inspiration

Improving the NHS: with added tribute to Dr Kate Granger

Last week I was introduced by Dr Kathy McLean, Medical Director at NHS Improvement to 180 people comprising senior NHS clinicians, managers, directors, chief executives, patient representatives and members of staff at NHS Improvement, including most of their executive team. And I wondered how my homespun talk about improvement, leadership, the universe and everything would go down.

As it turned out, quite well.

The cartoon above was drawn by Inky Thinking. I don’t know how they do it, but they capture everything you say that you want people to remember.

Here is a word-based precis:

If you forget that culture always trumps strategy, your efforts to improve services will be ineffective. I’ve been there and occasionally done it the right way. But more often the wrong way.
You can’t help others to improve unless you are OK yourself. I have form on not remembering this.
Leadership in public services has never been harder with our 24/7 media, including social media, and the anti-public sector rhetoric that appears in most newspapers.
Plus we live in a post-fact world – see this article by Guardian Editor-In-Chief Katherine Viner. People believe things that are not true, and don’t believe things that are. I’ve had personal experience of this. And it is horrible.
Being an NHS leader is very lonely. Never more so than when you are awake at 3am. People get in touch to congratulate you when something goes well. But when things go wrong, people you thought were friends seem to melt away.
There is never enough time to think when you are running NHS services because of competing demands, often from those who are meant to be there to help you make improvements. But you must create time to think or you will make bad decisions.
Filling senior vacancies in the NHS is getting harder. And we should worry about this. Because if we aren’t careful, the only ones who apply to be in the firing line will be those who don’t care what others think about them. And that would be very bad for all of us.
We cannot separate leadership from mental health. In my opinion, people who experience mental illness from time to time can make exceptional leaders. It is only one thing about them. Plus, they develop skills through therapy that are invaluable – such as managing their own mood, listening really carefully, and not making assumptions about others.
I have experienced depression off and on since the age of 15. A nurse said something damaging to me when I was 22 and vulnerable which I absorbed deep into my psyche. For the next 36 years I stigmatised myself, despite being an active campaigner against the stigma of mental illness. It was when I finally came out about my experiences that I was able to address my self-stigma. I have made many friends since then. But if only I had done it before, I could have been a better, more authentic leader.
Mental illness messes with your head. It affects 1:4 of us. But 4:4 of us should care about it, not just on humanitarian and economic grounds, but because almost everyone can be affected. We are all on a spectrum of resilience, and if enough bad things happen to us, especially at a young age, most of us will experience post traumatic damage.
When I appeared suddenly to get ill with an acute onset of depression in 2013, it was a culmination of things. My own susceptibility, but also workload, loneliness, weariness as I approached retirement, not taking care of myself, listening too hard to my own negative voices, and putting a lot of energy into maintaining a positive front. It wasn’t caused by internet trolls. But they didn’t help.
So please don’t do what I did. Get to know yourself. Talk to yourself honestly about how you are. Talk to your loved ones. Take care. Be the best version of you, but make sure that it is you. And try always to see yourself as an improvement project – this makes it easier to accept criticism without it cutting you to your core. I’ve only learned this in the last few years, and it is a revelation!
I am lucky. I have dear family and friends. And I got great care. I was able to go back to a job that I loved, which was a major part of my recovery. I know it isn’t the same for everyone.
Since the summer of 2014 when I finally hung up my chief executive boots, I’ve been helping others in various ways to be the best version of themselves. And I’ve written a book which I hope you will read when it is published later this year.

As I finish this blog, I think of someone who embodies improvement in everything she does. The talented, compassionate and extremely resourceful Dr Kate Granger. Kate is currently in a hospice in what are probably the final stages of a rare and awful form of cancer. But as well as sharing the intimacies of her progress through terminal illness via her wonderful talks and social media, Kate has also revolutionised the NHS and other healthcare systems around the world with her #HelloMyNameIs campaign. She has written several books, and completed amazing things on her bucket list. And not content with that, Kate and her husband Chris Pointon are urging people to make donations to the Yorkshire Cancer Centre, a small charity that helps improve the quality of life of people living with cancer. You can donate here.

Kate and Chris demonstrate that being a leader isn’t a job, it is an attitude of mind. That anyone can make a difference if they focus on something that matters, turn a great idea into an innovation and build support for it through honest endeavour. We can all learn about improvement from them.

