Re-booting; Catching Trains of Thoughts – Part Four

Living

As reflected, this week was to be one in which the question, “What matters?” was given full focus. Naturally, any answers will be contextualised by the person giving the answers, their circumstances and how they feel at the time. As one young woman, Elspeth, put it to me, “What matters will change through your life”. From someone in her twenties this was very insightful and presumably based on some telling experiences. From this it should not be inferred there is any ageism here or that young people are not capable of deep thought, it was a good example of an early recognition of change. In fact, we go through more change in our childhood and early adulthood than at any other time. Older people are just more prone to express their concerns and fear of change.

It became obvious during Day One the one thing which was certain was that by the end of the adventure there would be even more questions than at the start. Every issue, theme or topic raised was multi-layered, each one opened new areas to look at and ways to think about them.

More and more, society is sceptical regarding politicians and commentators who supply absolute and simplistic answers to the most complex subjects. Papers are purchased and TV channels watched by people seeking clarity and confirmation, so that is what is provided, however impossible it is in reality. The Daily Mail rarely sets agendas, it appeals to its known readership and then points out to politicians its power over the voting public. It is a self-serving approach to journalism which is very successful. Even people with lots of available time typically do not try to find answers for themselves. There is a sense of what is correct and then they buy into the version espoused by the favourite news outlet. Additionally, it should be recognised that a newspaper does not have opinions or goals, but its proprietor and staff do. In a word the success criterion is profit, in a phrase it is to make a profit whilst pleasing backers, friends and unseen influences.

In the USA Fox News TV is an unashamed political organ of right-wing interests. Donald Trump has been very grateful.

More than ask questions, my aim was to generate a conversation. As seen in Part Three, there were many specific conversations, mainly one-to-one but occasionally in groups. If there is a single disappointment it is that few people commented in social media. That just means it is an opportunity for future discourse. In fairness, the daily blogs did not attempt to go too deeply into the ideas being raised, hence these pieces.

This week was not a holiday in itself but it was a major contrast to normal life. As well as talking, there was a lot of reading, staring, thinking, and having more beer (it is just a fact, not a boast). So, my first recommendation is Socrates Café: A Fresh Taste of Philosophy, a book by Christopher Phillips. I originally found this is a scruffy bookshop in a back street in Chicago. It was not in a prominent position but somehow it made itself known to me. Phillips does not have all of the answers, but he does ask great questions. For my entertainment, I downloaded it onto my iPad. Do yourself a favour and find a little time to read this relatively short book. When we used to go on holiday, in the olden days, I would pack numerous books in an already heavy case. Whilst I still prefer the feel and smell of a book, convenience does demand the Kindle app is available.

As I did with the daily blog, I think it is right to highlight as the initial theme something which is positive. On Day One I wrote, “It is inevitable that themes are going to emerge, however, for this first blog during the trip I wanted to reflect on the contributions of two women; one is 26 years old and the other 88”.

The common factor is their positivity. Rather than focussing on negatives, albeit they had concerns, both wanted to emphasise the possibilities and examples of great behaviour. The Olympics in London in 2012 was a personification of teamwork, enthusiasm, and the adoption of a collective sense of purpose. Similarly, career is not something for compromise, but to grasp as a vehicle for inspiration and fun.

We will return to some of these perspectives later.

Moving south from Berwick-upon-Tweed to Peterborough I shared table with a small Scottish man named Hamish, who seemed to be asleep, so I didn’t disturb him. Across the aisle sat two couples who, it transpired were on their way to Paris. We fell naturally into conversation and they, like most other people I told, were intrigued by my mission. I am not sure a great deal of significant thought came from any of us, but it was a very funny hour or so. The guy on my table was actually awake and joined in the fun, at one point saying, “I am 80 years old but my twin brother is two years older”, which did raise a titter. Hamish slightly spoiled it by attempting to explain his witticism to Bill, one of the men opposite.

This guy, Bill, opined we should only be concerned about things we can influence. A few years ago I wrote a blog titled,

“Should we worry about things we cannot affect?”

This is something of a leading question. What are the differences between worry and concern? Is worry a deep-seated emotional response to a situation, fact, assumption or opinion?

Pain is the body’s method of telling the brain there is a physical problem. Worry is the mind’s mechanism for communicating there is a psychological issue. There are physiological signs of worry – sinking stomach, sweating, palpitations… but the resolution has to be within the mind. Worry is a painful but necessary reaction to circumstance. If we didn’t worry there would be no attempt to deal with the underlying causes such as debt, illness, relationship problems or physical threats.

Too often people adopt the ostrich approach to problem solving; ignore it and maybe it will go away. On most occasions this will not work. We need to address our concerns and deal with them.

We should show concern about issues which relate to work. If there is a report to be completed within a timescale it must be addressed; if there is a problem which needs to be solved it cannot be ignored; if personal timekeeping is poor, the reasons for the tardiness must be eradicated.

However, some people worry about matters which they cannot affect and are both a waste of time and immensely frustrating. Cricket is one of my passions and is totally weather dependent. In the week leading up to a match I watch the weather forecast diligently. Will it rain? Is the game likely to go ahead? Clearly, this is not an issue I can influence. If it rains, I will find something else to do. It will be a disappointment but no more. It is not a subject about which I should allow myself to actually worry.

It is tempting to say we shouldn’t worry about whether China is becoming too powerful in the world’s markets but, as we live in a democracy, my vote can elect a government which may stimulate our commercial activities. We ought to think about the issue but not worry.

If the train breaks down, should we worry about the meeting that is about to missed? Worry in the sense of reacting to the situation; a call to the organisation, an apology, a request for delay, purchase of a sandwich – practical responses but there is no point in fretting about the railway engine. It will be sorted but in the future. There is no point in worrying. On subsequent occasions there may be a decision to drive but that is a rational reaction to possible further issues. The biggest frustration with transport delays could be the lack of helpful communication.

Negative thoughts can become disproportional and debilitating. To add to the trials of daily life by worrying about the topics which can’t be affected can be unhealthy. Companies and other organisations do not do enough risk management. Do airports plan for heavy snow? Do transport companies consider a fuel shortage? Do care homes have a strategy for an influenza outbreak*? Don’t worry, plan. Don’t worry, have contingencies and alternatives. Address the issues which can be affected.

*This was written 5 years before the Covid crisis.

Reading this now, a big issue with which I deal professionally is stress in the workplace and the impact it has on people physically. Naturally, I cannot discuss specifics, but bullies win because they pick on the people who can’t fight back effectively. Bullies test the water and, if there is little resistance, dive in. It is not the case that only managers bully, supposed colleagues can be equally bad and may even gang up with others, compounding the problem for the victim.

Returning to the Fun Table, the one couple, Morten and Bente, are from Norway. Perhaps inevitably, the chat moved to food and the different diet they enjoy. It was very clear the six of us rarely missed a meal, not obese but well fed. Everyone had a story of unusual foods eaten, particularly in the Far East. In 2004 I was part of the MG Rover team “negotiating” with Shanghai Automotive as it decided whether to acquire us. On one occasion two of us flew to China to develop the issues around employment. We were treated very well, being taken to high class restaurants. At the time I was eating little meat and now I am a vegetarian, so I said to my colleague, “When a course arrives don’t ask what it is, we will only be appalled”. Inevitably, when something that resembled a wet sausage was served, I heard him ask, “This looks interesting. What is this?” “Sea cucumber” was the answer; I knew it was a marine slug, having seen one in the sea in Kenya. And protocol said we needed to eat some but not all as that may gain you extras. In any of the courses in which there was vegetation, it was completely consumed, in order that it looked like we were trying.

My Berwick train table chum, Hamish, was recently widowed and he was going to visit the widow of one of his friends in Peterborough. Here was a man facing a difficult situation head on and still looking for a life with relevance. It is fourteen years since my wife died from brain cancer. It is interesting to self-observe the way I could compartmentalise my life, grieving whilst functioning at work. Most people are able to do so to a degree, but several women have expressed a view men do it better. However, this was a life changing event, so I changed my life. In truth there was a simple question, “Give in or Get on?” In itself, an easy question to answer and promoted the follow-up, to do what?

