Woman's Hour - Yotam Ottolenghi, Long Covid and Women, Breast Cancer Screening and Talking to Children about Death

Episode Date: September 30, 2020

Flavour is the third instalment in Yotam Ottolenghi’s Plenty series which celebrates the infinite potential of vegetables. Along with co-author and recipe developer Ixta Belfrage they explore techniques and processes such as infusing and charring which brings out the full flavour of the vegetable. They join Jenni to talk about how to Cook the Perfect Spicy Mushroom Lasagne.We now know that tens of thousands of people in the UK are living with Long Covid – meaning that they have not yet recovered from the effects of the virus, even if their infection was relatively mild, and happened months ago. Symptoms vary but can include breathlessness and fatigue. You might have heard presenter Adam Rutherford yesterday on Radio 4 talking about his own experience of it, and looking at the growing body of science around the condition. A picture is also now emerging of how the condition is affecting women. The Long Covid Support group on Facebook has 23,000 members in the UK and 75% of them are women. Lesley Macniven is one of the group’s campaigners and a gender inequality researcher by trade. She joins Jenni from Edinburgh.It is estimated that nearly one million women in the UK missed their routine mammogram breast screening programme appointments due to Covid-19. This is according to figures from the charity Breast Cancer Now. Their Chief Executive Baroness Delyth Morgan outlines their concerns and what needs to be done to deal with a backlog of cases. In our family secrets series Jo Morris speaks to a woman we are calling Liz, who found out her father’s fifty year old secret at the worst possible time, when she was grieving for him. Isabel Thomas has written more than 150 books about science and nature for young audiences, including Moth, which won the 2020 AAAS Prize for Excellence in Science Books. She has now written Fox - A Circle of Life Story – a picture book inspired by her own experiences of talking to her three children about death, and of having her only parent die at a young age. The book gives an unflinching scientific answer to one of the most difficult questions children ask: what happens when we die?Presenter: Jenni Murray Producer: Clare Walker

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BBC Sounds. Music, radio, podcasts. Hello, Jenny Murray welcoming you to the Woman's Hour podcast on the 30th of September 2020. Good morning. In today's programme, the chef Yatam Otolenghi and his right-hand woman, Isla Belfridge, cook the perfect spicy mushroom lasagne, a recipe from their latest book on cooking vegetables with flavour.

Fox, A Circle of Life Story, the picture book by Isabel Thomas, answers the question, what happens when we die? And long Covid, why do more women than men seem to be affected? Screening for breast cancer appears to have been a victim of the pandemic. It's estimated that nearly a million women in the UK missed their routine mammogram because of COVID-19. The figures come from the charity Breast Cancer Now and their chief executive is Baroness Deleth Morgan. Deleth, how did you come up with a figure of a million? That's

an awful lot. Well, we've just used the publicly available figures and calculated who would have normally attended if the services are paused, as they have been throughout the UK during the four and a half months that the pandemic was really seriously impacting services and calculated it in a very straightforward way. And what it shows is that potentially nearly, well, over 8,600 women could be living with undetected cancer because of this. And so we want a plan to get it up and running but also to deal with the backlog. How many women would then normally have had a mammogram in any one year? Well it's going to be about four or five million normally throughout the year And so if you stop for any period of time, then it really is going to cause

a backlog. And as NHS England have said that the screening service is up and running, which in some places it is, and I know that everyone's trying really hard to do absolutely their best for women. And so, yes, the services are coming back up, but the backlog will also be continuing to develop because you just can't get through the same numbers because you know radiographers have got to clean the the machines down it takes longer to screen women so we have got a real problem here and it's going to mount if we don't get it tackled you know really systematically now obviously we asked the national health service um what their view of it was i'll tell you what they said the vast majority of cancers detected through screening programs are at a very early

stage and so any impact on patients who were due to be screened is extremely low more than 200,000 people were treated for cancer during the peak of the pandemic. Breast screening services are now fully up and running with more than 400,000 women invited between June and August and thousands more invites are now being sent every month. We would encourage anyone who is invited to book an appointment. What do you say to that? Well, I'd say that's absolutely true from their perspective. But we know that screening services are not up and running to full capacity as they would normally be. And that's for very practical reasons. into account the additional demands of the pandemic, but doesn't just, you know, kind of relegate the breast screening programme to a, you know, to a second rate priority. You know, breast

cancer is a really serious diagnosis, and it's vital that women are diagnosed as early as possible. We know that that makes a really big difference in terms of survival and so we need to have this tool the screening service which is a really important tool in early diagnosis for breast cancer as screening is in other cancers too it's a really important part of our of our strategy in this country for trying to improve outcomes in cancer and we can't just let it kind of wither away because there are other important demands on the health system. Now, that statement I read to you with NHS that was covering England. How are the other parts of the UK doing?

