Kipling’s critics are quick to include him as one of the ‘fathers’ who ‘lied’ – echoing his short poem ‘Common Form’ – ‘If any question why we died, Tell them, because our fathers lied’.
From ‘Kiplings War’
Kipling has long been viewed as a propagandist and supporter of war but that was perhaps merely a product of his passion for his country and his immense capability to express almost every aspect of the human condition.
He wrote, not only as a journalistic commentator but as a father, a common man and as something that compounded his guilt over the waste of his son’s and millions of other son’s lives – a survivor…
One of the most intriguing engravings of the 18th century shows an elegant lady holding a sword and staff, wearing a cross of the military order of Saint-Louis and, more bizarrely, wearing a Masonic apron. The engraving is entitled ‘La Découverte ou la Femme Franc-Maçon’ – roughly translated as ‘The Discovery of the Female French Mason’. Rites of Adoption were not uncommon in France, with women being admitted to quasi-Masonic Orders but what was most unusual was that the woman in the picture was actually a man. A cross-dressing author, diplomat, soldier and spy, the Chevalier d’Éon, became a legend in his own lifetime.
Article featured in The Square magazine – click on the link to read.
That phrase is becoming a bit worn now, I hear it every time I book another trip. I’ve been going since 2001, a month after the Twin Towers were brought down and the idea of going to Egypt appalled everyone I knew. I survived that and subsequent visits, including one that turned out to be timed just right for a revolution.
‘It’s fine!’ I always reply wearily. And it is, because to be honest, where is ‘safe’ these days?’
My choice, as usual, is to stay on the West Bank of Luxor – ‘the dark side’, as it is locally known. This time, due to my now somewhat limited mobility, I decide to spend the majority of my days with friends than indulge in the usual frantic temple-hopping. I stay at Villa Kaslan owned by my Swiss/Egyptian friends; tucked away in a village halfway to the Valley of the Kings.
After a few days’ rest, I catch up with a Swedish artist friend, we sip warm Coke and smoke at a local coffee shop overlooking the Nile. She mentions in passing that there is an art gallery. ‘Really?’ I ask. ‘In Luxor?’ She laughs and gives me directions. I head off alone, she has to go; the builders have arrived to work on her studio.
Luxor Art Gallery is inconspicuous down a back street. I ineptly dodge barefoot kids playing football – ‘Salah!’ they shout at me gleefully. Everyone in Egypt loves Mo. Inside the unassuming entrance I am greeted warmly and shown into the gallery, the only visitor. But the art is sublime; contemporary pieces rivalling anything in the Tate – explosions of colour fusing ancient symbolism with modern perceptions. I’m transfixed by a piece by Alaa Abu Al-Ahmed – his art is described as ‘like déjà vu, [they] feel familiar, yet are rare to encounter and mystifying to experience’. Yes, reader, I bought one.
I had no idea of the sheer scope of the talent to be found in Upper Egypt. Perhaps in Cairo’s deliciously trendy – and expensive – suburb of Zamalek but in Luxor? Who knew that hiding in the backstreets would be a hidden gem; a testament to the ancients’ formidable artistry but with modern vigour and passion?
Since I’ve returned, the gallery has moved. Its new home is opposite the famous Colossi of Memnon, and it has a new board of trustees, all artists. Next door is Rabab Luxor, run by friend of a friend Shady Rabab, a self-taught musician who teaches young people to transform waste into musical instruments; his Garbage Music Project won UN acclaim. This is the stuff tourists miss out on; their air-con buses whisking them from temple to tomb. I love the temples and tombs, but this is progress; this is an art revolution! I can’t wait to go back in a few months, not only to add to my art collection but to see how sleepy Luxor is waking up.
Going back through photos of my many trips to Egypt, I realise that I have a bit of obsession with feet! Don’t get me wrong, this foot fetish does not translate to modern times, I really do not have an obsession with 21st century human tootsies. But there is something deeply sensuous about the delicately carved, often strangely elongated, form of the ancient Egyptian foot; they just beg to be worshipped…
Wherever you go, there are feet sculpted from granite and granodiorite, black basalt and quartz – or the sinuous, almost ethereal anorthosite gneiss, of which the statue of ‘Khafre Enthroned’ was created from.
But it seems I am not the only one enamoured with the feet of Pharaohs; there is a superb paper by Art of Counting entitled ‘Analysis of Royal Sandals in Ancient Egypt’, which gives an in-depth analysis of the depiction of sandals worn by Ramses III at his mortuary temple of Medinet Habu.
Whatever your passion, there is no denying the tangible life-force that still emanates from the magnificent sculptures that the Egyptians are famous for. I defy anyone not to feel the urge to kneel before the feet of Pharaoh in timeless wonder and appreciation.
