Yesterday, 1st March, was Big Yellow Friday.  A day when the Children’s Liver Disease Foundation (CLDF) ramp up their programme of fundraising and awareness raising. Supporters wearing yellow in various guises, baking yellow cakes for sale, sponsored dish washing in those fashionable yellow rubber gloves.  It even coincided with St. David’s Day this year adding something else to the waving of yellow daffodils.

Yellow?  Simple.  Jaundice is when your skin or the whites of your eyes begin to show tinges of yellow.  It can be one of the early and developing symptoms that all is not well with a liver.

It was that sign of yellow in the whites of her eyes that took Lucia, the founder of Live Loudly Donate Proudly, to her local GP.  He triggered a process of attention that led to an emergency liver transplant after acute liver failure.  The yellowing of her eyes gave enough warning for Lucia to be in the heart of the hospital system before the crisis took hold.  Well worth watching for the warnings of yellow…

After her second transplant, just over a year later, Big Yellow Friday was Lucia’s first fundraising venture, along with the enthusiastic support of her sister and their friends.  It also helped her find her voice as she gave her first public, illustrated presentation on organ donation, aged 10.  In years to come Lucia was a regular supporter, participant and speaker in CLDF events and conferences.

CLDF is a firm favourite of ours in Live Loudly Donate Proudly.  It’s a fantastic organisation with a wealth of experience and resources to help children, young people, and their families weave their own ways through a world of new languages, big issues and complicated experiences.  Packed with resources, from leaflets about baby jaundice and even a colour chart of a baby’s stools, to inspirational information packs for young people on how to manage an inclusive range of growing-up experiences alongside liver disease and transplants.  More information packs for parents, for schools, and even for GPs.  Blogs and newsletters for health professionals, and grant support for vital paediatric liver research.

CLDF offers direct, personal and group support for children and young people, through events, residentials, and programmes.  ‘Talk, Tell, Transform’ was an excellent residential programme bringing young people together to share their experiences, learn from and support each other, and then through learning film-making skills, turn their stories into honest, moving, funny resources for others.  (Youtube playlist of CLDF Talk Tell Transform )  That programme is temporarily parked, but Hive, a “Facebook-based social network created by young people exclusively for young people with a liver condition or transplant” continues to cater for 13-15 year-olds and Hive+ for 16 – 24 year olds.

In a few weeks time, CLDF is to merge with the British Liver Trust, becoming one larger organisation in the belief and hope that they will be better together, better for each other, stronger and more effective and resourceful for others.

So, on Big Yellow Friday, we raised a yellow bun and a daffodil for this excellent organisation that offers solid and creative support for those who, out of the blue, find the hint of yellow that plunges them into new and demanding worlds.

Well worth a day of extra attention – and its always a good day for any support you are willing to give… Thank you, CLDF…

Twelve days of blogs. On this last day of Christmas, an invitation to a celebration.  A huge jump into what for many in the organ transplant world is the highlight of the year, the Westfield Health British Transplant Games.  This year they will be held in Nottingham, 1st – 4th August.

If you’re a donor, or you’ve received a transplant, there’s a place for you to participate as a competitor.  You don’t have to be a practised athlete, just someone who wants to have a go and give it your best.  Any age.  Teams are registered through the hospital that carried out your transplant so ask for your hospital’s Team Manager and sign up to come along.

You could also participate as a volunteer, or a sponsor or fundraiser.  (More info.)

Or you could just come along anyway.  Come and watch, come and support, come and cheer people on.  Sign up for the 5k or 3k Donor Run (or Walk!), a colourful and fun adventure for the serious and not so serious, all proud to raise awareness of the incredible world of organ donation and life-transforming transplants.  Watch the social media for the Games and pass the word along.  Just come and be grateful that it’s all there, miraculously, for all of us if and when we need it.

Or come to say thank you, one more time, for the donors and their families.   You’d be joining in with the loudest and longest thank you of the Games…

You may have given your consent to be considered an organ donor yourself. Donating blood, plasma, or bone marrow are also options as life-transforming gifts.  And letting your family, your loved ones, know what your wishes are about organ donation is as important as ever.  Without their consent it couldn’t happen.

If you’ve already done all that with your family, and you don’t need to make it any plainer, don’t stop there. Start a conversation somewhere else. Have fun with it. Wear a badge. Hang an organ donation air freshener in your car and give someone a lift. Use a lanyard at work that invites the conversation. Carry a rolled up copy of the Organ Donation Times (there isn’t one – you could start it?). Have your head, arms, or whatever tattooed with something that will start the conversation – some people have, seriously. As one friend of ours says in the name of her new Instagram account for organ donation awareness, “Skip the small talk”.

