This is a personal as well as a scientific blog, and as such is being posted on both my websites. My BMI currently puts me into the obese category. I have often said that I don't have an issue with food – I just like it too much. I may be fit and obese, running half marathons, but I can still be damaging my joints and my heart, and risking type 2 diabetes.
But now, in the time of Covid-19, obesity puts me at a higher risk than the rest of the population should I become infected.
How big is the risk?
In patients under 60, obesity is a risk factor for hospital admission. In a US study, patients with a BMI of 30-34 were around twice as likely to be admitted to acute or critical care, compared with those with a BMI of less than 30. In patients with a BMI of over 35, the likelihood of being admitted to acute or critical care rose by 2.2-fold and 3.6-fold, respectively. Higher numbers of obese patients require invasive mechanical ventilation.
The OpenSAFELY collaborative carried out a review of electronic medical records of patients in England. According to the results, having a BMI of between 30 and 35 (obese) increases the risk of hospital death by 1.3-fold. This climbs to 1.6-fold for a BMI of 35-40, and a BMI of greater than 40 (morbidly obese) more than doubles the risk of death (2.3-fold). Because the science is moving so quickly, this preprint has not yet been finalised or assessed by experts (peer-reviewed).
The science behind the difference
Being overweight generally makes it harder to breathe, and is known to be a risk factor in respiratory diseases such as asthma, sleep apnoea, acute lung injury and acute respiratory distress syndrome.
There are a number of theories behind the increased risk of more severe illness and death related to Covid-19 in people who are obese:
Looking at the futureMy weight has gone up and down over the years. My biggest gains were in my thirties, and I lost three stone before I got married in 2009, giving me a BMI of 24. During my marriage and following bereavement, the weight went right back on.
But it's not just me. The most recent Health Survey for England (2018) found that 67% of men, 60% of women and 28% of children were overweight or obese. As SARS-CoV-2, the virus that causes Covid-19, is likely to stick around for some time to come, tackling obesity is going to be important.
As part of COUCH Health's mission to improve 1 million lives by 2022, I have pledged to lose weight as part of a challenge alongside my friend and medcomms colleague, Ash Rishi. It has been up and down during the lockdown, but I'm going to try again, driven by the excess risk of Covid-19, using the evidence-based and NHS-backed Low Carb Program.
I need to place this post in some kind of context. It was written some days ago when I was feeling angry with the whole of the universe. I hurt, and I just wanted to bleed onto a piece of paper. I talked to a couple of very wise friends about whether to post it (you know who you are – thank you), and they both, independently, said 'why do you want to post it?'
I've been thinking about that. And I think I want to post it to say that this is how I have been feeling, and I know I am allowed to feel like this. And if it's how you feel, then you are allowed to feel like this too. But I am determined. I have made it through bereavement to get here, and no virus is going to stop me now.
In the words of Julian of Norwich, even though it doesn't always feel like it, 'all shall be well, and all shall be well, and all manner of things shall be well.'
It was supposed to be my time.
I worked to support my first husband so that he could achieve his dream of being a freelance music producer. We needed my income to help to buy the equipment, and also to buy food, to pay the mortgage and to feed the cats when he stopped his full time job. But before he became established and started making money, our marriage broke up, at least in part because there was someone he would rather be with. And during all this I got made redundant. But I kept on working.
Tim found me, and picked me up. And I worked to support us, and we developed his bookshop together. It was our investment and our future, and he worked full time and then some, and then some more. But it needed my income as well as his to work, along with some very generous help from his parents, to make it work. He was so desperate for me to know that it wasn't just up to me, that he was doing everything that he could to make it right for us, and that he didn't want to let me down. Then, just as it became successful, and his name known nationally (and internationally), he died. Sometimes I worry that he worked himself to death for me.
So, I worked all hours over the next couple of years to hide from grief, pay off debts and to build up a bit of money.
And then. It was supposed to be my time.