June 21 marks the day to raise awareness of Motor Neuron Disease (MND). There are several rare diseases classified as Motor Neuron Diseases – Hereditary Spastic Paraplegia (HSP) and Primary Lateral Sclerosis (PLS) both share clinical similarities with the most recognised form of MND– Amyotrophic Lateral Sclerosis(ALS, a.k.a Lou Gehrig’s Disease, named after the American baseball player who died from MND aged 38). The world-famous physicist, the late Stephen Hawking suffered from MND. To date there is no cure.
I have Hereditary Spastic Paraplegia (HSP). Over the past two years I have ‘met’ hundreds of people with all forms of MND, on Facebook groups and forums across the globe. Those of us with HSP and PLS keep on going: often in constant pain, with increasing spasticity, weakness, and a host of other neurological issues – it is the ‘gift’ that keeps on giving* (*sarcasm alert!) But one of the saddest things of being part of this global MND community is seeing the ever increasing posts informing us of another member’s death from ALS. ALS is the one we hope we never progress to – it is, as the video above demonstrates – ‘a terrifying roller-coaster ride where every turn and loop brings you closer to death and you can’t get off ‘.
Someone – a complete stranger – asked me a while back why I use a crutch. At the time I was newly diagnosed with HSP, I was unaware that it was classed as a MND, and didn’t really know how to describe it. For want of a better description, I said that it’s a rare neurological disease with symptoms like Multiple Sclerosis (MS). The woman responded acidly that she has a relative with MS and I should be grateful I don’t have that. To say that stung a bit is an understatement and, as I have found out over the past year, it is a common response that ill-informed or insensitive people say when confronted with someone with a serious – yet unheard of – disease.
But, I can say with all honesty that I am grateful every day that I do not have ALS – my heart goes out to those suffering from it, and all those who care for them. And as for the nasty woman? I hope she’s constantly grateful she doesn’t have what I have, but more importantly, she doesn’t have what some of my friends across the world are dying from.
We desperately need a cure for MND. Medical research is progressing at a huge rate; we are seeing incredible new genetic editing techniques that may just cure this awful disease. It might not be in time for many of us but it will happen for those in the future!
However, the main issue is awareness – what is a MND? Do you know what it is? What it does to us?
Motor Neuron Diseases (MND) are a group of neurological disorders that affect motor neurons in adults and in children. Motor neurons are specific types of cells that control voluntary muscle activities such as speaking, walking, and breathing. In adults, symptoms of these disorders often appear after age 40, while in children – particularly in inherited or familial forms of the disease – symptoms may be present at birth. Motor Neuron Disease generally refers to the diagnosis of Amyotrophic Lateral Sclerosis (ALS), or Lou Gehrig’s Disease. In the UK, Motor Neurone Disease refers to both ALS specifically (the most common form of disease) and to the broader spectrum of motor neuron diseases, including Primary Lateral Sclerosis (PLS) and Hereditary Spastic Paraplegia (HSP).
Amyotrophic Lateral Sclerosis (ALS) is a rare disease, occurring in about 2 out of 100,000 people. People with ALS experience progressive weakness in muscles responsible for movement, speaking, swallowing, and breathing. These symptoms are due to dysfunction and death of motor neurons, disconnecting them from their target muscles. Muscles that are disconnected from their parent motor neuron become small (“atrophy”) and exhibit spontaneous twitching (“fasciculations”). People with ALS also may develop stiffness, called “spasticity”, which is also do to the death of motor neurons. Sensory functions – such as sight, smell and taste – remain intact, and significant pain or numbness are not typical. About 25% of people with ALS will also develop abnormalities in cognition and behavior termed dementia. The current treatment of ALS is focused on managing symptoms and maintaining strength and the best possible quality of life, as there is no cure for the disease.
Primary Lateral Sclerosis (PLS) is a rare form of motor neuron disease affecting the upper motor neurons only, resulting in increasing muscles stiffness (“spasticity”) and weakness. PLS progresses more slowly than ALS, and unlike ALS, PLS does not cause muscles wasting, as spinal motor neurons or lower motor neurons stay intact. However, some people who initially appear to have PLS will, with time, develop weakness and muscle loss, transforming the diagnosis to ALS. PLS does not usually run in families and the age of onset is generally between 35 and 66 years of age. The treatment of PLS is focused on symptom relief, as nothing is available at this time to prevent, slow, stop, or reverse the disease.
Hereditary Spastic Paraplegia (HSP) is a group of rare, inherited neurological disorders whose primary symptoms are progressive muscle weakness and increased muscle stiffness (spasticity) that usually starts in the legs. HSP is identified by difficulty walking due to increasingly weak and stiff muscles. Initial symptoms may include difficulty with balance, and, as the disease progresses, canes, walkers, or wheelchairs may be required. Other common symptoms of HSP are hyperactive tendon reflexes, involuntary muscular contractions and relaxations (known as clonus), and congenital foot problems such as pes cavus (high arched foot). While HSP usually runs in families, even within the same family the severity of symptoms and the exact age of symptom onset can differ. Treatment of HSP is focused on symptom relief, as no treatments are available at this time to prevent, stop, slow, or reverse the disease.
