Tag Archives: role

In my role as chaplain, I have seen joy in hospital at Christmas as well as sadness

Enid* had become the granny of the ward. She had been in the hospital for some time. The staff loved her; she knew them all by name and they would seek her advice. The ward was the place where she felt loved and wanted. She had attended services I led in the hospital chapel when she could – and this had become her church.

I went to visit Enid a week before Christmas and this time she was miserable. It was so unlike her: she was usually such a cheerful person and always had a tale or two of her childhood to tell. I asked her what the matter was and she told me that the decision had been made to discharge her. She knew that she did not need to be in an acute hospital any more – but she was going to miss what she saw as her community and ward family.

She would have community support at home, but she would be on her own for most of the time. We sent her home with a food parcel as we have links with a local food and clothes bank.

That day I was interviewed by the local BBC TV news for a short piece about being in hospital at Christmas. I talked about the difficulties of people being separated from families and friends at a time when everyone else seemed to be having a good time. Although Enid was not going to be in hospital, I was thinking about her distress and anxiety. It was due for broadcast in the following day or two, but got bumped as there was a snowstorm that filled the news.

I was working on Christmas Eve – and there is always a lot to do, such as catching up with people who were being discharged for Christmas Day. Most, unlike Enid, were very happy to go home, even if it was only for a day or two. I also wanted to see those people who were staying in.

There were the families waiting by their loved ones’ bedsides for their lives to come to an end: the family of a young man who had come off his motorbike, and the relatives of a 40-year-old woman with cancer who was not going to see another Christmas. There were people, too, from long distances away, whose families would not be able to visit over Christmas. I guess this is what I had reflected in the TV interview.

We have an army of volunteers who come in on Christmas Eve to go around every ward and sing carols. I tell the teams, “If you make the nurses cry, you are doing your job properly!” They, and the patients and their families, are so touched that people care enough to come in on such a busy day to sing to them.

As we worked our way around the wards, I was surprised to see Enid back on the ward she had been in before. She looked very happy indeed. I was concerned that she had had to be admitted again. Enid told me afterwards that this was the best Christmas she had had for years. The ward manager had sat with her as she had her Christmas dinner and all the staff made a great fuss of her.

We talk a lot about holistic care in the NHS and this seemed to me a fine example of it. As it turned out, it was Enid’s last Christmas: what a wonderful gift.

I got home at about 9.30pm with a sore throat – and heartily fed up with carols. My family and I caught the news before going out again to the midnight service. There I was on the TV talking about what it was like to be in hospital over Christmas. I had forgotten about it completely. I realised that Enid’s experience had altered my thinking and that, if asked again, I would say something different about being in hospital over Christmas. I would say that I have seen joy in hospital at Christmas as well as sadness. Joy and hope can arise in the most unpromising circumstances.

*Name and some details have been changed

If you would like to contribute to our Blood, sweat and tears series about experiences in healthcare, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs.

Digital disruption: the role of tech entrepreneurs in improving healthcare

Technology in the NHS is the bane of many healthcare professionals’ jobs. Clinicians have spoken about decrepit computer systems on hospital wards and not being able to access patient information at the right time.

Other sectors, such as the airline industry, banking and retail, are years ahead and incorporate the latest technology to make life easier for customers and employees while also protecting users’ data. The NHS, which uses one in 10 of the world’s pagers and still relies on fax machines, has yet to catch on to some of the more modern developments in technology.

So how do healthcare professionals who have grown up with technology at their fingertips find working in the NHS? What are they faced with in their jobs and how do archaic and creaking IT systems impact on patient care?

Who are the digital entrepreneurs trying to do something about the situation? What innovations are out there? And what challenges do people face trying to introduce them into the NHS?

Join us at the Guardian’s offices in London on 7 February to discuss these questions and more. The event is aimed at healthcare professionals and those with an interest in healthcare tech, and while it is free, please be aware that space is limited. If you’d like to attend, please fill in the form below. Those who have been successful will receive an email to confirm their place.

Programme

6.30pm-7pm: Arrival, registration, refreshments, networking

7pm-7.05pm: Chair’s welcome, Denis Campbell, health policy editor, the Guardian and the Observer

7.05pm-8pm: Panel discussion

Panellists

  • Harpreet Sood, associate chief clinical information officer for NHS England and a practising NHS doctor
  • Mahiben Maruthappu, London-based doctor and co-founder of Cera
  • Nadia Masood, junior doctor and Justice for Health campaigner
  • Neomi Bennet, registered nurse and chief executive, Neo-Innovations UK Ltd

8pm-8.15pm: Audience Q&A

8.15pm-8.45pm: Networking

Digital disruption: the role of tech entrepreneurs in improving healthcare

Technology in the NHS is the bane of many healthcare professionals’ jobs. Clinicians have spoken about decrepit computer systems on hospital wards and not being able to access patient information at the right time.

