This is a story about n^th chances...

Is the UK so short of people with the technical skills and experience that I possess, that I would suffer no career setbacks even if I literally curled out a turd on the table in front of the entire board of directors, having waltzed into the boardroom, leapt onto the boardroom table, lowered my trousers and squatted?

I've been doing more-or-less the same job for 21+ years, and every single enterprise CRUD app for a large organisation is exactly the same as the rest. Yes, I switched from one programming language to another. Yes, I switched from one kind of way of managing a project to another. Yes, I learned a load of technologies that do a lot of 'magic' for me, so my job is 95% plugging things together, and only 5% 'programming'. It's not even programming any more... that 5% is just renaming stuff that you've copied and pasted, so it's not so obvious that you copy-pasted it, and then sorting out a bit of rewiring and configuration.

The last couple of projects I worked on, I got so bored and I had so much spare time, that I was able to do things properly for once - I did things which are hard, so most people don't bother; I was thorough. I didn't cut any corners. When I found the inevitable complex technical problems which defeat most people, I didn't kludge round those problems... I spent those days and whole weeks, tearing my hair out with frustration, to arrive at a "textbook" solution. I should write a frigging book: "How to write nice elegant software in a horrible corporate environment where nothing works like it's supposed to". I guess the title could be a bit shorter.

The main project I worked on last year involved a lot of conversations like this:

• CEO: I want the app to look like this
• Me: I'll make an app that has the essential features, but it'll be ugly, then I'll work on the other 70% of stuff that needs doing
• CEO: Yes, but the app needs to look and work exactly like this
• Me: Ideally, in a year or so, it could do yes, but right now you've only got me, so if you want to launch something in a couple of months, I need to do lots of other things as well as make a pretty app
• CEO: OK, but it'll look like this, right? The design is 100% complete
• Me: It won't look like that because the design includes things that are impossible
• CEO: OK, but it'll look almost like this?
• Me: I think you're getting too hung up on the app. There's lots of other stuff to do too.
• CEO: But it's important that the app looks like the designs we've produced
• Me: I think you should hire somebody else who can tweak what I produce to make it look the way you want it to look, and I'll get on and finish all the other essential bits
• CEO: We already had 6 different freelancers from 6 different countries produce 6 different apps, and each one looks nothing like the design I want. Can you re-use any of their code?
• Me: No
• CEO: OK, well, I'm sure you'll have it all done in 2 months

So, I worked on the thing that I usually wouldn't bother doing, because it's not my core skill, which was to faithfully reproduce the design that the CEO wanted. I spent a lot of time making a really really pretty app. I learned a lot. I stopped being so afraid of UI/UX work. I started to feel quite confident building attractive and complex user interfaces; pretty apps.

Then, onto my bread-and-butter: take a load of data, convert it and store it somewhere, create some means of retrieving it, and create some means of users interacting with it, plus gathering loads of data and analytics on who they are and what they're up to.

Only, almost all my time had been wasted making a stupid pretty app, and when I came to look at the source data which has supposedly been analysed, it turned out that the analysis was total BS. Half the data which the pretty app was going to display to the users quite simply didn't exist - it was fiction; fantasy. "We'll scrape that data together ourselves" said the CEO. The price of a pint in 120 towns and cities. The average rent in 120 towns and cities. The total number of students in 120 towns and cities. The number of nightclubs in 120 towns and cities. Lunatic.

So, I've had occasion to become somewhat obstreperous. Rather than just plod along and ignore the lunacy, and waste my time on wild goose chases and impossible tasks, I've gotten stroppy; I've let my frustration be known loudly and clearly. I stop doing what I'm asked to do - because it's lunacy - and start working towards a finished product.

I wonder how many times I've left a project, and the CEO or whoever has been thinking "thank God we got rid of that guy who gave us a complete working application, and who told us in precise and concise detail all the problems that we were going to face if we continued on our chosen path, which we've repeatedly refused to deviate from". It's actually interesting to see the pretty app that I developed, live in the App Store, exactly how I left it - none of the impossible lunatic things are there, unsurprisingly

Given that each of the 6 previous freelancers had looked at the previous developer's code and thought "nah, this is rubbish, I'm going to throw it away and start again" but whoever it was who took over the complete and working system that I left behind, decided that it was actually exactly what they wanted and needed, so they released it to the App Store.

On another note, I keep getting sick. I work very hard, I try very hard, and I immerse myself it what I'm doing - I live and breathe the projects I get involved in; I care. It's the caring part that's the problem. When you care too much, you get upset and then you start to get frustrated, which is exhausting and it makes me sick. I literally get sick: I get too unwell to work.

I bust my balls, then I get sick. When I get sick, all kinds of bad stuff happens. I might end up in hospital. I might end up in trouble with the police. I might end up falling out with friends. I might end up running out of money. I might end up homeless... who knows? It's anybody's guess how bad things are going to get when I get sick. I've attempted suicide 3 times already.

So far though, nobody seems to have gone out of their way to do life-changing damage to me: to black-ball me from ever being able to work again, to punish me, to give me black marks against my name that would exclude me from civilised society. Nobody seems that keen to see me dumped on the enormous pile of humans who we've decided serve no useful purpose. Nobody seems that keen to prevent me from ever having another chance.

The last couple of projects, I didn't get obstreperous and I didn't get so sick that everything got badly messed up. The last couple of projects, I gave the client exactly what they asked for, more or less... I just ignored the lunacy, and built useful high-quality working software and ignored all the questions like "where's that [impossible/useless] feature I asked for?" and sure enough, they forgot all about it in the end, and they were happy.

In my personal life, I don't know why my misbehaviour when unwell hasn't landed me in more trouble than it has, and ejected me from civilised society and consigned me to a life that a great many of our "unwanted" and "unwelcome" members of society suffer, because they've caused trouble and they're now permanently branded as "trash". It must seem very unjust to those who have been branded as "human trash" to know that the rules and regulations of life are supposed to be applied fairly and evenly, but evidently they are not. Maybe it's because I can pretend to do a posh accent. Maybe it's because I try to remember to say please and thank you lots. Maybe it's just because I've been lucky up to now, but luck won't last forever.

I know people have found my blog and they know that my visible tattoo advertises that I've got problems, but nobody ever says anything, except for the occasional "do you wear contact lenses?" or other hint that they've seen my bespectacled profile picture: my alter ego.

My plan is to try and get myself onto page one of Google (I'm on page 2 at the moment I think) but the truth is, I don't think people - the decision makers - actually care that much, when they find somebody with the skills that are apparently in such short supply that a person like me can limp along and suffer the horrible manic highs and depressed lows in full view of my office colleagues, when economic circumstances force me back into that environment.