May you go well, both of you.

25 July 2016 postscript:

Chris has just posted on Twitter that his wonderful wife died yesterday peacefully in the arms of her family.

I only met Kate once. I will never forget her. She had an extraordinary stillness and presence. I hope the knowledge of the difference she has made and will continue to make for many years to come will sustain Chris and all who loved her in the difficult times ahead.

My heart goes out to all of you. May her lovely soul rest in peace.

What would Mary Seacole do?

Professor Elizabeth Anionwu and me

On difficult days, I ask myself what Mary Seacole would do.

Those who seek to denigrate her memory are more than mean – spirited. They not only question her nursing contribution in the Crimea – for which she was honoured by the British Army, the Times newspaper, Her Majesty Queen Victoria and 80,000 members of the public who attended celebrations in her honour. They also question whether she actually was a nurse. They say that she wasn’t really black. And having campaigned as hard as they could to undermine the Mary Seacole Memorial Statue Appeal, they now say that it is OK for there to be a statue to commemorate her, as long as it is small and not in a prominent position.

I will not stoop to naming these people nor to referencing the nastiness they have whipped up. Articles in The Independent and The Guardian have helped set the record straight. And today my dear friend Professor Elizabeth Anionwu CBE, Vice Chair of the Mary Seacole Statue Appeal, pictured with me above, will be on Woman’s Hour talking to Jenni Murray about the importance of Mary’s memory to all who believe in equality.

And today is the day that Mary’s beautiful statue, created by renowned sculptor Martin Jennings, will be unveiled outside St Thomas’ Hospital in London. Mary will proudly face the Houses of Parliament across the river. And she will be the first statue to a named black woman in the whole UK.

This is what will be written underneath:

“I trust that England will not forget one who nursed the sick, who sought out her wounded to aid and succour them, and who performed last offices for some of her illustrious dead.”

Sir William Howard Russell, War Correspondent, the Times Newspaper, 1857

We need Mary’s legacy now more than ever. The referendum campaign has unleashed xenophobia and racism. The poster of people with dark skin queuing for refuge with that hateful slogan underneath said it all. Some hoped such ugly days were over. Many knew this was not so. Fear and hatred for “the other” lie behind words such as “I’m not a racist but….”.

The NHS is not immune to racism. Or sexism. I have nothing against able and honourable white men. But when the NHS workforce is 70% female and 20% BME, why does the top look so male and so white? This excoriating report by Yvonne Coghill and Roger Kline tells us a lot. About unfairness and disadvantage and about how NHS staff who experience these things can lose hope. It was published earlier this month. It is in danger of sinking without trace unless we do something different now.

I have no personal experience of racism, although I have seen it in action. Sometimes I have done something about it. And sometimes I have not. For this I am ashamed.

I do have experience of anti-Semitism, of being teased for having a “funny” surname, and of sexism. I know about the stigma of mental illness. And I know that, had I stayed where I started, at a London teaching hospital, I would not have become an NHS chief executive. My face would not have fitted.

It was for these reasons that I, a white woman, felt I had something to contribute to the Mary Seacole Statue Appeal.

Trevor Sterling, new charity chair, Leon Mann, ambassador and me last year at the site where Mary's statue will be unveiled tomorrow morning

Trevor Sterling, new charity chair, Leon Mann, ambassador and me last year at the site of the statue

And now, trustees of our new charity, the Mary Seacole Trust, chaired by the brilliant lawyer Trevor Sterling, will be calling on Mary’s legacy to inspire those at risk of disadvantage. In schools, universities, communities and workplaces including the NHS. We will encourage people to work hard and do their best. To be compassionate AND entrepreneurial. To aspire to great things. To speak up for what is right. And never to give up.

Despite not bring born in the UK, Mary Seacole never gave up playing her part in helping those from a country she loved. Throughout her life she remained proud of her dark skin and her heritage.

I urge anyone in despair or need of inspiration to visit Mary’s statue. It depicts her coat furling around her as she strides defiantly into the wind to meet her destiny.

These are very difficult times. Let us join Mary Seacole. And let us never give up.

An earlier version of this article was published in the Health Service Journal. I have updated it for my blog and to increase access beyond the NHS. I will update it again with photographs of the statue.

Be inspired #Confed2016

This time last year, I wrote a blog for newbies going to the NHS Confederation Conference. I decided to do an update for #Confed2016.

