Tag Archives: illness

A wedding and a funeral

I’ve wanted to write about this for a long time, but haven’t had the energy. It’s not the easiest story to tell. And I have a feeling that even now, I’ll tell less of the story than I really want to.

Lucy’s Illness

Another person who started the year with a dose of flu was my nephew’s fiancée,  Lucy. However, she didn’t do as well as I did; early in January she went into hospital with pleurisy and various other problems which looked like flu complications. The hospital drained copious amounts of fluid from her chest.

Initially she appeared to be recovering well. But around the third week (the timescales are a little vague in my mind now) she started deteriorating again. A scan revealed shadows on her liver and pancreas, which could have been signs of an infection spreading there, but which of course put other worrying thoughts in our minds. By then she was too ill to have an anaesthetic to take samples from her liver and pancreas. But one from her spine proved to be cancerous, and a sample of the fluid drained from her chest turned out to contain cancer cells too.

A few days after the cancer was confirmed, my nephew Pete was called into the hospital. This was, I think, on the Friday or Saturday. He was told that Lucy may only have a week or so to live, and that if they wanted to get married, they shouldn’t wait for the July date they’d planned.

The wedding

The Sunday afternoon was spent planning the wedding, which took place next day in hospital. Amazingly, all the people who were to take part in the original July wedding were able to get there, at 24 hours’ notice, and about fifty guests were able to attend as well. Lucy wasn’t well enough to get married in the hospital chapel, and there wasn’t room in the hospital ward for all the guests, so there were two parallel services: a marriage blessing service in the ward, and a communion service in the chapel for the rest of the guests.

I wasn’t able to get to the wedding, because I hadn’t recovered enough from my flu to travel down to the other end of the country (the journey just to orchestra and back for a  rehearsal wiped me out). But considering the circumstances, it seems to have been a fabulous occasion, and as close to the originally-planned event as possible. For example:

  • rings were purchased from a local jeweller similar to the ones Pete and Lucy had intended to get
  • Lucy was able to dress as she’d planned for the original wedding
  • a member of the hospital staff made a wedding cake
  • another member of staff (maybe the hospital press officer) took lots of wedding photos—and got one printed out on the day so Lucy could see
  • one of the nurses asked the people who were doing building work outside the ward to take an hour off so it would be quiet for the wedding
  • champagne also arrived, via the hospital staff.

Pete and Lucy were married on January 31st. Lucy died just 15 hours later, early in the morning of February 1st, still wearing the ballgown she’d worn for the wedding, aged 40.

The Funeral

Lucy’s funeral wasn’t held until just over a fortnight after her death; this was largely in order to give as many people as possible the chance to get there, especially since the wedding had been planned at such short notice. It was of course a very sad event, but it was also an exceptionally supportive one. There was a short committal service at the crematorium (which had to be invitation-only because of the number of people expected), followed by a memorial service at Pete and Lucy’s church, where they were originally going to get married.

When I arrived at the crematorium, which was packed, I was immediately struck by the supportive atmosphere. One notable moment in the service was when we listened to the heartbreakingly appropriate song Bye My Love by Brian Houston, which Pete had chosen. I was in a seat near the front, but was aware of everyone getting their handkerchieves out as the song progressed. The gist of the song was “I’ve got to go now, but my love for you remains”.

The memorial service was (as it should be) a wholehearted celebration of Lucy’s life.  It was conducted by a minister who had known Lucy for about twenty years, initially as her student chaplain at university. So his own personal memories of Lucy were included along with those from various family members. It was also done in such a way that anyone could participate meaningfully; not only those with a Christian or other faith. I feel this was really important, since it was obvious that those attending were there because they wanted to be there—there was no sense of anyone being there from a sense of duty or whatever. Everyone wanted to remember and celebrate Lucy, and it seemed to me that they were all able to.

Towards the end of the service, Pete spoke about Lucy’s final moments. How he found the strength to do this I don’t know. I won’t go into detail here about what he said, but it was inspiring and had to do with Lucy embracing her departure from life as fully as she’d embraced living.

Somewhere between 350 and 400 people were at the memorial service. And as funerals go, it was about as celebratory as you can get.

How the year began: A dose of flu

2011 began with a dose of probably-swine-flu. “Probably” because the only way you can be sure about that is to send of a sample of the virus for testing.

The experience was different from what I expected. Just before New Year, I caught what seemed like a fairly normal, but feverish, cold. It came on gradually, over several days. When I’ve had proper flu in the past, it’s come on very quickly: e.g. going from being well to being ill in the space of less than an hour. So I was confident that this wasn’t going to be flu, just a cold. My temperature went up to about 100–101 °F for about three days, which is typical for me when I catch something like that. It stays up for about that long, then gradually goes down again over a few more days, and the cold is over (with the possible exception of a lingering cough afterwards).