Other sectors, such as the airline industry, banking and retail, are years ahead and incorporate the latest technology to make life easier for customers and employees while also protecting users’ data. The NHS, which uses one in 10 of the world’s pagers and still relies on fax machines, has yet to catch on to some of the more modern developments in technology.

So how do healthcare professionals who have grown up with technology at their fingertips find working in the NHS? What are they faced with in their jobs and how do archaic and creaking IT systems impact on patient care?

Who are the digital entrepreneurs trying to do something about the situation? What innovations are out there? And what challenges do people face trying to introduce them into the NHS?

Join us at the Guardian’s offices in London on 7 February to discuss these questions and more. The event is aimed at healthcare professionals and those with an interest in healthcare tech, and while it is free, please be aware that space is limited. If you’d like to attend, please fill in the form below. Those who have been successful will receive an email to confirm their place.

Programme

6.30pm-7pm: Arrival, registration, refreshments, networking

7pm-7.05pm: Chair’s welcome, Denis Campbell, health policy editor, the Guardian and the Observer

7.05pm-8pm: Panel discussion

Panellists

  • Harpreet Sood, associate chief clinical information officer for NHS England and a practising NHS doctor
  • Mahiben Maruthappu, London-based doctor and co-founder of Cera
  • Nadia Masood, junior doctor and Justice for Health campaigner
  • Neomi Bennet, registered nurse and chief executive, Neo-Innovations UK Ltd

8pm-8.15pm: Audience Q&A

8.15pm-8.45pm: Networking

Treating a dying child made me reflect on my role as a paramedic

We arrived at the scene in an ambulance to see the usual collection of bystanders clustered around a body. It was a child. She was still alive. A pale grey face, mumbling and moaning, eyes half shut and flickering. There was blood pooling from a wound to the back of her head and one of her legs was facing the wrong way.

The five-year-old girl had been struck by a car. The driver hadn’t been speeding or driving recklessly. The road was quiet. She had been out on her scooter. Suddenly, with a child’s spontaneity, she rode her scooter off the pavement and onto the road. The driver didn’t have time to brake.

We started high-flow oxygen and inserted a plastic airway into her mouth to stop her tongue blocking her airway, taking extreme care not to move her head in case she had a spinal injury. A dressing was placed under her head and her leg was realigned to a neutral position to prevent further tissue damage. Although she was breathing and her lungs sounded normal, we placed a bag valve mask over her mouth.

I shone a light into the child’s eyes. The right pupil was fixed and dilated. I advised the rest of the team of my finding and a colleague started to cry as she knew it meant bad news.

When the helicopter arrived, the doctor administered anaesthetic drugs and passed a tube down the child’s throat to manually control her breathing.

At some point the parents arrived. I can’t remember when, but it was before the helicopter had landed. I remember the mother running up to our huddle of green paramedic shirts and seeing her daughter lying there, her hands clamping over her mouth in horror. I cannot begin to imagine what she was going through. Seeing your small child, grey, moaning, bleeding and unable to respond to you is something no parent should experience. We encouraged her to kneel next to her daughter’s head, hold her hand and keep talking to her. Even now, years later, I’m crying while typing this.

As the crescendo of the ascending helicopter became a distant clatter I reflected on the picturesque setting. This was a tranquil village – in complete contrast to the trauma that had unfolded at its centre.

In the post adrenaline-fuelled, great-team-work atmosphere we bantered with each other. There was dark, dark humour as we checked over our shoulders to make sure the bystanders were out of range. Lots of swearing and jokes that only paramedics remain hardened to. Each of us adding another layer of veneer to shield our bravado.

After a quick debrief back at base we were back on the road, dealing with all the usual mundane shit.

I thought I would be ok.

When I got home my seven-year-old wanted to dance with me in the kitchen while my wife was preparing dinner. I remembered how three short years ago he had been riding his green scooter around our neighbourhood, carefree and happy, jumping off curbs crying: “Watch me do this, watch me do this.”

During dinner I held his hands and remembered how I had held smaller hands a few hours earlier, my blue examination gloves sticky with blood.

I remember an anecdote about a city where the ambulance service went on strike. The police were called upon to fill the gap in emergency medical response. When someone dialled the emergency number they would turn up, throw the patient in the back of a police car, no matter how serious the condition, and rush them to hospital. It was reported that patient survival rates significantly increased during this period, which caused the public to question the utility of the ambulance service.