Well, if I'm honest, I think they've been really frank about the fact that breast screening has been paused, which has allowed everyone to take account of that. And, you know, they are getting up and running. But obviously, it's still a worry that there's a backlog. But, you know, we have to face up to the reality of how, you know, the difficulty that screening services are having we need to have investment which um obviously the the there's the comprehensive spending review preparations being done in government you know we need to have investment in these services so that they can tackle um this really challenging time now if a woman is concerned and we do not want to scare anybody at this point and she hasn't received an appointment what should she do well firstly um you know we are being told and you know i absolutely support that that the nhs is open for business so anyone who has any worries

about anything unusual that they might find or feel in their breasts, they should talk to their GP. Now, it is possible that they can only talk to their GP, but they should have a referral if they need one into the diagnostic services for cancer. And that is that's absolutely what what should happen. And it's really important for women to be breast aware. I mean, we've got Breast Awareness Month coming up starting tomorrow. And it's really important for all women to be breast aware and to check their breasts. And, you know, if they notice anything that's unusual for them to go and talk to their GP. Just remind us, checking your breasts.

Go on. What exactly do you do and what do you worry about if you find it? Well, the most important thing is that everybody is different and we don't advocate any really strict regime because that can really stress people out. So it's really important to look. So you need to look in the mirror and see you know what your breasts normally look like is there any unusual puckering of the skin is perhaps the nipple changing position slightly or is there have you noticed a discharge from your nipple in any way and then of course there's the the kind of the the kind of palpating motion where you kind of i'm doing it at the moment you kind of go so am i isn't it funny?

As soon as you started talking about it, I started to do it in my one remaining breast. Yes, and so you just, it's just about feeling and not being nervous to touch your own breasts and to know what's normal and also going right into the armpits because breast tissue goes up into the armpits. And if you feel anything, any change, anything that you're worried about, then, you know, talk to your GP. You know, that's what they're there for and they want to hear from you if you feel anything, any change, anything that you're worried about, then, you know, talk to your GP. You know, that's what they're there for. And they want to hear from you if you are concerned. And of course, we have loads of information on the Breast Cancer Now website. We have our helpline with specialist nurses who are really happy to talk to anyone who's worried about the potential symptoms of breast disease or breast cancer. So, you know, it is and we have to remember that, you know, nine out of 10 breast lumps are not breast cancer. There are lots of other things that could be going on. And so fear shouldn't hold anyone back from seeking help or talking to their GP or seeking advice.

Dennis Morgan, Baroness Morgan, thank you very much indeed for being with us this morning. Now, as you may have heard this morning, a record rate of infection with COVID-19 has been announced with some 7,000 new cases as the virus hits its highest daily level. We're also beginning to learn of the possible long-term effects for those who have had it. There's growing evidence that long COVID exists for tens of thousands of people. You might have heard Adam Rutherford yesterday on Radio 4 talking about his experience of symptoms which have gone on and on. There's also some evidence that women may be affected in greater numbers than men. The Long Covid support group on Facebook has 23,000 members in the UK and 75% of them are women.

Lesley McNiven is one of the group's campaigners and one of the founders of Equality Starts at Home. Lesley, why do you believe Long Covid is primarily a women's issue? Hi Jenny well we know that we have roughly three women for every men in the group but we don't know for sure if that is indicative of the general population however we believe Tim Spector who's been running the Zoli app a citizen science project is looking at verifying some stats and is looking around the 70% mark as well. So it is very interesting and I've got some theories about it. I mean, myself, I'm currently a freelance non-fiction writer,

women's career and life coach and a diversity and equality consultant. And since 2015, I've been researching equality in the workplace for women or the lack of. I did a creative writing master's degree so that I felt I could justify telling the stories of women that I'd worked with at various points in my career and so that we could amplify their voices and it became quite significant. At the beginning of 2020 i started working with an artist and we were working up a script for a graphic novel which we entered into quite a prestigious um comic award uh first graphic novel prize so this was very much my focus and then as soon as we submitted it covid hit hit us. I got COVID myself in the middle of March.