Ideally, I'd like to send out my CV and have my email address as nick@manicgrant.com and list my website, as well as including details about exactly what's happened in my life since I got sick. I'll just write a summary of my life and career to date - good and bad - rather than the corporate friendly horses**t nonsense that conforms to the expected standard.

At the moment, do I require mercy? Yes, a little. I'm in a precarious situation. There are a few people who could choose to bring the full force of the blows raining down on my head, but they've been merciful, so far.

At the moment, do I require an n^th chance? Yes of course. I always feel like I'm on the back foot; I always feel like an imposter or a fraudster, even when I've just finished a big project and the client's really happy. I always feel like my not-so-secret website and the stuff that's happened in the recent past - which would usually be confidential - somehow disqualifies me from doing the job that 21+ years of evidence shows I'm very capable of doing to a high standard.

For the first 11 years of my career, I had an unspoken agreement with my bosses: they'd let me have days off sick or come in late when I was depressed, because they knew I'd be so productive when I was manic. It was a system that worked well. The trouble is, with short projects, it's so much harder to establish the trust in that relationship and accept that a member of your team is not a regular 9 to 5 Monday to Friday mediocre plodding drone who doesn't give a f**k.

It would be arrogant and unreasonable of me to expect special treatment in the workplace, or indeed in society in general. I don't know why I keep getting more chances. Do you think it's fair?

Tags: #career #computing #bipolar

This is a story about preferential treatment...

If you Google Translate "Very Important Person" (VIP) into Portuguese, you get "Pessoa Muito Importante" (PMI). It seems like the Portuguese prefer the acronym CIP, but I can't find a definition of what that stands for.

Anyway, as well as getting to spend a couple of days with my friend, I also get to be his guest in the airport lounge reserved for frequent fliers. The big advantage of this is a comfy seat near a power socket, where I can do a bit of work, write this blog post, and otherwise kill time until my flight starts boarding, which won't be for a few hours.

Most of the conversation with my friend during Saturday, Sunday and today, has revolved around middle-class guilt and social conscience. Is it right, for example, that the most wealthy are able to hide their money in Swiss bank accounts and offshore, to shield it from taxation? As a proportion of a person's income or net worth, it's the poor who shoulder the biggest burden in taxes, fees and other things - such as exorbitant interest rates on loans - which prejudice the opportunities of the most disadvantaged members of society, to escape from poverty.

A friend who's a chartered accountant has decided to become an independent consultant, like me. We discussed the tax efficiency of owning and operating our own companies versus paying full income tax and National Insurance on our gross income. Surprisingly, we pay slightly more tax than those who are PAYE (Pay As You Earn) and have their taxes deducted at source by their employers.

Also surprising is the laudable decision of some of my friends who have been lucky enough to become wealthy, to not hide their wealth offshore or in Swiss bank accounts - they're paying their fair share and playing by society's rules; they're giving back to the economies which they profited from. You might say that "laudable" is the wrong word, but there is a considerable burden involved in the administration of complex tax affairs, and the bureaucracy of ensuring that governments receive all the taxes which they are due. Often times, it would be far easier to avoid taxes than to pay them, because there's a whole industry which profits from providing simple and convenient services to the wealthy.

Are we being philanthropic; altruistic? No, of course not. The thing that's driving our behaviour is guilt. We feel guilty that we have been lucky when others have not been. Paying taxes doesn't absolve a person of that guilt, but deliberately avoiding taxes is something extra that the lucky ones should feel guilty about.

What about giving money to charity? Does that absolve a person of the guilt they feel about their fortune in life?

The problem is that a clean conscience can be bought very cheaply. A seemingly large charitable donation might actually be only a tiny fraction of a person's net wealth; a bit of 'disposable' income that wouldn't be missed at all. Even more perversely, tax rules can make a rich person's donation of "pocket change" look like a significant act of philanthropy, while a poor person's unavoidable tax burden is by the far the greater contribution, and yet not recognised as such.

Then, there's the protective bubble problem. If you work on a secure campus or private estate and live in a gated community, you're largely insulated from seeing poverty, homelessness and disproportionately protected from becoming a victim of crime. In fact, just living in a wealthy country, you're insulated from the global wealth disparity created by the subsidies, import tariffs and other economic weapons which are employed to keep the rich rich, and the poor poor.

After 3 days of chatting, my friend and I arrived at the conclusion that we'd have to go through 3 generations of misery to reach a state of global equality and social justice. When I say "we" I mean mostly the wealthiest 2% of people on the planet, which my friend is convinced we can count ourselves amongst; he and I.

How can I disagree with him that I enjoy a life of wealth and privilege which 98% do not, when I'm sitting in a leather chair typing these words on one of my 5 laptops, enjoying free electricity, free food & drink as well as having the leisure time to craft this valueless contribution to the internet's quadrillions of webpages.

It's OK though: I'm a CIP. I deserve preferential treatment.

Tags: #politics #economics #friends

This is a story about dead ends...

Sir Clive Sinclair is a very clever man. So also is Hermann Hauser. So is Dr. Robert Sansom. So are the fellow members of my cohort who were lucky enough to be chosen from a very great number of hopeful applicants for an opportunity to fraternise with Cambridge's tech elite. We were destined for greatness.

The pinnacle - the apogee - of an entrepreneurial career in tech would be the moment when you have the undivided attention of a packed auditorium with a total net worth of tens of billions of pounds. Even if only for 5 or 10 minutes, all eyes are on you. It's your 5 minutes of fame, insofar as any geek can ever expect to have in their lifetime.

With offensive dismissiveness, the egotistical front man who would claim credit for the meeting of these minds, said my co-founder "was last seen with twins around his ankles" (he actually has 3 young children) and that I had returned to my former career with my tail between my legs.

Whatever I do, I think I do it with dedication and I achieve results. I obsess over my goals and I work tirelessly to reach them.

However, I feel old, unwell and somewhat burnt-out; spent.

If intellect was a good predictor of wealth, we'd see a much stronger correlation between the top exam grades, first-class degrees, doctorates and those who have been lucky enough to earn their fortunes, such that they have the financial means to retire early. If you think that a high IQ and studying hard at school and university is going to help you get ahead in life, you're sadly mistaken: you'll be a wage-slave in the rat race, just like everybody else.

I thought momentarily that I had found a tolerable compromise: a way to enjoy the lifestyle of the trust-fund endowed sons and daughters who can rely on family wealth to bankroll their carefree existence, while only sacrificing a small amount of my time each week to rather boring, menial, unethical and demeaning labour. I struck a deal with the devil, as it were.

