Woman's Hour - Elkie Brooks, 'Emotional vampires', Breast cancer drug

Episode Date: October 18, 2024

Why has a drug that can extend life for advanced breast cancer patients not been made available on the NHS? NICE have made the decision that Enhertu, a drug that can give around an extra six months to live on average, is too expensive. BBC Health Correspondent Cath Burns joins Anita Rani alongside Kate Wills, who has stage 4 cancer and has been campaigning for the drug to be made available.Do you have an 'emotional vampire' in your life? It’s that person who can make you feel drained with their negativity, who isn’t taking your own emotions into account. It can make for tricky relationships – so how do you identify an emotional vampire, and how do you handle that person? Chartered psychologist and author Suzy Reading joins Anita to discuss, alongside journalist and author Radhika Sanghani.Elkie Brooks is the renowned British rock, jazz and blues singer. In a career spanning six decades, she was the biggest selling female British artist and still holds the accolade of the most Top 75 albums among female artists. She began singing professionally aged 15, shared a bill with The Beatles and went on to front the group Vinegar Joe with Robert Palmer, before going solo. She’s currently on her Long Farewell Tour and joins Anita in the studio to talk about her career and turning 80 next year. In the latest in our series on special educational needs and disabilities we speak to the comedian Josephine Lacey. Today, we are looking at a very personal issue which will resonate for some mothers of boys with SEND. Josephine joins Anita in the studio. Presenter: Anita Rani Producer: Emma Pearce

This BBC podcast is supported by ads outside the UK. I'm Natalia Melman-Petrozzella, and from the BBC, this is Extreme Peak Danger. The most beautiful mountain in the world. If you die on the mountain, you stay on the mountain. This is the story of what happened when 11 climbers died on one of the world's deadliest mountains, K2, and of the risks we'll take to feel truly alive. If I tell all the details, you won't believe it anymore. Extreme, peak danger. Listen wherever you get your podcasts.

BBC Sounds. Music, radio, podcasts. Hello, I'm Anita Rani and welcome to Woman's Hour from BBC Radio 4. Just to say that for rights reasons, the music in the original radio broadcast has been removed for this podcast. Good morning, welcome to the programme. One of the most successful British singers now in the sixth decade of her career, Elkie Brooks, will be joining me to the programme. One of the most successful British singers, now in the sixth decade of her career, Elkie Brooks will be joining me in the studio. Now, about a month ago, Nuala presented a very powerful and important programme all about children

with special educational needs and disabilities, or SEND, and the people who have the duty to make sure their needs are met. If you didn't hear it, you can go back and listen to it on BBC Sounds. Well, today, comedian Josephine Lacey will be here to tell us about her teenage son and how you navigate as a mother dealing with puberty and sexuality when your son is autistic. She'll be talking to me about her very funny and incredibly moving stand-up show called Autism Mama. And then we'll be discussing emotional vampires. Do you know any? Maybe you are one. It's got absolutely nothing to do with sleeping in coffins or craving blood. These are the people in your life who somehow seem to sap the life force out of you when you

spend time with them. The drains, not the radiators. The ones who demand you sit and listen to their problems, make it all about them and never ask you anything you may know the type but how do you handle that relationship how have you have you been able to tell that person how you feel did it change anything or do you just bin them off and move on from that friend uh you can't do that with everyone can you not especially if you're related or can you um i would like to hear your thoughts and feelings and experiences around emotional vampires today. The text number, as usual, is 84844. You can also email me via our website, or you can contact me on social media. It's at BBC Woman's Hour, or if you'd like to send us a WhatsApp or even a voice note, it's 03700100444.

That text number, once again once again though 84844. But first more than a thousand patients with advanced breast cancer are not able to access a drug on the NHS that can keep them alive for longer. It's available in 19 countries in Europe including in Scotland but not in the rest of the UK. The drug called Anhertu can give patients with a specific type of incurable breast cancer an extra six months to live on average. The health assessment body NICE is the only organisation around the world so far to say no to the drug for this condition. It says that it's too expensive for the NHS to fund. Well, to discuss this, joining me is BBC's health correspondent,

Catherine Burns, and Kate Wills, one of the women who is affected by this decision. Kath and Kate, welcome to the programme. I'm going to come to you first, Kath. What cancer does this drug target in particular? And who are the patients that can benefit from it? So we're specifically talking about a certain kind of cancer. It's advanced HER2 low breast cancer.

As you said, it's about 1,000 people, mainly women, who were infected here. And they're generally average ages 50s. But I've been talking to some who are as young as in their 30s, a whole range of women. And this drug, when it was announced at a cancer conference a couple of years ago, it got a standing ovation. I spoke to one drug company exec who said I've worked in this field for 25 years I've seen that happen twice so there is no argument about whether this drug works it does what it does is it extends life so like you said an average of an extra six months and the drug company says it's got some patients who are

still alive after three years so it can can't cure them, but it can give them that extra time. Do we know why this drug has been approved in other countries, but not here? Yes, it depends on who you ask on this one. So starting with those other countries. So Scotland, it's been available there since December last year. The first country to approve it in Europe was France in November 2022. Since then, 19 countries have done it. And if I could list them, it goes on, you know, France, Germany, Italy, Spain, also places like Luxembourg, Bulgaria, and Slovenia. And then worldwide, you've got Australia, Canada, America. Lots of countries have done this. It doesn't mean