I began the MA in Writing for Performance at Derby University, paid for by selling Tim's stock. I went to university where nobody knew me so that they could know me just as me. Not as a widow, unless I wanted them to know that. Not as my ex-husband's partner. Not as Tim's partner. Not who I had been. But as who I am now.
I got a good grade for my first piece of coursework. I started psychotherapy in Derby to get my head round my grief and my depression. I did contract work so I knew I could have three or four paid days of work a week while I was studying.
I started making contacts with theatres, planning how I could get known to the right people there. Booked solo trips and trips with friends to theatres to get a feel of how plays were written and performed. Saturated myself in audio drama. Started to get a feel of how I could craft my words for stage and radio.
And then it was the coronavirus' time.
I knew alone on a scale that I had never known alone before.
My contract work dissolved, but I wasn't eligible for any of the government hand-outs. All the theatres shut so my planned trips were cancelled. All the scratch nights were cancelled. News started to come in of the smaller theatres that would never open again. The larger theatres that would struggle and only get through once they opened again (if they opened up again) on known writers and known plays. The theatres that would be unlikely to accept an unknown new writer.
The imposter syndrome genie invaded my head, to ask me who I thought I was to consider that I could write well enough to ever be on stage or radio, and to tell me that the coronavirus was the universe's way of telling me that I might as well give in now.
The university closed, though fortunately I had completed almost all my sessions for this academic year. And now I have no idea whether lockdown will be over by the beginning of the next academic year.
And this was supposed to be my time.
Not sure why I needed to write this today. But I did.
Tim and I had a fairy story. We met in our early twenties at a youth prayer group. I had other commitments – a boyfriend called Paul – and Tim sighed gently, tucked the candle he held for me in his back pocket, and we became friends. We stayed friends through thick and thin. Through his troubled times. Through his diagnosis with type 2 diabetes and his hospital stay for a rather scary bout of acute pancreatitis. Through my marriage falling apart and my descent into depression. And finally, through my divorce.
I was separated for two years, though Paul and I continued to live in the same house, and over this time I fell in love with Tim. With his kindness and his humour, his ability to tell stories, his love for films and books and cars, and of course, his adoration of me. I have never been loved so much.
Tim proposed in a motel in France, just as we were going to bed. I think he may have still been in his knickers and socks. I said no, but only because the divorce wasn't yet final. He proposed for the second time as we looked at a beautiful channel-set diamond and white gold ring in the window of a jeweller's shop. It's still on my finger.
We married at the church where he was christened, and where his grandparents are buried. It was a day of sun and joy and light and family and friends, and he was my beautiful boy, his face full of happiness. Our honeymoon in Greece was sweet and quiet, with time just the two of us, and time with Tim's wonderful godfather and namesake Tim, and his lovely wife Aphroula.
We moved to Tideswell, to the house where I still live, and he created his bookshop downstairs. I worked upstairs in my office, and we would talk many times a day. My favourite moments were getting up early to work and then snuggling back in bed with him before we both started our days for real. I also loved heading downstairs with a cup of coffee for him, and on Wednesdays for Fiona too. We would hug the warm mugs and talk about everything and nothing.
Unfortunately, not all fairy stories have a happy ending. Eighteen months before our tenth wedding anniversary, the morning after a wonderful night out, and with no warning at all, Tim breathed for the last time. Despite CPR, and me pumping his chest as I screamed down the line at a wonderful phone handler, and despite work by indefatigable paramedics, he never breathed again.
In a broken parody of our mornings together, I curled up next to his still warm body. I tucked my head into his neck. I inhaled his smell, and kissed the soft skin behind his ear. Fiona held my hand. Simon and Gillian, my dear friends, anointed him and sent him on his journey.
And then I had to do the hardest thing I have ever done. I had to call his parents. I had to call our friends. I had to call my family. So many calls. Telling the same story so many times. Accepting the kind wishes, the love. Managing their grief as well as mine. The rest is numbness. Sleeping alone that first night. Organising a funeral and burial at the church in Somerset where we were married, with the ceremony carried out both times by the same old friend. Organising a memorial service and wake back here in Tideswell. Accepting a life where he was never going to be back, however hard I wished.
