Manika’s Plan (start to latest)

Here we give you each episode running into the next, in case you need a full blast in one go…

Episode 1 – (published Mar 15)

This is a story.

(‘What’s this got to do with No Biscuits?’ – Just go with the flow…for a few of weeks’’) (Note July 25 – many weeks)

Once, there was an Indian lady who lived and worked in the UK. Her name was Manika. By the time I heard about her, she had already passed away, but she had spent decades as a family doctor in South London.

For more than forty years, she became not just a trusted doctor, but something more—someone with an unusual secret.

I never met her. But I found out about her, when, on a long-haul flight, I found myself sitting next to someone who was the elder one of her two sons. (We agreed that I would not mention their names)

We started talking – about travel, about life, about family. It was one of those rare conversations where both people want to listen more than they want to speak, pulling the discussion deeper and deeper. I spent a good deal of time explaining my ideas for “No Biscuits”.

By the time we landed in Istanbul, we had agreed to stay in touch. As we parted, he said something unexpected:

“I think that there’s some quite special information that I’d like to share with you—something our family has never told anyone. But I have made certain commitments to my brother and father, so I need to check with them first.”

Intriguing, right?

I thought so, too. But I decided to leave it up to him to get back to me. And while I never completely forgot about our conversation, with each passing month, it slipped further from my daily thoughts.

Then, more than three years later—out of the blue—I received a message.

“Dear Will,

I’m sorry I haven’t been in touch. You must have thought I had forgotten about our conversation on the flight, but I haven’t.

After we met, I spoke to my father and brother about sharing something very personal with you. They both refused. Their reason? Neither of them knew you. And, if I’m honest, I couldn’t really argue with that. But I held on to my instinct that you would treat this knowledge with respect.

For years, there was nothing I could do.

Then, about twelve months ago, my father was diagnosed with colorectal cancer. He chose not to have treatment—partly because of his age, partly because he didn’t want to undergo the side effects of chemotherapy.

In the last days of his life, just over three months ago, he called my brother and me to his bedside. He was physically very weak by now, but his mind was still clear. He told us about a dream moment he had experienced during one of his brief afternoon rests.

In it, he was seated with our mother, Manika. The only thing he remembered after waking was that she had placed her hand on his arm and said: “You can share.”

My father knew exactly what she meant, so he called my brother and he then also agreed that I could contact you.

Two days later, my father passed away. Since then, we’ve been dealing with everything that follows a death. But now, we’re ready. If you can come to London, my brother and I will share the information….”

I was quite curious to discover more. But still, it took me another three months before I made the journey from Sofia to London.

The brothers chose to meet in a quiet corner of the Hotel Russell (as it was then), in Russell Square, central London.

First, we caught up. I also got to know the younger brother, and I felt some obligation to let him test me out as part of the preparatory process. We talked through all recent events. But after a couple of hours, we came to the heart of the matter.

This was a secret, more than anything, a professional secret that their mother had kept since she first became a doctor—more than fifty years ago.

And when they told me what she knew, I immediately understood both the power, the weight and the sensitivity of that knowledge. I also understood why it had never been possible to reveal the secret while she was still practising and even while she was still alive. She had asked them to promise not to reveal anything until after she had passed away, and you too will understand why that had to be.

In a couple of weeks, I will tell you more.

Manika’s Plan – Episode 2 (published 1st Apr)

Where did we leave off?

A long-haul flight, an unexpected conversation, and a decades-old secret held by an Indian doctor named Manika. Her son had promised to reveal it—but only when the time was right.

That time had come.

We met and sat in the far corner of the bar of the Kimpton Fitzroy Hotel, a grand Victorian landmark on Russell Square, London. The elder son greeted me with a firm hug, his warmth unchanged since our last meeting, several years before. The younger son, whom I’d never met, was more reserved—polite, but slightly detached, as though unsure of his role, other than as a family witness, in the unfolding, very personal story.

We settled into our chairs, and once the tea was poured, the elder son leaned forward. “Right, let’s start.”

He began at the beginning.

“Our mother was born in 1930, in Calcutta. A Bengali family, ambitious, driven. She was just 20 when she and her parents moved to the UK, right after the war, when Britain was crying out for doctors. She qualified as a General Practitioner.

She began practicing in Newham, East London—a place still bearing the scars of wartime bombing. Communities were struggling. Men worked the docks, women stitched garments in textile factories, and the National Health Service (NHS) providing free health care for all, barely a decade old, was stretched thin.

She built a solid reputation quickly,” he continued. “Hard-working, dedicated. Families relied on her. She knew their struggles, their illnesses, their hopes.”

And then – one day….

She noticed something strange. At first, she dismissed it. A trick of the mind. But it kept happening. Over and over again.

He paused, choosing his words carefully.

“This is the thing….within minutes of meeting a patient…..she would see a number in her mind – a week, a month, and a year. She would soon come to know this date as the date, or week, in fact, when she simply knew that their lives would come to an end.”

I felt my pulse quicken and my thoughts tossed between incredulity and disbelief.

“She told herself it was nonsense. But it was happening with nearly every patient. If she was very tired or unwell, it wouldn’t appear. But on a normal day, it was automatic. She would sit down, listen to their symptoms, and the number would be there.”

I had to ask the obvious question. “Did she ever tell anyone?”

“No. Not for decades. Not even our father. But she kept records. Every date, every patient, every meeting, carefully noted in her medical diary. And of course, over time, in some cases years or even decades, the dates were verified against actual events. Without exception, the last date timing that she saw, proved to be accurate to within one week.”

He glanced at his younger brother, who had remained silent until now. The younger man gave a small nod, as if to confirm that, yes, this was real.

I still struggled to grasp this as truth, but the grave look on their faces told me that they were not playing around.

The elder brother continued.

“After she retired, without telling anyone, she handed over all these diaries, to her own solicitor, whom she had appointed herself and whose only task was to manage their safekeeping, for obvious reasons. He was sworn to secrecy in his handling of this task. Our family solicitor, who dealt with all the admin after her death, and dad’s, was a completely different person and company.

