Never Write in the Dark

 

Writing is a very solitary activity; we sit there on our own, writing away on our computer or laptop, or even doing it “old school” via paper and pen, pouring out our stories and preserving our characters there in the written word. But how do we know that what we are writing is any good?

We can ask our family and loved ones, but will they give us the feedback we need? They are our loved ones and so often they want the best for us and may not give us the feedback we require, or they may not be able to handle what we are writing about, especially if it doesn’t fit their image of us. As a teenager I wrote poetry, like so many teenagers. I wrote a poem about loneliness. It was bitter, angry and dark. “Nothing kills you faster than loneliness,” was its last line. My mother read the poem and said it was “Nice.”

As writers we can get so absorbed in our own writing, get so far into our characters’ heads that we can miss the obvious. We may have failed to introduce our characters, not given them a distinctive enough voice; we may have left huge plot holes; we may have overused one particular word literally. Because we are so close to our writing, we can’t see these mistakes. We also need to know that our writing is readable and engaging, and that cannot always be achieved by rereading on our own. Good and honest feedback will always make our writing better.

Writers’ groups have provided me with this; they have been a wonderful source of feedback and support. I’ve learnt so much just from meeting with other members.

The first writers’ group I went to was when I was eighteen. The Old Swan Writers were based in the Old Swan district of Liverpool and it was one long bus ride away from my then home. Those bus rides gave me plenty of time to think and read. But that writers’ group told me and showed me I could write. This group of adults showed me I could create a story and characters, plot it out and write it down on paper. It was an amazing revelation. There I received feedback without any agenda. They weren’t pulling me down because they thought I was getting above myself by wanting to be a writer or else telling me polite things because that was what they thought I wanted to hear, both of which had happened before.

(Unfortunately, after an extensive Google search, I cannot find any mention of the Old Swan Writers. Like all good things, they seem to have ended)

When I moved to London, I stopped attending any writers’ group, not because London is short of them but because I led a very gypsy lifestyle in those early years. I changed jobs frequently and I often moved home. I only really started to settle down when I started my nurse training, and that didn’t leave me much time to write anything that wasn’t related to my studies.

I seriously came back to writing after the millennium, when I started to find many avenues for my writing, not just fiction. It was also when I reconnected with a writers’ group, first online and then later in person.

I’m now a member of my local writers’ group, Newham Writers Workshop, and they have been so helpful. I’ve had some very helpful feedback on my writing, how my plots and characters are working, how readable my writing is, how my descriptions work, how they paint a picture for the reader. I have also learnt so much about the craft of writing, subjects like “head-hopping”, “filter words”, distance and intimate view points and about using the “unreliable narrator”. I learnt about self-publishing from my writers’ group.

But giving feedback to other writers has also helped me. We have a policy of always giving feedback that supports the writer in what they want to write. So there is no saying, “I don’t like this,” neither can you just say, “I liked this.” You have to explain why, what makes this a good piece of writing, where the writer could improve it, what does not work but why it does not work. I have also been exposed to some amazing writing there, listening to/reading other writers’ work has opened my eyes to how you can do things differently and stylistically. It has also shown me what my own personal style is; I like to write from a very intimate point of view of my characters, to get under their skin.

The vast majority of my stories in Case Studies in Modern Life have benefited from the feedback from my writers’ group, in some cases I have completely rewritten them after getting some really thought-provoking feedback.

My writers’ group has also shown me how inclusive my writing is. The previous two writers’ groups I joined (one online and one in person) were both LGBT groups. I wanted the support of other LGBT writers, it was a safe place and a safe idea, but good things can come to an end and both these groups closed for different reasons. I’m now a member of my local writers’ group and this is an open group. I’m the only openly gay man there and yet that has never been an issue. Now I am writing about gay issues and themes; the other writers there have understood my writing and have seen what I want to write about. It has shown me that my writing has a wide appeal and that is amazing and very reassuring. Newham Writers Workshop has been the last cog, though a very big one, in the machine that encouraged me to publish my collection of stories, and I’m very grateful for this.

And then there is the social element. After each meeting, when meeting face-to-face, most of us go to a local pub for a drink. Talking with other writers about writing in general, or even life in general, is a breath of fresh air. It takes the solitude out of it all. And I’ve made some good friends there from very different backgrounds. It is nice to get out of my comfort zone.

I would encourage any writer to join a writers’ group; no matter what your experience or level of writing, you can only benefit from good and honest feedback.

 

Drew

 

CaseStudies in Modern Life (On Amazon) 

Case Studies in Modern Life (On Smashwords)

Case Studies in Modern Life (Behind the Words)

 

Case Studies in Modern Life is my first published book and it has been a long time in writing.

I have been writing all my adult life. I was eighteen when I discovered I could write stories. At first I was writing sketches for a drama group. It was an amazing feeling turning an idea I had into something written down that worked and then watching actors perform my words. It was also the first time I realised I had an ear for dialogue. I would hear people talking in public and remember how they spoke; later, I would be able to write in the style of their dialogue.