Realising, however, that I was cash rich and time poor, I started work on projects which far predated websites like taskrabbit.com and mybuilder.com. My dot com - getajobdone.com - might not have been a world-class brand, but this was soon enough after the dot com boom [and crash] that I can claim some bragging rights.

I was too young and inexperienced to profit from the dot com boom, but I was at the very forefront of the iPhone app craze.

But where did it all go wrong?

How did I end up back in my old career, as Jon Bradford so astutely [and offensively] observed?

Fuck you. That's why: fuck you.

I make simple plans which seem fairly achievable, like having a nice little apartment with sea views and a yacht in the marina. Simple plans like having a job where I can drive to work in less than 15 minutes and enjoy a 6-figure salary. Then, it all goes to shit, so fuck you. I have it, then I lose it. I get a taste of it, then it's snatched away.

Where did it go wrong? Fucking everywhere, that's where. Everywhere from breakups to losing jobs - through no fault of my own - to the fact that the world is just a crazy competitive dog-eat-dog awful cut-throat world.

I live a charmed existence, by all accounts, but you should never forget the sacrifices I've made. While the rest of you have been creating clones of yourselves and lining the pockets of the banks with your mortgage interest payments, I've been cut loose in a world which views a man with no family ties with suspicion. In fact, having no family ties and no local connection to anywhere puts me at risk of destitution; total abandonment - I'm one of society's unwanted members. No safety net exists for me.

In 25 hours I'm hoping to be reunited with an old friend whose path through life might see him [incorrectly] labeled as an "overnight success" story. What a world apart, the last 6 or 7 years of our lives have been. How could we ever reconcile the differences in our experiences? Him the millionaire and me the pauper.

To divine where it all went wrong is an impossible task.

All I know is that I'm exhausted and I've got nothing to show for my efforts.

I'm not bitter though, I think. I cherish my experiences, no matter how harrowing and traumatic they've been.

Tags: #career #startups #cambridge

This is a story about the values you raise your children with...

It seems like I have had the sentimental attachment most of us feel towards everything we revere in society systematically thrashed out of me. If you pick one thing that summons feelings of safety, security, comfort, respect for authority and faith in the divine/spiritual, then I will tell you how exactly how I came to question everything: every institution, everything sacred, every tradition, every profession, people who are normally considered beyond reproach and ultimately even existence and its purpose.

Starting with my birth, I'm literally a bastard. I was born outside of wedlock. My parents never married and always planned to remain unmarried, such that I took my mother's surname instead of my father's. Ironically, my mother had once been married, and I have the surname of her ex-husband instead of her maiden name. Confused? Imagine trying to explain that to your fellow pre-schoolers when you're 3 years old. I didn't really understand it at the time, but I understood that I was different; unusual.

My schools would often address letters intended for my parents to Mr & Mrs Grant, and my father would always tell me that I was the only Mr Grant in the house and therefore the letter was addressed to me. My mother would tell me that she was no longer Mrs Grant and she was Ms Grant. "Why not Miss?" I would ask, and she would explain that she had been married, and Miss was only used by women who hadn't been married. If anybody telephoned the house and asked to speak to Mr Grant, my father would hand the receiver to me and say "it's for you", which it never was, of course.

I understood that there was divorce and some of my school-friends were raised by a single parent, or a step-parent. My peers would often ask if my father was my step-father, to which I would reply "no". Nobody could understand how I came to have a different surname from my biological father, or entertain the notion that I could have been given my mother's surname, not my father's.

At some point, a fairly clear question formed in my mind: "why aren't my parents married?". 

The reasons why people get married had become quite clear in my mind, for the very simple reason that I had endured years and years of people's reactions that suggested that not getting married was very atypical behaviour. Nobody wants to feel unusual; freakish. Nobody likes to feel odd.

When I posed my question - "why aren't you married?" - to my parents, they replied with their own question: "why should we get married?". I had a pretty easy answer for them, as I've explained: because that's what everybody else does. "Do you want to be like everybody else?" my parents asked. "Yes" I replied.

[I just burst into uncontrollable sobbing. If it wasn't what you experienced, I don't think you can begin to understand what it's like to spend your entire childhood as the freakish weirdo; the odd one out... the one who's different from everybody else]

Having covered marriage there is a natural segue into the topic of religion, and the origins of my atheism.

For a number of formative and important childhood years I lived in an attractive terraced house in an area called Jericho, on one of the most desirable roads in central Oxford. These houses are the most expensive in the world, far exceeding real estate prices in London, San Francisco and Hong Kong, in terms of their affordability. However, these £1.5 million houses were bought by the first wave of gentrifiers, when academics and young professionals with families started to move into slummy areas because they couldn't afford family homes in the more desirable parts of the city.

When your immediate neighbours include an MP, a barrister, a heart surgeon, a City banker and a number of promenant Oxford dons and professors, their children were raised in an environment which was knowledge-rich and encouraged the exploration afforded by a curious rational mind; critical thinking. Nobody went to church. My friends, whose father was a consultant at Oxford John Radcliffe Hospital, went to Quaker "friends meetings" occasionally, but my peer group - the sons and daughters of the intellectual elite - had little place for God and church in their lives.

We should rewind a little bit, back to the village our family lived in before we moved to central Oxford. If one were to imagine the most quintessentially English picturesque Cotswolds village, with the manor house, the village green, the workers' cottages, the post office and village shop, the village pub, the village school, one should not forget the church and its graveyard. The church's presence and influence is not to be underestimated. My religious indoctrination began as soon as I started school, with the vicar regularly present. Village social events are very often church-linked, like harvest festival, and of course everybody who grew up in such an idyllic village wants to get married in that particular church, have their children baptised there and be buried in that graveyard.

Essentially, the church's opportunity to exploit a child's vulnerable immature mind were scuppered by my father. For everything that the church had a comforting but incorrect explanation for, my dad cited a lack of evidence and instilled in me the skepticism which gradually became integral to my developing personality: "show me the evidence".

When we moved to the centre of a city whose university is globally recognised for its academic excellence, I never encountered another simple-minded fool who had been persuaded to believe in Gods and other aspects of religion, which are so obviously irreconcilable with the pursuit of knowledge. Religion encourages ignorance but I had been raised to question everything and remain skeptical until I had seen convincing proof. "What are atoms made of?" I remember asking one of my friends who lived on my street. "Quarks" he replied. We were perhaps only 5 or 6 years old - the product of a childhood immersed in academic culture, as opposed to the sentimental and traditional.

The disturbing and unpleasant consequences of an irreverent life can impose themselves on a child at a worryingly young age. I've already been uncontrollably sobbing about just one thing - the tradition and sanctity of the institution of marriage - and I haven't even mentioned how a child deals with the concept of mortality and threat of death without the comfort of religion.