I was left with similar questions. Two ambulances and a helicopter didn’t make any real difference to the outcome for this little girl. We made a difference to the parents and the bystanders. For as long as we were still treating their child, they held on to the fragile hope that everything would be ok in the end.

I guess sometimes that’s the only difference you can make.

Some details have been changed.

If you would like to contribute to our Blood, sweat and tears series about experiences in healthcare, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs.

Princess Diana’s very real role in fighting the stigma of Aids | Letters

I’d like to take issue with the statements about Aids in Hilary Mantel’s otherwise wonderful Princess Diana essay (The princess myth, Review, 26 August). It is not right to say that in 1987 only the ignorant or bigoted thought that casual contact would infect them – or perhaps it’s more true to say that the ignorant and bigoted made up the majority of the population.

In 1987 the US banned HIV-infected immigrants and travellers. 1987 was the year President Reagan first mentioned the disease in public, and the beginning of the UK’s “Don’t Die in Ignorance” campaign. It was also the year that the activist group Act Up was founded, meaning the very beginning of concerted public information. There wasn’t just ignorance about transmission, but widespread uncertainty in the medical community itself. As the New York Times reported in February 1987 in an article entitled Facts, theory and myth on the spread of Aids, “Experts say there is no danger in a peck on the cheek of an infected person but they recommend against any exchange of saliva and deep kissing with an infected person.” Stigma played a huge part in the ongoing nightmare of an Aids diagnosis, and whatever else one may think of Princess Diana, her gesture in touching a person with Aids did occur in a climate of widespread and unnecessary ignorance and prejudice that she did her best to dispel.
Olivia Laing
Cambridge

Ms Mantel dismisses in a one-liner Diana’s impact on the Aids “epidemic” of 1987 referring to “legend”. As best friend and executor of Ivan Cohen, I wish to put into context the very real threat perceived and not restricted to the “bigoted and ignorant”. Ivan was the only person in the special wing of the Middlesex Hospital willing to be photographed with the princess and only on condition that he was photographed from behind. The stigma associated with Aids is difficult for an outsider to gauge in retrospect and Ivan certainly saw it as such. She was indeed instrumental in highlighting the incongruous attitude.
Philip Chklar
Lewes, East Sussex

In 2013 Hilary Mantel wrote a piece for the London Review of Books entitled Royal Bodies, in which she took an erudite and articulate swipe at Kate Middleton and Princess Diana among others. She also referred to a theory, not her own, that attempted to attribute Henry VIII’s terminal decline to the McLeod syndrome, and his wives’ recurrent failed pregnancies to Kell blood group incompatibility causing haemolytic disease of the fetus and newborn.

I wrote to LRB to point out that the theory was based on several false premises and was untenable. Hilary Mantel graciously replied to acknowledge my contribution and to explain that she had raised the matter merely as an interesting idea that encourages us to think more kindly about Henry and his unfortunate wives. She finished her response with a touching personal aside and her observation that “a bit of posthumous sympathy doesn’t go amiss”. The public response to Diana’s tragic death may have been excessive, but it was in part driven by the perception that a vulnerable young woman with psychiatric problems had not been given the support she needed. What’s Hilary Mantel’s problem with royal women?
Dr Gerald Smith
London

Hilary Mantel both elevates and skewers the princess myth in her brilliant exposition on Diana, the people’s princess. The comparison with Marie Antoinette is apt: “Diana’s experience as daughter of a landed family did not prepare her for Buckingham Palace, any more than Schönbrunn prepared the teenage Marie Antoinette for Versailles.”

In 1770, the marriage of the Hapsburg princess, Maria Antonia, to Louis Auguste, heir to the French throne, was arranged for political reasons. Marie Antoinette, as she would thenceforth be known, was introduced to her prospective husband, for the first time, two days before the wedding. She was 14. He was 15 and shy. It is not surprising that their bedding ritual at Versailles was observed to be unsuccessful. The non-consummation of the marriage for the next seven years frustrated all interested parties. A couple of teenagers were responsible for the great union of France and Austria that their marriage symbolised. It had to work. This was politics.