These are my top ten tips for having a fruitful time. By the way, you don’t have to be going to Manchester to make use of it 😉

Don’t try to see and do everything. Be choosy. Treat the conference like a festival. By all means tweet about what you hear. But do also give the events you choose to attend your undivided attention.
If you only seek out sessions and speakers to confirm your views, you will waste time and money. Arrive with an open mind. Ask questions. And be prepared to learn new things and to unlearn old ones.
Some people need no encouragement to network. But if you aren’t confident about bounding up to someone you admire with an outstretched paw, don’t worry. Practice saying #HelloMyNameIs to people who look like you feel – perhaps a bit lost or lonely. And remember what Dale Carnegie said: You can make more friends in two months by becoming interested in other people than you can in two years trying to get other people interested in you.
Dress for style AND comfort. These are not mutually exclusive.
Never forget you are at work. Stay out late if you must. But if someone makes you an offer you feel you cannot refuse, say No. And mean it. What goes on at conference does NOT stay at conference.
Take breaks. Go for a walk. Have a rest in your room. Do shopping or emails or visit the Lowrie. Drink coffee.
At the same time, stay focused on why you are there. The NHS is in a bad way. It is not only being slowly starved of cash. Services are overwhelmed because current methods of doing things are unfit to meet the demands of so many people with multiple problems. We need leaders like you to find two or three changes that will make the most difference. And to devote their careers to making these things happen.
Remember that innovation is as much about stopping things as starting them. That there are no quick fixes. And that culture eats strategy for breakfast*.
You will meet folk having a hard time. Please don’t avoid them. Despite all the talk about compassion, our beloved NHS has become less compassionate. There is too much focus on inspection, compliance and performance. And insufficient attention paid to recovery, renewal and support. Please spend time with people working in very tough places. Listen if they seem angry or frightened. One day, this could be you.
Take a look around you. Notice the top of the NHS. How very white and very male it is, despite the NHS workforce being 70% female and 20% BME. Ask yourself why this is so. And if you think it matters, do your bit to help to change it.

I’ve been to a few conferences. And been inspired. I hope you will be too. Have a wonderful time xxx

*This was never actually said by Peter Drucker or Edgar Schein, to both of whom it has been attributed. But it was what they meant. Sort-of.

Open dialogue

I went to a conference in Nottingham yesterday to learn about a technique called Open Dialogue. I wanted to know more because of how it has revolutionised the care of people who are in crisis in parts of Finland and the US, reducing demand on mental hospitals and transforming lives.

I care deeply about mental health services, although I don’t run them any more. These days I campaign to make them better. I volunteer in suicide prevention. I chair the Time to Change mental health professionals project. And sometimes I need help from services myself.

I wish you could have been there too. Some massive pennies dropped, not just for me but for everyone who hadn’t already appreciated the possibilities. We learned that Open Dialogue is about being with people rather than doing something to them. And we realised that here was a way to mend things that previously seemed unfixable.

Let me explain.

There are some who say that the NHS is broken. And that mental health services are badly broken.

I’m not sure that broken is a helpful way to describe things. I prefer to think of them as badly wounded. And when someone is wounded, you take care of them.

I believe that people in highly influential positions do care about mental health. They are just unsure about what to to do, other than saying they care. They know that mental health services around the country are buckling under the strain of increasing demand. Referral rates have never been higher. And continue to climb. Services find it increasingly difficult to discharge people because there is nowhere for them to go. Staff are overwhelmed, and there is a growing recruitment and morale crisis.

Added to which, successive governments say one thing about the importance of mental health but allow the opposite to happen regarding funding. Despite the fine words and promises in the response to the Mental Health Taskforce report published in February, we heard just a few weeks ago from NHS Providers that mental health trusts are not seeing the promised investment and some are reporting funding cuts in 2016 – 2017. Parity of esteem? Actions speak louder than words.

How might Open Dialogue help?

Firstly, it isn’t simply a technique for listening really carefully to people who experience trauma and distress AND their families so that together they can work out their own solutions, with support. It is also an extremely respectful way for people to relate to one another, in teams, across teams, organisations, health care systems and society. Even the NHS.