everyone has said yes, some are still negotiating, but only one decision so far has been a definitive no. So why? Well, NICE, which is the health assessment body that's responsible for saying, are we going to put this drug on the NHS or not? They say it comes down to price. They say it's not good value for money. And that's the decision. They've been as flexible as they can. That's not going to work for them. The drug companies, they say, this is a fair price, they argue. And because of that, you can see all these other countries that have accepted a price. What they say is about how NICE has made the decision. And how have they? Well, they've changed it recently. So they used to have a system called end of life. And they worried that under that, diseases that weren't cancer were not getting through funding. So what they've done is they've changed it and brought in something called a severity modifier. And they can either give it

no severity, in which case it doesn't get any extra weighting. If they say a condition is high severity, it gets a lot of extra weighting and therefore is more likely to get approved. In this particular case, though, they've said it's medium severity and that hasn't been enough to do it. Because they have to decide where they're going to put the money. Well, yeah, I mean, NICE makes the decision about which products, but it knows that the NHS has got a very finite pot of money and they are very conscious of that. I'm going to bring you in here, Kate. Can you tell us about your current situation? Because you're having treatment for stage four cancer yeah yeah um i was diagnosed with primary breast cancer when i was 34 um about 13 years ago um and then in the middle of covid um i was out on a cycle ride with my kids you know the only thing you could do in winter

and i got to a traffic light i put my foot down just to wait and my um my hip fell off um and at that point it was that peak covid period there were no there were no ambulances so everyone it was that crazy and I um my son pulled me into a taxi and dropped me at the hospital um and at that point when I was sitting in A&E um they said the only reason this happens like this is because because you've got the cancer the cancer's come back so at that point I knew the cancer had spread to my across my body so it was originally in my breast it was stage three in my lymph nodes and then it has now spread to my bones and my lung and it's in my legs my hip my ribs um and my sternum and um at that point I thought I I really I lay there and there was barely any medical staff at that

point everyone was running around crazy and I just thought I was going to die in a week or two I thought that was it it was over um and then And then I realised that I could stay, I could live a good life for a while with drugs, but I had only a limited number of treatment lines. I'm on my first treatment line. I've been really, really lucky. I've got about three treatment lines, and then hair two is one of them.

It's probably my next one. So what's your reaction to the decision that mice are saying it's too expensive? It blows my mind. I'm lucky enough to be in a community of incredible other patients who are in a similar situation. There's about 20, 30 of us who are really fighting for this. Some of us need it right now. I've got a couple of friends who need it right now and they will die sooner without this. When you get your stage four advanced cancer diagnosis and you think you're going to die quickly, you know, you have to come to terms with it. But what you hope for are drugs that can extend your life. And your ultimate hope,

what I think we're all going for here, is that cancer becomes a chronic condition, that it doesn't mean the end, like HIV AIDS. This is one of those drugs which can help us get to that stage. What would the extra time mean for you? We've heard that they're saying it can prolong your life for six months. And Kath mentioned that somebody who's had it says, is that three years later. I know people who've been on it for two years. Can I just give Kate a little bit of credit here? Because she's the reason we did this story. She emailed me and said, do this story.

And she's put me in touch with all these women. And they're so keen to make the point that this isn't going to be an extra six months lying in bed. So I said, OK, show me, show me your lives. And they sent me videos. I've got Kate cooking to rap music. I've got her cold water swimming, skydiving. You guys are living full and active lives. You're bringing up children.

You're looking after parents. More of that. So tell me, what would this time mean? I mean, we are women in our prime. We are women. There are women I know between the ages of 30, no, younger, in their 20s up until the 60s. I work nearly full time. I'm bringing up two teenage kids. I've got to do the GCSE revision. It's really stressful.

My dad is currently dying of cancer. I need to be there for him. I've got so much to give to society and it to feel that nice at the nhs the very system that is supposed to prolong our lives is actively choosing to say that we're not worth the investment that six months of our lives that 18 months of our lives isn't worth the extra funding and then just to leave us in an abyss at the moment I've no friends who've spent their last months crowdfunding so asking you know the very time you want to be saying goodbye trying to get those last memories they're spending their time trying to raise thousands of pounds to get the drug we're discussed we discuss moving to Scotland or mortgaging our house yeah and tell me a bit if you don't mind those discussions the conversations you've had with your husband

around that. They're serious discussions. And you sit there and you think this is insanity. How is the system getting it so wrong that this is what we're having to spend our last years doing instead of trying to stay well? To move to Scotland is on the table, but it would mean uprooting my children, moving away from my family, my network, my oncologist. At the very time, I'm going to need them most. So it's probably not a good decision on balance. To use our money, you know, I'm not going to be around to earn money for my family for very much longer. So I've literally had the conversation with my husband where I said,

I think I'd rather die sooner. And then you've got a bit of a backup for my kids when I'm gone so it's insane and I think I think nice no they've got it's an algorithm I think they've got it wrong I'm gonna we did invite nice onto the program they declined to be interviewed but a spokesperson for nice told us we were deeply disappointed that we were unable to recommend Anherto. We know this was devastating to all those hoping for a different answer. If Daiichi Sankyo and AstraZeneca decide they are willing to drop their price to a level that makes Anherto good value for money for the taxpayer, NICE will consider it under its rapid review process with a decision potentially within weeks.

Can you understand that they are strapped for cash? I can, I can. But I look, well, I believe the government this week or last week talked about the fact we need to get, there are too many sick people and we need to get people back to work and being productive. We need to build a future. These are women, these are women in their prime. So many of us are working, we're contributing.

