The Sunday Times - UK (2022-04-24)

The Sunday Times April 24, 2022 V2 23

NEWS REVIEW

Enduring

grief for

a twin he

never met

Simon Usborne hears how one man’s life

has been shaped by the guilt he feels

over his twin sister’s death in childbirth

Surviving twins

often describe

a bewildering

sense of loss that

can take hold

A

fter an unsettled infancy

spent mostly crying, David

Elvy recalls becoming con-

sumed as a boy by a feeling

that something — or some-

one — was missing. “Every-

thing I did, I felt that I should

have been doing it with

someone else,” Elvy, 73, tells

me. He would often talk to a

being who felt more like an extension of

himself than an imaginary friend.

When he was seven, his mother, who

helped to run an east London chippy,

told him that he had a twin sister who

died moments after the birth.

“Things sort of clicked into place,”

Elvy, a retired surveyor, says from his

home in south London. “It was almost

like I had been living two lives — that hav-

ing lost a life, I was trying to make up for

it.”

He has been thinking about his sister

since the footballer Cristiano Ronaldo

announced last Monday that he and his

partner, Georgina Rodríguez, had lost a

son who was one of non-identical twins.

Women expecting multiple births face

a higher risk of complications and are

more than twice as likely to experience

stillbirth than those having one baby,

according to research carried out at

Oxford University.

The impact on parents can be devas-

tating, but in the coverage of Ronaldo and

Rodríguez’s loss, Elvy was struck by a

familiar feeling: that we do not under-

stand the effect on a surviving twin. “An

awful lot of people think that if you lose a

twin at birth, it doesn’t matter because

you never knew them, and that’s just not

right,” he says.

Research is scant, but one Italian

study, published in 2011, used ultrasound

scanning to discover that physical inter-

action between twins becomes increas-

ingly common as the pregnancy goes on.

Anecdotal evidence backs up the idea

of a prenatal bond. Surviving twins often

describe a bewildering sense of loss that

can take hold before they learn they were

a twin. “Bear in mind you’re never going

to be as close to anybody as you are in the

womb,” Elvy says.

Elvy now runs the Lone Twin Network

(LTN), a voluntary support group. Almost

half its 500 members lost a twin at birth.

The group started life in 1989 after Joan

Woodward, a psychotherapist who died

last year, surveyed 219 bereaved twins.

They described an “endless seeking for

what they knew could never be found”,

as well as the effects of guilt and overpro-

tective parenting.

When Elvy joined LTN in 1994, he was

amazed to discover like-minded survi-

vors. The sense of guilt was huge for him.

“My mother said I’d eaten all the food and

therefore my twin died,” he says. “Need-

less to say we never had a good relation-

ship.”

Elvy’s mother, who died in 1983, also

denied her son the chance to grieve. He

never understood why he wasn’t allowed

birthday parties. “I only realised later

that of course it was because my parents

were in mourning,” he says. Elvy’s father,

a dress designer, also struggled with emo-

tions but had a warmer heart. He insisted

on naming his daughter Dawn and bury-

ing her at a cemetery, but without a head-

stone, which was then prohibited for

newborns.

“It was miraculous because it wasn’t

unusual then for babies to be thrown

down the incinerator chute,” Elvy says.

Elvy, who had an older sister, Helene,

now dead, muddled through to adult-

hood. He visited Dawn’s grave, at one

point smuggling in a small marble head-

stone bearing Dawn’s name and dates.

Nobody dared remove it.

He was rebellious yet insular and had

few friends. He continued to feel like he

was living half a life — and that nobody

had recognised the missing part. And

always there was guilt. “It nags away at

you, the idea that you’ve killed your

twin,” he says.

