Woman's Hour - National Poet for Scotland Jackie Kay, Author Tracy Chevalier, Growing up with a child with cancer

Episode Date: September 5, 2019

National Poet for Scotland Jackie Kay on a new production of her 1980's play Chiaruscuro.A new survey by NCT (National Childbirth Trust) and Netmums on the limitations of postnatal checks for new mums. Kavita Trevena who's just had a child shares her experience, and we hear from Abigail Wood Head of Campaigns at the NCT, and Helen Stokes-Lampard, Chair of Royal College of GPs. Tracy Chevalier, writer and author of 10 novels, including Girl with a Pearl Earring and At the Edge of the Orchard, talks to Jenni about her latest book, A Single Thread. Set in 1932, it follows the life of Violet Speedwell, who is still mourning the loss of her fiancé and brother in the First World War. Every day 12 families in the UK will receive the devastating news that their child has cancer. Over the next few weeks we'll be talking to both the parents and the children themselves about what life's like for them. Today we hear from two mums, Andrea Hanbury mother of Keeva, and Kate Hewson mother of Charlie. How are their families adapting to life after cancer treatment? Plus Lucy Waller, Clinical Physiotherapist in the cancer unit at Great Ormond Street Hospital for children in London tells us about the positive effects of physical activity for children treated for cancer. Presenter Jenni Murray Producer Beverley PurcellGuest; Jackie Kay Guest; Tracy Chevalier Guest; Andrea Hanbury Guest; Kate Hewson Guest; Lucy Waller Guest; Kavita Trevena Guest; Abigail Wood Guest; Helen Stokes-Lampard,

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, Jenny Murray welcoming you to the Woman's Hour podcast for Thursday the 5th of September. Jackie Kay is Scotland's makka, the national poet. Her play, Chiaroscuro, was first performed in 1986 and is being revived at the Bush Theatre in London. What does she remember of herself when she was only 25? Every day, 12 families in the UK will receive the terrible news that their child has

cancer. Survival is improving, but what does the treatment do to a child and how does a family adapt to life in remission? And a new novel by Tracy Chevalier, best known for Girl with a Pearl Earring. This time, in a single thread, she explores the life of what was known as a surplus woman, unlikely to marry after World War I. Now, when you have a baby, you expect there will be some attention from your midwife and a health visitor in the first few weeks after you get home and everyone is entitled to a check-up with the GP six weeks after delivery. It should be for both mother and baby. Research carried out by the National Childbirth Trust and Netmums has found nearly half of all new mothers are getting less than three minutes of the doctor's time for them to discuss their physical and mental health.

Well, Helen Stokes-Lampard chairs the Royal College of GPs. Abigail Wood is head of campaigns for the NCT. And Kavita Trevina had a baby just over a year ago. What was her experience? I had to have an emergency caesarean so I was hoping to be fully checked by the midwives when they came to visit me. Unfortunately for me that didn't happen however my health visitor was incredible and she came along and helped me on my process. When I got to my six-week check my son son had his checks, not a problem. But when it came to me, I think I had about 90 seconds.

And she didn't even check my scars. What did other new mothers tell you about their experience, Abigail? So, like you said, nearly half of new mums said they had either less than three minutes or no time at all dedicated to them and their mental well-being. But they also told us that new mums who have concerns about their mental health feel really nervous about disclosing that. They're worried that they might be judged, that they might be considered a bad mother or even that their baby might be taken away from them. So it takes a really sensitive conversation with those specialist skills that GPs have in order to make them feel comfortable enough to say how they're really feeling. But it also takes time. That's not the kind of conversation you can rush at all.

You really need a full appointment in order to be able to do it. Who was it that you saw who gave you your 90 seconds? It was a nurse practitioner. So I didn't even have an appointment with the doctor. So it's every Wednesday, there's a block for babies and mothers, and it's always with a nurse practitioner, never with the doctor. And what attention did the baby get? Probably 90% of my time or the time that we shared together. His check was incredible.

Everything was done with him. All the sight, sounds, everything that needs to be done was done with him and I was asked if I needed to go on the contraceptive pill if I'm breastfeeding and if I had baby blues and to get over it if I did to get over it yeah that was the the phrase that just lingers in my mind every time I think about that time at the beginning was do you have baby blues actually I think I do uh just get over it what What about your caesarean? I mean, presumably that needed to have stitches checked. No one checked my caesarean scar once I came out of the hospital. I think my, apologies, I think my health visitor might have looked at it because I asked her. But as far as I can remember,

no one looked at the scar after that. What, Abigail, do you reckon should have happened in Kavita's case at the six week? I mean, she'd obviously had good care immediately after delivery. Well, it sounds like really there needs to be enough time for a woman to raise all of the concerns that she has. And obviously, there'd be a list of other things that the GP would talk through. But that absolutely relies on there being enough time in the appointment for them to get through it and for them to raise anything that they're worried about. Helen, as a practicing GP, as well as the chair of your Royal College, what do you make of the kind of service Kavita had? I'm truly saddened to hear what Kavita went through. And it sounds to me as if two things are getting really mixed up here.