And even after she passed, as per mum’s instructions, it was several years before her “medical” solicitor contacted us and handed over this letter, written by mum.

I would like to read it to you now and if we then can agree on everything, I will give you a copy after.

To be continued…

Manika’s Plan – Episode 3

Where were we?

Manika’s son reveals a startling secret about his mother—as a doctor, Manika possessed an uncanny ability to foresee patients’ deaths with eerie accuracy, recording each date in her medical diaries. Years after her passing, a solicitor that she had secretly entrusted with these records, delivered a letter from their mother, holding the key to her lifelong mystery. So here continues the conversation in the hotel with the two sons…

Her elder son said..

So this is the letter that we received from her “secret” solicitor.

‘‘My Dear Boys,

I need to explain to you why you are reading this letter now and the events that I needed to know were already in place before I could tell you about my life and its powerful secret; something that I have been struggling to hold and manage on a daily basis, for such a long time.

Firstly, I knew that your father would pass after me and I didn’t want to burden him with managing this issue in the latter years of his life, especially when it was clear that his health was already failing. I also needed you both to be mature enough to handle the matter. Thirdly, you will understand that I had to protect and respect the confidentiality of my patients.

So I made two stipulations to my solicitor, whom I appointed without you or your dad’s knowledge The first one was that I had demanded that no details from my diaries may be used until that patient was no longer alive and secondly that an alias name be used in all cases.

So having made that caveat clear – this is what it’s all about.

Since my earliest days as a doctor, almost immediately after qualifying and starting in my GP practice, I was able to receive information (it just came to me, with no effort) about when a patient would pass, to within the accuracy of a week or so. For weeks after this, I was in total physical and mental shock, and your father thought I had fallen ill.

This bizarre ability proved itself constantly over many years and decades and I had to learn to manage the effect of this information and the weight of thre responsibility; and it wasn’t easy. Initially, I just had a list of patients, meeting dates and death dates, for much want of better words.

Over time, I was able to understand this phenomenon and its consequences more deeply.

After the first meeting, I always had a “departure” date for them. But of course, I was seeing the same patient repeatedly, at least a couple of times per year and often much more frequently. Most of my patients and their families tended to stay with me for the long term, so over my 45 years, I was seeing some people for literally decades, sometimes across three generations of one family. But this wasn’t the most interesting aspect of all.

What I came to realise, over time, was that if they changed their behaviour or habits in some way, or if I was able to successfully administer some kind of treatment to them, then, when I met them again later, I noted that the date of their passing could shift. So the ‘death date’ could shorten or extend, it was changeable, I really doubted my own sanity.

But as I became used to handling this burden of responsibility, this date movement was what really intrigued me, because over the decades, I was able to witness real changes in peoples’ lives when they decided to take control and change something. Or, in fact, contrastingly, more often than not, I also saw how some seemed powerless to change negative habits, even when they knew that they were effectively harming themselves.

So as a consequence of all this, I was able to develop, over this period, a sort of a template or plan. After I retired, I counted up my patient meetings and over 45 years it came to over 330,000 interviews, can you believe it? So much listening (And then I used to come home after work and your father and you boys still expected me to listen to you too!!) But really, I always, always felt my spirits lifting, when I was on my journey home to see you all, I love you so much.’’

We had to have a pause here for a couple of minutes, as the boys were a bit overcome with emotion and I gave them some space for a few minutes.

The elder son recovered and continued reading…

“My plan was built on these thousands and thousands patient interviews and treatment sequences. Because when I had a sequence of treatment over days, weeks, months, years or decades, I could see the effect on the…let’s just call it the “due date”. So I knew, unbelievably, what effect any treatment was having and I could judge its effectiveness. This contributed to my success rate, and I think it is why I retained so many of my patients for so long.

Going back to the release of the diaries, at some point, after the due diligence has been completed, the solicitor will start to release to you my first batches of diaries, and you will be able to read of and then monitor the cases, through the passage of time.

My wish has always been to share this, but it has to be shared correctly and with someone who will act responsibly and morally with the information received and to use it to help others”.

The elder son paused here, partially overcome again with emotion, then steadied himself, and said:

“So you see, this is what is happening….based on what you told me and based on Dad’s dream, we are hoping that you are the right person to use this information in the correct way. The only question is……

To be continued…

For the first time the younger son spoke up, in a rather agitated voice, pushing himself forward in his chair:

“The only question for me is…what do you propose? How are you going to handle this information, and how will you do justice to our mother’s legacy? Without looking at him, but out the corner of my eye, I could both see and sense that the elder son, who remained silent was also holding his brother’s unspoken thought.

The younger son’s eyes, voice and total energy said, very clearly, ‘‘why should I trust you?’’

What could I say? It told me that the relationship between him and his elder brother was not sufficient for him to believe the word of his elder brother, nor the message received from his deceased mother. He, maybe rightly, wanted his own proof of my word, my ability to honour the memory of his mother and maybe a guarantee that I would not somehow take advantage of the privilege that I was being given

I knew, like it or not, that this moment was probably my only chance to win their full approval. I could easily blow it and I could feel my stress level rising.

I had to think fast but remain calm and let my heart speak first. This is what came into my head.

‘‘Look, I know this is not easy, you have only received an indirect message about releasing this information from your mother via your father, neither of whom are with us any more, so I understand both the burden of responsibility and the uncertainty of allowing me into the centre of this highly personal situation.

You need to trust me. Where does trust come from? Only one place, the truth. How do you measure the truth? You compare words with deeds overtime, and you see the evidence of truth repeated, you look for any gaps between the words and the deeds.

I cannot create that trust without due process, so you have to decide to let me begin that process and let it be slow and careful, but let it begin. That is how you will trust me.”

Let’s agree this.

It is you who will receive the diaries, from time to time, as we know, from your mum’s solicitor, and it’s only you who can release them, so that is totally under your control and always will be. And I will always be accountable for the diaries to which I have access, let’s record it formally.