In 2020, Huan Song, a researcher at

Sichuan University in China, found that

the risk of having a psychiatric disorder

diagnosed increased by up to 65 per cent

among Swedish twins who had lost a twin

compared with twins who had not. The

risk was higher among twins who had

experienced the loss early in life. Elvy

started a counselling course in his twen-

ties, partly as a way to understand him-

self. Aged 30, he met his future wife, Car-

men, who had a son from her first

marriage. It all helped but, after joining

LTN, Elvy says his biggest breakthrough

came as he approached 50.

A couple of weeks before the big day,

Elvy wrote a poem, which he reads to me.

a box. “She opened it and inside there

were two peace lilies,” he recalls. “I froze.

She said, ‘It’s one for you and one for

Dawn,’ and that was the first recognition

that it was her birthday as well.”

Elvy urges bereaved parents of twins

to seek specialist support and to be

open about the loss with children as soon

as it feels right. They should also try to

resist the urge to overprotect or indulge

them. It has taken him a lifetime to feel

like a whole person, and to overcome the

guilt and pining that defined him. “But

even now, Dawn is still part of me and she

always will be,” he says.

Lonetwinnetwork.org.uk. The Twins Trust

has a bereavement support service for

parents and carers: Twinstrust.org/

bereavement

It ends with the line: “My birthday cake, it

burns so bright, but all I see is memorial

light.” On the day itself, Helene gave him

Gallagher

says he caked

himself in

Deep Heat,

suggesting a

kamikaze

approach

it’s advisable

to avoid

says that the vagina too has a

“delicate, interconnected

ecosystem” that is an

extension of your body’s

immune system and a

protective barrier, keeping

out “intruders while helping

keep the body’s equilibrium

in check”.

Where it is different from

the gut, she adds, is that a

healthy gut has a diversity of

different bacteria, whereas a

healthy vagina is usually

dominated by one main

group: lactobacillus.

“This should be a really

important realm in

microbiome science,” she

says. However, when she met

people researching vaginal

microbiome transplants, a

technique that could treat

recurrent BV, they told her

they had a hard time getting

their work off the ground.

“That’s because it’s female

sexual health — not life-

threatening, but quality-of-

life-threatening — and it’s not

taken seriously enough. But

guess what is taken seriously?

Erectile dysfunction.” This is

part of the broader argument:

that the fact scientists have

mostly been men has limited

our understanding of

women’s bodies.

Gross, who worked for

Smithsonian magazine, says

that even when she pitched

articles such as the history of

the intrauterine device (IUD,

a form of contraception) or

the development of robotic

vaginas for medical training,

“older male editors in the

news room would get kind of

uncomfortable or would not

be interested”.

The prism through which

women and their bodies are

seen is problematic too, she

argues, with science treating

women as “walking wombs”,

focusing entirely on their

capacity to reproduce. This

leaves them flummoxed, for

example, about the purpose

of the clitoris.

The clitoris is the only

organ in the human body

specifically designed for

pleasure, while the penis has

a triple duty: pleasure, peeing

and procreation.

“A lot of researchers are

obsessed with finding the

reproductive function of the

female orgasm and the

clitoris,” Gross says. “They

say it must be the vestigial

version of the penis or it

must have some role that we

don’t know.”

One theory suggests it

We know more about Mars than we do the vagina

helps get sperm into the

uterus — “upsuck”, Gross

calls it. “I think it is

interesting that people get

really stuck on the clitoris

having a purpose besides

pleasure — like they can’t

handle that it’s the main

thing it does. Yet we have

so much still to find out

about its function and how

it interacts with the rest of

the body.”

When embryos in the

womb are six weeks old, both

sexes look the same, with a

nub between the legs, which

then develops into female or

male genitalia. The same

tissue turns into the clitoris or

the penis. Science, however,

treats the penis as the

standard, Gross notes. It’s

true in zoology too.

“Scientists would tell me

that whenever you have an

animal with a large clitoris —

like a hyena — it is called a

‘pseudo penis’. They don’t

ever say that the penis is

an unnecessarily large

clitoris!”

