Tuesday, December 22, 2015
Monday, December 21, 2015
Saturday, December 19, 2015
Martin Luther King was a great apostle of non-violence. Picture: AP
‘Deus Vult” which can be translated as “God wills it” or “God willing” was the phrase used by Pope Urban II to launch the First Crusade in 1095.
It was a response to a cry for help from Eastern Orthodox Christians who were suffering Muslim invasion and conquest. The bloodiness that came later in the Crusades and is used to this day as a whip to beat the Church often overlooks the cause which places Christendom as a defender of justice rather than aggressor.
That is not to say that Christians through history were not at times instigators of bloodshed but any examples that may be cited of people of religious belief fighting one another or others on religious grounds does not offer any basis whatsoever for claiming that violence is linked to religion rather than simply to human nature.
It is a claim without any foundation whatsoever and shows an astounding ignorance of both history and religion.
Human nature is one with violence in the way that nature is one with rapine. The tenets of the Christian faith direct us to not alone conquer the urge to violence but to make friends with our enemies.
The message of Christ, heralded as “the prince of peace”, is one of peace to the point of turning the other cheek. His teaching is anticipated in the Old Testament in images such as swords being turned into ploughshares and the wolf lying down with the lamb.
Through the scriptures, there is of course a recognition of the nature of humankind in a fallen world and again and again we have stories of strife and struggle, wars and holocausts.
The biblical call to justice, reconciliation and peace speaks to the violence in the heart of humankind. Violence is the context of the message of peace. Otherwise, it would not have been necessary.
It is very demonstrable from the pages of recent history that most violence comes from those who are without religious belief or hostile to the very idea. In the 20th century, the greatest violence was perpetrated by avowed atheists.
Millions died under the Stalinist regime in the endless wastes of the Gulag. In China, during Mao Zedong’s Great Leap Forward, 45m died. Hitler, whose religion was social Darwinism, said that Christianity was opposed to the natural law of selection and survival of the fittest: it was that philosophy that brought six long years of violence on the world in which millions perished.
The Cold War between the Communist East and the Capitalist West, which came perilously close to a nuclear inferno in 1963 with the Cuban missile crisis, had nothing to do with religion.
Elsewhere in the world in the latter half of the 20th century ethnic conflicts, the worst of which occurred between Hutus and Tutsis in Rwanda and the dirty wars of state repression and persecution in several South American countries, arose from clash of ideologies and interests and not from any religious cause.
To claim that there is some inherent link between religion and violence is more absurd than claiming a link between a particular nationality and violence, or a particular political ideology and violence.
It would be much easier to mount a case for a link between British people and violence given their colonial history and the fact that they appear as players in most of the great wars of history as well as generating a fair amount of home grown, bloody wars and battles too.
Something similar might be said of Germans or Americans US or Russians. Easiest of all, however, is to establish a link between violence and the ideological, institutional atheism of the 20th century.
It may be argued from the same pages of history that religion has led many people to actively promote peace in places of conflict.
Christians do not of course have any monopoly in this and one has only to think of Mahatma Gandhi, a Hindu who was the great apostle of non-violence in the early 20th century.
A notable Christian example is the great Martin Luther King, the leader of the American civil rights campaign of the 1960s. The collapse of the Iron Curtin during the early 1990s through a series of “velvet revolutions” was in no small way helped by the peaceful, diplomatic exertions of another great religious figure, Pope John Paul II.
Yes, you can point to violence in the pages of the Bible. In fact when there was only one family in the narrative with only two sons, one of them Cain, murdered the other, Abel. That was not promoting violence: It was acknowledging its reality.
However, as the biblical narrative moves along down the generations the idea of reconciliation is gradually developed. A later family of brothers sell their father’s favourite, Joseph, into slavery but are forgiven by him many years later when their fortunes are reversed.
With the entry of Jesus into the history of Israel, an overwhelming emphasis is placed on peace and forgiveness. He tells Peter that those who live by the sword will die by the sword.