The ex-King Louis XVI was taken to his execution in a carriage. Marie Antoinette was put in an open cart for the hour-long trip to the guillotine in Place de la Révolution on 16 October 1793. Aged 37, in a white dress, hair shorn, hands tied behind her back and on a leash, she could hear the crowd screaming “Autri-chienne!” (Austrian-bitch).
Alison Hackett
Dun Laoghaire, Co Dublin, Ireland

Referring to Lady Diana’s boyfriends as “non-white” (Diana was society’s warning, 31 August) is the fallacy that Plato drew attention to, of dividing all the people in the world into the Hellenic race and the rest, alias barbarians, as is shown if we describe Prince Charles’s second wife as “non-black”.
Vivian Cook
Colchester

Twenty years ago this week a woman died whose charitable work was legion and whose care for others was universally known. Has anyone recognised in writing or broadcasting the memory of Saint Teresa of Calcutta? Thought not.
Edward Thomas
Eastbourne

In reviewing Diana: Seven Days, Tim Dowling says (G2, 28 August) the outpouring of public grief caught those in charge on the hop. Maybe, but one amazing aspect of that amazing week was the speed with which those in charge made and sometimes changed the arrangements for the funeral. The princess died on a Sunday morning. By Monday it had been decided to invite representatives of the charities with which she had been involved to walk behind her coffin to the abbey. On the Tuesday I was chosen as one of the London Lighthouse representatives. We were told the procession would start from St James’s Palace. Then we heard that we would be walking the longer distance from Kensington Palace. Then it was decided that the coffin would start from Kensington Palace but that we, with Earl Spencer and the royals, would tag on behind the coffin when it reached St James’s Palace.

After I had carefully chosen my shirt, tie, socks etc, I got a registered letter from the lord chamberlain saying: “There is on this occasion no formality in what you should wear,” and that I should, if possible, wear a T-shirt with the London Lighthouse logo. These had to be specially made. We were supposed to get them on the Friday but, in the event, I didn’t get mine until the Saturday, the day of the funeral. Luckily it fitted. That was a day I’ll never forget: the heavy silence, broken only by the sound of the horses’ hooves, the tolling of the abbey’s tenor bell and sobbing from the crowds.
Chris Birch
London

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

Princess Diana’s very real role in fighting the stigma of Aids | Letters

I’d like to take issue with the statements about Aids in Hilary Mantel’s otherwise wonderful Princess Diana essay (The princess myth, Review, 26 August). It is not right to say that in 1987 only the ignorant or bigoted thought that casual contact would infect them – or perhaps it’s more true to say that the ignorant and bigoted made up the majority of the population.

In 1987 the US banned HIV-infected immigrants and travellers. 1987 was the year President Reagan first mentioned the disease in public, and the beginning of the UK’s “Don’t Die in Ignorance” campaign. It was also the year that the activist group Act Up was founded, meaning the very beginning of concerted public information. There wasn’t just ignorance about transmission, but widespread uncertainty in the medical community itself. As the New York Times reported in February 1987 in an article entitled Facts, theory and myth on the spread of Aids, “Experts say there is no danger in a peck on the cheek of an infected person but they recommend against any exchange of saliva and deep kissing with an infected person.” Stigma played a huge part in the ongoing nightmare of an Aids diagnosis, and whatever else one may think of Princess Diana, her gesture in touching a person with Aids did occur in a climate of widespread and unnecessary ignorance and prejudice that she did her best to dispel.
Olivia Laing
Cambridge

Ms Mantel dismisses in a one-liner Diana’s impact on the Aids “epidemic” of 1987 referring to “legend”. As best friend and executor of Ivan Cohen, I wish to put into context the very real threat perceived and not restricted to the “bigoted and ignorant”. Ivan was the only person in the special wing of the Middlesex Hospital willing to be photographed with the princess and only on condition that he was photographed from behind. The stigma associated with Aids is difficult for an outsider to gauge in retrospect and Ivan certainly saw it as such. She was indeed instrumental in highlighting the incongruous attitude.
Philip Chklar
Lewes, East Sussex

In 2013 Hilary Mantel wrote a piece for the London Review of Books entitled Royal Bodies, in which she took an erudite and articulate swipe at Kate Middleton and Princess Diana among others. She also referred to a theory, not her own, that attempted to attribute Henry VIII’s terminal decline to the McLeod syndrome, and his wives’ recurrent failed pregnancies to Kell blood group incompatibility causing haemolytic disease of the fetus and newborn.

I wrote to LRB to point out that the theory was based on several false premises and was untenable. Hilary Mantel graciously replied to acknowledge my contribution and to explain that she had raised the matter merely as an interesting idea that encourages us to think more kindly about Henry and his unfortunate wives. She finished her response with a touching personal aside and her observation that “a bit of posthumous sympathy doesn’t go amiss”. The public response to Diana’s tragic death may have been excessive, but it was in part driven by the perception that a vulnerable young woman with psychiatric problems had not been given the support she needed. What’s Hilary Mantel’s problem with royal women?
Dr Gerald Smith
London

Hilary Mantel both elevates and skewers the princess myth in her brilliant exposition on Diana, the people’s princess. The comparison with Marie Antoinette is apt: “Diana’s experience as daughter of a landed family did not prepare her for Buckingham Palace, any more than Schönbrunn prepared the teenage Marie Antoinette for Versailles.”

