All posts by Ivar Petersen

ENHans, Hans

Don’t look down

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“How do you do it?”
A question I often hear when I give speeches to conferences or participate in discussions, where Hans’ experience with the Health System can be used to improve it. When I reply rather vaguely, it’s not because I don’t want to talk about it, but rather because the answer is complex and developing over time.

I did the eulogy at Hans funeral, 14 days after his death. Even though it was hard to give the speech, it was much harder to write it. When I managed to get through the speech, it was an inner power compelling me, a force stating that I would and should do it. I was helped by still being in shock and by me only superficially – on the factual level – accepting his death. It was simply out of the question, not to do the speech.

In the following weeks, Hans’ story was told again and again to friends, family and journalists. Later, when we got involved in inquests and work around meningitis and various support groups, the story again had to be told, and in a strange fashion you get desensitised  to the actual facts. It’s noteworthy, that on the occasions where the story does visibly move me while telling it, it ‘s when I mention a new detail or when I reflect on feelings I haven’t brought up before.

Complicated as it is, the answer to the question of how I can talk about Hans’ death in front of hundreds of conference participants is easier to answer than the question I ask myself: How can I keep on living? Go to work every day and plan for the future?

I constantly think about Hans and I do nothing to avoid it. His picture is on my phone and my Facebook page. Besides the candle that has been burning since 2/1/17, he has his corner of the house with photos and another collection of photos in the living room. I have some of his ashes around my neck in my silver heart and his autograph tattooed on my arm.  I visit his bench as often as I can to sit and reflect. It will soon be 23 months since he died. That in itself is surrealistic. But the realisation is complete. We have reached a point in our lives where we can think and talk about a future life. A life without Hans. It’s just so much harder when it comes to the present. When Hans died, a meteor crashed into my soul, destroying most and leaving a huge and deep crater. Fellow sufferers often describe the grief as coming in waves, and it seems to me, that those days where I am low – where I’d rather stay in bed and cry all day engulfed in self-pity – are days where I have peeked towards the crater. Occasions where I have dared to think deep – think about my present life without Hans. How I miss a 19-year old living the rest of his life. With football, fashion, girls, friends, study, traveling, music and politics. How he tried to be cool and hide his actual respect for his parents who he would otherwise publicly  find antiquated and make fun of. His compassion when he thought we needed it. How he expressed his love and humor.  I miss the problems. When I hear parents talking about problems with their teens, I envy them. I wish I had problems with Hans… and then vertigo strikes. The empty feeling in the stomach. I have peeked towards the crater and I’m forced to look away. I can’t look down, I can’t think deeply about Hans and take hold of emotions deep in my soul. I remember as a kid, we warned each other not to think to hard about infinity. The story went, that if you by some chance suddenly got your head around infinity, your head would explode! That’s kinda how I feel about Hans.  I fear going mad, if I think too deeply about him missing from my present life. I realise his death on all levels of consciousness, but I keep the consequences hidden for that part of my soul, that is still not anywhere near being able to take it. There might be a day, where my whole soul can take the truth, but until then, I am not looking down.

ENHans, Hans, Philosophy

I am not bothered with birthdays

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I am slowly beginning to understand why for the second year in a row I have chosen not to celebrate my birthday in any way. Last year, it seemed the natural thing to do. It was just ½ year after Hans’ death, and I didn’t hink I had anything to celebrate.

I am currently going through life trying to do the right things. I’ve attended a psychologist, I see friends as much as I can, go to work, volunteer with patient safety, attend grief groups, talk about my feelings – in short, I act as all experts and other grieving parents recommend. One common trait among grieving parents is, that even if we look, sound and act like we did “before”, it’s an illusion. Vi er seeking a new life with new meaning and new values, a life we hope we can learn to live and which we might even at a point be happy to live. Until then, we play ourselves. The role as myself, is a role I know really well and I’m best at playing it – I have after all, been living it until disaster struck.

Back when I saw the film The Da Vinci Mystery the self inflicted torture by the villain just seemed at filmmastic element to increase drama and mystery surrounding the person. I was vaguely aware that selv inflicted pain is about penance and identification with the suffering of Christ. Still without any greater understanding of the religious elements, there are things in my life, which have given me a greater understanding of the entire concept.