My kids had to basically stop school immediately. We were locked down and then a week later everybody else was locked down. I was looking at the news to find out what on earth I should be doing to help myself but also to kind of work out what in fact was this going to have on society and on equality for women.

So what actually happened to you, Lesley, after that initial realisation that you had the virus and then you thought you'd got better, what happened then? Yeah, well, I mean, according to the news, you would be better, if you were a woman my age, you should be better in seven to ten days. I had pretty mild symptoms. I had fever, flushed face, lethargy, brain fog. But as the time went on, and by the end of the first week,

I was starting to feel pressure in my chest. I felt like I had a massive big fat cat sitting on me, squeezing my sternum. And by day ten, I discovered I had real crushing fatigue and had to go back to bed. I'd had glandular fever as a teen. I'd spent two weeks absolutely bedridden. Eventually got out of bed, went back to work and kept relapsing and having recurring symptoms

until I finally stopped fighting. I took a period of time off work, excuse me, and then managed to get my health back and resume normal life. So I just thought, oh, here we go again, and I'm going to have to rest up for a while. My boss, I didn't have one to worry about. I didn't have colleagues to let down. My kids were now feral anyway, so getting my health back became the priority.

Why did you join the online long COVID support group? I found it in May. It was an amazing finding, I think, for everyone who's encountered it. I became a moderator because at that point there was half a dozen of us all sick women trying to get this up and running and it was growing at an exponential rate. I started in media for the group because I was in better shape than most people. It's really hard to do live radio slots when you've got cardiac symptoms and brain fog. It doesn't exactly help.

We were working with researchers, but the most important thing was that this peer support group was amazingly supportive and compassionate and people literally cried when they found us. Now as I said 75% of this group are women. Could that be because women are more likely to join a support group? That is a possibility and we have found that more men are joining. But I think there's a lot to do with the way women are socialised, our life experiences. actually might end up with prolonged symptoms, not simply because their immune systems predispose them to getting long COVID, but because they weren't actually having an opportunity to have adequate rest. So, you know, we've seen in lockdown that women continue to do the majority of child care and, you know, if people are getting ill and even extending to things like support groups, where a lot of women are reaching out and supporting each other and other people.

Equally, lots of women are finding they're being furloughed, they're having to scale back their hours because they're ill, and we're now starting to see women losing their jobs. You mentioned Phil Spector, who of course is a very well-known doctor now, who's doing research Tim Spector I mean what's he really coming up with? Is he really believing that women are at greater risk of long Covid? Absolutely

I mean at one point it looked like it was a 60-40 split and now as we're analysing the data it's looking like it's creeping up to 70 and you know we advocate for all people but my fear as somebody who writes about gender equalities in life pre-Covid is that we're seeing these inequalities exacerbated and we're seeing more women being impacted when Helen Pankhurst did an excellent article in the Guardian this morning explaining how in pandemics women generally fear end up worse off than they did pre-pandemic because of poverty and so forth. Lesley McNiven, thank you very much indeed for joining us this morning.

I wish you the very best with your recovery. And we'd also like to hear from you. If you have suffered in the way Leslie has described with what's known as long COVID, we really would like to hear from you, both men and women. Let's see what's been happening to you. You can send us an email or of course you can send us a text. Now still

to come in today's programme Fox, a circle of life story. Isabel Thomas' picture book for children answers scientifically the question, what happens when we die? And of course the serial episode three of Broken English. Now if you've been listening

over the past week, you will know that the 2020 Women's Hour Power List is focusing on our planet. On Tuesday next week, Jane will be joined by some of the Power List judges to answer your questions about the climate and living a greener life. So what do you want to know? It could be a big question on the climate or you might want answers to whether you should have your heating on low all day or put it on high for a few hours when you get home. We'll take them all. You can tweet us questions or emails through the Woman's Hour website. You may have missed yesterday's discussion about the Gender Recognition Act

