Woman's Hour - The power of crying, Hubble astronaut Kathryn Sullivan, Children and Coronavirus

Episode Date: March 7, 2020

The power of crying - Keith Brymer-Jones, one of the judges on the Great Pottery Throw Down, the psychoanalyst and psychotherapist Susie Orbach, and voice coach Joanna Cross discuss.Kathryn Sullivan, the first American woman to walk in space, was an astronaut in the team that launched the Hubble Space Telescope in 1990. After mastectomies the aim is to make breasts look and feel as they did before but sensitivity tends to suffer. Sarafina Nance is leading a campaign to increase understanding of sensitivity and talks about an experimental nerve-preserving procedure she received in the USA last year. We also hear from the breast surgeon Dr Ayesha Khan on treatments available in the UK. Composer Emily Hall on the inspiration behind her piece for the Seven Ages of Women, a new commission by Radio 3 to mark International Women’s Day. Coronavirus – how do you reassure children when everyone is talking about it, and how can they best protect themselves? We hear from Professor Trudie Lang, Director of the Global Health Network at the University of Oxford and Emma Citron, consultant clinical psychologist. Vogue Williams, TV presenter and Instagram influencer on the rise of parent shaming. Celebrating 10 years of the Women of the World Festival - two young activists Eunice Mwende and Dajanaa 'Dexi' Stosic on working to empower young girls and women in Kenya and Serbia. Presenter: Jenni Murray Producer: Dianne McGregor

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. Good afternoon. In today's Weekend Woman's Hour, the 10th anniversary of Women of the World, the WOW Festival. And tomorrow it's International Women's Day. Emily Hall is one of the seven composers commissioned by Radio 3 to make the seven ages of woman.

Coronavirus. How do you reassure your children when everyone is talking about it and how can they best protect themselves? And crying. Why do we do it in public? Keith Brimer-Jones is a judge on The Great Pottery Throwdown

and does it a lot. I remember that the first time I got tearful was the first five minutes of the first series of the first episode. The director could hear her in the background going, my God, the judge is crying. This is brilliant. The TV presenter and Instagram influencer Vogue Williams asks why it's so often another parent who makes you feel ashamed if your child's throwing a wobbly. And new research on breast surgery. Is it possible to retain sensitivity after a mastectomy?

Now, I clearly remember sitting in the Newsnight office in 1986 as we all gathered round to watch the Space Shuttle Challenger take off, and the stunned shock we all suffered as it disintegrated before our eyes. I can't imagine anyone ever wanting to travel into space after such a terrible disaster, but Catherine Sullivan did, and became the first American woman to walk in space. She was part of the team that put the Hubble Space Telescope into orbit in 1990. She had been to space on an earlier occasion in 1984, two years before the Challenger. Well, she's written about her life as an astronaut in a book called Handprints on Hubble. She had studied oceanography at university. So what's the connection between the oceans and outer space? In one level, they're quite closely connected. And that is you have to mount

a fairly complex expedition to explore and understand either realm. So I had begun doing oceanographic expeditions my fourth year at university and carried on through graduate school. Loved going out to sea, really enjoyed the jigsaw puzzle, if you will, of planning an expedition and thinking through all the what ifs so you could carry on even if the weather turned bad or a bit of equipment broke down. And that's essentially the same discipline, but on steroids, that NASA sort of needed for the job that I was applying for, which was what we called it Mission Specialist, which means all of the cargo and operations that are the reason the shuttle's going into orbit.

Plan those out, make sure you're really ready for it. Again, make sure you've thought about a lot of the what-ifs and you can keep everything going. How does it work? It's a little bit like when you're asked to be recruited to the spy services in Britain. You get a little bit of a note in your university pigeonhole or a tap on the shoulder at a cocktail party or something.

How did they recruit for NASA? Yeah, a little more blatantly than that, OK? Especially back then, this was the first round of selections for this new thing called the Space Shuttle. And at the time it was projected the shuttle would fly very, very frequently. So NASA was wanting to really dramatically expand the number of people in the astronaut corps. They hired Nichelle Nichols, who'd been the actress that played Lieutenant Uhura on Star Trek. And they had her going around encouraging women and

people of color, people who'd never been in the astronaut corps before, to throw their hat in the ring. They put advertisements in many of the scientific trade publications that academics would be looking at. In my own case, I was at graduate school in Canada. You won't be surprised to know NASA did not advertise widely in Canada. But they had caught my brother's attention in California. And when I went home for a Christmas break, he began encouraging me to apply for the program. When I first thought it was, you know, continue being

an oceanographer, but now try to do it from 200 miles away from Earth. I thought that was nonsense. But when I made this connection between the expeditions I already loved to do, and the kind of expeditionary work, it sounded like NASA was planning with the shuttle, then it started to make some real sense. This is the 1980s, where the space shuttle was taking off relatively frequently. It was something that actually those of us, I was at university at the time, had begun to take for granted until the terrible accident in 1986 involving the Challenger. You'd already been in space at that time. What impact did that have on you?

Well, it was, of course, an absolutely devastating moment for all of us. Four of the seven people on that flight were classmates that I had known since 1978. All, you're gone in an instant. And after all that, and it must have had a colossal psychological impact on all of you at NASA, you went back into space as part of the team that launched the Hubble telescope in 1990. It must have taken enormous courage, it goes without saying. Let's just hear a little bit of audio of the take-off. Antennae to the CNTS, the valve's closed, we're go. OK, you have a go to proceed. Yellow Cisco, for auto sequence start.