Secondly, Open Dialogue is the antidote to what is sometimes called the biomedical model, when doctor knows best and patients are compliant. This works when there is a fairly simple problem and solution. For example, a broken leg. It doesn’t work for the vast majority of health conditions in which people need to become the expert themselves if they are to lead fulfilling lives. And it certainly doesn’t work in mental health. Mental health professionals know this. But we organise and regulate mental health services as though we were fixing broken minds instead of legs.

Open Dialogue builds on what some call the Recovery Model, based on hope and fulfilment rather than simply diagnosis and treatment. It provides a method to apply a recovery-based approach, involving the whole family and team. It is the antidote to outpatient clinics and ward rounds.

Thirdly, Open Dialogue provides the basis from which to challenge many of the perverse incentives and restrictive practices that have grown up in mental health care out of fear of incident, media criticism or what a regulator might say. Such as staff spending more time documenting care than in giving care. The absolute adherence to risk assessment even though successive independent investigations show it to have limited predictive value. And risk management, which taken to extremes means that those who might possibly pose a risk to themselves or others, are cared for in inhumane conditions with no privacy or dignity, no sheets, cutlery, shoelaces, phone chargers or indeed any other item that someone somewhere has said might pose a risk. And yet we know that ligatures and weapons can be fashioned from almost anything. And that people who are ill, frightened and alone can be driven to do increasingly desperate things. The greatest risk management tool available is compassionate, skilled attention. Open Dialogue offers high quantities of that.

Open Dialogue is being used in a growing number of services in the UK. A research bid has been submitted and passed the first round of scrutiny. If successful, it will explore human, clinical and cost effectiveness, as well as developing a model that is scalable and sensitive to local circumstances.

I want to thank everyone at the conference for opening my eyes. Including Tracey Taylor, Simon Smith, Pablo Sadler, Lesley Nelson, Jen Kilyon, Russell Razzaque, Mark Hofenbeck, Julie Repper and Steve Pilling.

And to Corrine Hendy, who I first met at an NHS England event about putting patients first last year: Your journey from being locked in a mental hospital to becoming a skilled mental health professional, public speaker and highly effective advocate for Open Dialogue, is more inspirational than any you will hear on X-Factor. I want to repay the inspiration you have selflessly given.

I’m going to do what I can to spread the word.

Three blogs and a bike ride

This week has been Mental Health Awareness Week. I’ve written three articles, visited a friend, given a talk, attended a party and been on a bike ride.

There’s been some other more difficult stuff which I don’t feel able to write about just now. More anon.

I wrote this piece about the loss of Sally Brampton through depression and what is assumed to have been suicide.

Suicide casts a long, cold shadow. My heart goes out to all who have lost someone that way. And to all who have tried to keep them safe. There is sometimes talk of failure in such circumstances. I fully understand why. But it can be cruel and destructive to those left behind. It can affect the grieving process and have terrible repercussions. I decided a while ago to devote some of my time to being a volunteer in suicide prevention. This work can of course be distressing. But is so worthwhile. If more people were involved in understanding about suicide, it would improve compassion and more lives might be saved. Blame doesn’t save anyone. If anything, it can have the opposite effect.

On Monday I popped up to Rugby to see the lovely Gill Phillips and learn more about the groundbreaking work she does through her company @WhoseShoes. Gill had a special birthday this week – now she’s nearly as old as me! I love the way that this entrepreneurial woman has started a new adventure. I hope I can support Gill to bring Whose Shoes to the world of mental health. Go us!

Just Giving asked me to write this list of ideas to help people to manage their own mental health. It’s been fun watching the list grow throughout the week, and hearing comments from unlikely places about the tips. I just curated the list – none of them were invented by me. I try to follow them, not always successfully.

And I wrote this piece called Serendipity for NHS Employers. It was also Equality and Human Rights week. It was serendipitous to bring two things together that matter very much to me but which I hadn’t realised before had so much in common. I’ve had some useful feedback. It has sparked conversations about how we can use Mary Seacole’s legacy to inspire young people not just to dream, but to work hard and not be deterred by setbacks from achieving their ambitions.

One of my ambitions is to see the top of the NHS become less white and less male. Nothing against you guys, but as it says in my blog, the way things are now just isn’t representative. And having an unrepresentative leadership breeds alienation and resentment which has a negative impact on services.