It's now two years. I have the same life and a different life. I have my old friends, and I also have the friends I thought I would never have. The friends joined in grief for losing a partner too young. I am at university, studying something new. I am moving forward (I don't say that I move on) and I have travelled, run, written, laughed and learned.
But I still grieve. I think I always will.
I'm starting to sort out again. The lengthening of the days is bringing back a little of the energy and attention that has been missing for half a year, through a summer of lost purpose and a winter of anniversaries. Memories, dusty as ghosts, come rising out of dented cardboard and crumpled carriers.
My first poems and stories, hand-bound into books with board fronts and backs.
Craft projects kept carefully by my parents over many years, and brought home when I cleared out their house for the last time. My parents' wills.
Love letters from my ex from before we were married. Evidence of his love in my hand where it once was in both of our hearts.
Pictures and paperwork from houses I bought with my ex, including the house in Doncaster that was to be the fresh start for a struggling marriage (I thought) and that turned out to be the step closer to its finish.
Divorce paperwork. Condensing 14 years into just a few pages. Startling in black and white.
The contract for the house in Litton Mill that was a river-lined retreat from the chaos and became the start of my life version 2.
Tim's tenancy agreement from the house in Dadford where things began.
Tim's statements and pay slips. Scraps of paper filled with his spidery writing. Notes left on my desk. Cards from him, loaded with so much love it spilled over the sides.
The estate agent's flier for his beloved shop, now empty, and this beautiful house, now holding only half the love it did. The place where things ended after a decade filled with sweetness.
In August, September and October I will be running two half marathons and three 10ks in a Diabetes UK vest to support and publicise Diabetes UK. I chose this charity because my beloved husband Tim had type 2 diabetes. He was starting to lose his sight from the disease. Then he suddenly and unexpectedly died in February 2018 at the young age of 50 when his heart failed, a complication of his diabetes. The money from selling Tim's record collection has gone to Diabetes UK, and 10% of sales of his model kits on Ebay is going there too.
Diabetes UK is a brilliant charity that provides support and funds research in type 2 diabetes, and I support it so that others might not have to go through what I have.
There are also other reasons why I run. As well as raising money, running helps me live with my depression. It helps me fight grief. It keeps me fit. It shows people that not all runners have perfect runner's bodies. And it reduces my personal risk of type 2 diabetes, a vile disease.
If you would like to make a donation, please go to my Just Giving page. But I know that not everyone can, and I have asked for money a number of times over the past few years. So if you can't donate, or don't want to, can you still spread the word about Diabetes UK?
Support people you know with diabetes. If you are diagnosed with it, or with pre-diabetes, take it seriously. Type 2 diabetes steals your sight. It destroys your heart and your kidneys. It damages feeling in your hands and feet. It leads to amputations. It shortens your life. It takes you away from people you love.
Think of me or wave me on when I run at:
Leigh 10k - 11 August
Wigan 10k - 1 September
Great North Run - 8 September
Stephen Price Memorial 10k, Ashton on Trent - 15 September
Manchester Half - 13 October
I've just bought a new shredder, and now my office carpet looks like it's been hit by a cellulose snowstorm. I'm going through a huge box of papers and getting rid of anything older than five years.
There's a satisfaction of pushing sheets of paper into its tooth-lined maw, and filling paper sacks with shreddings for recycling. It is making me think of things that are no more. Cars, houses, cats, jobs. And marriages.
There's a lot of Tim's paperwork in here. Payslips, bank statements, bills, receipts, car documentation. And always the challenge of seeing his writing. I can't keep it all but there is part of me that feels guilty getting rid of it, as if I am erasing him.
There are some things I'm keeping, though. An old driving license. His invitation to his cousin's 21st birthday party. The receipt from a wonderful; holiday in the Loire Valley. Notes that he left on my desk. It's a balance between preservation and decluttering, and the most valuable things there are I still have. My memories of him.
