Majestas

In this issue

• Fitness and Faith
• Vicar's Letter
• News
  • Celebrations at Great St Mary's
  • PCC Report
  • Ascension Day at Great St Mary's
  • Cricket Match at Girton
  • Andrew Braddock
  • Cambridge Views
• Hospital Social Work
• Medical Support in Romania
• Medicine Man
• Does the NHS Have a Future?
• Religious Imagery
• Diary
• Who's Who
• Publication
  • Submissions for the next editions of Majestas

Fitness and Faith

Where are we going?'' asks Nicholas Ash, Chairman of Cambridge YMCA, in its current Annual Report. He admits that it is a simple question with a multitude of different answers.

George Williams was a young assistant in the large drapery firm of Hitchcock and Rogers in St Paul's Churchyard, London, where 140 young shop workers worked long hours and lived in dormitories over the shop, with the temptations of London around them. A prayer group started by George Williams developed into the London Young Men's Christian Association ``to influence young men to spread the Redeemer's kingdom amongst those by whom they are surrounded''. Other groups were formed and, partly as a result of the Great Exhibition of 1851, it spread to other countries, particularly France, Germany and America. In Cambridge an initial meeting on 27th February 1851 resulted in the formation of Cambridge YMCA. It met in two rooms at 14 Rose Crescent and in 1853 moved to four rooms at 5 Sidney Street. There were classes, lectures by University dons, debates and prayer meetings. A reading room was provided and a library (run for many years by Robert Bowes and Alexander Macmillan) had more than 2,300 books in circulation by 1853. In 1859 the YMCA moved to Hobson's Passage and in 1866 to rooms in St Edward's Passage. A bold plan to build a meeting place developed and a piece of land between Petty Cury and St Tibbs Row became available. Local businessmen such as W. Eaden Lilley, G.E.Foster (of Fosters' Bank) and Robert Sayle (who trained at Hitchcock's in London before opening his own drapery business in St Andrew's Street in 1840) bought the land and held it in trust. The Alexandra Hall, Alexandra Street, was built for the Cambridge YMCA and the first meeting was held there on 1st January 1871 - a devotional meeting attended by 300 members. The official opening was on 11th January 1871. Classes, lectures and debates continued; a cricket team had been formed in 1866, followed by a boat club in 1872, a tennis club in 1878 and a table-tennis club in 1902. Instruction was given in swimming, gymnastics and athletics.

The redevelopment of Petty Cury included the demolition of Alexandra Hall which stood where the Lion Yard is now. A new building was built in Gonville Place overlooking Parker's Piece and was opened in September 1974. It includes study bedrooms for 128 young people and in 1994 29 bedsits and flats were added. Robert Higginbottom was a resident in 1974 when he was an apprentice at Fisons. He became Executive Director of Cambridge YMCA in 1992 and he referred to its mission statement: ``The Cambridge YMCA is a Christian charity working to enable young people (and others) to grow to their full potential by participating in and supporting the Christian community through its housing, youth work, health and fitness and other programmes.'' Cambridge YMCA is an autonomous charity and has a membership (male and female) of almost 700. The worldwide membership is now 30 million.

There is a small gym called GYMCAN (with YMCA at its centre) which is well equipped with CV (cardiovascular) and modern weight training equipment. There is also a dance studio for aerobics, circuit training, etc., with programmes for young people, business people, young mothers and the 50+ age group (with a different type of music!). The approach is holistic with emphasis on the individual rather than exercise for its own sake. There is also a befriending scheme in which volunteers work with someone with a disability who can then exercise in a safe and supportive environment. The YMCA invented two sports --- basketball and volleyball --- and is committed to making exercise accessible and enjoyable for all, regardless of age and ability. The Cambridge YMCA runs football teams which play in the Cambridge and District Sunday League and a Netball Club which plays in the local netball league. Nationally the YMCA is one of the recognised providers of training for fitness instructors.

Cambridge YMCA's current business plan has seven objectives and the first is: ``putting and keeping the `C' in YMCA : to be recognised and experienced as a Christian community''. Robert explained: ``The `C' has never gone from YMCA. We very much retain our Christian ethos and principles.'' Weekly meetings for staff, residents and members are held for discussion and for prayer. Robert thinks that many of the links with local churches were lost at the time of relocation. He recognises this as a weakness and is keen to re-establish contacts with churches.