And, can anything be more radically anti-violence than turning the other cheek to your assailant? It is a trope rather than a literal instruction but it makes the point. When Christians engage in violence and there is no denying that they do, it is not because of their faith but despite it.
Yes, there has been violence based on religious difference and yes and there have been religious wars but in the tapestry of human conflict they are very far from being the dominant strands.
In the context of Islamist terrorism, the religion of those involved is without doubt a large part of their motivation. Can they find justification in the pages of the Koran? It is disputed but it is certainly possible to find passages there that are equivocal in their denunciation of violence.
The same might be said for selected passages of the Judaeo-Christian scriptures but they must be read against the call to mercy and forgiveness which is the base doctrine of the Christian faith.
Nobody can dispute that Islamist violence, with its manic barbarity and disregard for any life — including the lives of their own adherents — is as horrific as any manifestation of violence the world has ever seen.
It does not offer a basis, however, for concluding religion of its nature tends to violence. The tendency is in human nature. The Christian faith — and perhaps others too — offer a remedy.
The remedy cannot be said to have failed where it has not been applied.
Archbishop of Dublin Diarmuid Martin. Picture: Niall Carson/PA
Dr Martin told a gathering that he had an issue with parents who baptised their children in order to gain entry to a Catholic school. There have been numerous reports in recent years of parents who are not practicing Catholics doing just that.
“Baptising children simply to be able to attend a specific school is an abuse of baptism,” he told a schools’ mass at St Mary’s Pro Cathedral in Dublin.
He has a point. Baptism is a sacrament of the Church. Engaging in it with a hidden agenda is certainly an abuse. Yet the archbishop might well have asked another question of those who would act in such a matter. Who could blame them?
It’s not a matter of abusing the sacrament to get into a specific school, but of doing so in some cases to get into any school at all. The Catholic Church enjoys patronage of more than 90% of primary schools in a State where practice of the religion is down around 30%.
Take an example of a large town or city suburb that has, say five local schools, four of which are under the patronage of the church. The non-Catholic parent is faced with the scenario of confining their chances to getting a place in the fifth school. Everybody wants to send their children to the “best” school available and if that happens to be one of the Catholic schools in the above scenario, our non-Catholic parent is guaranteed to see their child miss out.
In rural areas, the absence of a baptismal cert puts the child at the bottom of a waiting list. That’s how things go in a patronage system that is 30 to 50 years out of date.
I have respect for those who practice their religion, and particular respect for Diarmuid Martin, a lonely progressive voice in the Church. Yet I would advise any parent to have their child baptised in the interests of education. This may well be an abuse, but what do you expect in a system whereby a Catholic education is the default setting of the primary school system.
That’s just one of a number of crazy outcomes that exist in a patronage system that is dysfunctional. Dr Martin touched on another in that particular talk — the matter of teaching religion.
“Teachers who do not believe should not feel compelled to teach religious education or faith formation,” he said.
“Those who do not believe — who may very well be men and women of great personal integrity and goodness — are in any case not the ones who can transmit what faith means.” Again, he is spot on. But put yourself in the shoes of a young teacher applying for a job. You appear before an interview panel, which may or may not include the priest who is a member of the board of management. Are you prepared to teach religion and faith formation, which are basic tenets of our ethos?
Of course you are because if you say you’re not you can be damn sure the next applicant will nod vigorously at the question, ensuring that he or she has a better chance of landing the job. The reality is that any teacher who really wants the job will swear blind that they’d be only too happy to teach religion.
In a survey by the INTO two years ago, teachers were asked whether they “willingly taught religion”. Only 49.17% responded in the affirmative.
So at least half of the teachers in Catholic schools don’t even believe what they are imparting. Diarmuid Martin is of the opinion that they should not feel compelled to teach religion, but in the real world no teacher is going to stand on such a matter of principle unless he or she is entirely secure in their employment, and have no ambitions for career advancement.
These are features of the dysfunctional patronage system. The Church controls the schools, but at what cost to the tenets of the religion, and does anybody in the hierarchy, apart from Dr Martin, care about these things? Or is the imperative to retain as much societal power as possible through the status quo.
