TOPIC: Dr Joanna McGraw
Day 7 in Court cont'd... 25 Sep 2014 19:04 #11
There is so much I want to write, but simply don’t have time. I'm also contending with my own painful eyes so will tell you as much as I can before tomorrow.
Yesterday Slimon Cridland and Nicholas Yell presented their closing arguments to Judge Bailey.
L’il Crid opened with a statement that Optical Express had instructed him that they had purchased the ASSETS of Rosen Eye Clinics Associates Ltd in 2006, NOT the company. They therefore did not accept that Paul Rosen was ever a Director of Optical Express.
As I mentioned yesterday, Joanna McGraw was not present in Court, and I will be surprised if she's there tomorrow.
Cridland said that by signing the Consent Form Stephanie confirmed she had read and understood it all.
Judge Bailey noted that it was apparent that the Consent Form had NOT been provided with the Patient Information pack, because there were marked crosses where Stephanie had initialled on the day. She had also initialled for a Lasik procedure she wasn’t having!
I told you the Judge was a smart cookie
When giving his evidence on Tuesday, Rosen said that Stephanie could undergo a successful ‘enhancement'. Yet when he 'hot tubbed' with Watson he changed his mind and agreed retreatment was unadvisable.
He did agree that patients should have an appointment with the surgeon prior to the day of surgery.
Judge Bailey commented yesterday that “enhancement” was a strange word to use to describe a retreatment. (I’m in total agreement, having argued the use of the word many times)
He said it could be suggested that if the actual percentage of problems were explained to patients it would deter them from undergoing surgery, adding: “I’m mindful that OE wants their surgeons and optoms to quote successful examples of surgery.”
He said that not to be told about the operation was: “Like a vertical climb on a glass plate”. Our Judge has a great way with words!
I particularly liked his view that: “A medical procedure within a commercial concern raises concerns, if not hackles”!
It should be mentioned that the same names were repeatedly mentioned throughout this trial: David Mungall (Tweedledee), Stephen Hannan (Tweedledum), Steven Schallhorn and Jan Venter. Of course no mention of the puppet master, CEO David Moulsdale.
Whilst hearing the closing submissions, Bailey pulled out the Patient Advisory Flow and commented that although he knew OE were embarrassed by the document he was likely to mention it three or four more times! He said it did confirm much of what sales counsellor Alison Lemarchel and optom Mark Glover had given in evidence.
Glover had admitted that he would have the PAF open in front of him when selling procedures to customers!
Judge Bailey said an astonishing number of patients were being operated on in one day: Joanna McGraw admitted to twenty-two. (I do wish that Nicholas Yell had questioned Joanna about her pay structure, as he did Mark Glover.)
It was disturbing to hear references to research papers offered as supporting evidence for OE. As with pharmaceutical companies, industry-based funding often skews the results in their favour, as Moorfields surgeon Julian Stevens admitted, when I pointed this out to him during a consultation with one of my clients.
Abbott Medical Optics (AMO) is one such company funding research, and as I have mentioned in previous posts, both Julian Stevens and Steve Schallhorn have highly lucrative consultancy positions with AMO.
The Judge made mention of the fact that OE did not meet the GMC’s Good Medical Practice Guide and this would be likely to give rise to complaints to be made to the GMC.
Unfortunately I have lost count of the number of complaints made by MBE clients to the GMC, none upheld. Today I spoke to two new MBE clients - both operated on by Stefan Klopper, who’s had numerous complaints against him made to the GMC.
Cridland claimed that Stephanie was “well motivated” to undergo surgery, and even had she been advised of the risks would have gone ahead. I hear you shouting “No!!”, as I wanted to do!
With no surgeons present in Court yesterday, it was very frustrating for me not to be able to answer some of the Judge’s questions thrown out to the barristers,
When he asked: “What is MGD?”, they all looked puzzled, with me desperate to shout out, 'MEIBOMIAN GLAND DYSFUNCTION’! But even if I had, it’s unlikely they'd have a clue what meibomian glands are!
After Dr Jan Venter (referred to as ‘Professor' by Joanna McGraw) had retreated Stephanie’s left eye in 2009, leaving her no better off, in reply to her complaint, David Mungall wrote with: “Profuse apologies”.
The Judge commented that Tweedledee didn’t argue or investigate Stephanie's claims but simply apologised. Again, I’d love to have explained to the Judge how many similar letters my clients have forwarded to me.
Judge Bailey said that surely, as Patient Customer Care Manager, Mungall would be clear on procedure. He agreed with Yell that Stephanie had not rushed into litigation and had tried to resolve her eye problems before doing so.