We are go for start. Booster hydraulic power units have started. 20. Sound suppression water system has started. 15. T minus 13 seconds. T-minus 10, go for main engine start. We are go for main engine start.

T-minus 6, 5, 4, 3, 2, 1, and liftoff of the space shuttle Discovery with the Hubble Space Telescope, our window on the universe. Great line, window on the universe. Great line, window on the universe. So Hubble, tell me about it. What is it for? Oh, it is the most fabulous looking glass that's ever been pointed towards the stars since Galileo, by far. What is it for?

It's for understanding more about how our own solar system works. It's for understanding more about how stars form and galaxies evolve. It's for looking far, far, far back in time to try to understand the origins of the universe. It's for making more precise measurements than were possible before to help understand how rapidly is the universe expanding. And somewhat unexpectedly, but in the course of its operating life, it became the first telescope to spot evidence of planets circling other stars. Later telescopes that have come along since have now run that number of exoplanets, they're called, outside of our solar system, up into the thousands. This is a really dove question, but I feel compelled to ask it. Where is it? Ah, it's about 330 miles above the Earth.

It orbits the Earth not right at the equator, but tilted to the equator by 28.5 degrees. It does one full circuit around the Earth about every 97 minutes. So it's traveling at 17,500 miles an hour continually. There are so many questions about this. Let's deal with the cynics question first of all. It's not looking at Earth, so it doesn't have a military capability. It has no military capability.

And it is looking out. Yes. Okay, so out it gazes, out at the known and unknown universe. And if it was worth something, it should have taught us something about how utterly irrelevant we are. Has it? Has it improved human behavior at all? I think Hubble has done something in that vein that's undeniable. It's the only scientific spacecraft I can think of since the dawn of the space program that has bled over into the popular culture in a really massive way. Some of that is down to the beautiful imagery it's returned,

and some of it is down to coming along at the time that the computer era and the internet were exploding to what we now know them to be. You can hardly turn around anywhere and not see a Hubble image. I've seen it on tattoos. I've seen it on socks, on lunchboxes, on the sides of rented trucks. And it's not just that advertisers have picked it up and taken it to those places, But the entrancement of Hubble's findings, you can see in the internet statistics and the search statistics. So from a motivation or inspiration point of view, make us a little more curious, make us pay a little more attention to our place in the universe,

what it is and what it's not. Are you a religious person? I would say spiritual more than religious in a denominational sense. Do astronauts, you can't generalize, but do you share a sort of interest in spirituality? I mean, you've walked in space. What does that do to your thinking? I do believe, I mean, every one of my colleagues I've ever talked to, it does, as you are suggesting, It rescales your sense of place in the universe, what's important and not important in discussions and debates amongst human beings on this little earth. You zoom a little bit further back and, I mean, you can see some political borders on the earth from orbit.

But you see them from that vantage point and they look like the silliest little lines that have been drawn in such an arbitrary place. Then if you look at one where you know there are hostilities across that border, you kind of put your head on your chin and say, can you tell me again why we have so much in common of our dependency on this magical little blue ball we live on, so much that ought to be bringing us together. But you ought to manage to draw this line and then go fight about it. I mean, how can that possibly make sense? Catherine Sullivan was talking to Jane and Ellis wrote,

I lived in the US for a while as a fairly geeky child in the 1980s when I was fascinated with space travel and intent on becoming an astronaut myself. I wrote a letter to Catherine and she sent a personal reply of encouragement and advice and a signed photograph with the message, Reach for the Stars. I still have her letter today. I'm now an early years teacher, so didn't end up pursuing my original goal,

but it was wonderful to hear Catherine speak and to be reminded of my childhood dreams. And if you want to hear about more inspiring women in space, you can go to the Women's Hour website and the Instagram feed at BBC Women's Hour and you can watch a new video. Helen Sharman tells us what it was like being the first British female astronaut.

Now, this weekend sees the 10th anniversary of Women of the World, the WOW Festival, which takes place at the South Bank Centre every year around this time and is now spread across the globe. It was begun in 2010 by the then artistic director of the centre, Jude Kelly. She now works full time on WOW and we were there yesterday. Jude, how did the idea for WOW emerge? It was simple. I was, by the time I started this, a very senior woman in the arts as a theatre director and as a producer and that was really almost unthinkable when I was a five-year-old that a woman could be in that position running the South Bank Centre and I reflected on the fact that so many other people had had to get me to a place through the vote, through birth control, through education and I'll never have met them

but then I was also meeting a lot of young women in particular coming to me 10 years ago and saying first of all I am not a feminist to make that very clear to me but then telling me the litany of things that were holding them back in their lives, intimate issues around partnerships, ideas about children or not having children, things that they felt they couldn't talk about, barriers to life, etc. And of course, these were women from all backgrounds. And I started to realise that we had lost our sense of understanding systemic inequality. We'd stopped naming it, we'd stopped watching out for it, and we'd stopped learning about it.

