Posts Tagged ‘learning’

Alongside all the up-in-the-airness of the last few weeks, paediatrics has been really quite lovely. I love children. A baby can get me smiling when frankly, little else will. I had a nice week on neonates, essentially following a doctor and sticking my pinky in babies’ mouths to comfort them whilst they got prodded and poked – and loved it. The hard side of paeds, is, of course, when children get exposed to things they shouldn’t be, whether that’s a serious illness, family hardship and disputes, or more sinister things like abuse. We see all of this – and nothing makes me question those big questions about life and fairness and morality, quite like an abandoned, disabled baby with a history of neglect, does, and such complex needs that few fosterparents will consider them. Some people just are not born with fair chances. I hate that.

One of the things people associate with toddlers and small children are the temper tantrums over trivial things – but for me, this is a good thing. Firstly because I’m patient and young enough that screaming children don’t put me off and don’t make me love them less – but also because when a child is crying because they didn’t get their choice of ice-cream, or DVD, or jumper, or whatever – it means they’re still shielded from the worse parts of the world. It means they are still innocent from the badness and hardship that happens to everyone, eventually. When a child doesn’t cry at those things, because they are frequently  beaten, or hurt, or demeaned, and used to real pain, that’s so much worse. When they stop crying when you take blood because they’ve been through so many painful procedures, it’s so much worse than when they do. It’s difficult, seeing these babies with what the professionals call ‘frozen watchfullness’, before they’ve learned to smile. It’s hard, hearing the sound of a baby withdrawing from methadone, which is the most heartbreaking thing I’ve ever heard. It’s hard, seeing the photographs and hearing the stories about the depths to which human cruelty can reach.

We all ‘grow up’ at some point. When I was at school, I remember being jealous of all the other kids who didn’t have a father that drank himself silly or was always on the cusp of violence. I envied their freedom and security. The petty disputes meant less to me, as I had so much more to handle. The arguments over boys, meant less, when I was spending evenings visiting in rehab, or hiding the whisky bottles, or making sure my younger brother was ok. I sometimes think that I grew up far too quickly, and missed a lot of milestones due to my families difficulties, and then started going backwards once I hit 21, and tried to see if drinking the same as everyone else would make me feel less different. It didn’t make me feel less different. It made me feel more alone, as no one else struggled with it as I did. Both drinking and not-drinking isolated me for a long time. My early experiences coloured everything and made me see things in a different light.

I have a happy-ish medium now, in that I am confident in choosing not to drink when I don’t want to, but can also enjoy a glass of wine occasionally without starting to panic about following in family footsteps. This has probably been the single best thing that’s happened this year, as having a healthier attitude towards drinking makes so many things easier. And yes, my early experiences do mean that sometimes I find it harder than others, and that I’m not comfortable around people who have drank a lot, and am actually quite scared of them – but I get by. I’ve found a vague balance.

I was back at the GP’s today, and she really is a good, lovely doctor. She asked me if I’d had bouts of depression before, and now, it’s easier to see that I have had periods of low mood, probably since I was sixteen, if not longer. And when she asked why I hadn’t seen anyone, all I could say was that my family was preoccupied with other things, and no one noticed that I was fading into the background. No one noticed at all. As for me, I thought it was normal, and it wasn’t until recently that I read my old journals, that I realised just how sad and lost I was, so determined to escape. It wasn’t until I came away that I realised just how hard my family life is.

I don’t remotely suggest that my own childhood even comes close to some of the things unfortunate children go through – but I do mourn, when I see that something has stolen their childhood from them irreparably, I do mourn, when I see that they are forced to grow up too soon and act in ways beyond their age. I wish that all every child had to cry about, was the wrong sort of icecream. I wish that all every teenager had to worry about, was whether some boy knew their name. We don’t live in a world of fair chances.