In 2011, then Education minister Rúairí Quinn set up the Forum for Patronage and Pluralism to provide a roadmap for, among other things, how the Church should divest itself from some of the schools. Despite the best efforts of those involved, little has changed. Two schools have been handed over by the church, out of around 2,900.
The stock defence from the hierarchy is that it can only act with the consent of parents; and parents want to stick with having their children educated under a Catholic ethos.
But what is that ethos? Certainly, some parents, most likely a minority, have strong views on having their children raised in the faith. There are also those cultural Catholics who want to see their offspring go through the sacraments, as they themselves did.
One attraction of the Catholic school for some of that cohort is that they can subcontract out the religion business to the school. They don’t have to involve themselves with that stuff. It gets taken care of in school, just like maths and PE.
For these people, a change of school might force them to involve themselves in preparing for the sacraments, or, God forbid, organising it outside of school hours, as is done under patronages such as Educate Together. Some would consider having to involved themselves in the inculcation of religions as an imposition.
Apart from any of that, one might well ask what exactly consists of a Catholic ethos in education these days.
In a recent contribution on Today FM’s The Last Word, the theologian Vincent Twomey pointed to a culture of “inclusion” as evidenced by how immigrants have been integrated into Catholic schools in this country.
Another “expert” in this area, Dr Niall Coll, touched on a similar theme in The Irish Times recently. He concluded that the ethos was “a vision of education as essentially a humanising endeavour characterised by love, home and social justice, forming young people who will serve the world with their gifts.”
Both these gents may well be learned men but they appear to be making the basic mistake of confusing religion with morality. Their respective characterisations of a Catholic ethos could easily be applied to the ethos of any educator anywhere in this country and beyond. In fact, the inference that the virtues mentioned apply to a Catholic ethos only is downright insulting to all other educators.
That’s the problem when a system is dysfunctional. The air tends to thicken with accusations of abuse and the dispensing of casual insults.
But enough of all that at this time of joy and goodwill. Happy Christmas and keep an eye out for those who are lonely at this time of year.
Friday, December 18, 2015
Mark O'Neill has been an emergency department nurse for eight years, and the job is as hectic as ever. Picture: Nick Bradshaw
My day kicks off at 6.30am. I cycle to a job I love. Everyone that I work with loves their job.
There’s no team like the team in the emergency department (ED). It’s not a place where you can coast, or where you would even want to coast. Staff in the ED have a different mindset. We’re all there to treat the sickest patients. If you want a less frenetic nursing environment, you steer clear of the ED. There are other options, like the calmer atmosphere of a nursing home.
My shift starts at 7.30am. There are three separate areas in the ED: ‘Triage’, where patients are prioritised for treatment based on clinical need; ‘rescus’, or the resuscitation/trauma area, where staff carry out life-saving procedures; and ‘majors’, where seriously ill patients receive more thorough assessment and treatment.
Examples of majors include chest pain, difficulty breathing, abdominal pain, and neurological complaints. Patients with less serious conditions are sent to a ‘minors’ area. These might be patients with fractures, dislocations, or cuts that require a few stitches.
Most people assume that we deal mainly with major trauma, but, in reality, we see more patients with a medical illness. The numbers coming in due to trauma have reduced; some of it’s down to people being more diligent about wearing seatbelts, some of it’s due to improved vigilance vis-à-vis health and safety on building sites, and some of it is just down to people being more sensible about their behaviours when it comes to protecting their health.
Once the night staff have completed their handover, myself and my colleague in triage get stuck in, while, over in ‘majors’, about 25 patients are waiting to be seen, a really mixed bag of injury and illness.
There’s a 17-year-old with appendicitis, a 90-year-old woman who has broken her hip, a man in the palliative care stage of cancer and in dire need of pain relief. Some have been there all night. On a bad day, 10-15 patients will have been there overnight. We triage the patients, working our way through the list, but, before long, we are feeling the squeeze, as more and more patients arrive.