We have a baby check, a top-to-toe check of the baby, which clearly happened in Kavita's case. But there are two people in this encounter, the mum and the baby. And the mum also needs a check. Now, in some practices and some setups, these are very distinct. In my own practice, I much prefer having them separately because the baby clinic is often a very busy place where we're talking about immunisations and all the anxieties and we want to focus on babies.

But we need time to focus on mums too. And the challenge that we're talking about today and that the research that the NCT have uncovered is showing that the women are not having proper postnatal checks. with a GP or other qualified healthcare professional to talk through the physical challenges that they may still be facing following delivery, but also the psychological issues, the challenges whether they, you know, one in 10 women will be developing postnatal depression and have signs of it by that six-week check, as well as their social situation.

Is there anything else that we need to factor in? So truly holistic care, but it takes dedicated time and it's quite separate from us checking over and focusing on the baby. Why in a national health service is this not a universal provision? So the baby check, part of the childhood surveillance programme is funded, is an obligation that we have to do this, we have to provide it, it's mandated, it's contractual, and therefore it happens. Whereas checks for mother are one of those nice things that's good to do,

there's no contractual obligation, there's nothing forcing, there are no searches done to seek out these women. Women are expected to contact the surgery to ask for an appointment, and if they're not guided and directed to do so, then the GPs have no way of knowing who these people are because of course we've got the risks of the new babies but we don't know necessarily who their mums are. The baby's records are completely separate from the mums so we need a contractual mechanism to ensure there's funding for this because it is

important. I don't think there isn't a GP in the country who would disagree with it. We value that time to bond with our new mums because we know we'll be seeing them in the country who would disagree with it. We value that time to bond with our new mums because we know we'll be seeing them in the years to come with their children. Now, Kavita said she saw a nurse practitioner and I know nurse practitioners do a lot of very good work. But how acceptable is it for a nurse practitioner to have the burden of doing the kind of check-up you're talking about? A nurse practitioner is more than capable of doing a very good postnatal six-week check if they're suitably trained and

they've got the backup of a GP or other colleague. There may be training issues but nurse practitioners are brilliant colleagues. The key thing is the time to do this properly and if a nurse practitioner detects issues particularly around the mental health side of things which tends to be an area they're less expert in, you would expect them to be referring on to a GP to flag this. Or, as I said, the majority of these checks and mum's checks are usually done by GPs still. Now, Abigail, I know you're calling for the 10-minute check-up to be included for mothers in the GP contracts. What have you managed to find out about why it isn't? So it's been a bit of a challenge to be honest to find out we get the impression that in the past

the maternal check was included in the contract that sets out everything that GPs are required to do and then that comes with funding but it's not there at the moment as Helen said and without that funding and its inclusion in the contract it seems less likely to happen and less likely that women receive this really vital care. It was funded at some time in the past, I think, wasn't it? Helen, do you know why it disappeared from the contract? So my understanding is it was definitely in the contract prior to 2004. But in 2004, there was a massive shakeup

of the contractual systems for general practice. And many things were stripped out as being cumbersome and unnecessary. And what GP's said is, look, women are more than welcome to come along and have their appointments.

It's part of good care. We'd like to provide this. But what's happened over the years since then, the 15 years, is the general practice has got far more pressured and far more stressed and we're understaffed and under-resourced.

And so what happens is we don't pursue these things in the way we would have before. Our focus is on the urgent care, the people who are desperately asking for appointments from us. And so we don't go out seeking these things. Also, there's been a greater distance from our midwifery and then health visitor colleagues.

In the past, we used to bump into them at the surgeries. We would have conversations about our new mums and any issues that anyone was suspecting. Now we've lost that due to fragmentation across the system. So there are several things coming into play here. But we know that putting things in a contract is actually an incredibly helpful way of making it happen because you then prioritise, you have a bit of resource to make it happen and to find the space and time to seek out these women and make it easier for them to come and see us. Helen, we all know that GP services are under tremendous pressure, but do I read into what you're saying that women's health is suffering more than most? No, we don't have

clear-cut evidence of that, but we do know that people who are busy, who are stressed, and particularly people with mental health problems, don't have the perseverance sometimes to battle through the system to get an appointment. So sometimes those who really need to see us are the ones who find it most difficult to, because our systems are set up for people who have got the time and energy to work, to sit on the phone, to get an appointment, to go on the computer and to be looking for a slot. So it's sometimes,

it's not that anyone is deliberately deprioritising women. Let's face it, over half our GP is a female. Women's health is a massive priority for us and we spend a lot of time on it. But it's more of a consequence of several factors coming together. Over a million people today will be seeing a GP or one of their teams up and down the country. We're working really, really hard and we want to do the best by every patient. Kavita, how are you now? And how's your baby?