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This week I had a ‘first’ in my life as a medic. I had a young woman come to see me in my ‘student surgery at the GP’s last week with a first presentation of depression. I’d taken a history, done the questionnaire etc, and suggested some medication (and referred for psychotherapy), checked everything with the GP, who agreed, and we asked her to come back in ten days to see if she improved. Because my allocated psychiatry block was with an intensive home team, and how my other placements have happened to fall, I’ve never actually seen someone with mental health problems improve in a clinical setting. When she came in again on Friday, it was like seeing a completely different person. It really did seem like a miracle. Antidepressants, when you get the right one, for the right person, at the right dose, really are life-changing. She wasn’t crying, she wasn’t thinking about killing herself, she was sleeping and eating better, all round, it was so good to see. Such a difference to how she was before. Incredible. She was also really thankful that we’d managed to sort her symptoms out; I felt like I’d been part of making a difference. It’s a good feeling. Obviously, this person will still have a long way to go before she’s fully back to ‘normal’ – but hopefully she’ll get there a bit sooner than I did!

This made me think about two things:

1) I sometimes let my own experience of antidepressants colour my view of them – seeing a clear case where they actually significantly helped someone, has sort of renewed my faith in them as options that actually can work. I get a bit cross when they’re handed out like sweets as an easy option, but it’s good to remember that there is an evidence base behind them, they do work, and they do make a difference, and it’s not just that other options are more expensive to deliver. If I am going to give hope to my patients, I need to have hope myself that these drugs will work for them, some of them, anyway.

2) I gave up on antidepressants. I clearly wasn’t given the right one for me, and had a horrific six months of putting the dose up, and up, and then stopping it myself as it completely accelerated my dangerous thinking and gave me a tremor that frankly scared me senseless. The second time it was increased, I didn’t eat anything at all for four days and only realised that when I fainted and was asked when I’d last eaten- that’s how out of synch it made me. I wasn’t fortunate enough, like so many are not, to get put on the right one. And when I lost faith in fluoxetine, I lost faith in all of them. I was afraid to try another one in case it also pushed me close to the edge. I was too scared to use something else psychoactive. Sometimes, I wish I had been braver – I was not brave. I was more scared than I’ve ever been. Sometimes, I wonder if this whole episode would have lasted the full year it has, had I been put on citalopram or sertraline from the word ‘go’ – I’ll never know that. I only know that doing it cold, was tough – but I didn’t really have anyone encouraging me to try it another way.

People ask me sometimes how I manage being ‘hard core into science’, and a Christian. I love science; I love being involved in research and finding new things out. My specialist areas are across neurodegeneration, plasticity, and molecular genetics, and I love learning about how our bodies work on the most intricate level. I love that someone worked out what’s going wrong in a disease, and someone else engineered a drug to target that mistake. These things only strengthen my faith; when I see someone improve as I did this week, it’s as though I’m seeing the tools God has given us to start to put right all the stuff that’s wrong, all that’s not ‘good’. God so often gives us the keys we need to set things right. For me, science is a big part of that. Medicines, are a big part of that. I’m not saying they’re the only solution, at all – but it’s been good to remember this week that often they are a big part, of a solution. When science works, it’s pretty cool.

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Work in Progress

Today I went on a home visit with one of the GP’s to see a very old man, in his nursing home. Before we got out of the car, the GP turned to me and said, the picture of nonchalence, ‘by the way – he might ask us to euthanise him – just so you know. He asks every time we visit him.

Sure enough, this man, who is over a hundred, with no living family, no friends to visit him, and incredibly frail health, started asking about what it means to die, and when it would come, and could we, please, please doctor, help him, now, right now? And of course, we sat and told him that we couldn’t do that, and that we didn’t know when death would come, but that when it did, we hoped it would be peaceful.  And he talked, for a long time, about what lay behind in his youth, and what lay ahead, in his dying, and the loneliness in the room was so heavy it felt like we were sitting in thick fog. Then, the time came for us to go and move on to another patient, and it made me wish, as I do so many days, that I was training to be a magician, rather than a doctor. There’s just aren’t enough magic wands in medicine. I wish there were more.

It’s things like this that remind me how good the church, or any similar group, for that matter, can be. Now that our communities lack the cohesiveness and closeness of the past, it falls to groups like the church to come in and reach out, and keep people connected. I’d like to think that if this man was a member of my church, that someone would be going to see him, taking him Communion, dedicating time to those questions that are still for him, so painfully unanswered. Patients in hospital have access to chaplains and ministers; it’s when they leave, that they so often are left lonelier than ever. I’ve been so proud to see the student charity I founded two years ago grow, to be able to provide regular visitors to elderly patients across three hospitals, if they don’t have family to come and see them – but there are so many older people alone in their homes, that we can’t reach. It’s painful. I want to do more. I want it to be better. There are so many gaps in society that I want to help fill. I know that I can’t fill them all. None of us, can fill them all.

