MANY DIFFERENT KINDS OF LOVE: a story of life, death and the NHS, by Michael Rosen

I have no doubt that your life, just like mine, has been steeped in COVID-19, and feels as saturated by it as an old, used tea bag. And it’s no wonder. It’s hard not to talk about COVID every day—even if simply to express a longing to see and be with people we love—but also to express fears and worries about those who are infected or might be infected. The appearance of the word “variant” in our language has reinforced our sense of being trapped in a drama that won’t end.

But there are always glimmers of hope. Things unforeseen. About a  month ago, something helpful, thoughtful and moving made its way into my life and has had a very strong impact on me.

A book, of course.

The most topical book you could want to read which is also true, down to its core. It’s beautifully put together, mixing fragments drawn from short, brave messages from the author’s wife; excerpts from an ICU diary in which nurses and other health care workers left daily notes to their patient; and a series of deeply personal and strangely universal prose poems recounting the author’s real-life, unique voyage through the dark and painful tunnel of COVID-19 (the book was published roughly a year after the pandemic began).

It’s a luminous book titled Many Different Kinds of Love, a Story of Life, Death and the NHS, and it’s written by Michael Rosen.

I brought it to bed the night I received it, and read the whole book in one sitting; all 270 pages of it. And then I lay there, thinking and feeling everything I had just read, reluctant to let go of the strong reaction I was experiencing.

The story of Michael Rosen’s nightmarish illness is told in the simplest language, recounting the COVID-19 experiences of a man and his loved ones. His book takes the reader through his entire journey from near death to fragile survival. His narrative is organized chronologically from “Feeling unwell”, to “Going to the hospital”, to “Induced coma”, to “Recovery Part One”, to “Rehab”, to “Going home” and finally, to “Recovery Part Two”.

Michael’s ordeal mirrors what was happening throughout London (England) during the first wave of  COVID that shook the world. Though Rosen was likely among the first large group to fall ill (he was 74 when infected, in March 2020), he was also a father with children still at home, and a vibrant, successful professional life. He was not, in spite of his government’s policy, someone who should be thrown under the “herd immunity” bus.

There were the early days when Rosen was infected, but didn’t know it. And yet…something was seriously wrong. There were calls to 111, (the British version of our 911), which resulted in Rosen’s being told to stay home—to avoid hospitals.  As his condition grew worse and worse, and his complaints of weakness and difficulty breathing continued, Rosen became trapped in a diagnostic loop, vividly described in the book:

The GP has closed.

            A recorded message at the surgery

            says not to come in

            and not to go to A and E.

If you think you might have COVID-19,

            call 111, it says.

I call 111.

I get through to the Ambulance Service

            and talk to a man

            who asks me some questions

            No, I’m not coughing I say.

No, I don’t feel worse today

than I felt yesterday.

He tells me to keep taking the paracetamol

and ibuprofen.

I do.

In the spare room at home

I say to Emma

it feels like I can’t get enough air.

There isn’t enough air.

‘I can’t catch up,’ I say.

There are moments I feel hotter

than ever before.

I shudder as if I am naked

out of doors.

[…]

The doorbell rings.

Emma has asked our friend, a neighbour

who is a GP, to visit.

She gives Emma

a contraption to check if

I’m absorbing oxygen and

waits outside on the doorstep.

Emma Hands it back to her.

She calls out:

“You have to go to A and E right now,’ she says.

“I can’t really walk,’ I say, “I get the shakes.”

just going to the loo.”

“You have to go now,’ she says, “bump downstairs

on you bum,’ she says, I’ll ring them to tell them

you’re coming.’, she says.

Emma drives me to A and E

I am panting.

It’s night.

The road is empty.

The moment I go in

I am surrounded by people in masks.

They put and oxygen mask over my face.”

In this simple prose-poem style, Rosen pulled me right into his story, almost as though I were part of it, and, more importantly, instantly bringing his experience to life.

[Note: A normal  oxygen saturation level is at least 95%. Michael’s was 58 when he was finally admitted to hospital. It is astonishing that he was even conscious. He was told by a friend who is also a physician that with such a number, he should be dead]

His next 48 days were spent at the hospital, in intensive care, his health failing and his family unable to come and see him. 

Michael Rosen

Induced Coma

It is common practice in the hospital where Michael was, to keep a diary at the bedside of each patient who has been placed in a state of induced coma. The idea is that every person who administers any kind of care will leave a message to the patient–a personal message, like this one:

10/04/20

“Dear Michael,

I’m one of your helpers today and we’ve just given you a wash and turned you over so you don’t get sore

I’m normally a speech and language therapist working with children. I have two boys (four and two) and we sing Bear Hunt [a book written by Michael] wherever we go. You’re our hero.

Keep fighting XXX

Claire Elliott-Purdy”

I wonder if this practice with comatose patients is also part of the care Canadians receive. Of everything I’ve read since the beginning of the pandemic, these passages were my favourite and helped me to feel that in spite of what I’d seen and read online, this beautiful secret–the purest sort of human solidarity and compassion–was commonplace, and that it was happening every day.

14/04/20

Dear Michael,

My name is Aime, and I am one of the nurses here in ITU. You were admitted in the early hours of 5 April and immediately intubated. That means that a tube was placed in your throat to help you breathe. You were very sick when you came in and over the next few days you were proned (turned on your front) for long periods of time, this is to help with your oxygen. You have been kept fully sedated to allow you to tolerate the tube and to give your lungs and other organs time to recover. We were very worried about you for a number of days but I’m glad to see that now you are starting to improve and you are receiving a lot less support from the ventilator. You still have some way to go until you recover, but your body is now fighting this virus and I promise we will keep you giving you the best care we can give, until we get you back on your feet.

