future.

It is always darkest mentally in the hospital ward not just before dawn, but at 2.30 am, when several strangers are snoring or coughing within earshot. That is if they’re not plaintively asking for help, but not using the call bell. Or gasping in pain because the blood pressure monitor hurts them, or their foot with the broken bones has moved just the wrong way.

I’m writing this at 3.30 am in the ward, which is not a good time, but is at least an hour nearer the point when there are other people around to talk to and things happening that will distract you from the thoughts in your head.

It’s my fourth night in hospital with a bad case of cellulitis and it’s a reasonable night because I got some sleep early on and I’m well enough to regulate my mood and remind myself that a few days of poor sleep won’t harm me. My first two nights were the hardest – not with pain (I didn’t have much when not walking), but with the stress of unfamiliar surroundings. It wasn’t the kind of illness that left me lethargic and dozing. And even physical pain would have distracted me from mental pain.

Instead, especially the first night, I lay there with the ancient terror of depressives in my head. Things are never going to get better. This is how it will be for ever, or it will get worse. The first couple of days the women in the ward with me were aged 77, 89 and 99 (we had to give our dates of birth repeatedly to nurses). I’m 53: to my literally feverish mind, I was looking at forty years of pain and decline and aloneness. That was if I lived. I’d heard the phrase “signs of sepsis” used of my case when I was admitted and I knew that could kill. Was it better dying now, my only child aged sixteen, or end with dementia like the 89-year-old? And since I had only one child, would there be any family to visit me in hospital when I got old and ill again, or to provide care support at home so I wasn’t trapped in hospital?

Those weren’t my only thoughts, of course; even I’m not so morbid. But I’m not sure the doctors and nurses always understand that the swings in their statements from “you’ll be discharged tomorrow”, to “we’re keeping you in for at least two nights more” are the triggers of depressive thoughts for me. There might never be an end to this. And that’s compounded when you’re told that you can’t go home because your heart rate is too high. So you’re forcing yourself to try and stay calm when your vital signs are being taken (and I’m disappointed every time I “fail” the test), but since they don’t know what your normal heart rate is and neither do you, could you be trapped here for ever till it gets down to some supposedly ideal state where it’s never been?

I’ve mentally got through my long dark night of the hospital soul, I hope, but tonight someone else had it, at the nursing station at 2.30 am, unable to sleep, wanting to phone her son so she could leave. The nurses persuaded her to go back to bed. I prayed silently for her and later offered her some earplugs, as she’d offered me cough sweets when I’d needed some. This is not an intensive care ward for the desperately ill: all of us will probably get out safely and back to normal life. But some nights it’s hard to believe that.

 

 

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The problems of English education 4: should you change subject?

Graduation at Nottingham Trent University – image from https://www.flickr.com/photos/nottinghamtrentuni/15749642150

It’s become apparent to many university staff that one of the great hopes of the current government is to use LEO (Longitudinal Education Outcomes) statistical data to influence prospective students’ choice of courses. Specifically, they want to encourage students to switch subjects to those that on average produce higher-earning graduates. This is seen, for example, in the suggestion that this data should be incorporated into subject teaching (TEF) assessments, even though there is no  good evidence that how high a salary you earn as a graduate is connected to how well you were taught.

This is obviously worrying for those who teach subjects whose graduates (on average) earn less in the long-run (including historical subjects). I don’t think it’s possible to put the genie back in the bottle and ignore LEO data, but I think there are more useful analyses of it that can be made. That’s because too many discussions about subject choice start from the assumption that a seventeen-year-old prospective student can decide when investigating universities that they want to study medicine at Oxbridge rather than Media Studies at Poppleton University. Any realistic view of switching subject has to start from a more basic question: what subjects is the student actually good at and enjoys studying?

Agender and the patriarchy

A teenager I know has recently begun to identify as agender and has asked me to use them/their pronouns regarding them. I’ve agreed to do so, although I’ve not been that successful at remembering about this. This person feels themself to be neither male nor female. I can sympathise a lot: when I was young I might well have identified as non-binary if that had been an option.

The illegible Carolingian army

The title of this post is inspired by the work of James C. Scott, whose book Against the Grain I’ve recently finished. One of Scott’s repeated themes is that states, including ancient ones, are always trying to make their subjects and their lands “legible”. They want complete and standardized descriptions of all the areas and individuals they control for planning purposes. Early states, in particular, wanted to be able to assess resources and people so they could raise tax and levy armies.

It’s at this point that the Carolingianist starts to point out anomalies in which seems overall like a sensible argument. Carolingian rulers didn’t have centralised land-based taxes as part of their revenue. But they did raise considerable armies. So how did they do that when they didn’t have ways in which to make their large territory legible?

The price of good history

I want to discuss a couple of examples I’ve seen recently of the problems of making good-quality history available to the general public. The first comes from the announcement of a special issue (44-1, 2018) of the journal Historical Reflections. The senior editor, Linda E. Mitchell, explains that the special issue:

is devoted to a wide-ranging and erudite critique of the claims of evolutionary psychologist Steven Pinker that (a) the modern world is less violent than the premodern world, and (b) historians are not treating the period of the seventeenth and eighteenth century known as the “Enlightenment” with the respect it deserves. As the pages of this journal have demonstrated over and over, these statements are not just problematic and controversial, they are patently tendentious. Pinker—who is not a historian—belongs to a group of people, often our colleagues, who believe that writing history is easy and that anyone can do it. We know that what makes a good historian is training in the theories, methodologies, and materials of historical study. We know that history is not merely a narrative. Historical writing is labor intensive, often requiring hundreds of hours of sifting through archival materials in many languages and many forms. It also requires a clear understanding of and sensitivity to the contexts of historical inquiry. The 12 articles in this issue demonstrate the best kinds of historical writing in critiquing the methodology and conclusions of Pinker’s best-selling pseudohistorical study.

The problems of English education 3: the irrationality of white students

My title, is, inevitably an exaggeration: I’m talking here about undergraduate students at English universities and referring to only one aspect of irrationality: economic irrationality. Nor am I saying that all white students are economically irrationally. But I think there is a good case to be made that white students are less likely to be economically rational when choosing their degree than BME (black and minority ethnic) students and that potentially poses a problem for academics in some subject areas.

To see this irrationality, here is data analysing the earnings of students after graduation graphed against the “whiteness” of the main subject groupings (using the JACS code). The earnings data is from the LEO project (Longitudinal Education Outcomes), specifically the Subject tables from  SFR60/2016. This looks at the earnings of UK domiciled first degree graduates from English HEIs.

In the first graph I show the median annual earnings for the cohort (male and female) who graduated in 2008/09 five years after their graduation, i.e. tax year 2014/15.

In the second graph I show the median annual earnings for male students who graduated in 2003/04 ten years after their graduation, i.e. tax year 2014/15. The data on ethnicity is from HESA Table 8 and is for full-time UK undergraduate enrolments for 2016/17.

Here are the figures:

5 year subject earnings v “whiteness”

10 year male subject earnings v “whiteness”

The problems of English education 2: diverse forms of diversity

The recent IPR report on diversity within universities has the great merit of providing some hard data on what is obviously empirically: universities vary greatly in their ethnic diversity. It also looks at this in terms of broad subject categories, which is particularly useful (and challenging) for historians, since history is one of the “whiter” subjects. The disadvantages of the report are firstly, that the main tables are only in pdf format and secondly, that the main measure used to analyse diversity is an entropy index, which isn’t intuitive to non-specialists. But I’ve got some of the data out of the tables and have started playing with it, so here are some of my initial thoughts on overall university diversity. (I’ll say more about subjects in a later post).