The role I left was Human Resources Director of one of the GKN businesses, well paid and as secure as any other job is. There had to be more to life, more variety and more fun. We created Naturally Concerned (for Alison) Ltd. The way my life would have panned out if I hadn’t made the change we can never know and does not matter. What mattered then was the release that came from independence. In some ways it was early retirement whilst doing interesting things and being paid for some of them.

Pension Fund actuaries did research into retirement and death. At the time the data was only available about men and was sobering. On average, retire at 65, die at 66.5 but retire at 55, die at 79 and retire at 50, die at 89. Think about these numbers and the implications for the individual, their employer and the state. Employment as a topic will be covered later, this is more about mortality. People who used to retire at the point their state pension became eligible faced a range of issues:

• They had worked hard, until on a set day, a rule said no more, and they hit a metaphorical brick wall
• They may not have had time to create an alternative world, perhaps based on hobbies. People need passions. It may be sport, the church, a charity, or anything else as long as there is a focal point
• People who work until 65, or later now after the law changed, might not be so financially secure
• A point many people overlook is the impact on the retiree’s partner. She, remember these statistics related only to men, has her own life and now a lump of humanity is sitting for days on end on the sofa

By inference, those retiring earlier could afford it, had passions and weren’t as exhausted. They did not stop work and stop living. I don’t intend to retire and not just because one way to beat the statistics is to carry on working and, therefore, avoid the prospect of dying (does it work like that?). I enjoy the things I do, with exceptions like the annual accounts, but I won’t do as much as my other passions use up more time. The psychology I use on myself is to equate the filing of accounts as being a mechanism to allow me to do the things I love.

As human beings, we can spend only three things: time, energy and money. How we do so is our choice but the theme here is make a conscious choice and do the right thing for you and those you love. To use a railway analogy, we will reach the end of the line, but we don’t know when. Do we want to know? How would we behave if we did? How many people would throw themselves into leaving the world improved or how many would behave hedonistically? Recently, one woman faced by a prognosis of a terminal illness found it to be liberating and, amazingly, retained enough energy to help others.

Most of us are far less careful with the way we spend our time, despite the fact we cannot replace it. Money may be earned again, energy re-generated but time has gone and we all “know” it goes quicker as we get older.

As a coach, I often ask people to consider this scenario; they are 85 and sitting in the rocking chair and reflecting on their life, will they be able to say, ‘Yes, I lived life well’? This does raise the question, what is well? It will be different for us all and presumes we created principles to live by and expectations to meet. Below is a piece I published a few years ago:

I will be 85 years of age in 2039. This is a long time away; twenty-nine years as I write this. Twenty-nine years back I was twenty-seven, four years out of university, engaged to be married, buying a house and in my first management job. I was a fully-fledged adult with responsibilities, hopes and the foundation of my life complete. It was all upwards and onwards. As I look back to that time it seems more like five years ago. Time does travel fast and accelerates as we age.

I never was ambitious in the sense of specified targets, jobs I aspired to getting, levels of wealth to accrue, brands of cars to drive. I was competitive, so if an attractive job became available, I would go for it, exotic holidays were the norm and fun cars came and went. The highlight of my life is my daughter, Natalie; the lowlight the loss of my wife, Alison, aged just fifty from brain cancer.

Alison’s demise caused Natalie and me to think about direction and what matters. To carry on was the easy decision; doing what was more difficult but we already had the basis of the idea. So, at the end of 2008 I left corporate employment to set up Naturally Concerned (for Alison) Ltd, with co-directors Natalie and Gregor, Alison’s brother.

Throughout my career in Human Resources, during counselling sessions, I have asked people to think about being eighty-five years old, sitting in their rocking chair and considering the life lived. Will they say, “Do you know I made a pretty good effort at making it worthwhile” or will it be, “I wish I had done more/less/different”? Rarely are people satisfied. They reflect on opportunities missed, loves lost, decisions made, chances spurned and victories for apathy over action.

This is not a description of unhappiness but a realisation for many (most?) folks that there could have been more to life. It isn’t regret about what is but what could have been added on. Some marry the wrong person, pursue the wrong career or support Aston Villa. This is a statement that it is never too late. At eighty-five the options may be limited but they exist. At fifty-four I grasped the chance to create something that mattered and to change my life. The circumstances were more than disappointing but that underlines the powerful need to see the situation for what it was and to take the moment by the scruff of the neck.

The business is founded, a book about safari published, consultancy on-going and animal causes are supported. And there is so much more to come. Our strap line is “Time to consider…” and people need to finish the sentence for themselves and to do it now not in advanced old age.

This is not a recommendation to get a divorce, but it might be a time to think of more things to do together.

This is not a recommendation to resign from the current job, but it might be a time to think of alternatives, to go back to college or save frantically to buy a business to do that which you love. Giving a guy his Voluntary Redundancy cheque, I asked him what he was going to do. His answer was profound. This was his opportunity to fulfil his lifelong ambition, to open a fish and chip shop. As it happens this would be very low on my list of challenges to take up, but he could do it and he was excited.

This is not a recommendation to sell the house and buy a boat to sail the world. However, there may be equity in the house which could be used to pursue the dream. If the kids have left home, why do you need more than one bedroom?

This is not a recommendation to take just any job to get off unemployment benefit, but a job gives self-esteem or re-training can lead to something very worthwhile.

This is not a recommendation to blow the life savings on a fabulous holiday, but a break may allow a better perspective of today and how tomorrow may look.

This is not a recommendation to do anything. Life may be pretty good and change may not be for the better. My entreaty is to seriously consider the situation and decide, really decide if what you have is good (not adequate but good) and how it can be improved.

The biggest stumbling block for many people is money and any ideas need to have a base in reality. At fifty-six I still have ambitions to play for Birmingham City and some weeks it still looks like a possibility but my strong passions are now directed into our business and the potential achievements.

We may be a long time dead, but we are also alive long enough to make a difference if we want to do so. The only person stopping me is me. Young people may have a lower amount of drive as they see a long life ahead. Then suddenly time has flown. It is neither too late nor too early to make the decisions and to live life fully.

As we sit in our rocking chair our reflections will drift to the things we wished we hadn’t done, to the great things we are glad we did and to the mass of okay stuff. We will consider the things we didn’t do. Perhaps our greatest guilt is kept for the good that we didn’t do.

Do it now.

Even if you are 84 and a half. 

I will, in a later piece, address the need for a sense of purpose but we have to be alive to fulfil it.

My book, ‘Beating the Wisdom of Hindsight: 75 ways to pursue fulfilment and avoid regrets’ reflects on some of these issues.

Health and Wellbeing

Understandably, the most frequent responses to “What matters?” were family and health. The people who gave this answer typically developed other thoughts as well, but their instinctive answer reflected the most fundamental issues.

Just based on appearances the people I talked to seemed to be in good health and grateful for it.

Two young women are an inspiration;
The first girl, Trudy, I met in a bar/restaurant (hold your thinking) where she is a member of the management team. She had left her previous life because her sister had been seriously injured in a motorcycle accident in Vietnam. I remembered the reports as I had only recently returned from Vietnam and had been amazed by the millions of motorcycles and the utter randomness of their behaviour on the roads. Trudy had moved back home to support the family in very difficult times and had no option but to take a job purely for financial reasons and without seeing it as a long-term career. The great news is her sister is recovering better than the doctors expected, thanks to her being a very fit woman.

The second woman, Sarah, had recently broken her hip in a cycling accident, only two years after being diagnosed with cancer and these had changed her whole perspective of life. It would, wouldn’t it. She was studying for a Master’s Degree in Global Epidemiology, to hopefully enable her to make a significant difference to the world. She said her focus had been relationships previously but now it was on something greater. She has the world to live for, now she wants to live for the world, and with Covid hitting the whole world, could she have made a better choice?

Sarah then told me about a colleague on the same course who had also fallen off a bike, with even more catastrophic consequences; she broke her back and severed her spinal cord. Inevitably, this finished her career as a veterinary surgeon. Yet, even without the same physical capability she has created a new norm, which includes starting a family being, at the time four months’ pregnant.

And I sat on a train talking to people! Really, the sacrifices I was making were beyond the call of duty.