I trust many of you who are in, or planning, litigation now realise why tomorrow’s decision is so crucial?!
I am very pleased that I was able to provide Stephanie’s legal team with the PAF document, because without it the Judge would have had no proof of the pressured sales tactics used by OE.
However, there is someone else who deserves enormous credit for the fact that I was in a position to do so
Without the PAF, Judge Bailey would only have had Stephanie’s word to go on, because OE employees have no problem lying under oath, as I saw for the first time at Luke Cowell’s Employment Tribunal in January.
Be it for financial gain, or fear of David Moulsdale, they are unconcerned that they’re committing perjury. Of course they’ve had plenty of practice working for Optical Express.
NB: Anyone wanting a copy of the PAF for a legal claim against OE should ask their solicitor to contact me.
Should Stephanie surprisingly lose this case, I will ask everyone similarly damaged by OE to write to Judge Bailey. It will be too late to help Stephanie, but it will help future cases that might be brought before him.
I like the Judge - just hope I still feel that way tomorrow
Day 7 in Court 24 Sep 2014 19:40 #12
Apologies to all my 'court blog' fans, but you'll have to wait until tomorrow for today's report.
To those of you disappointed that you'll miss hearing what riot of colour Dr Joanna McGraw was wearing today: please don't be - she wasn't there!
And, as we've got a day off tomorrow while the Judge deliberates, I will have more time to update you before Judgement Day!
The following user(s) said Thank You: Nick
Day 6 in Court... 23 Sep 2014 23:05 #14
Day six began with an early start @ 10.00 am.
Joanna wore the same scoop necked grey cotton knit dress she did last week, patterned with navy blue butterflies!
I'm disappointed that she is obviously not reading my blog after I warned her that , for doctors who have to spend hours sitting in court because they’ve ruined someone’s eyes and life, cotton knit is really not best the fabric to wear as it loses shape when seated!
Dress was topped with a navy blue fitted jacket, nude tights, and midnight blue suede court shoes.
Paul Rosen, Medicolegal expert for the Defence, was the first person called to the witness stand.
Last week Paul sat slouched next to Defence solicitor Susan Silk (great name for legal rep), with his arm arrogantly thrown across the back of her seat, disrespectfully chewing gum in full view of the Court.
Today he was knocked off his arrogant perch when Nicholas Yell opened up with questions about Rosen’s position as Director and 18% shareholder with Rosen Eye Associates Ltd (REA Ltd) from 7 June 2007 to 6 August 2008.
It was like watching a balloon suddenly deflate!
Rosen looked very uncomfortable when Yell asked about his continued position as Director two years after Optical Express had acquired the company, for proximately £250k in October 2006.
Judge Bailey asked Rosen if he had disclosed this to the Court at any time when writing legal medial reports for OE.
Rosen said he hadn’t realised he was still a Director of REA Ltd at the time - hey, did you just see that pig fly by?!
I’m not familiar with corporate law but the Judge is, and he advised Paul Rosen that he should disclose his relationship with Optical Express before appearing as an Expert witness in any case related to them in future.
NB: Anyone previously involved in litigation with Optical Express where Paul Rosen was engaged as a Medicolegal should seek legal advice. If you think this may affect you in any way, for more details, contact email@example.com..uk
Meanwhile, following that unexpected little 'eye opener', Rosen’s bravado vanished as he gulped his way through an entire jug of water.
(I trust Optical Express paid Rosen a considerable amount of money to hang around Court chewing gum for four days!)
Yell began questioning Rosen by quoting some of the Royal College of Ophthalmologists' guidelines. (Remember, Joanna admitted last week that OE don’t follow them)
Rosen agreed that a patient most definitely should meet with the surgeon before the day of surgery. Yell asked him why he thought OE didn’t observe these suggestions, but he had no answer.
Watson and Rosen had agreed on a number of points in their joint medical report, but Rosen said he’d changed his mind on some of them.
The Judge was not happy with this and invited Watson to join Rosen in some ‘hot tubbing’.
Amazing, it worked, and Rosen reverted to his previous recorded joint report with Watson.
I told you he’s a clever Judge! (Today's pin up)
The afternoon was taken up with mind numbing discussions and reports from Employment consultants relating to the amount of damages to be awarded to Stephanie should she win her case.
One conversation did wake me up.
Pre surgery, Stephanie had a successful position buying and selling in the antiqaurium market, so L’il Crid asked employment expert Mr Nicholl where he thought Stephanie would be able to sell if unable to pursue any other aspect of her previous employment.
Hard sell - where else?! I was so temped to shout out “Optical Express!”, as they need highly motivated salespeople - forget good surgeons and expert surgical procedures!