Apart from the provision of accommodation and catering, opportunities for fitness training and running training schemes (such as the Prince's Trust Volunteer 12-week course and the possibility of `Foyer' training, both under the Government's New Deal initiative), Cambridge YMCA is planning to go out from its base in Gonville Place to work in the community. Robert said: ``We have got some pioneering work where we're trying to develop links in certain communities such as East Chesterton and Queen Edith's. We've got a very strong link already through the church at Girton and there is a Bus Shelter project there that we're involved in.'' So this is one direction in which Cambridge YMCA is going.

Vicar's Letter

This month the National Health Service celebrates its 50th anniversary. The service on 5th July here in Great St Mary's will bring together a huge variety of people who have shared in providing healthcare for our city and the area around. The network of healthcare includes both huge and complex institutions like Addenbrooke's Hospital and the personal care provided by nurses in people's homes. It should be a great celebration for the whole community.

Yet as we celebrate, we should also ask questions. It has sometimes been commented that we do not have a National Health Service but a National Disease Service. We do not go to a doctor if we are well, but in times of illness or disease. We do not expect the doctor to help us to live in a healthy way from day to day but to deal with specific needs and crises.

The Church has always been concerned with health. The Gospels are full of accounts of Jesus healing the sick. For the people he lived among, he was someone they could turn to for healing of physical sickness and also of psychological disorder --- defined in the language of the day as possession by devils --- and for forgiveness of sin as well. The concept of what it means to be whole and well is, in the Bible, a broad and embracing idea. Physical healings are accompanied by words spoken by Christ which remind the person concerned that there is more to health than physical well-being. Right relationships are especially important, both with God and with each other.

A part of the celebration of the 50th anniversary of the Health Service is the asking of questions. There is concern about the future of healthcare. There is a growing gap between what is technologically possible and what can be afforded and delivered. There is a growing number of elderly people with new needs which are going to be increasingly difficult to meet. Questions about health will become more urgent for us all, as the meaning and possibilities of healthcare change.

The Christian Gospel will remind us that our health is bound up with the health of others. The choices we make affect the lives of those around us. On a simple level this means, for example, the recognition of the effects of passive smoking. But it also involves a recognition that our chosen way of life can have dreadful effects on health through industrial pollution or the exploitation of the natural resources of other countries. These could be some of the implications of the Gospel message.

News

Celebrations at Great St Mary's

Two special anniversary events are taking place at Great St Mary's this month.

On Sunday 5th July, at 11.15am, there will be a Service of Thanksgiving for the 50th Anniversary of the National Health Service (see Vicar's Letter left). The service will be led by the Revd Ian Morris, Chaplain of Addenbrooke's Hospital and the Revd Dr John Binns, and all are invited to come. The address will be given by the Bishop of Ely, the Rt Revd Stephen Sykes.

The week beginning Sunday 26th July will see Great St Mary's host a ``Centenary Celebration of the Life and Legacy of C.S. Lewis'', organised by the C.S. Lewis Foundation. There will be a re-enactment of Lewis's Cambridge Inaugural Address in Great St Mary's on 26th July at 7pm and a Concluding Service of Dedication and Choral Eucharist at 8.30pm on Friday 31st July (to be confirmed). Speakers at the conference will include Francis Warner, Barbara Reynolds, Jeremy Begbie, John Neuhaus, Stan Mattson, George Marsden, Janine Langan and Os Guinness.

PCC Report

The PCC had the first meeting of its New Year on 27th May. We were pleased to welcome four new members: Roger France, Bridget Le Huray, David Hollier and Sue Joyce. The initial business of the meeting was to appoint the officers for the year, and all those holding office from the previous year were re-elected. Appointments were also made to the sub-committees.

The meeting approved and supported the application of Sheila Cameron to train as a Reader. We also heard confirmation of the post of Julian Wilkins as the next Assistant Organist after the departure of Sarah MacDonald. The meeting passed a vote of thanks to Sarah for her work and inspiration during the year and wished her well in her appointment at Chelmsford Cathedral.

Paul Cornish gave a preliminary report on the Stewardship Campaign. Although quite a number of replies were still outstanding, the overall financial position was improved and it was hoped that by the end of June the desired target will have been achieved.