And I thought, you know what, we can celebrate so much that women have achieved. It's been amazing what women have achieved. Let's celebrate, let's have a festival, and let's use the stamina and the energy and the optimism of a festival to say, can we still be brave and talk about all the stuff that's got to be solved still. Now, an organisation called With and For Girls was set up in 2014 with the intention of supporting and empowering the next generation of female activists around the world. Every year, awards are handed out,

and two of this year's winners are Eunice Mwende, who works with girls from 15 to 18 at a resource centre in Kenya, and Diana Dixi-Stozic, who's a peer educator for the Human Rights Committee in Vranje in Serbia. Now, Dania, what does your organisation do exactly for girls? My organisation is part of the Human Rights Committee, Vranje, but the thing that we have programmed, especially made for girls who are aged from 12 and above, we are working with girls in every elementary school

and every high school in our district. And girls who are in high school are actually teaching other girls who are in high school as well or in elementary school about gender-based violence, about types of violence, about how to recognise it and where to report it if you know somebody who is a victim or you are the victim. And the other problem that we have is that we are working 24-7 on SOS Hotline providing help for women who are victims of domestic violence.

And we are completely free. We offer free lawyer support and free medical support. And yeah, we have tea parties. This is like a little British. So we still have something about you, but sorry. That's all right. Tea parties are always fine, as long as the rest of the work that you're doing is serious. Yeah, we have tea parties every Thursday about the subjects that girls are suggesting.

So in the end of the tea party, one of the girls, like, picks up the jar, the piece of the jar that they've written, and says, oh, in the next tea party we're going to talk about reproductive health. And on the next tea party we call, like, a female doctor to talk with them about reproductive health or we as peer educators talk with them about it. Eunice, what about the work that you do? So Resource Centre for Women and Girls is based in a rural place called Machakos in Kenya. At the moment we do work with girls from all over Kenya.

Resource Centre has quite a number of programmes. The flagship one is called Mentoring and Development Retreats. from all over Kenya. Resource Center has quite a number of programs. The flagship one is called Mentoring and Development Retreats. So this program, we recruit girls from the age of 15 and 18, and they come to the program for a period of three years. The reason it's longer is because we feel like if they come for only one workshop, they don't get enough information and knowledge to equip them in their day-to-day life.

So during the mentorship programs, they are residential. They run between 5 to 12 days, since most of our girls are still in high school. So they come to the program and they study quite... They are taught. We invite different facilitators who have majored in different fields, you know, peace building, governance, sexuality,

health, human rights, and our main aim is to enable them, to equip them with knowledge and skills so that they have a fighting chance in their day-to-day activity, life. Diana, how did you get involved in it? It was a little bit funny story. Like, I was on a workshop for learning how to make a jewelry, and they called me, like, on mistake.

And then I was... They called you by mistake? Yeah. And then that's how I got into peer education. But then I heard about everybody being mad at feminists and at feminism. And like whenever I hear something feminist in the street, everybody's just cursing about it. And I was like, they did it wrong. So everybody hates them.

And then I search it. I Google it. And I was like, no, but they didn't do anything wrong. Like, I should be that. They should be mad at me. Come on. And that's how I actually got into feminism. And I worked and I went to training, to courses, how to teach other girls, how to know about

women's rights, about basic human rights and everything. And then me with some other girls went to the president of Human Rights Committee. And we're like, it was actually her idea that a lot of women who report violence from their husbands actually do it because their daughters made them, because their daughters cannot stand with violence anymore, not the woman. So she was like, can you just teach girls how to recognize violence so they can teach their mothers or aunts to report it?

And we were like, yeah. And it's supposed to last only one season, but we're like three years old now. And now you know you're not doing it wrong. Yeah. You're doing it right. Okay. Eunice, how did you get involved in it? I heard from somebody that there's this group of women who take girls to hotels.

And in the hotels, you know, they have a buffet, they have different setups of food. So I was like, okay, I also want to go to a hotel because I've never been to one and have, you know, food which I can't serve. That was the initial thought which I thought, you know. I was like, oh, and I'll be sleeping in a bed and I don't need to make it. So that is why I applied for the program. Very good feminist printing, I reckon.

But once I joined the organization, I knew there's way more to learn and I've learned so much. So what benefits do you reckon the girls who work with you really get from you, Eunice? First of all, I'll use my example. When I joined the resource center, we have like, for instance, medical camps, which are regular. And I remember in 2014, when I went to the first medical program, one of the camps was for breast cancer. And during that time, we were taught how

to do self-examination. Initially, I knew, like, for instance, if it's breast cancer, you have to be over 50 years and your family has to have, like, a history of breast cancer. And at that time, I was 23, so I was like, oh, okay, let me just, you know, learn. And actually, surprisingly, two years later, I was diagnosed with breast cancer, and I noticed a lump during, you know, the checkups I was lead a sexual and reproductive health project

as I want to transfer the knowledge which I've already gotten to other people. And you're well now. Yes. Well, not quite. So I was diagnosed in 2016, did my treatment then. And last year in November, around November, I had a recurrence again but I am on medication and yeah I'm feeling well and I'm happy to be here. The very best of luck to you with that and to both of you with the work that you're doing. The front page of every newspaper and the lead of every news bulletin throughout this week has had the word coronavirus.