When you receive any diaries, you can give me one, and I will produce a draft blog, draw from it, write up the story and I will send it to you before I release it via the newsletter and so you will have an editorial veto on the content and the style. Then it will be my task to win your trust and confidence in the way that I tell the story.’’

There was a long pause – the younger son, with his head lowered, stared at the floor. Eventually he raised his head, looked at his elder brother, who gently nodded and with that the tension ebbed away and the younger son sighed and said: “I am still not sure”.

I don’t know why, but this was my last desperate attempt to rescue the situation.

‘‘The last thing I can say to you both, is, please don’t forget that I am someone who knows suffering, for most of my life, real hardship. I have known the depths of despair and disappointment, more than most, on many days, on many afternoons particularly.

“What do you mean?” said the elder son, with a furrowed brow of intrigue and concern.

‘‘It’s very simple’’ I said. ‘‘Since the age of 10, I have been a dedicated, loyal supporter of Stoke City Football Club – that’s all I need to say’.

They looked at each other, there was a long pause, then they both looked at me and burst out laughing. It was over….

To be continued…

Manika’s Plan – Episode 4

What happened last time?

A mother, a doctor with the uncanny ability to predict patients’ death dates, reveals her secret in a posthumous letter to her sons. Over 45 years and 330,000 patient interviews, she saw how choices could alter fate, leaving behind diaries filled with life-altering insights. Now, her sons must decide if they’re ready to wield her knowledge responsibly, respect her legacy and let it offer hope to others.

(If you want to read Manika’s Plan from start to latest episode, you can click here. – every 2 weeks a new episode).

For the first time the younger son spoke up, in a rather agitated voice, pushing himself forward in his chair:

The younger son’s eyes, voice and total energy said, very clearly, ‘‘why should I trust you?’’

I knew, like it or not, that this moment was probably my only chance to win their full approval. I could easily blow it and I could feel my stress level rising.

I had to think fast but remain calm and let my heart speak first. This is what came into my head.

I cannot create that trust without due process, so you have to decide to let me begin that process and let it be slow and careful, but let it begin. That is how you will trust me.”

Let’s agree this.

I don’t know why, but this was my last desperate attempt to rescue the situation.

“What do you mean?” said the elder son, with a furrowed brow of intrigue and concern.

‘‘It’s very simple’’ I said. ‘‘Since the age of 10, I have been a dedicated, loyal supporter of Stoke City Football Club – that’s all I need to say’.

They looked at each other, there was a long pause, then they both looked at me and burst out laughing. It was over….

To be continued…

Manika’s Plan – Episode 5 – “Albert”

Previously in Manika’s Plan:

Tensions peaked as the younger son finally broke his silence, challenging the narrator’s intentions and demanding proof of trust. A careful pact was proposed—one built on truth, process, and accountability, but doubt still reigned with the younger brother and the shaky agreement nearly collapsed. But a desperate last pitch at humour launched saved the day, and the story begins.

(Author’s note – We can call this these last four episodes “The Introduction”. We understood a little who Manika is and about her “gift”. Now we will start to explore Manika’s diaries and to extract stories from them, sometimes across hours, sometimes across months, years and maybe decades. We will piece together her Plan, hopefully with the willing cooperation of her sons.

They have now agreed to be named, as the elder son, Sharvan and the younger, Sanjay. We will also get to know their father, Manika’s husband, Ravi, Ravi Kundu – altogether this is the Kundu family).

(If you want to read Manika’s Plan from start to latest episode, you can click here. – every 2 weeks a new episode).

It’s 9 o’clock, Monday – and I am expecting Albert, to be seen for the first time. In walks, not Albert, but a diminutive, bustling, weary looking 50 plus year old lady, her rather large handbag swinging from the crook of her elbow, eyeing me nervously. “Albert?” I ask enquiringly, with as gentle a smile as I can muster,

She shakes her head: “He’s coming.”

Ah, a reluctant patient. I poke my head around the door to glance into the waiting room, to see Albert, still seated in a prayer like position, holding both hands together with his head and gaze lowered to the floor.

“Albert”, I call, and then glancing at my notes, I ask slightly louder, “Mr Biggins?” He looks up, and with a heavy sigh, rises very slowly and awkwardly to his feet and edges unwillingly towards us.

I ask his, I assume, wife: “Who made this appointment? “I did” she says. “It’s me who can’t sleep”. I am slightly confused that we seem to have two patients in one session, one who booked the appointment for the other, who doesn’t want to attend and she who booked it who both wants and needs help.

I manage to get them both into my room, shut the door, consider locking it, to prevent an Albert escape and gesture for them both to sit.

I take my own seat across the divide of my desk and begin to assess what faces me. Albert has also seen more than 50 years, is tall and large, and breathing heavily. I can almost hear the wheezing of his chest and feel the discomfort of his shallow breaths. They look an oddly contrasting pair, but both clearly in need.

“So how can I help you…mmm…the two of you?”

A small pause and Albert’s wife, whose name, I discover, is Mary, lets fly.

“It’s Albert, it is. I can’t sleep because he wheezes. He wheezes because he can’t breathe properly. He can’t breathe properly because he has asthma, and he has asthma because…”.

Almost at the same time as she says the word asthma, the drift of stale tobacco from Albert’s clothes, reaches my edge of the table and then….I see, for the first time a date in my head, very connected with Albert, and this date is only nine months away. It’s Albert’s calling card, his days are rather numbered and as always happens, I face the shock of knowing someone’s fate, and knowing that I have to preserve this secret, to protect myself from the impact of it and take the situation forward.

I need a few moments to gather my own composure, to remain stable and keep control, so I make some notes and let the silence sit and let my pulse rate at least level out.

As much as I would like to use Mary as his interpreter, I know that at some point, I need to reach Albert. I decide to keep it formal. For now, I will play the role of the “kind prosecutor”. I need to drag forth but the simplest of information via some binary questioning. I calculate that he will not yet willingly tell me the story, but on the other hand he looks unlikely to muster untruths.

“Mr Biggins, is it true that you could be sleeping better than you currently sleep?”

“Mmmm” says Albert, hands together, head lowered again.