Some months ago I suffered from an illness that potentially can be extremely painful. So painful, in fact, that you kan have Opioide pain relief prescribed. I ended up taking 1 Paracetamol 4-5 times during a 1 month period. Without any masochistical enjoyment of the pain, I wanted it. It seemed to me so unreasonable, that I had watched my own son die after suffering immeasurable pain, and then I couldn’t  even stand some pain which wouldn’t kill me.

I think this is how it is with my birthdays as well. It’s like this, that every morning I wake up, I am reminded that I have survived one day longer than Hans. He should not have died before me, and thus every day, is one day too much. A birthday is a representative for the preceding 365 days, where I have survived my son.
That does not call for celebrations.

ENHans, Hans, Philosophy

How fast are dreams, how long do nightmares last?

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With all our individual differences, and DNA, it’s easy to imagine that we are all unique. That no-one else thinks, feels, believes and reacts exactly as we do. My life, as it has formed over the past 16 months, has shown me that the differences are only paper-thin. When it really comes to damage deeper than just the outer layer, we are all very similar. I’m in a group of over 300 parents who have found together over one thing: the fact that we have lost a child. It varies, but when it’s possible to breathe in a forum with so much tragedy and concentrated sadness, it is a place where we can freely communicate with each other about feelings and the things in our new life that are particularly hard . Or just a public place where you can virtually scream frustration over the injustice of life, with the assurance that everyone understands and nobody condemns. When the focal point is the loss of a child, it is truly a cross section of the population. Age, Education, Geography, Background, Extrovert, Introvert … All possible categories are represented. It happens time after time that nearly every time somebody writes about their feelings, about their loss, their struggle to move on in life and about the things that make it difficult, it’s not just me that nods in recognition but everyone else too. The feelings are the same; thoughts, despair, hopelessness … the variations only seems to be dictated by how long since you have lost, not who you are. The reactions and actions are something else – they vary, but the feelings they come from are the same.

When necessary, dreams can be very fast. I consider myself to be a rational person with cognitive abilities above average. I have been in life-threatening and critical situations several times in which I have acted calmly and rationally with an eye for the best approach to the best results. In the morning of 1/1/17 after Hans’s first cardiac arrest, where they got him back to life after 14 minutes of CPR, I recalled that I was asking the doctor what his prognosis was under the various circumstances. At that time, we needed rationality. A little after 16:00, we were in a relatives room when a doctor comes in. He goes to Jackie and me, presents himself and says, “I must tell you that we have stopped treatment.” He does not pause unnaturally before the next sentence, so it takes about half a second to continue. In that half second, I dreamed that Hans had recovered so much that they no longer needed to treat him. Although I knew the prognosis, even though he had been transferred from Hillerød to the Central Hospital with medical assistance and had further cardiac arrest just before … all that was rational and I was too aware of what the next sentence from the doctor would be and my brain could, for half a second, build a defense, a world where Hans had recovered and everything was alright … a dream, to keep the doctor’s next word from being spoken: “Hans Michael is dead.”

Then the dream burst and the nightmare began. I cannot answer how long it lasts. Rationally, I can read from the “old ones” in the group that only after 2-4 years of living a life forever affected by the loss, something resembling something one can call life emerges to be lived and enjoyed. I hear that 14 months “is no time”. I trust it’s right. I now dream of a new life sometime in the future, to replace the nightmare.

Travel, Vin, Wine

The Hottest place on earth!

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The first time we left our Brisbane base was when we went for a week at the Gold Coast/Surfers Paradise. We were invited to stay at a luxury 10th floor apartment right on the beach with a balcony view over the ocean. In the most relaxing way we had quite a tight schedule for the whole week.  Most days we still managed a walk along the beach, the destination typically being some nice café to have breakfast or brunch. 

One day was set aside for a trip on a friend’s yacht. We were picked up from the pier  in a dinghy and taken the short trip out to the yacht. We had remembered the Dramamine which proved to be completely unnecessary: Unfortunately for us, the yacht had been anchored tactically for prime viewing position of the New Year’s firework and thus our hosts were not inclined to take the boat out on the ocean risking loosing their place. So we enjoyed the luxury of the yacht safely anchored in shallow water. We did see (in)famous celebrities sail by and more excitingly wild dolphins very close to the boat, and since the fridge was well stocked and the company pleasant we had nothing to complain about.