And on Wednesday, the first words spoken to me when I arrived at work were, Are you scared of the coronavirus? So how are children coping with the deep anxiety from which everyone seems to be suffering? How can we reassure them and get them to put it in perspective? Professor Trudy Lang is Director of the Global Health Network at the University of Oxford and joined us from there. Emma Citron is a consultant clinical psychologist. I think sticking to the facts is always a good starting point, Jenny. So just letting them know what we know so far and keeping them abreast of the facts. I think the worst thing to do is to try to hoodwink them or gloss over that. So that's a starting point. And then just

to point out, you know, we're not expecting an Armageddon here. We're not expecting to fall off a cliff. We're just expecting to manage and tackle and deal and then going on to quietly reassure them really. We have had an email from someone called Alice who said my five-year-old is very worried having nightmares and thinks we might all die. He thought he would catch it by being bitten by a fox. So I think he half heard something about live markets and filled in the blanks. But he is enjoying singing Happy Birthday with his hand washing. I mean, that is real extreme anxiety, isn't it? It is. And I think whenever there's something in the press or something going on in the world,

it does have this effect on some people. It's recognising that anxiety, even being prepared to take a child to the GP to discuss it and get a referral if the anxiety stays high. But I think in the first instance, it's a question of trying to present the balanced argument, presenting them with a different narrative that isn't just all about doom and gloom and catastrophe, because I think that's often what the headlines highlight. Trudy, we have been told that overall the illness is much less common in the under 20s. Why? And how do we know that that is definitely the case?

So my role in this is a researcher and I'm working with colleagues around the globe to address these unknowns. I'm also a mum, so I'm busy myth-busting with the children and trying to put this all in context. So absolutely, we know from the figures in China that less than 1% of those infected have been children and none have died. And the majority of the burden of the disease is of course still in China but we have to plan for more transmission in the UK and that's what the politicians have to do but we do need to keep it in context with the very low numbers we're actually still seeing now. What myths are you busting then with your own children? You know they come out with all sorts of things and they dramatically inflate the numbers sometimes too so I think just understanding the facts and putting them in context. But what would you say to them about

their worries about their mums and dads and possibly their grandparents because of course it's the older generations that are assumed to be most at risk. And that's where the government and Public Health England and everybody's working to really make sure that the most vulnerable part of the population is absolutely safe. And so that's where we're trying to make sure that everybody does the hand-washing if possible. We try and avoid situations where those people in the population can be protected. And that's why everybody has their part to play. But keeping that in context, the real risk to the individual is low extremely low

to children but we do need to make sure that if it does pass through the population in high numbers and that's an if that we can look after the most vulnerable and a lot of that is about the hand washing and trying to make sure that everybody doesn't get ill all at once and how easy is it to communicate the advice about hand washing without encouraging obsessive compulsive disorder? This is a very interesting one, Jenny. I think for those people, adults and children who have OCD, obsessive compulsive tendencies, this is not great, this news that we're getting, because clearly it's feeding into that aspect of their mental health. I don't think it's going to trigger OCDs in children or adults, but I do think that

it's going to exacerbate those symptoms for people that already have an underlying disposition. And what do teachers need to watch out for? Because it seems to me when this virus is so much talked about, it might create a reason for bullying somebody. Have you washed your hands? Your hands are dirty. Where do you come from? Have you been in touch with it? That kind of thing. What should teachers be looking for? Well, I think teachers should be keeping an eye out for that, particularly down ethnic roots or people, you know, with even Italian roots or whatever it is. I think there is a real danger of that, actually, of people being stigmatised in that way. I think teachers are very good at weaving into sort of talk time, class time, general discussions, which cover a variety of topics like the environment and other sources of possible anxiety.

And teachers need to be aware of bullying potential and also of the anxieties of the youngsters and how that's being triggered by the stuff that we're hearing about in the media. And just finally, Trudy, how would you explain the importance of the hand washing and it not just being about protecting yourself but maybe about protecting others? Yeah, I think I'd also start with saying it's such a good prevention step for any infectious disease including the normal flu.

So it's something that children should be encouraged to do anyway so perhaps it's been a useful step in just introducing that. I've spent most of my career working in Africa and trying to prevent infectious disease spread and hygiene and hand washing is central to that as well so it's it's a sensible educational step that we can put in so maybe that's a helpful context to put it in as well. Emma, how surprised have you been at some of the stories where we've heard that kids have not been taught to wash their hands before they eat or when they've been to the toilet? That certainly wasn't the case when I was young. I think it's horrifying. I think we've got a little bit too relaxed and I think the professor's right in that respect. So there have

been some useful lessons that have come out of this. And I think it's really nice to emphasise the positive and the proactive and what can kids actively do to make a small difference, because that empowers them and makes them feel that they can actually do something, which I think is good for their mental health too. I was talking to Emma Citron and Professor Trudy Lange. It's International Women's Day tomorrow, and to mark the occasion, Radio 3 has commissioned a choral work composed by seven composers of different generations. Each woman has written a movement for the piece, which is called Seven Ages of Woman. Each was asked to choose a text they feel represents them and their age.

Emily Hall is one of the composers. She's 41 and chose as her text a poem called Veins by the Russian poet Marina Tsvetaeva. Why did Emily choose veins as her text? I know Marina Svatyava's work and it always chimes with me. And I found this particular poem, which is about creativity and just how urgent it was for her to express herself even in the sort of context of domesticity and just everyday life which can be so time consuming and it it just struck a chord with me in my 40s there's less time but somehow there's always kind of music that I need to express. So what did that image of opening your veins mean to you? Well, it is a dramatic opening and it's an interesting text because it doesn't really reveal itself till the end.

