How to be a good patient

July 5, 2017 § 3 Comments

I have dealt with a lot of doctors in my time. It’s not that I’ve been particularly ill, but I was married to a doctor for two decades, and I’ve been a health journalist for about the same length of time – although one had nothing to do with the other, coincidentally.

This has given me a unique vantage point, and when I interview doctors for the stories I write, the same things come up over and over again: a kind of wish list that doctors have when it comes to their patients. So here’s a handy how-to, in the interests of fostering good doctor-patient relationships.

First, resist the urge to google your symptoms. A few weeks ago I went to a braai [barbecue] and came home with a bunch of symptoms, feeling decidedly unwell. “I’m a health journalist,” I thought. “I can figure this out.” By the time 1am arrived, I had added anxiety and insomnia to my symptoms, as I’d convinced myself I was going to die from smoke inhalation with a side order of salmonella. It turned out I had a bad flu, twhich morphed into pneumonia. I’m pleased to report that I am still alive, several weeks later.

As the epithet on the mug on my doctor’s desk says: “Don’t confuse your Google search with my medical degree.” Your doctor has an encyclopaedic knowledge of the human body – trust me on this. I’ve seen the books; I know how much doctors need to know to get those two degrees. And then there’s a whole lot of experience on top of that, which adds to their already impressive knowledge. The good ones know what they know, and they also know when they don’t know and it’s time to send you to a specialist. Find yourself a good doctor – there are many out there.

Once your doctor has made a diagnosis, by all means go to a reputable site like or and read up some more on whatever you have. But don’t google symptoms and expect a sensible diagnosis to pop out. The diagnosis is everything – you can only treat an illness properly when you know what it is.

Second, accept that you may have to wait sometimes. Doctors don’t like running late any more than you do. Believe it or not, they have spouses and families and other commitments just like you do. (And please be considerate – they are also entitled to time off to rest and spend time with their loved ones. Don’t pester them after hours if they’re not on call.)

But they are also aware that they have a duty to be thorough in taking a history and examining you – both of those things are part of the diagnostic process, and help them to decide if further tests are necessary or if they can simply send you away with a prescription.

In fact, you should be wary of the doctor who doesn’t take the time to listen to you and examine you properly, but runs exactly on time. If your doctor runs late it’s probably because they examined the patients before you properly, and gave them the attention their malady deserves. When it’s your turn, you’ll get the same care and attention. If you don’t – find another doctor.

Then, go back to the doctor if you’re not improving. It’s a bit much to expect your doctor to be psychic too. They can’t tell that you aren’t getting better unless you tell them! There are very few conditions with only one option of treatment, and every body is different. Some people respond well to one method of treatment, and some don’t – so go back and say, “This isn’t working,” or “I’m not feeling any better,” or “I’ve noticed that I have this or that side-effect.” Work with your doctor and you’ll get better treatment.

Which brings me to my next point: take the treatment as prescribed. Too many people only take some of the treatment, or do some of what is suggested and then mutter about how useless the doctor is. You’ve asked for their expertise, so use it! Comply fully with the treatment and if it’s not working, then go back to them so they can try a different tack.

Finally, take responsibility for your own health. Partly that means living a healthy lifestyle – eating well, exercising, not smoking, drinking moderately and getting enough sleep. But it also means asking any questions you have – about what is wrong with you, about your treatment, about how you can support the prescribed treatment. Your doctor wants you to be well. You want to be well. If you work with your doctor instead of against them, you’ll have a much better experience overall.

  • A postscript: if you find yourself at a social occasion with a doctor, it is not okay to start asking them about your medical conditions. If you want their opinion, make an appointment during consulting hours.

The L word

June 7, 2017 § 2 Comments

I remember how I cringed the first time I overheard my one of my teenage daughters and her boyfriend saying “I love you” to each other.

I cringed because I grew up in an era where you didn’t tell a significant other that you loved them until you were sure. Very sure. You had to know that this person was The One before you used the L word. And you could be almost guaranteed that the expression of love would be followed by a proposal.

This idea was so well entrenched that I remember whole story arcs in books and movies where characters agonised about whether or not this was the right time to say, “I love you.” Those three little words weren’t just sprinkled around indiscriminately. The right to say them had to be earned.

In the last year or two, however, I have revised my opinion. Because I don’t know where this idea of holding back came from. Perhaps it’s the fear that the person wouldn’t say it back – or that they would, but only because they felt they should.