I glance at Mary, she nods… that’s definitely a yes from Albert.

“Mr Biggins, do you believe that your problem is your asthma?”

“Mmmm” I know what this means, but to build my rapport I glance again at Mary, give her a smile of encouragement and she nods, quite vigorously, her eyes lighting up.

Here we go, pushing now into darker territory….

“Mr Biggins, do you smoke….. cigarettes?”

Silence.

Mrs Biggins, nods almost imperceptibly, torn between truth and betrayal.

I already have all the information that I need, there is nothing more to ask. What I need now…. is a plan.

I think that I have to go for the jugular.

I grasp the moment, as, for the first time Albert glances up at me. There is a sad desperateness in his eyes, mixed with fear.

This is my chance and I take it.

“Mr Biggins… do you… love your wife?” I stretch this out.

An unbearably long and awkward silence of tension ensues, now it’s Mary’s eyes that turn downward and Mr Biggins just stares at me, like a rescued dog, seeking the end of its suffering.

His head shakes slightly, and I notice the beginnings of a tear appearing from the corner of his left eye.

That’s good enough, that’s very good, in fact.

“Mr Biggins, thank you very much, you may go now, and I will talk with Mrs Biggins about her sleep problem”.

As if released from prison, Mr Biggins rises quite quickly, turning away from his wife, dabbing his eyes with his handkerchief and after a quick shuffle, closes the door behind him.

Mary did not see the tears, but I did, and they mean that I can smile deeply at her and convey something of the love that I know he feels for her.

“Mary, we need a plan, and I think I know what we can do to improve your sleeping, but I need your help. This is how we are going to begin, and we don’t have time to waste…..”

Manika’s Plan – Episode 6

Previously in Manika’s Plan:

Manika has an appointment with Albert. His wife Mary, actually booked the appointment for him. Albert is not in good shape…long term smoking and respiratory issues. Manika sees Albert’s “due” date – only nine months remaining for him, he’s still in his fifties – she’s shocked. She has to deal with Albert’s “closed shop” and Mary’s tired anxiety. A tear reveals the truth. Manika needs a plan. She enlists Mary as the key to Albert’s healing. Not much time left.

It was Wednesday afternoon and I had asked for Mary to come in while Albert was still at work in the docks. Ostensibly, I had said that I wanted to help with her inability to sleep, and that was true, but I really wanted to address the source of the problem, which was not Mary, but Albert. His constant wheezing reduced her sleep to intermittent intervals and when I asked if she could sleep further away from him, she shuddered at the thought, saying that she could not let him down. I didn’t start to question that.

“Mary, for how long has Albert been smoking and how heavily?”

She sighed deeply and folded her arms.

“When he was younger, he played football, not professionally, but at a good amateur level, but when he was 26, he broke his ankle in a tackle and that meant that he could not play again at a serious level. We had just married and this hit him really hard. His club just dropped all interest in him and made no effort to support him psychologically. It wasn’t long after that he turned to smoking. Over the years he then tried to quit three or four times, but by the time he was forty-five, he was on about twenty a day and that’s how it continued. Since he was fifty, five years ago, I began to notice his breathing problems as well as a weight increase, as if each problem compounds the other. There’s no pleasure for him in the smoking, it’s just a habit that has gripped him”.

“And what about your relationship with Albert, how would you describe that?” I asked, carefully.

“Not so good, he’s often in a bad mood, because of his breathing, and that gets me down too and there’s no real break from it. I wake up tired.”

“I understand that. You know what, Mary, I don’t think he’s unhappy with you at all, in fact I know that the opposite is true”. Mary picked her head up quickly and quizzed me with her eyes. “How do you know?” she said.

“Just trust me, it’s true, he’s far more disappointed with himself than he is with you and that is what’s blocking him from you, that’s what we need to unlock.

I need to give you some homework to do, will you do that for me?” She nodded reluctantly, and I could see that half of the solution here was with the thinking as well as the doing.

“What I want you to do is to try to help him find a motivation for change. A motivation that can be or that can become stronger than his heavy habit.”

She rolled her eyes.

“Mary…. we have to believe, me and you at least, that he can find something solid. I know he’s blocked to change right now, and it won’t be easy for him to move, but we can try to help him find the solution, he won’t take it from anyone else. We cannot change him, he can only find the will within him to make his own changes.

So when it feels right, I just want to give you some ideas for questions to ask him, and they won’t seem like much in themselves, but they are just like seeds that we need to plant and then keep them moist.

“I’ll try” said Mary.

“I think the timing is critical, before you ask these questions, they need to feel like natural questions that won’t spark his suspicion, and he needs to be in the best mood possible. Can you think of any times when he is going to be happier, most of all?”

“Oh yes”, Mary jumped in. “Around 5.00 pm on a Saturday if Arsenal have won, then he is really alive and joyful for at least a few hours”

“Well there we are, try it then. These are the questions, I think that two are enough:

What is it that you miss the most, Albert?

What would you really like to change?

Mary’s eyes lit up for the first time. “It’s Wednesday today, I will check when Arsenal have their next game and will hope it’s not a difficult match!.”

“Yes” I said, looks that we, ladies, both have to take an interest in the fortunes of Arsenal Football Club”.

Give me a call on Monday, before 9.00 am and tell me what happens….

Manika’s Plan – Episode 7

Previously in Manika’s Plan:

Manika arranges a private conversation with Mary to address her sleep troubles, which stem from her husband Albert’s chronic smoking and health decline. Mary reveals Albert’s emotional spiral began after a football injury ended his athletic hopes, leading to a long term smoking habit. Manika gently guides Mary to help Albert rediscover a personal motivation for change, suggesting she ask him two key questions when he’s in a good mood—ideally after an Arsenal win. Mary agrees, feeling a spark of hope for the first time and must call Manika.

(If you want to read Manika’s Plan from start to latest episode, you can click here. – every 2 weeks a new episode).

“Mary, is that you? Good, so I see that Arsenal played at home and managed to win in the last five minutes. So, any luck with Albert and the questions?”