In 1770, the marriage of the Hapsburg princess, Maria Antonia, to Louis Auguste, heir to the French throne, was arranged for political reasons. Marie Antoinette, as she would thenceforth be known, was introduced to her prospective husband, for the first time, two days before the wedding. She was 14. He was 15 and shy. It is not surprising that their bedding ritual at Versailles was observed to be unsuccessful. The non-consummation of the marriage for the next seven years frustrated all interested parties. A couple of teenagers were responsible for the great union of France and Austria that their marriage symbolised. It had to work. This was politics.

The ex-King Louis XVI was taken to his execution in a carriage. Marie Antoinette was put in an open cart for the hour-long trip to the guillotine in Place de la Révolution on 16 October 1793. Aged 37, in a white dress, hair shorn, hands tied behind her back and on a leash, she could hear the crowd screaming “Autri-chienne!” (Austrian-bitch).
Alison Hackett
Dun Laoghaire, Co Dublin, Ireland

Referring to Lady Diana’s boyfriends as “non-white” (Diana was society’s warning, 31 August) is the fallacy that Plato drew attention to, of dividing all the people in the world into the Hellenic race and the rest, alias barbarians, as is shown if we describe Prince Charles’s second wife as “non-black”.
Vivian Cook
Colchester

Twenty years ago this week a woman died whose charitable work was legion and whose care for others was universally known. Has anyone recognised in writing or broadcasting the memory of Saint Teresa of Calcutta? Thought not.
Edward Thomas
Eastbourne

In reviewing Diana: Seven Days, Tim Dowling says (G2, 28 August) the outpouring of public grief caught those in charge on the hop. Maybe, but one amazing aspect of that amazing week was the speed with which those in charge made and sometimes changed the arrangements for the funeral. The princess died on a Sunday morning. By Monday it had been decided to invite representatives of the charities with which she had been involved to walk behind her coffin to the abbey. On the Tuesday I was chosen as one of the London Lighthouse representatives. We were told the procession would start from St James’s Palace. Then we heard that we would be walking the longer distance from Kensington Palace. Then it was decided that the coffin would start from Kensington Palace but that we, with Earl Spencer and the royals, would tag on behind the coffin when it reached St James’s Palace.

After I had carefully chosen my shirt, tie, socks etc, I got a registered letter from the lord chamberlain saying: “There is on this occasion no formality in what you should wear,” and that I should, if possible, wear a T-shirt with the London Lighthouse logo. These had to be specially made. We were supposed to get them on the Friday but, in the event, I didn’t get mine until the Saturday, the day of the funeral. Luckily it fitted. That was a day I’ll never forget: the heavy silence, broken only by the sound of the horses’ hooves, the tolling of the abbey’s tenor bell and sobbing from the crowds.
Chris Birch
London

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

Princess Diana’s very real role in fighting the stigma of Aids | Letters

I’d like to take issue with the statements about Aids in Hilary Mantel’s otherwise wonderful Princess Diana essay (The princess myth, Review, 26 August). It is not right to say that in 1987 only the ignorant or bigoted thought that casual contact would infect them – or perhaps it’s more true to say that the ignorant and bigoted made up the majority of the population.

In 1987 the US banned HIV-infected immigrants and travellers. 1987 was the year President Reagan first mentioned the disease in public, and the beginning of the UK’s “Don’t Die in Ignorance” campaign. It was also the year that the activist group Act Up was founded, meaning the very beginning of concerted public information. There wasn’t just ignorance about transmission, but widespread uncertainty in the medical community itself. As the New York Times reported in February 1987 in an article entitled Facts, theory and myth on the spread of Aids, “Experts say there is no danger in a peck on the cheek of an infected person but they recommend against any exchange of saliva and deep kissing with an infected person.” Stigma played a huge part in the ongoing nightmare of an Aids diagnosis, and whatever else one may think of Princess Diana, her gesture in touching a person with Aids did occur in a climate of widespread and unnecessary ignorance and prejudice that she did her best to dispel.
Olivia Laing
Cambridge