and Lee Lawrence talking about his memoir, The Louder I'll Sing. You know, if you miss a live programme, all you have to do is go to the BBC Sounds app and there you will find us. Now, Flavour is the third instalment in Yotam Otolenghi's plenty series of cookbooks which celebrate the potential of vegetables. Today, he's joined by his co-author and recipe developer, Ista Belfridge, having cooked the perfect spicy mushroom lasagna. Note, having cooked, as yes, they are with me in the studio. You might have just heard Iza laughing. But COVID-19, unfortunately, will not allow us to fire up the baby belling just yet,

which you're telling me you're probably quite relieved about. You don't have to cook on our baby belling in the studio. But what sort of processes and techniques have you employed to make vegetables have flavour? Thank you, Jenny. And yeah, it's quite nice not to be firing the baby bell because, well, we know cooking on the radio is always funny, but I've enjoyed all my times here on this show doing that.

But in this particular case, we can actually evoke quite a lot of those flavors just and and techniques just by talking about them so ista and i have been cooking vegetables for the last couple of years um in in great intensity and finding out incredible ways to increase flavors to inject them with with what you want because vegetables are fantastic but you sometimes need to work a little bit harder with them to make them taste with what you want because vegetables are fantastic but you sometimes need to work a little bit harder with them to make them taste good so in the book we talked about processes they include charring and browning and aging which we all aging aging something like a cheese you know that's aged or a wine or things that take time to develop a good flavor.

But there's also other things that happen with vegetables. So in the book, we're talking about our mushroom lasagna. Certain ingredients are just so intensely flavored. What chefs like to call umami, which sounds like a very fancy term, but actually it's that savoury deliciousness that comes when you have mushrooms. And Nista created this incredible lasagna, which goes back to her childhood,

that involves four types of mushrooms, parmesan cheese, pecorino, and it's just the most gratifying thing. And it all comes out of mushrooms. Nista, how did you come to be working together in your son's test kitchen? Well I always say it was a sort of a case of being in the right place at the right time but I had gone through a lot of jobs which I hated and my passion was always cooking it took me a while to realise that that's actually what I wanted to do and I tried out on

my own at first I started a little catering operation and I had a little market stall and then I realized I really didn't know what I was doing so I applied for jobs in restaurants thinking that no one would ever take me because I had no experience but Noppy one of Yotan's restaurants gave me a chance and that's sort of where I cut my teeth. So, Jochen says this recipe, the mushroom lasagne, comes from your background. What background does it come from? Well, I grew up in Italy, in Tuscany, and just up the road from the mountain that I grew up on is a little restaurant called Ristorante Pizzeria Corne. And there they have this secret, classic dish called Pinne alla Corneze

which is a pasta dish with a pork ragout actually. I know we're talking about vegetables but this particular ragout is made out of ground pork but the most important thing about it is the incredible umami flavour you get from porcini mushrooms which is unmissable and like i said it's a secret recipe but um i sort of wanted to recreate that in in a vegetarian context and that's how we came up with the recipe for this mushroom lasagna so it's sort of trying to echo the deep flavors of of meat and bringing out that porcini flavor and like yottam said there's lots of different mushrooms in it fresh and dried and it all sort of comes together into something that i mean you're never going to miss the meat with this lasagna it's interesting your team is female uh in the

in the kitchen and your collaborators on the books have been women why do you love to work with women i have collaborated with men as well. So Sami Tamimi has written a book and also Ramal Scully. But I have been over the last few years collaborating with women. And it was never a decision. It was things that have happened naturally in the test kitchen. And I've got a small test kitchen. It sounds more fancy than it actually is.

It's quite a basic kitchen in Camden in North London. But people that come to work in the test kitchen need a particular set of skills. And often chefs, male chefs that are traditionally trained, don't love this way of cooking. It has to do with, well, you need to be quite particular about how you take notes and write things down, which is not often the natural way with professional chefs. But the other thing is that the focus, my focus is home cooks. And it's a particular kind of cook.