I mean, we're paying our taxes. We're actually paying for this. NICE have said that a number of times. I went to the APPG. I sat opposite NICE and the NHS. I know the drug companies have dropped their prices already. I believe they're playing games with us and meanwhile our friends are dying two of our friends died last week one of our friends who's done a lot of media can't do it anymore she hasn't got the energy I said to um Kath we're the most inefficient campaigning group I've ever been part of because we keep dying in the middle of campaigning. And we are literally using our last energy to point out the injustice because also this isn't just about N-her-to. This isn't just about breast cancer. This is a decision they've made, an algorithm they've built that will affect other drugs.

Other boards of experts are saying it's the wrong decision. And I think, nice, I don't think they've got the guts to say they've got it wrong and to go back and fix it. Kath the health secretary Wes Streeting has said I'm incredibly disappointed that the manufacturers of Inheritu were unwilling to sell this life-extending drug to the NHS at a fair and reasonable price despite the best efforts of NICE and NHS England. Yes he's very much on the same thought of process as NICE that this is a price issue and NICE has looked at its severity modifier recently and it says it is working as it's intended to and it points to that to saying

you know there are diseases that weren't getting funding before like cystic fibrosis and hepatitis b and they are getting funding now and it says actually so far it feels that it's still sort of giving as many positive recommendations for cancer as not but the drug companies will say we're worried about launching future medicines here can the drug companies not lower their profit margin i've asked them that um and anything about price is confidential. So they can't tell me what they're doing on price. What I've also asked is, if you can't come to a deal with the system, can you come to a deal with these women privately? Because options for women like Kate right now, they could try and get it on a clinical trial.

We've talked about moving to Scotland. One option is getting it privately. So I've had quotes from £7,500 every three weeks up to £13,500 every three weeks. Would you be willing to pay that? That's the decision my husband and I talked about. I think we would fight, we'd try and get it, but it would be taking money from my kids' futures, which feels insane. But I think it's so short termist because we know that it takes money to develop drugs. These are the next generation cancer drugs. These are the drugs that are going to make cancer chronic.

One in two of us are going to get cancer. This country says it's a lead in health and it's making a decision which is counteracting that. They have to pay a premium for the first few years. And then we saw that with COVID, the other drugs will come in and they will be cheaper. So we will fight. me and my other girls the women on this group we will carry on fighting i have a glimmer though so when i asked the drug company yes what do they have what could you do about this they the answer was vague of we're looking at all options but that's one of the options that they're looking at so maybe that

is something that could happen the prime minister kirsten ordered a rapid independent one of the options that they're looking at. So maybe that is something that could happen. The Prime Minister, Keir Starmer, ordered a rapid independent review of the NHS this summer and Lord Darzee concluded that it was in critical condition. We know that. We've spoken about it on this programme. These decisions, I mean, they are utterly heartbreaking, especially if you are involved on an individual level. But the bigger picture is that the funding is scarce. So this is what NICE says.

I did interview NICE about this and they they said we have a really difficult job here and if you look at these things on an individual patient level it's heartbreaking but they said their job is to take a step back look at the wider system because they said if we approve one drug it's not like more money goes into the system the drug company's answer to that by the way would be well actually it's slightly more techie than that, because there is a voluntary pricing agreement that kind of lasts for five years between the industry and drug companies. So essentially, if the NHS spends more than a certain amount in a year on medicines, then the drug companies have to give them a rebate, they get that back. Kate, what do your family think of you campaigning for Nher 2?

I think they understand and they respect that I'm doing it, but they also, it scares them because they see the toll it takes on me. We've been campaigning for over a year. I never thought it was going to go on this long. I thought it was the sort of, we'd have to just show that it mattered and then they'd come to an agreement. But it just keeps going on. It's exhausting. I think every time my children hear me talking about it,

it brings back the memories of what's coming. They know that I'm fighting to stay alive so I can get them through school. And this is your precious time. And this is my precious time. But I feel I am caught in a catch-22. Every time my mum, my husband, my friends say, just does it have to be you? Why does you have to go and campaign?

I'm like, well, if I don't do it, you know, who else is going to do it? And you mentioned your group. Yeah, they're an amazing group. Yeah, I'd like to know what that support and togetherness means. Together, one of us is always pushing. So it allows one of us, you know, we often have to have breaks and take a rest or we get ill. As I said, we're a very inefficient group.

But we are pushing our local newspapers. We are, we're currently looking at whether we can take NICE to court because we don't know whether there are any other options left and we don't know how else. NICE don't talk to us so we're currently crowdfunding to see if we can take them to court but it is an enormous slog. One of the things that's been amazing is it's not just us patients with this particular cancer as primary breast cancer patients are getting involved typically we're the with the sort of

black sheep of the family no one wants to talk about us because we're the scary ones that die and we ruin the sort of pink fluffiness of cancer but um i think between us we won't give up and i just think this decision is so short term there isn isn't enough money. We know that, but we are contributing to society. We'll be putting money into society. So to make decisions which stop us living fully, that stop us being able to contribute to society, doesn't make any sense. Kate, I would like to thank you for coming in to speak to us

so honestly and openly. And Kath, thank you. And of course, we'll be keeping a close eye on this and you can come back and update us. Catherine Burns and Kate Wills. 84844 is the number to text. Now, I mentioned this at the beginning of the programme. Emotional vampires.