However you do it, wherever you are in any of the blogs these twelve days of Christmas, somebody, somewhere, could already be saying thank you for you.  From the deepest place in their hearts and minds. Even if they don’t know you. You may be, or become, a donor. Or you may be the “single word that can make a heart open”, the ripple that becomes the crashing wave of someone else’s gratitude.  Live Loudly Donate Proudly…

School’s back, or soon will be for everyone else. Terms will also start in many hospitals, too, so children who are inpatients don’t have to miss out.

There are lots of ways of helping children keep up with school progress and interests in learning while they are in hospital, or off school for long periods due to their illness.   Some of the Children’s Hospitals could have as many school staff as some average size schools.  The staff may teach in small classrooms, in corners of a ward, or one-to-one at the bedside.  Most children will be short-stay patients so teachers will have to build relationships very quickly and work with flexible lesson plans, as well as often manage some intense emotions.

For the children it is a way to recover some normality, something familiar, creative distractions from serious illness and the traumas of being in hospital.  But it’s not just ‘back to school’, it needs to be tailor-made to suit the students and their circumstances.  The vision of the James Brindley Academy, providing schooling through Birmingham Children’s Hospital, is “…to ‘Think Differently’ to inspire young people to overcome all barriers and achieve their dreams.” (A good model for education everywhere?)

For those children, and sometimes their siblings, in hospital for lengthy stays or frequent visits, the school team is a valuable part of the picture.  Good support for parents too, seeing their children cared for and enjoying opportunities to develop their skills and learning.  Time to slip off for a coffee, or a phone call, with gratitude to yet more people in the team.

Meanwhile, in the home community, there are teachers who help the class show their care for their absent friend, holding their space in the place they know best.   Cards made in class time, letters written from school friends and sent to the hospital, are treasures that reassure a distant patient that they are not forgotten and haven’t lost their place.  A ‘welcome home banner’ painted by the class.  Time given helping classmates understand the reality of the illness and the space given to the young person on their return to school.  A chance for them to tell their story, if they choose, and to be accepted and understood if not.  A novel about children and organ transplants read together in class with sensitivity and understanding.

For some it can take other pathways.  Time out of school can bring disruption to friendships and circles.  Misunderstanding of medical conditions and fears that grow in the absence of accurate information can leave someone vulnerable to isolation or bullying.   The schools that manage that well will not be forgotten (nor, sadly, will those that don’t).

How do teachers, learning support assistants, others in the school teams, deepen their own understanding of organ donation, or other long-term conditions, to make it better for everyone?  How can they sharpen their focus on the children in their charge who are in most need of support?  Paradoxically, they may be the very resources that could strengthen abilities in us all for empathy, compassion and care.

(Live Loudly Donate Proudly has helped ensure organ donation awareness materials are available for all primary schools in N Ireland, with secondary schools to have the same this year – for more see our previous blog).

Schools, like the rest of us, work best when we pay caring attention to those who need it most.  It’s repaid many times over.  Grateful for our own experience, and that of many other friends, thank you – thank you to those who make it all work through their teaching in hospitals, at home, or in our schools, teaching much more than a curriculum.  Five Gold Stars on the chart…

Maybe you are one of those good souls who was working over Christmas or New Year, keeping the engines running and the wheels turning, the ward looked after and the shop open.  If so, thank you, and enjoy your well-deserved break when it comes…

For others it was back to work on Tuesday, or today, after some time to be somewhere else and do something different.  There are more than enough wistful jokes on social media this week about finding ways to avoid going back and prolonging the holiday instead.

There are some who won’t be going back this week because of being in hospital, either as patients themselves or accompanying those they love who are ill.  They will need another set of supporters.  Colleagues and bosses who can understand enough to say, “Go. Do what you need to do. Be where you need to be.  We’ll work out all the rest between us.”

It isn’t everybody’s experience. Not for those whose hearts are breaking and must still turn up for daily work. How do you concentrate then? How do you pretend you want to be at work when everything tells you and those around you that you want to be by the side of your son, your daughter, your loved one, in their own personal, painful, frightening journey?  Sometimes it’s called compassionate leave, compassionate for a reason.  But can it still be called compassion if it starts to drain funds and doesn’t last long enough?