On Thursday afternoon I spoke at a Brighton Housing Trust Health and Wellbeing Service event (photo above). I was invited there to inspire the women with my experiences of being a high profile woman who is also open about my own mental illness. But to be honest, it was they who inspired me. I heard some stories I will never forget. I want everyone to know what we agreed, which is that people who live with mental illness have assets to share. Rather than deficits to avoid or accommodate. I’m going to be returning to this theme in the future.

I was at the beautiful Black Cultural Archive in Brixton on Thursday evening at a comedy night with a purpose – to thank all the ambassadors and trustees who have spent 12 long years raising money for the Mary Seacole Statue. That’s me with our brilliant and indefatigable Vice Chair Professor Elizabeth Anionwu CBE. Mary’s statue goes up in six weeks – much more about this soon.

And on Friday I was out cycle training with my friend Sally who is joining me on Ride 100 on 31st July when we will be raising money for Samaritans. You’ll be hearing a lot more about that shortly. Suffice to say, after doing 20 miles of hills, including the notorious Box Hill (twice) we felt pretty smug 🙂

A bit of courage

The more worried I feel about expressing my views on a particular topic, the more interest a blog seems to generate.

I’ve written this in anticipation of the Mental Health Taskforce Report, finally due out next week. Although, I’m unsure what you’ll think, I feel the need to say some things I could not have said when I was doing my old job running mental health services.

Mental health services are undoubtedly scary. But they are not all the same. The atmosphere and standard of care even on different wards in the same hospital can vary widely. It depends on the expertise and most of all the compassion of the doctors, nurses and the people in charge. If you have had a poor experience of care, either as a patient or a family member, that is terrible. It is vital that we face the fact that 1 in 3 people say they experience stigma within services. The Time to Change project I’ve been chairing addresses this, with more to report later this month. But at the same time, we must do all we can not to terrify people who need treatment. The chances are they will receive care that will really help. And if they start out assuming the worst, it will be even harder for the staff working with them to establish a therapeutic relationship. And this is the most valuable treatment tool available. I know this from personal experience.
The standard and availability of care in mental health services also depends on the attitudes and expertise of those running and commissioning these services. There is a real and present danger that, faced with wicked choices of saving vast sums of money from the NHS, commissioners look to make savings which will cause the the least outcry, ie from mental health. This isn’t an opinion, by the way. It is a fact. In particular, they look at most expensive care, which happens to be in hospitals, and persuade themselves that the local population can do without most or even all of it. But they can’t. To try to “re-engineer” aka cut beds without careful testing and sustained investment in evidence-based alternatives is irresponsible and dangerous. And yet this is exactly what has been done and continues to be done all over the country right now. Lord Crisp’s report into the availability of acute mental hospital beds published yesterday laid the facts bare. It was a good start. And the access targets it proposes will help. But we still have a long battle to rid ourselves of stigma towards mental health services not only from society but also from the rest of the NHS.
Alcoholism and misuse of drugs are symptoms of mental distress and/or of underlying mental illness. To treat them simply as addictions is cruel and pointless. It may seem cheaper in the short term to separate such services from the NHS and employ unqualified staff to provide care. And it may be politically attractive to take a punitive, non-therapeutic approach to those who self medicate with alcohol or illegal drugs. But to do so condemns vulnerable people to a half life of pain and a premature, horrible death.
There are millions of treatments available for physical illnesses. The same is so for mental illnesses. But why is it that people think they have a right to comment on the treatment of others who are mentally ill in a way they would be unlikely to do for, say, diabetes or heart disease? It’s true that psychiatry and psychology are inexact sciences. This is why they take more expertise, humanity and humility than the other disciplines of medicine. So if you feel tempted to comment on someone else’s treatment, unless you are their trusted clinician, please don’t.
There is no hierarchy of mental illnesses, and no patients who are more “deserving” than others. People who experience psychosis don’t deserve more pity than those who have bipolar disorder, or vice versa. And a short bout of clinical depression can be just as fatal as anorexia nervosa. Please remember this and put away your judgements.
You can’t see mental illness. And that’s part of the cruelty. Getting up and going to a cheap cafe to spend the day with others who understand the challenges of mental illness might sound easy to you. If you feel inclined to bang on about the value of work to those for whom the thought of being compelled to attend a job interview causes them to seriously consider jumping under a train, please shut up. Just because some people don’t get sympathy from tabloid newspapers doesn’t make them any less of a human being than you.
I’ve no problem with the use of words like bravery to refer to those experiencing cancer. And I know from friends with cancer that they have no choice but to be brave. But can we please recognise the courage, guts and determination of those who experience life with mental illness? And can we stop talking about suffering, because it implies passivity and weakness. The one thing I know about every person I have ever met who lives with a mental illness is that they are anything but weak. They are creative and heroic, in ways those who’ve never faced a life such as theirs can only imagine.