My baby is incredible. I think all mums say that he's a little terror and he runs around everywhere. I'm still working on myself for my mental health and trying not to relive those first six weeks because I found that difficult. All I want to do now is with Abigail is help NCT, help other mothers to not feel the way I felt in those first couple of weeks because it is very lonely. You don't feel valued and you just feel really isolated. That's what I want to do well go to travina abigail wood and helen stokes lampard thank you all very much indeed for being with us and of course we'd like to hear from you too if you had problems similar to cavitas do let us know you can either tweet us or of course you can send us an email. Now, Jackie Kaye's list of achievements is now very long. She's the MACA, Scotland's National Poet,

Professor of Creative Writing at Newcastle University, Chancellor of the University of Salford, and writer-in-residence there. Her bibliography includes books of poetry, plays, novels, and a memoir, Red Dust Road, which was recently performed in Edinburgh as a play and is now touring. Well, it was in 1986 that she wrote a play called Chiaroscuro, which is being revived at the Bush Theatre in London

in a series of productions called Passing the Battle. The intention is to reacquaint audiences with the work of writers of colour who've worked their way up through British theatre. Jackie's play, written when she was 25, has four women all trying to understand who they are and where they come from as black women in Britain. And Jackie joins us from Glasgow. Jackie, what do you remember of the 25-year-old Jackie Kay? Quite a lot, actually, because I still feel like the same person.

I don't feel like I've changed much at all. But I do remember a theatre of black women who first did the production asking me to write a monologue. And so I wrote one single monologue. And then they said, actually, we'd like you to write a whole play. So they put on these workshops and supported me in writing a play. I'd never written one before. And so that was my first play. And I think, yes, I was about 23, 24 when I started writing it.

What's it like to revisit a work that you wrote? I'm sorry to remind you, 33 years ago. Thank you, Jenny. That's kind of you. It's really strange. I mean, it's strange when you're a writer because you have different ways of remembering your past and one of them is through your actual writing

you know so rather than just have photograph albums and other different ways that people remember things you have your writing itself that puts you in touch with that younger you and at that age I was really interested in the whole question of identity which is still very pertinent today and particularly in differences between

black women so that's what I was writing about and so it's interesting that they've picked that Lynette Linton has picked this to do a revival of it I mean it's a great honour you hardly ever get a revival these days I think it's the first play of mine to have a revival so it's quite exciting. Now Beth who's played by Shiloh Coke, one of the characters, is about to start an affair with Opal. And she ponders, what does it mean to be a black lesbian? And when I was listening to her, I thought, how much is she Jackie Kay? Yeah, she probably is a bit like me. She's probably the character that was the most like me. Because, yes, when I was in my early 20s, I was thinking about that

because people sort of thought that you would either be black or you'd be a lesbian, but being a black lesbian wasn't really talked about that much then and so I wanted to create a character who was a black lesbian and put her out there and so it's nice that Beth is getting this reincarnation. She's also thinking about having a baby and I know that your son Matthew was born in 1988 so how much were you thinking about him or her I mean you didn't know he was going to be a him at

the time in the writing? Yes I always wanted to have a baby and I never thought that being a lesbian should preclude me having a baby so yes, he's 31 now just turned 31 yes, if you were in front of me I'd say, tell me I don't look old enough Of course you don't Yes, and it's

yeah, and I've always been a lesbian mum I mean, I remember when he was 14 saying to him, Matthew, it's quite cool having a lesbian mum, and he, I remember when he was 14 saying to him, Matthew, it's quite cool having a lesbian mum, and he said, it's not. It's not cool at all. He said, it'd be cool to have a lesbian gran. I told this to my mum and she said,

what am I supposed to do, change my sexuality at this late stage? To which you said, no, mum, you don't have to, of course. At the centre of the play, it seemed to me, is the difficulty the four women have in communicating with each other. Why was that an important question? Well, I just remember those early days of black feminism. I first went to the OAD conference in 1984, which was the Organisation of Women of African and Asian Descent.