Another day we went to Natural Bridge, Springbrook National Park. The rain forest is always impressive with it’s animal life and overwhelming nature. On the way to the Glow Worm cave we saw amazing bird and plant life, as the cave and the surroundings are home to many rare species of animals. The cave itself is not particularly big, but very noisy because of the en-suite waterfall. 

On the way back to the beach we passed through the New South Wales town of  Murwillumbah, a quaint but – we were told – typical town for the area. We also went to Tweed Peak and Point Danger, again amazed at the scenery you find every where you turn. 

We couldn’t come back home not having had a barbecue at the beach, so  one was arranged for  New Years day at 08:00. How that ever seemed to be a good idea, I’ll never know! Well, everyone showed up pretty much on time, and our hosts put on a spread unmatched anywhere in town. It was a good start to the new year.

Brisbane Roar, who’s game we would be attending when returning to Brisbane, were playing Melbourne away, so some of us went to the local Hooters which can be counted on to be well stocked with TV-screens, spicy chicken wings and beer – just a perfect venue for watching the games you can’t attend live.

We also managed to fit a wine-tour into the schedule. We flew to Newcastle for a two-night stay in Hunter Valley. The unit we were staying at was one out of 8 attached units, the setup was perfect with a combination lock, two days worth of DIY breakfast in the fridge and all the coffee you would want. Unit was very nicely laid out with a wooden veranda equipped with BBQ and with a view over a small creek attracting wildlife, particularly morning and night. Second morning we came out to the view of 10 hot air balloons making their way across the valley.  Before settling in, a quick trip to the local shops were in order. Only the essentials, obviously, wine, beer and cheese, mainly… We ventured out on our own to various wine and nature sites, but the main event while we were in Hunter Valley was an organised bus-tour of wineries, a chocolate factory and a distillery.

The wine tour was, erm, different… We were last pickup, so the bus was nearly full – the largest party consisted of 14 English 21-25 year old girls, two of which had brought their boyfriends. It seemed they had been attending a friends wedding, and thought this would be a convenient way to get loaded up front for that days partying. They were loud and thirsty. We started out at Lucy’s Run – named after a dog. It was quite a small winery, only selling at the door, but presentation and wine wise, it was actually the best of the day. One of the guys from the big group of English youth were seated so he got served first when new samples were poured in our glasses. He managed to empty his every time well before the person sitting next to him was served. Hilarious! From there, we went to “The Cellar” for lunch and then onto Allendale.  That has got to be the weirdest tasting I’ve tried. The group was let into a store room with barrels and casks. We were told to “stay put” as we couldn’t be trusted not to steal stuff. The girl presenting the wine did so by arriving with the bottle, mumble a few words about the grape and name of the wine, pour the glasses and then depart again leaving us to wonder in amazement until she repeated the performance after 15 minutes. One of the bottles was not from the winery or the area – actually not even from the same state. No explanation was offered as to why we were tasting that, and she ran off before anyone could ask. By popular demand (mainly from the girls, I suspect) we stopped at a chocolate factory, and then on to a distillery tasting 18 different spirits, mainly flavored vodka. One of the girls from the earlier mentioned group managed an agreement with the presenter, that she was served two tasting samples every time – obviously in order to ensure she got round to all elements of the deep and rich flavors.  The whole bus tour took place about 25km from where they that day measured the hottest temperature on earth. 47C, apparently, though where we were it never seemed warmer than 45C! Weird company and temperature apart, it was fun to visit the different places, though wine educational-wise I wouldn’t say we went home particularly smarter than we went out.

                           

Hans, Travel

Aussie! Aussie! Aussie!

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As Rainman does, we find that our favourite airline is Qantas, and we flew with them from Tokyo to Brisbane. We had applied for our eVisas from home (they are free) and again got through the airport without any problems. Outside customs there are counters where you can buy sim-cards, and since we were going to be in Australia for a while and wanted to access social media on the move, we bought two 10GB data cards with unlimited national calls and SMS for around AU$ 25,- each.