It seems like it could be quite a dark poem, but actually she's making a metaphor about opening her veins and blood doesn't come out but poetry comes out and it kind of overflows from the bowls and the dishes which she's set the table with and it nourishes the earth and it's just got all these amazing kind of metaphors. You're obviously a great fan of Marina's work. How did you come across her? She died in 1941.

Yeah, I was asked by an ensemble called the Hermes Experiment to write, to set specifically Russian texts because they were doing a tour in Russia. So I alighted on her work and then I was surprised she wasn't more well-known in this country. How did you work with the choir and the other composers? Was all the work just done individually? You wrote it and sent it off to be performed? Or was there collaboration between you? There was a bit of collaboration. It was overseen by the eldest of the composers, Rhian Samuel.

In rehearsals, she sat next to me and she was like, go on, go on. When I had a, you know, when there was like a moot point, you know, she was like there going, go on, go on, Emily, stick to your gut. It was really nice, actually. So what kind of thing did you have to press for? Oh, there's always a little bit of a to and fro

between the conductor and the composer. And you do have to fight your corner because obviously what you've written is what you want. What about the younger composers, the teenagers? I mean, you were there with a grand dame overseeing you. What role did you play to help the young one? I tried to be supportive. I mean, I was pretty awestruck, to be honest. The youngest, Helena Paish, is only 17.

I sort of looked at her date of birth and realised she was only six years older than my son and had a bit of a, you know, double take. It's 11 years then since you had your son, your first child. What difference has it made to the way you work? You were talking earlier about Marina's work and the creativity and the domesticity and how domesticity can really interfere with the work. What's happened in your case?

I have less time and I think what tends to happen is the music and the songs tend to kind of well up in you and you know it's kind of why I was so drawn to that image of the poetry flowing out of the cereal bowls because sometimes I have to abandon you know fish fingers just because I have an idea I really really want to put down I mean the song that gets the most radio play of mine is called Eternity. And I remember writing that while my son was having a nap. And then the singer came to my house and we had to shoehorn the recording in. But funnily enough, it is the piece that's played the most. So I kind of feel you have less time, but I do feel there's been a sort of ease of getting things down on the

page. I was talking to Emily Hall and you can hear The Seven Ages of Woman on Radio 3 tomorrow at one o'clock. Still to come in today's programme the television presenter Vogue Williams and the way parents can be made to feel ashamed by others. Is it your fault if your child throws a wobbly in the supermarket? And why is weeping a powerful thing to do? Don't forget, if you can't hear the live programme every morning at two minutes past ten, you can always find us any time. All you have to do is subscribe to the Daily Podcast. It's free and you find it through Sounds or the Woman's Hour website.

Now, those of us who've had a mastectomy know that the sensation in the breast and nipple to which we've been used has the tendency to be there no longer. Indeed, when my surgeon suggested reducing my remaining breasts to match up with the one that now had an implant, I refused. I didn't want to lose all possibility of pleasure on both sides. Even now, 14 years on from my surgery, when reconstruction techniques are of a high quality when it comes to appearance, there's still a lack of feeling. An American student, Sarafina Vance, had a prophylactic double mastectomy recently at the age of only 26 because she'd found she had a high risk of developing breast cancer because of imitation in the BRCA2 gene.

Well, she's now heading a campaign about new techniques where sensation might be retained after the operation. I spoke to Dr. Ayesha Khan, who's a breast surgeon at the Chelsea and Westminster Hospital in London and from California with Serafina. How did she discover that she might lose all sensation, even though she had a really good reconstruction? When I started researching my surgeon and what type of reconstruction I wanted and just kind of how the process was supposed to go, that was one of the

shocking things that I learned. And honestly, not everybody was talking about it, which was even more shocking. I am a PhD student. I do a lot of research during my job. And so I knew sort of what academic journals to read and how to comb the literature. And that's sort of what I learned. But I was shocked that that was not emblazoned on every single reconstruction page of, you know, you can expect to lose sensation when you have the surgery. And so I sought surgeons that were, of course, really well trained and doing good work. And that was one of the first questions that I asked. And Aisha, why is it hard for surgeons to preserve feeling when they do a mastectomy? When a surgeon's performing a mastectomy essentially they're trying

to remove all the breast tissue. On top of the breast tissue is a layer of fat before the skin and it's in this layer of fat where all the sensation nerves run. So if you imagine you're trying to remove the breast tissue but essentially trying to keep that fat there's often a fine line between that particularly if a patient has cancer and you want to remove a rim of normal tissue around it it's not always possible to leave that layer of fat completely intact and also different women have different amounts of fat in that layer some women can be quite skinny but actually have a really good layer of fat underneath their skin before the breast tissue and other women have a very thin layer of fat and it the cancer but also to remove a margin around it.