And actually, that’s all balderdash. Because the person’s feelings about you are none of your business. How they feel about you shouldn’t change whether or not you love the person – that’s expedience, not love.

Love is a one way street. “I love you” is a straight line of love from my heart to yours. No detours, no hairpin bends, no potholes or speed bumps. Just love, flowing from me to you.

So I think we need to tell people more often that we love them, not less. And I’m not just referring to romantic love – we should be telling everybody! Our family, our friends, the cat, the dog, the hamster – if you love someone, just tell them already, dammit.

And stop feeling uncomfortable about saying it, or having it said to you – what is that about?! I think all of us could do with hearing more often that we are loved; the world in its current state of crisis could certainly do with a whole lot more love.

Because here’s the beautiful thing about love – it’s not depleted by being shared. Give it away, and it grows and overflows.

And why wouldn’t you want a little more of that in your life?


PS. I love you guys.



Thinking about overthinking

May 24, 2017 Comments Off on Thinking about overthinking

I went to bed at 8pm last night, so tired I was almost in tears, and fell into one of those deep sleeps where you wake up and feel like you haven’t moved a muscle. It was 2.07am, and as is my wont at that time of the morning, I began to think.

Thinking is one of those things that is underrated in today’s world, I fear. Certainly, a day spent on social media will probably convince you that thinking is on the brink of extinction. At 2.07am, however, it’s highly overrated. If your mind latches onto an idea that carries even the smallest shred of anxiety with it, you can be assured that your sleep is about to be severely interrupted at best, and over for the night, at worst.

Luckily I managed to distract my brain with a book, but it did get me, erm thinking. About overthinking. Because I do try to remind myself of that lovely line which only appears in the movie version of The English Patient, where Caravaggio says: “You get to the morning and the poison leaks away, doesn’t it?”

And that’s certainly true. Something about the sunrise makes all those anxieties in the “wee small hours of the morning” seem a lot less important – if you can even remember what you were worrying about in the first place.

But there’s another form of overthinking that is just as debilitating, and that’s analysis paralysis – where we spend so much time plotting and planning and perfecting that nothing ever happens. “I’ll do it when it’s ready,” we tell ourselves. “When I’ve done X and Y and Z.” And the list of all the things that have to be in place gets longer and longer, and we never do the thing.

I’ve been trying to change that recently. Because there are oodles of people out there who don’t do all the planning – they just do the thing and make up the rest as they go along. Those people are my heroes. They’re also often pretty successful. And I really admire these kinds of people – people who aren’t risk averse, who can throw caution to the wind and themselves into everything they do without stopping to tick off a myriad to-dos first.

In both cases of overthinking, I think, the cure is action. I treat my anxiety wakefulness in two ways now. If I’m lying there worrying about something I can do something about, I get out of bed and do it immediately, regardless of how ridiculous the hour is. Because sorting something out is the obvious way to stop worrying about it.

If it’s not something I can sort out straight away, I make a note of how I’m going to fix it and when, so that I don’t lie there worrying that I’ll forget to do it. Out of my head and onto the page – that’s my mantra.

As for the analysis paralysis, the answer is also action, I think. Because I know that it’s just a form of procrastination, which almost always stems from fear – fear of failure, fear of success, fear that I’ll be found out, fear of looking like an idiot, fear of boredom.

So I tell myself to be brave and I try to think of one thing I can do – actually do, not plan – to move myself forward. It can be tiny, but it has to be an action. And often one small action leads to another, and you’re doing what you’ve been saying you’d do for so long. And you can’t for the life of you remember where you put your to-do list but things are getting done regardless, and no one has yet exposed you as the impostor you’re convinced you are.

I know so many super talented people caught in a downward spiral of thinking they’re not good enough or cool enough or experienced enough to do X or Y, or in that downward spiral of impostor syndrome that can leave you curled up in the foetal position in a corner of your mind, hiding from the world. I know, because I used to be one of them.

But I’m not anymore. Certainly, I’m not as bad as I used to be. I’m not cured yet – it takes time to reverse half a lifetime of faulty thinking – but I’m working on it, one small action at a time.

Too much

May 17, 2017 § 6 Comments

More and more these days, it feels as if the world is too much with me, to borrow a phrase from Wordsworth.