Do you have one in your life? I'm not talking about a Dracula-type vampire here. An emotional vampire is someone who sucks the energy from you with their negativity. That friend who might complain to you a lot or demand much more from the friendship than they perhaps give back um i imagine most of us can think of someone in our lives who fits that description so how do you handle that relationship well joining me now are suzy redding a chartered psychologist and author radhika sangani author and journalist um welcome suzy welcome Radhika Sangani, author and journalist. Welcome Susie, welcome Radhika. Susie, let's start with you. I sort of gave a bit of a definition. What is an emotional vampire?

Okay, so I think there are a few different characteristics. There is certainly an excessive need for attention, for validation, for reassurance. But there's also a sense of nothing that occurs in their life is their fault. They're very slippery characters. And while there is this real focus on self, there's also little awareness of the patterns, their behaviours and how that impacts on other people. And I'd also say that there's little compassion for others in those moments and they have no idea they're doing it yeah it's it's it's yeah

there's there's little awareness they're not very conscious of it um Radhika what's your experience of emotional vampires sadly I do have experience with them um are you one are you one absolutely not but you know as I was listening to Susie just now I was thinking gosh when I was younger in my teens maybe for my early 20s I don't think I would have recognized these people I think I would have thought it was my fault like oh why is this conversation not working you know am I just not being interesting enough like you know am I not giving enough I would have made it all about me um and now you know I feel like I'm so much more aware of them and I don't put it all on me I'm like oh actually this isn't working I'm coming away feeling really drained um and I'm able to see you know it's it's them like they are the problem not me so what have you done about it in some situations you know if it's easy enough I will just withdraw um especially if it's someone

I've met who's fairly new you know there was a time when I was dating if it's a first date no I'm not going to go on a second date with an emotional vampire um but obviously it's a lot more complicated if it's someone you have a closer relationship with um my friends and I have a really useful system to think about this yeah and we call it plus twos minus twos and zeros so it's like you have a social encounter was it a plus two do you come away feeling lifted was it a zero like neutral you know maybe a work encounter or is it a minus two where it is an emotional vampire and they're draining you? Is this in like all encounters or just within a sort of dating scenario?

No, no, absolutely everything. Like, you know, family, friends, work. And it really helps me personally think about, okay, how am I planning my week? You know, have I got too many zeros in there? Can I get some plus twos in? If I've had a minus two, can I counter them with a plus two?

Well, that sounds quite fair. So you're not kind of giving up on the minus twos. You're just like, if I've got a minus two, can I counter them with a plus two? Well, that sounds quite fair. So you're not kind of giving up on the minus twos. You're just like, if I've got too much minus in the week, someone's going to have to, like, take a hit that week. How do you deal with emotional vampires, Susie? Do you know, I think it probably is helpful to sort of take a look at what are the things to be on the lookout for? Because I think like it's

a really important part of this conversation to acknowledge that there's such a preoccupation in modern times with resilience, where, you know, there's this sense of you've got to shoulder your burden alone. And I want to say that that's not healthy. Like we need emotional intimacy, we need to share with others, we need to, we need to share with others we need to we need to lean on others so this conversation is not about get on with it keep quiet deal with it on your own but let's take a look at where you're interacting with people who are always the victim who enjoy creating chaos but then don't want any feedback on that or any solutions in resolving the chaos or where they just want to vent

with no sense of interest in how that impacts on you. But it also manifests in some other ways. Like it's not always necessarily they've got to be the centre of attention. It might be that they chip away at your self-trust or your self-belief by backhanded comments or or maybe they there's a real sense of toxic positivity where they deny you the right to express yourself so it's it's a matter of taking a look at what those warning signs are and just observing where are you at you know where's your energy levels at let? Let's give ourselves permission to pace ourselves. I bet there's people listening right now,

listening to what you've just said, thinking, oh my goodness, there's that person in my life. It might be someone they're related to. It might be their mothers. So how do you go about it? Like, what do you do if it's someone, you know, you either decide, as Radhika has, you know, I'm not going to spend time with that person today or I'm just going to cut them out., what do you do if it's someone, you know, you either decide, as Radhika has, you know, I'm not going to spend time with that person today, or I'm just going to cut them

out. But what if you can't? What if you don't? It's not that easy. It's really tricky, isn't it? I think first and foremost, where possible, limit exposure. You know, give yourself permission to choose who it is that you spend time with. And in terms of that decision-making, you can also choose where it is that you get together, what it is that you do, how long you spend together, the frequency at which you meet. So if you've identified someone in your life that has a tendency to drain you, well, then think about what kind of activities,

if you want to sustain that friendship, and quite often there are historical friendships that are still important to us. But, okay, so instead of getting together for a coffee and having this wall of noise, why don't you go for a walk together? Why don't you exercise together so you're still having your needs met? And it sort of dials down their tendency to just dominate everything. Even better, go and play tennis. I bet Radhika's got some solutions. I bet you've got some ideas, Radhika. You're

striking me as the sort of person who's really thought this through and have got systems in place to deal with this. So what do you do if you have to spend time with that person? I mean, I actually just think what I'm trying to do now, which I'm finding quite empowering, is finding the courage to say it out loud. You you know I'm not saying you're an emotional vampire I'm saying look this behavior I feel like lately when we're hanging out I don't feel heard I feel like maybe it's a lot about you I'm not really being asked any questions you know whatever it is I'll try and think about it and I will try and awkwardly find the courage to say it out loud and for me you know a true friendship worth keeping and investing in is one where that person can see that and hear me and have a conversation about it