After a short car drive, we arrived at our base in Ormiston, part of Redland City and close to Cleveland, a small suburb outside Brisbane. With a swimming pool, sundeck and day temperatures in the mid to late 30C, we were all set for a long period away from the cold, grey and wet Denmark. We unpacked essentials, rested and then ventured into Brisbane to meet up with the remaining family for a drink at the Riverbar, before a nice meal at the seafood restaurant Jellyfish in the best possible company.

We were still waking up relatively early every morning- typically between 4 and 5am. It gave us the opportunity to work a little online or to watch some of the Premier League football games live! It was initially a strange feeling watching football at 5 in the morning – over a cup of coffee rather than a beer, but I quickly got used to it.
It was also good to get a swim in early. At 7am, the neighbour’s dog was let out, and he objected loudly to the fact I seemed to be drowning whenever I swam lanes, so that was best done before then.  The day after we arrived, we went to one of the many fitness centres located in and around Cleveland. As we knew we were going to be spending some time at the Gold Coast too, it was important to find a centre with branches both places, and we had chosen GoodLife, as they also seemed to have a substantial number of Les Mills classes on offer, not least BodyCombat. I always enjoy taking BodyCombat classes at new places when I am travelling. Obviously, the whole concept is for the class to be familiar (similar) no matter where in the world you take it, but there are always local variations in style and presentations that can inspire to improve my own instructing. A couple of differences I noticed: In Australia for IP reasons, they can’t use the original tracks but have to use covers. That makes the music OK for the purpose, but not as good as the originals. Class exercise always draw more women than men, that’s true for Denmark too, but even more so in the classes I took in Australia. I managed to do six BodyCombat classes in the 3 weeks, and half of the time, I was the only man out of 30+ participants. Other differences were very BodyCombat technical, so I will spare you. The GoodLife fitness centre chain are open 24/7 – they have staffed hours, and when unmanned, members let them self in with a key-card. That seemed to work pretty well. The walk from Orbiton to Cleveland took us through some woods in which, there were known to be koalas. This time, however, our third trip to Australia, we never saw a single koala. Granted, we saw many other animals and we did not exactly go looking for them, but still… Cleveland Marina is a clear indication this is not exactly the redneck outback. Many big and beautiful yachts moored at the piers, and nice cars were parked, waiting for their owners returning back from their trips at sea. Coffee shops serve full breakfasts, all kind of coffees and a wonderful range of smoothies and milkshakes, and on a couple of occasions we made the walk to have breakfast out.

We went on a day-trip to Stradie (Stradbroke Island). A 1-hour boat journey across the bay, and we were ready to explore the island that with its shops and cafés had a kind of Maui/San Francisco feel about it – relaxed. We took the North Gorge Walk from which you at all times had an incredible view over the ocean or the gorge. On the two-kilometre walk, out and back, we saw sharks, rays, dolphins and turtles. We also saw a number of birds sitting in trees and a few eagles in the air probably waiting to make them lunch. Speaking of which, there are great places to eat and drink around Point Lookout! We had however brought our own lunch, which we enjoyed at the picnic tables by Brown Lake. Brown Lake, towards the west of the island, is big enough to have a beach, and we started what we have since made a regular ritual of writing Hans’ name in the sand as we are settling down.

Not all islands accept their island fate. Take King Island visible from Wellington Point. that daily fight to retain contact with solid land. Another day, while the tide was out, we walked on dry sand all the way out to the island. It’s worth paying attention to the tide table. Do not be a science denier; it might still work for the 45th US President, but trust me, the tide will come in, when it is well and ready to do so, and a trip wading back to land in shark-infested water with potholes to the right and left of you, is more excitement than I would volunteer for. Therefore, we stayed only a short while and made it back to Wellington Point and an ice-cream well before the tide came back in.

We would be celebrating the Christmas Holidays, Australia style, but on Christmas Eve, when Scandinavians have their main celebration, our hosts had put up a full Danish Christmas Dinner, complete with all the “right” food, including rice pudding. The fact that I got the whole almond and the prize, was probably due to the fact I personally ate at least half of the whole bowl – even if it took me till boxing day to complete the task. The evening was just one of hundreds of efforts everyone was making to ensure we had the best possible stay. We are so grateful for having friends and family like that!