For those employers and work teams and colleagues who give the gift of time, and secure protection, who find ways to care and to support from within the workplace, who take up the slack for a missing colleague, keeping things going in their absence, finding ways to make it happen and getting creative with the support, going an extra mile, or two – this is also a gift beyond words. Time given to an employee is precious time given to a child, a close relative, a dear friend, a contribution that allows the best of love to continue…

Thank you to those who help us to be where we need to be. Thank you to those who work at it and guard it when it’s needed.  It can never be repaid, though it will not be forgotten, and who knows who may need it next?

 

 

Christmas and New Year can stir up a variety of emotions, some grateful or hopeful, but also some difficult. For some people, organ transplantation and related illnesses do the same.

Our mental health may need, from time to time, the trained healers.  There is no shame in that, anymore than going to a podiatrist or a cardiologist.  We need more of these services, and easier, faster access when they are there.  But it also depends on so much more than the professional healers.

It all counts.

The shop assistant saying hello and giving a smile, someone helping us find street directions when we need them, a chat over a pot of tea, the thousands of ways the web of goodwill holds us together.  Unexpected carers, who include us in their daily threads, weaving us back into normal life when we are at risk of feeling – or being – isolated.

Family and friends, giving space to listen, to speak, not making us fit a mould but allowing us to be ourselves, in our own different ways.

The networks of support for our very particular needs – like those groups in yesterday’s blog who, receiving kindness themselves, develop ways of paying it forward.

Those who share similar experiences to us and don’t need everything explaining, who know before we say, or recognise deeper issues when we scarcely have enough energy to give hints or clues.

It’s all about our mental health.  And reasons to be grateful when it’s named, accepted, befriended, and talked about.  Grateful for the skilled professionals, and for the space we give each other where we can breathe, slowly and steadily, while we regain our balance…

The countdown.  The clock ticked past midnight, and a new page began for a new year.

Whatever resolutions we make, or don’t, and whatever it says on our calendars, it’s all still to be written, page by page.  Whatever comes, and whatever we bring to it, we hope for good reasons to celebrate, good people to share it with, and good support to help us hold it all together.

The blogs over these twelve days are each about some of those good people we find through the organ transplant experiences.  And there are so many.

For most of us, our introduction to the concerns that may lead to organ transplants is not a gentle opportunity to dip a toe in a warm sea by a sunny beach but more like being thrown headlong into the shocking cold of a grey winter’s crashing waves.  Unlike the voluntary choice of a cold water swimmer, it’s unwanted and unwelcomed.  And it’s not long before the questions start to come ashore, as relentless as the waves.

The good news is that there are lots of people who can support, accompany, listen carefully, and then provide, or help find, the information that could be most useful.  (Google is not usually the best place to start.)

Because Live Loudly Donate Proudly grew from experiences with liver failure and liver transplants, that’s the path we know best, but there are many groups and organisations that have grown from or focus on issues and illnesses from all aspects of organ failure and transplants.  Many of these have been started by individuals or families deeply affected themselves, determined to offer as much support as they can to others in similar circumstances.  Like the ‘yes’ of consent to organ donation in the pain of the death of a loved one, there are countless people turning their own stories of shock and struggle, healing or not, into resources for others.

And like other stories in these twelve blogs for Christmas, their work goes on all year round.  You may come across them anytime, in the local papers or on social media, in the office, the supermarket, on the bus – anywhere, doing any of the following:

• Fundraising to provide accurate information and resources, or to support families and individuals through the financial hardship that can often accompany sudden or prolonged illness
• Looking for support to continue programmes for children, young people, parents, families, bringing them together to listen to and talk about the million and one different issues that come with transplantation, and the illnesses that may lead to it. And to have fun, ‘be normal’ with others who understand and don’t need explanations
• Adding extra non-medical resources in hospitals for patients and for their families, making their stay as supportive as possible
• Providing extra equipment, or training opportunities for medical staff, creating spaces for shared learning ‘outside the structure’
• Telling stories of others, making experiences less isolating, less frightening
• Bringing people together for coffee in public places, providing support for some and information for others
• And the list goes on…

Somewhere out there, in this new year and all through it, hidden in plain sight, are thousands and thousands of people giving their time, mental energy and ingenuity to making the place a little easier for someone else caught in these waves.  If you are one of them, thank you.  Thank you.  And thank you again.  If not, keep an eye out, an ear open, for this incredible dynamic of goodwill.  So much to be proud of. Whether we need its direct support or not, it is a good thing to start a new year knowing the uncertainty of the coming calendar is already sown with the seeds of kindness…

 

Some helpful friends:

Children’s Liver Disease Foundation

Kidney Care UK

The British Heart Foundation

NHS Blood and Transplant

Organ Donation N Ireland

Live Life Give Life

Altnagelvin Parents Support Group (Facebook)

RVH Liver Support Group (N Ireland)

She’s only three.  She hands you a picture, pride, joy and excitement in her eyes.  “It’s for you, Mummy.  I did it in playgroup.”