and if they instantly deny a defensive you know then that to me shows they're not someone you know I may be one in my life and has that and has that happened have you done that it has happened yeah it has and you know who is can you share oh no you don't have to name them not dude yeah sure like I think with a cup with a couple of friends it is how it has happened where I've said you know I'm finding lately um you know this this happening I don't feel so heard I feel like we're talking loads about your your stuff and I'm not you know having any I'm not really feeling that there's much space for me and in both situations those that person was just you know mortified and wanted to know more and wanted to fix it so to me that is a sign you know that there's someone I want to have in my life yeah

lovely all right Susie what if you've tried that what Radhika suggested but nothing changes and you decide you need to cut that person out of your life how do you go about that oh it's tricky isn't it yeah i think where there's no willingness or no desire to to to create change we do need to protect ourselves now whether that is refining boundaries or whether it is saying i'm sorry i need to call time on this relationship and that obviously will involve some kind of grieving process um we need to clearly articulate what it is that we need to feel safe and healthy in relationship with that person. So it could be simple things like if you cannot extricate yourself from each other's lives, there might be some boundaries

around how we communicate. It's not going to be endless WhatsApps. The nature of that communication needs to be targeted to. We're not going to talk about our emotional lives. It's going to be around, for example, if you're co-parenting, it might be it's all about arrangements for childcare. It's about nurturing the children. So being really clear on what's okay and what's not okay.

I'm going to read out a few messages. Yeah, I'm going to read because we've got quite a few in. So I've got one here saying, I have an emotional drain friend. I feel like she treats me like a journal, just downloading her worries and woes onto me, reveling in anything negative. I'm slowly and unassertively creating more distance between us. Another one here, anonymous in Tunbridge Wells.

I like that level of detail. I love my social vampire friend as he takes the pressure off me when we meet up. I can just let him go and i get to listen it's a relief i find the really shy hard to talk cynical people are the true emotional vampires i find them draining radhika this person in tunbridge wells has said but i think that's the thing isn't it it's like what makes them draining to you might not be the same for everyone and that's what's important to focus on.

OK, so there are layers and levels of emotional vampires. OK, someone has said here, this is a good question. What if you're married to an emotional vampire? And apparently it's anonymous, please, because the in-laws are listening. Suzy. Divorce them. Come on, Radhika, what's the solution? Divorce them, run away leave suzy well i think you know this is this is we're going to take a look at where responsibilities lie and and i would say that

in our close relationships yes we have the opportunity to rub off each other's rough edges okay so there is an opportunity for growth and And like Radhika has already said, there are plenty of examples where people have been given that feedback and they've been aghast. They've had no idea the impact that their behaviors had on other people. So we need to become skilled in giving feedback, in being direct and saying, when you do X, this is how it feels. Because otherwise that person goes through life noticing this atrophy of friends and they've got no idea.

So we need to get skilled and speak up. And then if there's no change, well, then we need to take a look at what we need. Then we go to the Radhika School of Thoughts and just do one. Both of you, thank you so much for enlightening us on how to deal with the emotional vampires in our life. Susie Redding and Radhika Sangani.

I'm going to read a couple more here. I've never heard the term emotional vampire before and find it really unpleasant. We all need support from others. Perhaps the question we should ask are, what qualities do those people see in us that they seek our support? We need to look at ourselves,

understand our own resilience and know what we can offer as a friend or family. I'm Sarah Treleaven and for over a year I've been working on one of the most complex stories I've ever covered. There was somebody out there who was faking pregnancies. I started like warning everybody. Every doula that I know. It was fake.

No pregnancy. And the deeper I dig, the more questions I unearth. How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's Baby. It's a long story, settle in. Available now. Remember, that text number once again, 84844.

Now, I am delighted to introduce my next guest. Elkie Brooks is the renowned British rock, jazz and blues singer in a career spanning six decades. She was the biggest selling female British artist and still holds the accolade of the most top 75 albums among female artists. She began singing professionally aged just 15, shared a bill with the Beatles and went on to front the group Vinegar Joe with Robert Palmer before going solo. Her hits include Pearl's A Singer, Fooley If You Think It's Over and Lilac Wine and she's currently on her long farewell tour

which runs until next November. Elkie, welcome to Woman's Hour. Thank you. Good morning, my dear. It's wonderful to have you here. Thank you. It's very nice, you lovely lady. So are you. And it's very nice to have a, even if it is a Lancashire accent, sitting across the table. Oh, yes. We're not going to start war now. No, we're not. We're not. I'll leave that. Leave it. Back on tour.

I've never stopped touring. I mean, I've been on the road all my life, practically it. Back on tour. I've never stopped touring. I mean, I've been on the road all my life practically, as you were saying, 64 years. What keeps you going? Well, I've got a reasonably good diet and I try not to drink too much alcohol and I exercise a lot. I'm glad this has come up straight away.

You're incredibly fit, aren't you? You train in a martial art called Aikido. Well, yes. I don't train as often as I used to because the club that we have is no longer running now. But yes, I do every morning. I still do the exercises and stuff from Aikido. I trained, I started in 1988 and I took my first down in 1995.

So I've kind of kept it sort of going since, you know, it always holds you in good stead to keep exercising. I'm fascinated because I love martial arts. I know a bit about Aikido, so I was very intrigued to know a little bit. I was watching Steven Sergalal, actually, last night. He's wonderful. He's very good, yeah. My husband sent me the video on my phone.

He's incredible, isn't he? He is incredible. He really is good at Aikido. We could nerd out over martial arts movies, but I think people would probably want to hear a bit more about your life right now. Okay, yeah, let's stop going on. I can hear my son and my daughter-in-law now say, come on, mum, you've come to talk about what you're doing now.