And they were very exciting conferences and groups, a black lesbian group formed out of that. But everybody was exploring differences, differences in political persuasions, differences in opinions, and differences in consciousness and ethics and what to wear, how to dress. I mean, these were quite early days of feminism

and particularly of black feminism. So there was lots and lots of conversations around identity, lots of arguments, disagreements, people just trying to work themselves out, really. And I found that period of time very, very exciting. I mean, I'd grown up in an all white environment. So just having black friends was new for me. And so it was it was, yeah, it was a kind of heady time. I remember when I went to Owe and not not even knowing if I would be kind of accepted there. And because I didn't know if I was dark enough. And I didn't know what the differences were between dark women and light women and, and all of that. So these were the kind of issues that I was exploring in Kearoscuro. And, and interestingly enough, these are these are still current, these issues of identity. People are still talking about them. Yes, that comes over very strongly in the play, pointing to the issue of how skin shade means women are treated differently. And I was a little bit surprised to find that that still stood after all these years.

I know. Well, we live in a world that is very, very racist. And, you know, in that world actually seems to be getting more so in lots of ways. So I don't think it's necessarily, I mean, it's sad because in the 70s, I think we thought that racism was something that we could fight and win. But today in 2019, we see that that is an ongoing battle. We still need to have hope, and we still need to have a great deal of hope at the amount of people that are opposing racism. But it's shocking to see the rise in racist attacks in our country,

for instance, after Brexit, and the ways in which that pits people against each other. It was written around the time of the Clause 28 debate. And I wondered from that perspective, on the question of sexuality, how much does it now feel very specific to its time? Yeah, I think that probably the greatest change in our lifetime has been the changes in attitudes towards gay people. I mean, we're still experiencing

homophobia and we still experience attacks, but there has been a massive shift in attitudes towards gay people just even in the last 20 years, particularly in Scotland, I think. Scotland's meant to be one of the most gay-friendly countries to live in in the whole of Europe, which is kind of unthinkable. You know, when I was growing up, I was 16 in the art class and I remember the school bully going, Miss, Miss, Jackie's a lessee. And the art teacher turning around to me and saying, well, are you Jacqueline? Are you a lesbian? And that kind of thing.

What did you say? I said, I don't know. I really don't know. And that shut Anne Kerr up. She just stopped talking. It was the truth. And I just really didn't know. But and I remember saying to my mum, you know, when I was 17, how would you feel if I was to tell you I was a lesbian?

And my mum saying, I would be very upset because you would be becoming something I don't know or understand. You wouldn't be Jackie anymore. And that really disturbed and kind of upset me. And I thought, oh, I'd still be Jackie um so that kind of attitude has changed my own mum's changed massively but people's families have changed massively on the whole um I mean obviously people have negative experiences as well but I think the shift in in societal opinions has been vast so it'll be interesting to look at Kiaroscuro from that point of view too. Jackie Kay such a pleasure always to talk to you thank you very much for joining us this

morning and Kiaroskoro will run from the 31st of August which has already passed until the 5th of October and thank you very much Jackie There's still to come in today's programme a new novel by Tracy Chevalier. A single

thread is inspired by those women known as Surplus after the First World War. It's set in Winchester, among the embroideries of the cathedral, and the serial, the fourth part of How Does That Make You Feel? Now, every day in the United Kingdom, a family receives the terrible news that their child has cancer. The statistics for children surviving cancer improve every year, but treatment can be pretty brutal. Sometime soon we'll be talking to young people who've survived their diagnosis, but today it's parents. How do families cope with the news, the treatment and the impact of surgery, chemo and radiotherapy? Lucy Waller is a clinical physiotherapist at Great Ormond Street and the organiser of the Mini Olympics to be held on Saturday at the Queen Elizabeth Olympic Park in London.

Kate Hewson is the mother of Charlie, who's now nine. He was diagnosed at nine months with an aggressive sarcoma in his right thigh bone. He's been in remission for five years. Andrea Hambry is the mother of Kiva. She's eight and was also found to have an aggressive sarcoma when she was three and she's been in remission for two years. Andrea what treatment did Kiva have? Kiva had quite intensive chemotherapy. She had very severe surgery on her left thigh. And then we were sent to the Proton Centre in Jacksonville, Florida, where she received proton beam therapy. And now, of course, she could have had it in this country,'t she because it's been introduced. Yes the centre in Manchester just opened in January so yes.

And what about Charlie Kate? What treatment did he have? So Charlie had chemotherapy and then he went on to have surgery which is called rotationplasty to remove the tumour and then he also had high dose chemotherapy after surgery so it's 10 months in total. And what physical effects are there now he's in remission? So he had to have an amputation so he now has a prosthetic leg. Rotationplasty is where you take the lower leg and you move it up and you turn it around 180 degrees so his foot effectively now becomes his lower leg. So he now wears a full prosthesis every day. And what about Kiva?

