Early start to get the train to London, I down the morning meds and go. I make good time and get and early train and spend the journey finishing Early Riser. A good read and a charming ending. Pull into St Pancras and there is the Trace Emin glowing in its deep pink glory. It makes me smile and starts my day in a good way.

I get to Royal College of Psychiatry and head for the canteen to get breakfast. I check my e-mails and get ready for the meeting by watching the TED talk that was referenced with the agenda for the day. I liked the idea that no one would consider laying of family members if the family were not doing well but in a company its the people that sacrificed first to keep the managers/leaders salary intact and the shareholders dividends up. At meeting time I go to the meeting room with a colleague and we get going on our task of discerning, defining and devising something to do with leadership of an enabling environment. We worked till three and then we scattered to other meetings and journeys home.

I slept on the train home. Off the train and I drive to the gym to meet my partner and we decided to eat out. When I checked my e-mails I found the photographer had put our album on the website ready to view and to check. We of course returned home and I set up my laptop and the TV to view the album. The photos were what would be expected of a civil ceremony, the usual family and friends photos pre and post the actual ceremony. I am sure that people will recognise the day and the people they met and will remember the day. Everyone looked as I remembered them, and they looked like the people I knew, I did not. I was shocked to see myself. I did not recognise myself. Confronted with multiple views of myself I became more and more aware how the distance between my self-image and what the reality of the person walking around in the world had grown. I no longer recognise myself. I am bloated, distorted and ugly. I cannot stand to see myself. I am embarrassed at what I have become. Now I have a new battle alongside the cancer, now I have to find a way to be in the world as I am while I try to get myself back to where I recognise myself again.

I remember a client who was admitted to a service I was director of. She arrived deluded and paranoid with little grip on reality. Months later and full of the medication the team had administered she came into a clinical review meeting and said “look what you have done to me”. She had put on a considerable amount of weight to the extent that she had had to buy new larger size clothes. She no longer recognised herself; I now know what she meant.