The PCC was asked to give further thought to the Aims Review that began in 1997, to analyse the achievements and to prepare for the extension of those aims into 1998, and to determine areas needing attention.

We feel we have once again a good PCC team, and hope that all reports will demonstrate purpose and attention to matters of concern to us all during the year.

John Talbot, Secretary to the PCC

Ascension Day at Great St Mary's

Ascension Day began at 7.30am at GSM with a special service at the top of the tower (see picture). Singing was led by the Parish and Girls' Choirs, directed by Michael Haynes. Afterwards breakfast for all was served at the back of the nave.

Sixteen college choirs (300 singers) conducted by Sir David Lumsden, raised the roof at the University Eucharist for Ascension Day in the evening. The galleries were full with the congregation, as the choir sat in the nave. An ecumenical service is planned for next year.

Cricket Match at Girton

The Parish Cricket match this year will take place on Sunday 12th July at Girton College's cricket pitch, beginning at 2pm. The play will be gentle, and all are welcome to come and play, or spectate! Drinks will be provided, but please bring something to share for tea. If you know you can come, add your name to the list at the back of church. Bring any cricket equipment you have with you. For further details, please contact Robert Avery, tel: 01223 350914.

Andrew Braddock

Andrew Braddock, who has been on placement at GSM this year from Ridley Hall Theological College, is due to be ordained at the start of July to serve his title in the Ranworth group of parishes on the Norfolk Broads. We thank him for his work at GSM this year and wish him well as he begins his ministry.

Cambridge Views

Can you discover the location of this object in Cambridge? Bring or send the answer, and your name and address, to Majestas, Great St Mary's, Cambridge CB2 3PQ, by 31st July. The first correct answer drawn out will win a book token for £10 donated by Heffers Booksellers.

The image in the June edition can be found on Hobson's Conduit in Trumpington Street.

Hospital Social Work

Pauline Davison reveals what her job involves, and why she believes so strongly in it.

I went back to college to train as a social worker when my youngest child started school. Since then I have worked in the community in various places, for the the last 4 years at Papworth, an NHS Trust Hospital which specialises in cardio-thoracic medicine. Papworth is famous for its Transplant Unit, but it is also a centre for cardiology, cardiac and thoracic surgery, for the treatment of cystic fibrosis, for the investigation and diagnosis of lung cancer and the treatment of lung diseases --- from asthma and emphysema to (the mercifully rare but deadly) primary pulmonary hypertension.

My social worker colleague and I are employed and managed not by the Trust but by Cambridgeshire Social Services Department, and our slightly peripheral position reflects our role of dealing with issues which may be caused by, or which affect, the patient's illness but are not medical. In working with nurses and doctors we try to ensure that the patient is there as a whole person with a family, home, job, friends, history, and not just as someone with an illness. While helping with many social and practical problems we also give emotional support when people are coming to terms with illness and death, making plans for the future, or wondering how to break bad news to the family.

Under the NHS and Community Care Act there is a duty to ensure that patients are not discharged without appropriate help and care being provided if needed, and I carry out, in the words of the Act, a `needs-led assessment'. The patient or carer and I come to an agreement as to what the needs are, but limited resources mean that these cannot always be fully met, and the patient may go home with a minimum of help. Resources vary too, from one local authority to another and from one part of Cambridgeshire to another.

Another part of our role is to give advice about welfare benefits --- mundane but very necessary. People suffering serious illness are often hit very hard financially, particularly those under retirement age or whose illness is terminal. The most fortunate are the minority who are in employment with generous sick-leave provision, but most receive only a few weeks' salary and then have to rely on statutory sick pay. The hardest hit are the self-employed, few of whom have any cushion against illness. I hate having to tell them that incapacity benefit is £57.70 per week. We try to relieve severe financial hardship by applying for grants to charities like the Macmillan Fund and the C.F. Trust, and we have a small hospital welfare fund, but these are drops in the ocean.

Housing is often another problem in people's lives. They may be in unsuitable accommodation or need help with applying for adaptations like stair-lifts, or to be rehoused. Letters from social workers and consultants can have some influence on Housing Departments.