 It’s things like today that make me want to go and shout from the rooftops that until we have a society that has a place for every person in it, we have no society at all. We talk about the community of church, so often, and yes, it’s fantastic, the things that happen when a group of people get under a steepled roof and lift up their hands and cast upwards their eyes, but does any of it matter, if we’re not taking it to those places that need it the most? Does any of it matter, if there’s still an old man, lonely, or a young mother, not managing, or dare I say, a student, dropping off the edge of depression? The people most on the outside are the ones most in need, and hardest to reach. There are so many places that just need someone alongside someone else. There are so many places that just need a hand ontop of a hand, a heart beating next to a heart.

We all know that according to Genesis, one day, God looked at this world and said that simply, it was ‘good’. For now, I’ll pass over God’s extensive use of the understatement.

Now – forgive me if, thanks to my hazy knowledge of the Bible, I’m off the mark here, but from what I know, God’s not said that, since. Our world is not being looked at and passed as ‘ok’. Can you imagine what the world would look like if God still thought it was ‘good’? I’m not sure I can. It’s so far away, from what I have seen. And I know, that Jesus changed everything and set the wheels in motion for it being ok, more than ok even – perfect – I know, that before Jesus we were living in a spiritual cemetery, and without Jesus, we’re still sitting amongst the gravestones – but our world is still not good. We, are still not good. No matter what you believe, we can do better. We need to do better. We need to sort this stuff out. We need to figure out how to stay connected. We need to figure out, how to get our hand on top of the hand that is shaking. We need to figure out, how to get our heart beating next to the heart that is failing.

Let’s all try and figure out, how we can do better. We’re all works in progress.

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Leadership lessons

On Monday, I met my friend E for a drink and a chat, but came away with a little more than I’d bargained for. E is a few years behind me in medical school and we first met through the university windband, when he joined as a first year three years ago, the year I was band’s president. After that, we crossed paths again when we both started at the same church at around the same time, and with a similar amount of uncertainty (ie a lot), and this was when we got to know each other more on a par, as with band, I’d always been ‘in charge’ and leading things, and he’d always been following. We’re very different in some ways, and after a hard year for both of us (he is resitting a year after failing a lot of exams before finally being diagnosed with dyslexia) I really value his friendship.

We were discussing what we’ve been doing in the last few months and I was talking about the mentoring scheme I’m heading up and what’s happening with the choir and hospital volunteer scheme I founded two years ago, and he asked me why I’ve not ended up ‘in charge’ of anything at church when I seem to fall into leadership in most other things I do. And I replied that I’ve never really thought that I’m able to lead, or gifted in leadership, or however you want to put it – in ‘church life’ – that I’m always a bit unsure of what part I’m supposed to play, what space I’m supposed to stand in.

This lead to what I’m going to call ‘affectionately being completely shot down.’

E basically asked me if I honestly thought that God’s gifts were different depending on whether I was standing in church or somewhere ‘secular’, and then (somewhat amusingly) went a bit Lord Kitchener on me (your church needs YOU! Your God needs YOU!) and told me to step up and stop drawing a line in the sand, so to speak, between the parts of my life that are lived in church, and the rest of my time, where my faith is perhaps not quite as much on show.

All I could really say was ‘oh’. The phrase ‘you got told’ comes to mind.

He’s right in a lot of ways. I do have a tendancy to separate things out and think that I’m not really that useful to any church and that I don’t have any gifts, that in the world of 1 Corinthians, I’m one of the less vital, more silent, body parts, whereas it’s fairly true that outwith that, I feel confident in leadership roles (I even got an award from the university for it once) and like filling gaps I see and changing things I think need changing. I’m a project person – I’ve always got some scheme on the way, whether it’s getting the patient library together, or currently, this mentoring thing. It just doesn’t always carry over to who I am ‘at church’. Sometimes I fall back into thinking that I’m just kind of gatecrashing the party – that everyone else has an invite and a reason to be there, whereas I’ve just snuck in through the back door, and am listening in the dark at the back, and God can’t be bothered to chuck me out.