Let's talk about the tour. Blinking Aikido. But I'm interested, genuinely. What can people expect to hear on this tour then? Well, I mean, obviously the hits, you know, I've been doing for many, many years and I have an acoustic album coming out at the end of this month that people can actually pre-order. We recorded it live just after the lockdown in North Devon at the Landmark Theatre so people can actually get the album at the end of this month and I recorded it with my piano player Tom Kincaid who's going to be accompanying me today and Mike Smith on the saxophone. They are poised and ready we cannot wait.

You've dangled that carrot we are going to hear you sing live but before we do I think we'd like to rewind and go right back to the early days. What kind of music were you listening to when you were very young? Well my brother, who passed away unfortunately this year, a wonderful man. I'm so sorry. He bought me for my 12th birthday Ella Fitzgerald. The album Ella Fitzgerald's thing swings lightly. So I really loved that album and I used to come back from school.

I was at North Salford Secondary Modern School when I was at 12 and I used to come back from school. I was at North Salford Secondary Modern School when I was at 12 and I used to come back from school at lunch and I'd be singing along to the album and I knew every single word and to how high the moon I could do all the scatting and everything. It was lovely. Yeah, there is always that definitive album. It's about 11 or 12 when you really start tuning in. I still love her. Of course. And what was life like growing up in Salford? What was your family like? Well, it was a very Jewish area where I came up in. And I went to the local school there, Kings Road School, Sedgley Park County Primary.

I don't know whether it's still called that. But my father was a baker, F bookbinders and some. He had a bakehouse and four or five shops, one on Park Hill in Presswich. And the synagogue was the opposite, the Holy Law Synagogue that we used to go to. So, yes, it was quite a little closed background, really. What, musical family? Well, my brother Raymond played the bass and the trumpet. My brother Tony was a drummer. So, yeah.

And he used to play with Billy J. Kramer and the Dakotas many years ago. I think he's retired now, though. And did they encourage you? Sort of. But my brother Raymond did. In fact, he got me my audition with the Eric Delaney band when I was 16. He read it in the stage paper and took me to London for the audition. Yeah, you mentioned this. You were 16 when you auditioned for this competition and that led you on to supporting the Beatles in 1964.

What can you tell us about that time? Well, it was quite unusual. In fact, my cousin, Susan Bookbinder, sent me a photograph from the papers. And there's me in the photograph with 200 men who were all sort of like part of the show, obviously working on the show. The Yardbirds were on the show, Mike Cotton Sound, but all the people on the production side and everything they were all men and just me little me how did you hold your own then i mean of course the voice the voice speaks for itself plenty of guinness dear plenty of brandy in those days um i must i must mention because yesterday we heard the very sad news that liamne, a member of One Direction, found fame on it. He found fame on X-Fest.

The reason I'm bringing it up is because he too found his success on a talent show. He was only 31. Of course, you existed in very, very different times. And there's lots we don't know about Liam's tragic death. But I imagine it's so challenging. It must be so challenging being in the spotlight from such a young age. Well, the thing is for me, I mean, obviously it was different how it is now.

But it could be very, very lonely because I was completely on my own. I'd be driving myself everywhere. I'd have me frocks in the back of the car. From what age? I'd do me little sound check with the band at five o'clock that couldn't read my music properly, which actually got me into learning how to play the piano so I could accompany myself. How old were you when you started to learn the piano?

Oh, I must have been about late teens, 18, 19. Just so that you could accompany yourself, you don't have to bother with anybody else. Well, because they were so awful, some of them. And I thought, blammin' heck, I can't do it. Not you. No, not my lovely Thomas. No, but it was so awful that I thought, well, you know,

I've got to do better than that. And I wasn't enjoying it. And I think if you're not enjoying your gig, forget it. You know, do something else. Elkie, that says something about your personality that you thought, well, might as well just learn, take it up yourself. Where does that drive come from?

I don't know, honestly. Possibly my mum. I don't know, maybe. Why, tell us about your mum. You know, her mum was, because my mum wasn't musical at all and neither was my father. But her mother was very very good. You nearly gave it all up though? No there was a point where I was thinking of doing that but I met Humphrey Littleton and he

persuaded me to you know stay in the business which I have done obviously ever since but I was going to go with my friend Maxine she was going to Israel and I was going to go with my friend Maxine. She was going to Israel and I was going to go to Israel with her. But you met Humphrey Littleton, everything changed. And then you were in the band Vinegar Joe with the late Robert Palmer and you had successes with top 10 hits. And how did that change your life? Well, most certainly two days away, the album that I made with Libra and Stola

in 1977 completely changed things because Pearls of Singleton was released on my birthday in February 77. And it became a hit. It's the first hit I've ever had. And I was 32. So I had done a bit of an apprenticeship, you know, and that to me is the most important thing, is to do that apprenticeship. A lot of people think, well, bang, bang, bang, they can just like get their one, two, three. Did that enable you to deal with the fame because you'd grafted and you're a little bit older?

Possibly, possibly. But maybe I'm just rather a strong woman. I don't know. I think you are definitely a strong woman. I'm feeling that vibe and I'm very much enjoying it. You released your first solo album, Rich Man's Woman, in 1975. Oh, gosh. Can we discuss the cover?

Because you look incredible. You posed nude on the album cover. I got persuaded to do that by the photographer. I really did, honestly. And I really shouldn't have. Is that a bit dodgy? Well, the thing is, I can remember so well going to an interview with a lady, a very, very serious journalist, and she had such a go at me about having done that album sleeve.