With younger patients, particularly those who attend the Cystic Fibrosis centre, our brief is even wider, covering areas like education, training and employment. Patients come from all over East Anglia on a regular out-patient basis, staying in the recently-opened unit when necessary. There are over 100 on the list, starting at 16, with most in their twenties and thirties, two in their forties and one (an Anglican priest) aged 52. Some are relatively well, able to walk and lead a nearly normal life. Some are so sick they are awaiting a transplant, and some are unsuitable for transplant or die while waiting. We get to know them and their families very well, and their deaths sadden all the staff involved. What makes the centre special is the style of the consultant: a dedicated physician who believes in and practises a multi-disciplinary approach.

When I tell people that I'm a hospital social worker I sometimes get the response ``I don't know how you do your job.'' But most of the time I love it and feel very privileged to be working with people facing serious life-threatening illness. The patients aren't all angels; they are ordinary people in a very critical situation --- vulnerable, angry, frightened, sad, depressed, but also full of courage, humour, patience and long-suffering. It is as if the illness strips away some of the defences and pretensions we all have, and reveals more of the real person.

Working at Papworth has also made me more aware of the value of the NHS and its central philosophy that the best possible health care should be available to everyone, regardless of status or income.

Medical Support in Romania

Up until 1990 my only experience of hospital healthcare provision was as a patient. Hospital sojourns --- despite meningitis, jaundice, broken neck, appendicitis and an axe wound --- bring happy memories of smiling nurses. But my work with Medical Support in Romania (a charity supplying medical equipment and training to the Romanian health service) has opened my eyes to the amount of infrastructure needed by a modern general hospital. Hospitals have laboratories that aid diagnosis. X-ray departments have major safety issues. The control of hospital-acquired infection is an issue that touches all aspects of the hospital. Food arrives, but what is the kitchen like? Linen is washed, but what would happen if the laundry broke down? I had never given a thought to sterile services or waste disposal. I had no idea that over the past few years Addenbrooke's had built new, EU-compliant incinerators which now receive clinical waste from as far away as Wales.

Romanian hospitals, despite massive under-investment, are the focal point of the Romanian health service. There is little primary health care. Salaj Hospital, one of about 43 district hospitals, has over 1100 beds. It was built, along with some 20 other district hospitals, only 20 years ago. A combination of poor design, low building standards and no preventive maintenance, is leading to an infrastructure crisis.

Medical Support in Romania, a registered charity since September 1996, has focused so far on the laboratories, X-ray department and an ever-widening number of other departments such as A&E and Ophthalmology at Salaj. Over 30 Salaj Hospital staff have come to Cambridge for training, and 77 British specialists --- doctors, nurses, engineers etc. --- have given time in Salaj. Despite meagre funding, the hospital has responded magnificently by refurbishing the departments re-equipped by MSR. This has been done most strikingly in A&E, the Mortuary and Pathology areas, X-ray and laboratories. A surprise was in store for our recent visit. A nurse had initiated the painting of murals in the neo-natal department. They are wonderful. For the first time something has been done to create a cheerful and stimulating environment for the young.

Increasingly MSR's attention is turning to infrastructure. In February there was a massive crisis in the hospital laundry. There is no adequate alternative laundry service near Salaj. MSR's £25,000 emergency laundry appeal has just topped £24,000. Refurbished laundry equipment will be installed this August under the supervision of Addenbrooke's staff.

The aim of MSR is not just to help one hospital. The staff of Salaj Hospital are now partners with MSR in seeking to bring change to Romania's healthcare provision on a nationwide basis. This means that practices, standards and procedures can be piloted in Salaj to be emulated elsewhere. It means a focused effort to change out-of-date and inappropriate regulations. There is some progress.

Two people from the Bucharest Institute of Public Health will spend June in Cambridge to learn about hospital laundries. They will be based at the Addenbrooke's laundry located at Fulbourn Hospital. This is the first of three training modules in MSR's Transfer of Knowledge Project for this environmental health team which, amongst other things, draws up regulations for the Ministry of Health. Other modules cover sterile services and waste disposal.

