I returned to work last week after my extended absence due to respiratory illness, which may or may not be related to three years of breathing the poisonous gasworks’ air.

I find I now have to literally climb over two rough sleepers camped outside the door of my workplace in order to get in. There is no more space in the nearby doorway, and the doorway around the side entrance is similarly occupied.

By my reckoning, we have five more rough sleepers than we did two months ago, or two years ago, or four years ago.

Meanwhile, Southall’s skyline is rapidly changing from terraced family houses to much-needed ‘genuinely affordable’ skyscraper studio flats, while ‘parklets’ are opening up in the posher parts of Ealing.

To be fair, I did see that the Bell regime have cut a deal with Compton’s foldaway bikes so that residents on the Copley estate can hire them without having to pay a membership fee, and improve air quality at the same time.

Originally intended as a follow-up to part one of my milk-based food product styled personal review of 2010, this post quickly regressed into a metaphorical guide to the cheesemaking process, as you will see.

By the end of the first week of March 2010, I felt like I was several thousand feet above sea level. High up a mountain, again, perhaps mostly due to the ever-decreasing capacity of my right lung, but plummeting to new emotional depths thanks to the leaden weights of my ever-increasing self-doubt and sense of despair, perhaps partly as a reaction to stopping taking my antidepressant medication (although I stopped because I was feeling worse, not better).

One of the problems I found with officially going a bit mental is that I started to lose all confidence and trust in myself and the rest of the world. I think it’s fair to say that I’ve always been a bit of an independent-minded so-and-so and generally not afraid to say out loud whatever comes into my head. This invariably leads to me getting punched in the face. Or some other non-violent conflict.

The Big Cheese

A few years ago, I worked for someone who was responsible for making the lives of a few of her staff abjectly miserable, quite contrary to our organisation’s stated raison d’être ‘for better mental health.’ It appeared that she would move from one person to another and to another and then, it seemed to me, it was my turn. I decided I wasn’t going to take it.

During a torrid six months as her primary target, I had to undergo hospital tests on my heart for still unexplained and not since repeated vomiting and blackouts. When I told my GP what was going on at work she immediately signed me off with stress and didn’t want me to go back when I did. By the time my boss had finished with me I was unemployed and unemployable. Never underestimate the power of a bully.

I learned from painful experience quite a lot about how bullies and psychopaths operate. I learned that, while part of me wants to stand up to them and expose them for what they are, the sane part of me wants to avoid them altogether. So when I did manage to find a new job with a decent manager and then moved on from that with a good reference into my current post four years ago, I was delighted to be in a position where I was ’the boss’, although, of course, I still had to report to a management committee made up of volunteers, led by a truly wonderful Chair.

When I say I was glad to be in charge, I don’t say that because of any desire to have power over others. Quite the contrary, in fact (unless I’m deluding myself). I’ve always believed in sharing power and responsibility as much as possible, but you can’t do that if you have an egomaniac boss or a rigidly hierarchical organisational structure. Yes, there are differences between staff and service users (staff get paid being the main one), but I try to minimise these as far as I can.

Cheese Grating

It was also gratifying to work in a London borough that not only funded my new organisation’s work, but whose commissioners seemed genuinely supportive. Within two weeks of me starting my new job, however, it was grating to be informed that the local authority would be able to fund us for only 40% of what we had budgeted for on their advice of just three months earlier. My first significant and highly unpleasant task, therefore, was to have to ask staff to reduce their hours from full-time to two days a week or to make them redundant in order that the organisation could survive.

Over the next two years, we began to flourish and I was able to bring in external funding to supplement the local authority’s money so that we could provide a still much-reduced service to what we had originally planned. Even so, it seemed popular with members, staff were highly skilled and dedicated to their work and feedback from carers and professionals who referred people to us was without exception, I think, almost worryingly positive.

Cheese Ripening

By working together on daily household and business tasks, we had established a sense of community, friendships and social engagement from a safe and supportive workplace. A lifeline for people whose experience was often one of many years of loss of sense of self and worth and an absence of meaningful relationships and occupation. A second home, where they were welcomed back with warmth and kindness into the human family (cite Richard Bentall’s ‘Doctoring The Mind’) and encouraged to believe that they had real reasons to hope for - and expect - better lives.