It's about feeding and putting meals on the table rather than showing off with food, which is often the case with male chefs in restaurants. You didn't come to cooking through the conventional route, did you? What was it? Masters in philosophy? Then into food? How did that happen? I mean, in that respect, Ista and I are quite similar because we both went through unusual routes in order to get into the world of food. Yes, I went to university

because I think it was expected of me to go and study and pursue an academic career. But I didn't get the kind of satisfaction that I thought I would from university. And then when I was reaching the age of 30, I was in my late 20s, I've decided to try to cook for a living. And I loved it. I love the fact that my audience was immediately so much bigger in, you know, when I cook for people than I did when I was in, you know, in an insular environment at university. And I have to say that still today, and this is why we're here now being able to talk to thousands of people about what we do, the audience for food is amazing and it's growing and growing and the books have just have been marvelous and it's your degree was design i

think well i i never actually got the degree uh i tried two degrees one was fine art painting and the second one was design but i i didn't get very far um it was never for me and i just it took me a while to realize that my passion was, should also be my career. I don't know why it wasn't more obvious from the beginning. Now clearly the recipe for the lasagna is going to be on the Wanda website and I'm not able to taste it, which is very sad.

But there are cakes. I know you were so kind. And you brought me cake. We knew we were on your penultimate show and we thought we have to bring you cake. You're so much part of, for me, you're so much part of my day to day listening to Woman's Hour. And I've been here in the studio a few times in the past. So I thought you'll bring me some cakes. That is so kind of you. I can't wait. But Ista, just tell us how you make this lasagna.

Right. So, like Yotam said, we've got lots of different mushrooms. We've got fresh mushrooms, oyster mushrooms and chestnut mushrooms. And then we've got dried mushrooms in the form of porcini mushrooms and mixed wild mushrooms. So, you finely chop all the fresh mushrooms until they're as small as you possibly can get them and doing it in a food processor is much easier and then you actually roast them at a really high temperature so they lose all their moisture and become sort of small clusters of browned

almost like mincemeat I'm sorry to keep on saying meat in a vegetable book but it is almost like mincemeat and then you've got your dried mushrooms and your porcini mushrooms soaking and then you sort of mix those caramelized browned mushroom clusters with the dried mushrooms and then cook that down and when you're when you've got that in the pan you actually want to resist the urge to stir it because you want to create a beautiful caramelized browned layer on the bottom again you keep on wanting to brown it and then you add your liquid so you add the liquid that you soaked your dried mushrooms in and you add more water and tomato

paste and you've got a sofrito mix in there as well so tomato and onion and carrot and celery and then that all cooks down for about 25 minutes and you get what you're left with this this umami ragu and really i mean you could you could stop there if you want and just toss it through pasta or you could go the whole hog and make the lasagna which we'd really recommend uh but uh yeah and then you just let there's no bechamel there's no bechamel on this recipe. So in that sense. It's got the two cheese, the pecorino and the parmesan.

Yeah. And then you layer it and there's a little bit of added cream at various stages, which just makes it just that bit richer. It sounds really, really delicious. We keep talking about this wretched virus and the lockdown and all of that. How have you managed when the Test Kitchen presumably had to close during lockdown? Yeah, so I mean, like many other people, we were like, actually, everyone, everybody, we had to just stop doing what we were doing. And there's kind of three, four people who work regularly in the test kitchen having different jobs. And we all went into our respective homes and lockdowns.

But we had to carry on cooking. But it was a different kind of cooking. So rather than cook dishes for the general public, we cooked for ourselves and our families. And I have two young boys. And that really informed the recipes that I cooked. You know, there's a lot of very child-friendly recipes. Isra can talk about her lockdown, but we were all...

So in a way, funnily enough, the recipes that came out of lockdown are really even more geared towards home cooking. Well, we'll have to end there, I'm afraid. Yosan Orulengi, Isra Belfridge, it has been such a pleasure to have real people sitting in the studio opposite me this morning. Thank you both so much for coming in. And, of course, you can find the recipe on the Women's Hour website.

And you can download the Cook the Perfect podcast through BBC Sounds. Thank you both very much. Thank you, John. Can't wait for the cake. See you later. Thank you, John. Can't wait for the cake. See you later. Thank you. Now, for some time now, we've been talking to women about family secrets, which have had a powerful impact on them when they were discovered. A woman we're calling Liz found out her father's secret at the worst possible time.

