Over the years my features have appeared in everything from glossy monthlies to obscure health publications. The following three articles on subjects I feel strongly about first appeared in Shots and the CWA's Red Herrings.

CARIES AND THE CRIME WRITER

This article first appeared in Red Herrings.

Ominously, my toothache started on Friday 13th June. I immediately phoned my dentist but they said that as I hadn't been for eighteen months I'd have to re-register and that the earliest I could do so was Monday. So I made an appointment but was left wondering how I'd survive the weekend.

Luckily my husband reminded me that he was scheduled for root canal work that day so I phoned the dentist back and asked if I could have his appointment. 'No, his dentist is only taking on private patients now,' I was informed. In other words, if I was able to go private I could be seen that day - but as an NHS patient I'd have to wait.

Did they assume - as many laypeople do - that all crime writers made a fortune? I was tempted to lend them my copy of David Armstrong's brilliant How Not To Write A Novel which tells how little the average mid list author makes.

Ironically, when my husband turned up at the surgery one of the dentists had nothing to do and was so bored that he made coffee for the receptionist and dental nurses. He was still at a loose end when my husband left. Meanwhile my mouth was throbbing so badly that I was eating and drinking as little as possible. Monday seemed very far away.

But at last it arrived, only for the phone to ring. 'Your NHS dentist is sick. We have to cancel you.' I reminded them that I'd had toothache all weekend and they added 'You can come in tomorrow morning instead.'

Toothache invariably worsens when the sufferer lies down so on Tuesday I again got up bright and early. Cue another call. 'I'm very sorry but we have to cancel you. Your NHS dentist is still sick.' By now I feared that my toothache could worsen into an abscess (which is apparently more painful than giving birth) and I insisted on seeing someone. The receptionist then said that I could come down to the surgery for pain management.

I ran all the way before they could change their minds, but the dentist who saw me said that he had another patient in ten minutes so he could only give me a prescription for antibiotics. This despite the fact that my treatment tends to be quick because I don't have an injection, so there's no time wasted waiting for the local anaesthetic to kick in. More pertinently, it's noted in my records that I'm highly allergic to numerous medicines but they just said to discontinue the antibiotics if I had a bad reaction. Unconvinced, I went home and put the prescription in the bin.

I now boosted British Telecom's profits by phoning every dentist in town, only to find that it was months before any of them could take on an NHS patient. I was close to tears when one receptionist kindly told me about the Dental Emergency Service - and two phone calls later I had an emergency appointment for the following morning, albeit in a village several miles away.

The emergency dentist was brilliant. A quick drill down showed him that debris was entering the tooth and aggravating the pulp. He removed the nerve and put in a temporary dressing, explaining that it should be replaced by a permanent filling, supplied by my own dentist, in about a week.

I made an appointment with my dentist to have the filling put in on Wednesday 25th June. The day dawned and, yes, they cancelled. My NHS dentist seemed to have the worst health record in living history. The earliest appointment they could give me now was 8th July.

But my temporary filling was fast eroding so I phoned the emergency services again and was given the same village dentist as last time. He explained that the emergency service isn't allowed to give patients a permanent solution, so all he could do was put in a longer-lasting temporary dressing. This one would last till August or September, by which time my NHS dentist would have to fill the tooth.

On 12th August I finally got a permanent filling courtesy of my NHS dentist. It's been great and I'm very glad to have it. But I'm shocked that NHS patients are now seen as second class citizens. When I was a dental nurse we always gave priority to anyone with toothache and saw them at start of business. It was partly about one human having compassion for another, partly about a duty of care. A temporary dressing (which is often what's required to settle the tooth down) isn't a lucrative procedure but we'd prioritise it over an expensive one such as a patient who wanted crowns.

I'd urge any Red Herrings reader who has recently moved house to get themselves on an NHS dental waiting list today. You may not have problems now - but dental caries (aka tooth decay) and the common cold are the world's most common medical problems. Once the pulp becomes inflamed, persistent toothache is virtually guaranteed. If you don't have a dentist, you can use the emergency dental service but that may mean travelling some distance which is particularly difficult if you're in pain.

Best-selling authors can, of course, put their money where their mouth is and sign up for a private dental plan.


REALITY CHECK

This article first appeared in Shots magazine.

A woman runs from her house at 3 am bleeding from each ear. Another leaves with a bulging carrier bag - her life's possessions. A third wife is kept so penniless that she has to reverse the charges at the phonebox in order to call her sister for help.