We had people going out into the community to volunteer and set up our own catering service to employ some of our members in very part-time casual work, based on their existing skills and interests. For all but one, this was the first paid work they had done in years. We weren’t able to find anyone permanent full-time employment during a time of global recession, but still I felt proud of what we’d achieved in difficult circumstances and with fairly limited resources.

Cheese-Induced Nightmare

So when I attended our annual review in 2009 with our main funder and described what we did and the impact it had on people’s lives I was gobsmacked to be told ‘We don’t care what you do or how you do it. We just want people off benefits and into work.’ I felt physically sick and faint.

While I understand (and, in principle, support) government targets to help people with disabilities to return to work, I’ve always been sceptical about the management-theory driven obsession with outcomes and, worse, the introduction of outcome-based contracting - where service providers get paid only if they meet agreed targets. What happens, is that the largest national providers are able to tender for local contracts with the lowest unit cost, inevitably, in my opinion, sacrificing quality (process) in the name of quantity (outcomes). Except that they fail to deliver.

Processed Cheese

To me, what we do and how we do it - the process - is of fundamental importance. There are plenty of organisations who work in completely different ways and who consistently fail to get people with diagnoses of schizophrenia (who form 60% of our membership) off benefits and into work and who receive considerably larger sums of money for doing so, making their CEO’s rich (and famous) in the process. Pushing people who lack confidence and don’t feel ready to work into inappropriate and unsupported employment simply doesn’t work for most and carries the very real risk of being detrimental to their mental health.

In order to massage their figures, these organisations ‘cherry-pick’ or ‘cream’ the most able and likely to find employment while ‘parking’ those with the most complex needs and severe disabilities, the very people small, local organisations like mine tend to work with. This is not to say that these people are not able. My experience tells me that indeed they are, but that they require much longer to build up sufficient confidence and trust and need much more support to do so. Time and support costs money, but so does a lifetime of unemployment and welfare dependence, not to mention the personal and social costs of inactive and isolated lives.

Cheesed Off

Well, that was a rather long-winded way of saying that in 2009 I began to feel that I was being fucked about at work. What I believed to be the right way of working and what I was being told to do by my paymasters conflicted and didn’t make any sense to me. A year later, while I had time on my hands due to my own physical and mental illness I ‘discovered’ that evaluations of the way I was being told to work clearly stated that this approach doesn’t work, either. I felt angry for not trusting my own judgment (based on experience and advice from mentors) and felt like I’d been bullied into submission, yet again.

Join me for another cheese and whine morning next time.

Abstract: Gagging for it. Tags: waterboarding, NHS, bronchoscopy, torture, worklessness, Nazi, psychotherapy, banana, splat

On Another Planet this week: controversial new government plans to tackle ever increasing worklessness using waterboarding.

Techniques refined and perfected by secret military personnel known only by their codename ‘Our Boys’ are being piloted by the NHS in an effort to ’encourage and empower’ people claiming statutory sick pay to return to work.

One persistent malingerer, who asked not to be identified, claimed that he was subjected to an horrific ordeal at the hands of his torturers and says he was tricked into believing he was just playing a game of ‘doctors and nurses’.

‘I always liked playing doctors and nurses when I was a kid,’ said Roger (not his real name).

Over to Roger to tell the rest of his story.

Nazi

I received a phone call from my local hospital telling me I had an appointment with the chest consultant I’d seen before. I thought it was a bit odd, because I’d seen the surgeon who operated on me only the previous day, but I went in anyway. I felt I could trust these people after they did such a great job of fixing my lung. Anyway, when I got there, they made me wait for an hour as usual, then a pretty young student doctor asked if I minded if she sat in on my appointment? How could I say no? I could barely speak with my tongue hanging out like that. So I just nodded and wiped the dribble from the side of my mouth hoping she hadn’t noticed. When I got to see the consultant himself I thought it was a bit odd that he was wearing full Nazi regalia, but he seemed like a nice guy and to know his stuff.