Vagina Obscura should

cause a revolution in how we

think about the vagina, in the

same way that another book,

Florence Williams’s Breasts: A

Natural and Unnatural

History, published in 2012,

did for boobs. “I’ve suggested

she and I do a talk together,”

Gross says. “We’ll call it

‘Upstairs Downstairs’.”

Vagina Obscura: An

Anatomical Voyage, by Rachel

E Gross, is published on Friday

(WW Norton, £19.99)

A new book asks why women’s genitals are still largely a mystery to medical science, writes Rosamund Urwin

This may

be the first

book to

have been

inspired by

a vaginal

infection

clitoris calls it an “iceberg

organ” because far more of it

is hidden than is visible,

while it is now believed that

ovaries are capable of

producing new eggs, rather

than women having the

maximum that they’ll have

for life when they’re in their

mother’s womb. Eggs also

aren’t pliant cells waiting to

be fertilised — they can help

determine which sperm wins.

This may also be the first

book to have been inspired by

a vaginal infection. “Ah yes,

my burning bush!” laughs

Gross. “A dubious honour. I

had an uncomfortable month

in the office, running to the

bathroom, and encountering

a huge lack of knowledge

[about the condition], even

from my gynaecologist.”

Gross’s “itch she couldn’t

scratch” was bacterial

vaginosis, commonly known

as BV, a condition that affects

one in three women and is

caused by an imbalance of

bacteria in the vagina. Her

gynaecologist prescribed two

courses of antibiotics, which

didn’t work.

“She told me, ‘This just

comes back for some women,

but as a last resort, we could

try this thing that might

work.’ It was basically rat

poison.” The treatment was

boric acid, which is also used

to kill cockroaches. She

began taking it, then started

to worry. “This got me

looking into what this was

doing to the vagina and its

ecosystem, which was

basically destroying

T

he people — the men —

responsible for naming

the female genitals often

included the word

“shame”. A French

anatomist who dissected a

clitoris called it the membre

honteux — the shame

member; in German,

Schamlippen means the

vulva; while the word

“pudendum” — still found in

many medical textbooks — is

derived from the Latin verb

pudere: to be ashamed.

Rachel E Gross, an American

science journalist and the

author of a new book, Vagina

Obscura, argues that this has

stymied our understanding

not just of female sexuality

but of the female body.

“There are parts of your

own body that are less known

than the bottom of the ocean,

or the surface of Mars,” she

says. “And it’s striking that in

sex education, we don’t learn

the basics of the anatomy.

You learn about the

reproductive parts, about

ovulation, the ovaries, the

uterus. But the parts you’re

interacting with in daily life

are shrouded in mystery. So

many people can’t find the

clitoris or name the vulva on

a diagram.”

Gross, 33, who lives in

Brooklyn, New York, admits

that even she didn’t know

that much about the vagina

before spending three and a

half years researching it and

writing about it.

Her book delves into the

latest scientific research: a

urologist remapping the

Rachel E Gross: the female genitals were named by men

Top, David Elvy

as a boy with his

family. Above,

Cristiano

Ronaldo and

Georgina

Rodríguez last

week announced

the death of

one of their

newborn twins

MONIQUE JAQUES

everything, creating a

scorched earth,” she argues.

In recent years, doctors

and researchers have

increasingly highlighted the

importance to good health of

the gut microbiome. Gross

O

ur bodies let us all

down eventually, even

rock stars who told us

they were gonna live for

ever. Liam Gallagher

has revealed that he has been

advised to get a double hip

replacement. But in typically

belligerent fashion, the

former Oasis frontman, 49,

said he would rather live with

the pain and be pushed

around in a wheelchair.

He has had to give up

jogging, however, which has

not been helping his arthritic

joints. Worryingly for all

around him, Gallagher says

that without his running he is

like a “neurotic f***ing

housewife”.

Despite the belief that

running is bad for your knees

and hips, it doesn’t have to

be. In fact, runners are at no

greater risk than the general

population of osteoarthritis

or joint degeneration, and it

is possible to have a long and

fruitful relationship with the

sport — even after a hip

replacement. Here’s how to

stay injury-free.