Ms Mantel dismisses in a one-liner Diana’s impact on the Aids “epidemic” of 1987 referring to “legend”. As best friend and executor of Ivan Cohen, I wish to put into context the very real threat perceived and not restricted to the “bigoted and ignorant”. Ivan was the only person in the special wing of the Middlesex Hospital willing to be photographed with the princess and only on condition that he was photographed from behind. The stigma associated with Aids is difficult for an outsider to gauge in retrospect and Ivan certainly saw it as such. She was indeed instrumental in highlighting the incongruous attitude.
Philip Chklar
Lewes, East Sussex

In 2013 Hilary Mantel wrote a piece for the London Review of Books entitled Royal Bodies, in which she took an erudite and articulate swipe at Kate Middleton and Princess Diana among others. She also referred to a theory, not her own, that attempted to attribute Henry VIII’s terminal decline to the McLeod syndrome, and his wives’ recurrent failed pregnancies to Kell blood group incompatibility causing haemolytic disease of the fetus and newborn.

I wrote to LRB to point out that the theory was based on several false premises and was untenable. Hilary Mantel graciously replied to acknowledge my contribution and to explain that she had raised the matter merely as an interesting idea that encourages us to think more kindly about Henry and his unfortunate wives. She finished her response with a touching personal aside and her observation that “a bit of posthumous sympathy doesn’t go amiss”. The public response to Diana’s tragic death may have been excessive, but it was in part driven by the perception that a vulnerable young woman with psychiatric problems had not been given the support she needed. What’s Hilary Mantel’s problem with royal women?
Dr Gerald Smith
London

Hilary Mantel both elevates and skewers the princess myth in her brilliant exposition on Diana, the people’s princess. The comparison with Marie Antoinette is apt: “Diana’s experience as daughter of a landed family did not prepare her for Buckingham Palace, any more than Schönbrunn prepared the teenage Marie Antoinette for Versailles.”

In 1770, the marriage of the Hapsburg princess, Maria Antonia, to Louis Auguste, heir to the French throne, was arranged for political reasons. Marie Antoinette, as she would thenceforth be known, was introduced to her prospective husband, for the first time, two days before the wedding. She was 14. He was 15 and shy. It is not surprising that their bedding ritual at Versailles was observed to be unsuccessful. The non-consummation of the marriage for the next seven years frustrated all interested parties. A couple of teenagers were responsible for the great union of France and Austria that their marriage symbolised. It had to work. This was politics.

The ex-King Louis XVI was taken to his execution in a carriage. Marie Antoinette was put in an open cart for the hour-long trip to the guillotine in Place de la Révolution on 16 October 1793. Aged 37, in a white dress, hair shorn, hands tied behind her back and on a leash, she could hear the crowd screaming “Autri-chienne!” (Austrian-bitch).
Alison Hackett
Dun Laoghaire, Co Dublin, Ireland

Referring to Lady Diana’s boyfriends as “non-white” (Diana was society’s warning, 31 August) is the fallacy that Plato drew attention to, of dividing all the people in the world into the Hellenic race and the rest, alias barbarians, as is shown if we describe Prince Charles’s second wife as “non-black”.
Vivian Cook
Colchester

Twenty years ago this week a woman died whose charitable work was legion and whose care for others was universally known. Has anyone recognised in writing or broadcasting the memory of Saint Teresa of Calcutta? Thought not.
Edward Thomas
Eastbourne

In reviewing Diana: Seven Days, Tim Dowling says (G2, 28 August) the outpouring of public grief caught those in charge on the hop. Maybe, but one amazing aspect of that amazing week was the speed with which those in charge made and sometimes changed the arrangements for the funeral. The princess died on a Sunday morning. By Monday it had been decided to invite representatives of the charities with which she had been involved to walk behind her coffin to the abbey. On the Tuesday I was chosen as one of the London Lighthouse representatives. We were told the procession would start from St James’s Palace. Then we heard that we would be walking the longer distance from Kensington Palace. Then it was decided that the coffin would start from Kensington Palace but that we, with Earl Spencer and the royals, would tag on behind the coffin when it reached St James’s Palace.

After I had carefully chosen my shirt, tie, socks etc, I got a registered letter from the lord chamberlain saying: “There is on this occasion no formality in what you should wear,” and that I should, if possible, wear a T-shirt with the London Lighthouse logo. These had to be specially made. We were supposed to get them on the Friday but, in the event, I didn’t get mine until the Saturday, the day of the funeral. Luckily it fitted. That was a day I’ll never forget: the heavy silence, broken only by the sound of the horses’ hooves, the tolling of the abbey’s tenor bell and sobbing from the crowds.
Chris Birch
London

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

Princess Diana’s very real role in fighting the stigma of Aids | Letters

I’d like to take issue with the statements about Aids in Hilary Mantel’s otherwise wonderful Princess Diana essay (The princess myth, Review, 26 August). It is not right to say that in 1987 only the ignorant or bigoted thought that casual contact would infect them – or perhaps it’s more true to say that the ignorant and bigoted made up the majority of the population.