You see the colours arranged on the page.  Some lines in it somewhere.  “That’s beautiful, thank you, so much!”  A big hug.  You daren’t ask what it is.  It should be obvious.  You wait.  Eventually, “That’s our house, and that’s my puppy (when can I have a puppy?), and that’s a polar bear, and…”

It may not look like that to everyone else, but it’s lovely.  It goes on the fridge, or gets tacked to the side of a bookshelf.  It may even find it’s way into a frame and become a family treasure.

Families and friends.  Mostly they are around, near or far, and we dip into each others lives when we can, when we wish, or when we must.  When illness refocuses our priorities, we may see each other anew, clearer parts of the picture, if not actually in our true colours, then something a bit more evident.

We’re all in the picture, somewhere.

Two good friends visited us in the hospital, wanting to be there for us, “…and not just as decoration.”  The man proudly handed over a home-made cake.  His wife suggested, mischievously, “Ask him why he baked it.”  Rumbled.  “Yes, well, I saw the oven was on and didn’t know there was anything in it. I turned it off.  So I thought I’d better bake another.”  It was a good cake, all the better served with love and good humour.

Friends who look after siblings at a moment’s notice. (“My parents abandoned me,” she smiles, with cheeky tones, “but they had a better shower than ours so it was OK!”)

The practical ones, those who look after the cat, bring the food, look out for the carers, keep the right news circulating.  Make sure the bank account doesn’t run dry with unexpected expense.  Solid.  Dependable.

Those who hate hospitals and sickness and everything to do with them and would run a mile from it all given the choice, but show up anyway, sitting hard on their own fears, as long as they can, for the sake of another.

The whacky ones wafting into a ward or post-hospital lives causing a mixture of embarrassment and humour, caution and wonder.

The poets and artists, digging deep into images and connections and bringing smiles with a simple hand-made card, a photograph, a small gift of thought and beauty. Philosophers, with alternative frameworks and different perspectives.

Those who travel, hours and miles, to give time and company for as long as they can.

Those who dip in and out, juggling demands of home, family, employment, and still find space to include you.

Those too young to understand or too elderly or vulnerable to take it all in but give their gentle hugs anyway.

Those who plead your case in the highest divine courts they have in their toolkit of beliefs, pounding the doors, demanding attention and the best results.  Others with no words who simply light a candle on their mantelpiece and keep you in heart and mind.

Those who stay the course, long after the first plunge into hospital care, through many more operations, procedures and hospital visits, loyal and untiring, knowing organ donation isn’t simply a cure…. “A friend is someone who knows the song in your heart and can sing it back to you when you have forgotten the words.”

Those who…  you fill in the gaps with the ones you know, or the one you think you are…

In the universe of organ donation, there is another family we may never know anything about.  They are often, sort of, on the other side of the paper.  As their own story becomes their worst nightmare, their yes to organ donation answers the dearest wish of another.  However unseen, they will always be part of the picture, as essential as the paper and the paint.

Living donors may be in full view, shaping the painting in equally permanent ways.

We’re all in the picture somewhere, colours blending or clashing, hardly ever fitting neatly between the lines.  Messy?  Yes,  probably.  And some colours may come to mind because they are missing.

It’s given with love’s intentions.  We do our best in the only ways we can.

So we’ll receive it with hugs, stick it to the fridge with the magnet we found on holiday, or frame it, hang it in pride of place and treasure it for ever.  Family and friends, this one’s for you.  Thank you… (Oh yes, and Happy New Year!)

 

There will never be a shortage of reasons for gratitude in our world of healthcare.

That’s not turning a blind eye to genuine mistakes, mess-ups, even abuses and cover-ups.  They all need timely attention at the least, lessons learned, new practices implemented, holes blocked up and serious intentions of “never again”.

Unfortunately, bad news sells, and when things go wrong, we seem to pay more attention.  The headlines in the mainstream and social media may suggest that more things go wrong than right, but that’s a very long way from the whole story.

Most of us who find ourselves in the care of the NHS and its supportive structures could tell a different story.  The bad stuff, horrible enough when it happens, only accounts for a minority of experiences. Most of what happens is at least good, or very good.  Some of it is, by any definition, excellent.