The stay in Brisbane incorporated a stag night! 16 guys, starting out with lunch, going on a pub-crawl only “pausing” to take in a Brisbane Roar football game before finishing off the pub crawl in style… what could go wrong?  Well not a lot, really. Having said that, though, I have, at a ripe old age of 56, been to quite a few bars, clubs and pubs in my life, and I’ve managed to avoid ejection. During the ½ pub-crawl before the football game, we managed to be asked – ever so politely, mind you – to leave. Twice! I think it was mainly for being loud – there were some of the guys with football referee whistles, the blowing of which for some inexplicable reason seemed to annoy other patrons of the bars. The football game, frankly, was awful. Not only not played very well by either side, but Brisbane Roars were behind 0-2 at half time. The best thing about the game was the Roar’s Danish player Thomas Kristensen who after the game brought a signed jersey for the stag and posed for pictures with some of the inebriated company. What a trooper!

Outdoor sports is a big thing in Australia, the weather and the country lend itself well to activities such as football, rugby, golf, swimming and sailing. Being a Commonwealth country there’s also cricket – a peculiar Marmite sport; typically either hated or loved. A tournament called Big Bash has gained momentum. Based on 20-overs games with a lot of extra activities and entertainment thrown in, it has succeeded in appealing to the younger generation who, I otherwise suspect, would never have been caught present at a cricket game. We went to the Brisbane Heat v. Sydney Thunder game. Due to rain it was reduced to 17 overs, Sydney were batting first and managed a 4-149 against which Brisbane seemed to be struggling until the very last over, where, through a couple of great hits, they won the day and the game, 4-153. The game was OK for result excitement, though I don’t think I am going to make it a habit attending cricket games. One section in the stands was a pool, making it possible to watch the game while floating in a swimming pool. Can’t see it catching on at my local football ground.

While in Brisbane we had 2 embedded holidays. We spent around a week at the Gold Coast/Surfers Paradise and later a couple of days in Hunter Valley, New South Wales. Those trips will be covered in the next installment of my travel log.

We had brought ½ of Hans’ ashes with us to be scattered over the ocean. The plan from back home was to do this on January 1st 2018 – exactly a year after we lost him. New Year ended up being very emotional, a marker in time where it was natural to evaluate what we had been through in 2017. It goes without saying, that the year 2017 was the worst year of our lives. That is, our lives turned from ordinary happy lives before 2017 to disaster from New Year. Having said that, it was the life crushing devastating event of Hans’ death, which made it so. The year itself, oddly as it might sound, was remarkable in its own right. We experienced such an outpouring of love and support, not just from old and close friends, but also from every corner of our network. Many of our friendships have been cemented and we have formed new strong friendships. There is a lot of good in a lot of people out there. When on New Year’s Day it came to the crunch, we couldn’t muster the strength to do it. In the end we left it to the morning of the last full day, we were in Australia. We were up before sunrise and went to the Ocean outside Wellington Point. As we stood with the urn, taking in the spectacular sunrise, a sea eagle made a casual swoop past us, getting a lot closer than I have ever experienced them. We scattered the ashes, and stood for a while as another milestone was passed and then made our way back for the point. Astonishingly, the sea eagle from before came back and made another close fly-by.

The whole Australia trip with Hans’ ashes would always be very emotional, and it was. We had feared coming up to the 1st of January and the scattering of the ashes. As expected, it had been hard and emotionally draining, but we also felt somehow relieved. We were now past first occurrence of every special day: Birthdays, Christmas, New Year, Wedding Day, death day… It had not been easy, but we were through it. As we packed our suitcases and headed towards the airport for the stop in Vietnam, it felt it would from now on be somehow easier working on establishing a new life, a new future.

Food, Travel

Back in Japan

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At the end of 2017, we were going  on a special holiday.
The main destination was Australia, where for some time it had been planned we would go together with Hans before he later in 2018 would do his 1 year gap stay there. We were now bringing 1/2 of his ashes with us to be scattered over the ocean outside Queensland and we had planned it so we would be away Christmas and New Year, and thus the painful 1-year anniversaries.
On the way to and from Australia we would take in old (known) and new, never experienced, places, and we started of going to Tokyo where we had lived for three years back in the mid-90’s.