She said, you are a good singer. What are you doing, doing an album sleeve like that that's terrible I really think that's awful and I have really thought I started to think about things a bit more after then I didn't really think too much about it you know I thought well yeah you know reasonably good figure you know

amazing figure a feather boa over me I thought yeah yeah yeah great you know what's the problem but oh she really did she said you're not going to get anybody to take you seriously, she said, with an album sleeve like that. I thought, oh, right, OK, I better do something about that. Maybe the next one I won't. Oh, no, so you took it seriously? Oh, I blink and did, yeah.

Did you not think I can do what I want? Well, no, no. I thought, well, perhaps, you know, maybe she's got a point there. I mean, now it's perfectly, I mean, not just now, since then. It's not like you were the only person who'd put some, you know. I don't know about that. I mean, I really don't. I mean, really, if you want to be taken seriously, I don't think you should really walk out nude, babe.

I don't know. I think, I don't know. There's a different thought process for different people. Yeah, maybe. But anyway, I think I've done it right. I think, I don't know. There's a different thought process for different people. Yeah, maybe. But anyway, I think I've done it right. I think you have done it right. You've definitely done something right. And you've got a new album coming out next year.

I have, yes. As I say, I've got an acoustic coming out at the end of this month. And then we have a complete new album that I've been working on for many, many, many years with my son, Jay, who also manages me as well with his wife, Joanna. And they've produced this fourth album together that we've done. Incredible, incredible.

I'm going to ask you a bit about finances as well because you've been so successful. But I mean, the contracts were so different and actually you didn't make a huge amount of money. Oh of money oh well never mind as long as you're enjoying yourself I and are you enjoying yourself but you lost your house at one point well yes there you go that's a long story as well people have to read the book they'll read the book it goes on um having a good time still Elkie of course else I wouldn't do it I mean i am in a situation where i have an incredible band that play they're great great musicians all get on with each other and we have a good time and

i'm thoroughly enjoying myself and i've thoroughly enjoyed speaking to you as well would you would you sing for us of course i'll sing for you darling if you put the money down on the table it's a free treat for us today and this is going to be such a joy okay thank you so much if you go and take your place i will do the wonderful elkie brooks we're going to get here and sing live um she's going to be singing i put a spell on you uh by nina simone and the band are tom kincaade on piano and Mike Smith on saxophone. Elkie Brooks, I'm standing up for you. I'm standing up. That was amazing. Thank you so much. Thank you, Mike. And thank you, Tom, as well on piano, Mike on saxophone. Wasn't that something? Elkie Brooks and the long farewell tour runs until november next

year what a voice what an absolute treat that was i'm going to read out a couple of your messages now um on emotional vampires hi anita just to let you know that here in glasgow we call emotional vampire vampires joy hoovers thank you lorraine we like that anna from london says my younger sister is definitely an emotional vampire. It's always about her problems. We are the only two left in the family. And as the older sister, I feel I have to support her, but I never thought about her in these terms.

Perhaps it will help me understand how to manage it. I hope so. I hope that today's chat about it, Anna, was helpful for you. Now, last month on Woman's Hour, we looked at the send system send stands for special educational needs and disabilities as it's referred to in england since then we've heard from mums of children with send who are bridging the gap some have been forced to give up work some are struggling with the cost of transporting their children to school today we're looking at a very personal issue which will resonate for some mothers of boys with SEND. The comedian Josephine Lacey is taking her stand-up show, Autism Mama, to Soho Theatre next month. It's an exceptionally frank and honest insight into what it's like to raise an autistic child

and some of the challenges and dilemmas that many single mums like Josephine face as their boys reach puberty. Josephine, welcome to Woman's Hour. Hello, thank you for having me. Isn't that something? Oh, she's brilliant, isn't she? Isn't that amazing? Yeah. As is your stand-up, I have to say.

Before we talk about that, let's talk about your son. Why did you write this and put your son at the centre of it? It was just, you know, as a comedian, the turnover of jokes and when lockdown happened, I knew all my comedy buddies would be writing new jokes. And I thought I'd better write some new jokes. And I didn't do any of the Zoom gigs that were floating about. occasion to talk about autism, any aspects of it, for a friend who was thinking about putting something together when the lockdown finished. And I didn't know what to talk about. And what we were actually living with at the time was my son's challenges with puberty. And I had not long got some support stuff to like literature and stuff to read

and I just went through that and it was after I did that I got this overwhelming feeling that there was something more I could do with this and not so much club jokes, but I wanted to use my comedy to say something more meaningful. And it's incredibly meaningful. Before we talk about the specifics of the stand-up, tell us about your son and how his autism presents. He was non-verbal for the first five years of his life and then he developed echolalia, which is the ability to repeat normally a sound, a word or a phrase, often repetitively and often in the tone that it's first heard in. So he developed that.

And then he, we just, because at that point I was told he would never like speak, he would never use his vocal cords. And that seemed to be true because he wouldn't cry I did it was only when he did echolalia that I knew his vocal cords were actually working what was the first thing he said and how old was he the first thing he said was he was copying the his v-tech and one day I noticed he what he just walking around and it was in the exact tone so I don't actually know how long he was doing it and he was walking around and he was saying choose the right answer is it a or is it b and I saw the words come out of his mouth and I'm like, he just said that

and I just cried. How old was he? He was about five and two months. And then the stand-up specifically, as you said, tackles when he becomes a teenager and what you had to deal with as his mother when he reached puberty. Some aspects of it.