If you have read thus far – thank you! And I ask that next time you want to donate to charity, or raise money for a good cause, please consider the following charities – they are all working so hard to raise money for medical research into treatments for ALS, PLS and HSP, but they also help those of us with MND live as long and as comfortably as we can, until a cure is found.
Is anaesthesia a problem for someone with HSP [hereditary Spastic Paraplegia]? This was a question I needed an answer to when I was told that I may need surgery for the spinal cyst I have. Blank looks, eye-rolls or shrugs were about the sum of it. So, I turned to Dr Google and found a few clinical papers but they were on medical websites I could not access or gave only the abstract. There were others available discussing the use of anaesthesia for other neurological patients, which although in the same bracket, didn’t give me the definitive answer.
I did however, garner facts that those with neuromuscular disorders, especially with degenerative or progressive conditions, can experience adverse reactions/complications to anaesthesia; some of which at the least could exacerbate neurological symptoms, but at worst be life-threatening.
Then, a few days ago, I received an email with the latest copy of Synapse(Volume 22, Issue 2 – Spring 2019) , the e-newsletter from the US-based Spastic Paraplegia Foundation. Most of it is US-centric, so I idly flipped through – but then something caught my eye, lo and behold, the article I had been searching for – ‘Surgical Anesthesia in HSP and PLS’ (Malin Dollinger, MD.) Dollinger is a medical doctor, who also has Hereditary Spastic Paraplegia (SPG4).
Dollinger’s first sentence summed up my own findings that there is a ‘frequent lack of awareness of special anesthesia requirements in patients with HSP and PLS’ [Primary Lateral Sclerosis] So what can we do to prevent any complications? Dollinger provides an extract from a paper authored by Franco Hernández, J.A., et al. ‘Use of Sugammadex in Strumpell-Lorrain disease: a report of two cases.’ He advises us to print it out and give a copy to our primary care providers, to our specialists and crucially to those who will care for us in the event of an operation – not just the day before but when we are assessed for our pre-op. Heck, I say give it to them all to keep on file – you know we have to be our own advocates! But what do we do in an emergency, when there is no time, or perhaps the ability, to talk, to explain – should we wear a wrist band? But what would it say that would be universally understood? That’s another question…or two.
So, after a description of the different types of anaesthesia (local/general/twilight sedation etc), Dollinger explains what occurred in cases where certain types of neuromuscular blocking drugs, including depolarizing and non-depolarizing muscle relaxants, were used in patients with HSP/PLS:
This topic became vitally important when people with HSP or PLS were given general anesthesia along with a long-acting muscle relaxant, such as succinylcholine, and unexpectedly became weak and unable to work their muscles for several days or even a few weeks! Persons with PLS were especially vulnerable in this situation because their condition often includes involvement of the nerves at the base of the brain which control swallowing and breathing, both of which could be affected by the long-acting muscle relaxants. “Life support” might be needed in that situation until the muscle relaxant wears off.
This is exactly what I was concerned about should I need elected – or god forbid – emergency surgery. It also made me wonder if this could be why I had reacted badly to anaesthesia in the past. Even though I have only recently been diagnosed with HSP, I imagine it has been quietly causing havoc in me since childhood. In retrospect, so many odd symptoms seem remarkably joined-up. After a general anaesthetic at 19, I took ages to fully come round and felt dreadful for weeks; then 8 years later my dentist attempted to extract my painfully impacted wisdom teeth using a local. I was terrified but joked to the lady in the waiting room, that if she saw me being wheeled out on a trolley, she’d know things had gone belly up. Little did I know that 20 minutes later, I would indeed be rolled out past her (her face rictus with fear and local anaesthetic) unable to draw breath, with an oxygen mask clamped firmly over my numb face and my legs shaking uncontrollably in an undignified impression of a vitus dance! Four hours later, after an EMG and several cups of hot tea, I was released from A&E with the diagnosis of a ‘panic attack’. Thank god, I have never had a ‘panic attack’ like it again! Round two of teeth extraction occurred under ‘twilight’ sedation; which felt more like ‘dark night of the soul’ sedation, as once again I took some coaxing to come round and felt like s**t for the next two weeks with dizziness and an inability to walk very far’. Makes you wonder…
Anyway, I digress. I have, thanks to this timely article, got my definitive answer – there is indeed a problem with anaesthesia for those of us with neuromuscular disorders BUT armed with this knowledge – and/or a knowledgeable anaesthetist – the problematic risks can be lowered to that of a person without the disease. It is reassuring that there is some advice and guidelines out there for us but sometimes finding it takes a bit of sheer luck – or serendipity!
Some people may not think twice about having an anaesthetic, but for me – and all those with neuromuscular conditions – Dr Dollinger’s article could literally be a lifesaver.
If you want to know more about HSP and PLS and/or would like to donate to help research, or you are a sufferer and would like to know more about research and living with HSP/PLS, the SPF has a massive resource section – you can find them here https://sp-foundation.org/