It was a good sign that Mary had called when we had agreed. Increasingly, in my career of dealing with patients and people in general, I was always wary of gaps between what people said they would do and what they actually did. It was a common syndrome and in my own head I used to refer to it as the “Mind the Gap” syndrome or in doctor’s unofficial shorthand “MTG”.

Sometimes, people don’t even realise they have a gap, some ignore it and others expand theirs – it often widens but rarely narrows. I have to keep a sharp eye on my own MTG too. It can erode or destroy trust instantly.

“It was hard” said Mary, “because it was1-1 till almost the end and the excitement of the winning goal gave him a coughing fit. It was like the hot water boiler was exploding and this dampened the immediate impact of the win.

But after about 15 minutes, I was able to ask him some questions while I was making him a cup of tea”.

She had jotted down the questions and then also his answers. He was now sitting in his arm chair, smiling and gazing at the ceiling and I could see him re-living the last minute Arsenal goal. Mary knew that this was the moment to strike.

She passed him his cup of tea and asked:

“Albert, dear, what is it that you miss the most?”

Answer – “Time… time…. I wish I could go back in time and not have started smoking. I should have been a drinker instead….” Not often did Albert joke like this, dark as it was – but he was quite cheerful.

“And what would you really like to change?”

Answer – “Do you know what, Mary? I would love to be able to run, or just to jog for five minutes without being out of breath. I was always running as a kid and then training daily with Enfield or just on my own, jogging along the canal paths and through parks, until the Millwall game.

Albert always referred to the day of his football accident as the “Millwall game”, the end of his football career, during a match against local rivals, Millwall’s second team.

I was a bit excited by these responses. “Mary, that’s very good, do you realise that?”

“What do you mean?” she said.

I replied: “He has given us, albeit unwittingly, due to the late goal, opened the window all but briefly into how he feels and maybe, just maybe, we have a hook of a solid motivation. What I mean is, he is firstly acknowledging to himself and to you, that he regrets smoking. Ok, we already know that, but it’s still an opening up, but even more importantly, he is giving us a way forward.

Now we just need to help him build his motivation to jog, that’s all”.

I could hear Mary sigh in heavy disbelief at my “misplaced” optimism.

“Let me ask you some questions to see if we can exploit this in the next few minutes before I start surgery at 9 o’clock.

Who or what could stimulate Albert to start exercising and using what trigger?

Did he ever want to stay in the football world, even after MAD?”

There was a pause, whilst Mary drew on her memory.

“He did toy with the idea of becoming a coach for a youth team, because that was what one of his close friends did, who had also become injured. In fact, that old friend is still a coach, and he’s the same age as Albert.”

“Are they still in touch?”

“No, Albert fell out with him. He became very negative, and I think he was unable to cope with how his friend had transitioned into a new role. They haven’t spoken for years.”

“Maybe it’s time that they did. Let’s see what we can do. What was his name?”

“Geoff Bridges.”

“Ok, let us both think about it and see what we can figure out. Well done, Mary, good job.”

I had a funny feeling that I had another Bridges on my patient list, I checked it out. It was a Lucy Bridges, but it wasn’t clear if she was a relative, and I couldn’t really breach patient confidentiality by asking her. A week later, I called Mary.

“Did you find out anything more about Albert and Geoff Bridges”. Mary sounded down.

“Albert told me that they had had a major falling out, about 5 years ago, when Albert’s breathing worsened. Geoff had a go at him and criticized him for not quitting the habit. Albert was hurt and jealous, hung up on him, and that was that.”

I checked the file on Lucy Bridges and saw that she was supposed to come in for a follow-up checkup on her last visit, but hadn’t yet done so, so I asked Jane, the practice receptionist, to set up a session. Ten days later, I met Lucy Bridges, a young mum, with a noisy three-year-old and just as she was leaving, I asked her: “Do you know of a Geoff Bridges, he’s an amateur football coach? He lives in Newham.”

Lucy paused at the door and scrunched her forehead in concentration, my heart sank a little.

Then her look brightened as she focused.

“I think he may be a cousin of my mum, but I am not sure – why?”

“I am in need of a football coach, and he may be someone who can help or recommend someone – can you ask your mum, and you could just let Jane know at reception, that would be so good, thanks.”

Two days later, I came into my office to find a stick-it label on my desk from Jane, “Geoff Bridges – 07760…12”.

I immediately called Mary. She was pleased but hoping that I would call him, but I explained that I couldn’t start to intervene in this way. I had done what I could, partly by good fortune and partly with a touch of detective work.

“You are going to have to ring him, Mary.”

“I’m scared to.”

“I know, but you need to find the courage, for Albert and for your family.”

To be continued….

Manika’s Plan – Episode 8

Previously in Manika’s Plan:

Mary uses the emotional high from a football win to connect with Albert, who opens up about his regrets—especially smoking and losing his ability to run, after a football injury. There is a chance for change by reconnecting Albert with his old friend Geoff, now a football youth coach. After some detective work, they track down Geoff’s relative and obtain his number. Mary is urged to make the call, despite her fear, for Albert’s sake.

(If you want to read Manika’s Plan from start to latest episode, you can click here. – every2 weeks a new episode).

Mary came home from work, plumped her bag down in the hallway, and walked into the lounge. What she saw shocked her. Albert was sat on the floor of the lounge, with his back against his armchair, staring in front of him.

“Albert, what on earth are you doing? Are you okay?”

Albert looked up slowly at her and said, “I’m okay. I’m meditating. And that’s all.” Albert went back into his pose.

Mary stood there in disbelief, staring at him and wondering quite what was going on. “Well, when you’ve finished, come to the kitchen. I’ll make you a cup of tea and maybe you can explain what is going on.” And off she went to the kitchen.

About five minutes later, Albert appeared, with a strange, detached demeanour, but somehow with an element of unusual calmness about him, and he sat down at the kitchen table.

“Geoff Bridges called me,” he said.

“What?” said Mary.