In 1987 the US banned HIV-infected immigrants and travellers. 1987 was the year President Reagan first mentioned the disease in public, and the beginning of the UK’s “Don’t Die in Ignorance” campaign. It was also the year that the activist group Act Up was founded, meaning the very beginning of concerted public information. There wasn’t just ignorance about transmission, but widespread uncertainty in the medical community itself. As the New York Times reported in February 1987 in an article entitled Facts, theory and myth on the spread of Aids, “Experts say there is no danger in a peck on the cheek of an infected person but they recommend against any exchange of saliva and deep kissing with an infected person.” Stigma played a huge part in the ongoing nightmare of an Aids diagnosis, and whatever else one may think of Princess Diana, her gesture in touching a person with Aids did occur in a climate of widespread and unnecessary ignorance and prejudice that she did her best to dispel.
Olivia Laing
Cambridge

Ms Mantel dismisses in a one-liner Diana’s impact on the Aids “epidemic” of 1987 referring to “legend”. As best friend and executor of Ivan Cohen, I wish to put into context the very real threat perceived and not restricted to the “bigoted and ignorant”. Ivan was the only person in the special wing of the Middlesex Hospital willing to be photographed with the princess and only on condition that he was photographed from behind. The stigma associated with Aids is difficult for an outsider to gauge in retrospect and Ivan certainly saw it as such. She was indeed instrumental in highlighting the incongruous attitude.
Philip Chklar
Lewes, East Sussex

In 2013 Hilary Mantel wrote a piece for the London Review of Books entitled Royal Bodies, in which she took an erudite and articulate swipe at Kate Middleton and Princess Diana among others. She also referred to a theory, not her own, that attempted to attribute Henry VIII’s terminal decline to the McLeod syndrome, and his wives’ recurrent failed pregnancies to Kell blood group incompatibility causing haemolytic disease of the fetus and newborn.

I wrote to LRB to point out that the theory was based on several false premises and was untenable. Hilary Mantel graciously replied to acknowledge my contribution and to explain that she had raised the matter merely as an interesting idea that encourages us to think more kindly about Henry and his unfortunate wives. She finished her response with a touching personal aside and her observation that “a bit of posthumous sympathy doesn’t go amiss”. The public response to Diana’s tragic death may have been excessive, but it was in part driven by the perception that a vulnerable young woman with psychiatric problems had not been given the support she needed. What’s Hilary Mantel’s problem with royal women?
Dr Gerald Smith
London

Hilary Mantel both elevates and skewers the princess myth in her brilliant exposition on Diana, the people’s princess. The comparison with Marie Antoinette is apt: “Diana’s experience as daughter of a landed family did not prepare her for Buckingham Palace, any more than Schönbrunn prepared the teenage Marie Antoinette for Versailles.”

In 1770, the marriage of the Hapsburg princess, Maria Antonia, to Louis Auguste, heir to the French throne, was arranged for political reasons. Marie Antoinette, as she would thenceforth be known, was introduced to her prospective husband, for the first time, two days before the wedding. She was 14. He was 15 and shy. It is not surprising that their bedding ritual at Versailles was observed to be unsuccessful. The non-consummation of the marriage for the next seven years frustrated all interested parties. A couple of teenagers were responsible for the great union of France and Austria that their marriage symbolised. It had to work. This was politics.

The ex-King Louis XVI was taken to his execution in a carriage. Marie Antoinette was put in an open cart for the hour-long trip to the guillotine in Place de la Révolution on 16 October 1793. Aged 37, in a white dress, hair shorn, hands tied behind her back and on a leash, she could hear the crowd screaming “Autri-chienne!” (Austrian-bitch).
Alison Hackett
Dun Laoghaire, Co Dublin, Ireland

Referring to Lady Diana’s boyfriends as “non-white” (Diana was society’s warning, 31 August) is the fallacy that Plato drew attention to, of dividing all the people in the world into the Hellenic race and the rest, alias barbarians, as is shown if we describe Prince Charles’s second wife as “non-black”.
Vivian Cook
Colchester

Twenty years ago this week a woman died whose charitable work was legion and whose care for others was universally known. Has anyone recognised in writing or broadcasting the memory of Saint Teresa of Calcutta? Thought not.
Edward Thomas
Eastbourne