Best wishes,

Aime

Illustration by Chris Riddell

20/04/20

Dear Michael,

My name is Sara. I’m helping to look after you with Sheeba (urology nurse) and Raquel (infection control nurse) today.

            I normally work as a dental hygienist and therapist in the community but I’m helping out in ITU due to COVID-19. All the doctors and nurses are happy with your progress!

            We have all worked together to keep you warm and comfortable today.

Thank you for your beautiful poems and books you have written, especially the 60th anniversary of the NHS poem, it is beautiful.

            I hope you continue to improve!

            Keep fighting!

            Sara

          

May the fourth be with you!

Dear Michael,

My name is Joe Lynch, and ex-ITU nurse who answered the call to help with the influx of COVID-19 patients in the intensive care. I am writing in retrospect as I have looked after you twice so far. About five weeks ago and also last It is amazing to see how far you have come. I was the nurse who shaved you before a video call with your wife. Sorry to have you clean shaven but you can only imagine how curly your beard had got.

The second time I looked after you I spoke to you a lot. You seemed quite agitated and I know this is such a confusing time for you, I am truly sorry. Everybody says hello to you every day as you have been with us 29 days. Everyone knows you and is rooting for you to keep improving and getting stronger.

Things may seem like a dream when you are here. You may remember vivid memories and images, sounds or even smells.That is very normal.Your family have been sending their love every day.

All the best in your recovery,

Joe (nurse)

17/05/17

18:10

HI All,

At short notice today, the hospital allowed me to visit Mick [Michael Rosen, her husband]. They wheeled his bed out onto the 4th Floor where there is a great views of London so I could sit with him. I played him all the little messages twice and he definitely responded to them.

            He is off the ventilator and was on a low level of oxygen (28%) and they hope they will be able to step him down to the ward (high dependency) soon. They’ve got a programme of music, TV , and radio worked out for him to help him reconnect with his surroundings, and I handed over the IPad.

He has now also had a negative COVID test. Bloody Hurrah!

All love,

Emma x

Michael was released from the ITU a few days later, to begin his long resolve-testing, often harrowing recovery.

Rosen with his wife Emma (post-infection)

Recovery

In this part of the book, more than the others, Rosen lays himself bare before the reader. He survived the invasion of his body and being kept alive by a ventilator, but these left him…well, wrecked. There isn’t a more descriptive word for the challenges he faced. Rosen’s body was so ravaged by COVID that he had to gather the strength, over the course of several months, to come back to life, one finger, one limb, one step, one breath at a time.

“Two people come to my bed

and say they are physios.

They say I need to get moving.

They try to get me to stand up

but I can’t.

When I try to make my legs support me

nothing works.

They stand on either side of me

And prop me up.

The whole of my body is shaking.

I look down at my legs.
They are shrunken, white and wrinkled.

They look like my father’s legs

when he was dying.

I’m panting. Gasping.
Can I lie down? I say.

They say they will come back soon.”

And so it goes, for almost two months, Michael Rosen and his team of physiotherapists and occupational therapists teaching him the most basic actions humans repeat without even thinking, thousands of times, taking each one for granted.

Among the losses the author counts is almost total blindness in his left eye and deafness in one ear. He is also told that his doctors have found 3 blood clots in his lungs. But through it all, there is kindness, patience, and love.

“Emma sends in a furry blanket

and a duvet that has a black and white checked cover.

At last

my hands and feet are warm.

I put my cheek next to the fur

or the linen of the duvet cover.

I feel safe

and strong.

Emma is with me here.”

I loved this very personal and honest narrative of a life reduced to a heart that still beats and lungs that still draw breath.

I was astonished, and deeply moved to realize that the world is full of people like the caregivers who—despite their fatigue, and the fact that for many of them, this was a second work shift—left their personal, handwritten notes to Michael, who was unconscious and as vulnerable as a newborn. I was humbled by my failure to realize much sooner that in health care, there is a roving army of therapists of the body and of the mind –psychologists, psychiatrists, occupational therapists, physiotherapists, dieticians and more—for whom helping people to stand on their feet after life has given them a savage blow is simply what they do.


I am grateful to every person who helped another when times were especially hard, during this pandemic year.

Thank you, also, to Michael Rosen, for his willingness to share the story of the most vulnerable time of his life.

Many Different Kinds of Love is a beautiful book everyone should read, if only because it paints the clearest, most unvarnished picture possible of the ravages COVID-19 can cause, but also of the care, effort, love and compassion that hovers above the sick, given by their caregivers and all those who love them.

“If it’s a road,

I got very nearly to the end.

But then people, many people

pulled me back.
They wouldn’t let me go.

They worked harder than me:

Incisions, tubes, drips

pumps, ventilator.

They sat beside my bed

Making sure that I didn’t

head off to the end of the road again.

I just lay there sleeping

and absorbing.

And absorbing. 

Michael Rosen, Many Different Kinds of Love (2021)

P.S. This is the book that inspired the poem I wrote very recently and that is featured in the previous post.

Note to readers:

The Library does not yet have this book on its shelves. It does, however have 17 of Michael Rosen’s books:

Howler,

Uncle Gob and the Dread Shed

Alphabetical: How every letter tells a story

Send for a Superhero

Little Rabbit Foofoo,

A Great Big Cuddle: poems for the very young

We’re Going on a Bear hunt

Crumble

Bear Flies High

Tiny Little Fly

The Disappearance of Emile Zola: Love, Literature and the Dreyfus case

The Bus is for Us!

And many more…

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