It gives more than food for thought and screams the question, why do many of us have dreams but at our peak, the prime of our lives, we find reasons not to follow them? These conversations cannot do anything but make us think:

What should I do?
Why do I want to do it?
How do I do it?
Who will it affect?
Is it possible?
Do I do this alone or with others?
What will be the ramifications?
What support do I need?
Are there financial implications?
When will it be feasible?
Are there constraints?
Does it mean changing location?

And a million other questions, some of which will be discussed later.

Asif, one of the guys I chatted to outside New Street Station, with a cameraman almost literally on my shoulder, had just returned from a six-month sabbatical in which he and his wife had spent time in New Zealand in rural areas. Now he was back to his job in Human Resources but with the knowledge that for them there is a preferred life elsewhere. Have they opened the door to a better existence, or have they created a huge sense of frustration that there is a better reality which is unavailable to them? Only they know the answer, but I suspect either will cause some pain and joy. The position in which the pendulum stops will direct the outcome.

As the train sped towards the South-West, there was a noticeable change in the conversation and not one repeated elsewhere in any numbers. It seemed everyone I spoke to wanted to reflect on the pace of life. It is much slower, chilled, and better, they claimed.

Phyllis and June are a middle-aged lady and her daughter who had “emigrated” from near Manchester in Lancashire. Mum had moved down to Devon seven years ago and her daughter had brought her family two years later. They love it in Devon, although daughter did admit it had taken a while to adjust, particularly her driving style, but now adaptation was complete. These ladies introduced the concept of “Dreckly”, as in, if you ask a handy man to come around to do some repairs, he (or she) will commit to “being there Dreckly”, which means whenever… It might be called Devon and Cornwall time or mañana. Indeed, in Penzance, as described by a local giving me directions to the pub in which I stayed, there is a restaurant named Drecklys. It was inevitably closed.

Donald, a retired gentleman, who is in his 70s, from St. Austell was standing in the corridor at the end of the carriage. In essence, the only thing that matters to him is, “the pace of life”. It appeared there was genuine contentment with his lot, he had found his version of perfection.

In the pub, the Dolphin Tavern, which was perfect for my needs, I spoke to a number of holiday makers, all expressing a desire to live in the area. Penzance is the sailing gateway to the Scilly Isles and has a fair amount of people staying one night as they pass through, possibly back home and having a last beer or two. The landlord, Sam, had had the pub for ten years and has sorted life out well.

I awoke the next morning to a view of the harbour and beyond to the sea. It took all of my willpower not to ring the station to say I will be there Dreckly but to let the train go anyway at its scheduled time. Cornwall is a place I‘ve been to a few times, most notably on cricket tour once, but it isn’t somewhere explored to any degree. Naturally, commitments to return were made and the thought of riding the rails to peace and quiet is awesome. However, when Cornwall is reached, a car is a pretty imperative requirement. A few buses do run but to get around and to see a lot means a car. A five-hour car ride to get to Penzance isn’t as attractive. It is all about choices and living down there is a good one.

House prices in attractive seaside towns are rising, mirroring people’s desire to live in Cornwall or to purchase a second home. This is another subject; second homes raising house prices and effectively precluding locals from buying in the area in which they were born and grew up. Do the local inhabitants have any actual rights? Is it fair rich people own more than one home? Is this simple supply and demand economics? Is the overall economic impact locally a positive one? Without this extra surge of cash would the area become deserted? Is this the type of subject in which our governments, locally or nationally, need to be involved? Why shouldn’t people spend their money as they see fit? If they didn’t spend it, would it merely sit unused in passive investments?

The Medical Profession

On my last day, a Sunday, I boarded the train from Taunton to Cheltenham. Before I even sat down a guy had begun a conversation with me. It certainly made my task of creating a conversation easier. This is the only time I will use the person’s real name; this was Dr Paul Grundy. His Wikipedia page describes him,

“Paul Grundy MD, MPH, FACOEM, FACPM, known as the “Godfather” of the Patient Centered Medical Home, member of the Institute of Medicine and recipient of the 2012 National Committee for Quality Assurance (NCQA) Quality Award is IBM’s Global Director of Healthcare Transformation.

In this role, Dr. Grundy develops and executes strategies that support IBM’s healthcare-industry transformation initiatives. Part of his work is directed towards shifting healthcare delivery around the world towards consumer-focused, primary-care based systems through the adoption of new philosophies, primary-care pilot programs, new incentives systems, and the information technology required to implement such change. He is one of only 38 ‘IBMers’ and the only physician selected into IBM’s senior industry leadership forum known as the IBM Industry Academy.

Dr. Grundy is also the Founding President of the Patient Centered Primary Care Collaborative and is an Adjunct Professor, University of Utah School of Medicine, Department of Family and Preventive Medicine.

An active social entrepreneur and speaker on global healthcare transformation, Dr. Grundy is driving comprehensive, linked, and integrated healthcare and the concept of the Patient Centered Medical Home. His work has been reported widely in the New York Times, BusinessWeek, Forbes the Economist, the Huffington Post, New England Journal of Medicine and newspapers, radio and television around the country. Dr. Grundy is also invited frequently as a thought leader to conferences such as TED conference, Smarter healthcare by smarter use of data, or NHS Confederation conference, Foundation for Healthcare Transformation.”

Paul was in the UK for two main reasons; firstly, to review some pilot projects and secondly, to meet and advise the then Health Secretary, Jeremy Hunt about Patient Centred Health Care. Remembering my own views were not relevant to my quest, I was able to suppress my, probably ill-informed thoughts, about Mr Hunt.

It may be clear from the description Dr Grundy is American. He is one of the prime movers in this move to putting the patient at the core of all treatments, to improve all services and their co-ordination and to improve the all-round efficacy of health processes. He showed me a book entitled, The Familiar Physician: Saving your doctor in the era of Obamacare by Peter B. Anderson, M.D. with Bud Ramey and Tom Emswiller. Dr Grundy features heavily in the text. Despite its title, the thesis is not as political as it appears.

The fundamental aims of Patient Centred Health Care are:

• Improve the experience of care
• Improve the health of the population
• Reduce the per capita cost of health care

The principles are:

• Everyone has a personal physician
• Physician directed medical practice
• Whole person orientation. Links to other health support and specialists at all stages of life including acute care, chronic care, prevention and end-of-life care
• Care is co-ordinated and/or integrated to include physician, specialist, hospitals, home health, nursing homes and community. Patients are actively involved
• Enhanced access to care e.g. open scheduling of appointments, expanded hours, better communication options
• Payments based on added value (this is in the USA but the NHS has volume targets)

All of these aspects are supported by high quality systems, as you would expect from someone employed by IBM. However, there is a total emphasis on high quality service and care.

Paul Grundy will also be discussed in a couple of other aspects of my findings.

I very much like the thought we should have preventative healthcare and a focus on wellness. In the United States, approximately 17% of GDP is spent on medical care and yet people do not think they are getting what they need. Apart from the reaction from certain shrill media outlets, why shouldn’t the gym or yoga classes be available on prescription? Why do a few people make a lot of money from a system which is designed to cost a lot of money and still the general populous isn’t being given things they need?

I met Jasmine travelling from Chester to Manchester; I should have alighted in Warrington, but the conversation was too interesting and I missed the stop. As it happened, I arrived in Manchester to find a connection to Edinburgh only twenty minutes later. Kismet.

Jasmine works as a salesperson in Pharmaceuticals, in a small organisation. However, Big Pharma is a major beneficiary of the emphasis in healthcare being on cure rather than prevention, it has a vested interest in perpetuating the current approach.