“He called me at work this morning. He must have had my number from before. And he told me that he’d had a dream about me. That’s all he said. He just said, ‘I had a dream about you last night after my niece mentioned your name’. And in the dream, you were fully dressed, in a kind of long coffin-like leaky box made of boards. So like a coffin, but not a coffin. A series of boards fitted together the length of a coffin, but not perfectly sealed. And you were in this sort of coffin box, floating down the middle of the River Thames in the centre of London. Floating quite high in the water for some reason, but nevertheless floating down the river inside the box. And the boards on the top were not totally tight, so there was a tiny bit of light and air inside this box. But you were stuck there, wearing your work suit, floating down the river. And at some point, the River Thames became just a large weir, and you disappeared over the weir and fell away into the distance. And that’s all I remember.’”

Albert picked up his cup of tea and sipped it.

“So, what was that all about?” said Mary.

Albert said, “I think it was a message, a warning, a signal that maybe I need to do something. And after that message, which wasn’t very pleasant, I thanked Geoff. That was the end of the conversation”.

“How very strange.” whispered Mary, clutching her teacup with both hands.

Then, during my lunch break, I found some guidance on the internet on meditation. Because I thought that if I want to change what I do, first of all, I have to change what I think about.”

Mary was quietly flabbergasted, but also quietly encouraged.

“So what’s meditation as far as you’re concerned, Albert? I have never heard you speak of this in the 43 years that I have known you.”

“Well, meditation is not what people think it is,” said Albert slowly, sounding as though he was some sort of expert on the subject. “Meditation, most people think, is about clearing the head of thoughts. To have no thoughts and just be sitting, thinking of nothing. But actually, meditation is not that at all.

And by the way, Mary, I smoked nineteen cigarettes today, not twenty. And tomorrow, I shall smoke eighteen and not nineteen.”

“Oh my goodness, Albert, what’s happened to you?”

“I think, Mary, Geoff’s phone call, Geoff’s dream, is a message to me that I need to change something. Otherwise, things are just going to get worse and worse. So that’s what I’m doing. I’m trying. In fact, I’m not just trying, I am just doing it, reducing my smoking. And I am starting to meditate. And in a couple of weeks I will be able to explain to you how the meditation works. Maybe it will be useful for you too.”

“I’d like to know, Albert. Of course, I’d like to know. Of course, this is a good thing. I’m just a bit shocked. In fact, I think that I am so shocked that I am going to have another cup of tea”.

A bit later, Mary felt she had to leave a message on Manika’s phone.

“Doctor, I came home tonight and Albert was meditating on the lounge floor, having been called directly by Geoff Bridges, who told Albert about his dream of seeing Albert floating down the Thames in a sort of coffin, and now he has also started to reduce his smoking by one cigarette per day. I don’t really understand anything about what’s going on, maybe he’s gone mad, and after all this, I had to have two cups of tea, but anyway, see you Monday.”

(to be continued……)

Manika’s Plan – Episode 8

Previously in Manika’s Plan:

(If you want to read Manika’s Plan from start to latest episode, you can click here. – every2 weeks a new episode).

“Albert, what on earth are you doing? Are you okay?”

Albert looked up slowly at her and said, “I’m okay. I’m meditating. And that’s all.” Albert went back into his pose.

About five minutes later, Albert appeared, with a strange, detached demeanour, but somehow with an element of unusual calmness about him, and he sat down at the kitchen table.

“Geoff Bridges called me,” he said.

“What?” said Mary.

Albert picked up his cup of tea and sipped it.

“So, what was that all about?” said Mary.

“How very strange.” whispered Mary, clutching her teacup with both hands.

Then, during my lunch break, I found some guidance on the internet on meditation. Because I thought that if I want to change what I do, first of all, I have to change what I think about.”

Mary was quietly flabbergasted, but also quietly encouraged.

“So what’s meditation as far as you’re concerned, Albert? I have never heard you speak of this in the 43 years that I have known you.”

And by the way, Mary, I smoked nineteen cigarettes today, not twenty. And tomorrow, I shall smoke eighteen and not nineteen.”

“Oh my goodness, Albert, what’s happened to you?”

A bit later, Mary felt she had to leave a message on Manika’s phone.

(to be continued……)

Manika’s Plan – Episode 9

Previously in Manika’s Plan:

Albert, rattled by a haunting dream relayed by Geoff Bridges about him floating down the Thames in a coffin-like box, decides it is a warning to change his life. When Mary comes home, she finds Albert uncharacteristically meditating and calmly announcing his plan to cut down on smoking, leaving her stunned. As Albert explains his newfound determination, Mary struggles to process the sudden transformation. In her confusion, she leaves a worried message for Dr. Manika, unsure whether Albert’s change is inspiring — or a sign that he’s lost his mind.

(If you want to read Manika’s Plan from start to latest episode, you can click here. – every 2 weeks a new episode).

The door to Manika’s surgery clicked shut. Manika stared at it with a broad smile on her face and giggled for a second. Albert had just left and whilst slowly closing her door had waved his hand over the top of the door, like two little puppets waggling their legs.

Two years had passed since Manika had met Albert. Two years ago, Albert had been overweight, a habitual smoker, depressed, without meaning or purpose in his life. When she met him, Manika had seen nine months written clearly above his head as his life expectancy. Not only that, but she could foresee the increasing illness into which he would sink in those last nine months.

But look what had just happened. Albert had just told Manika one of his favourite jokes, tripped jauntily out of the surgery, and in one hour would be training the under-nine football team at his local club. She finished her concluding notes, knowing that Albert would not be back in her surgery for years, if not decades to come. Manika had written down his new “Sell by” date, and all we can tell you here is that it gave Albert a prediction of a vital and positive outcome for many years to come.

Still, the smile stayed fixed on her face. Her heart was filled with quiet joy, she understood deeply why she had become a doctor. This was someone who had been battling to breathe 24 hours a day, who had overcome those challenges and become, in every way, a new person, or maybe more accurately had simply found who they were supposed to be.

She re-opened her diary on the page where she had closed it, and flicked back to the beginning of her conclusion.

What were the lessons learned?

