Shifting Sands


My spellchecker doesn’t even recognise this word and yet I see it written in so many patient histories. Acopia: the inability to cope. The shameful state of affairs where someone does not possess the correct physical or emotional armoury to deal with the world. God has short-changed them, life has trampled over them in its rush to get on with all the important things it has to do and society has left them to drift alone in an ocean of self-contempt.


I read acopia and I see an alcoholic.

I see him lectured to and tutted at. I hear him find the courage to admit to how much he drinks and then I listen to the silence around his bed as people evaluate a life they know nothing about. I watch as chlordiazepoxide is poured into his system and addiction is evicted from his body and I witness the struggle as he allows it to leave. When he is finished, I watch him walk from the ward in borrowed clothes, with a carrier bag filled with nothing, to be catapulted back into a society which neither cares nor even cares to understand.

I read acopia and I see a suicide attempt.

I see other patients listen through paper-thin curtains and hide their judgement behind Sunday morning newspapers. I watch someone whose mind is wrapped in so many layers of self-loathing, no one can hear its screams. I see someone who tries to walk through their day with the weighted pull of misery around their ankles and I watch as they try and fail to keep up with everyone else. I listen as they search for the words which will lead those with tranquil minds along a path of understanding and then I feel them admit defeat. I hear them recite from a script. An easy, deceitful script of regretful words and denial of recurrence and I watch as they put on a mask of untruth which is so tight, it won’t even allow a bead of misery to leak on to their face. Yet, as they walk away, I can smell the trapdoor. I feel its pull and I hear its comforting words and I know it lies waiting with patient self-assurance.

I read acopia and I see an old man.

I hear how he uses the edge of furniture to get from the kitchen to the sitting room. I look into his eyes and wonder who he used to be and I listen as he struggles to remember the answer for himself. I hear him tell people that he lost his wife and I watch as people regard this with such little significance, no one even bothers to write it in his notes. I sit in meetings where strangers calculate the worth of his life on sheets of A4 paper and I watch them sweep eighty years of existence into a neat manila folder. I see him stapled and paper-clipped and led away from one small life into another small life. And I see a new life which is so small, it doesn’t even allow room for the thin slice of himself he had managed to hold on to.

I read acopia and I see a cancer patient.

I see someone the same age as me. I see someone who knows the lyrics to the same songs, who marked their life with the same tape measure as I did, who assumed the same guarantee as I assumed. As I assume even now. I see failed chemotherapy. I read on, as the entries in their notes become shorter and shorter and I try to catch the hope which slips through their fingers, because somehow, I feel I have an obligation. As I stand by their bed, I think about the birthdays and the Christmases and the lyrics to the songs, and I see a mirror. The reflection in the mirror is almost unbearable, and yet I stare and stare because I must find the difference or I will never be able to look away.

I read acopia and I feel the shifting sands beneath my feet.


  1. December 5, 2011 / 8:30 pm

    This is beautifully written, Joanna. Really moving . . .

  2. December 5, 2011 / 8:35 pm

    Heartbreaking and honest as ever, Jo.


  3. December 5, 2011 / 8:48 pm

    Words almost fail me – this is so indescribably moving, human, compassionate. Utterly superb writing, Joanna.

  4. Clare
    December 5, 2011 / 8:49 pm

    Your empathy and compassion shine through your powerful prose, Jo – I doubt anyone could read this and fail to be touched. Thank you. x

  5. Mandy
    December 5, 2011 / 9:02 pm

    You are hugely talented and will have a three book deal before next year is out! The old man who had lost his wife and nobody bothered to write it up was so sad, but so true. People just see the inevitability of ageing and losing loved ones.

    Perhaps it’s too hard to acknowledge the pain and hopelessness. Perhaps if people really let themselves think about what life without his wife must be like, they wouldn’t be able to function. Perhaps they tuck it away under their businesslike day-job veneers, but in the early hours, perhaps it haunts them, prevents them from sleep. Perhaps I think too much!

  6. December 5, 2011 / 9:06 pm


  7. Diane Becker
    December 5, 2011 / 9:09 pm

    Beautifully observed, beautifully written.

  8. December 5, 2011 / 9:13 pm

    You are such a compassionate writer and I can’t wait for your first book. I have always said that medical staff think when curtains are pulled around a bed they are soundproofed.I have had to listen to some really personal stuff being said during my stays in hospital and it’s horrible.

  9. Anne Booth
    December 5, 2011 / 10:05 pm

    I think this is beautiful, written with love and respect. Any one of those characters could be the subject of a novel which you should write and many many people would read.

  10. December 5, 2011 / 10:28 pm

    Incredibly touching and beautiful…. One of those pieces where I am a better person for having read it.. Thank you

  11. December 6, 2011 / 12:27 am

    Another beautiful post. Once again you speak for those who have no voice, or whose voice is neglected. The people you write about here could be any of us, either now or in the future.