People who live with mental illness should be applauded and lionized. Not criticised, preached at, commented on, misunderstood and shunned. I hope next week’s taskforce report will recognise this.

Go us. Thank you.

Hello, my name is Lisa

We all have days that are hard. When what we need to do seems insurmountable, when we wonder whether anyone knows or cares about our efforts, and when we question our own plans, motivations and abilities.

As a writer and mental health campaigner who experiences depression from time to time, such days come along not infrequently. They also go away again, but only if I find ways to work through the negative feelings that beset me. To keep on keeping on, as Bob Dylan called it.

To do this, I deploy various methods. One of my favourites is to summon someone I admire, and imagine them watching me. Or I ask myself what they might do if they were in my position. It doesn’t make depression go away, of course, but it helps me face up to the difficult stuff.

It is a great honour to have met one of the people who, without knowing it, helps me on occasions to get over myself. And to have done so back in June 2014 when she spoke at the NHS Confederation Conference about the campaign she started which snowballed into the social movement Hello My Name Is.

I am of course talking about the indomitable, courageous and wise Dr Kate Granger, who has terminal cancer and yet as well as Hello My Name Is has managed to complete her medical training to become a consultant physician, get an MBE, bake amazing cakes, play the flute and tick off more things from her bucket list than most of us manage in many years longer than she knows she probably has.

In a tweet earlier this week to Kate’s husband Chris Pointon, who I haven’t met but I know must be a wonderful man because Kate wouldn’t have married anyone who wasn’t, I said I would write about why Hello My Name Is immediately struck a chord with me. This is it.

In my old life as an NHS mental health trust chief executive, I grew to learn that values mattered many times more than strategy. And that these needed to be simply stated, oft repeated and regularly practised by me and all our staff. We had five.

We welcome you – because first impressions really matter
We hear you – listening really carefully
We are helpful – being pro-active, flexible, creative
We work with you – sticking with people through the difficult times
We are hopeful – being optimistic for people – staff and patients – and our services

I love these values. You can find out how we developed them when eventually you read the book I have almost finished (hint). For now, I’d just ask that you notice the first one, We welcome you. It links closely with Hello My Name Is. And with name badges.

Name badges really matter in mental health and related services. Because patients can be confused or experience hallucinations. Because services can be scary, for real or imagined reasons. And because no-one wears a uniform so you really can’t tell who is who. And you need to know.

So when I first became CE, the executive team agreed that we would always wear badges and that all our staff would always wear badges, as these would help us to introduce ourselves to each other and to patients. And then however stressed or forgetful someone was and however many people they met, they would always know who the other person was.

During my time as a CE, for the most part, people wore their badges with pride. But not always. You’ll have to wait for my book to hear some of the excuses I came across during 13 years on why staff, including extremely senior ones, were not wearing a name badge. And why I take ultimate responsibility for this.

But what I will tell you is how, back in early 2014 when Hello My Name Is was beginning to gain traction, I wrote about it in my weekly blog, and asked our people to think about incorporating it as part of We Welcome You. And I got some really nice responses. But also one or two dusty ones. Including from one senior person who said that they were deeply insulted that I was suggesting such a thing, because of course they always introduced themselves to their patients and didn’t I have something more important to write about. This wasn’t the same person who had previously told me that they didn’t need a name badge because everyone knew who they were and anyway they didn’t work in Tesco. But it could have been.

I believe that people like this are, at heart, good and caring and that they are not untypical in any part of the NHS. But they have some way to go to understand that the Hello My Name Is campaign is about seeing the patient and not just their disease, and about bringing your whole compassionate self to work, rather than just your intellectual self.

Kate, your inspirational campaign is still very much needed. It will remain topical and relevant for many years to come. You have set a standard for how we work together to which we can all aspire. You are a shining beacon whose work will live on long after we are all gone.

Hullo, my name is Lisa. Thank you for inspiring me on my difficult days to keep on keeping on.

Lisa Says This

Using what I've learned to help others