He had a loving wife, Mary, but Albert had become isolated, isolated inside his own head, incapable of breaking out of the cycle of negative thoughts. He could find no reason, no source of strength to break free from those damaging habits. But underneath, both his wife and Monika knew there was something, something deep in his subconscious that could be awoken. And they had found it. Football, and an old friend.

These two things together were just enough to give Albert a spark of hope, to nudge him toward believing there was something still worth living for. And so his bumpy journey had begun. His mind had grown curious again. His spirit started to awake.

He gradually moved from twenty cigarettes a day, gradually cutting down, one by one. Yes, there were a couple of setback days when Arsenal lost on a Saturday, understandable, really. But over two or three months, Albert managed to reduce his intake to five cigarettes a day. Giving up completely was a bridge too far at first. He needed a replacement, not a vacuum, and found it in two things: chewing gum and coffee. It wasn’t perfect, but honestly, far better to be chewing and sipping coffee than hacking up a lung every morning.

Mary was much happier cleaning away abandoned coffee cups and peeling off occasional blobs of chewing gum from the kitchen bin lid than cleaning out the filthy, rancid saucer of cigarette butts on the kitchen window sill outside.

By leaning on those two crutches of support, he gained enough strength and finally broke away from his dependency. Within a month of stopping smoking, four months since meeting Manika, his breathing eased. His walking improved. And, almost unbelievably, he took up meditation as a daily ritual.

For Albert, meditation was simply breath work: four seconds in, four seconds hold, four seconds out, four seconds hold — box breathing, as he called it. Four minutes in the morning, six minutes in the evening, which sometimes stretched to ten minutes before or after an Arsenal match. On some days, he did nothing at all, but gradually, over several months, it became a habit.

Of course, he was at first embarrassed about this. In his mind, meditation was the preserve of a cave living Nepalese guru on a Himalayan mountain top, not an ex-dock worker from East London with a beer gut and a questionable passion for football. But Monika understood perfectly how powerful breath work could be, and she encouraged him every time.

She also supported his understanding of meditation.

“Albert, it’s not about trying to clear your mind and think of nothing, it’s about sitting calmly, relaxing, slow breathing, eyes closed. Then allow your mind to wander where it wants, letting it go off course and then gently realising that it’s gone off and then quietly inviting back to the source of the music or whatever the source is. And it’s like going to the gym, Albert, the more you do it, the easier it becomes, the better you are at it, but take it slowly and be patient.”

Albert used it to go to sleep also, Mary bought him some headphones, and he played his meditation music each night after he had given Mary a gentle hug and wished her good night.

Along with better breathing, more walking, and his new meditation routine, Albert felt stronger week by week. With Mary’s steady support, he adjusted his diet, after studying how to eat better. Less bread, fewer potatoes, pasta out, rice nearly gone. He took Monika’s advice, it was simple but effective:

“Think what your grandmother would have eaten (less the bread) – meat, fish vegetables, and if she was lucky, some fruit.

His weight came down.

Within six months, Jeff Bridges, who had been quietly keeping tabs through Mary, gave Albert a call.

“Albert, we’ve got a problem,” Jeff told him. “We’re losing our under-nine coach in six months, and we need a replacement.”

That was enough, Albert could feel that deeply as his staircase of further improvement to really gain some positive meaning to life.

That conversation gave Albert a six-month goal to get himself fit. Geoff set Albert a bar that was quite high:

“If you can run a mile in under ten minutes, and then within two minutes of finishing tell me a joke that makes me laugh, you’ve got the job.”

Challenge accepted.

Albert hit the canal, the park, the staircase, anywhere with a gravity challenge and chance to step out, back to training. At first, he could only walk, but by month four, he was jogging half a mile without stopping, building up his endurance. Eventually, he passed the mile and joke test with ease, surprising even himself, as well as Geoff and Mary.

For a man who had once coughed his way up a single flight of stairs, running a ten-minute mile was practically a minor miracle — though, of course, Albert wouldn’t have put it quite like that. He would have said it was“not bad, for an old smoker.”

(to be continued……)

Manika’s Plan – Episode 10

Previously in Manika’s Plan:

Albert, done and dusted, a new chapter follows. And by the way, Albert’s Under-10s football team is doing well.

But we move on, and Manika is going to be stretched in a new direction, pushed outside her comfort zone, and is going to have to make difficult professional and deeply personal decisions. It gives me goose bumps just thinking about what is to come, so we better get going.

(If you want to read Manika’s Plan from start to latest episode, you can click here. – every 2 weeks a new episode).

The door to Manika’s surgery clicked open. It was Marjorie. Marjorie was an attractive, lively 38-year-old, wife and mother, whom Manika had known since Marjorie had been pregnant with her only child, who was now a boy of ten years old, Marcus. Manika had not seen Marjorie for nearly six years, because she had not been ill and neither had her son and there were no vaccinations due. Marjorie had missed her last smear test appointment, due to ‘pressure of work’ and never followed it up. Manika had seen Marjorie’s lifespan date then, six years ago and again now, and there was nothing to worry about. Marjorie was set for a long, extensive life span, or was she?

Marjorie was the office manager for quite a large accounting firm in central London, and her responsibilities ranged from hiring and firing receptionists, booking Michelin chefs to come in to prepare Board lunches, to ensuring that the coffee machine was not raided of beans by the cleaners during their night shift work. One night, she had slept under her desk in order to catch them red-handed.

“Marjorie, you look very well and have barely aged a day since I saw you last,” said Manika, in truth.

‘‘Thank you, Doctor, but maybe you need to see one of your colleagues to get your eyesight tested.’’

It was the same Marjorie, punchy, fun and never slow with an answer.

“So tell me this, I see from my notes that three years ago, we had a ‘‘no-show’’ from you for your smear test at 35 years and not a whisper from you since. You told our receptionist, Ann – ‘work pressure.’ when she called you. Just how bad was this work pressure?’ asked Manika.

Manika’s facial expression remained smiley and positive, but she swivelled her sitting position slightly, which Manika did not fail to notice.