We’re so trained to spot what’s wrong rather than what’s right that we may walk past the good and the better, and even the excellent, without comment, even taking it for granted.  And when we do say thank you, however fully and eloquently we manage it, it may be received with a wave of the hand and “Thank you, but we’re only doing our job.”  What then?  Perhaps a card, a letter to the ward.  Will it be seen by those we thank?  What if it were, and could be appreciated and taken to heart?

Adrian Plunkett is a consultant in the Paediatric Intensive Care Unit (PICU) at Birmingham Children’s Hospital.  After reflecting on his own experiences as a patient, he set up Learning from Excellence, encouraging staff to recognise and report when things go well.   It’s a way of saying thank you that gets logged, and triggers a note of appreciation for the staff member.  It provides a way of learning from when things work well – asking not only what was good, but why it was good and what difference it made.  Saying thank you, expressing gratitude, and being appreciative of team members is also powerful food for morale and resilience.  ( Learning from Excellence )

We weren’t surprised to see such a thing start in Birmingham Children’s Hospital.  Live Loudly Donate Proudly blogs are littered with thanks for years of incredible care for its founder, Lucia, her family, and for many others.  Learning from what works well should keep them all busy for a long time, there’s plenty of it…

This day four years ago it was another team, in King’s College Hospital, London, that showed us their excellence.  Actually, we didn’t see most of it as it happened inside the Liver Transplant Theatre, and through most of the night.  Lucia had walked along the corridor and into the care of the theatre team for a fourth liver transplant.  Through her hugs and smiles, her hope shone.  “Well, see you next year!  You’ll see me before then, but I won’t wake up until then.”

The transplant coordinator spoke with us a few times through the night, then, at 3.30am,  “They are still working.  It’s not going very well.  They are doing all they can.”

A long hour later, the lead surgeon came into our waiting room.  “Better,” he said.  “Not good, but better.”  There was immense, intense relief in hearing that simple word.  Better.  Even though what followed set its limits.

Later, we began to hear the story of that night’s operation.  It’s for another place and time, but we heard enough over the next days and weeks to understand something of the excellence that had been given to Lucia in the theatre.  More, we heard of Lucia’s own incredible strength and resilience as, time and again, the team thought they had reached the limits.  “The anaesthetist assured us, ‘Lucia is still responding.’  So we carried on.  Lucia led us through.  Her name means Light, you know? She was our light in there,” they told us.

In the continuing quality care that followed, one after another of that team told Lucia, and the rest of us, how much that experience meant to them, how astonished they were by Lucia, and that lessons were learned, not from something that went wrong, but from something that, against all odds, seemed to go right.

Months later, the story turned.  Now we write these blogs in Lucia’s place.  But in all the entangled emotions, thoughts and memories that this day brings, there shines a thread of gratitude, for excellence. In the hospital theatre, in those teams and, always, in Lucia.

Saying thank you will not wear out, and there is still so much to learn…

 

 

There are probably a few too many ornaments and craft things in our house, but most are soaked in memories and won’t get thrown away.  Some originated with the play specialists from times in Birmingham Children’s Hospital (BCH), and their invitation to paint, draw, and imagine, and some of what was created hangs on our Christmas tree each year.

These delightful visitors to the bedside use play to help children (and their families!) feel more comfortable in their environment, express their hopes and fears,  and deal better with the unknown and with what is going on with them.

That’s not unlike another team who find their way to wards and bedsides and who, at their best, also play a part in creating safe space for patients and visitors alike to express the tangled emotions and concerns that being vulnerable can bring.  The multi-faith team of chaplains. Loitering with intent.  Twenty four hours a day.  Seven days a week.  “Available to lift and soothe spirits of our patients, families and staff…in times that are hard and sad, confusing and anxious, and also to celebrate good news and healing.”  And since their purpose is to offer support, it doesn’t matter whether a person is religious or not, whatever their faith is, or isn’t, and “we won’t mention God unless you talk about God first!”

There’s a skill to being around but not being intrusive, available but not disturbing.  A skill to popping a head round the door with or without an appointment, and sensing the moment well enough to offer to stay and chat, or pop back later.  The smiles help.  And, for some of us, even adults in the Children’s Hospital, a chaplain’s outrageously colourful shirt smothered in teddy bear patterns or Christmas motifs was never off-putting.  Quite the opposite, and it’s hard not to crack a smile yourself.