The last witness of the day was Dr Rowe, another employment expert, engaged by OE.
He did his best to talk down the considered living costs needed by Stephanie should she win, but then unexpectedly made me cry!
He said that he hoped Stephanie would be able to again enjoy life as she did before surgery.
Deep breath… I don’t know about anyone else, but I will never again enjoy my life as I did before that fateful day when I underwent laser eye surgery on 18 February 2011
Day 5 in Court... 22 Sep 2014 22:07 #15
Fifth day in court and L’il Crid continued to accuse Stephanie of exaggerating her problems...
It’s easy to bandy words like glare, haloes, starbursts, dry eyes, etc... but the debilitating extent these aberrations have on our lives is impossible for ‘normal’ sighted people to entirely grasp.
If only we could find a way of letting others see through our eyes - not for long though, because whilst the idea of seeing starbursts (like fireworks) everywhere you look (every day) might sound trippy and cool, believe me it’s no fun at all!
‘Suicide’ is a word I have heard from too many people damaged by elective eye surgery since I started MBE, and indeed I too flirted with this consideration in my early post op days.
Somehow I eventually managed to climb out of my depression, and then I got angry - very.very.angry!
And I have stayed angry, which fuels my fight against the corrupt high street industry, and that's how I deal with the mess of my eyes!
Enough about me, as I know many of you are waiting to hear what Dr Joanna McGraw wore today!
(I think her wardrobe must suffer a serious case of colour deprivation, and I imagine when she opens the door it screams silently: “Give me colour, please give me colour!”)
Dr McGraw wore a navy blue pencil skirt, with a navy blue fitted jacket - who knew there could be so many shades of navy?!
The trademark scarf around her throat was royal blue with midnight blue splodges. Joanna wore midnight blue suede court shoes with natural colour tights. I say tights, but of course they may have been stockings. I didn’t like to ask.
Her face was its usual whiter shade of pale.
Stephanie and I wore dark glasses.
Court sat just after 11.30am, when Nicholas Yell (photo below) asked that Optical Express provide evidence of Mark Glover’s
Cridland wasn’t happy about this and said it wasn’t relevant to the case. Judge Bailey commented that surely it wouldn’t take more than a few minutes for Optical Express to produce the evidence.
L’il Crid continued to argue it’s lack of importance, claiming Yell’s query was "nuanced’. Yell responded by pointing out that it was of import, perhaps proving it was in Glover's financial interests to have persuaded patients like Stephanie to buy the more expensive option, also therefore unlikely to explain the serious risks for fear of losing his commission.
Yell said he couldn’t understand why OE couldn’t disclose this information.
Judge Bailey is a shrewd cookie however, and said he had assumed that Glover's commission was 1.5%of the patient’s payment - adding that he thought it very low, until Nicholas Yell pointed out that would be multiplied by 10 to 15 patients per day.
The Judge said that unless there was evidence to the contrary he would accept that as correct.
Just think, if 15 people book surgery in one day - as they mostly do thanks to the intense sales pressure from OE's optoms and “refractive technicians” @ £2k minimum (sometimes £4k), multiply by 1.5% equals £450 - PER DAY in commission alone!!!
(See 'Deposit Refund’ topic on OERML website re sales pressure)
Mark Glover did in fact receive at least 1.5% of the total cost paid by each customer he signed up, so it’s hardly credible that he would put customers off by explaining the very real risks to them!
Judge Bailey commented that Optical Express’ “resistance" to producing this evidence was "a little surprising”.
If only he knew the half of it!
Next was Cridland’s cross examination of Stephanie’s Medicolegal expert, the lovely David Watson.
Mostly repetitive, with L’il Crid trying to persuade Watson that because the risks of PRK and LASEK are so similar there is no need to have a Consent form for PRK, that the LASEK Consent should suffice for both.
Watson very sensibly replied that this idea would set a ”dangerous precedent” for medical procedures.
It was like watching a very dull tennis match with L'il Crid boring us all with the same questions over and over again. Unfortunately Watson was not the best expert witness, but there is a good reason for that.
On too many occasions I have seen a Medicolegal expert destroy what should be a cast iron case, simply by sitting on the fence, or disagreeing with a patient’s specialist's medical report, even when written by a highly experienced and world renowned surgeon.
For those of you who don’t know, Medicolegal experts are paid huge amounts of money, no matter what they say.
Most renowned ophthalmic surgeons (not found on the high street) won’t touch this legal work because they are good enough surgeons to make plenty of money doing what they do well.
David Watson is now retired, but chose not to pursue a career in laser eye surgery and therefore has no bias toward the industry. However, ophthalmic surgeons who sell laser eye surgery whilst acting as medico legal experts very often support Optical Express, even when they’re being paid by the Claimant!