This time though, once the three days were over, my temperature continued going up. Friends on Twitter became increasingly alarmed as I reported the daily temperatures.  In particular, it tended to shoot up in the evening, during the gap between one dose of paracetamol wearing off and the next being due. It reached 103.4 °F one day; 103.6° the next; 103.8° the next. And of course it did this over the weekend of New Year, in which the Friday and Monday were both public holidays and the doctor’s surgery was closed. I did my best to drink plenty of fluids, slept a lot, and (surprisingly) managed not to feel too horrible by being very careful about how much I ate and when. My technique was to avoid having a full stomach at times when my temperature was likely to go up.

Unsolicited advice abounded of course, mostly boiling down to

  • Drink lots of fluids, which you already know and are already doing as a matter of course, but we still think we should tell you to do it.
  • Go to the doctor, which is physically impossible while confined to bed and which the surgery have specifically asked people with flu NOT to do, so you can make yourself more ill by travelling there, and so you can irresponsibly infect everyone else while waiting to be told to drink lots of fluids which you already know and are doing.
  • Keep your temperature down to stop us worrying, even though it’s a perfectly normal flu symptom and is probably helping to fight the virus.
  • Here are the symptoms of meningitis which you’re already familiar with. Are you sure it’s not meningitis? You should really get the doctor to check that it’s not meningitis, even though you’ve checked the symptoms umpteen times already and definitely don’t have any of them. Even though you’ve not got any symptoms of meningitis, we’re still scared that it’s meningitis.

Admittedly the temperatures were the highest I’ve ever had except for the occasion when I did have meningitis at the age of 17. But I was surprised not to feel considerably more ill at nearly 104 °F than I did. (With the meningitis, I remember feeling horribly ill and disoriented, sitting on the side of my bed with very little sense of where I was or what time of day it was; feeling nauseous and having a severe but bearable headache; not wanting much light because it hurt my eyes; not being able to put my chin on my chest because my neck hurt if I tried; and my father taking my temperature then saying  either “It’s 105!!!” or “It’s 104.5!!!” in a tone of voice that implied that my temperature had no right to be that high. I remember the symptoms coming on extremely fast. And I remember my mind being too fuzzy to absorb whether my father said 105 or 104.5.)

When I was finally able to ring the doctor on the Tuesday, he cheerfully told me that I didn’t need to worry about the high fever “unless you start coughing up blood or anything like that”, and (surprise surprise) that I should drink lots of fluids. Also he confirmed that it was OK to take ibuprofen as well as paracetamol. So I took ibuprofen doses half way between the paracetamol ones, thereby achieving what I now thought of as “low” temperatures around 101–102 °F and avoiding the idiotically high ones I’d been experiencing. (I was also, incidentally, amazed at the dramatic quantities of sweat my body was capable of producing in the process of cooling itself down by two degrees. Ugh.)

A couple of days later, my temperature started heading back down to more sensible values. The most alarming thing was that it showed no sign at all that it was going to do this: the fever simply stayed up on its plateau for days on end, with virtually no change. And I had a nasty feeling that the infection was trying to work its way lower into my chest. I didn’t fancy the idea of getting pneumonia, or the laryngitis that it was hinting at either. So it was a relief when the flu showed signs of finally improving.

When I finally made it back to orchestra, I was a bit startled when several people said they’d never had flu in their lives. Maybe that’s why I got the odd reactions on Twitter, though. I’ve had real flu three or four times, including Hong Kong flu as a child in 1968, and a flu in 1986 which knocked me out for months, so I tend to assume that people have experienced flu and know how to deal with it (namely by expecting a high fever, drinking enough, resting until it’s taken its course, and calling the doctor if anything happens which doesn’t seem normal for flu or which could be a complication).

The flu left me exhausted for weeks afterwards, of course. But it also had a positive side effect: I’d been trying to get down what I think is my ideal weight (the one at which I feel healthiest), and an enforced week of eating next to nothing brought me within a few pounds of that now-achieved goal.

The next event of 2011 is a much more serious one, involving a bereavement in the family, so I’ll write about that in a separate post. I don’t want any hints of flippancy from this post to spill over into that one. The two are connected though, and part of the reason for my extended silence here is that we were hit by that before I’d had a chance to recover my strength from the flu.

Another new experience

Last week I wrote about the experience of leading an orchestra while under the influence of a cold and its medication.

Another concert

Yesterday I was again leading a concert, with a different orchestra. It’s a smaller, less ambitious one; most of the music this time was (somewhat) less demanding. We played one of Elgar’s Wand of Youth Suites, Schumann’s Cello Concerto, On Hearing the First Cuckoo in Spring by Delius, and Haydn’s “Clock” Symphony. The symphony acquired its nickname from some mechanical accompaniment patterns in the slow movement, which are (somewhat) reminiscent of the ticking of a clock.