A US Air Force pilot who drank at the village pub which my parents later bought and now live in, drunkenly boasted about the ability of the United States to wipe humanity off the face of the earth. I was definitely no older than 4 years old. With my friend with whom I had discussed subatomic particles, we talked about the temperatures which could be reached near ground zero of a fission or fusion nuclear bomb, and how the radiated 'heat' (electromagnetic radiation) had instantly vaporised human beings in Hiroshima and Nagasaki, with only their shadows left behind, permanently etched into the walls of buildings.

If you believe you live in a Godless world with no afterlife you naturally want to know what everything's made of if God didn't make it; you want to know why it's here. How did it get here? Why is it here? You start to pick everything to pieces by iteratively asking what each thing is made of: humans are made of cells, and cells are made of molecules, and molecules are made of atoms, and atoms are made of quarks and leptons... and you can in fact keep asking the question. There's good proof that the electron is not a fundamental particle, as had originally been thought.

When your schoolmates are smart-arse little shits, because their parents are brilliant academics, teachers and school loses its awe and authority. If you're being taught science that's almost 100 years old, and sometimes even 200+ years old, the whole exercise is nothing more than a box-ticking exercise to be endured.

The other thing to consider is that my parents used illegal drugs on a daily basis, and had strong views about the legitimacy and usefulness of the law, certainly in the instances that suited their own addictions. As with many drug users, they were very paranoid. They viewed the police as corrupt and not to be trusted - the enemy. My father's criminal conviction for drugs not only poisoned his views on the police, but also made him very anti-American, as he believed he would never be allowed to enter the country due to his criminal record.

[I'm crying again]

It was only because of first-hand dealings with the police that my viewpoint changed from skepticism due to lack of evidence: the police had never caused me any harm, and in fact I had never had any dealings with the police at all for most of my adult life. You might be surprised to learn I adore and respect the police. My accumulated experience of police encounters has consistently shown that they are some of the most kind, patient, empathetic, forgiving, reasonable people, who have always gone out of their way to bend the rules and simply help as opposed to ever enforcing the letter of the law.

One shouldn't mistake my respect for the men and women of the police force for reverence. I would never for a minute expect that a 999 call is somehow going to be the answer to my prayers. I don't feel safer or more secure, knowing that I can call for police assistance. I wouldn't feel any more comfortable in a stressful situation if there was a police officer present. Of the very many police men and women who I have had first-hand dealings with, they have always treated me very fairly and kindly, and it's quite clear that they deal on a daily basis with a huge number of very vulnerable and damaged people, which they do so with incredible compassion - they are the living embodiment of humanity not deities who should be worshipped and revered.

[More crying]

So if I don't revere priests, vicars, teachers, headmistresses, marriage, religion, military superpowers, soldiers, the police, the law and my own parents, what else is there left for me to lack reverence for?

Cumulatively, I've spent almost 6 months having my life saved in hospital - often in high dependency and intensive treatment unit (ITU) wards. Shouldn't I revere doctors; surgeons?

I think that if there was one thing that would make almost anybody feel more secure and happy in a stressful situation, it would be knowing that there's a doctor present. It's such a clichéd question: "is there a doctor here?".

To explain my irreverence for doctors, we merely need to explore the reasons why I have ever had to deal with one, and the outcomes of those interactions.

Having been lucky enough to escape congenital abnormality, it doesn't take a rocket surgeon to figure out what I want from a doctor and why. You don't need to spend 5 or 6 years at medical school to know that the human body has been dealing with pathogens since the species first came into existence. You hardly have to be brain of Britain to figure out whether you're dealing with a viral, bacterial, fungal or parasitic infection, and furthermore, which is likely to be treatable. In actual fact, I've never been to my doctor for antibiotics: every infection has always cleared up on its own. Fungal and parasitic infections can be dealt with without a doctor obviously: head lice shampoo is available in every pharmacy, without a prescription, for example.

At the age of 28 I went to my doctor wanting treatment for depression, but I knew which specific medications I was prepared to try and which medications I didn't want because the side effects were not acceptable. Having my choices limited only to SSRIs provided firm evidence that doctors were an obstacle to be overcome, not a panacea.

When we think about the first time I was hospitalised, do you think I didn't know that I was going to end up there and what the problems were going to be? Do you think it was an accident that I ended up in hospital?

Again, you don't need to spend 5 or 6 years at medical school to know that the human body needs water, salt, glucose, proteins, amino acids, vitamins, minerals and myriad trace elements, or else the bodily functions haven't got the fuel, carrier fluid and raw materiels they need. You don't need to be a doctor to know that human body temperature needs to be homeostatic as much as possible - much like every other measurable thing in the human body - and any extreme variation too high or too low is going to have dire consequences.

When you are making choices in full knowledge of the likely consequences, medicine ceases to be lifesaving magic, and instead it becomes another simple case of what do you want and why?

One must consider the very last time I was hospitalised to truly understand my irreverence.

Not only had I quite carefully pre-planned my suicide attempt, when I arrived at hospital against my will, I gave very clear instructions: do not put activated charcoal into my stomach, do not perform gastric lavage, do not intubate, do not provide life support and most importantly of all, do not resuscitate. "Do you know what's going to happen?" the A&E doctor asked. "Yes. I'm going to die of a combination of organ failure and serotonin syndrome, with a lot of seizures" I replied. "Do you think you'll be unconscious? Do you think it'll be painless?" the doctor asked. "No. I expect that it will take a long time to die and I'll be conscious and in a lot of pain for most of it" I replied. Then I started having seizures.

Doctors see a lot of people who are scared and they don't understand what's happening to them. They're desperate for somebody who seems to know what they're doing and what they're talking about; doctors are an authority figure. I have no doubt that for feckless simpletons and those who lack access to medicine, the arrival of a doctor or a priest/shamen/witch-doctor is incredibly soothing and comforting. If you don't know what you want and why, your reverence is misplaced, but it may still ease your passage from life to death.

When shit goes bad, who are you going to turn to? If you have to pick your team of people to survive on a remote island, who are you going to pick and why?

Why revere anyone? Why kiss anyone's arse and tell them they're great because they did the study and training that you could've done if you wanted to. You could have passed those exams. You could have gained those qualifications. You could have followed that path if you wanted to. If you wanted it bad enough, you could put on that uniform; you could get that job title; you could prefix or suffix your name with the bit that tells the world just exactly why everyone should drop to their knees and worship you.

Nothing's sacred to me. I could do your job if I wanted to.