Between the woes at home and abroad, as you scan the headlines and timelines, you’d be forgiven for thinking that the world is ready to implode, right about now. You wouldn’t be wrong. Just the projections about global warming are enough to bring on major depression, and that’s without all the warmongering and posturing and lack of respect for human rights that characterises large parts of global politics.

And yet, and yet. If I walk way from social media, ignore the newspaper posters, and click off the radio’s marketplace patter, I see the world differently.  Because every morning when I turn into my street, the security guard on the corner and I exchange enthusiastic hand-waving and thumbs-upping. In the supermarket, a few blocks away the man at the till next to me regales both the teller and everyone within earshot with his ribald, good-natured jokes. A small girl waves at me as we pass on the street, beaming up at me with doe-eyed, gap-toothed innocence. The fruit vendor at the traffic lights smiles a greeting. My neighbours and I rush into the street to see if we can help when we hear the unmistakable sound of two cars colliding.

I know I can’t bury my head in the sand. But I also know that in this always-on, always-outraged, always-informed world, we are rich in knowledge and poor in wisdom. There’s a lot to take in, and most of it isn’t quality. And if it bleeds it leads – so it’s always going to be bad news.

So sometimes, it pays to withdraw from that cycle altogether. Because believe me, the truly important news will get to you. Log out, switch off, disconnect, and reconnect to your fellow human beings in the tiny moments that make up an ordinary day.

It’s the only antidote I know – reminding yourself that it’s not the whole world that’s gone mad. There are many, many decent people all around us, every day. We just have to stop to look them in the eye sometimes, and say hello.

Bibbidi bobbidi bum glue

April 26, 2017 § 5 Comments

There’s a question I’m asked almost every time someone hears I’m a writer. “Where do you get your inspiration?” they ask, their faces beaming up at me, waiting to hear about this magical thing I do. And then I have to be the one to burst their bubble, rain on their parade and, as we say in South Africa, piss on their battery. Because the sad and sorry truth is that there is no magic.

Oh, how I wish that there were some magic potion I could sprinkle on my fingers moments before they hit the keyboard each day. I wish that somehow whole paragraphs could leap to life, fully formed on the page before me.

The truth, however, is far less glamorous. The truth is that writing is work – like any other work. The inspiration is the easy part, usually. The perspiration is another thing entirely.

Because you don’t just sit down and magically write something. You can’t write well if you can’t think well, or if you haven’t ruminated on what it is you’re going to write. So before you put a single word on the page, you have to have some kind of shape of what you’re about to write in your head – a road map of sorts. You need to know what you’re going to be covering, in some sort of rough order; how you plan to start and finish, and then you can start.

No matter how how good you are, you still have to write the way we all write: one word at a time, brick by brick, till you build your house. But when you’ve done that, you still only have the most basic structure – the outer walls and the roof. Now you begin the process of refining – moving the internal walls to improve the flow of the building, choosing finishes to create a certain aesthetic.

It takes time and effort and craft. It often requires that you research various topics as you go along, that you hunt for exactly the right word here or there. That you learn to be detached from the work itself, but remain very attached to the outcome you wish to achieve.

You have to walk in the reader’s shoes – experience the piece as they might – and ensure they will understand exactly what it is you are trying to say, feel what you want them to feel, leave with the right message ringing in their ears.

Sometimes you move a word here or there, or delete it completely, because somehow the rhythm isn’t quite right. You join two paragraphs here, divide that one there, or change a punctuation mark to create a bigger or smaller pause. Good writing ebbs and flows – it moves and shifts and doubles back on itself, pulling the reader by the hand along an unfamiliar path, requiring complete faith that the destination will be worth the journey.

And then once the house is more or less built, you go to the garden and weed. You take out anything extraneous, anything that distracts, detracts, diffracts. You want that house to stand out clearly against the sky, to be appreciated for its beauty, its function, its form. You want the reader to see the welcome mat, the open door, the warm fire and the mugs of hot cocoa inside.

And if there is in any magic to this process, it’s in that mythical stuff – bum glue – which must be religiously applied to your seat before you sit in it each day. Some days you’ll need more, some you’ll need less. Because if anything will turn you from “I want to be a writer” into “I am a writer”, it’s bum glue: sitting in that seat day in and day out.

Writing requires that you show up at the page – regularly, religiously, relentlessly – till the words are finally there, and the damn thing is written. Trust me. I’m a writer.