  12. Fionasrotties
    December 6, 2011 / 1:44 am

    Brilliant Jo. So well thought out and put in to words. Don’t ever change how you think & how you see the world. X

  13. December 6, 2011 / 5:29 am

    beautiful, tender, heartbreaking…

  14. December 6, 2011 / 7:54 am

    Thank you for those beautiful words.

  15. December 6, 2011 / 7:57 am

    Ah Jo, you made me cry on the train again.

  16. December 6, 2011 / 8:01 am

    Beautiful writing Jo. I wonder if there is another part of the story? – the difference that is felt when that small slice of their heart has been seen, and heard, and noticed by another human being, quietly, and with kindness.

  17. Mine Jarman
    December 6, 2011 / 8:05 am

    Jaw-droppingly beautiful words, Jo. X

  18. Rebecca Leith
    December 6, 2011 / 8:30 am

    Beautiful, and thought provoking. Thank you.

  19. Ann Patey
    December 6, 2011 / 9:02 am

    If our knowledge of the NHS came only from the media it would be easy to believe that doctors are too busy to truly care. I’ve been unfortunate enough to have a life threatening cancer, and yet fortunate that my NHS treatment was delivered in a timely, efficient yet nonetheless caring manner by a superb team of professionals who patiently helped me through all the different stages and whom I will never forget.

    The world can be an unfair and cruel place but people like you make it a better one and I really like to think your beautiful writing speaks for many others in your profession.

  20. December 6, 2011 / 9:24 am

    I started crying when I read that. This particularly got to me:

    “I see someone who tries to walk through their day with the weighted pull of misery around their ankles and I watch as they try and fail to keep up with everyone else.”

    I wasn’t always like this. I was successful. I was going places. I had a lot of things I was doing, and it all got swept away from me, and now I’m like that guy.

    I was a big powerful man, now I’m emaciated, thirty pounds underweight and that was all muscle that I lost.

    People look at me and tut, and think “That poor man.” and they don’t understand, that I wasn’t always like this.

    I used to smile all the time, and I was known for my sense of humour, and now I haven’t smiled in months. I don’t even seem to be able to smile anymore.

    People used to say, that I was the most talented man they knew, the smartest, the most capable. Now people see me, and they see a shuffling broken wreck, a man who moves like he’s old with an unsteady step and everyone now and then a strange gives me sympathy and I tell them:

    “I wasn’t always like this.”

    And they nod as is they believe me, but I know that they don’t.

    But the truth is…I wasn’t always like this. I wasn’t always a shattered broken wreck.

    • January 5, 2012 / 8:38 am

      I have just read your comment and my heart went out to you. I know nothing about what has brought you to the place you are at the moment BUT can I just give you a {{HUG}}

  21. December 6, 2011 / 9:49 am

    I’m with Ann Patey (above). All the time there are people like you in the NHS there is hope. I saw a huge amount of care and compassion from the staff who treated my dad during his final illness and total disregard, disrespect and downright unkindness when my mum fractured her shoulder and arm so badly last year. Thank you for being one of the good guys.

  22. m louise kelly
    December 6, 2011 / 10:57 am

    How lovely it is that you are there for these people – and that you can express it all so beautifully.

  23. December 6, 2011 / 6:46 pm

    What an incredible piece of writing.

  24. December 6, 2011 / 9:33 pm

    This is a truly moving piece of writing – heartbreaking and beautifully expressed. Thank you for writing on behalf of people who are unable to speak up for themselves and for giving us such an illuminating glimpse into your world. It is heartening to know that you are able to be a sensitive, loving presence in the lives of people who suffer so greatly.

  25. Nicola
    December 7, 2011 / 9:53 pm

    Whenever I read your blog – this is what I feel; “She gets it. She really does.”
    I am so grateful you do, because there are very few of you.
    Thank you.

  26. dandeliongirl01
    December 8, 2011 / 9:30 am

    I love that you give these people a voice. Make us stop and think about the people we see around us every day and will run into in the future. One of the responses above was very moving and he was able to be so honest, because you gave him a chance to. plathianmale you are very brave. Beautifully written Jo. x

  27. alisonwells
    December 18, 2011 / 6:50 pm

    Breathtakingly real. One of the best things for me about being online is finding a person such as yourself who speaks the truths of humanity that really resonate with me and many others. Such a delicate, beautiful, fragile, lovely life.

  28. December 18, 2011 / 7:00 pm

    This makes you think so much. As does every post you write.

    Heartbreakingly beautiful.

  29. January 5, 2012 / 8:02 am

    Wow. Amazing. You really make a difference. You really make me ponder.
    I just discovered your blog. What a pearl.


  30. January 27, 2012 / 12:08 am

    You take the scalpel of rhetoric and incise direct to the heart.

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