She met Joe Morris at her home. What was the hardest thing about discovering her family secret? Finding out that my parents had kept a secret from us for so long, that was the hardest thing. So not the secret itself? Not the secret itself. Well, speaking for myself, and I think my brothers would probably say the same thing,

it was finding out that my loving parents had kept a secret from us for so long. So where does your story begin? What I know of the story began in 2006, just after my father died. What happened? My mother let slip to my brother. My brother was going through the probate form for my father with her and he'd gone through all the routine questions and there was a question, does the deceased have any other children?

And she said, yes he does. He was obviously very taken aback and I believe he thought she didn't understand first of all and said it again she said yes he does he had had an affair 50 years previously and there was a daughter that was the result of this affair so in fact we had a half-sister so my brother then had to phone me up and my other brother to tell us about it, which was obviously devastating for us all. How much of a shock was this to you, Liz? It was a big shock. It was a big shock that there was a half-sister, but the main shock was the fact that we knew

that they'd kept it secret from us for so long. That was the most upsetting thing. I was also later, because it preyed on my mind for quite some time, concerned my father was dying for quite a few weeks and thinking of him in his hospital bed, probably thinking about his life and knowing that he'd got another child somewhere that he had no contact with.

And as a parent, I can't imagine not being able to make contact with one of my children. My mum didn't really understand at the time why we were so upset. It was a very difficult time because we were all grieving, and she was obviously grieving terribly for my father and we were trying to support her and she didn't understand why we were so upset by it. Why didn't your mum understand why you were so upset? What did you say to her? She thought we should be more upset about her and what she'd gone through and not the fact that she hadn't told us.

She couldn't see the problem. In fact, she said to me, you won't tell your children, will you? And my children were obviously grown up at the time. And I said, I don't keep secrets from my children. Maybe it's a different generation. Things have moved on so much. I think that was the big thing, that she couldn't understand why I wouldn't want to keep it from my children.

How long did your mum keep the secret for? 50 years. And it was almost like they forgot it. Because that's what family secrets are, really, the things that have happened that you put away and don't talk about. And I presume they didn't talk about it. We'll never know. Growing up, Liz, did you have any inkling of this? Is there any now, looking back, the benefit of hindsight,

do you think, oh, actually, maybe that makes sense. I do remember when I was 10 or 11 complaining that my parents didn't have the money to buy me something that I wanted. And my mother took me to one side and said, well, we have lots to buy. Dad's looking after this little girl who, a friend of his he he died and when they were in the army and he promised to help look after her and so he's looking after her until she's 16 and i just accepted that in my naivety at the time that's what it must have been that they were they were supporting her were you angry yes yes i

was i mean i was grieving myself at the time whether my anger was part of my grieving process it was like it wasn't a big thing it was just sort of almost dropped in conversation i don't think she appreciated that first of of all. Did you ask your mum why she kept the secret for so long? Did you ask her outright? Yes, and she just said, well, it wasn't my secret to tell. That was it. Did you ask her why she'd chosen to tell you now? She said it was a legal document, and so she had to tell the truth. I think she felt about herself as being the victim and so we shouldn't be upset, we should be feeling sorry for her and maybe that's a generation thing.

I somehow think that these days women are a lot stronger and would do what they think is right rather than just blindly supporting their husband because they were told to keep it a secret. Did it change things with your mum when you found this out? It did initially, yes. The way that I felt about my mum, because I couldn't unlearn what I'd just learned.

It didn't ruin our relationship, but it definitely altered it. If she had said, oh, I'm sorry, I probably should have told you, but I felt I shouldn't and can you forgive me, then it might have been a bit different. So how long did your mum live for after your dad six years before your mum died it was never mentioned again no no and no mention of it in her will or no nothing no has there been a difference you've got two brothers younger brothers has there been a difference? You've got two brothers, younger brothers.

Has there been a difference in how you've all reacted to the disclosure of the secret? I think I possibly felt more betrayed than they did. Why do you think that is? I just wonder if it's the mother-daughter relationship. Are there things that you would have liked to have asked her that you didn't get a chance to ask? I would like to have talked to my dad about it. That is the sad thing.