Look at this article from CBS News;
When Turing Pharmaceuticals bought the 62-year-old drug called Daraprim in August, the company immediately raised the price of one pill from $13.50 to $750. The increase drew protests in the medical community from those concerned that many patients will no longer be able to afford the drug. According to Turing CEO Martin Shkreli, however, the move is simply a smart business decision.
“Why was it necessary to raise the price of Daraprim so drastically?” CBS News correspondent Don Dahler asked Shkreli.
“Well, it depends on how you define so drastically. Because the drug was unprofitable at the former price, so any company selling it would be losing money. And at this price it’s a reasonable profit. Not excessive at all,” Shkreli responded.
Daraprim was developed in 1953 as a treatment for toxoplasmosis, an infection caused by a parasite. It comes from eating under-cooked meat or drinking contaminated water, and affects those with compromised immune systems, like AIDS and cancer patients.
When Turing Pharmaceuticals raised the price of Daraprim to $750 per tablet, the average cost of treatment for patients rose from about $1,130 to $63,000. For certain patients, the cost can go as high as $634,000.
While Shkreli acknowledged that the move might look “greedy,” he said there are “a lot of altruistic properties to it.”
“This is a disease where there hasn’t been one pharmaceutical company focused on it for 70 years. We’re now a company that is dedicated to the treatment and cure of toxoplasmosis. And with these new profits we can spend all of that upside on these patients who sorely need a new drug, in my opinion,” he added.
“There’s no doubt, I’m a capitalist. I’m trying to create a big drug company, a successful drug company, a profitable drug company,” he said. “We’re trying to flourish, but we’re also — our first and primary stakeholders are patients, there’s no doubt about that.”

Mr Shkreli was arrested by the FBI after being indicted on federal charges of securities fraud. He was convicted on three charges in August 2017. He had already resigned as CEO of Turing Pharmaceuticals. Turing later committed to changing the price hike but fudged it. This is a case worth researching a little as an example of ex-Prime Minister Ted Heath’s “unacceptable face of capitalism”. We can debate the merits of economic systems, but this was gross opportunism.

Jasmine is highly confident her company acts well. Indeed, the reward basis for salespeople only has a small bonus element, so there is no motivation to cut corners or behave improperly.

Drugs are problems. The best doctors try to get patients off drugs rather than onto them, albeit drugs are a critical aspect of many treatments. One of the biggest issues for doctors is our inability to maintain the drug regime or we stop taking drugs too early (although another study says we don’t always have to finish treatments). Patients do not help themselves. Of course, few people want to take medication but then a few are addicted, and this is an addiction as compelling as for illegal drugs.

Crystal raised the issue of legalising drugs. Why do we criminalise so many of our young people who have, in the greater scheme of things, done little to offend society? What is the point of imprisoning people when education is the need? If drugs were legal, we could benefit from taxes and monitor the health of the addicted, so why resist? However, no politician is bold enough to say these things. After decades of headlines screaming “Lock them up”, to now say drugs are not an issue would offend the thinking of the general population and the preferences of the Daily Mail.

In the USA even just using drugs for personal pleasure can result in many years of incarceration. In the States 46% of prisoners are there for crimes directly related to drugs but in the UK it is just under 20%. However, many of the other offences for which people have been convicted are drug related and, in the UK, probably more than half of the prison population are there due to drug abuse. Locking people up is not the answer, education and help are. Imagine the number of prisoners dropping by a half. Inevitably, the Government would proportionately cut the budget and close jails but think of the improvements that could be made towards the goal of preventing re-offending. It is often said jails are the universities of crime, so let’s reduce the number of students drastically.

Society does like a modicum of vengeance in its sense of justice.

Naturally, alcohol is completely legitimate in my world. Despite all of the research many of us drink too much. It affects our health, weight and, for some, behaviour. I can’t defend drinking a few glasses of wine or a pint or two, but I do enjoy them. They do help me deal with stress, so it is swings and roundabouts.

Throughout the week away, whilst health was the most common theme, there wasn’t much discussion about the NHS. It seems we all blindly believe it will always exist, despite its gradual drift into the commercial world. The irony is it was a Labour Government under Tony Blair which opened up the possibilities for private business.

Is the NHS efficient? Could it be better? Are vested interests, both external and internal, getting in the way? Are we personally prepared to alter our habits to prevent illnesses? Should we educate people about the effects of junk food or tax it up to a point healthy eating is cheaper? Do we care about the health of poorer people?

Food

Weight and obesity are a major issue in the Western World.

How many of us (and I do include myself in this) are clear about the problems of being overweight but fail to act. We know there is a very direct correlation between obesity and ill-health and, ultimately, death prior to the allotment of our span on Earth.

The equation is simple: we need to burn more calories and consume fewer.

We are too busy to exercise. Really? Is watching TV a critical activity? Are 9 hours sleep that much more important than eight? My current problem is an App for the game of Bridge; an hour can evaporate. We encounter Time Sponges everywhere.

We cannot resist temptation in its various forms: alcohol, sugar, fat. Have you ever noticed how more awful food is for us, if it begins with the letter C? Chips, chocolate, curry, crisps, cheese, cake, cookies… Celery is merely one of my pet hates.

Fat is typically a problem in the mind. It is difficult to assign any real negative value to biscuit, somehow it doesn’t actually count. Missing one walk won’t truly make a difference. But if one cake isn’t too harmful by simple mathematics two or three can’t be desperately bad.

Fat isn’t a feminist issue, it is a major heath one. Our health service will be unable to cope with the number of patients who have, in effect, made themselves ill. We know the problem but will not or cannot act.

The conundrum is how do we inspire people to act?

My thanks to Tammy Williams for this puzzle;
There were five frogs on a log. Four decide to jump off. How many remain on the log?
Five. There is a colossal difference between deciding and doing.

Don’t be a frog. Your health and your planet are personal issues, so act and behave as if they matter to you.

The psychology of eating is the determining factor. In their book Bridges Out of Poverty, Ruby Payne, Philip DeVol and Terie Dreussi Smith compare various behaviours of three classes of people; those in poverty, the middle class and the wealthy. One of the categories is food. In this analysis, the question those in poverty ask is, did you have enough? For those in middle class it is, did you like it and the wealthy want to know, was it presented well?

As I have little experience of contact with the upper echelons of society, I cannot confirm the observation about all of their attitudes, but this seems to meet my preconceptions of the inherent pomposity of nouveau cuisine and posturing of the rich. Appearance is everything, pay for the differentiation rather than the substance and find the characteristic which delineates them from the rest. When money doesn’t matter, why would it matter what it is spent on? Having the money isn’t important but funding status and protecting position is.

There are numerous definitions and criteria for being classified as middle class. It may be salary, savings, home size and location, job title, place of birth, speech style, educational qualifications, status of  own family and in-laws, and many more. It is certainly aspiration; to rise out of the working-class milieu or to fight to stay away from it. As the wealth of the nation has risen, salaries have exceeded inflation and consumerism has run amok, the number of people who would describe themselves as middle class has increased dramatically. Maybe this self-assignment is the best judgement. Millions of people have stepped up from poverty, have more spending money and feel they deserve good quality. Food is more than taste; it needs to smell, look, and feel good. There is a sense of anticipation, joy and satisfaction as the food is cooked, eaten, and digested calmly. Who wouldn’t prefer decent quality grub? I am sure the wealthy want it to meet all of these criteria; they just place appearance as the most important factor.

The poor have a different priority – quantity. Scale and size are everything, being full is the critical criterion. Given these people are poor there is less scope for purchasing high quality products. The capacity for acquiring variety is limited. The more typical approach is a simple diet in which the amounts on the plate are large. The inevitable consequence is the rapid increase of obese people and the attendant health issues.

The problem is the profound taste of many fattening foods, in particular sweetness. Lettuce and spinach are bland, but pizza and chocolate are delicious to the uneducated palate. It may not be a surprise some individuals take on too many calories. If we think about the animal kingdom there are thousands of examples of creatures which feed as often as possible and store energy for times of scarcity. Perhaps sub-consciously we are programmed to gorge ourselves in circumstances of great food availability.

As I was born less than ten years after the Second World War, just as rationing was finishing, most people were hyper conscious of food deprivation and were primed to make the most of more plentiful supply. The question was never, “How does it taste?” but always “Have you had enough?” or “Do you want any more?”. Visitors had plates piled high, with seconds available. This was, of course, a sign of generosity, yet underpinned by the need to take on-board sustenance. Eating everything was accentuated by a lack of refrigeration. The larder was cooler than the rest of the house, but food didn’t last very long. It had to be eaten and nothing was to be left on the plate or it was re-cycled as bubble and squeak, hash, fritters, rissoles, and faggots.

Poorer people also need oral satisfaction. Linked to quantity and volume, the mouth must be full during the eating process and rapidly re-filled post swallowing. There has to be a sense of protecting that which has been hunted or gathered. Slow and delicate eating habits were inappropriate in more competitive times, when finding food was truly a daily fight in which failure could mean imminent death.