Part of this is probably down to the last year, when standing at the back of a service was as much as (and sometimes more than) I could handle, and I’ve been conscious as I recover that I shouldn’t overfill my time or take on too much (not that I’m managing this well at all). Another obstacle is that until this year, I just wasn’t stable enough in my faith to feel as though I could really be that involved, or active in things – as Ulysses Grant once said, you can’t blow an uncertain trumpet. I didn’t really comfortable spreading a gospel I wasn’t that sure of. I didn’t really want to infect anyone else with my perpetual, and often consuming, doubt. I didn’t feel ‘qualified’ or ‘capable’ or ‘allowed’ to be an active Christian – I had too many hours still to spend working things out. I thought I was better suited to sitting quietly at the back and trying not to lose my place in the hymnbook. My trumpet was certainly uncertain for quite a while.

Now however, talking with E made me remember that everything I am comes from God, and that I need to step up more and contribute my share to the kingdom we’re all trying to build. I’ve been thinking a lot recently about where I fit and what I feel called to change, so this conversation was certainly timely. I’ve got a feeling that the Bible study some friends and I are starting might be the start of a more well defined path for me, but only time will tell, at the end of the day.

And in other news, the GP let me stitch someone’s head cut today. Sorry if you’re squeamish, but it was AWESOME. The things that make me happy…..

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For a while, I’ve been thinking about how I would explain to someone what it’s like being a Christian with, or recovering from, clinical depression. Sometimes, I think that although ‘depression’ is a word that we often toss around with little thought, a lot of people don’t really understand it. So, here is, as my gran would have said, my ‘twopennoth’.

When I think of my relationship with God, I think of it being like two phonelines, one going direct from me to Him, and another in the other direction. In order for any phone system to work, you need a few things:

1) Both parties have to be willing to pick up the phone when the other person calls

2) Both parties have to be willing to talk to the other person

3) The lines need to carry the message from one receiver to the other

4) The receiver needs to relay what is said, to the right person, without distortion.

Depression can knock all of these, in some way. Probably the easiest one to understand, is that when things get tough, you just stop wanting to either hear from God, or talk to him, at all. Your prayer life falls by the wayside. You don’t want to be in church. You don’t want to be around God, or anyone. And when you know so clearly that God is speaking, you block it out. You ignore Him; it’s all too painful. Depression stops you picking up the phone, at all. It rings and rings, but you just can’t find the courage to pick it up. You leave it be. You run until you find some place where you can’t hear it ringing. These places, are often not good places.

Sometimes, however, the problem isn’t that you don’t want anything to do with God – sometimes, it’s as though you’re shouting and shouting down your phone,  pleading for help and guidance, but for some reason, it’s as though no message gets through, and God just leaves you be. People tell you to ‘pray your way out’ – but you’re already praying, you’re already on your knees, and still, the blanket of depression closes in and shuts you out. You’re shouting as loud as you can; the line just seems broken. Depression breaks the line between you, and God; at least, that’s how it feels, even though it’s not true. Eventually, you might give up. Shouting wears you out, after a while. The silence you’re hearing is overwhelming and cuts you to the core. The threat of abandonment feels like the deepest of wounds. You think God is ignoring you.

And then sometimes, depression distorts the messages you hear from God.  Either you hear what is said, you hear about the love and the grace and the faithfulness of God, but just can’t believe it was meant for you – you think it’s gone to the wrong number, so to speak- or, more dangerously, the message gets completely distorted and the meaning gets lost, and before you know it, you’re believing something that’s not true at all. I believed, at the height of my depression, that God had marked me for suicide, as some sort of modern-day martyr to mental health. I had started my preparation and was literally just waiting for a signal to ‘go’. Was it true? No. Was it dangerous? Yes, undoubtably. I thought I was hearing God’s voice clearly. I was wrong. I had the wrong message. I was listening in the wrong language. Depression changes your ability to hear God, just as it alters your ability to speak with him.

However, what I’ve learned is that no matter how many times you shut God out, stop talking, stop listening, or get it wrong, he never stops speaking down his receiver to us. His line never fails. He never hangs up, and then, when depression lifts, it’s like you get a load of messages on that answer machine you’ve not been checking, that remind you of how faithful he has been, that remind you that no matter how alone you felt, you weren’t alone at all. We’re told so often that prayer is a ‘two-way thing’ – and I believe this. For the last year, my line with God was disrupted in so many ways, so many times. When I think of it this way, I find so much comfort in remembering that God didn’t, and doesn’t, let me go.