I also experienced something else. If people enjoyed a sketch, they didn’t call “Author, author!” They really weren’t interested in who wrote it; people usually heaped their praise on the actors, and I liked that too. I could happily hide away in the shadows and carry on watching people and writing about them.

The first piece of writing I sold was a short monolog to my then local radio station. It was about someone who stole pillows, and only pillows, from stately homes. It was about getting away with the “perfect crime” because no one cared about missing pillows. It was a silly piece but again, when it was broadcast, I could hide away behind the knowledge that the vast majority of people who heard it knew nothing about me.

The first short story I had published in print was a story about a gay couple spending Christmas apart because one wasn’t out to his family. It wasn’t a happy story; I’d wanted to capture the reality of life for some people. But as I saw my own story in print, with my name attached to it, I had a marvellous feeling. The vast majority of people who read this story had no idea who I was. I could communicate with people and all they knew about me was my name on a magazine page. People read it without any prejudice against who I was. They would like the story, or not, based solely on its content. That felt so good.

You’ll be sensing a theme by now; I like to hide behind my writing. My writing isn’t about me rehashing my life as fiction, rewriting my life so that I always come out on top, re-writing history so that I am always the winner. My writing is my way of exploring themes and events that fascinate me or make me angry. I want to find the people behind a subject. I don’t want to be the focus of my writing.

The theme of Case Studies in Modern Life also took a long time to come about. Coming out as gay changed my life in many ways and it certainly gave me something to write about. As I explored my gay life, I found there were so many different things to write about. At first, I wrote wish fulfilment stories. I was in my twenties and wanted the best of all possible worlds. As I grew older and experienced more of life, I saw the ways in which gay men adapt to the challenges of their lives or don’t, and this started to fascinate me. How do gay men maintain relationships with lovers, friends and relatives? How does being gay affect our attitudes to health and illness? How and where do gay men find a place for themselves in this world? After reading some of my stories, a friend of mine suggested that I put together a collection about gay life that didn’t focus on the typical subjects of dating apps and finding a boyfriend. I am so grateful for her advice.

The stories in this collection cover some of my favourite themes to write about. There are stories about sex, not sex stories about people’s attitude to sex, which I find endlessly fascinating. There are stories about relationships. Not stories about trying to find a boyfriend, but stories about how relationships work or don’t work; the compromises we make inside relationships and that unique moment of joy that I thought we might never see. There are stories about the issues gay men can face in our modern world, some that only gay men face and some that are universal to all people. And there are stories about how health, ill health and a change in health can affect someone’s life, but this is something I have seen first-hand (though all the characters in this collection are fictitious).

If you read my collection please leave a comment about it, on Amazon, and if you are minded please review it on Amazon. Comments and reviews drive people to my work, as they do for any author.

Case Studies in Modern Life can be found here on Amazon.co.uk and here on Amazon.com

Drew

The Healthcare Professional Will See You in Four Hours Plus

Two years ago I had pneumonia. After three weeks of antibiotics and resting at home my symptoms had not improved. I staggered to see my GP, that Friday morning, and he advised me that I needed to be treated in hospital, there was no more he could do for me and I wasn’t getting any better. Reluctantly I agreed with him and my husband took me to your local A&E. We arrived at 12.00 noon, at 1 o’clock in the morning I received my first dose of antibiotics.

At the time I was so angry and demoralised to be treated like this, as if they didn’t really believe I was that ill, but later I came to realise what had happened, after talking to other people and checking some facts. The whole hospital, not just the A&E Department, were short staffed and having to cope with a large increase in demand. Is it any wonder that the system cracked?

On Monday 28th January, the Government took a step that will make my experience happen more often and to more patients, they announced that they will scrap the four-hour waiting target for A&E treatment (1). The Chief Executive of NHS England, Simon Stevens, announced it the Health and Social Care Committee meeting, on the 28th (2). Matt Hancock, Secretary of State for Health and Social Care, was also giving evidence to the committee at the same time. Simon Stevens said the four-hour target would be significantly altered, political language for scrapped (1).

This has certainly come as a surprise to everyone working in the NHS because no one had been consulting on this, neither the Royal College of Nursing (RCN) or the Royal College of Emergency Medicine (RCEM) were consulted about this (3), the Government just dropped it on us. This isn’t a new idea from this Government, in January 2018 Jeremy Hunted had hinted at this, in the face of the winter pressures on the NHS (4). It seems that the Government is using Brexit, and all the chaos we are facing because of it, to push through something they have been wanting to do for a while.

The four-hour A&E target has been a thorn in the side of this Government for so long. The target is that 95% of patients are treated within four hours in A&E, but in December only 86.4% of patients were treated within this target, and since July 2015 the target has not been met once (3). This has been a constant indicator of how poorly this Government is resourcing and managing the NHS.

The four-hour target was not reached by plucking a number out of the air, but is evidence based (5). It was introduced in 2004, following extensive consultation by the then Labour Government, as a response to overcrowded A&E Departments were patients were faced with long waits for treatment (5). Yet now, when we are again being faced with overcrowded A&E Departments and patients facing long waits, this Government plans to scrap the four-hour A&E target. What is the logic in this?