I'm not smarter than anybody. I'm not better than anybody. That's the whole point: I'm lucky enough to not have anything that's holding me back; limiting my potential.

I really don't recommend telling your kids they can follow their dreams and be anything they want to be. I really don't recommend telling your kids to question everything, and understand everything about how the universe works, to the point where they reach the very bleeding edge of scientific research. I really don't recommend raising your kids to challenge the status quo and resist the urge to fit in with wider society and their peers.

Take it from me: there's a mind-destroying kind of cold uncaring "nothing matters" bad feeling that comes from being too rational; too much of a free-thinker. Take my word for it: understanding the absurdity of existence will destroy your mental health.

You should probably experiment with hard drugs. That's probably way less likely to fuck up your life than going down the rabbit-hole of picking everything to pieces and trying to reason from first principles and pure logic.

Tags: #philosophy #childhood #parents #oxford #physics #hospital #depression #suicide

This is a story about being unhinged...

A highly paid civil servant decided to doodle this cock onto a poster which was affixed to the toilet door, at a government agency which is responsible for the collection of £6bn in taxes per annum. You'd have thought that the kind of people who clear the stringent security vetting wouldn't be the types to do graffiti in toilets, especially the toilets at the highly secure office.

There's nothing in writing yet, but I'm getting the shove... services no longer required. Project delivered, happy client, but there isn't another project at the moment, and I'm quite expensive to have sitting around doing nothing, although the banks I've worked for have never seemed to care much about that.

It's the worst-case scenario. Contract has finished early and no extension. Nothing that's very appealing in the local area; not a lot of choice... in fact, pretty much just one contract I could apply for, which I'm pretty sure I'd hate.

If I go on my holiday instead of working, I'll lose £3,000 of potential income. That's a helluva expensive holiday, when I could just write off the £600 it cost me for the flights and accommodation. Should I work that week, and use the extra money to go on a holiday which'd be much more suitable for me now I'm single? Should I work that week and simply go on a better holiday, to cheer myself up? Should I work that week and be sensible, and save the money, given that I'm about to lose my income?

What have I got now? No girlfriend. My car is about to be declared unroadworthy. No job. I've only got 2 friends in the local area, and one of them I haven't seen for 6 months and the other I've only met twice. All my money is earmarked for debts, rent and bills. I have no surplus which I can use to have an unplanned break from work - I need another contract.

Wind back to September 9th 2017 when I tried to kill myself. Why did I go through that hospital treatment to save my life and restore me to physical health? Why did I go through that psychiatric treatment, to make me safe to release from hospital? Why did I go though the stress of moving to yet another city where I don't know anybody? Why did I work my arse off and have the misery of living out of a suitcase, staying in a different AirBnB every week? Why did I work my arse off getting security vetted and landing a cushy public sector contract? Why did I spend every spare penny I had getting a car and an apartment? Why did I wine and dine and generally woo and wow a girlfriend? Why did I bother? Why did I think that I'd get anywhere; that I'd make any progress; that I'd ever be able to get ahead in life? Why did I think I'd ever be happy; content?

I'm not sure if I'm a danger to myself, others or both. I'm unhinged. I'm mad. I'm deranged, demented and disturbed. What the hell am I going to do? How the hell am I going to react? Who or what am I going to blame?

Desperate people who believe they have nothing to live for - that their lives are not worth living - are dangerous, aren't they? Can you think of anything more dangerous than somebody who's got nothing to lose?

Fear of consequences is the thing that keeps our behaviour 'in check'. What possible consequence could be used to threaten me or control my behaviour? Why on earth should I behave myself? What reason have I got to give a damn about consequences? I've got nothing to lose.

I've played by society's rules and it's gotten me nowhere because the game is rigged. I've conformed and complied and it's been to my detriment, because there are so many who lie and cheat and break the rules. I had hope and I had things that I didn't want to lose, but now I don't. That's a dangerous situation. That makes me a dangerous person.

I'm liberated. Too liberated. Too liberated for society to tolerate... depending on my completely unpredictable behaviour.

Should I be locked up?

Tags: #suicide #career

This is a story about desperate men...

If you ever wondered about the origins of extremism, you probably think it has something to do with religious fanaticism, indoctrination or some underlying hatred of a certain race, gender or other form of identity. You'd be wrong.

People strap bombs to themselves and blow themselves up because they're marginalised and they feel like they've exhausted all other avenues; their voices are silenced; they're oppressed.

Think about the "lone" part of "lone wolf" and you can see that at the very core of disturbing behaviour is loneliness, isolation... and in a lot of cases discrimination, stigmatisation. Lone wolves are pariahs. They are so often described as "loners" but do you think that loneliness was their choice?

The more we demonise and profile certain groups, lumping them together as probable perpetrators of atrocities, the more we isolate and marginalise them.

It's a self-fulfilling prophecy.

You think you can bully and abuse somebody until they do what you want? You think that the solution to the so-called bad eggs in society is to filter them, block them, ignore them, threaten them and marginalise them? You think that through fear and intimidation you'll achieve anything? You think that by excluding people from the conversation - denying them a platform - you're making the world a better, safer place?

You think you can put locks on your doors and hire muscly men with pointy sticks to keep you safe? You think you can build a wall? You think you can create an impregnable fortress, where you're safe from the dangerous fanatics; the lunatics?

I think it has the opposite effect. The more Islamophobic we get, the more at risk of terrorism we are. The more we perpetuate the lie that all men are violent murdering rapists, the more at risk of incel extremism we are. The more walls and barriers and so-called 'security' and 'defence' that we surround ourselves with - marginalising and excluding members of society - the more lone wolves we create.

If this sounds threatening, I don't mean it to. I'm sad. I'm sad that we have a society that grows more and more fearful, and more and more mistrustful. I'm sad that the net result is this unpredictable, unstable, dangerous world that we live in. I'm sad about it.

If you want to defuse and de-escalate a situation, don't bully and intimidate. Apologise first, ask questions later. Communicate. Lower the defences. Lower your weapons. Take down the fences; the barriers.

Think about who is strong and who is weak. Think about who has the power and the force, and who has none. Imagine the example of the Palestinian children throwing rocks at an Israeli army with tanks, guns, drones, missiles and the rest of its military might. Think about how pissed off those poor people, who are basically unarmed, are about being tyrannised by those with so much power. It's a pressure cooker; a tinderbox.

Why not offer an olive branch; make a peace offering? Why not be the bigger person and back down, even though you know you're far stronger, far mightier and you can crush your opponent in a humiliating defeat whenever you want?

The route to a safer more co-operative and more stable world is not bigger and better weapons, and more henchmen to threaten and bully, it's surely got to be communication, diplomacy and just downright being nice to each other - apologise first, ask questions later.

