"Goodbye was painful" - reflections on a life changing journey

Last month we published a video diary by Professor Nandini Chakraborty, an early intervention psychiatrist who joined colleagues and patients on an unforgettable and unprecedented sailing adventure. Having got back to dry land, Nandini wrote about the adventure - her brilliant account is below.

The Voyage to Recovery was a UK wide project born out of a networking initiative of early intervention in psychosis (EIP) teams in liaison with Cirdan Sailing Trust, a non-profit charity organisation.

Cirdan specialises in enabling groups of young people, particularly those who are disadvantaged in some way, to experience the challenge and adventure of life at sea on large sailing vessels.

It was in December 2020 that I was contacted by a fellow consultant psychiatrist working in EIP, Dr Wolfgang Kuster, from Tees, Esk And Wear Valleys NHS Foundation Trust. The project at that point was well underway.

Dr Mike Jackson, Consultant Clinical Psychologist, Betsi Cadwaladr University, held the central organisation. The plan was to have an 8-week project, involving 8 legs which would each include 5-6 days of sailing around the British Isles.

Each leg would have involvement from one or two EIP teams- around 10 patients and 5 staff supported by 3 professional crew from Cirdan.

In an initial meeting with Mike and Wolfgang, to discuss how I could help the project, the direction was obvious- to get the Leicester EIP team involved. We were slotted in with Norfolk and Suffolk EIP who were looking for partners for their leg from Ipswich to London.

Our boat would be the hardy Faramir. Faramir, a Ketch with a length of 22.35m and a breadth of 5.26m, was designed by Marine Architect David Cannell in 1982, specifically for use as a sail training vessel for an organisation called Shaftsbury Homes & Arethusa, from where she gained her name, ‘Arethusa’.

In 2002, after many years of service, during which she developed a following of loyal sailors, Arethusa was sold on to another sail training organisation who changed her name to ‘Bulldog’. Not being able to fulfil her potential, her owners sold her to The Cirdan Sailing Trust in January 2006.

Being absolutely ideal for the work undertaken by The Cirdan Sailing Trust, she was purchased to replace the vessel Hartlepool Renaissance which had to be retired from service at the end of the 2005 season. Finding it necessary to change her name again, the vessel was renamed Faramir after Cirdan’s sister charity with which it joined forces in 2002.

The project was due to start in June 2021 but was pushed back by COVID restrictions. Ultimately when it started in late July 2021, it was only down to the perseverance and hard work of the Cirdan staff- Pippa and Leonie who set down to re-booking marinas and re-organizing the trip.

By sheer determination they pulled it off. Unfortunately, it would not be a ‘round the UK’ sail anymore but a ‘there and back’ along the east coast. Leicester and the Norfolk-Suffolk team still got Ipswich to London, dated for 12th to 17th September. 

Sadly, there were team members on both sides who could no longer make the new dates. They stuck with us till the end, helping with food shopping, emails, paperwork. Our hearts were with them throughout the trip.

The rest of the write up is a daily trip diary.

12 September 2021, Leicester to Ipswich, then somewhere into the River Orwell

So, at last we set off. An early meet up at base, Merlyn Vaz centre to do a last set of current lateral flow tests and register them on Gov.UK, we set off in taxi at 7:30 AM. Along with Gen, my CPN colleague, I was responsible for the four patients who were accompanying us on this trip. They were all in their early twenties, had been through psychotic episodes, doing well currently but still fighting anxieties as they readied themselves for new jobs, universities, and volunteering. All of them were keen for the trip. A little nervous, uncertain what to expect but certainly enthusiastic. Catherine Bayley, our clinical psychologist who had been instrumental in helping plan the trip was unable to join us but waved us off.

We reached Haven Marina in Ipswich where we met our Norfolk/Suffolk colleagues for the first time (outside MS teams). Craig was a peer volunteer, Felicity a social worker and Laura a mental health nurse. Also waiting for us was Justin, our photographer arranged by the Royal College of Psychiatrists to take our ‘set-off photographs’. Some of our staff set off with our patients for a McDonald’s snack. Craig from the Norfolk & Suffolk team and I stayed back to guard our stuff.

We discovered on ringing Mark Oliver our skipper that Faramir was right at the opposite end of where we had offloaded our luggage and considerable food supplies (whatever else happened, we were not going hungry). Whilst we were trying to figure out how to get there with all our bags, Mark sent over our bosun Jake with a dinghy to gather our luggage so that we could walk the mile needed, with just our day packs.

So now it happened- our foray into the world of posh boats, yachts, and marinas. Armed with the code which let us through the gate, admitting us to the towpaths, we had a view of several cheekily named vessels, lined up on a watery version of car park. Several poshly dressed couples passed us on the way to their private yachts as we stood surrounded by Tesco bags full of carefully budgeted food and toilet supplies. It was a brilliantly sunny day, blue sky, and blue water. We had arrived at the marina. We had established contact with our crew. Nothing was going to dampen our spirits.

We reached the Faramir in a procession after sending over the heavy bags. The first sight of Faramir, with her name painted over deep blue, tall masts with her sails neatly tucked away, rich, and heavy wood stretching out in an oblong 22.35 metres.