At the time of writing (22nd May), the 4th Romanian National Pathology Meeting is taking place in Salaj because of the upgrading of the pathology department by MSR and its refurbishment by the hospital. It is the first Romanian Pathology Meeting with British participation. MSR trustee Prof Sir Dillwyn Williams (a past President of the Royal College of Pathology) and Dr McNicol, an internationally known pathologist from the Royal Infirmary, Glasgow, are guest speakers. Some 120 pathologists from across Romania are attending.

MSR's narrow focus/wide impact strategy is beginning to work. Now it is time for the next miracle. MSR's pilot Infrastructure Project to re-equip sterile services and laundry and to build the first clinical waste incinerator in Romania will cost £6.5 million. It is a tall order, but the past has been a miracle so why not the future?

Medicine Man

David Cassidy, a third-year medic at Trinity Hall, describes the work of a medical student.

So how does it all begin? Well, most are the offspring of doctors, others are keen scientists who see medicine as a potential outlet, some are the kind souls who just want to look after people's welfare... all are slightly mad!

Getting into Cambridge to study medicine requires three `A' grades at A-level and on average six times as many apply as get places. Naturally, therefore, the interview is a rather gruelling process.

So, now you are in and the marathon begins. The Cambridge course is done at an accelerated rate with a higher level of content and depth than other universities. The first two years are spent studying medical sciences (Anatomy, Physiology, Biochemistry and so on) and in the third year medics are allowed to study pretty much anything they want, from Pathology to History of Art, and generally the workload is reduced from the first couple of years.

The common view of medicine is one of blood and guts. The reality is a little different. Medics study a lot of science and the only real contact is in Anatomy, but this is more than enough! On the first day of the course you are presented with coat, latex gloves and a dissecting kit and told to go and ``meet'' your body. The smell of formaldehyde is over-powering and as you turn back the cover you are struck by the ``life-like'' qualities of the cadaver in front of you. The students are allowed ten minutes with the corpse and then have to wait until the following day before actually dissecting. The strange feeling of cutting open another person and examining their internal appearance takes a lot of getting used to, but eventually everyone becomes a skilled operator of the various dissecting instruments and the challenge of finding obscure nerve routes and blood supplies keeps the mind distracted from the fact that it is a dead person in front of you.

Following undergraduate study, the ``real'' blood and guts comes into it. Students progress to clinical school and hospital work. This is the stage that I am now at and the prospect of working with people and learning about the art of medicine rather than the science of it presents a real challenge.

Does the NHS Have a Future?

Sheila Cameron reports on a recent `Open Discussion' at GSM concerning the current state of, and future expectations for, the National Health Service.

Expectations, technology, rationing; these were the keywords in an open enquiry into health care held at GSM on the evening of Sunday 31st May.

Dr Fiona Cornish, a Cambridge GP, gave a practitioner's view of the NHS, its origins, major changes and our response to them. Nye Bevan's vision had been to provide health care ``from cradle to grave'' in an era when the major diseases were the infectious ones such as TB, brucellosis and rheumatic fever and when there had been few active drugs. Fifty years of technological advance and the emergence of new diseases had radically changed the situation; moreover, there had developed a high expectation that services would be delivered on demand. People were used to consulting their GP whenever symptoms appeared and there had been a clear shift of responsibility for health from the individual to the system. The burden needed to be shifted back to the patient to some degree, especially in view of the enormous costs of treating today's major diseases, like cancer and heart disease. The rationing of resources seemed inevitable in a climate of high cost and demand.

Dr David Girling, Director of the Medical Research Council's Cancer Trials Unit in Cambridge, spoke of the cost of research in an account of the work of the MRC, a government-funded body with an annual budget of £400 million. The MRC, also dating from the 1940s, was originally engaged in clinical trials in relation to tuberculosis; today new drugs are being tried for a number of diseases including leukaemia and HIV/AIDS. A drug trial must be judged to be potentially informative, technically relevant, and it must be conducted cost-effectively (a single large trial could cost £500,000). Patients were entered into trials voluntarily and were given full information about their risk; success was measured in terms of extension and quality of life.

The issues raised in open forum included the cost of transplant surgery, the burden of residential care for the increasing number of the elderly, regional variations in health care, rationing and prioritisation, and the treatment of self-inflicted illnesses such as those caused by smoking. Concern was expressed about pressures on health care personnel and it was noted that there was a movement towards encouraging patients to treat themselves for minor ailments. Rationing of resources in Cambridge was commented on, where measures such as the cut-back in the health visitor service had taken on a political dimension. The meeting closed on a positive note with an expression of gratitude to Addenbrooke's Hospital for its quality of care.