‘Don’t rush back to work", he said.

‘Now, about this bronchoscopy. Don’t worry, I’m sure everything will be OK. I’m 90% sure everything’s fine. People say it tickles a little bit, but you’ll have a sedative and some local anaesthetic that they put up your nose and on the back of your throat. That will make you cough, but it’s really nothing to worry about.’

‘Fine, I’ll do it,’ I told him.

So this week I went in for my ‘bronchoscopy’. After waiting the requisite hour, I was hurried into the day surgery operating theatre by a pretty young nurse and ignored by the doctor. Another nurse made small talk with me to reassure me. I clambered on to the operating table so that I was sat upright with my legs outstretched. The second nurse put a bib on me to deal with my dribbling while the doctor chatted with his friend on his mobile.

‘Hi, I’m Dr Heydrich,’ he said to me finally.

Although I had been feeling relaxed, at this point I suddenly felt a twinge of anxiety.

‘I’m going to put some anaesthetic gel up your nose,’ he said, as he squirted anaesthetic gel up my nose.

The second nurse then stuffed a tube up my left nostril, saying, ‘Don’t worry, it’s only oxygen.’

Banana splat

I looked at her and she had donned what looked like a welder’s visor. ‘You look like you’re about to do some welding,’ I said.

‘It’s just to protect myself from any splatter,’ she replied.

Another twinge.

‘OK, open your mouth, please,’ barked Heydrich. ‘I’m going to spray some anaesthetic on the back of your throat. It tastes very strongly of bananas,’ he added, as he sprayed what tasted like banana flavoured liqueur on to the back of my throat, making me cough. ‘Just a little bit more,’ he said.

‘UURRRGGHHH!!!’ I splattered.

‘UURRRGGHHH!!! UURRRGGHHH!!!’ I repeated.

‘It’s OK,’ said the second nurse, holding my head down with her hand. ‘It makes you feel like there’s a ball in your throat and you can’t swallow.’

‘UURRRGGHHH!!! UURRRGGHHH!!!’ I repeated, desperately.

Heydrich then took what I had thought was a stethoscope and zoomed towards me with the bright flashing end of it and shoved it up my right nostril.

AARRRGGHHH!!!" I said.

‘Let’s try the other one," said Heydrich.

They swapped the oxygen for the stethoscope, which then dropped out of my traumatised right nostril.

‘AARRRGGHHH!!! AARRRGGHHH!!!’ I repeated.

That hurt even more than the right one did. The second nurse (I don’t know what the first nurse was doing, but she was there afterwards) then pushed something into my mouth, saying, ‘Open your mouth and hold it with your teeth.’

Heydrich zoomed back into view.

‘We’ll try it through the mouth’, he said, as he pushed the thick black fibre-optic tube down my throat.

‘UURRRGGHHH!!! UURRRGGHHH!!!’

I tried to cough and splutter, but my throat was numb and I couldn’t breathe. I felt like I was drowning.

‘UURRRGGHHH!!! AARRRGGHHH!!!’

I panicked and pulled the tube out, gasping for breath.

‘I can’t do it!’ I cried, literally, tears rolling down my cheeks.

‘I can’t do it. I’ll go back to work. I promise!’

Over. Roger and out.

Another Planet understands that if this pilot is successful, then the procedure will be rolled out to the rest of the UK in the coming months.

As Nick Clegg-Hess, Deputy Prime Minister, said:

‘What we need is strong, stable government. That means we must weaken and destabilise people who are not working for whatever reason and by any means necessary to get them to conform and work to pay our taxes. This is about control and maintenance of the status quo. Anyone who thinks otherwise is sadly deluded and will be dealt with accordingly. Waterboarding is an effective and reliable means of manipulating even the craziest of people to do what we want them to do. It’s in the national interest to get people off benefits and into work and we will do whatever it takes to make that happen, even if it means torturing people after they have already confessed."

On a more serious note, I’m open to suggestions for other medical procedures you’d like me to blog about. Let me know your ideas in the comments!