We flew from Copenhagen arriving Friday 15/12/17 at Tokyo/Narita with SAS after an uneventful pleasant 11 hour flight. Immigration and customs were  straightforward; there is no need for a visa for short stay, all you have to do is to fill out a landing card. 

After customs we went to the Narita Express/NEX counter to buy train tickets for the trip to Tokyo or rather to Shinjuku, where our hotel was located. As always the train departed on time and after an hour and 20 minutes journey we were at the extremely busy Shinjuku station. Hyatt Regency, where we were staying, had a Hotel Shuttle Bus service every 20 minutes, but Shinjuku station is really really big, and we didn’t spend much time looking for the bus before just walking the 25 minutes it took to get to the hotel. One  reliable hotel assistant was on duty about 20 hours a day, 7 days a week – I assume s/he was being re-charged the other 4 hours. S/he would answer questions about hotel facilities and Tokyo tourist sites. The more human members of staff were all service-minded with a single intent of making your stay as pleasant as possible. The hotel was decorated for Christmas as the Japanese like to embrace foreign causes for celebration. Christmas is very big here and Halloween is also being picked up.
The plan for our 5 day stay was to try as many of our favorite Japanese cuisines as possible and to meet up with old friends and former colleagues,

On Saturday morning, we went to our old neighborhood to check on “our” old house, the local temple and our old favorite restaurants. 21 years is a long time, and our local yakitori, alas, was no more. Nor was the local pizza restaurant which over the three years we were in Tokyo delivered quite a number of pizzas to the family! Naka-me-guro high street looked itself. We went into a couple of the old shops, a few of which were even run by the same people as they were 21 years ago. Nakameguro train station, on the other hand had been completely modernised and refurbished compared to the slightly run-down and tatty station we knew from the past.
From Nakameguro we went to Akihabara – the electric city. In the old days you could buy electronics and camera equipment significantly cheaper here than in Europe and in the alley-shops you could find home-made gadgets and novel electronic devices not easily found anywhere else. This time I found prices for camera lenses were comparable to those at home, and the selection and pioneering spirit over the alley shops were somewhat reduced. 

Other shops did remain the same, though, bakeries, for example,  still sold bread in bags with 3 to 10 slices per bag.

 

In the evening, we decided to have sushi at the hotels own restaurant, Omborato, starting in the bar with a Japanese gin and tonic. The meal was excellent, but we did pay for the convenience of not having to travel. It’s possible to get as good and much cheaper sushi out in town.

Sunday 17/12 marked our 34th wedding anniversary. We went to the Meiji Shrine in the morning and had a very interesting lunch at a tiny restaurant serving various noodle and rice based pots with local ecological beer. The monks at the shrine historically did a lot of brewing and produced sake for high and low. The sake was delivered in 25 liter containers, a sample of which is still in my possession, having received it as a farewell present from my team in Tokyo back in 1996. It’s encapsulated in concrete, weighs around 200 kg, will keep a long time but when opened needs to be drunk. Since drinking ½ liter of sake is quite a lot, I will open it when I have gathered at least 50 sake loving people! At the temples and shrines you can write a wish (prayer) to a deity and then attach it to a tree or a stand.  We also came across the “Husband and Wife” trees – very appropriate for the day, we thought.

In the evening we went to our all-time favorite restaurant in Tokyo, Inakaya, found in Roppongi. There are two sections, a larger with two chefs and a smaller operated by a single chef. The chefs sit behind the food on offer with the guests seated in a rectangle around them. Food is cooked in front of you and delivered to your seat by the chef on a long paddle. I can strongly recommend the red snapper, but vegetables and mushrooms are also fresh and prepared to perfection. The temperature in Tokyo, while we were there, never crept above 5C, so we felt completely legitimized ordering hot sake (atsukan)  with our beer. After the meal looking along Roppongi main street you can’t fail to notice Tokyo Tower – their very own copy of the Eiffel Tower.