Another opinion piece about that opinion piece 

April 19, 2017 § 5 Comments

There’s been a bit of a drama in the South African media arena in the last week or so. In case you’ve not been keeping up (tsk) here’s a summary: someone deliberately wrote an opinion piece to prove a point, sent it to one publication, who rejected it, then sent it to the South African Huffington Post, who chose to publish it in their blogs section. It caused an outcry at first because it was deliberately controversial and poorly argued. But hey, it was driving traffic to their site.

However, the main outcry was because it turned out the writer was a figment of the hoaxsters’ imagination. The editor had written a piece that appeared to support the writer’s point of view, and then the publication hastily backtracked when an actual journalist sensed something was amiss, did some basic research, and blew the whole thing out of the water.

Confused yet? Don’t worry – you’re not alone. There are excellent analyses of various political, journalistic and other concerns here, herehere and here, which will explain it all much better than I could. And I’d suggest you read them in order.

The reaction to this has been quite startling. There have been calls for HuffPo’s editor, Verashni Pillay, to resign. I’m not sure that’s the solution; I’m still thinking about all of this. But there is one part of me that feels like this kind of event was almost inevitable in the media environment we now live in. And that’s the part that really interests me.

I’m old enough to remember a time when keeping up to date with the news meant that you actually had to pay something – the price of a newspaper or magazine, your TV licence or satellite TV subscription. That time has passed. It’s an information era now, they tell us, and everyone expects to have that information for free, on tap, 24/7/365 – with little or no thought to how that news arrives on the screen of whatever device you use to consume it.

When you’re not paying for the news, but expect it to be there, for free, whenever you want to consume it, I don’t need to point out what the problem is (I hope). And while advertising revenue traditionally provided the vast majority of a news organisation’s income, that revenue stream has become more and more difficult to capture. What this has meant is fewer journalists in the average newsroom, and often what’s termed as ‘juniorisation’ – a euphemism for getting rid of the older, more experienced journalists, who cost more, and replacing them with younger, and therefore cheaper, people.

So now you have a website for your news organisation with an insatiable need for more and more content – words, pictures and videos to fill it up. And you have fewer and fewer staff members to provide that content – staff members who firstly don’t always have the gravitas required to make difficult decisions and, selfishly, insist on going home to sleep from time to time, and see their families or friends once in a while. I mean, really!

But wait! You have a cunning plan! There are bloggers and other members of the public out there, many of whom are just dying to have their say. And they don’t mind being unpaid for their labours, because they quite like the idea of being published. In some cases, this is the only way they would ever be published, because of the mind-numbing dreck they churn out, not to put too fine a point upon it.

What you have, as a result is something that looks very much like a win-win situation. The newspaper can satisfy its content needs without handing over any cash, and the unpaid contributors get to have their say on a newspaper’s platform.

There is a positive side to this – in a sense, it democratises the media; opens it up to diverse voices and opinions. But as they say, opinions are like arseholes. Everybody has one – just because you have one, doesn’t make it worth knowing about.

In your traditional newsroom, you see, not everyone gets to have an opinion. The right to espouse an opinion is earned. It’s earned through years of experience and knowledge and research, by working a particular beat, by reading voraciously around particular subjects, and being exposed to people who are the best in their field.

And then, once you’ve been given right to publish your opinion, you are required to analyse thoughtfully, think critically and back up your opinion by referring to facts and evidence, those old-fashioned notions. Good writing and language skills are generally required as well.

Alternatively, you are an expert of some sort who writes an op-ed for the newspaper: again, because you have some expertise in an area. You might submit the op-ed, in which case your bona fides will be checked out (patently not what happened in the case of the HuffPo piece), or you might be asked to submit one, because your bona fides are well-known. And not everyone will agree with your opinion, but it will be published anyway, because that’s how adults behave. And there was quality control – it went through several stages before it was loosed upon an unsuspecting public if it was controversial.

Today, however, it’s too easy to scan something, think you have the measure of it, and post it – because you know it will be controversial and probably go viral. It’s too easy to accept whatever drivel comes your way in your pursuit of that catch-all: ‘content’. It’s too easy to think of unsolicited submissions to your publication as ‘citizen journalism’, which is a positive development when it actually is citizen journalism; not so much when it’s a vomiting of vitriol. Because, hey. It’s going to drive the clicks, add content to your website and besides, it’s not going to cost you anything!

Well, it may not cost rands and sense, but it may cost you your reputation. In the case of the HuffPo, many are calling for the editor to lose her job – that’s quite a cost for her. And in a media environment where the advertising pie isn’t big to start off with, it may cost you a great deal of advertising revenue.