And also, and the second cohort are people like Serafina who actually don't have a cancer diagnosis but have a very high risk of developing the disease for whom it's quite different. But why hasn't it been a priority for surgeons to look at in the past? What might we do about this? How might we advise women about it? So breast surgery has evolved significantly over the past few decades and this cohort of women having surgery for risk reduction has increased dramatically in the recent past. So previous to that, the focus was cancer, we need to treat the cancer. And we need to reconstruct the breast and try to make it look as normal to the woman as possible. That was the main focus and our

reconstruction techniques to do that alone were evolving. And I think partly it has also to do with how society perceive women and how society want women to look perfect. And so when patients come to clinic, they ask about, well, how's my breast going to look? Is it going to be symmetrical? And we talk about sensation loss. And a lot of women accept that as part of their cancer treatment. But, you know, five, 10 years later, when they go on to live beyond their cancer, it then occurs to them, well, actually, I'm fine from my cancer. You know, I feel as though I'm back to a normal life. My reconstruction looks good, but my sensation is not coming back. So Rufina, I know you went to a surgeon in San Francisco who's pioneering a new technique. What did it involve?

She's a uniquely trained surgeon in that she does both the mastectomy aspect of the surgery and the reconstruction. Typically, there are two separate surgeons that perform both surgeries. Because she has a sort of unique training, during the mastectomy portion of the surgery, she does something called nerve preservation. So those nerves that are in the layer of fat, she is highly conscious of preserving them to the extent that she can. And if they are unable to be preserved, during the reconstruction portion, she works with a nerve surgeon who is coincidentally her husband, and they do nerve grafting where they actually reconnect the nerves. And so for me personally, one side has nerve preservation

and the other side has nerve grafting. So what exactly have you got now? We're what, four, five months on from your surgery? How much can you actually feel? So on my right side, which is the side that has the nerve preservation, I honestly can feel 100% of my breast. The nipple part and the areola part are a little bit numb still, but the rest of the breast is basically feels totally normal. And then on my left side, it's about three quarters of the way there. And so the way that nerves regenerate and heal, we expect for that sensation to continue to come back with time, typically over the time scale of about a year. Aisha, how likely is a woman to find such a technique in the United Kingdom? At the moment, the nerve repair techniques that Serafina had are very experimental.

So to explain that, I'll just say there are two broad types of breast reconstruction. One is the implant reconstruction, and the second is where you use tissue from elsewhere in your body, typically the abdomen, to reconstruct the breast. And there has been a fair amount of work in America and also the Netherlands looking at preserving the nerve when a woman is having a reconstruction using her own tissue, like her abdomen. What Serafina had where she had preservation or nerve grafting with an implant reconstruction is very, very new.

And there's only one published study reporting on this. And it's very early with very small numbers. In the UK, the main step towards trying to preserve sensation has been a shift towards trying to do nipple sparing mastectomies like Serafina had. And that procedure alone seems to improve a woman's sensation after surgery. So we did a study at the Royal Marsden a few years ago looking at breast sensation after mastectomy and reconstruction. And this was without any form of nerve repair being performed. And we found that in up to 57% of women, approximately three years down the line, they had normal sensation in at least one quadrant of the breast. So if a woman knows she's going to have to have a mastectomy, what sort of questions should be

she be asking of her surgeon you know first question is what if she has cancer or doesn't have cancer if she does have cancer and um you know is very worried about her sensation one way to try and improve sensation after surgery is to aim for a nipple sparing mastectomy. That is not possible in all women with cancer because the cancer is too close to the nipple. Also in women who are having it as a risk reducing surgery, it may not be possible depending on other factors like her breast size or whether she's a smoker and any other medical problems she may have. But at least ask the questions. Absolutely and it's something that surgeons in the UK are discussing anyway at this stage.

I was talking to Dr Ayesha Khan and Sarafina Vance. Now, we've all suffered at some time or another from guilt when another parent looks askance at the way you handle your children. It often happens in the supermarket or on the bus, but what's it like to be made to feel ashamed when you've put your child on the internet for everyone to see? Well, Vogue Williams is a television presenter and Instagram influencer. She's married to Spencer Matthews, some of you may know him from the reality show Made in Chelsea, and they have an 18-month-old son, Theodore. Our personal lives, a lot of it is obviously on TV,

a lot of it is on Instagram, but then a lot of it is hidden as well. So you kind of put out there what you want to put out there. But I would definitely think that we have more than probably you out there. But it's kind of just, it comes with the territory. And especially since having a baby, I can't help myself because I do put things on Instagram

and then I see Theodore doing something. I think it's so cute. I'm like, oh, I'll put that up. And I've got a nice little group of people actually on Instagram that follow me and loads of different ones. How many followers have you got on Instagram? I actually don't know the exact number. Over 700,000 anyway.

Theodore is a part of this though. He doesn't have any say in it because he's only 18 months old is it all going to stop when he's old enough to have an opinion? Oh I mean if he didn't want to be honest of course it would definitely stop but I think that the world we're living in is changing and I just think that a lot of our lives are online and a lot of people choose to be like that other people choose not to have their child online and that's that's fair enough as well but um for us it kind of was never a decision that we sat down and spoke about it just kind of came naturally i mean spencer's not really online very much um he actually hates anything to do with instagram funnily enough um so theodore doesn't really feature on his just mine

okay yeah um the whole business of shaming and shaming, I guess we are talking fundamentally about judging other people's parenting skills or methods. Yeah. I own up to the fact that I think we all do it. Absolutely. I'm a parent. I'm as average a parent, frankly, as any other parent. But what really gets you about the whole parent shaming business i think it's just the amount of it and the for absolutely everything you do and it's my own fault for

putting anything on instagram with theodore because you do have people that just can't help themselves but i mean if you if i put up a picture of him in his car seat which i just don't do anymore because it's just that's inviting trouble you'll have hundreds and hundreds and hundreds of messages saying that he shouldn't be sitting forward he shouldn't be doing this

his headrest isn't high there's like relentless things that people will shame you about and I know that I can be guilty of it too but like not to the there's

people just really get pernickety about it I mean I put up a picture of him the other day we were sitting having his his lunch and there was a big dollop of ketchup on his plate.