We went shopping on the Monday, mainly looking for new chopsticks and lacquer bowls. Japanese department stores are huge with an enormously varied selection of goods. All of them now conveniently have “western style” toilets, typically kept very clean and in order. Not all Japanese know how to use a western style toilet, which is why you can come accross some funny signs and instructions. For lunch we went to a standard lunch restaurant where office workers from all the surrounding buildings come for their udons. Sangokuichi is a chain of such restaurants and the food was exactly as good and cheap as I remember it to be. These kind of lunch restaurants typically have plastic copies of the meal outside so you can see what you will be getting.
At night we were meeting up with our friends and former colleagues at a typical traditional restaurants for after work socializing. One of our old friends had organised and had been able to find a restaurant that could cater for one special request I had: I would like to re-try bashimi, which is raw horse. For the whole group we had ordered a set menu, but I had my side-order of bashimi which was delicious. It was so wonderful catching up with everyone after so many years.

Before going to the airport on the Tuesday, we met up with one colleague not able to make it the night before. We had Okonomiyaki for lunch, which was even better than we had remembered. Okonomiyaki is kinda a cross between an omelet and a pizza, with the core ingredients being cabbage, flour, eggs and fish. The name means “as you want it” and it is cooked on plates at your table.

The restaurant we visited, Osakaya, is near Hotel Gracery, which has a big Godzilla on its outside wall and through loudspeakers a roaring sayonara bid us arewell as we made it back to the airport on our way to Australia.

ENHans, Hans, Uncategorized

Reaction to Hans’ Root Cause Analysis

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As Hans‘ parents we are not satisfied having read the Regional Pre-Hospital’s root cause analysis over the course of actions leading  to our son’s death on 1/1/2017.

At a meeting with the emergency services in March, we were told that in a root cause analysis you ask “why” until it stops making sense, and that Hans’ root cause analysis would be conducted by independent highly competent people.

The analysis arrives at a number of causes and action plans, but the causes are too superficial and the action plans too weak.

In the analysis is stated:
“Lack of specific training in very rare but very serious time-critical acute illnesses increases the risk of missing danger signals.“
 There is however no specification as to who will receive this training. All SFVs? The doctors employed? Nurses? The associated action (using the term loosely) is: “It’s recommended that the emergency service focus on ongoing information about rare but acute dangerous diseases, e.g. by using check-lists and seasonal varied postings and in time e-learning” To call this recommendation a weak “action” is almost giving it more credit than it deserves.

The Patient Compensation Board has found it probable beyond reasonable doubt that Hans’ died because of substandard visitation and the Danish Patient Safety Authority has found the Doctor responsible to demonstrate an unacceptable low clinical standard and sanctioned her to be under supervision for a year.

The lack of training (or rather clinical competencies) by the doctors on 1813 is according to the patient compensation board a probable cause leading to Hans’ death, but it is not the root cause. For that you must find the answer to the question: How can there be clinical incompetent doctors as backup for the visitator? Who hires them and why?

The doctors associated with 1813 have a very varied background. Psychiatrists, plastic surgeons, ophthalmologists, gynaecologists, etc.  There are also doctors with no specialty and – even worse – with no significant prior experience with emergency medicine.  Due to a conflict between RH and PLO, there are no (or very few) from the most relevant specialist area: General Medicine. In the original emergency medical care system (“Vagtlæge”), replaced by 1813, the doctors were required to be specialists in General Medicine and to have several years of experience in the field. One of the mistakes committed during Hans‘s course was that the doctor did not diagnose a meningococcal infection. She could/should have done that solely on the basis of the first 20 seconds of the conversation between Hans and 1813, and should there have been the slightest doubt, that doubt would be eliminated on the basis of the photos Hans sends in showing his petechiae and purpura. This is an opinion we share with the Danish Patient Safety Authority.

The purpose of a root cause analysis is to find the root cause behind an incident; thus the name. The motive for finding the root cause is to identify possible institutional or fundamental faults so these can be corrected and future occurences of similar incidents prevented.

This is where Hans’ root cause analysis fails completely. It should, on the basis of his and probably others cases ask:

“Is patient safety in the Region’s Emergency Services  impaired due to lack of relevant specialties and experience among staff doctors?“
The burden of proof that this is NOT the case must lie with the Emergency Services themselves.