Too little food and we die; too much food and we die.

Obesity leads to many health problems; heart disease, diabetes, breathing difficulties, high blood pressure… Yet we continue to eat and eat and consume. Or at least we do in developed countries.

In many parts of the world the population doesn’t have enough water let alone food. Of course, too little to drink certainly means there aren’t adequate supplies to cultivate crops or breed animals. Starvation is only one of the issues. Bodies are not resistant to disease and the complete lack of any balance in the diet, and a lack of vitamins, make the people highly vulnerable to illnesses.

It is wonderful how we react when there is a crisis anywhere in the world, the tsunami in south-east Asia, war in Ethiopia and earthquake in Haiti. There is a general compassionate response to help alleviate the intense suffering and life-threatening conditions. We are hugely moved by the plight of the thousands of affected people. Television crews arrive before rescue workers to beam their pictures of horror to our homes, and we donate, even those with little give. It is really impressive and worthwhile. We help the hundreds of thousands of people in trouble.

So, why do we not react as emotionally to the billions of people who are dying from starvation and deprivation? Why are we not donating weekly, generously and automatically? Do crises need an immediacy to be worthy of our attention? Does our consciousness trigger for us rather than the affected group? Is our desire to help enabled by the ability to quantify the problem?

If there are billions of fellow human beings in trouble, we cannot impact upon it. Millions of us helping tens of thousands of people in a far-off land is comprehensible. Perhaps it is the same psychology that affects us in relation to murder. The person who commits one or even several murders stimulates outrage. Genocide, the death of hundreds of thousands, is met with a shrug. Rwanda is a long way off, difficult to spell and they see life as less precious than us, don’t they? And, by the way, if it is tribal between the Hutus and Tutsis there is no answer. However, if there was a colossal landslide with TV images the money would flow in. Are we cynical, ignorant, or uninformed?

The UK Government has reduced the overseas Aid budget from 0.7% of GDP to 0.4%. This is because there is a need to spend money at home as the priority. This is another way of saying it is a vote catcher. The reduced percentage is compounded by a reduced GDP anyway. We have gone from less than a penny in the pound to less than half-a-penny in the pound. Of course. We should debate where the money is given and ensure it doesn’t get into the bank accounts of the powerful, but we must help the most vulnerable. If we think migration is an issue now, wait for the accelerating effects of climate change and starvation to drive millions from Africa to Europe.

I am a vegetarian. It is a point of principle based on a commitment to animal conservation, recognition of the unbridled cruelty mankind inflicts on any other creatures, and the adverse effect raising animals for slaughter has on the environment.

Even if these issues do not register with people, the health benefits of the vegetarian diet are clear. I was challenged by The China Study, a book by Dr T. Colin Campbell, (Jacob Gould Schurman Professor Emeritus of Nutritional Biochemistry at Cornell University), and his son Dr Thomas M. Campbell II, a physician.

The China Study examines the relationship between the consumption of animal products (including dairy) and chronic illnesses such as coronary heart disease, diabetes, breast cancer, prostate cancer, and bowel cancer. The authors conclude that people who eat a whole-food, plant-based vegan diet—avoiding all animal products, including beef, pork, poultry, fish, eggs, cheese, and milk, and reducing their intake of processed foods and refined carbohydrates—will escape, reduce, or reverse the development of numerous diseases. They write that “eating foods that contain any cholesterol above 0 mg is unhealthy”. The authors do accept there is significant opposition to their views, particularly from scientists aligned to the meat industries but, and they are preaching to the converted with me, do a very good job of rebutting the criticism. I know meat and dairy taste great, and we have enjoyed this diet for millennia, but are they the best option? Is habit our problem? We have been told all our lives that we must have these for our wellbeing, so why would we change? And numerous scientific studies emerge providing conflicting conclusions. How can we be certain? Hence, my decision is based on the principles described previously.

Stress

Stress has become a huge issue for society. Whilst it doesn’t only impact upon the workplace, scale can be seen from the Health and Safety Executive numbers:

• The total number of cases of work-related stress, depression or anxiety in 2020/21 was 822,000, a prevalence rate of 2,480 per 100,000 workers.

• In the recent years prior to the coronavirus pandemic, the rate of self-reported work-related stress, depression or anxiety had shown signs of increasing. In 2020/21 the rate was higher than the 2018/19 pre-coronavirus levels

 • The number of new cases was 451,000, an incidence rate of 1,360 per 100,000 workers.

• In 2020/21 stress, depression or anxiety accounted for 50% of all work-related ill health cases.

• By top-level industry, stress, depression or anxiety is most prevalent in:

– Education

– Human health and social work activities.

• In terms of occupation, higher than the all jobs average rate of stress, depression or anxiety were found in:

– Professional occupations

• The main work factors cited by respondents as causing work-related stress, depression or anxiety were workload pressures, including tight deadlines and too much responsibility and a lack of managerial support (2009/10-2011/12).

• Of the 822,000 workers suffering from work-related stress, depression or anxiety in 2020/21 an estimated 449,000 reported that this was caused or made worse by the effects of the coronavirus pandemic.

• These estimates of the number of workers who suffered work-related stress, depression or anxiety as a result of the coronavirus pandemic should not be subtracted from the overall estimate of work-related stress, depression or anxiety. It cannot be assumed that those individuals would not have otherwise suffered from work-related stress, depression or anxiety in the absence of coronavirus

Stress is the second largest category of absence causing illness. The human, state and corporate costs are colossal.

What is stress? What causes stress? Why do some people deal with the pressures better than others? Is it a weakness? Can it be cured?  What is the difference between stress and pressure?

As I recounted, numerous people in Devon and Cornwall were there just for the pace of life. They had exited from a life of targets, bonuses, bosses and deadlines. Not everyone can and not everyone wants to leave the pressure and stimuli. How can they know when it is becoming unhealthy? When do they become trapped?

Preventing Illness

Taking exercise is another of the time choices we need to make. Even a half-hour walk each day will have an impact. Acknowledging there are numerous alternative attractions and demands on our time, but exercise is beneficial for both physical and mental health.

Personally, I have always wanted there to be a ball involved for it to be fun. Football, rugby, and cricket have filled my life and I have gained from them enormously, socially as well as the other positives described. I may, in a moment of honest reflection, accept that sport has played a disproportionate part in my life. Certainly, Alison, my first wife, would agree with this. It was accentuated by a period in the 1990s in which I held numerous elected roles in cricket administration, school governance and business groups. For some people, retirement is the time to get involved, I just did it early, whilst having highly demanding jobs as well. I wasn’t at home a great deal. When my daughter, Natalie, was very young Alison insisted my cricket commitments were limited to one day per weekend. I was frustrated but she was correct, and I saw my daughter grow and develop. It is about balance both in terms of time and the emotional needs of all those affected.

Sitting on trains didn’t provide much exercise. However, numerous people discussed their fitness regimes and love of participating in sport. Sadly, the effects of the Olympic Games successes had quickly dissipated.

Prevention or cure is a great conflict. Presumably, nobody isn’t in favour of prevention, but are we spending too much of cures, leaving little money to stop illness ever happening? This seems to be ironic. The founder of Facebook, Mark Zuckerberg, and his wife Priscilla Chan are giving $3 billion to charities researching cancer, heart disease, and infectious and neurological diseases. Zuckerberg is quoted as saying, “At present, 50 times more money is spent on treating people who are sick than on curing the diseases that would stop them getting ill in the first place”. He doesn’t just make a financial case that it is effectively cheaper to stop illnesses occurring than treating the malady. There is a more fundamental perspective to the way we must look at society and its citizens, which is it is just decent humanity to help everyone enjoy a healthy and active life. There will always be illnesses, and new conditions will evolve, however we can hugely mitigate the current situation if the respective governments prioritise prevention and cure; it cannot be an either/or choice.

It has long been thought, or at least assumed, that happiness and fulfilment are highly influential factors in maintained good health. In the next section I am going to address the issue of finding and living life against a sense of purpose, but it is a very strong theme from my conversations with my large band of new friends.