Depression isn’t the only thing, that stops us talking and listening to God. We all think that we’re standing outside of grace at times. We all think we’re standing outside of forgiveness, at times. We all get the messages mixed up, at times. We’re all learning. I guess the most important thing is that, no matter how long a gap we leave, the phone’s always there, when we’re ready to pick it up again. It never disconnects. God’s always on the other end. He doesn’t hang up.

All I can say, is thank goodness that God doesn’t have to pay phone bills.

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On gentleness

My church’s latest sermon series has been on the fruits of the Spirit, as listed in Galatians 5. Whenever I think of the ‘fruits’, it’s always the ‘gentleness’ that makes me think the most- it’s not something we think and talk of often. I’ve prayed for help to be more loving, more faithful, more controlled, as many of you will have done. Had I ever prayed directly for more gentleness? No – not until I realised I hadn’t, anyway.

As I thought more about it, the lack of emphasis given to being gentle, in many circles, including churches, struck me as stranger and stranger. God has many characteristics and many facets, but when I was wobbling between uncertainty, and fully opening myself to belief, it wasn’t his omnipresence, or omniscience, or omnipotence, that lead me to faith. It wasn’t images of the ostentacious miracles of the Old or New Testaments that called me to Jesus. It wasn’t the loud, blunted shouts of the major prophets, it wasn’t the jubilant songs of David, calling me to rejoice, calling me to joy, it wasn’t the modernity of the worship band or the radicality of the lyrics. If anything, these things kept me away. They freaked me out.

What caught me was this quiet promise that God was gentle enough that coming closer wouldn’t hurt me more. It was the promise in James 4, that if I drew near to God, he would draw near to me, without lashing out, without the need to fear rejection. You can’t draw near to an angry being. You can’t come close, to someone who wishes you away. It was the whispered, dark-of-the-night voice that came alongside me and told me that if I was brave enough to trust, brave enough to follow, then all of those things in my life that seemed so wrong and messy, would find something new to focus on. It was the feeling of a hand on my lonesome shoulder as I sat in a lonesome prayer room in the small hours of dark mornings, telling me that yes, I was flawed and imperfect, broke-down and weary, but that there, in the shadows, was someone who could bind my wounds and heal my bruises. It was knowing that when I opened my soul and let down my walls, Jesus would protect my heart, as one of his own. I’m not saying that it wasn’t a gamble, or that it was easy; it wasn’t, it wasn’t at all, but in the end, that gentleness wore me down. I couldn’t hold off, anymore. Something had to give.

I have been a Christian for almost two years now, and although God’s goodness amazes me, his power bemuses me, and his control at times escapes me, it’s his gentleness that brings me back at every turn. When I am feeling far away and disconnected, it’s those smallest, most heartfelt prayers that seem to bring me home when I am at my most vulnerable. It’s that brushing against my heart that tells me, reminds me, that I’m held in the same hand that holds the Earth, which secures me. It’s the still, small voice that speaks as I shake and cry, that shows me the way I need to go. God has been gentle, with me.

Last week I met with the person who mentored me at church before moving back to her home country a year ago, when she came for a flying visit. She is who I think of when I hear the word ‘gentle’. Being with her for a few hours, after going a long time from being truly honest with a Christian after a pretty horrific encounter at the height of my depression, reminded me of how important gentleness is. She was nothing but gentle with me, both when I was having a hefty tug-0f-war with respect to my faith last year, and since then, when I’ve faced obstacles of a different sort. And in the gentle way she walks through life, I see more strength and power to touch the people around her, than I see in the louder, more exuberant Christians who so often end up at the frontline of churches and communities. I’m not doubting, in any way, their love of God, or their calling – but sometimes, I think it’s gentleness, that will open the most doors, heal the most wounds, and glean the most followers. I think it’s gentleness, that brings us most closely into step with Jesus. I think it’s gentleness, that will change things.