It is very worrying that in a root cause analysis, where both the initial visitating person and the responsible doctor lacked both relevant training and experience and are sanctioned for not meeting required professional standards, it is not seen as relevant to draw into question the (lack of) experience and training as a possible root cause. It hard to believe that there should be clinical objective reasons behind not looking at this and we suspect that the potential political consequence of drawing the organisation and basis of 1813 into question has spooked the involved professionals. This even more so, as it comes to light, that the chairman of the analysis team was NOT the independent outside expert we were promised, but rather the CEO of the emergency services. I.e. this person decides whether to question management decisions regarding required skills and experience that he had originally made himself. Very disappointing, but not surprising, that it never becomes a topic.

Here I also want to note, that the argument “Mistakes were also made under the old scheme” as a complete strawman. Yes, mistakes will always be made when humans are involved, but it should be obvious that they are more likely to be made by a doctor with no specialty and no relevant or current emergency  medical experience than by a doctor specialising in general medicin and current year long relevant experience.

Lacking a proper analytical approach to these questions we can only speculate and will also ask:
How many lives will the conflict between RH and PLO cost before they put their squabbles over power and money aside and give the citizens the best possible Emergency Services?

ENHans, Hans, Philosophy

Grief

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Grief is peculiar.
Exceedingly difficult to handle, in reality unbearable and absolutely impossible to describe or explain. None the less, that’s what I will attempt.

Just as ordinary pain, grief and the love it represents, is subjective as it is experienced on the basis of the individual’s identity and emotional profile. To the grieving there are various bereavement support groups that it can be helpful to join. For parents who have lost a child, there’s some comfort and security being with other who are not just grieving, but also grieving for a lost child. It can be difficult explaining to the person who has lost his or her partner or parent why we avoid general bereavement groups when special bereavement groups for parents are available. I would never claim our grief is stronger or worse than others, but I do claim it is different. You can think of it similarly as you think of love. Love for parents, partner and children can not be compared with respect to strength, exactly because they are all different in nature. The love you have for your children is infinite and not least unconditional and that’s what puts it apart from any other love. Love for parents might be similar, but it is still not the same. Here, I believe, we have a possible answer to why bereavement over a child is different from any other bereavement. It’s generally accepted, that grief is expression of love towards a party that are no longer present. And when that love is special in it’s infinite unconditional nature, it’s not so strange that the grief is too.

We are surrounded by the most wonderful people. Family, friends, acquaintances, colleagues – all have the greatest sympathy and do whatever they can to help. Often people do not know what to say when we meet, which is not so strange given there really is nothing to say. Nothing can reduce the pain, the loss or the grief. Typically, we end up with a careful “How are things?” and normally I reply honestly that things are not very well. “It’s improving”, I often say, “but very slowly”.
Occasionally I meet someone who has a desire to demonstrate that they they, to a certain degree, understand what I am going through. It goes like: “I know it’s not the same, but I also got hit very badly when I lost my…” here insert “father”, “mother”, “brother” etc.
I lost my father when I was 17 and I still have unresolved issues from my fathers death, something in connection with Hans‘ death, after nearly 40 years, I am finally beginning to discuss with a therapist. And believe me: It doesn’t even get close.
There was recently an article in a Danish paper, outlining how parents who have lost a child have a shorter life expectancy and a higher rate of sickness and injuries.  Parents die from suicide and accidents. I am in two on-line and one real-life bereavement groups. There are over 200 parents who have lost a child in the on-line groups. I have yet to meet or hear from a single parent who has not at one point or another considered suicide. I have heard of old people who choose to follow their life-long partner to the grave, but I have actually never heard of anyone choosing to follow their parent. There are no-one among the parents I have gotten to know, who in the ½ year has taken their own life, but there are a few for whom I am deeply concerned, primarily because I unfortunately possess the translation guide enabling me to interpret their comments on hopelessness and lack of meaning in life.

Grief is subjective and impossible to explain. I have attempted, well knowing I would fail, but maybe I have still provided a small glimpse into what is happening under the hood. I don’t hope anyone thinks I am claiming that our grief somehow is more important or otherwise more “right” than anyone else’s. I have just noticed – with all of us – an expressed feeling that it is different, and I have now shared my thoughts with you as to why that might be.