Typically, activity starts picking up from 8am and, by the time it peaks around lunchtime, you could be talking about a new patient arriving every five minutes. That would be normal. They come at us from all angles — those who walk in off the street, those who arrive by ambulance, those who were attending an outpatient clinic and have been referred by their doctor for admission to hospital via the ED. They present with a very broad spectrum of injury and illness and our job is to make sure the sickest are treated first.
In theory, this is the sensible approach. Those with life-threatening conditions need to be prioritised. But with just two of us triaging growing numbers of patients, things start to slide.
That’s actually the worst part of the ED, the everyday stuff, where you literally can’t get to people to look after their basic human needs. You know there are people here for hours and they haven’t eaten. You know bedpans need to be changed. You know people are in pain and that all they require is a couple of painkillers, but you can’t even get to do that. You literally have to keep going with the triaging, just to keep the system going.
The pressure to stay on an even keel means simple actions, like having time to chat with a patient, are also out the window. This is very tough on them and soul-destroying for us. We’re supposed to be a caring profession and people come to us at a time when they are feeling low. They’re not in peak condition. They need our help. They want to be reassured.
They’re worried about chest pain, about abdominal pain, about severe headaches. The various diagnostic tests are done and the patient is given the results. But that’s it. There’s no time for a chat or reassurance, or to explain why it was necessary to carry out the tests. There’s no time to educate them about maintaining their health going forward. It’s not fair on them and it’s frustrating for us. Part of healthcare should involve educating people about how to stay well.
The food situation in EDs is absolutely horrendous. People can spend a few days on a trolley and never actually get a hot meal. In any ED you go into, you can be sure people have gone hungry and been left in pain or in the cold. It shouldn’t happen in a first-world county, that basic human needs are neglected.
People need to go to the loo, but you are tied up assessing a new patient and they end up soiling themselves. You don’t get to change a bed pan on time. You don’t have to be a nurse to acknowledge that this is wrong. From a human dignity point of view, it’s horrific.
But the reality is while you are trying to make sure one patient is fed and reasonably comfortable, three or four more have arrived and so you find yourself doing the minimum — checking to see if a patient is in immediate danger, and, if not, moving on. In reality, the only time this practice should apply is in the event of a major disaster.
Our major-disaster training teaches us to assess the patient’s condition, stabilise those who need to be stabilised, and move on. But this is not the way the system is meant to work every day in the ED. The unpalatable reality is that it is exactly how the system works.
Mondays are particularly chaotic. By midday on Monday, we could have 100 patients. It is not unreasonable for them to be accompanied by at least one family member or friend.
People need this kind of support when they are unwell. But if each of those 100 patients has just one companion, we are then up to 200 people in the ED, in addition to staff, trolleys, and lots of medical equipment. We are then getting to the point where the logistics of getting them through the ED is becoming impossible. There are more people outside cubicles than in.
The number one concern this raises is the heightened risk of people spreading infection. Then, there’s the knock-on effect on patient assessments. There is zero privacy. The reality is that with 10 people within earshot, patients can be reluctant, or embarrassed, to tell you what is wrong. This can result in poor assessments. It makes it more difficult to deliver a diagnosis.
It means people are longer in the ED. We have too many patients to assess and we can’t move them through quickly enough. We end up shooing out family members and relatives. As triage times start slipping — our target is to see people within 10 minutes of arrival, but it’s regularly stretched to an hour — there’s a knock-on effect on ambulances. We can’t take patients from our ambulance colleagues and a queue of ambulances starts to form.
As they wait around, emergency calls start to back up. We spread ourselves thinner and thinner. We try to organise for those who are not acutely unwell to be transferred to less acute hospitals. Another portion gets admitted to our hospital. But they keep arriving. Our normal day is not delivering basic care, but trying to stop conditions worsening. Unfortunately, the pressure we are under means patient reviews are not always done in a timely way. Delivery of treatments and antibiotics are delayed. People get sicker.
Can I tell you how many times this has happened? Could I say if patients have died because we didn’t get to them on time? It’s very hard to say, it’s so subtle. If I’ve had 100 occasions when I should have given antibiotics sooner, then I could definitely say some of those people got sicker.