Get two pairs of shoes

The best way to avoid injury

is to find a shoe that is

comfortable and compatible

with the terrain — your old

Dunlop Green Flash won’t cut

it. Give a few pairs a test

drive. Buy a couple, because

different shoes change the

stress on muscles and joints,

improving strength and

preventing inflexibility. Look

out for signs of wear: people

suggest swapping every

300-500 miles, but it’s an

inexact science.

You don’t need to stretch

Stretching before a run is out

(you never hold muscles in a

stretched position while

running); we need to

“mobilise” muscles and joints

through a full range of

motion. This is best achieved

with a routine of dynamic

mobility exercises or drills.

Some runners stretch after

a run, but stiffness is largely

down to strength

discrepancies in your body,

which you should work on.

Set aside some time to do a

few simple leg and core

exercises. Just two or three

sessions a week of 10-15

minutes can make a huge

difference.

For a warm-up, I’d do

some leg swings (front to

back and side to side),

marching, skipping while

swinging your arms and

walking lunges.

Slow and steady

Consistent progress is the key

to avoiding injury and

improving running longevity.

Avoid sharp increases in

overall running volume (no

more than 15 per cent in a

week), rapid switches from

treadmill to outdoor running,

or increases in faster or hillier

workouts.

Keep things steady most of

the time. Elite runners spend

the majority of their training

week (roughly 60-80 per cent

of their miles) running at a

steady pace that allows them

to maintain a conversation.

This builds a strong running

base, developing strong joints

and tendons and a finely

tuned aerobic system. It’s the

sponge in our training trifle.

Without it you’ll break down

— like a sloppy bowl of jelly

and custard.

Get your landing right

Gallagher has described

himself as like Forrest Gump,

“only cooler”. Forrest had

nobody’s idea of good

“technique”, but there is no

right or wrong way to run.

That said, the way you move

can affect your performance

and susceptibility to injury.

The key is your “interaction”

with the ground — essentially

how you land and propel

yourself forward with each

step. A large proportion of

people overstride, landing

heavily with leg outstretched

in front of them. If you can

hear your foot hitting the

ground or you tend to tire in

your quads, you’re probably

doing it too.

Shorten your stride and

aim to land lightly on the

ground under your hips.

Don’t worry about which part

of the foot hits the ground —

“apply” the whole foot to the

ground.

Stand tall... and sprint

When you run, stand tall,

with “high hips” and lean

forward from your ankles as

you run. Imagine a line

running down the outside of

your body, connecting ears,

shoulders, hips and ankles.

Try to avoid too much

rotation around upper body

and hips. Arms should swing

freely like a pendulum from

the shoulder joint.

You’ll find technique often

improves the faster you run.

Once a week or fortnight,

after a short, easy run, try five

or six 80-metre strides, with a

walk back to your starting

position after each one.

Pain doesn’t equal gain

Gallagher says he “cakes”

himself in Deep Heat and

endures steam-room sessions

after a run, suggesting a

kamikaze approach you

would be advised to avoid.

Runners can expect a few

aches and pains but if a niggle

gets worse during a run, stop.

If it’s there for two or more

runs, or affects your walk too,

consult a physio.

Eat well and get some sleep

Gallagher has hit the herbal

sleeping pills to deal with his

hip pain, but there’s little or

no evidence for the benefits

of vitamins, supplements or

“recovery aids”. Eat a diet

rich in wholefoods and get an

early night.

Shaun Dixon is a former

international mountain and

cross-country runner and the

founder of Let’s Get Running

(letsgetrunning.co.uk )

Don’t limp

back in

anguish like

Liam: how to

run and stay

injury-free

The Oasis star needs new hips and

has quit jogging. But pounding the

pavements doesn’t have to be

damaging, says coach Shaun Dixon

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