If you ask anyone, “Do you want to be happy?” the answer is always going to be “Yes”. Nobody wants to be unhappy but most of us spend our time in the middle areas of the Happiness Spectrum, vaguely content and moderately pleased with our lot. True happiness is a transient state which isn’t easy to achieve and very easy to lose. During the interview which I gave on Radio Hereford and Worcester, the presenter, Andrew Easton, suggested I tried out my approach to people on him. The impressive thing wasn’t that he answered he wanted to be happy but that he knew the triggers which allowed him to achieve the state. Sadly, as I intimated, maintaining this wonderful feeling is very difficult. It passes and we think about other subjects. We may still enjoy a glow, a sense of pleasure but it isn’t necessarily the powerful condition of happiness.

It, therefore, seems very unfair that for people who are truly unhappy it isn’t easy to lose, and it can develop into despondency and despair. It isn’t a glow in the background, it is a reality coursing through the body and mind. Doctors can, and do, prescribe drugs to ease the pain but it will only go away when the person adapts and has something positive to live for in the future. Simple words hiding a horrid place to be.

My belief, and this is a personal construction, is there are seven levels of personal mood or state of mind:

• Morose; an inability to operate and function. Uncommunicative and surly.
• Peeved; decidedly irked by something or someone.
• Grumpy; usually sees the worst in any situation and prone to reveal those feelings
• Benign; the state we are in most of the time. We function on a plateau of equanimity
• Chipper; feeling pretty good, things are on an upward curve
• Perky; really good emotional state, positive and active
• Impish; a dangerous combination of vitality and being carefree

When my daughter, Natalie, was five years’ old an acquaintance asked what I wanted her to be when she grew up. I will be honest and say I thought it a facile question. Her personality, desires, style, and interests had a great deal of developing to do. It was clear she was bright, outgoing, and curious but so are most kids. I may have had ideas which would have suited my preferences but that wasn’t my role. In fact she went to Drama School and was a professional actor for ten years an option none of us could have predicted as there is no history of anything similar in the family.

My actual answer to this kindly and inquisitive individual was “fulfilled”. Only she could assess and evaluate her passions and remarkably from the age of about twelve was totally focussed on acting. We said things like, “Have you thought of being a vet?” and not because acting wasn’t a great thing to do but because it is so competitive and the chances of obtaining a place at an esteemed institution such as Bristol Old Vic Theatre School were so remote. Shows again that I know nothing.

What is fulfilment? One definition is “to achieve one’s hopes and dreams”. Inevitably, this is too generic and bland, but it is only six words. Fulfilment is that deep rooted recognition of success, of completing a desired aim, of participating in something which you designate as important, of satisfaction that your job or vocation is aligned with your values.

It may well be true that we cannot all be fully occupied and paid for performing a job which fulfils us. Most people do not know what that would be and, therefore, cannot ever achieve it. Perhaps most of us have a vague idea of our preferred role in life or, more likely, we know what we don’t want to do. Disappointingly, we need money and frequently compromise our desires for satisfaction for the compulsion of income. But at least ask yourself the question, “What would give me satisfaction?” If you know where you would like to get to, at least you have a chance of it. You may do things in your spare time which marry with these aspirations or you may educate yourself as a part of the answer. We are never too old to try.

There used to be a series of books of cartoons titled Laughter is the Best Medicine. Humour is therapeutic. How do you feel after laughing out loud? How often does it happen? Can you guarantee it is going to occur? The reason we pay for entertainment is it’s a contrast with the normality of our lives, even for people doing a job they adore. If Eddie Izzard is someone that usually amuses you, then distance and cost are, relatively, unimportant when he is appearing on stage. You “know” this will appeal to your sense of humour. In fact, you will forgive him jokes that don’t work because you like him, and you will laugh more than if the same story was told by Michael McIntyre (personal preferences revealed). The most entertainment I had during the train week was on the “Fun table” out of Berwick; we laughed. It is impossible to laugh and think of disappointment simultaneously, so mirth has several layers of benefit.

Mindfulness

Psychology Today states, “Mindfulness is a state of active, open attention on the present. When you’re mindful, you observe your thoughts and feelings from a distance, without judging them good or bad. Instead of letting your life pass you by, mindfulness means living in the moment and awakening to experience.” It is about being present now.

The first problem is there is no such thing as now. The instant we think we are in the “Now” it is history. We live reflecting the past or preparing for the future. The psychologist Daniel Kahnemann has opined that “Now” lasts for three seconds, a precise figure for a nebulous concept. I suspect most people think they live in the now and for now. Every action creates our history and structures the future. This all sounds fine but if you injure yourself the pain is omnipresent. The brain isn’t saying I was in pain, or I will be in pain, it is saying I am in pain. Perhaps Kahnemann sees there being a never-ending series of three second spurts of the present but then do they overlap as new experiences, sensations and thoughts occur within every three seconds’ period?

At this point I am not going to begin the discussion about purpose in life, this is a mental and physical state in which we can become highly adept at introspection and correction. Too many practitioners of mindfulness spend all of the time being inward looking but do not address processes to rectify any problems identified or tweaks needed. We must have both.

Gill and Bill were travelling back to their home in Devon. Bill described himself as a Nihilist and I couldn’t tell if he was being serious, but it was of little consequence in itself (very small joke). Gill had given a lot of thought to how she wants to live. Like most people heading for Devon and Cornwall her attitude, and decision to reside in the south-west, was an emanation from her deep personal analysis. Gill was mindful of the manner she needed to exist.

It is estimated we have between fifty thousand and seventy thousand thoughts each day. No wonder it is difficult to stay in touch with oneself. If you are in a relationship that means between one hundred thousand and one hundred and forty thousand thought between the two of you. It is, therefore, understandable there can be crossed wires and misunderstandings. This is accentuated by the fact that 80% of thoughts are negative. Again, just think about this. Eight thoughts in every ten are negative and it isn’t certain the other 20% are all positive. And 98% are the same thoughts you had yesterday. It is turgid and painful inside our brains.

How can we turn this around? In a small way I have started by asking if the negative experience I am enduring really matters. Each of us has to create our own mechanisms but it is fundamentally an issue of attitude. Excepting some older male members of society who proclaim their status as Grumpy Old Men, few people would relish being considered churlish, obnoxious, regressive, or a blockage to the happiness of others. Then off we go and behave just like that, egged on by our brain which is following the tracks of our habits. Pastor Will Bowen encourages us to abstain from complaining, criticising, or judging. However, as a friend asked, are we not always making judgements? We are but let us at least do it based on facts and not conjecture or gossip. Disappointingly, soap operas portray a view of society in which these three criteria are the only ones in active use. So, many people think these behaviours are the normal reality and copy them. This is aggravated for people who live vicariously. I would never visit my mother when Eastenders was on TV. She used to sit watching and making comments as if it was genuinely a real world and her views mattered.

Inevitably because we are all different, we are stimulated by different things. One person distraction is another’s energy provider. I can work really well in coffee shops despite the activities occurring all around me. Rather than absorb my focus and break my concentration the energy in the room creates within me a drive to succeed. However, I am also inspired by looking at the sky at night.

Arguably, the realisation that each of us is such a tiny speck in the universe could be a total demotivator. Alternatively, it can give a sense of possibilities. What is eternity? How can we imagine there are no limits? We want to know if there is infinity and what is beyond it?

Resilience

This is a term continuously used in the business world today. Like mindfulness it has become an industry in itself. So what is it? The former footballer Iain Dowie used the word “Bouncebackability”. Others have tried to claim it but it was originally Dowie. It is a Germanic approach to word construction, just merging separate words. It is also the capacity to absorb failure and rejection and still function. Many people can compartmentalise, so even though one aspect of life is difficult, they function very well in the other aspects. It is how grieving people can still go to work and operate.

Maybe it is living life as if death is certain, as indeed it is. Resilience is not just about specific events which hit us like a wet kipper slapped around the face but also the pressure of the gradual realisation something is wrong. Previously, we met Rachel, a woman in her early thirties who is in a job she enjoys but she has hit a metaphorical ceiling. She is very well regarded in her organisation; it is a charity so there is the inherent satisfaction from that but there is no chance of progression. Rachel has been with her partner for fifteen years, which adds to the overall feeling life has plateaued. She has to emerge from her emotional box which has been created by circumstances and need to satisfy the preferences of other people. This does not mean she has to abandon everyone, but she must get them to recognise and support her desires.