Then the listening ear, and every other gentle, respectful way of reading the patient and the other people in the room, helping trust and respect to grow.  Like the play specialists, some of the best chaplains are those who come to explore things with us and not explain, to invite our thoughts and feelings rather than just give us their own.  It strengthens the experience of respect and dignity, something that can slip away too easily when you’re at the mercy of everybody else’s action and ideas.

In the BCH chapel, as in many more, there is a welcoming space to be.  Somewhere to go in the gaps, day or night.   To think, or try not to think.  A place for tears too, and those silent screams of pain – or joy – silent only out of respect for those around.  A gentle place, with simple things to hold on to when other things are crumbling, changing, frightening.  Like the small basket of pebbles, some marked with words – fear, trust, hope, strength, joy, pain, courage…  Something to hold and focus a thought whatever it may be and wherever it may lead.

Small tealight holders on a side table with slips of paper that may become requests for prayer, for support, gathered at the end of the week and spoken by chaplains in a simple space together as the candles are lit.

A dry tree branch for hanging leaf-shaped cards bearing the names of those we care for, are concerned for, or who have died and whose names are honoured again as they are read by others.

The book at the back of the room for prayers, in any language, addressed to any hearer or none, human or divine; a book which becomes a kind of log for those on prolonged periods in the hospital.  Some trace the stories of others there, sharing their need for compassion and kindness, and a desire to be that for each other.  There is gratitude on many of those pages…

It might sound a bit obvious to say, but there’s great wisdom in being included in what’s happening in your own story, your own healing. It can add to confidence in conversations with the doctors and consultants.  It strengthens the faith we can bring to it all, our faith in the hospital, in the staff who look after us, the family and friends who are with us, in the donors and their precious gift, faith in the kindness of those who care.  Faith in those who are doing and will do their best with skill, wisdom, passion and dedicated attention.

So a thumbs up, a smile, and thanks, to the best of the chaplains, and to all others like them, who keep faith and hope alive…

 

 

 

Pine needles on the floor. Wrapping paper ripped off and tossed aside, or neatly folded for future use. Labels from new clothes.  Potato peel and outer leaves from all those sprouts. Dishes and greasy pans in and around the sink.  All that tidying work that needs doing.  Christmas includes all those messy bits as well as the glitz and glamour.  They can be unpleasant chores left for “somebody else” to do offstage and unnoticed, or shared out and managed with kindness, making the Christmas journey easier for everyone.

The story goes that, during a visit to the NASA Space Centre in 1962, President Kennedy noticed a man carrying a sweeping brush. He went over to the man and introduced himself: “Hi, I’m Jack Kennedy, what are you doing?” The cleaner said: “I’m helping put a man on the moon, Mr President.”  Never “just a cleaner”, he was part of the space team. Every cleaner’s in a story.

A dear friend of ours  is seeing Christmas through in hospital and, as a day began, was not looking forward to unpleasant medication.  Then, a message pinged in from her. “One of my angels in disguise, Jackie the cleaner, came and distracted me as I swallowed it down so only 2 more to go today…”   There’s more, of course: “This angel in disguise also comes and says good morning to me as she starts her day, and farewell at the end of her shift. When she leaves my bedside she always checks there’s nothing else I need that she can help with.  Much more than “just a cleaner”. She is a key to my healing.”

We remember some of those friendly faces from other hospitals, in Belfast, Birmingham and London. Jane, Rachel, Davy, Stefan, others whose names are mislaid in memory but whose kindness isn’t.  The best of them not only kept the wards clean (and changed the bags in those metal bins quietly!), but were always good for a conversation about the world beyond the wards, about their children and grandchildren, their trek to the hospital through the traffic or the snow, shopping and preparing for Christmas, about Strictly Come Dancing (laugh if you must but on many Saturday evenings Strictly proved a welcome distraction, something to look forward to as relief from the daily medical demands.  “Ke-ep dancing!”)

Angels in disguise indeed, with cheery greetings as the light first comes into the cubicle, something “normal” helping patients remember they are people first and always more than patients, with a wider spectrum of life than the necessary focus points in hospital.

And from a retired district nurse who was at the forefront of developing hospice care in N Ireland, we learned that “…cleaners were always involved in the multidisciplinary team’s psychosocial ward rounds at hospices, valuing the information and understanding they gathered while brushing under beds.”  Excellent indeed.

So, if you’re sitting down after tidying up for the umpteenth time, thank you, and especially to those on the frontline of infection control in the wards, thank you for reminders of how extraordinarily valuable the apparently ordinary can be…