Surgery the first time was quite invasive but unfortunately two years later she did relapse with a new cancer in her pelvis and we had a very severe diagnosis at that point and she had surgery to remove her pelvis most of her pelvis and her hip socket she hasn't nothing has been replaced with her it's all just healed but you know there isn't any physical with her appearance I think that she's got any problems but you know she will probably have a limp and in terms of her um spine we'll probably have to have further surgery and there'll probably be long-term implications from it but at the moment she's she's doing okay she's um what did it mean for the family's daily life, Andrea, as you went through this treatment? It was pretty horrific, to be honest.

The first time, you're kind of on a conveyor belt and you've been told by your physicians and your doctors and your nurses that this is what's happening. And, you know, I have three other children and we had to upheaval and go to America and take the whole family with us. We come back and you're just getting your life back in track. And then she relapses and the whole thing happens again.

And you go through the whole protocol. But I always say ignorance is bliss. And the second time for us, the diagnosis wasn't great. We were told that she may never walk again. And you've always got that in the back of your head that, you know, you may have a child who's got a severe disability um it has a terrible effect on the siblings that's exactly what i was going to ask you how on earth do you manage to give your other children your attention when one of them needs so much it's very difficult um i'm really lucky that you know my husband tom is very supportive and he had to take time off work.

I have my mum and my sister and my brother who were incredibly supportive. But, you know, you're living your life through the child who's got cancer because you are completely giving your time and your effort to them. It's very hard to come home and switch back to a normal life. But you do, you manage it. And looking back, you kind of think, how do we get through that? But you do somehow, you do kind of, you get strength. And my motto is that there's always someone far off worse. So yes, you're having a bad day, but let's be positive

and let's hope that today will be a good day. Kate, I think Charlie was your only child when this all happened. Yes. How was your daily life and that of his father? So we both weren't working. We were working, but our employee was fantastic, so we both didn't have to go to work. So I had him by my side 24-7, And we threw ourselves into it, threw us straight away.

And we had really supportive friends and family as well, which is incredible. So we're very lucky. But when something like this has happened, how do you look ahead and think, shall I or shall I not have another child? So I would say it took us a long time to decide to have another child um but i felt that charlie shouldn't be an only child he'd had a lot of attention and a lot of of you know it's a lot often it is a lot about charlie and i and i felt that to have a normal family and and to feel and to do it properly we needed to have another child. And I'm really, really glad we did. Really glad we did.

What are the major problems that face children who've been treated for cancer as they grow older, Lucy? There's a huge number of side effects. The survivorship numbers increase, which is fabulous fabulous but that comes at a cost there's a huge number of long and short-term side effects so Kate and Andrew have already talked about some of the musculoskeletal but we know children in the future struggle with fatigue pain cardiovascular endurance poor bone health, they're more likely to have osteoporosis, have problems controlling blood pressure, they find it difficult to build relationships with their peers, have good body image, self-confidence.

And there are some side effects of cancer, like these guys have talked about, that we are unable to solve. They are a consequence of being a childhood cancer survivor. But there are some things that we can do. And we know that being physically active and partaking in exercise is hugely beneficial on many levels to negate some of those side effects. We'll discuss all the bullying of these poor children that you do in a minute. No bullying occurs, I can assure you. What I wondered, Andrea, was, you know, how do you manage as they get older? How protective do you have to be?

How much do you think, yeah, she can do stuff. It's okay. I was saying to the girls earlier that when you're with Kiva, she's extremely active and very adventurous. And there are things that she does sometimes. And I do bite my lip and I do say, oh, my goodness, should she be doing that? But I can't hold her back. I can't put my fears and my inhibitions on her. I've got to let her know her own pain threshold

and know what she's capable of and what she's not capable of. But with her, there is no boundaries. She will do whatever any other child is doing. And in fact, she will do it 100% more because she wants to prove that she is the same as everybody else. So it is difficult. And I do say sometimes I go to bed at nine. I think, oh, my goodness, how does she do that today?

And I pray that there's no like there's no kind of problems with her hip or whatever. But at the moment, she just is a normal, active eight year old who does everything in her power to be as adventurous as she possibly can. And Charlie's a footballer. Charlie is a footballer. Charlie is a footballer. Charlie plays for his local team, Linfield, and with all his friends who have two legs. He also attends an England Amplitude Football Association camp up in Crewe three times a year, which is fantastic. So he does a bit of regular football

and he also does a bit of disability football as well. OK, Lucy. sticks so he he does a bit of regular football and he also does a bit of disability football as well okay lucy how do you persuade the children that they can play football they can go swimming they can ride a bike they can take part in a mini olympics well often it's not the children we have to persuade sometimes there's a bit of a completely understandable barrier from parents and I think it's about timing so obviously when parents and family get the diagnosis of childhood cancer they and I'm sure you'll agree great I will go through almost like a grieving process and coming in at that point is not often necessarily useful or beneficial. But I think once you explain and educate the benefits of being active