Targets, when evidence based, have proved very useful in measuring healthcare outcomes and help improve the quality of care. The RCEM, in a report supporting the four-hour target, have found extensive worldwide evidence that time-based targets help improve performance and were associated with reductions in morality (5). This target has also proved useful in highlighting places that are under pressure and strain, but now what it is doing is repeatedly showing how much strain the whole NHS is under, month after month, and embarrassing the Government, month after month.

A&E Departments are under stress for a lot of reasons, not just an increase in demand, but since 2011 there has been 8.8% raise in people attending A&E, this is 23.4million more A&E attendances, or 5,100 more patients a day (6). These increases in demand have not been matched with an increase in resources, which have stagnated since 2010, but there are also other factors putting huge strain on A&E Departments, such as:

- Staff shortages. 10.9% of nursing posts (7) and 7% of doctors’ posts (8) in the NHS are currently empty. These figures are for across the NHS, but this does mean there are far less nurses and doctors available to work A&E Departments. Shortage of staff has been directly linked to poor care. 45% of NHS staff, involved in patient care, have reported that they are too short staffed to deliver safe, dignified and compassionate care (9), and A&E Departments are not immune to this.

- Loss of hospital beds. In the last 30 years the NHS has lost half of its in-patient beds, right across the broad, including medical, surgical, maternity and mental health beds (10). Since 2016/2017, hospital bed occupancy has been running above 90% and regularly exceeds 95% during the winter months (10), which is far higher than the recommended safe limit of 85% (11). The less hospital beds available, the less availability there is to admit new patients, the harder it is to admit patients from A&E, therefore the longer patients have to wait in A&E to be admitted and the four hour target is routinely broken.

- Underfunding of social care. Since 2010 social care budgets have been cut by £7bn and between 2018-2019 they will be cut by a further £700 million, 5% of the whole budget (12). This directly affects patient’s ability to be discharged, because there is less money for home carers, less money for care home funding, less money to adapt patients’ homes and therefore less support for patients living in the community. When there isn’t the social care support then those patients cannot be discharged, becoming delayed transfer of care (DToC) patients, and DToC’s caused by social care problems have increased 130% since 2014 (13). And if hospital beds are being occupied by DToC patients, how can new patients be admitted from A&E?

- Not being able to get a GP appointment. Currently we are short of 15% of the GPs we need, 6,000 GPs (14), and there is a huge difference in the availability of GPs across the country (14). In some areas there is three times the number of patients for each GP (14), making getting a GP appointment far more difficult. The BBC found that only 40% of patients could get a same day appointment (15), 60% were not, while 27% of patients were able to get an appointment within that week. Not all of those who cannot get a same-day appointment will have urgent health needs, but many will, and where can they go when they cannot get a GP appointment? 40% of NHS Walk-In Centres have closed since 2010 (16).

There are a lot of factors that have caused the increase in A&E waiting times and there isn’t one, easy fix to it. Like so much else in healthcare, there are a lot of interconnected factors.

Different NHS Trusts and Social Care Providers around the country are introducing strategies and services to try and reduce A&E attendance. Doncaster has set up a multidisciplinary rapid response team to treat patients in their own homes (17); in Dorset an advanced nurse practitioner acts as a “gatekeeper” to A&E, redirect non-urgent A&E patients to other services where they can be seen (18); at the Chesterfield Royal Hospital nurses have been placed in charge of assessing patients at the children and young people’s assessment unit, therefore streamlining the service and reducing unnecessary admissions (19). But these are only local changes, none of them are national strategies, and it could be even argued that they are only tinkering around the edges. None of them are trying to tackle the reasons behind the increase in A&E demand.

What we need are national strategies to tackle this problem. We need more community services that people can access near to their home when they have an urgent care need (An infection, a wound, a sprain, etc…), which are not just open Monday to Friday, nine-to-five. We need services that enable people to stay in their homes when they are ill or have a long-term health condition, not just social care but much more healthcare being delivered in or near to patients’ homes. I am a Community Nurse, and many of my housebound patients still struggle to get to and from hospital outpatient appointments because there is no alternative. We need to move to a more community-based healthcare system. When I was a student nurse (nearly thirty years ago now) there was a lot of talk about moving us to a community-based healthcare system, and since then that is all there has been, talk. There are some local-based initiatives, but that has been no national policy or political will to achieve this.

In their new NHS Long Term Plan, the Government has promised, by 2023, an extra £20bn in NHS funding, but only £6.9bn will be spent in the community (17). How the are we expected to develop all these new services to reduce hospital admissions with only 34% of the funding? I would say this is a joke but it isn’t funny.

A&E Departments are not coping with the rise demand for their services, which is caused by a lot of factors, and yet this Government’s sole response has been the scrap the A&E treatment target, and therefore remove the one thing that has highlighted the problems in A&E Departments. Do they think that by hiding the problem it will somehow go away? Because this seems all they have done about it.

Managing Brexit is not the only thing this Government seems incapable of doing.

Drew Payne