The next three hours passed in a whir of getting everyone and everything on board, selecting bunks, putting away food in the fridges (tucked into the table in a genius of space saving), learning to put on our life jackets and the basic rules of sailing. We got to know our skipper Mark Oliver, first mate Sam and bosun Jake. Justin in the meantime busied himself clicking photographs and gave us a wonderful see-off.

We ultimately sailed 3 hours later, around 4:30 pm. Tides had to be right, the gates had to be opened and we had to absorb the enormous amount of basics to be of any use. It was all beginning to sink in, the combination of an understanding of physics and blessing of nature which can help a boat stream through the water, the bow cutting through the waves like a knife. We had managed a round of hot drinks and finished one of the rich chocolate cakes baked for us by a member of the Norfolk Suffolk EIP team. It would sustain us through to dinner.

We docked at around 7 pm. we stopped at a point in the River Orwell where an orange buoy was our point of anchor. Mark pointed it out to say that the ‘orangey balloon like thing’ would be our home for the night. We had sailed through a gentle river, rolling fields on both sides spotted with cottages. Felixstowe docks with its large cranes stood at a distance. 

After a dinner of chicken fajitas we turned in early. We had been told to sleep tight, it would be a long day tomorrow.

 13 September 2021, River Orwell, the Thames estuary and on to Dover

(This would be turn out to be one of the best days of the trip. A steady breeze, strong enough for the sails to pick up and the engine to take a rest for the day. 50-60 miles on the sea with a gentle sun and rocking waves. Ending with a view of the cliffs of Dover. Teamwork, beautiful scenery and feeling the rhythm of the Faramir under our feet. By the end of the day, we felt like true sailors.) 

We were to sail at 7 am. I put on the alarm at 6 am, had coffee on the deck, watching the sky lightening and the birds getting to work. A chat with fellow shipmates in the cockpit is great way to start the day.

We were divided into two groups, to take ‘watch’ in turns. One group to be led by Sam and the other by Jake. We had a rota of 4 hours at a time to be on deck. The system worked like this: when we started sail for the day and when we docked, it was a case of all hands on deck to help. In between it would be a case of changing watch between groups every four hours. The early part of the sail would need sails putting up, the later end putting them down, getting ropes and fenders ready. In between it would be making sure the sails were in the right direction, sometimes needing tautening, sometimes slackening.

Around 9-10 am we crossed Felixstowe docks with its huge container ships and cranes. I was downstairs doing dishes when I felt a sudden surge of nausea. Being downstairs in the heart of the vessel with its kitchen, dining area, bunks and two tiny toilets is overwhelming when feeling seasick. I rushed upstairs to feel the breeze on my face. The scenery had changed, we had crossed the Thames estuary and were on the sea.

We crossed Harwick, Margate, Ramsgate and turned to the chalk cliffs of Dover. As the groups changed, we all took turns at steering under the watchful eyes of our professional crew.

I watched our patients grow in confidence through the day. From being isolated and nervous in their own worlds, they were reaching out to each other, helping together as a team as instructions needed to be followed on deck and in the kitchen in making meals. Initially hesitant, they all ultimately took a go at steering.

As we got ready for bed after a dinner of spaghetti Bolognese, I reflected (and I truly would at different points during the voyage) on what I had learnt this day. I learnt about my own anxieties, the feeling of responsibility for our patients during the trip. And I realised that I was feeling more relaxed now.

Our patients were finding their own journeys, own spaces. I did not need to watch them every moment. Watching one of them help me when I struggled with a can of tomatoes and a not too efficient can opener; watching the patients of the two teams talk to each other openly sharing their feelings were tiny moments where no description is enough. Perhaps the greatest revealing moment was when I realised our skipper was an NHS consultant anaesthetist who used his annual leave to volunteer for Cirdan sailing trust, volunteering without charge. 

I struggled to keep my eyes open for my video diary and my mobile does not have a blow by blow record of each sailing moment. We were realising something else, living a moment is precious. Every moment does not need capturing on lens. The most exciting points on the deck were also the busiest.

We gave it our all. I do not need pics to remind me of that sun kissed sea we rocked through, sitting on the deck near the bow- chalk cliffs on one end, France on the other, a seal which jumped out with a tiny gymnastic roll to entertain us.

Amid all that beauty, rubber boats in a distance which might be carrying illegal immigrants escaping desperate circumstances. There almost seemed too much going through me as sleep came over. This was certainly not a holiday and not a sporting event. It was not meant to be.

14 September 2021, Dover to Ramsgate

Breakfast at 8am was followed by our first round of thorough boat cleaning. The entire team was given specific duties- sleeping quarters, kitchen and salon, the deck, chart house and most importantly- the toilets. We all did our bit, without question.

Done by 11 am we were given until 2 pm to explore Dover. Gen and I walked with three of our patients to explore some history in Dover Castle. One more was still feeling too anxious to come off the boat to land, we did not press too much. 

Walking up to Dover castle took twenty minutes. We spent an hour or so going through ruins which held stories of Anglo-Saxon times, Henry II and World War II. Our group stuck together, with a bit of guidance to show respect for each other, given importance to all tastes and views. We finished with the gift shop and it was a very satisfied team which returned to the boat.