and they are far-reaching, and then once you set small goals, and it might be about changing the way a child does something or setting new types of goals, and I think parents then can suddenly see or gain a real sense of empowerment actually so much is being done out of the family's control really to their child that actually doing an exercise program or getting them back on their bike or encouraging them back to PE and then seeing the benefits that the child then has for themselves interacting with their brothers and sisters, regaining those kind of building relationships with their friends and doing, being, you know, we take for granted being active

as something that children are able to do every day. And I think it's really important for them to be going back to doing things that they were doing previously or showing parents. And once you show them and the children then are so proud of what they're able to do then there doesn't really take a huge amount of encouragement after that because they've hold as well as the child and family can see the huge amount of benefits. Andrea how much he you've got a daughter now who I know swims with her father regularly if not daily? They do swim quite regularly.

When she was on treatment, she had what she called a Hickman line, which most cancer patients will have to receive their chemo and do their blood tests, and you can't get it wet. So we bought from Hammonds a very special dry suit, which allowed her to go swimming in the hydro pool, and that was part of her physiotherapy with Lucy and the team at Great Ormond Street and without that, that was her lifeline and she also was able to take part in a machine

that the physio team had at Great Ormond Street called a gravity machine which allowed her to, it took her weight and allowed her to walk as if she was walking normally but it held her weight but swimming, we got a bicycle from a very special charity cyclist fighting cancer and and that gave her you know to be like her siblings and her friends but what what are your concerns now as she grows older and

bigger and may need further surgery um i guess you it's always in the back of your mind and of course reoccurrence is always back in the back of your mind but you know she's under very strict surveillance we have scans every two months and I guess at some point they will say to us that she probably need reconstruction around her pelvis and hip and she may need surgery on her spine but I guess you can't think about that on a daily basis you have to you know live your life as normal as possible and just be grateful for what you've got at the minute but um you know I think there will always be that kind of nagging in your head that you know there could be a day when something is going to raise its ugly head

but you have to just be hopeful I think. And Kate what about Charlie and maybe further treatments or that terror of recurrence? That's I mean that that will always be there but we're on long-term follow-up care now so we don't have any scans to to check for any cancer anymore so I've put that behind me and we're just looking forward and and encouraging him he's now a child, not a patient. So it's time for him to just be a child and be like everybody else. How much does he talk to you about what he went through and what worries him? So he doesn't remember. He doesn't remember. He was tiny.

So he was nine months. He had his leg amputated at 13 months. He learned to walk with his prosthetic leg with the help of Lucy. I talk about him. So we had a conversation with him about two days ago. And I said, Charlie, do you feel different to anybody else? And he stopped and looked at me and he said, no. The only time I feel different, mummy, is when my leg snaps. Because every so often, because he's so active and so so um you know

trying to find a leg that that is is for his size to beat his level of his ability to run around so that's the only time that's the only time so you've got all these children coming on saturday to your olympics we have what sort of things will they be doing? Everything? Yeah, everything. We have a day for all cancer patients treated at Great Ormond Street, both on and off treatment. And basically the aim of the day is just to get children involved in being active through their treatment or at the end of their treatment and to kind of highlight the benefits. But the day is going to be, there's everything there,

from cheerleading to dancing, ballet, rock climbing, fencing. It's going to be a wonderful day that we will hope to run every year following this year. Lucy, Orla, Kate Houston, Andrea Hambry, thank you very much indeed, all of you. And best of luck to the kids in the Olympics. Thank you very much. Hope they win gold. Thank you.

Many thanks. Now, Tracy Cheval luck to the kids in the Olympics. Thank you very much. Hope they win gold. Thank you. Many, many thanks. Now, Tracey Chevalier hit the literary big time 20 years ago when she published Girl with a Pearl Earring, which was also made into a film. Her new novel is called A Single Thread and is set mostly in Winchester in 1932. Violet Speedwell is one of the women who were considered surplus after the First World War. Her brother and her fiancé had been killed and she lives alone with her rather difficult mother. She finds a new life and a job in Winchester and widens her circle among the women embroidering

cushions and kneelers in Winchester Cathedral. Tracy, what was it about Winchester Cathedrals that inspired you? Well, it started out with cathedrals. I've loved them since I was a teenager and used to explore the one where I grew up in Washington, D.C., trying all the doors to see if I could get up into the locked bits. And once I did get up high and I find cathedrals fascinating in the secular age that they're a building that are receptacles of history and culture and actually a lot of time and money that were poured into them. So they're often the focus of a place. And I thought, I want to set a novel in and around a cathedral in England, which one am I going to choose? And we have a wealth of fantastic cathedrals here. But Winchester particularly

appealed because it had such interesting stories attached to it. And Jane Austen is there, of course. But when I got there and looked around, there were all these, you know, different stories about Oliver Cromwell's soldiers rampaging the place, about a diver in early 20th century who shored up the foundations of the cathedral. But I found myself looking down at these cushions and kneelers that are in the choir stalls of the cathedral, which were made by a group of volunteer women in the 1930s. And I thought, I want to write about those. I didn't really think about why. And now I think it's because when you look around the cathedral, all of the art, the stained glass, the carved wood, the carved stone, the building, all designed and made by men.