Rachel is a vibrant and intelligent human being. For her to accept the compromised position in which she finds herself, will mean frustration for her personally but a loss of her potential for the rest of us. She almost has a duty to break the cycle and to become the woman she could be.

Work/life balance

Should we use the phrase work/life balance or are there more than these two elements? Reflecting on the people in the south-west of England being delighted with the pace of life, is this another aspect of that?

Pedantically, a point is some people are too young to work but they are in learning, or too old in the eyes of society, albeit days are full of worthwhile activities. And isn’t work part of life? Does work/life balance infer that work isn’t enjoyable, to be offset with fun things? Is the rest of life all fun or do we have to work at everything?

Perhaps there are three aspects to our waking hours; work or a substitute, family or substitute and our interests.

For some people work is finding a job. Unemployment is not, or should not be, sitting watching daytime TV. Dedicated job hunting is a full-time role. Others have two or three jobs, which are part-time. A number of us have jobs which are really extensions of our hobbies.

Not everyone has a typical family but thankfully most have at least one person from whom support can be found and to whom it can be given. A majority have a more traditional family unit but even then, it may be friends who are the emotional crutch. However, the family is generally the focus of all efforts; to provide home, security, food, and fun.

It is fascinating to listen to people describe their lives. Too many feel they have no interests, except possibly TV. Yet ask them about football, the government or the weather and a range of informed opinions emerge. Even asking about a soap opera will show a keen mind assessing the messages being delivered. Is this a waste of brain power or an understandable contrast to more mundane aspects of the day? How much latent ability do we ignore? Do bosses have all of the ideas or are they delusional?

Many years ago I asked a storeman what he did outside of work. Whilst his answer was extreme, it graphically demonstrated a point; he was a magistrate, city councillor, on the board of five schools, on which he was chair of three, and was a trade union official. He was a competent storeman but left work on the dot to fulfil his true passions and utilise his innate skills. His prerogative but how much more could he have contributed to the business?

Importantly, the equation life equals work plus family plus interests makes the point about the critical need for contrasts and emotional support. If any one element dominates it becomes unhealthy. To change the arithmetic configuration, imagine the three factors as sides of a triangle. We all have a unique triangle, in which the angles and shape differ. If one aspect becomes overly dominant the other two can only be accommodated in a distorted manner. It demonstrates the imbalance, unacceptable status and that is unhealthy.

If it is interests which takes control work suffers and family life becomes tense. Employment may become vulnerable and the response from the spouse or partner may be terminal to the relationship.

If family is too consuming, work again can be given too little attention, with the adverse implications and the person loses the stimulus of the contrasting external influence of interests.

The most discussed issue is the addiction or compulsion of the workaholic. Work can become life. Isolation and a single dimension to thinking take over. Some managers see holidays as a perk and would prefer their staff to take less than their entitlement; they want people to work weekends. Time at work must equal output. No thought to burn out or a need to re-charge and stimulate the creative juices.

Time does not equate to effectiveness. Every one of us needs balance but that balance will be different for each of us. Do we ever take time to consider the shape of our triangle and what makes us happiest and most productive?

Shift patterns

The train was going to Inverness from Edinburgh and on the other side of the table from me was Ivor. A man in his fifties, Ivor is part of the management team for railway signalling in east Scotland. He has been a railway man for thirty-two years, following his father and grandfather into the industry. He is a guy who loves his job, even if joining in the first place was unthinking.

Ivor’s team is predominantly male (a factor of historical assumptions) and he described it as non-politically correct. The humour is ribald and veering towards the coarse. Nobody complains but is that because of social pressure or they think that is the normal behaviour in that type of environment? What would happen if someone cried “foul”? Would most people in the team prefer it if they moved out of the 1980s?

The most striking aspect of my conversation with Ivor was his own shift patterns. There was no consistency, subject to late change and across the whole day. On the day we met, Ivor had been on the early shift finishing in time for him to have the afternoon at home, which sounds good. However, the following day he was doing the nightshift. How does he deal with sleep issues? Ivor expressed no concerns as he had become accustomed to the vagaries of his working life. He would go to bed at a normal time that evening and catch a two hour nap the next afternoon to set him up for being awake all night, overseeing the people keeping rail travellers safe.

The effects of shift work have been compared to jetlag. The body becomes disoriented, drained, and tired. Many years ago we were implementing a three-shift pattern, 6 am to 2 pm, 2 pm to 10 pm and 10 pm to 6 am. Whether people moved forward or backwards across the shifts, changing weekly, was a debate. Medical research indicated one way was far more likely to give the jetlag effect, but it also created a long weekend for the employees. Ironically, the Trade Unions fought for the option which was worse for their members’ health. “It’s what the lads (sic) want”, was the justification.

Should we care about the impact shifts have, given the people like any associated premia payments? Even though some people want to work nights regularly, should we make them emerge into the light?

Ageing

Alan is a forty something year old consultant and father of four children. He is a man who travels to the metropolis a lot and has time to think, not all of it positive.

When I asked him the question, “What matters?” his answer was instant. “I bet everybody has talked about pensions”. Well, actually nobody had talked about pensions and barely anyone else did. There were references in connection with other issues, but Alan was the one person with them as a matter of great relevance. In the interests of accuracy rather than making a point graphically, Gina, a train manager in her late twenties, did say she was trying to be “sensible” and putting a little into a pension pot each month.

In Part Three, Statistics, the wide range of ages is shown. The topic, pensions, could apply to anyone but how older people are coping I might have expected to be a key theme. It wasn’t.

Do people not care about their finances at some far away point in life? Do they assume it will all work out? Are they living for today? And this at a time the UK Government is pushing us to save for our dotage, as the population ages and the potential burden on the state will become colossal and unmanageable.

Will the emphases switch back to the behaviours through to the latter half of the twentieth century, when the responsibility for the aged rested with the family? Does it mean the end, for working- and middle-class people, to the inheritance? Houses will be sold to pay for care, so the family can continue to work.

A little acknowledged aspect of the ageing population is we may not have enough people to do the work and to pay into pension schemes. Even today, a lot of people think there is a pot of money waiting for them because they paid in through the years. There is a failure to recognise our contributions have paid the weekly or monthly pensions of the older people at that time. Later on I discuss employment and the workforce, but I am concerned the economy will not be generating adequate wealth for future pensioners to have a sustainable life style and the care services to cope with the demand.

Nobody expressed any negative feelings about growing older but making the most of their time was a primary driver.

Grace is in her sixties and very physically fit, as is her husband. Privately, Grace talked about her father-in-law’s dementia. It is an aggressive form of the disease which has adversely affected his behaviour; it is a very difficult time. The difficulties are exacerbated by Grace’s husband becoming very concerned the same thing will happen to him in the near future. Putting the family finances and other matters into order have become something of an obsession and it is affecting his demeanour. The wistful way Grace described this reflected it is also affecting her, even though she feels she can compartmentalise her emotions and operate well irrespective of her worries and fears.

Celia is a little older than Grace but has a similar but perhaps even more direct problem, as her husband has Parkinson’s disease. I am not sure Celia compartmentalises, I think she steam rollers her way through life. Her family supports her and she looks for the positives. Indeed, it was Celia who raised the wonderful way the citizens of the UK made the Olympic Games in London such a success. She did amuse me with her vehemence against Christmas decorations being in the shops in October. I dropped my impartial role to agree wholeheartedly. Bah humbug!

Trevor’s story was a bit different. Trevor is gay and has found the right person for him, who then sadly had major heart problems, leading to large scale operations. So, Trevor had given up his well-paid job and moved to Cornwall to look after him. There are compensations, of course, like walking their dog on the beach and slowing down the speed of existence.

Carers

A study by Carers UK has calculated the value to the UK economy of unpaid caring is £132 billion. If the government had to find this money, I suspect it would cost more, there wouldn’t be enough people with the prescribed skills and there couldn’t be the love. Do we need to support carers more? Does society duck its responsibilities? Is this a group of people with no power?