What triggered him having an affair in the first place and then if he was prepared to tell us about our half-sister. Are you curious about meeting her? It was too far down the line, and we didn't know what we might unearth, particularly when my mother was alive. And we don't know what she had been told. We might potentially upset her a lot as well,

because we don't know what she's been told about her parenthood. But there is a possibility that someone could come knocking on the door one day. If you had the option to never have been told this secret, what would you choose? Obviously, in some ways, it would have been easier if we hadn't found out certainly the way we did find out if it had come to light now or 10 years time that would have been even more devastating to have found out after both my parents had died and there was nobody we could learn nothing about it at all. I think I would choose to have been told as soon as we were adults. Do you still feel angry?

No. No. You can find all the stories in this series and an article about them if you type Family Secrets and Women's Hour into a search engine or scroll down on the front page of the Women's Hour website. Now, all of us who have children have at some time been asked what happens when we die. Some will take a religious perspective for an answer and maybe talk about a beloved pet or grandparent having gone to heaven. Isabel Thomas takes a scientific approach in her picture book Fox, A Circle of Life Story. Isabel, why did you want to answer this question for children?

Hello, my only parent, my mum, died in my mid-twenties. So before I had children, I imagine these very emotional conversations about death that we'd have. But in reality, of course, their first questions were very matter of fact. So it'd be things like, what's happened to that pigeon that we saw on the field? Or, you know, does it hurt that it has no head? Or even if we were talking about mum, it would be questions like, is your mum still dead? Or where is she right now? And I realised they were curious, not so much about the emotional side of death but the concept of death itself which is a very abstract idea for young children so what's the story of the fox and her cubs so the book focuses on a family of foxes a mother and three cubs with beautiful illustrations by

daniel agnes and it doesn't anthropomorphize the foxes we just watch them go about their daily lives as we might in nature and we see the circle of life in action as they learn to hunt and to scavenge and in the middle of the book the foxes are crossing the road and the mother fox is hit by a car and die suddenly and daniel and i tell and show this very sensitively but we don't gloss over it or hide it from view and then the rest of the book goes on to explore what happens next. So how nature recycles every particle that was once a fox and nourishes new life in so many different ways through those processes. Why were you keen that it should be a scientific explanation?

There is no religion, no going to heaven in the book. Well, I don't ever suggest in the book how readers should be feeling or responding. I simply explain what's happening in a beautiful kind of lyrical way and leave space for families to talk about death in a way that's opening but also comforting and to take away some of that mystery and that you know that silence and that awkwardness that can surround death. How easily did your children accept the explanation that death actually is not an end it feeds more life it's an ongoing conversation with them and i think a big part of helping them to make sense of the world you know and i take them to visit the woodland cemetery where my mom's ashes are buried under a tree and they can see for themselves how it grows over time

you know it was a sapling 14 years ago when we planted it now it's a huge tree and we went and planted daffodils around it and it's something that's tangible and it's always very comforting for all of us to be there together in this beautiful natural setting and it keeps changing the seasons so I find that if you talk about death as a part of life and nature you know and that can be long before your child ever loses a pet or a person that they love then they'll know and they'll understand that it's okay to keep talking about it and keep asking questions and that it's never a taboo subject now when the fox dies you explain very carefully how her her body deteriorates and what it feeds that's very different from someone who's been cremated and the ashes. How scientifically

do you explain what impact someone's ashes can have? Well, I don't talk so specifically in the book, but I've learned over years of science writing, you know, the more complex the topic and the more difficult, the more background and context children need before you start talking about it. So when my children ask me about death, I always start by talking about life, you know, about the building blocks that make up our bodies and everything else in nature and about how the processes of life all stop after death as well. So to reassure them that a dead animal no longer moves or feels or, you know, knows what's happening around them. And only then do I go on to explore

how, you know, nature works to recycle those building blocks of life. And children don't learn about, you know, decomposition until later in school. And we tend to think of it as adults, you know, even as something either quite boring or something quite grim. And, you know, I don't use that word in the main narrative at all. But actually, when you do learn about it every aspect of decomposition is about living things getting what they need to live and grow so they can understand that death is the end of one life but also the beginning of many more and in a way it's you know it's like the water cycle the building blocks of life are constantly on the move over long periods of time and there is something very beautiful about that and very awe-inspiring.