We were all feeling better today and lunch went down well. 3 pm, we sailed off in the direction of Ramsgate. We would retrace some of our route from the day before and dock at Ramsgate. It was still a lot at sea but only around 15 miles.

Dinner was casserole and cheesecake. One thing was for sure. We were eating very well. The crew were speaking from the heart when they said that we were making a very good job of the food.

15 September 2021, Ramsgate to Queenborough, Isle of Sheppey

It was breakfast duty for me today. Had porridge ready at 8 am so that we could eat and start off at 9 am. It would be a long sail, around 50 miles. But at the end we would re-enter the Thames estuary, sail up the river Medway and dock at Queenborough harbour on the Isle of Sheppey.

It was a sunny day again but with hardly any breeze. So, engines had to go on and there was less to do on the sails. Not very exciting but we made most of the time to sit on the deck and find time to talk. Over the week we got time for a number of 1:1 chats, between professionals and with our patients.

The sea this day had a number of interesting World War relics. We learnt about the ‘Principality of Sealand’ located on an abandoned sea fortress which due to its location in international waters is outside the jurisdiction of the UK. Claimed by Roy Bates, a major in the British army, Sealand has its own website where you are invited to apply for not only for merchandise but apply for knighthood and several other titles.

We passed a cluster of WWII gunning platforms which looked like huge barrels supported by several legs, something out of a Star Wars movie. An old ship sunk at sea lay just with its mast sticking out- the SS Richard Montgomery. Explosives still lay at its heart and apparently it had stopped air routes from passing too near it, in the apprehension that vibrations might set up a giant explosion.

Reaching Queenborough we were in time to see a brilliant sunset. We managed to grill our food and have a ‘barbecue’ in the cockpit followed by fruit salad. 

My handwritten notes were getting shorter and shorter. Physical exertion feels good, satisfying but very tiring.

16 September 2021, Queenborough to London

Woke up early to watch sunset over coffee in the cockpit with a heart-to-heart chat with Gen. Both of us were feeling deeply grateful for this opportunity- for our patients and for ourselves, really emotional about it. The priority of course was to finish the trip successfully but then go back home and talk about it further. It would be important to continue such activities in future.

A one off was not good enough. We needed sustained change, an embedding of a culture which looked at outdoor team building activities both for patients and staff. The trip had been rewarding not only for our patients but for ourselves as well.

I found one of our patients in the kitchen attempting banana pancakes for sixteen people, to use the bananas which were beginning to get bruised. I asked her if I could help, she confidently pushed me a bowl of bananas to mash. For once, I was following instructions. The pancakes were a huge success and good fuel for our next round of ‘deep cleaning’. 

This time I got the chart room- the space used by the skipper to navigate, communicate, and keep a log of observations. I expected to sweep the floor and wipe out the desks, but Mark had other things in mind. He got the floorboards off to expose a criss-cross of aluminium bars overhanging a deep chamber which held the machinery which ran the boat while on engine.

He assured me that it looked more frightening than it was, and I would come to no harm even if I happened to fall in, which was reassuring. To be honest, the aluminium bars were strong and broad. I was not unsteady on them. The floorboards went off to the deck to be hosed and I cleaned the aluminium bars of dirt and grime worth possibly a couple of decades. A round of hoovering followed by a fine tuning of all purpose liquid and a scouring pad did a fine job. I was rather proud to see the look on Sam, Jake, and Mark’s faces.

We had two hours to explore Queenborough. Everyone came off board today. Most of our colleagues and patients went to enjoy themselves on a beach, with swimming, paddle boating or simply sitting on the beach. I went to two patients to walk around and find Queenborough castle which turned out to be a plaque on the ground in memory of a castle that once stood there. So we spent the time in a park, entertaining ourselves with the swings instead.

We set sail at midday with no wind. So, it was a quiet engine driven sail from Medway into Thames, entering London.

The colour of the water turns from greenish blue to deep cornflower as the rivers change. Somewhere as we entered the Thames, three dolphins made a quick jump for us, delighting us for a few quick seconds. We crossed the Thames barrier, Greenwich, Cutty Sark, and the Queen Anne Naval School, finally docking with a gorgeous view of Tower Bridge and the Shard.

Dinner was curry tonight. With help from our patients and Gen, we did what Leicester does best- a curry dinner which was hugely anticipated, (no pressure). By 8.15 we had turned out chickpeas, mixed vegetables and pilau rice.

When we came out to deck after dinner, Tower Bridge and the Shard were lit up. We sat in the cockpit for a last chat. Tomorrow we would be busy packing and finishing final paperwork.

Afterword

The greatest gift from the trip was our feeling of teamwork and camaraderie. Laura, Felicity and Craig felt like long time known colleagues. But then you volunteered for a trip like this only if you felt and thought alike. I was extremely proud of our patients who put in so much effort, conquered their anxieties and got to know each other.

Goodbye was painful. As I reached out to shake hands with one of the Norfolk and Suffolk patients, his face crumpled. ‘I want a hug’, he said. Human relationships transcend everything we do.