However, the conductor had decided that one passage in the “clock” movement should be played, not by the entire section of first violins, but just by me. The music was straightforward, I felt I could make it sound nice, and it seemed to work OK musically. As far as I know it’s not a standard way of performing it, but I was reasonably happy with the idea.

The same cold

Colds take time to go away, especially if you go off and play concerts when you ought to be at home recovering. So I wasn’t yet rid of my mine. But that was fine: I’d found out a week ago how to cope with it, and I was feeling significantly better.

A different problem

Well, fine except for the fact that it had created a new, unwanted challenge. During the week, my left ear had become blocked with catarrh. So I could only half-hear out of it.

This makes a huge difference when you’re playing. The violin is right next to your left ear, and can be very loud. You become used to how loud it should be to blend correctly with the other instruments. With a blocked left ear, the violin sounds as if you’re hearing it from a distance and it’s very hard to know how loud it is. In an orchestra, it can even be hard to tell whether you’re hearing yourself or someone else.

So as the concert approached I was quite nervous about that aspect. As well as the volume, I had very little idea what kind of tone I was producing. All I could really go on was other people’s opinion when asked, plus the physical sensations of using particular bow speed and pressure. I was worried that the solo, accompanied by two wind instruments, would be either far too quiet or far too loud.

In the end I played with the bowing that felt right, and asked people in the rehearsal about the volume. They thought it was OK, so I went with that for the concert. Usually–with a normally-functioning ear–the task is to feel as though you’re playing considerably louder than the other instruments, and correctly judge the amount. Instead, I tried to make the distant sound of my own playing roughly equal to the sound of the other two. I’m not sure whether this worked, but I think it might have done. I got some nice comments, anyway.

It was also hard to hear whether I was putting the necessary dynamic phrasing into the solo. I simply used more or less bow as appropriate, tried to keep the right feel of the bow on the strings, and hoped it was working.

In the past, practising at home, I’ve found a blocked ear provides an unplanned opportunity to hear the violin “from further away”, and the situation can be used for that. Maybe there’s even a practise technique here, involving an earplug. But it’s not an experiment I ever wanted to do during a concert! Thankfully it’s a while now until my next one, so hopefully it’s not an experience I’ll have to repeat.

A cold and a concert

The cold

I’ve had a cold all week. It started to come on on Monday, and got steadily worse, reaching its peak on Friday or Saturday.

Normally this wouldn’t matter too much, but on this occasion one of the orchestras I play in was having a concert, playing Berlioz’s Symphonie Fantastique.

And normally, if I was too unwell to play in a concert, it would be possible to ring or text some of my violin-playing contacts, and find someone willing to substitute for me in the concert. Two problems with that, though:

  • I’d contacted most of them already, asking if they were willing to assist in the orchestra as extra players: so I already knew that most of them weren’t free, and any who were were already playing.
  • On this occasion, I was the leader–or if you’re American, the concertmaster (a much grander term!))

In fact, finding the extra players we already needed had proved a very difficult task, because of there being too many other concerts on at the same time. Everyone was already playing somewhere.

“But surely,” I hear you say, “it’s just a cold. Why does that matter?”

Well, think about it. For a start, coughing and sneezing are not particularly quiet activities. Then there’s the matter of the runny nose and of only having two hands, both of which are fully occupied playing the instrument. How do you blow your nose? And then there’s the mental requirement of a concert: sustained concentration so as to keep your place when counting rests, stay alert to what’s happening around you in the orchestra, and avoid falling into various musical traps (such as entries which don’t occur quite where you’d instinctively expect). And if you’re leading, you’ve also got to use your body language to communicate information to the rest of the first violins, or to the whole string section. A fuddled brain is not helpful, whether it’s caused by a fever or by medication.

And the cold stopped me doing the practice which I really needed to in the week before the concert, as well . . .

So it seemed that

  • I was probably not fit to play
  • I had no alternative but to play

and I wasn’t looking forward to it.

I don’t usually take anything to keep the fever down for a cold unless it’s high enough to make me start feeling particularly ill; research [1] suggests that its purpose is to help the immune system to fight the virus, and that recovery is quicker if the fever (within reason) is allowed to do its job. On the other hand, this was a concert . . .

So on Thursday morning I phoned the local chemist’s for advice on what I could take to enable me not to cough, sneeze or (sorry) drip for a three-hour stretch, and I got some Sudafed tablets (60 mg of pseudoephedrine hydrochloride).

On Friday I tried them out, together with Nurofen (ibuprofen) for the fever, and it looked as though I had a fighting chance of making it through the concert physically. As for the mental aspects, I wasn’t so sure. If I had enough concentration for the reahearsal, would I have any left for the concert? Would I absorb any information from the rehearsal anyway? And what about the passages which I’d planned to practise during the week but hadn’t, because of being ill? Would I have my wits about me enough to make up for that?