Why did you decide that it should be a family of foxes rather than a universally loved animal because foxes are not loved by everybody? I do love foxes but you see them a lot in children's books focusing on foxes as a character and as I say the foxes aren't exactly a lot in children's books, focusing on foxes as a character. And as I say, the foxes aren't exactly a character in my book. They're very much wild foxes. But they are beautiful and they are familiar because children are familiar with dogs. You know, we don't glimpse foxes very much, but we do know that they live around us. So they've got that kind of familiarity, but also that very strong link with nature.

They're very much wild animals and they have a sort of a mystery of their own and they're very beautiful to look at and illustrate as well now having been prompted by conversations with your children when they were young about this subject how have the conversations developed as as the children have grown older they definitely don't feel awkward talking about death and keep on asking questions. So they're different questions as they've grown up and they've had different experiences of, you know, knowing about death themselves. For example, one of our closest family friends died during lockdown. And that's very different from talking about my mum because they knew him very well and almost saw him as an honorary grandparent. So my 11-year-old recently has been asking a lot about immortality.

You know, why can't humans live forever? And we still tackle questions like that by sitting down and exploring the science together. And it doesn't completely take away his worries. You know, he's talked about being a biologist in the future, so he can start researching immortality before I'm in my 70s but overall I'm happy that they all feel they can ask whatever questions come to mind and and always share those worries because I remember when I was 10 or 11 there was a phase when I just lived and I remember going to school and being in constant panic that my mum was going to die one day and it's only recently talking about you know this picture book fox with my sister that i found out she felt the same way too and perhaps that's

because we were growing up in a single you know parent family but we never talked about this together and we never talked about it with mum either so we kind of carried this worry around with us so overall i hope that this book will help make a space for families to have those conversations and talk about death in a way that's very open is about they'll have to stop there isabel thomas thank you so much for being with us the book is fox a circle of life story now thanks to all of you for your tweets and emails about the long-term covid question. Helen said on Twitter, almost seven months after contracting COVID in Italy, I'm still suffering from acute fatigue,

cardiovascular problems, shortness of breath, plus a variety of more transient symptoms. There seem to be no answers and precious little support. It's tough. Emily in an email said, I had COVID back at the start of May and after the initial symptoms was just not getting better. I had crushing fatigue, joint pain, brain fog, headaches and cognitive issues. Since having COVID and being diagnosed by my GP with having

long COVID, I've only been able to walk to the end of my street for many months. Guy said, I can confirm long COVID. It took me five months to feel back to normal physically and mentally. Mentally felt subdued, lack of positivity and drive. Hard to explain, but it wasn't just the physical getting me down mentally because the mental lasted for months, not weeks. And then Trish said, I got COVID in March and I'm now long COVID. I'm a teacher in a secondary school. I'm currently unable to work and could potentially lose my job as my counsellor treating long COVID as a normal absence. I have a three-year-old who also had COVID and has problems with her eyesight and digestive system now and I can't be a parent.

I rely on my husband to care for her and me. He's helped me to wash and dress etc. I used to run half marathons and actually loved keeping fit. Now I can't walk upstairs. This is no life. On breast cancer screenings, Jill said in an email, the reason I've postponed my check is because it would involve travelling to the hospital by public transport instead of being able to walk to a breast screening van as I've done in the past. There seems to be an assumption in government and the media that everybody has a car and a smartphone. And another one on breast screening came from Lynn. She said, I just wanted to tell you about my recent experience with the NHS

and the way they dealt with my breast cancer scare. I felt unusual symptoms in my breasts and phoned my NHS surgery. They said they would get my doctor to call me. She phoned within four hours and I described my symptoms. She said she would ask Eastbourne Hospital Breast Cancer Department to give me an appointment. Within two weeks they saw me, gave me a mammogram and ultrasound they asked me to wait until a doctor was free to give me a biopsy i waited 20 minutes and they performed the biopsy two weeks later they called me back to the hospital where they gave me the good news that i didn't have

breast cancer wonderful nhs service even under a covid epidemic. And then on Ottolenghi, Anne said on email, had to email, as I've just had, Ottolenghi spicy mushroom lasagna for breakfast. Highly recommended. We, my son, girlfriend and myself, made it on Monday night. Worth the effort Otto Lenge is one of our favourite chefs and I have to say, having just eaten one of his cakes, I think he just might be one of mine. That's all for today. Do join me tomorrow for what, yes indeed, is my last Woman's Hour.

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.