You might feel self-righteous in your insular bubble. You might feel like you have the moral high ground. It's dangerous territory though. So many tyrants in history thought that they were justified in their actions; their atrocities.

Friends close, enemies closer and all that, eh?

Tags: #relationships

This is a story about warning signs...

One of the reasons why I write every day - and publish publicly - is because it's a healthy habit: I do it when I'm well, or at least not dreadfully unwell. One of the reasons I publish every day is because it gives a lot of clues about my state of mind, and therefore informs the reader about the risks to my life.

For example, I published every single day - without fail - while I was working in London, because I was on the brink of suicide nearly every day. More often than not, if I stop blogging, I'm either dead or dying. If you look at the previous blog posts leading up to the days I stopped blogging, then you'll see plain as day all the warning signs.

The problem is, people get used to hearing a struggling person casually saying "I wish I was dead" and they think it's part of their personality; they think that they're "crying wolf". Trouble is, many of those people will eventually kill themselves, or at least attempt to. There's a lot of bullshit about "attention seeking" and not having to worry about the ones who are talking about it: "it's the quiet ones you've got to worry about". Bullshit bullshit bullshit. There's a lot of bullshit - especially in the medical community - which equates to "I don't think you're really going to do it. Go on! Do it! Prove it! I call your bluff!".

The net result is dead people. Lots and lots of dead people. A man kills himself every 2 hours in the UK. When you visit a doctor and the number one thing that's going to kill you is suicide, and the doctor has the opinion that you're "probably not" going to kill yourself, they're arrogantly gambling with your life.

I get it. It's boring hearing about how awful people's lives are. I get it... it gets REALLY BORING waiting for a suicidal person to finally do it. DO IT ALREADY. I'M BORED OF WAITING. I'VE HEARD YOU SAY YOU WANT TO KILL YOURSELF SO OFTEN, SO I WANT YOU TO DIE SO I DON'T HAVE TO HEAR IT ANYMORE.

Thus, we arrive at the world's longest suicide note. 900,000 words and counting.

Nobody can say "I didn't know" or "we'd have done something if we knew" or "we don't understand".

I've documented in exquisite and unflinching detail, every single aspect of what makes me suicidal.

The photo above is taken using the night-vision mode of my smartphone. The photo is taken through the crack at the bottom of my door. You can see my bike in the hallway, but other than that the image is pretty hard to discern. This is a snapshot of psychosis - I was using the night-vision mode on my smartphone to 'peek' outside my bedroom and look into the rest of my empty apartment, but the psychosis was telling my that my apartment wasn't empty. I was looking for intruders: the shadow people.

My mental illness started as common-or-garden variety depression, meaning that I was planning to kill myself by sellotaping a bag full of pure nitrogen over my head, and asphyxiating. I bought the canisters of nitrogen gas. I bought the duct tape. I found an airtight bag big enough to envelope my head, and leave enough space so I could breathe in the nitrogen. Nitrogen is not a poisonous gas, but it's inert... if you breathe pure nitrogen, you're not breathing any oxygen, and you'll quickly pass out and die.

I bought potassium cyanide. I even put a picture of the potassium cyanide that I'd bought on Facebook and told people what it was and what I planned to do with it. The most notable reply I got was from a 'friend' who was angry that I had it in my house when he brought his kid over to visit... which I did not. It was triple sealed in airtight vacuum packaging, then placed in a hazardous chemical containment jar, then finally it was placed in a locked steel strongbox in my summerhouse - nearly 100m away from the house. His kid must be pretty special to be able to pick two locks, locate the container and open the packaging in order to ingest the deadly chemical. That was the most notable reply. THAT WAS THE MOST NOTABLE REPLY - anger that somebody's child might have died if they had the ability to time-travel and pick locks.

So... nobody gives much of a fuck.

I was immediately discharged as soon as I came out of my coma and my kidneys started working again, following my attempted suicide in Manchester, when I'd ingested enough tramadol to kill an elephant. They didn't transfer me to a psych ward. They didn't put me in a crisis house. They didn't do anything - they just discharged me, whereupon I had to go back to the apartment where I'd tried to kill myself, with its door hanging off its hinges because the emergency services had to kick it down to save me. The first thing I said to the ITU doctor when I came round was "I'm upset that I'm alive. I wanted to die. I told you not to treat me; not resuscitate me. I still want to die". What the actual fuck? Do the capitalists want to exploit me so badly that they'll keep me alive against my will?

There's an 'unsound mind' argument, but my mind is free from drink, drugs, medication and other mind-altering substances. My brain is working the way nature intended through millions of years of evolution. MY BRAIN IS FUCKING WORKING. If I'm depressed, it's because of depressing bullshit jobs, war, famine, climate change, inequality, brutality, bullying, people who don't give a fuck whether you live or die, and people who want you to stay alive so they can exploit you until the day you die of old age and exhaustion. My mind is perfectly sound. I'm having a sane reaction to an insane world.

If I'm not blogging, you should worry.

If I stop blogging, worry.

In a perfect world, I'd tell this fucked up world to fuck off and I'd become an artist. I'd quit my god-awful boring unchallenging piss-easy pointless bullshit job, and I'd go do something creative. I'd be a 'bum'. I'd be a 'loser'. I'd reject 'civilised' society and go have some damn fun. 21+ years in the rat-race full time, and 13+ years in full-time 'education' which was just bullying and absolute bullshit box-ticking for the sake of school league tables. I don't give two fucks about pieces of paper to wave around - they prove nothing - and I don't give two fucks about inflated job titles for work that is ABSOLUTELY USELESS. Take a long hard look at yourself - you're all talk and no action; you produce nothing; your job is completely and utterly useless; you're very busy doing NOTHING.

However I kill myself - quickly by jumping off a tall building, or slowly with drugs and alcohol - it's the same end result. We all die in the end anyway, so I really don't see the point in prolonging the suffering. Cut to the chase. Jump to the end. Skip the awful bit, with the commuting and the BORING BORING BORING bullshit made-up pointless jobs.

Yes, at one point I had lots of lovely holidays and lots of friends, plus lots of material trimmings like sports cars, yachts, speedboats, hot tubs, summer houses, a house, a garden, a cat... then I said to myself "but I'm still depressed that my job is utter bullshit which doesn't do anything of any use for anybody". So I became an electrician. I can proudly say that lots and lots of families have lights, and power sockets, and electric ovens, and electric hobs, and electric showers, and power to their hot tubs, and power to their sheds and outbuildings, and power to their electric gates and power to a million and one other things. Work that I did is responsible for improving the lives of all the tons and tons of families for whom I installed the electrics in their homes. Trouble is 1) people begrudge paying tradesmen, expecting them to work for minimum wage, 2) the work destroys your health, because there's so much brick dust, asbestos etc, and 3) the responsibility for doing a safe installation to safeguard the lives of everybody who will ever be in those houses, is not reflected in the wage or the health damage aspect.