These are true-to-life cases based on the year I spent working with an organisation for abused women and their children. Women who had been slowly and methodically robbed of their worldly goods, their co-workers, their self respect. Domestic violence is so common that you'd think crime fiction writers could accurately portray it. Unfortunately many of them just add to the existing myths.

Feminist fiction often deals with domestic abuse - but usually takes an 'All men are bad, all women are good,' approach that simplifies a complex subject. Many of these books end up with the women moving into an exclusively lesbian relationship, the subtext being that all men are potentially violent and that the abused woman can only find egalitarian love in another woman's arms. In reality, the maltreated women I know of tended to eschew the dating game for two or three years whilst they rebuild their confidence and that of their children. But most eventually went into a caring new heterosexual relationship.

The second mistake that crime fiction makes is in portraying domestic violence as designer violence. Take Laura, the battered wife played by Julia Roberts in the film Sleeping With The Enemy. The film shows Laura looking beautiful after an assault with just a modest bruise and minimal swelling to her otherwise flawless face. In real life such women often have their teeth knocked out or have their noses so badly broken that they require reconstructive surgery. Yes, it's an ugly picture - but crime is ugly and we'll never change it if we pretend that it's less appalling than it really is.

Fiction is much more palatable than fact, so Laura quickly starts a new life and attracts a gentle and creative boyfriend. Real life is rarely like that. The abused women will have been told for years that she's stupid and ugly, too fat, too thin, too brassy or too mousy. By the time she leaves her abuser she often sees herself as useless, as unworthy of new friends.

The fictitious notion that merely leaving the home is enough to wholly liberate the victim is a fallacy. She'll need peace and space and, ideally, the support of other women who have extricated themselves from very similar circumstances. It may take years before she can see herself wholly in survivor terms.

Another crime fiction misnomer is that poverty or alcoholism are the two things which cause violence to erupt. Admittedly they may escalate incipient violence but they don't cause it. We all know of loving men who occasionally become drunk - but they become loving drunk men. There has to be some deep rage in the abuser's psyche, a form of extreme wrong-thinking, for violence to erupt after a few pints. Similarly, cramped conditions and lack of cash can lead to feelings of hopelessness and deep depression. But frankly you could put an abusive man in a palace and he'd still find a 'what are you looking at me like that for?' reason to pick a fight.

Many authors are poor at describing the fear felt by the domestic violence victim. I recently read two crime stories on the subject by female authors. In each instance, there was so little emotion underpinning the assaults that the abuse just didn't ring true. These authors didn't successfully portray characters who had lived with the fear of mutilation week after week, month after month, year after year. Living in an abusive house causes the battered child or battered woman to question everything that they do or say, for fear that it may rile the abuser. It permeates their school and work life and erupts in bedwetting and bad dreams during foetally-curled nights. The victim's life becomes reduced to a clutter of self-hating thoughts and she may go into an almost trancelike daydream in order to escape them. She's liable to have digestive disorders and the regime of terror will show in her unhealthy posture, skin and hair.

In these short stories the victims also recovered with unlikely haste and were soon plotting their homicidal revenge on the conveniently absent man. Life just isn't like that. The battered wife (or child) will have spent time since the last attack trying to lull herself into a sense of hard won security. She'll have accepted the man's pleas that he didn't mean it. Or she'll have told herself that providing she doesn't burn his tea/answer back/wear nail-varnish then he'll have no reason to hit her again. The new attack robs her of this facade, of her fragile sense of safety, leaving her emotionally and mentally as well as physically brutalised.

Writers often describe this physical trauma in a novel - but their work remains gratuitous and unrealistic because they don't show the long term mental abuse leading up to it. In real life, if a man slaps his confident and economically independent partner for the first time then she'll either slap him back or press an assault case or leave. The would-be abuser knows this and he targets his victim as carefully as any serial killer does.

He'll note the body language of his potential new girlfriend, looking for the girl who is clearly from a loveless background. For the first few weeks or months of the relationship he'll treat her as well as a pretty teenager being groomed by a far-seeing pimp. Only when she's in love with him will he start to criticise her hair, weight, clothes, voice, cooking and cleaning. He tells her again and again that life's better when it's just the two of them.

Why on earth is she keeping in touch with her meddling sister? What does she need with that boring job and those flirtatious friends? If they could just move to this seaside town he used to go to on holiday as a boy then everything would be perfect. He geographically and emotionally isolates her and she lets herself be isolated because she loves him and wants to be loved in return. When she's completely reliant on him the abuse escalates and she's left feeling more worthless than she ever did before.