I've lived with depression for many years – since my teens at the very least. And it's not as a result of anything. No childhood trauma, no lack of love. It's worsened by stress, but not caused by it, and no amount of tree hugging or walking barefoot in the grass, or eating clean will cure it. It just is. I have had counselling and CBT, I take medication, and I run. And together they help me manage it.
Depression comes in waves. I can feel when it's coming on, the slide down. It's sometimes triggered by something small like a squabble on social media, or not being able to do something I should be able to do perfectly well, or actually nothing specific at all. And I know it's on its way, and I know I need just to ride it out, keep doing what I'm doing, until I feel the start of the climb up.
When I'm low, all the colour seeps out and it feels like the world has become black and white. Sounds are muffled and my brain fogs. I'm very good at putting a mask on, and I can work and function perfectly well. Before I was first formally diagnosed I assumed that I couldn't be clinically depressed, because I got out of bed, kept myself clean and tidy, and went to work every day where I met my deadlines perfectly adequately. After all, everyone knows that people with depression can't get out of bed.
The day that the gym being closed unexpectedly left me sobbing, curled up in a ball on the floor in the corner behind my bed, should have told me something was wrong. It took a wonderful and kind friend who made me go to the doctor, and a gentle GP and patient counsellor, to make me realise that not only was there something wrong but that it could be faced up to, and it could even be fixed. Or at least managed.
I am now in a slightly more complicated world, seven months on after losing my beloved Tim. Tim understood depression. He understood that it couldn't be fixed, but that it could be contained with care and the wave surfed. He would hold me while I cried, hug me when I just felt melancholy, and then make me laugh at the ridiculousness of it all at just the right moment. And now he's gone. And so I live with depression and grief.
Whereas depression is a world without colour, and smells and tastes of mud, grief is a different thing. It is greeny-yellow, and tastes bitter. It is sharper-edged than depression. And while both come in waves, grief waves I can't see coming. They crash in out of nowhere, sweep me off my feet, and leave me breathless and gasping. They are triggered by the smallest things – while I can put my big girl pants on and be 'brave' for a birthday or an anniversary, I can't prepare myself for opening a box and finding the piece of paper that he left on my desk with yellow roses, celebrating the anniversary of our first kiss. Or the realisation that now a load of washing contains only my clothes, not both of ours. Or seeing the half-made Airfix model or the half-read book.
Some days they are both there, and I can visualise the colours, intertwining but separate. I know the difference between the two. Those days are hard.
I feel that I should be able to wrap this up with a neat conclusion. An answer. A solution. Something bright and hopeful. But really, like so many things in this year of firsts, it is what it is. I'm not brave. I'm not wonderful or amazing. I am just me, dealing with each day as I can. One foot in front of the other and one breath at a time.
As I make my way through my first year of being a widow, there are a lot of 'today I should have'. Tim and I were my life version 2.1 and we spent a lot of time going to motor races together, particularly classic motor races. There were to be four major race meetings this year, and sadly we didn't get to any of them.
Tim was buried on the first day of the Goodwood Members Meeting, wearing his Bentley Drivers' Club tie, and with his entrance badge in his lapel and his programme voucher in his pocket. I couldn't face Le Mans 24 or Le Mans Classic, and yesterday should have been our first day at Goodwood Revival.
Instead, in life version 3, I had planned to run the Great North Run, and today I should have been heading up to Newcastle with my friends Sue and Pete. However, a bout of viral gastroenteritis, and perhaps my body telling me to have a break, put paid to that.
So, because of all this it's been a tough week. And on top of it all the dreams have been difficult. One where I was wandering through a house full of people and I couldn't stop crying. And another where Tim came back and told me it was a mistake, and when I woke up I turned to see if he was there.