Yeah, some aspects of it. A lot of parents struggle with the changes their children go through when they hit puberty. For an autistic boy like your son, what's the extra layer? The extra layer is him not understanding and not having a comprehension about the changes of puberty, the changes to self, in body, in emotion, in hormone, in growth. He didn't like his body hair. He has sensory processing disorder. So, and the testosterone before it kind of levels out. He was getting, like, big boosts of it and he was it just had an impact on everything

his behavior which is challenging enough but with the with the hormone changes and and he liked to take his clothes off he yeah he's clothes causing physical pain. But we're lucky in the sense that most days he keeps his clothes on when he's outside of the house. He has stripped outside of the house, but as soon as he comes home, he does like to go in his room and take his clothes off, which is fine. He doesn't share his room. And your stand up specifically discusses how you as a mother decided that you had to somehow explain to your teenage son about masturbation. Well, yes, because it broke my heart when he was saying his erection caused him physical pain. And no one likes pain. And as a parent, you don't want to see your child or any loved one.

The first thing you do is want to take away their pain. Now, if it's not something paracetamol can help with. And so I just thought, well, if his erection is causing him physical pain, he hadn't reached the stage of ejaculation yet. But I thought I didn't want to wait until then. I wanted him to prepare him for what was going to happen and explain to him it's quite normal that gentlemen penises grow. What kind of support was available for you? It was quite limited at first because I was at loggerheads with a lot of people because of his challenging behaviour with the puberty. But then there was, I was referred to a particular lady who worked with, who was working with children over the age of 14 who were going to the next stage of relationships

outside of their school relationships, their parents, their siblings, romantic feelings. But Callum wasn't actually 14 yet, so she couldn't meet with him. But because it was really challenging, she did meet with me. We spoke over the phone. She took details about the family, our household.

Then I met with her and I picked up an array of support mechanisms in the way of books literature tools support groups and she just said look you know your son best which I think for every parent we we are not experts in autism but we are experts in how autism affects our children we're experts in our children and so she said you will know what will help your son and I walked around and I picked up the tools that I thought would help and she said that it was great because it's so hard for her to have a conversation about masturbation with parents for whatever reason. It could be religious reasons, cultural reasons. It could be just a shy parent. But she said that I was really receptive and she just said like, yeah. And why did you decide to turn, which is quite a taboo subject,

into, and a serious subject, into stand-up? Because exactly that, it's serious and it's taboo and it shouldn't be. Yeah. Like masturbation is like the most natural thing a human being will do for self. But there is so much taboo attached to it for the same reasons that people find it hard to talk about religious cultural shyness uh people not people having body image problems um and and it's completely fine and i wanted to share it and it is it's it's incredibly moving thank you but it's very funny thank you um and i

we won't give all the the story away because you do tell the story and you explain how you take your son through this process and i guess people will just have to experience that for themselves but he's also um he turned 18 so he's technically an adult now Is that changing things for you? I've had to, not too much. I mean, legally, I don't have parental responsibility. But I've bereaved. It's been hard because he's no longer my autistic little boy. He's an adult who happens to have autism because he's no longer my autistic little boy. He's an adult who happens to have autism,

and there's so many aspects that he can do, and, you know, I just want him to be the broadest he can. I feel we really need to... We've already had some music, but I feel it's really important to share some of his talent, because he's very good at maths, and he's an incredible piano player as well. He's a savant for his musicality, yeah. Well, let's hear him play.

Here he is playing Bach's Prelude in C major. What kind of feedback have you had? I mean, incredible, incredible talents. It's beautiful. It's very moving. What kind of feedback have you had from other mums with SEND children? About the show? Yeah. It's been absolutely delightful. I mean, I wanted the show to obviously have an impact but I didn't expect the amount of attention it's gained so quickly I've had mothers come up to me and grandmothers because maybe the the parents are working so the care during the day

has been on the grandparents. And they've come up to me and I've had parents say, who children are older than my son? You know, I really wish I had had these tools. And very quickly, have you found it therapeutic for yourself doing this, Dundas? Yes, because I've helped him gain responsibility and I've helped him help himself when he's in pain. Thank you so much, Josephine, for joining me to talk about that. Thank you for having me.

You can see Autism Mama at Soho Theatre starting on Monday 11th November. Do join me tomorrow for Weekend Woman's Hour. That's all for today's Woman's Hour. Join us again next time. Hello, I'm Amol Rajan. And I'm Nick Robinson. And from BBC Radio 4, this is the Today Podcast.

And Nick, this is the moment to ask you what you most enjoy about spending a couple of hours in my company each week. Well, that would be enough in itself. But the fun is to go in depth on a story with an expert guest and for you and I to try and really get what's going on. I have CCTV on my home. I've had people rip my gates down. Is it worth it, Andrea, being an MP?

On no occasion... Did they know? ...did the scan that I'd had ever appear in the other hospital. So what do you enjoy most about doing? I love the fact that we've got a really strong sense of community. And yes, I love some of our star guests too. Frank Skinner! Yay!

This is where we need tinned applause. I'm going to clap as well, just to thicken it up. Listen and subscribe on BBC Sounds. I'm Sarah Treleaven, and for over a year, I've been working on one of the most complex stories I've ever covered. There was somebody out there who was faking pregnancies. I started, like, warning everybody. Every doula've ever covered. There was somebody out there who's faking pregnancies. I started like warning everybody.

Every doula that I know. It was fake. No pregnancy. And the deeper I dig, the more questions I unearth. How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's Baby. It's a long story, settle in.

Available now.