Friday, 16 October 2015

The Loneliness Of the Smart Phone User?

I've seen links to images by American photographer Eric Pickersgill a few times now on social media. He took photos of people looking at their smartphones but removed the phones. It's supposed to highlight now strange and lonely smart phones can make us, how we can be in the presence of friends, family or lovers yet be isolated from them by mutual screen addiction. Take a look at the pictures and see what you think.

Then, imagine that instead of replacing the phones in these people's hands, we put books there instead. Would we consider a couple snuggling on the sofa together reading to be sad and distant from each other? Would we shudder at the sight of three young brothers all reading books? The book readers are no more likely to be interacting with each other than the smart phone users but few people would criticise them for their page hours. Books are old and good, phones are new and bad. But I'd bet people once said the printing press would drive families apart.

I find the idea that modern technology makes us less social very odd. Of course there needs to be limits, we try to eat meals as a family around the table and phones are banned. My husband is no doubt raising a sardonic eyebrow at this post as I often tell him off for staring at the phone when I'm trying to talk to him. But overall, smart phones, tablets etc. help me to communicate more, not less.

Here's a few examples from yesterday, a pretty typical day.

I had a few minutes for myself before the kids got up so I flicked through twitter, catching up with news and opinions from American. Not the global events that would be in the UK press too but the smaller things that were interesting people while I was asleep.

After breakfast the girls were dancing around the kitchen so I took a few pictures on my phone and made a quick collage of them on Instagram. They are mostly blurred, but they meant that my Mum, who lives five hours away, would get a peek at what her grandchildren were doing that very day. 

At work I was watching a very dull experiment when I got a lovely message on WhatsApp from a colleague who works different days to me. She sent a picture of a meal she'd cooked, thanking me for the recipe and arranging to pop round to my house at the weekend and return some baby things I'd lent her. 

At lunchtime I only had time for a quick break on my own, so I flicked through Facebook and saw pictures of a friend's children playing in her house, she lives in Australia now and I've not met them all. 

I ran home from work with my phone stuffed in my bag but was still able to take a call from my husband, thanks to my bluetooth headphones. Afterwards I used my smart watch to send him a link to my phone's GPS. It meant he knew exactly when I'd be home and that it would be worth keeping the kids up so I could read them a bedtime story.

At the end of the day I curled up on the sofa with my husband and we watched a film, streamed to our TV and controlled by an app on his phone.

None of this is big interesting stuff, it's just the mundane everyday business of life. If everyone you know and care about lives in the same village as you then smart phone communications probably don't matter. But like so many people my loved ones are spread around the world, keeping in touch with them was the main reason I started blogging. Without my smart phone and laptop I'd still probably hear about the big things, the marriages, deaths and babies but I wouldn't get to share the everyday details of life. The silly poster someone spotted or the friend who's had a bad day at work. I wouldn't get to read interesting articles from writers all over the world in publications I may never have heard of. My parents wouldn't be able to see their grandchild via skype, jumping about in her fancy dress costume. I wouldn't have met many wonderful, fascinating and diverse people through online groups and discussions.

Technology can come between people, but it can also bring us together, shrinking the barriers of geography and time zones. It can be lonely, being at home with only very young children for company, waiting for yet another delayed commuter train or living many miles from all your family. But with my smartphone in my hand I always have friends a few taps away. My village is global but I carry it in my pocket.

Tuesday, 13 October 2015

Acupuncture For All - On the NHS?

I was really disappointed to read this article today in the Guardian, The general gist is that some doctors think acupuncture works and should be available on the NHS with all doctors learning at least a little about it in training and midwives being trained to administer it to ease labour pain. According to the article the NHS is only denying us this treatment because of the "entrenched scepticism...of the medical establishment" and GPs "making a judgement on something they do not know anything about".

The first thing that really bugged me about this piece is how very one sided it is. Those promoting acupuncture are painted as brave and caring individuals fighting against a faceless dogma. But non of those sceptical establishment figures or judgy GPs actually get to articulate why they don't refer patients for acupuncture. The piece also throws in various claims to support the practice but they don't stand up to a great deal of scrutiny and the writer doesn't question any of them. Edzard Ernst has gone over a number of these on his blog so head over there to see what I mean.

But what really bugged me was the statement that a major London hospital was offering acupuncture to all women who wanted pain relief in labour. I actually find this idea a bit insulting.

At this point it might surprise you to know that I had acupuncture just before MissE was born. I was overdue, hot, uncomfortable and desperate to avoid an induction. The acupuncture session was lovely. I lay in a dim room for an hour, soothing music playing and a friendly woman listening to how I felt, offering to help with my concerns and asking if there was anything else she could do for me. I came out feeling calmer and less achy than I had done in weeks, but I didn't go into labour for another four days and I suspect a good massage would have had much the same effect.

Which is one of the things that concerns me about offering acupuncture in labour, The evidence for it is, at best, limited. But I have no doubt that a midwife taking time to listen to a women, understand her fears, acknowledge her pain and offer ways to ease it would make labour easier, less stressful and probably less painful. That's the placebo effect, it's very powerful and you don't need needles to achieve it, you need time. If a women accepts the offer of acupuncture and gets dedicated one to one care, even just for a little while, then that's great for her, but does it also draw care away from women who don't want needles put in them? Perhaps this hospital has plenty of midwives to go round so they can afford to give every woman great care, needles or no? If so I'd rather they were promoting whatever it is they've done to achieve that because it certainly wasn't the case for me at another major London hospital not far away!

I hope they also have lots of anesthetists available. I hadn't wanted an epidural when I had MissE, but 24 hours into labour with no end in sight I asked for one. I then had a miserably long wait as all the anesthetists were busy, then the drugs had run out. Frankly, if they'd offered me acupuncture instead at that point I'd have thought they were taking the piss! Difficulties in getting an epidural are a pretty common story, I've heard plenty of tales of women told they couldn't have an epidural because they weren't far enough along/ were too far along/ should just try to cope without. Perhaps those things never happen at this hospital? I certainly hope women aren't being encouraged or perhaps forced to rely on an unproven technique instead of effective drugs.

Which all in all leaves me wondering if women are being fobbed off here? Sending a midwife on a one day course is a lot cheaper than training and employing more anesthetists. Taking time to listen to and care for those women who want acupuncture is easier than applying the same standard of care to all. I also get that familiar, uneasy feeling that women who choose the serious, pharmacological pain relief options in labour are being judged for it. Acupuncture is ok because it sounds ancient and mystical and (if it does anything) it'll only help with the pain not remove it entirely. But drugs are modern and man made and perhaps women should still suffer to bring forth life?

In a fantasy world where NHS maternity services had infinite supplies of money and staff I'd be fine with it offering acupuncture for all, chuck in some massage therapy for those who don't like needles, doula's for anyone wanting non medical encouragement etc. etc. But that isn't the NHS we have or, probably, ever will. So I'm really uncomfortable with the idea that we should be spending more time and money promoting techniques that may be little more than placebo, especially if doing so could mean ignoring the need to improve access to proven forms of pain relief and better midwife care.

Time, care and choice - I wish those were available to all on the NHS