Pushing paper around my desk and pretending to look busy carries zero risk that a mistake of mine might kill somebody, but yet I get paid 5 or 6 times more money... but I'm intolerably bored.

I might as well be an artist. At least with the creative arts, you're paid fuck all but it's lots of fun, intellectually stimulating, free from responsibility, and nobody gets electrocuted to death if you make a tiny mistake... in fact, can you even make a mistake as an artist?

This blog is an artwork; it's a piece of evolving art - it's durational to use the wanky arty term.

But, when the art stops my heart stops.

If I stop blogging, you should worry about me.

Tags: #writing #art #suicide #psychosis #depression #career

This is a story about it being all in your mind...

Uncontrollable shaking, jaw chattering, nausea, insomnia, restlessness, chest pains, elevated body temperature and sweatiness, breathlessness, diarrhoea and stomach cramps - it sounds like I'm physically sick, but I'm not. I genuinely believe that there's no physical reason why I'm experiencing all these symptoms. It's all in my head.

My symptoms are not due to disease, medication, drugs, alcohol, injury or any tangible physical thing. A medical examination - purely physical - would conclude that I'm in good health.

Why do I feel so damn awful then?

It's been months since I stopped taking the addictive sleeping tablets. It's been months since I stopped taking the addictive painkillers. It's been well over 6 months since I stopped taking the addictive sedatives and tranquillisers. It's been about a year since I stopped taking the stimulant I was addicted to. It's been over a year since I stopped taking opiates for the pain in my ankle. I'm completely clean and I recently had 5 days of sobriety, to prove that I hadn't become alcohol dependent and give my liver a break from the booze.

From what we understand of addiction, there are physical addictions, which we treat with substitute prescribing because the physical symptoms are too awful for addicts to withstand, and there are psychological addictions, which are just a lack of willpower and an indication of moral deficiency and bad character. We understand that psychological addictions are easy to deal with - just quit cold turkey and get over it.

It upsets me that I've done all the hard work of getting off at least 8 addictive substances, with 7 of them considered to be physically addictive, but the 8th still has a psychological hold on me, somehow... 1 year later. That's not supposed to happen. In the textbook, once you quit drugs your life becomes amazing and brilliant and perfect and you never look back. Certainly, the textbook will tell you that physical addictions are real addictions, and psychological addictions are not real addictions at all - they're all in the mind.

So why is it that I'm so sick?

If it's all in my head, why do I feel so nauseous?

If it's all in my head, why is my body shaking uncontrollably?

If it's all in my head, why are my symptoms so manifestly physical that other people can notice them?

Addicts are taught to hate themselves. We're told that we're bad people; that our problems are all our own fault. We're told that we have bad character; we're weak; we lack the moral fibre to buck our ideas up and behave properly. We're told that we're worthless scum... worse than worthless, in fact - a menace to society and death's too good for us.

How can it be then, that I've done all the right things and proven my worth to society; I've proven that I can white-knuckle my way through cold turkey and get clean from not just 1 addictive substance but 8. I've done all the right things, but there's still very a real and tangible physical manifestation of my addiction, which isn't supposed to exist because any residual addiction that I still have is psychological apparently.

It upsets me that I've done all the hard work and proven that I've got incredible willpower, yet this psychological problem with physical manifestation still plagues me.

With my bipolar disorder, I have to be very careful to manage my stress levels, make sure I get enough sleep, have a good routine, eat well and generally look after myself, but I still suffer bouts of depression and episodes of mania. I have to be very careful to not get carried away when the early warning signs of mania and the triggers are present. I have to struggle an incredible amount to hide the fact that I regularly have debilitating depression and suicidal thoughts.

With addiction, we're told that there aren't any tablets to treat it, unless it's a physical addiction. My kind of addiction has supposedly been cured, because I've used the only treatment option that's available: willpower. For over a year, I've managed to control my addiction to my substance of choice, by simply willing my addiction to go away.

It seems a little remarkable to me that I've managed to rebuild a lot of my life and I appear to be a very functional fine upstanding member of society, but yet I'm sick enough to cause concern to my nearest and dearest. How can I be so sick when I've been doing all the right things? How can I be so sick when I haven't done anything wrong? I've followed the textbook to the letter, but reality does not correlate with the wishful thinking you find in the textbooks.

In a perfect world, I'd disappear for a month and go lie a beach in a hot country. In a perfect world, my income would be secure. In a perfect world, I wouldn't have Damocles' sword dangling over me all the time. In a perfect world, I'd put my health first and society's expectations and the unbearable pressures on me second.

This is not a perfect world. I'm trying to build a glider while falling off a cliff.

Tags: #addiction

This is a story about triggers...

Having money burning a hole in your pocket is thought to trigger relapses, but I think it's the period of poverty that precedes it that causes the problems. Flush with cash after such a long struggle trying to make ends meet and not go bankrupt, who wouldn't be flooded with relief and be significantly affected by such a rollercoaster ride? Our boom and bust, feast and famine world is highly destabilising to our mental health.

Back in September I found myself jobless, homeless and without enough cash to afford to rent a place to live and support myself for long enough to get to payday. Mercifully a friend managed to get me a job in Warsaw in the nick of time, and I was just barely able to afford to be able to live in AirBnBs until I got paid - I escaped bankruptcy with just £23 left in my bank account the day before my pay finally started to arrive.

Back in February I had to buy a car so that I could get to my new job, tax it and insure it. That nearly wiped me out.

Back in March I had to rent a place to live, and paying the first month's rent, deposit and letting agent fees again nearly wiped me out.

I've spent April praying that nothing goes wrong - that I don't lose my job and that my car doesn't break down. I couldn't afford any unexpected bills - I've been running on fumes, although it wasn't quite as bad as when I got down to my final £23.

My financial distress dates back to December 2016, when the Christmas and New Year period delayed me from getting back into work, and by the time January arrived I was very unwell - I spent 3 weeks in hospital on dialysis and promptly lost the job I'd just managed to get. Things got worse and worse, peaking in July when I had a very large tax bill to pay and I had to leave my apartment in London because I could no longer afford the rent. Out of desperation I took a job in Manchester, which turned out to be disastrous - I didn't know anybody in Manchester and my entire life was in the hands of a company which ended up treating me very badly indeed. I tried to commit suicide.