In reviewing Diana: Seven Days, Tim Dowling says (G2, 28 August) the outpouring of public grief caught those in charge on the hop. Maybe, but one amazing aspect of that amazing week was the speed with which those in charge made and sometimes changed the arrangements for the funeral. The princess died on a Sunday morning. By Monday it had been decided to invite representatives of the charities with which she had been involved to walk behind her coffin to the abbey. On the Tuesday I was chosen as one of the London Lighthouse representatives. We were told the procession would start from St James’s Palace. Then we heard that we would be walking the longer distance from Kensington Palace. Then it was decided that the coffin would start from Kensington Palace but that we, with Earl Spencer and the royals, would tag on behind the coffin when it reached St James’s Palace.

After I had carefully chosen my shirt, tie, socks etc, I got a registered letter from the lord chamberlain saying: “There is on this occasion no formality in what you should wear,” and that I should, if possible, wear a T-shirt with the London Lighthouse logo. These had to be specially made. We were supposed to get them on the Friday but, in the event, I didn’t get mine until the Saturday, the day of the funeral. Luckily it fitted. That was a day I’ll never forget: the heavy silence, broken only by the sound of the horses’ hooves, the tolling of the abbey’s tenor bell and sobbing from the crowds.
Chris Birch
London

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What is the role of patients in healthcare? Live discussion

The role of the patient is changing. Gone are the days when they were a passive recipient of care. Doctors are now expected to engage patients in their own health, care and treatment. There are also a number of initiatives to foster patient involvement in the design, planning and delivery of health services.

With advances in technology, there is scope for patients to have more control over their care. A raft of apps and digital innovations can help keep patients with long-term conditions at home longer. Patients now manage their own health with the support of doctors.

In a column for the Healthcare Professionals Network, commentator Richard Vize wrote: “The ubiquitous availability of medical information is irrevocably putting more power in the hands of patients.”

He added that in the UK, access to information is growing in a random and patchy way, while the ability of patients to use that information effectively in their discussions with doctors and other clinicians is entirely at the whim of the professional who is seeing them.

How can this be changed? What is the role of technology in empowering patients and healthcare professionals? What examples are there of patients being involved in designing and delivering health services? How can patient feedback play a part? Join our expert panel on Thursday 20 July from 12.30pm to 2pm to answer these questions and more.

The live chat is not video or audio-enabled but will take place in the comments section (below). If you would like to feature on the panel or propose questions, please get in touch via sarah.johnson@theguardian.com or @GdnHealthcare (#Gdnpatients) on Twitter.

Discussion commissioned and controlled by the Guardian, funded by Brother

The panel so far

Michael Seres, blogger and devises social media strategies around patient engagement. He was diagnosed aged 12 with the incurable bowel condition Crohn’s disease

Angela Coulter, senior researcher at the department of public health, University of Oxford

Sophie Castle-Clarke, fellow in health policy, Nuffield Trust

James Munro, chief executive, Care Opinion

What is the role of patients in healthcare? Live discussion

The role of the patient is changing. Gone are the days when they were a passive recipient of care. Doctors are now expected to engage patients in their own health, care and treatment. There are also a number of initiatives to foster patient involvement in the design, planning and delivery of health services.

With advances in technology, there is scope for patients to have more control over their care. A raft of apps and digital innovations can help keep patients with long-term conditions at home longer. Patients now manage their own health with the support of doctors.

In a column for the Healthcare Professionals Network, commentator Richard Vize wrote: “The ubiquitous availability of medical information is irrevocably putting more power in the hands of patients.”

He added that in the UK, access to information is growing in a random and patchy way, while the ability of patients to use that information effectively in their discussions with doctors and other clinicians is entirely at the whim of the professional who is seeing them.

How can this be changed? What is the role of technology in empowering patients and healthcare professionals? What examples are there of patients being involved in designing and delivering health services? How can patient feedback play a part? Join our expert panel on Thursday 20 July from 12.30pm to 2pm to answer these questions and more.

The live chat is not video or audio-enabled but will take place in the comments section (below). If you would like to feature on the panel or propose questions, please get in touch via sarah.johnson@theguardian.com or @GdnHealthcare (#Gdnpatients) on Twitter.

Discussion commissioned and controlled by the Guardian, funded by Brother

The panel so far

Michael Seres, blogger and devises social media strategies around patient engagement. He was diagnosed aged 12 with the incurable bowel condition Crohn’s disease

Angela Coulter, senior researcher at the department of public health, University of Oxford

Sophie Castle-Clarke, fellow in health policy, Nuffield Trust

James Munro, chief executive, Care Opinion