Religious Imagery

Clergy of all denominations are reporting that, increasingly, the houses into which they are invited have no books; televisions, certainly, newspapers and magazines perhaps, but no books. The implications of this fact for the spread of Christian faith are profound but as yet little explored. A religion that for the past four centuries has placed great emphasis on reading the Bible may now need to look for other ways of spreading the word. In the centuries between the very beginnings of Christianity and the availability of printed books in the sixteenth century one major task faced every generation of Christian teachers. This was to overcome the serious problems of how to teach the faith and hold the basics of that teaching in the minds and hearts of the ordinary people. Oral teaching was the basis, both to groups and individuals, but more was needed. Gregory the Great's instructions on the function of visual imagery, given to that Augustine whom he sent to convert the peoples of Britain, emphasised its role as `the books of the unlettered'. Throughout the Middle Ages images were considered of vital importance for communicating the faith. And this, not only to the unlettered but also to those who could read books. Pictures and statues were thought to bring more clearly to the mind the stories of the Bible and the lives of the saints, the delights of heaven and the terrors of hell. Visual images could engage the feelings more powerfully than the written word. Modern psychological tests have confirmed that more is retained in the memory if the written word is combined with pictures. Even more is retained if there is something to be done; the tradition of church processions helped congregations to remember festivals and their meaning. Imagery became an important part of the structure of church buildings - not merely applied as decoration but decoratively functional. Thus niches with statues of the saints helped to provide stability by weighting the buttresses, just as metaphorically the saints were understood to be supporting the Church. Nevertheless, throughout the ages, in both eastern and western Churches, there has been controversy over the appropriateness of Christian visual imagery. This controversy has centred on differing interpretations of the second of the Ten Commandments, that which forbids the making and worship of idols. A strict interpretation might suggest that religious imagery is entirely forbidden, since the commandment begins: ``Thou shalt not make unto thee any graven image...''. Those who disagree with this interpretation point to the continuation of the commandment, culminating in the stricture: ``Thou shalt not bow down thyself to them, nor serve them...''. This suggests that the essence of the commandment is not to prohibit all religious art, however used, but rather to prevent the worship of anything other than God. It is relevant here that Judaism, generally considered to have always and everywhere strictly forbidden religious imagery, in fact has its own pictorial tradition. Among other evidence of this is the discovery by archaeologists of a synagogue and a church at Dura Europos, both dating from the mid-third-century and both boasting internal walls covered in murals representing biblical and allegorical scenes. Archaeological study of the catacombs and remains of early Christian churches in Rome also suggests that imagery was used, as soon as permanent buildings became available, to teach and inspire the faithful people of God. In our own country much survives of the varied imagery on and in medieval churches. It shows that the Church made a determined attempt to use all available resources for its mission. The content of the medieval Church's teaching is not exactly what today's Church might need to preach. Yet the underlying Christian message is the same as always. Our ancestors used humour and drama to catch the attention of the people, to remind them of their moral and spiritual needs. They used beauty to inspire them with wonder at the limitless creative bounty of God. Much might be learned from that use of imagery for an appeal to those people who today are more used to looking at pictures than reading books.

Dr Lynne Broughton considers the role of visual imagery in illustrating the Christian faith.

A collection of Lynne Broughton's first six articles for Majestas is available from the bookstall at Great St Mary's, price 50p.

Diary

All events take place in Great St Mary's unless otherwise advertised.

Who's Who

Since this is the same from issue to issue, we have included a single copy of it on the site, as our Who's who at GSM page.

Publication

Majestas is edited by Robert Avery, Sheila Cameron, David Hollier, Philip Oswald (proofs) and John Sturdy (HTML) and published by: Great St Mary's The University Church, Cambridge CB2 3PQ, Tel (01223) 350914, Fax (01223) 426555.

Please contact the editors at the above address.

Submissions for the next editions of Majestas

The deadline for the August/September edition of Majestas is 5th July. Please submit copy to the Church Office.

The Parish

For further details of the parish, including the regular service times, please see the GSM home page.