Now, I was sharing the chips with him, so I was eating the ketchup too, but my God, the amount of people that mailed me over the ketchup. Really? The sheer quantity of the ketchup or the fact that it was there at all? Just the fact that there was ketchup there. Has anybody knowingly ever fed

any child under the age of 25 without putting a load of ketchup on the side of the plate? I confess I certainly haven't. I love a bit of ketchup. How much time do some of these people have in their lives that they've got that moment to have a go at you for feeding a child ketchup? I think it just, it kind of stems from the whole trolling vibe as well. People feel like that they need to have an opinion

on absolutely everything, where I will happily look at people's stories and 99.9% of the time say nothing or else if I was going to say something, it would be something positive because I just wouldn't really want to put any negativity out there. But I think that people kind of see it as a way to just, oh, it's so easy just to send this and then it's gone.

You forget about it. And people, especially with other people's parenting styles, love doing that. But I even found when I became a parent, just the amount of unwarranted advice that you're being given. And I know people are probably trying to be kind, but myself personally, I try not to give any new parent any advice unless they ask for it because you know yourself really yeah well uh tantrums you haven't quite got to that stage yet though have you he went through a little minute of them uh and now he's more than a minute along in a moment i know i know well he he's he's really coming into his own now where

he's deciding what he wants to do and like we've had to move his snack press because he'll just go over and take stuff out of it and he just. His snack what? He has a snack press, we say press in Ireland, you say cupboard here. You've got a snack covered. A snack covered but like one section is his little bits that he might have. And he has access

to this. He doesn't anymore, we've had to put that at a higher level. But you do acknowledge that if a child misbehaves in public I remember my elder daughter having a massive, massive event at Gatwick Airport over some cheerleaders pom-poms. It was unbelievable

and it drew a crowd. Even though nobody directly verbally assaulted me they were all judging my inability. Oh you can see their judgy eyes. That happened to me on a flight once. That was the only time I ever cried on a flight. And I have to say we fly all the time.

But God, he had a meltdown on a flight before we'd even taken off. And I could literally see a man putting his fingers in his ears and tutting. And I just felt like, do you know how hard this is for me? And then the air hostess came up. After all these people like turning around in their seats and kind of having a look like is for me? And then the air hostess came up. After all these people like turning around in their seats

and kind of having a look like what was the problem, then the air hostess came up and I just burst into tears. I was like, I'm so embarrassed. This is a generalisation, but it is often men who appear to react that way. And I always want to turn around to them and say, oh, sorry, were you never a baby? Sorry, I didn't realise you were born 47. Oh, OK, fine.

But it's just, they clearly weren't. Men hate it though I sat beside a man before and he tutted and said I always get stuck beside the baby and I was like well excuse

he might not want to sit beside you either and then eventually he moved which I was quite happy about the arrows just moved him but I just thought

that is so rude we haven't even sat down Vogue Williams was talking to Jane and Elissa wrote a friend of mine was on a flight from America with their colicky three-month-old baby. The father, who's actually a nurse,

was walking his son up and down trying to soothe him when one of the American air hostesses came up and said, speaking as a mother, you are agitating that baby. Can you believe it? Talk about parent shaming.

And Kate wrote, at my five-year-old sports class this week, there was a sibling who screamed for the whole hour. The mum tried to talk him round, tried ignoring him, tried distracting him, but there was no stopping the toddler. All the other parents were discussing his behaviour and being a bit judgmental, but none of us had the answer to make him stop, so we didn't try to help. At the end of the session, most parents walked off, but I gave the mum a hug and asked if she was all right. It was horrible because no one wants to listen to a screaming toddler, theirs or someone else's. We were all stressed out at the end of the session, but what should we have done to help?

Now, it might happen in the cinema, the theatre, walking out of the office when someone said something to upset you, but I suspect most of us are a little bit embarrassed about being seen to sob in public. Others don't seem the slightest bit ashamed. Take Keith Brimer-Jones, a judge on the great pottery throwdown on Morphore and Channel 4. In every episode, he starts to cry. Why? I just well up and I have a certain connection with said potter on the programme. It's a great honour to watch a potter from conception

through the process to fruition when that kiln door opens to see what they've made but what is interesting about your crying and your emoting is that it is because of other people's efforts it's nothing to do with you being maudlin or self-obsessive it's other people have done something and you're so pleased for them i really am because i i realize how hard it is to put yourself out there on a programme like the Great Potter Throwdown and also to bare your soul in something that you really, really love doing. And obviously it's something that I love doing too.

And so there is that connectivity between me and the Potters on the show. OK, also with us, Susie Orbach, psychoanalyst, psychotherapist and writer. Welcome, Susie. Hello. And Joanna Cross coaches people in the workplace and also help people with their voices. That's right. That is right, isn't it?