Working in Warsaw and London during December, January and February, meant I was incurring a lot of expenses, with flights, hotels, train travel, AirBnBs and the other costs of living out of a suitcase. I tried to live off pot noodles and other things that can be prepared without a kitchen, but economising can become impossible when you have to travel around from place to place - I had to re-buy all the things you generally keep in the kitchen cupboards, or carry food around with me without the contents of the open containers leaking and turning everything into a horrible mess.

Finally, I managed to rent an apartment but it didn't have a single saucepan, plate, glass, mug, utensil or cutlery item, let alone all the other myriad things which make a house a home, such as toilet brushes and a million other things you take for granted.

To go on the journey from having less than nothing, to re-entering civilised society and having enough money to keep the wolf from the door, has been extremely stressful and exhausting. I'm still in the process of setting up my standing orders and direct debits so that the council tax, TV license, gas, electric, water, sewerage, broadband and all the other various utilities can be paid regularly every month. I'm still in the process of re-stocking the cupboards with all the things that are needed for daily living.

Yes, my situation seems to be rapidly improving, but there's still so much work to do and I'm still a long way from being comfortable and having a financial cushion in case there are any unexpected problems - there are many more sleepless nights ahead.

I don't mean to moan, because I'm very lucky - things have gone my way and finally getting paid some of the money I'm owed today has a big positive impact on my life. I can loosen the purse strings a little, although I still have to be very careful.

There is of course an impulse to go mad now that I'm a bit more financially comfortable, but that's a reaction to the relief I'm feeling, after so many months of having the threat of bankruptcy, homelessness and destitution hanging over me. My main impulse is to draw the curtains and not get out of bed for a month, because I'm so exhausted and emotionally drained after such a horrible rollercoaster ride.

Because of the way I get paid, I'm not expecting another payday for another couple of months. If I can make it to the next payday it'll be a huge milestone and I'll very definitely be on the road to recovery, but I still have a very challenging time ahead of me.

I hope you don't think I'm moaning. It's always a good day when you get paid.

Tags: #homeless #debt #money #economics #capitalism

This is a story about primary care...

Primum non nocere is in and of itself a non sequitur because the use of Latin and other languages of classical antiquity is primarily intended to deter the hoi polloi from becoming educated. The number of doctors who are able to train, qualify and practice, is something that is tightly controlled in order to maintain high salaries - artificial scarcity - as opposed to allowing the unrestricted proliferation of medical knowledge which might improve the health of the nation.

Those who profess the Hippocratic Oath might be able to stay true to the vow they have sworn if they practice the treatment of acute illness in a hospital - dealing with curable disease and injury - but in the treatment of chronic illness in the community, as General Practitioners (GPs), can we say the same?

If we look at a few obvious statistics, we can see that medicine is failing. Average life expectancies have started to fall and chronic illness has seen a dramatic rise. There is an epidemic of mental health problems, and suicide is the biggest killer of men under the age of 45.

Of course, one might say that the root causes of these conditions are non-medical.

It occurred to me that a significant piece of the NHS has already been privatised, in that many general practice surgeries are owned and operated as private profit-making enterprises. This seemed to present a significant conflict of interest, so I decided to conduct an experiment.

I asked a GP a simple question: when you're treating a patient, do you think about their healthcare needs, or do you think about other things? The reply was shocking.

"It's not about [the patient] it's about everybody else"

I'd had my suspicions for a while - gathering plenty of evidence - that those who profess to do no harm might actually have been corrupted into serving other purposes; into betraying their profession and failing in their duty of care. This was the final confirmation that my worst fears were realised, and there are powerful actors within the healthcare system who place other things above the health of their patients.

By co-opting doctors into the capitalist profit-driven sector of the economy, and by co-opting them into the welfare system, we are asking doctors to choose between their luxury cars, the private school fees for their children, and other trimmings associated with their high social status, versus increased taxes to pay for the welfare state. By placing the most vulnerable people in society in front of the doctors, when seeking incapacity benefit, the government is pitting one group against another.

If the study of economics has taught us anything, it's that people respond to financial incentives. While a GP might argue that they're saving valuable taxpayer money, which might be spent on the NHS, by denying incapacity benefit to a vulnerable member of society, one must also admit that the GP acts in rational self-interest. Less money spent supporting society's most vulnerable means a lower tax burden and more money in the pockets of the profiteers, which include GPs who are partners in their practice.

The first principle of do no harm forbids a doctor from weeding out malingerers based on their best guess. To cut off somebody's incapacity benefit is definitely harmful, and there is no diagnostic test which could decide with a high degree of accuracy who is the malingerer and who is genuinely unable to work. If the doctor in question truly cares about their patients, they would have no option but to choose the option which gives most benefit and inflicts least harm.

We see so many suicides because patients are fobbed off with inferior treatment options, because it's a cheaper alternative to give somebody pills than to give them psychological therapy. While I understand that being cost-conscious might be seen as being pragmatic, it again violates the principle of do no harm. To fob a desperate and vulnerable person off with ineffective medication, when better treatment options are available, is tantamount to negligence. If a doctor has a consultation with a man under the age of 45, they must surely be well aware that suicide is the thing that is most likely to cause their death, and they should therefore treat it as a serious threat to their life. To call people's bluff and knowingly prescribe ineffective treatment is obviously the reason why suicide rates are so scandalously high.

I imagine that some doctors - although egotistical and in love with themselves - have a tiny piece of them that wants to make a difference and save lives. I think that exhaustion and the pressures that are felt by ordinary people are imposing themselves on doctors now, who are struggling to send their children to the best private schools (boo hoo) and are feeling compassion fatigued because of burnout. If we can relieve the pressure on GPs, they may become more willing and able to work in support of their patients' needs, as opposed to "everybody else" (read: being the government's job police).

I strongly believe that we have an urgent need to change primary care, so that it becomes not-for-profit, and patient healthcare can become the primary objective. Perhaps profits are not the primary motivator, but money has a corrupting influence which can be clearly seen when you speak to a GP who is/was a partner of a practice. Co-opting healthcare professionals into the job of coercing vulnerable people into bullshit McJobs, where they are exploited by the capitalists, has absolutely nothing to do with healthcare and is most certainly harmful.

I've witnessed first-hand how this care for "everybody else" - instead of patients - has become shorthand for the compassionless, sympathy-lacking, bullying, hectoring and suicide-inducing grotesquely twisted vision of so-called medicine, inflicted on society's most vulnerable people.

If you want to be the job police, and you think that suicides are an acceptable price to pay, so you can feel superior and send your kids to private school, perhaps medicine is not for you.

Tags: #nhs