She also reminded me that they’re called ‘fruits of the Spirit’ for a reason – they don’t spring up overnight. As someone who measured a Christmas tree seedling every single day for two years as a child, I know full well that growing takes time. I get frustrated sometimes, that God’s timeline is different to my own, that it took months for depression to lift even a little, and it’s taking months more, to gain back all the ground I’ve been steadily losing for so long. I get cross with myself that I don’t have more faith, or more self-control, and sometimes seem to lack the passport needed to get within a hundred miles of real peace – but I know that these things will take time, and that with time, they will come. I will learn. If you take Genesis at face value, it was an apple that lost us the Kingdom; funny that it’s ‘fruits’ that will bring it back. In the meantime, I’m praying for more gentleness.

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I’ve had a nice weekend off, seeing a few friends and chairing the meeting for a new medical school mentoring scheme I’m heading up. I rounded things off with an evening service at church, but found myself not quite at ease as I listened and sang.

I’m back in counselling tomorrow afternoon and it’s been quite tricky sorting my timetable at the GP’s to get the time off – and after spending a few days with them, am not really that keen on being completely honest about why I need it. I’m also just getting completely fed up of having to always, always be thinking about how to get the afternoons off I need, where my next attachment will be (and whether I can get back from it for counselling), of knowing that on Monday evenings, I may well be capable of no more than collapsing in a heap and crying. I’m fed up of having to keep marching to this constant drum. I’m fed up of being constrained, first by depression and now by recovery.

I was sitting in front of a girl in my medical year tonight, and sometimes, I just feel so jealous – jealous that other people haven’t had to deal with juggling depression and medical school, recovery and medical school, counselling and medical school. I get envious about the things I miss out on, as for example, I can’t go to a lot of the teaching hospitals at the moment as I would’t be able to get back in time on Mondays, so am stuck in the city. Recovery, as so many of you will know, takes so much time and so much effort. Sometimes, I really do just get a fit of the ‘poor-little-me’s’ and want to say, why, why is is me that was brought down in this way, why was it my life that had a year, if not more, completely wiped out of it, why is my grades that, after four years of working so hard to stay in the top end of the year, have now slipped, thanks to last year? Why is it my life that was turned upside down, my mind and reason that went AWOL, my body, that didn’t take well to medication? The list goes on.

I know, so well, that it’s pointless looking and envying people. A lot of people, if not all, have significant struggles to work against. A lot of students take a hit from illness of one sort or another. A lot of people go off to counselling and survive to tell the tale. I’m not usually one prone to self-obsession (that would be my older sister). And yet, sometimes, I just feel so frustrated I want to cry. I feel so tired of this ‘journey’ that I want to sit at the side of the road, and not move another inch. I want to hang up my hat, turn in my chips, leave it, leave it all behind. I don’t care, for the reasoning that for all I know, this girl, or anyone in my year, probably has a shedload of stuff going on, behind closed doors. I don’t care, for the reasoning that no one had a clue that I was falling apart last year, so how can I assume things about anyone else? I don’t care, that it’s unfair, unjust, unreasonable to crack out the envy and let it seethe. I don’t care, that having the odd hissy fit at God, won’t get me anywhere. Sometimes, I just have to hiss. I just have to stamp my feet and let it out.

I think part of it is that at the moment, I’m feeling quite alone in all this. Sometimes I wish that I had a family who rallied round and helped me through things, rather than the dysfunctional, corrosive one I have. I get fed up sometimes, of managing on my own. Sometimes, like at the moment, when I’m having a few days of feeling oh-so-vulnerable, oh-so-easily wounded, all I want is someone to take it all away and help me know what to do. Last year proved that I’m not always good at making my own decisions, and as a result, I don’t feel quite as capable or invincible as I did before. Walking wounded. After the whole run in with the substance-misuse doctor the other week, it’s as though all my armour has been stripped away and suddenly, it’s only to obvious to the world that I am defenceless, fragile and not quite as bullet-proof as I’d have it believe. I’m back to square one again. I hate square one. Sometimes, depression feels like a game of snakes and ladders, but with no ladders and extra snakes. It’s hard enough to stay in one place, let alone move forward.

God – please help me stop being so grumpy and ill-thinking. Please help me see the way through this. Please help me keep my eyes fixed on you, and not on things I can’t change. And please don’t let counselling finish me off. Love, Char48.

So – let’s hope that this week isn’t quite as grumpy as the last.

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