Yes, that is right. Okay, right. You're a voice coach. So Susie, is crying in the way that Keith does it because he's empathising with other people and their efforts, is that common in terms of crying? I think it is. Why do we cry at movies? why do we cry at movies why do we cry at

a picture that we have aesthetic responses we're moved in many different ways and for some reason we think crying is about pain when that's a very small piece of what crying is about tears of joy always always or being moved or being moved being moved yes indeed yeah joanna what about crying in terms of how other people perceive it when an individual cries in public let's take the workplace if you've got somebody who seems to cry regularly i think that's not helpful for the individual because then if they cry over something that really is important to them they might not be taken so seriously or they get a label. But I do think crying is often a build-up of frustration

and undealt-with situations, and it's a bit of a final straw moment. We know that, for example, Ian Wright, who's a retired footballer, he was on Desert Island Discs a couple of weeks ago. That was wonderful. It was wonderful, and he had a good cry. And he got such, I think, frankly, he got kudos for it. Are we a little easier on men who cry than on women who cry? Interesting. In a lot of my sessions with men, I've seen loads of men cry.

I think there has been a reluctance for them perhaps to cry publicly. But I think, yeah, I think we are becoming more tolerant of crying, definitely. Well, yeah, but my point was we're easier on the men prepared to do it in public, perhaps because it has a certain novelty value, whereas a female celebrity or professional person openly weeping might be, well, I know what they'd say if it was somebody my age, hormonal. Yes, which is really frustrating and unfair.

But I think that labels aside, what I would say to somebody in the workplace who's been, you know, feels like they're crying, you know, out of frustration, is that it's like a book of stamps. You build up your resentments, your lack of boundaries, not being able to say no, and then somebody says, can you go and make a cup of tea,

and you suddenly find yourself weeping, and everybody says, what's wrong with her? You know, but actually that's often a backlog of situations. Susie, can I just read some comments to you from our Instagram? This listener says, I cry every day. Often it's a mix of grief and gratitude for people loved and lost. But sometimes it is frustration. And I cry much more easily at films and TV since I've had a baby.

I am never ashamed to cry. I think it helps me to process and acknowledge. Well, that sounds a very healthy attitude to me. Lucky her, yes. Yeah, no, that sounds good, doesn't it? I mean, contrast that to people who come into my consulting room. And of course, you know, all therapists have tissue boxes. But people in an initial session, if they cry, will apologise as though there's something wrong with them for having that kind of expression of feeling. So no, go ahead. All right. Little Rooster says,

one of the reasons I hate confrontation is because I can't help but cry. And this is maddening because I usually don't want to cry in those situations. She doesn't like confrontation and she's angry with herself for crying. Right. I suppose if we were talking together, we'd ask her what was so difficult about confrontation. And would there be a way for her to be able to process that there is some kind of difficulty? She does need to stand up for herself and crying in a way stops her being able to do that. You mentioned that in your therapy sessions sessions you have a box of tissues. Two actually. Two boxes of tissues, right.

One for you. Yeah, of course. Is one for you. No, but it doesn't mean I don't have silent tears. I do have silent tears. I can be extremely moved and it's not appropriate for me to cry in a therapy session but I'm very affected by what's happened.

But the very presence of the tissues would indicate to me that you are expecting tears. You know, that is a damn cliché of us therapists, and I'm sure it happened 40 years ago that you went, when you were in training, or a lot longer for me, you went in and there were tissues in the therapist's office, and therefore it's just become part of the furniture of a therapist's room. Right, so it is possible to have therapy, successful therapy.

Without crying. Without any crying. Absolutely, and there are people who have a very different relationship to tears. For some people, it's an absolute accomplishment to cry. They really can't cry. And being able to have those tear ducts open and soothe themselves with the tears, which is what it does, might take years and they might never have been able to cry in their family or in their relationship. For other people, they really do flood, but it doesn't have the same valence for them. It's just a form of

expression that they know about themselves. So if your relationship with crying is such that a good cry, and you hear that expression a lot, makes you feel better, you should carry on doing it. I don't think there's any should here, Jane. I think if you... Well, you're the therapist. Absolutely. It's a good job I'm not. I mean, the point is, if you're crying because you feel vulnerable,

you want to do that in a very protective space. Right. OK. Right? If you cry because you're moved by the pottery, you don't need the protected space. You are in that engagement. They're different kinds of crying. Keith, you were telling me earlier that your producer just says, don't stop crying, mate, it's TV gold.

Yes. I mean, we are in showbiz, but it's true, isn't it? Well, no, no, it's true. I mean, I remember the first time I got tearful was the first five minutes of the first series of the first episode. And they kept you ever since. And I remember the director could hear her in the background going, my God, the judge is crying. This is brilliant.

Keith Brammer-Jones, Joanna Cross and Susie Orbach were all talking to Jane. Now do join me on Monday morning when I'll be talking to the pop star turned podcaster, Jessie Ware, and her mother, Lenny Ware. They will join us to discuss Table Manners, the hit podcast where the mother and daughter cook dinner for and interview a different celebrity every week. It's now in its third season with 10 million listeners and they've just released a cookbook of dishes from the show.

That's Monday morning, two minutes past 10. Join me if you can. Meanwhile, enjoy the rest of the weekend. Bye-bye. 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.