“Doctor”’ she said, while she threw a carefully placed carefree glance at the ceiling, ‘‘if I remember correctly, on that very same morning, I had booked a critical hairdresser’s appointment with a close friend, who had some very hot gossip for me, and at the same time, we both had a 10% discount for making a dual booking during a low demand period. In the battle that played out for hairdressing and gossip versus smear test, Sasha, the hairdresser, won.’’

‘‘I see’’ said Manika, somewhat lost for further words. ‘’Well, hmm, so, well let’s book you in for next Wednesday, during your lunch break, and you really try hard to make it. Deal?’’

And with that, Marjorie swished back out of the room, allowing the door to clunk slightly more loudly and harder than it should have.

On the next Monday morning, early, before the Wednesday booked Marjorie smear test, Manika received a call from Ann at reception. ‘Manika, Marjorie is here and wants to know if you can squeeze her in before nine, she is acting a bit disturbed, even for her’.

“Okay, send her in, I have about 7 minutes, let’s see what’s going with her.’

Almost at the same moment, Marjorie both simultaneously knocked and crashed into the surgery and plumped herself heavily on her chair.

“I hope it’s cancerous, I hope it’s so cancerous that it’s straight to stage 4, Do not pass go, and we’re done and dusted and Iam off to meet the main designer before the end of the month. That’s how it is, doctor, that…is…how…it…is.’’ She was almost shouting,

as she thumped her first on the table five times with each of these last words.

Manika, forever the professional, calm on the outside, but gripped by slight stomach uncertainty, decided to stay quiet, observing Marjorie from head to toe, and waiting to see what else was going to come pouring out, before any questioning would begin.

Her normally cheerful healthy looking face, was red and blotchy, she had clearly already wiped her eyes of any traces of mascara, her attractive long brown hair had been partially brushed, and she was sitting, her body tense, leaning to one side, with her fist still set on the table. There was silence for half a minute and then began the trickle and the stream of tears, the liquid release of pain.

Manika was used to tears, trained and practised in not letting these intimately expressed raw emotions touch her own heart. She needed to stay totally in control and be ready to start catching the fall-out, asking the right questions and starting the repair. She waited patiently, while Marjorie sobbed, wiped, blew, breathed unevenly and sobbed yet more.

“Ann, you are going to have to delay the 9 o’clock by 10 minutes, ok? whispered Manika to Ann.

The sobbing softened and for the first time in three minutes, Marjorie looked Manika in the eyes and Manika saw such pain of suffering that she bit her lip.

“Marjorie, I am really sorry, but I need to see another patient now, but I want you to wait so you can tell me what’s going on”.

She awoke in mind, voice and strength:

“There’s no need for me to wait, because I can tell you now in less than one minute…”

(To be continued…..)

Manika glanced at her watch, nodded and waited for this explanation.

It exploded out of Marjorie in a mad rush.

“I choked on my latte this morning. My dear husband, Paul, told me that via social media, specifically meaning YouTube, that six months ago, he came across a former student of his, a woman, by the way, who now lives in Australia, and who is one decade younger than me, with whom, he has explained, that he has a connection, whatever that means – I didn’t want to hear any more and left the house”.

Manika was waiting for more, but after a pause, it was clear that that was it. Marjorie had blurted it out in less than 30 seconds and was done.

She stood up and walked out, and the door slammed.

Manika gathered her thoughts and tried to ground herself.

“I am a GP, I am trained to look after my patients for certain physiological aspects, to examine them, assess them and to decide an action plan for their symptoms. I am neither a psychologist nor psychiatrist, nor do I aim to qualify as one of these. Marjorie is physically healthy, she is having a bad day, and that day will end and being as she is, she will move on from this, with or without her husband. It’s all quite straightforward, if emotionally painful”.

There was one thing though, thought Manika, Marjorie is maybe not going to make her smear test on Wednesday, and that is my concern. Manika moved on with her daily appointments and tried to let Marjorie slip into the lower levels of her thoughts.

It was Tuesday afternoon.

“Ann, please will you check that Marjorie has received her sms reminder about tomorrow’s smear test, thanks.”

Ten minutes later, Ann forwarded an sms from Marjorie, which read:

“The only reason that I will go for the smear test is in the huge hope that it promises a cervical cancer diagnosis that gives me 48 hrs to live, 48 hrs, I need, so at least I have time to get my hair done for the last time before I cross over”.

Manika sighed, “Oh Marjorie, for goodness sake”.

Then Ann called Manika:

“Marjorie wants an emergency appointment during lunch on Thursday.’’

“Ann, I can’t do that, that’s not how it works, the results of the smear test will be known Monday, and I am not prepared to see her before then and then only if there is anything wrong. So do your best to explain that gently.”

Ten minutes later, Ann forwarded another sms from Marjorie:

“If I don’t get my emergency appointment, I will dress up in black as the devil incarnate and stand outside the surgery entrance and shout – ‘death meets all who enter here’ and that’s a promise! And by the way, I will take the whole day off work and someone else can order more blasted water bottles for the office and be nice to the Michelin chef”.

Manika smiled; at least there was a sliver of black humour buried in the depths of her anguish.

“Ann, tell her that she can write to me, that’s the best I can do, she can send me an email, give her my work email. I can only hope that when she has to compose her feelings in writing, it might help her to slowdown, calm down and think about what she is saying.”

The sms stopped flowing, at least for now.

Each time that Manika logged on to her email, she first glanced a little nervously at the bold font messages at the top of the Inbox. It was coming, this email, it was just a question of time and would be a top priority for the hurting sender to fire it off.

However, the days went by. By some miracle, Marjorie had attended the Wednesday smear test, the result received Monday was clear; this was now nearly a week since the requested Thursday emergency meeting.

Part of Manika said, maybe the problem is solved, they have talked it through, she just had an awful initial and exaggerated emotional reaction, it’s not an issue, her husband is still on side and, we can all relax… Nevertheless, a part of her felt that this was not the end, but it was the weekend and on leaving the surgery on Friday afternoon, Manika felt light and free.

Little did she know what would be waiting for her on Monday morning.

(To be continued…..)