But one thing has definitely been made by women, and that is the cushions and kneelers. And why were you fascinated by the idea of the surplus woman, the woman uncomfortable with being considered a spinster? Isn't that an awful name, surplus women? Of course, that was dubbed by the newspapers in the 1920s for a census was taken in 1921. And they found out there were 2 million more women than men post World War One. And the newspapers went a little hysterical with this, saying it was going to be a big problem. The cushions and kneelers in Winchester were made in the early 1930s. And I thought, my heroine, I want her not to be young. I want her to be a

little older. And that means she's been really affected by World War I. And then I found out about this surplus women. And I thought, Violet Speedwell, my heroine, is going to be a surplus woman. She's a spinster. We have no good words for any of this. What's a good word for a woman who is single? We still haven't come up with it. They're always pejorative, old maid, maiden aunt, spinster, harridan. And I thought, I want to take a single woman and show what she can become, what kind of independent life she can make for herself. Now, Violet is not real. She's your imagination. But Louise, is it Peasel or Peasel?

I wasn't... Peasel. Peasel. She is. Who is she? Louisa Peasel was a woman who was born in Bradford in the late 19th century, and she became an expert in embroidery from all over the world. She helped the V&A with its collection. She taught girls how to embroider in Greece. She

went traveling all over. She remained single. And in 1931, the Dean of Winchester Cathedral hired her to make design and make cushions and kneelers for the choir stalls. Now that part of the cathedral is quite dark, and she decided to make them very bright. They're yellow, blue, red, geometrical designs. And these medallions in the middle of the cushions that are designs of scenes from history of Winchester in England. And they're really unusual and beautiful. But she needed literally hundreds of women to make them because there are, I think, 300 kneelers and about 56 cushions, all big cushions. And she went from 1931 to 1936, keeping, corralling these women and designing them and making sure that they looked great. She had them unpick if they needed to.

So I was fascinated by the dynamics of a volunteer group of women together. Now, Violet has a difficult relationship with her mother. Why were you keen to explore that? Single women at that time were very dependent on their families. And often you would get a woman who, when she didn't marry, in a society that expected women to marry, if she remained single, she was expected to look after her parents. And so Violet lives with her parents, then her father dies, and she's left with her mother, who's still grieving the loss of her son in World War I.

And I wanted, Violet was going to get stuck in this life of looking after a difficult mother, and she wanted to have her independence. And so I needed to make the mother difficult enough for Violet to be willing to renege on her responsibility. And brave enough to go and take the room on her own and the job. Twelve miles away. It's not very far. She moved from Southampton to Winchester, but her mother treated it as if she'd moved to Canada. You get very involved, I know, in the lives of your characters. I think you took up painting for Girl, fossil hunting for Remarkable Creatures, quilting for The Last Runaway. So how good are your embroidery and your bell ringing, which she also

learned? Yes, there are. I was really interested in the communities that develop around a cathedral and there still is an embroidery group that works for Winchester Cathedral. I took up the needle and did what's called canvas embroidery then. It's now needlepoint. I did a bit of it so that I would be able to describe it more accurately. That's why I do it. That's why I learned to paint and and and quilt so that I it's easier for me to write about it. And then I wanted to have to contrast the community of embroiderers with another group, mainly male at that time, bell ringers in the cathedral were an all male group, and they're they're tucked away up in their bell tower.

