Occupational Health

Christine was sunny and bright. She smiled at strangers.

One teenaged summer holiday, she volunteered for a project that provided respite for families with disabled children. Against her adolescent instinct, she would wake early and make her way to the local primary school. Christine and the project coordinator worked in a small, windowless room with school desks, low chairs and brightly coloured art supplies. Children usually stayed with the project for half a day, but Paul and Angela were booked in for a full week. Christine had read their files and looked up the syndrome in the coordinator’s hand book. They had a progressive condition so that before their brains had matured, they began a physical decline and developed dementia. Paul and Angela’s bodies and brains were collapsing. There was no cure. The cause was a rare genetic disorder. Christine had already outlived their life expectancy.

The siblings were in need of constant attention. Angela, the younger child was still active, but without much ability (or desire) to follow instructions. She was stronger than she looked and therefore could not just be ‘placed’ in front of activities. Angela laughed as she caused havoc in the small space. Persistently hungry, she would put things in her mouth and laugh until she almost choked. Christine got used to handling toys covered in saliva. Paul, slightly older, was further along in his physical decline and relied on a wheelchair for mobility. He had limited use of his arms and occasionally they would flail around impulsively, knocking over cups, pens and once, Christine.

The project coordinator decided the children needed more space and so Christine helped strap them in to a minibus and the coordinator drove them to the local park. Christine noted the importance of driving, because the outdoors was a revelation for all of them. Christine rediscovered her sunny disposition and started smiling again. Angela loved the swing. She was heavy and it was physically hard, but Angela smiled and gurgled with the movement. There were no accessible swings, so Paul sat in his wheelchair and Christine took him for a stroll around the paths edging the grass. He seemed content and Christine saw him laughing at a group of boys fooling around with a football. He looked like he was in on their jokes. That smile mattered to Christine. It felt important.

This experience all looked good on her application to the local polytechnic for her diploma in Occupational Health.

Over the years, she upgraded her diploma to a degree, to a masters. She surprised herself with how she took to studying and how much she loved the sociology of disability. It was a revolution. It turned her thinking upside down. She used her experience and her passion to get agencies to employ more people with disabilities. But over time she was nudged back; the revolution was reversed. A few years ago her contract was moved to the private sector working for a consultancy to help employers improve health and safety and getting sick leave down. The work was routine. She became comfortable.

She checked her make up in the mirror before leaving for work. She looked fine. Then she put her glasses on and drove to one of the many sites she was expected to cover.

Helen’s appointment was held in the Human Resources department of the university, housed in a building on the edge of campus. It had been built at the turn of this century and was quickly found not to be fit for any purpose. It was now a mess of improvised stairwells and corridors. Signage was haphazard. Helen’s manager had proffered assurances that an Occupational Health appointment should not be seen as a punitive measure. It was a service to support her. But she felt worn down and wearied just finding the office she had been told to report to. She was given papers to sign and asked to sit in a corridor repurposed as a waiting area. The easy chair was very low to the ground.

Helen was called into a room and her hips groaned at the movement from easy chair to office. There was a woman of a similar age to herself in a nurse’s uniform, sitting facing a computer. The nurse didn’t turn from the screen to greet her, so Helen assumed she was meant to sit on the wooden chair (probably pulled out of one of the teaching rooms) to the side of the desk.

“So, Ellen, sorry Helen, why are you here?”

Helen proceeded to pour out the litany of crap that made up her life at that moment. Her Mum had died suddenly over last summer. Helen had gone on holiday thinking her Mum was a sprightly 80 year old and come back to find she had a terminal diagnosis of pancreatic cancer. Mum had been given 3 months to live. She lasted two weeks. Her step dad had been diagnosed with MS and with no other family, Helen and her brother had to start taking it in turns to shout at social services to get more care for him. Helen had a teenaged daughter with learning disabilities and epilepsy. Her job at the university was part of a research team looking at the respite needs of families with disabled children. Spoiler – the research showed that their needs were not being met. She spent her working days pouring over other people’s trauma that mirrored her own.

“Have you had any time off?”

“Yes, I’ve had carer’s leave for when Mum was ill and a couple of weeks compassionate leave for the funeral. I’ve also been off sick recently when things got a bit much. But I’m back now and have cut down my hours to three days a week.”

“Why do you think you were referred to Occupational Health?”

“Part of my job is writing up my research and I have struggled to do that. I haven’t led on a journal paper in the last year. I’m doing the rest of the job – attending meetings, teaching, admin, collection of data, but just not the writing. The department are worried that if I don’t write, then funding will soon dry up.” She didn’t add that writing for academic journals seemed irrelevant to anybody but universities and funding bodies. She was focussed on sounding as though she cared.

“Are you getting any help?”

“I’m seeing a therapist.”

“And your GP?”

“Yes, she gave me the last sick note.”

“What sort of therapist?”

“Psychoanalysis.”

“How long have you been seeing them?”

“A couple of years, just after Doug’s diagnosis – my step dad. We don’t have a great relationship and I thought it might help.”

“Two years and you still feel like this?”

“Well, yes, my Mum’s still dead. My step dad’s still ill and I’m apparently a crap Mum, daughter and worker, so yes, I still feel like this.”

“But two years…”

“Yes.”

“I’m not a doctor”

“No.”

“But when you see the doctor have you thought about asking for anti-depressants?”

“I don’t want to take anti-depressants.”

Helen gritted her teeth and then unclenched her jaw. She didn’t have the energy to say that she was not anti-depression. Depression seemed like a reasonable state to be in given everything she had just said.

“Like I say I’m not a doctor.”

“No.”

“But after 2 years may be you need to try something.”

“No thank you.”

“How old did you say you are?”

“50.”

The nurse looked at Helen for the first time and her face assumed a question. Helen saved her from asking.

“I’m not there yet. I’m still having regular periods and I’m not having any of the usual reported symptoms. If this was the menopause I wouldn’t have a problem with taking HRT, but it’s not. I’m just sad, because my life is sad and I’ve used up a lot of my resources.”

For Helen it seemed like the conversation went back and forwards. The nurse, who never gave her name, spent most of her time tapping through screens on her computer. Helen had to remind her as she ploughed through the forms that it was her mother who had recently died. Her Dad had died when she was a child. Her step Dad had MS. And yes, she had a partner to help out. They were both tired.

Helen continued with a monotone, answering all questions, determined to show some sense of willing.

***

Christine wrote up her Occupational Health report for Dr Helen Wilson and her manager. In it, she recommended that Ms Ellen Wilmot should continue to work three days a week, with Wednesday afternoons set aside for writing tasks.