But it’s very hard to prove it was due to ED overcrowding. As a nurse, you’re trying to act as a safety net and not let anyone slip through, but there is only so much a person can do.
Do people get annoyed with the treatment delays and the failure to cater for basic needs? Of course.
Everybody gets annoyed. It’s like we have the same conversation all the time. At this stage, my response is almost automatic: “We’re doing our best, we’re under-resourced, we’ll get to you as soon as we can.”
You can’t get annoyed back. People are ill. You can’t get upset at someone demanding pain relief for their elderly mother. At this stage, apologising for how bad things are is part of our daily dialogue.
At the end of the day, people coming in have a good idea of what to expect, which is a sorry indictment of the mess our EDs are in. At times, they are quite understanding. They read about it every time they open a newspaper. “I’ve heard about it, but I didn’t know it was this bad,” they say.
Some surprise me, because they come in with no notion of how bad things are. People with private health insurance can get upset because they are paying €3,000-€4,000 a year for healthcare and they find themselves waiting in a long queue. But, in the ED, everyone is equal. In the public system, people are treated on need and not ability to pay.
Most people recognise that you are doing your best. They realise you really have no control over the system. But you do get physically and verbally abused. I’ve been pushed and shouted at, particularly where there’s alcohol involved. Or, sometimes, where mental illness is a factor. The chaos of the ED is not the best environment to calm things down. In saying that, a lot of people have the impression EDs are full of drunks and junkies. That is not the case. It’s much more nuanced than that.
Working in the ED eventually gets too much for most. Everyone who leaves always asks: “Is it any better? I’d go back if it was better.”
That’s the feedback I get from colleagues in Saudi, Australia, the UK. They all want to come back to Ireland, but they work in EDs with reasonably good working conditions, so where’s the incentive? I’m as senior as it gets now in the ED, after eight years. Everyone else has gotten out.
What qualities do you need to work in an ED? You need to want to solve problems and solve them quickly. There are new challenges, not just every day, but every 30 seconds. We tend to thrive on hard work. We are confident and driven, from a knowledge point of view. We are motivated to learn. But things are so bad at the moment, morale is so low, that that kind of enthusiasm tends to ebb away. And that kind of motivation is not something Health Minister Leo Varadkar can dole out. It’s intrinsic to the job, but it is slowly being killed off.
My shift is scheduled to end at 7.30pm, but, in reality, it’s 8.30pm. I head home on my bike. Do I bring the day’s problems home with me? If I’ve had a particularly stressful day, it can be hard to switch off. I replay situations. I worry about things I didn’t get done. I end up ringing in sometimes to make sure something I didn’t get to has been looked after.
Is it physically draining? Some days. But it’s emotionally draining every day. You’re going solidly for 13 hours and there are times when I get home and all I want to do is sleep.
Wednesday, December 16, 2015
The whole aim of practical politics is to keep the populace alarmed (and hence clamorous to be led to safety) by menacing it with an endless series of hobgoblins, all of them imaginary.
It is now quite lawful for a Catholic woman to avoid pregnancy by a resort to mathematics, though she is still forbidden to resort to physics or chemistry.
It is even harder for the average ape to believe that man has descended from him
Most people want security in this world, not liberty.
Morality is the theory that every human act must be either right or wrong, and that 99% of them are wrong.
Faith may be defined briefly as an illogical belief in the occurrence of the improbable.
Puritanism and fanatism: The haunting fear that someone, somewhere, may be happy.
We are here and it is now. Further than that, all human knowledge is moonshine.
The common argument that crime is caused by poverty is a kind of slander on the poor.
Judge: a law student who marks his own examination-papers.
No one in this world, so far as I know - and I have searched the records for years, and employed agents to help me - has ever lost money by underestimating the intelligence of the great masses of the plain people.
A society made up of individuals who were all capable of original thought would probably be unendurable.
One may no more live in the world without picking up the moral prejudices of the world than one will be able to go to hell without perspiring.
A Sunday school is a prison in which children do penance for the evil conscience of their parents.
H L Mencken (1880-1956)