And they are kind of disconnected from the rest of the cathedral, and they ring for the pleasure of doing it for themselves. Whereas the women are making the cushions and kneelers for the comfort of other people. And I wanted to contrast and balance those two groups. So Violet gets to know a bell ringer and goes up into the bell chamber the way I did many times to watch the bell ringers. And they have a dummy bell where you can pull the rope and it doesn't ring because it's so hard to do. It takes years to learn to coordinate properly and learn to ring with other people. So they did let me pull that. And I also went to St. Anne's Church in Highgate, which is not far from where I live, and they ring every Thursday,

and they let me ring an actual bell. So I think I woke up the neighbours one evening with my bell ringing. And which bits of embroidery have you actually still got that you made yourself? I made a spectacles case, and I made a needle case, both of which my character Violet Speedwell made, and I wanted to recreate them. Well, Tracy Chevalier, thank you very much indeed for being with us this morning. And I thoroughly enjoyed the book, by the way. Thank you. We had lots of response from you on the question of the six-week mother and baby health check. Karen said, my daughter had exactly that experience. The baby was thoroughly checked, but when she asked for her few minutes, the doctor, female, said, you're okay, aren't you? She wanted to talk about contraception

and her severe depression, but was completely brushed off. She stood with tears running down her face but received no compassion or indeed interest. She went on to develop postnatal depression. Your piece made me wonder if that could have been avoided if she'd received more care at that early stage. Elizabeth said, I had a baby on the 2nd of January this year. I had a letter from the GP practice saying they no longer make six-week appointments for the mother because they expect you to raise any issues with the midwife or health visitor. But an appointment with a nurse practitioner would be arranged if required.

I phoned and asked for an appointment with the GP because I was still having pelvic pain and urine issues and was told I couldn't have one. I went to the appointment with the GP because I was still having pelvic pain and urine issues and was told I couldn't have one. I went to the appointment with the nurse. She asked me about contraception and how I was and when I said I was still having a lot of pain she said well what do you expect you've just had a baby and that was it. Someone else said I'm listening to this program and it's brought back terrible memories of being terrified to disclose that I was struggling to my GP. When I finally got the confidence, I disclosed to my GP, who was horrified, and contacted social services as she felt my baby was at risk. I was spoken to by social services, who dismissed her concerns but offered me no help.

I then struggled with this for three years on my own. Dr Meg said I'm a locum GP. We're only given 20 minutes for a postnatal check. This includes mother and baby. To examine a baby adequately and discuss and examine mothers is nearly impossible to do in the time allocated. It's an incredibly important opportunity to look for postnatal problems. There isn't enough time for. It's a reflection of the pressure on general practice, not a reflection that doctors don't think it's important. Victoria said,

I have two children born since 2014 and in both cases I had an extended appointment with a GP where myself and my sons both had a full check. My check included both my physical and mental health. My second son was very unwell when born and spent his first six days in the special care baby unit. When we came home I got a call on my mobile from one of the GPs to say welcome home and how glad they were at the GP surgery to know that my son was safely home. Also to encourage me to contact them should we need any support at all. Excellent care is out there. Samantha said as a midwife when I'm discharging women to come home from hospital I tell them to make an appointment with their GP. I always tell them to make a double

appointment as the GP should check her over and ensure she's recovered from pregnancy and birth as well as checking the baby. And Janet said disappointed at the snapshot of checks for mums and babies as a recently retired health visitor of 48 years. I know checks were being done and as health visitors we diligently followed up all mothers. In the deep and distant past, we did the baby checks, but they took 30 minutes and incorporated mum's physical and mental health, who were also seen by a GP. Postnatal depression has been a priority always in the health visitor service.

Of course, this service has been diluted and stretched. It breaks my heart. Joe said my son is 13 days old and we've booked our six-week check where our GP surgery is given as a 30-minute appointment. On growing up with cancer, Anna Griffith's car said, I'm sitting in my kitchen sobbing. I've been having a difficult week with my little fellow, three years, three months, feeling like a bit of a duff mum. Now I'm hugging him close on my lap while listening to these incredible women talking about their own beautiful babies. And then on Tracy Chevalier, Lettie Hawthorne said, I loved this book, being lucky enough to receive an advance copy. Learned so much and loved the story.

Tracy always writes so beautifully, well-researched and engaging. Great interview. And then Leo Donaghy said, Good morning, Jenny, just listening to your programme. An old unmarried friend of mine called Lily Parry liked to be known as one of life's unclaimed treasures, not a spinster. Quite right, too. Now, do join Jane tomorrow when she'll be talking to Sue Chung about her book Chinglish, an almost entirely true story.

It's an account of Sue's adolescent as a first generation Briton growing up in 1980s Coventry above her parents' Chinese takeaway. That's tomorrow, two minutes past ten with Jean. Bye bye. Russell Cain here and I'm here to tell you about Evil Genius, the BBC Radio 4 podcast where we take icons from history and then decimate them by slinging mud. Think you know everything about Einstein? You don't. He was a woman hater. You probably think you know about Amy Winehouse, that she was a victim. She had a pretty dark side, and we're not shy about exploring it.

Evil genius. We take people from history, and a panel of three fellow jesters have to vote at the end of the show. No ifs, no buts, no grey areas, evil or genius. Plus hilarious banter as well. So head to BBC Sounds now and hit subscribe. 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.