'Damaged people are dangerous. They know they can survive,' wrote Josephine Hart in her debut novel Damage. (Arrow, 1992.) I suspect that the reverse is actually true - it's because the battered woman fears that she can't survive in the outside world that she stabs her abusive husband. She cannot face another attack and so lashes out at the one person who is preventing her from finding sanctuary in her home. If you've been told by the one man who professes to love you that you are human flotsam then you fear the imagined hostility of strangers even more.

Another crime fiction lie is that domestic violence and sexual power games are the exact same thing. They really aren't. S/M games are consensual acts in which lovers aim to heighten their dual arousal. Domestic violence aims for the reverse - abject fear. The abuser's agenda is all about control at any cost so he attacks his wife because he wants her to give up her job, dress a certain way, not sleep if he himself isn't sleepy. He wants a robotic Stepford Wife.

The novel Sex Crimes by Jenefer Shute, (Vintage 1998) is a beautifully written book (as was her incredibly well observed debut, Life-Size) but it unfortunately blurs the lines between the care-filled consensuality of S/M and an angry attack. By erroneously showing shoving and slapping style domestic violence as being on a par with the character's more thought-out forays into bondage, she misrepresents the battered woman's reality.

All too often the media hides human abuse from middle class eyes, acting like a veritable nanny. As such, a children's charity did a survey and found that the public 'didn't think that child neglect was too bad a crime.' That same public, I realised, obviously hadn't lain, starving, in their own excrement for days at a time. As a result I wrote The Ghosts Of Bees short story, which appeared in the crime writers anthology Fresh Blood 2. (The Do-Not Press, 1997). It's about the kind of mindset that leads some parents to neglect their children for year after year. The mature presses praised it but it was ignored by the more trendy reviews pages, because, I suspect, it didn't fit in with their all- abuse-results-from-government-underfunding philosophy.

One writer who does portray familial violence in an unerringly realistic way is Andrew Vachss, the renowned child lawyer. He's seen the worst case scenarios and writes about them in fiction unflinchingly. Andrew Vachss sees exploitation in its most extreme forms - sees it and wholly renounces it. When it comes to domestic violence there is no excuse.

People don't just read crime fiction for escapist fun - they read it to learn more about their society. The crime writer who misrepresents that society is selling his or her readers short.


EXIT POLL

The following article on male suicide first appeared in the Crime Writers Association's Red Herrings newsletter.

'The thought of suicide is a great comfort. It has helped me through many a weary night,' Neitzche wrote in the nineteenth century. Today, the male suicide rate is still rising and the British government has pledged to tackle it.

If this isn't simply a soundbite then they face a monumental task - a restructuring of society as we know it. Britain would have to develop a wholly different socialisation process, changing the often unspoken rules which govern relationships in the workplace and personal relationships.

Statistics show that the highest number of male suicides are amongst the young and the middle aged. A look at the former group shows that they are often emotionally unsupported and relatively unnurtured. Mothers often stop hugging their male children when they reach puberty - yet it is a proven fact that humans who are untouched by others have greater risks of depression, illness and feelings of low self worth.

Such youths often don't have a sympathetic adult they can talk in confidence too. After all, how much do typical forty- four year old parents have in common with their twenty year old son? They may live in the same house but each inhabits a very different internal universe. Both parents may also be physically absent - after all, they're probably involved in their most challenging working years.

The boy then turns in desperation to his peer group for support in the hope that they'll assuage the loneliness he's suffering. But his peers are mainly adrift and unsupported too. He's lying awake worrying about his virginity whilst they're bragging that they've laid three girls (triplets who were begging for it) that very week.

Questions about sexuality are also most likely to arise amongst this age group - and it's a known fact that the male suicide rate is higher amongst gay and bisexual males than amongst young heterosexual men. Small wonder, given that he isn't allowed to read positive images of gay lifestyles in school and may face similar homophobia at home. But lets assume our young male toughs out the years of alienation. He matures into what society has wanted him to mature into. That is, a husband and father who provides his unit with wealth, a family hatchback and a semi-detached suburban home. He works long hours in a workplace that is increasingly aggressive and spends the weekends doing the grocery shopping, taking his children to various clubs and catching up on seemingly endless household DIY tasks. He's tired, torn in too many directions and he's long ago lost sight of his original raison d'etre - but at least he feels needed by his family so believes he has a purpose in life.