Chris was worried she could never work again. After looking after her mother for five years, who had now sadly passed away, she was facing the task of finding something to do. It was implied money wasn’t the problem as her mother’s estate left her in a comfortable position but that wasn’t enough. Chris was in her early forties and had a lot of time and energy to give. We underestimate the skills, knowledge and experience people like Chris have to contribute to our world. She felt she had been invisible for the last five years and wasn’t sure how to emerge.

Mothers returning to work after the children go to school have the same quandary. We are talking about millions of people with exceptional capacities to participate but how? We have created a business called Work Horizons. The core of this enterprise is a Membership Website offering, through a variety of media, support in job hunt, self-employment, the associated philosophical issues, and assimilating back into the workplace. Carers and mothers we see as two prime groups but graduates who cannot find a career rather than a minimum wage job, ex-service people, people returning after illness and those just frustrated may also need support. We don’t see limits, but we do see a need to help some very worthwhile individuals.

Homelessness

Can being without a home be living or is it merely existing? It seems incongruous that in a society as wealthy as ours is we have people sleeping on the streets, or in hostels if they are lucky.

Why are they in this situation? Inevitably, the number of reasons is equal to the number of people affected. There are certainly themes; unemployment, severe debt, mental illness, drugs, alcohol, abuse at home, relationship breakdown. However, one word appears to dominate, vulnerability.

Society, us, dislikes homelessness. Rough sleepers look horrid, they beg, they reflect back to us how close we are to being that person. It is said nearly half of us are only one pay day from being insolvent. We live on the edge of being broke. We borrow, we defer payments, and we hope nothing too awful catches up with us.

Gary is in his thirties and works in a betting shop (when did these premises stop being Turf Accountants?) If it is his shift to open up there is an unexpected problem, irritable homeless people wanting to use the loo and getting aggressive if they are thwarted or delayed. There used to be an area outside the old Central Library in Birmingham, but under cover, where numerous people slept day and night, and it stank of urine and who knows what else, so access to proper facilities is good news for the general public. Gary, understandably, gets annoyed with this behaviour and hates the way, in his opinion, any money goes towards illegal drugs. He thinks there are enough beds in Birmingham for nobody to sleep out and he may be correct but is a bed in a hostel actually addressing the issue?

Is it living to spend your existence thinking about finding food and passing time until the nightly quest to an undisturbed sleep? Prisoners in jail take drugs to blank out long periods of time. If you are serving a six-year sentence incarcerated, is effectively reducing it by fifty percent by taking drugs, not a logical thought? Is it the same for the homeless?

Rationally, and some politicians are hyper-rational, the time could be spent finding a job and “pulling themselves up by the bootstraps”. For some this is part of their day but for many, many others the complications are too great.

Do we accept some people will always be on the streets or do we try to find sophisticated answers? The system is not supportive. If they applied for government support there would be precluding sanctions immediately. Charities do an excellent job but we are treating the symptoms, not the causes. It is estimated there are 648114 uninhabited homes in the United Kingdom. This is a figure worth thinking about a little. If the average of only 4 people per abode was achieved that is more than 2.5 million people accommodated, from the utterly homeless, through those in massively crowded homes, to people threatened with eviction. Shelter, the housing charity, receives about 1000 calls each day to its emergency helpline as costs spiral and landlords avoid their responsibilities. 

It is an ever present cry that we need more social (i.e. affordable) housing. This is especially an issue in London and the southeast of Britain. Walking around Bromley in Kent I was shown a new apartment block which will have “Affordable” options. ”Affordable” is 80% of the published price. This is in an area with soaring house prices, in which the typical citizen has no chance of purchasing their own home. Let’s be honest, 80% of zero chance is equal to 100% of zero. It is a political joke, and the property developers are being allowed to cheat.

The Government announces plans to build 300000 new homes which is a good number but by when and how realistic is it as a target.  The property companies already own the land but are waiting for favourable conditions, which means an inflationary economy or government subsidies. If there was a regulation forcing them to fully build within five years, the change would be huge, and the law of supply and demand would force down the prices. However, lobbying groups and the wealthy ensure homes are unbuilt, half-built or empty for tactical reasons, as the absolute poorest in society are literally freezing and starving to death.

Money

This was another subject which I could have imagined would be high on the list of things that matter and Alan worrying about pensions is an example. Perhaps this is the area in which the non-scientific nature of this exercise is evident. I did not speak to a representative proportion of the population from Mrs May’s JAMs (Just About Managing).

Pauline had a very large suitcase. Was she coming or going? She was travelling to Dubai to cruise to the Far East. A single woman with a life well ordered, Pauline works to holiday. Money matters but only in the sense of it being an enabler. My late wife, Alison, took exactly the same view, so we travelled the world. Thankfully, we were never a couple which planned for a great life in retirement, we did it whilst we could without ever thinking one of us wouldn’t live long. Our final holiday was a safari in South Africa which was probably the finest experience we had. My daughter and I wrote a book about our Sub-Saharan African trips called Africa, Animals and Alison. It was a cathartic exercise for us and allowed me to use photographs I loved. Dawn, a train hostess in her twenties also felt she needed to focus on her ability to have great holidays, to make work an acceptable way to pass the day.

Travelling with his son, going to university, was 67-year-old Peter. Peter clearly still has funding responsibilities despite being beyond the traditional retirement age. He supplements his income by doing odd jobs. This allows him to live a flexible life which includes finding time to do the things he loves, and this attitude came through numerous times. I have no intention of retiring but maybe doing less as I grow older. Why do we feel we should stop doing something I love to do what?

Peter, possibly reflecting his age and his son’s relative youth, admitted he worried about his health. The guy looked fit but that doesn’t always mean there weren’t issues with his wellbeing. He said he didn’t fret about sickness, and I hope he, and everyone else, avoids the desolation which can follow unsubstantiated health worries; it can be a self-fulfilling prophesy.

It is more than possible my new colleagues were avoiding revealing their true financial position, but I don’t think it was the general case. Let me finish this section by mentioning Stephen. Stephen in a very matter-of-fact way let out what he is worth runs into nine figures; write down nine figures and gasp. Nice guy with a house in California and no need to work but he does.

When is life not worth living?

Is it an unexamined life? A question for Part Six in a philosophical way but given the suicide rate in the UK and USA, especially amongst young men, ‘When is life not worth living?’  is a question society must address.

The first and more nebulous aspect of this conundrum came up numerous times but suicide not at all, although John, an Army Captain knows people leaving the forces do struggle to adapt to the outside world. These people are amongst all of the worst statistics, including homelessness, drug addiction, alcohol abuse, mental illness and suicide.

Let’s be clear, if every minute of your life is dealing with these major adverse factors, individuals are not spending time considering philosophical conundra. In fact, Socrates only spent his life talking to Greek citizens of some wealth and standing, who could take time to think about the things that matter.

One of the most quoted management theories is Abraham Maslow’s Hierarchy of Needs, “which suggests five interdependent levels of basic human needs (motivators) that must be satisfied in a strict sequence starting with the lowest level. Physiological needs for survival (to stay alive and reproduce) and security (to feel safe) are the most fundamental and most pressing needs. They are followed by social needs (for love and belonging) and self-esteem needs (to feel worthy, respected, and have status). The final and highest-level needs are self-actualization needs (self-fulfilment and achievement). Its underlying theme is that human beings are ‘wanting’ beings: as they satisfy one need the next emerges on its own and demands satisfaction and so on until the need for self-actualization that, by its very nature, cannot be fully satisfied and thus does not generate more needs. This theory states that once a need is satisfied, it stops being a motivator of human beings.” This description is from the on-line Business Dictionary. Very clearly, we cannot possibly help people to really know what matters conceptually if what matters is surviving to the end of the night.

This Part is about living and many of us pay a great deal of attention to our health to extend our life span and to make sure we are fit enough to enjoy it and contribute to our world. It ends, as does life, with death. Do those of us who can choose how to live make the most of our opportunities? Is the unfulfilled life a sin? Even if we cannot achieve world changing success, should we at least make the changes within our compass? Should we examine ourselves and our lives and shift the way we behave?

My book Beating the wisdom of hindsight link is below (Ctrl+click)

Amazon.com: Beating the Wisdom of Hindsight: 75 Ways to Pursue Fulfilment and Avoid Regrets eBook : Ball, Rob: Kindle Store