Mess up badly, and the advertising revenue could dry up all together – advertisers are very skittish creatures. Think I’m exaggerating? A big food company once threatened to withdraw all its advertising from a local media conglomerate some years back just because a journalist had criticised its new packaging, for example. No, really.  They threw a major commercial tantrum, and the conglomerate nearly lost massive amounts of money.  (I can’t find a link, but this kind of thing happens all the time.)

And what it all boils down to, is that old Afrikaans saying, goedkoop is duurkoop (loosely translated, buying cheaply often ends up more expensive in the end). If you want a quality product in a factory, you need quality workers and quality machinery. The same applies to newsrooms. You also need people to buy your product – the same applies to news. It’s a product, and you should be paying for it.

Remember that if you pay peanuts, you get monkeys. If you pay nothing, monkeys start to look like members of MENSA by comparison.

People complain about paywalls and subscriptions, but in a world of fake news, outright lying, shoddy reporting and the fairly recent formation of dedicated fact checking agencies (does it not blow your mind that we need to have these?) we should be looking for reputable news organisations – yes, they do exist – and paying for quality, not quantity. And those newsrooms should be paying for the content they put on their pages – because when you’re paying for something you are far more likely to ensure you’re buying something of value, not so? And in the long run – in the greater scheme of things – surely advertisers are far more likely to stick around for quality over tacky quantity?

I know journalism isn’t exactly in its heyday at the moment. But I also know that it’s bloody hard to be a journalist at the moment. And that many colleagues in news are burned out by the impossible demands placed on them – produce more and more with less and less, blood from a stone. But you can’t expect quality anything for free. Somewhere, something’s got to give.

I bumped into an old colleague in the supermarket the other day. She’s 50, she’s a seasoned, superb journalist and political analyst and she’s just been retrenched. And after we’d caught up a little she remarked of her retrenchment, “There’s no room for analysis in newspapers anymore.”

And that was one of the saddest things I had ever heard.

Writes of passage

March 15, 2017 § 3 Comments

On a whim I took down the polka-dotted box labelled “Memories”. I knew there were some photos of Gavin Andrews and Mark Irvine, blonde, blue-eyed boys I loved with innocent passion at nine and eleven respectively. I remembered the adolescent love letters, folded in complicated shapes, from a boy I kissed on a long train trip, probably for no reason other than it was something to do.

At the bottom of the box I found a number of magazines dedicated to Princess Diana at the time of her death, and oddly, my French notes from university. But the rest was mostly letters and cards.

As much as I spend my days tapping at a keyboard, I love a handwritten note. The noticeboard above my desk has cards and letters pinned to it – words of love, thanks and appreciation that warm me when I’m feeling low. In my bedside table there’s a letter that makes me smile, and two that make me cry. Letters fall out of books sometimes, bookmarking my memories in their papery folds.

In the box there were letters from my mom, my dad, my grandmother, the handwriting firm and sure. They took me by surprise. Remembrance caught at my throat, pricked in the corners of my eys. Five or six birthday cards reminded me of the short poems my dad wrote each year for our birthday – some wise, some witty, some downright silly. Postcards and telegrams carried birthday greetings and congratulations. Bundles of cards, in groups, marked achievement or occasion: deputy head girl, happy 21st, deepest sympathy. Not all occasions are happy.

But I love that each of those notes has something of the person left behind on the paper, in blue and black ink, the whorls and turns of looping letters as individual as the writer. I love that I can tell by the handwriting – and sometimes the misspelling – who the letter is from.

I still write letters from time to time, by hand, frustrated at my scrawl wrought by too many years of frantic note-taking and at the ease with which my hand tires. I have no idea if the recipients – my children, my friends, the people I love fiercely – will read and reread as I do, carefully folding those notes back along their original creases, or if they’ll simply read the words and discard the letter.

But I hope that we never forget how to write each other notes – for important occasions, or for no reason at all, other than to connect in a very personal way. A handwritten note doesn’t have to be fancy, or well-structured or eloquent. There’s no right or wrong way to write one.

In my box there’s a letter from my dad, in pencil, pleading with teenage me over the space of four pages, to pull myself together and be more organised at school. And there’s an unsigned scrap of foolscap, torn from an exercise book, in childish blue ink, consisting of  just four words. 

But really, they both say the same thing: I love you.

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