Then his wife asks for a divorce. Invariably she gets to stay on in the family home with the children - so he has to rent a student-style bedsit. By the time he's paid child maintenance and probably part of the mortgage on the family house that he's no longer allowed to live in, he's struggling to pay the bedsit's rent. In a few short weeks he has lost his partner and in time he'll probably lose his children, as many men find it too emotionally painful to keep seeing their children after their wife has embarked on a new relationship. A high percentage of fathers choose to make a clean break (however unfair this may be to the children) and sever all ties after the first separated year.

The middle aged and now totally isolated male looks at what he's got to show for twenty odd years of working hard - and finds it's precisely nothing. Unemployment after years of trying to climb the corporate ladder can have a similar detrimental affect. Small wonder he goes for a one way swim or drives to an isolated location and feeds a hosepipe into his car.

The problem is that society doesn't teach the male how to deal with failure in any form. The message men are given from an early age is that they must go out there and fight their corner. They are expected to cope with workplace and marital stress. I've know women who have similarly failed in academic and employment terms - but they quickly moved into the socially sanctioned role of motherhood. In the short term it gives them an unhumiliating way out. And no, I'm not saying that raising a child is easy (hell, I've heard that childbirth alone is the equivalent of defecating a coconut) but within weeks of getting pregnant the women has a reason not to work - and she can put off re-entering the emotionally and physically draining workplace until that child goes to school at age five. At which point she often has another one. Modern Britain doesn't give the male a similar option - the househusband who performs the exact same tasks at his female counterpart is usually unfairly branded as being lazy and workshy. He's viewed with suspicion and often derision by men and women alike.

More women attempt suicide than do males - but more males succeed. Having decided to end it all, the average male seems to feel no ambivalence about his decision. It's not a cry for help - it's a meticulously planned and performed final act.

But what of the males who do try and fail, perhaps being found in a monoxide-filled car before the fumes have proved fatal? You would think that medical staff would treat the failed suicide with compassion - but the reverse is often the case. Anecdotal evidence shows that nursing staff often see parasuicides as time-wasters. Nurses want to concentrate on those who are ill rather than those who are damaged by their own hand. When my parasuicide-based chapbook EXPIRY DATE was published several people were shocked that a would-be suicide could discharge himself and go home alone to the flat he'd just tried to kill himself in. But it happens every week.

And it will continue to happen unless people are willing to look at the socialisation that led to the suicide. I know of one woman whose father committed suicide with his own shotgun. Twenty five years later that same woman was terrified when her son bought a gun for sport. Yet she was missing the point - most of us have the means to take our own life constantly available. We are surrounded by sharp knives, potential nooses, deep cold water and towering heights. She should have concentrated on making his childhood a loving and multi-faceted one which showed him that he didn't have to strive aggressively in every sphere of his being. She should have helped give him the skills to talk honestly about his problems, and to listen to others rather than brooding alone or drowning his sorrows in whisky or beer.

I've yet to find exactly how the British government plan to tackle the male suicide epidemic, but I read of one medical report which suggested that GP's could prevent the problem by helping manage patient depression. The other panacea suggested was to offer a dependable source of support. The report added that a half to two thirds of people who commit suicide see a doctor during their last months - presumably for the clinical depression which often preludes or accompanies suicidal thoughts.

This GP intervention scheme, though laudable, is like putting an elastoplast on an arterial wound. How long will it be until the suicidal man loses his next job or his new partner? We have to socialise people differently to that they can cope with life's ongoing vissitudes. We cannot counsel them in real time for every single event.

Many American anti-youth-suicide projects have gone into schools. Other projects train community workers to take part in a Gatekeeper Programme. That is, these adults are shown how to identify the potential youth suicide. Again, for my money it is too little too late.

One study suggested that parents keep potential suicide weapons away from clinically depressed teenagers. Is this really the answer, to let someone go on living in emotional torment? Surely you have to give teenagers the self belief and support so that suicidal desire never materialises? And if it does arise surely concerned adults should work on alleviating the teenager's angst, not just hide the weapons with which he can obliviate his pain?

The Stoics said that man shouldn't complain about his life as he always has the means to leave it. Some people simply don't feel that life has a sufficient upside. They should be entitled to take themselves out without suffering the censure that the would be suicide currently endures. A far happier solution, however, would be to create a world where men felt supported in making alternative lifestyle choices. A world where they had the options that the British woman has.

Will the government really have the courage to change everything that so-called cool Britannia currently stands for? Or will it throw together a few suicide crisis helplines and watch, bewildered, as men continue to die in droves?