This morning, when I went to the doorstep to pick up the milk that Sue had dropped off before she left, I found a bunch of glorious yellow roses. Yellow roses are important to me. The day my dad asked my mum to marry him, he picked a yellow rose off a bush and gave it to her, and somewhere I have that rose. Dad would buy mum yellow roses on their anniversary, and Tim would buy me yellow roses to make me smile. Mum, Dad and Tim were all remembered by yellow roses.
So, though I am sad, and my heart is definitely elsewhere today, I do have yellow roses by my side.
I'm having a grief attack today. They happen now and then, and as the Grieving and healing in the afterloss page says, they are not setbacks but part of the grieving experience.
It started with the Lancaster flight across Tideswell. Standing at the very top of the garden, in the glorious sunshine with friends, we heard the low rumble of the four distant Merlin engines. And then the beautiful Lancaster flew across with a sound that vibrates deep inside you. Three sweeps across the village, grey against the china blue sky, the final right over my head. Tim would have so loved it. Would have known where it was based, its history. And would have done a far better job of explaining how the bombs worked to a friend's young cousin. I feel I have lost so much – so much knowledge, so many stories, so much love.
And now I'm just about to disassemble the bed that Tim died in. I have ordered a new bed and mattress, new bedding and new bedlinens that are all arriving on Monday. I need to do this, as part of… something that's hard to describe. It's not moving on. It's not working through. It's not getting over. I don't know what it is. Perhaps it's part of being brave, living life 3.0 to the best of my abilities.
I was excited about all this newness. A waxed pine bedframe. A wool mattress, duvet and pillows. But now it has come to it, I'm no longer sure. It feels like I am giving a part of him away. That the room will be my bedroom rather than our bedroom. I know that I can't make the house a shrine to Tim. And that making changes will help me to cope in the longer term. But there is always a cost.
For part one, go to Tales for Tim: The Bare Arms weekend #1
My darling Tim
I signed off the last letter about feeling the odd one out. I was feeling alone and sorry for myself and very much out of my depth. And I sat with Jules and I cried about you, about feeling alone, and about being unfit, old, inadequate, afraid, shy, overweight, out of my comfort zone. All my inner demons came out and sat on my shoulder.
But over a glorious shared supper of local food we all started to talk, to learn about each other, to tease and to joke. I also found a fellow petrolhead and talked about motor racing and the joy of classic car racing.
We then went to sit outside the 'pub' – a garden shed with a couple of barrels of rather nice local beer – and I talked about how I had handled the bullets and the tactility, the sound, the smell of it all, the words that had danced in my head. I talked about your synaesthesia and about the amazing conversations we had about words and smells and tastes. The glorious sensory world you lived in. And people listened, joined in, made me feel part of the team. And I realised how wrong I had been. It also made me wonder – how many of us were sitting there thinking that we were the odd one out?
An early night in a pretty room shared with the amazing Kelley, a breakfast of cereal and fruit with fresh local milk that you would have loved, and then back to the classroom. A morning of firearms law, initially so complex that it made my head spin and then it started to fall into place. Civilians can have sporting and hunting rifles and shotguns, as they can't be hidden as easily as handguns, and they have a maximum of three rounds – while they can be lethal, they are not weapons for mass use. Revolvers, pistols, machine guns, and (perhaps not surprisingly) rocket launchers and cannons are more tightly restricted. Weapons for productions and rehearsals are generally real but adapted for blanks and supervised by an armorer.
And then we were handed assault rifles. AR15s. M4s C8s. M16s. Lighter, sharper, looking less like an antique and more like something that means business, but still effectively a bolt-action rifle in a party dress. Why rewrite a 1916 classic.
These are designed to do mass damage – 30 rounds in a magazine and one in the chamber – with an automatic reload fuelled by the exhaust gases from the previous shot. We learned to check the state of the weapon. Safety catch on, remove the magazine, open the bolt and three-point check, and hand it over open. Then ready to go – push the magazine in, a pull to check. It's loaded. Cock it – pull the bolt back and let it go. It's hot, or ready, or cocked, and you have to focus.