The rehearsal

The day had the usual pattern for the orchestras I play in: three-hour rehearsal in the afternoon, concert in the evening.

In the event, things went better than I feared. I was still a bit fuddled, but the Nurofen did a good job of keeping my temperature down enough for my brain to be reasonably functional. But it was also a state in which I clearly couldn’t concentrate very hard.

In fact, though, it can be an advantage not to concentrate too hard in the dress rehesarsal. One skill, learnt over time, is that of managing the amount of mental energy you use, so as to have enough left for the concert. I always maintain that during the rehearsal you should concentrate enough to notice your mistakes, but not enough to avoid making any. People laugh at this. But I’m serious. As you make mistakes in the rehearsal, you accumulate a mental list of things which could go wrong; as a result, you’re prepared to watch out for them during the concert and give them special attention so they don’t go wrong. Whereas if you play stunningly in the rehearsal, you neither know where the pitfalls are, nor have enough concentration and energy left to avoid them. I think this is the truth behind the popular saying that a “good” rehearsal means a bad concert and a “bad” rehearsal means a good concert.

Anyway, I played during the rehearsal with the concentration I’d got–which wasn’t much. I was relieved to discover that that the passages I’d been worried about, and hadn’t been able to practise during the week, had nevertheless improved. They’d been going through my head all week; I have a theory that when this happens it’s a sign that some unconscious “internal practice” is going on. I don’t know whether this theory has been tested by any research.

I was also relieved, instantly, to find myself automatically doing the necessary body language for entries, accents and so on, despite my lack of concentration. In fact it was even happening when I felt quite disconnected from my surroundings and from the rehearsal. I think this means that as far as the brain is concerned, it’s just another set of learnt techniques like those of playing notes on an instrument. Once you’ve learnt and practised them they become automatic, just as notes which have been learnt become automatic.

The concert

After the rehearsal the medication started to wear off and I began feeling decidedly grotty again. I waited a while, timing my next dose to take effect properly before the beginning of the concert and not wear off before the end. I started the concert with rather less concentration available than I really wanted, and concerned that maybe I’d overdone the rehearsal. Would I be able to sustain my concentration through the concert?

What you do in this situation is to ration the concentration. The more you’ve practised the music, the easier it is to do this, since more of the playing happens automatically. (This had been one reason I was worried during the week about not being able to practise). The idea is to conserve energy as you can. You play the straightforward passages in “automatic mode”, and “wake up” for the problem ones. And you know where the problem ones are: you found them in the afternoon, by not trying too hard. While you’re playing the straightforward stuff, you can be reminding yourself “The entry near the bottom of the page happens in a tricky place, so it’s really important to count the rest just before it” or whatever.

And you mustn’t waste energy on anything other than playing the music. Mentally, it’s a matter of quietly keeping your place in the music, keeping an eye on your playing, and being prepared for the next bit. If you start thinking about train times home, or worrying about the difficult bit that’s coming up–as opposed to just reminding yourself what you need to do to play it–then you’re wasting energy. It’s not a matter of “concentrating hard”–that uses energy too–but of gently bringing your attention back where it should be. And when there are points where you can relax, it’s important to use them to relax.

By the way, I think physical and mental relaxation while playing are often quite distinct things. Some passages require no mental effort at all to play, but are physically quite demanding. Here, your mind can relax but your body has to put in the effort. On the other hand, “rests” in the musical sense can be anything but restful mentally. Clearly you have to count them accurately, and you can’t relax from that activity until you’ve started playing again. (And there are pitfalls. Some rests can be very stressful to count. I’ll write more about that in another post; for now I’ll just say that it can be made less stressful if you’ve got practical techniques for it.)

What should while you’re counting a rest is that your body relaxes as completely as possible, while your mind counts the rest. But what can happen is that if the rest is a tricky one, the mental effort of counting makes you tense up physically in sympathy with it. So maybe learning to relax your body and mind separately from each other is another skill of musical performance which one learns.

The concert went pretty well. My memory of it is mostly of being in a rather stupefied state, of using all these energy-saving techniques to get through it, and of some rather unfortunate intonation from one of the extras in the brass section during the Dies Irae section of the final movement. But as the brass player wasn’t one I’d invited, that wasn’t my fault.

Anyway the audience reacted positively, the concert went as well as it could, and I was surprised afterwards when an audience member commented “You led really well”–from my point of view I’d mostly been trying to make sure I survived to the end with no disasters, really. It was an educational experience. But next time I lead a concert I’d prefer to do it without having a cold, please.

Footnote

[1] Maybe one day I’ll get round to looking up the various pieces of research I keep mentioning in my posts and linking to them. Many of them have been mentioned in science news releases at ScienceDaily. For now, you’ll just have to trust that I’m not making them up. [back]