Next were the pistols, which are effectively the middle section of an assault rifle. So if the AR15 is a Lee Enfield in a party frock, the Glock is a little black number. Small, sleek, satin black, with the slide at the top that acts as a cocking handle and threatens to take your fingertips when you pull it back and let go if you hold it wrong. Even more so when you fire it. (Sorry, Bags. You told me that almost as often as you told me to take my finger off the trigger. See, I remember it now…)
The Glock is semiautomatic and has no safety catch, as it is designed for rapid fire. Its role is as a primary weapon for the secret services or armed police, and as a secondary weapon for soldiers. Slip the catch (takes practice), load the magazine, pull the slide and let it go to cock the weapon.
Once we were down at the range, we loaded and fired, blanks for the Glock and live shells for the rifle. And I finally got my eye in and hit the target. James Bond has nothing to fear from me, and to be fair the enemy would still get off lightly, but I was so proud of my perforated sheets of paper. And the rifle didn't have the kick of the Lee Enfield, which had left me with an awesome bruise.
Another night chatting in the pub, enjoying the beer and the company. Talking about cars, how writers think in words and dancers think in movement. About the tactility of swimming, feeling the flow of the water. Discussing films. Listening to stories about sets and stages. Enjoying being in a place that was outside of my still very new normal.
And the morning of the last day. What had seemed to stretch far away was suddenly there. We talked about marksmanship and movement. This is all about poise and balance and focusing on breathing. Standing or kneeling or laying in a stable position, with the weapon pointing naturally and without effort, the sight picture correct and movement kept as small as possible. Walking with a weapon needs to be smooth and silent, the head remaining level.
We practiced fast exchanges between a rifle and a pistol. Think John Wick. Aim the rifle, shoot, out of ammunition, turn to the side to check the weapon, down to the hip with the rifle with the left hand and draw the pistol with the right, making it as smooth and fluid. And then loading and firing the pump action shotgun with dummy rounds, bringing out my inner Arnie and leaving me with a grin on my face that disturbed quite a few people…
The whole weekend was a work up to the final scenario, where we had to move through enemy territory and transition between four different guns, three with live rounds. Choregraphed movement has always makes me feel vulnerable and self-conscious. It has been mentioned that I have all the grace of a fairy elephant, and as a child it was suggested that I could trip over a shadow on the ground. It felt like the combination of just before an interview and being picked last for PE. But I did my very best to get inside the mind of my character and the 'mind' of the gun. To move silently and smoothly. To see the jungle and the buildings and the 'bad people' with the guns.
And just before this, the final assault, I leaned over to Jules and said 'For Tim'. Because I wouldn't have dome it if you hadn't persuaded me to.
We began with firing a sniper rifle at a very distant target, and then loading and holstering a semi-automatic and a Glock. Moving and shooting five rounds with the semi-automatic rifle, switching to three rounds with the pistol, and finally picking up an abandoned pump action shotgun and being Rambo. It felt like being inside an impossibly loud computer game. The buzz was incredible. I wouldn't say that I kicked ass but I certainly nudged bottom.
We went through the scenario twice and after the second time I hid in the corner shaking with the adrenaline and weeping silently that I could never tell you about it. But I know that you would have been proud of me. And startled. But mostly proud.
I wondered whether it would make me understand the power of guns and why people feel so empowered by them. But it didn't. It left me with respect for the people who can handle them safely and smoothly, and an understanding of the hours and hours of practice it requires. And respect for the mind of an actor (and of a soldier) that can be fully immersed in the now. I'm not sure how many live rounds I shot, but you will be glad to know that the only blood I saw was when I scraped my finger shifting a piece of scenery.
I am so glad I did this. It gave me time to spend with Jules. And it gave me the opportunity to meet some amazing and charming professional actors who were very kind and welcoming to this writer and amateur thesp. Thank you to Bags and Al and to all of my fellow Bare Arms students for your patience, humour, talent and encouragement.
And thank you my darling for encouraging me to go. Love you and miss you.
For always, your Suzanne.
Writing short fiction, monologues and plays