There are reasons for this which I’ll explain another time, as I’m far too tired to do so now!
I’d love to write more, but when I return home from Court in the evening I have to catch up with the endless emails from yet more damaged patients contacting me for help, and find time to shower and eat - not yet done so! I will try to fill in the gaps another time.
is she for real?? 21 Sep 2014 08:50 #16
Check this out:
I particularly like this bit:
"An advanced form of laser eye correction called LASIK is used at Boots. Dr Joanna McGraw stressed that only those suitable for laser eye surgery are recommended for the procedure."
No shit Joanna?
I dread to think of the consequences of someone having laser eye surgery who is not suitable - oh wait, there's quite an irony here!
True or false?! 19 Sep 2014 20:34 #17
If we were to believe OE's lies, that in fact Stephanie was "warned she risked being left with a very bad result because of her type of eyes" (published in The Sun newspaper yesterday), this then begs the question - why did Dr Joanna McGraw agree to operate?
Surely no conscientious surgeon would be willing to endanger a patient's healthy eyes if they believed there was such a risk?!
Day 4 in court 18 Sep 2014 22:52 #18
Due to a conflict with Judge Bailey’s Friday timetable, Stephanie’s hearing is now adjourned until Monday.
Like everyone else who’s been in the courtroom for the last four days - not least Stephanie, I am extremely tired and my eyes very sore, so today’s update will be abbreviated until I have more energy tomorrow.
Joanna McGraw took the stand this morning, and whilst of course I fervently hope that Stephanie wins her case, given the word case scenario, Joanna provided so much information that can be used by others suing Optical Express.
When cross examining Dr McGraw, Nicholas Yell referred to the Guidelines set by the Royal College of Ophthalmologists, recommending that the surgeon should meet the patient at least 24 hrs before surgery, to explain the procedure and allow the patient time to consider.
Yell said: "That's something you don't comply with?"
Joanna's reply was emphatic, just three words: "No we don't."
Yet Dr McGraw claimed that the counselling system at Optical Express is quite robust, although admitted that surgeons only get to spend 3-4 minutes with a patient before surgery.
She claimed that she tells the patient as much as she can within that short time, trying to persuade the Judge that she DID fully inform Stephanie, and performed eye tests, all within a 3-4 minutes slot.
No doubt confusing for everyone in the courtroom who has not gone through the process.
Joanna also claimed she had been betrayed by the system she works for.
Poor thing… I almost felt sorry for her, pushed to meet targets set by that big baddie David Moulsdale. Duh, silly me - Joanna has worked at OE for EIGHT years, so she can’t be too unhappy with the set up!
Mark Glover, the OE optometrist who approved Stephanie for lasik surgery in 2008, was employed by OE from 2007 until 2011. OE’s witness, and he also lied on the stand. Glover is an elderly man, seemingly hard of hearing, yet still registered with the GOC and practising. Yikes!
When Nicholas Yell asked Glover whether he had received commissions for booking patients for surgery, he said yes, but claimed it only equalled 1% of his monthly salary. He denied there were any incentives for optoms and counsellors to get their booking figures up.
Yet I have information that OE offer plasma TVs, iPads. weekend breaks abroad or £500 cheques as incentives.
I’m also told that OE optoms are paid approx 1.5% of the price they persuade a patient to pay for treatment, with the “refractive technician” paid 0.5%
Therefore, even if it were only 1% in 2008, if Stephanie paid £2,900, Glover would have received £29 in commission for her booking alone.
Any OE employees reading this prepared to help me out with more info, please contact me. Confidentiality guaranteed as always.
Dr McGraw told the Court that she often finds patients don’t understand the difference between LASIK and LASEK, so instead of mentioning Lasek she just tells them they’re having a surface ablation.
Let’s just step back and think about this for a few moments.
Firstly, if you didn’t know the difference between LASIK and LASEK by the time you were about to undergo surgery, then you could not have been fully informed, and the consent process invalid.
Secondly, if you were dumb enough not to understand the difference between IK and EK, which even I could explain simply enough so a child of ten would understand, then how could you possibly be expected to know what a “surface ablation” is?!
At one point, in relation to her feelings for a damaged patient, the Judge said to Dr McGraw: “There must be some sensitivity?”
Perhaps Joanna had decided she hadn’t shown a sensitive side to her personality, because as she was excused from the stand, she asked the Judge if she could say one more thing.
Astonishingly she turned to look at Stephanie, and said: “I just wanted to apologise to Stephanie for any hurt she’s received at my hands.”.
She was almost in (crocodile) tears, so perhaps it’s time she listened to her conscience not her bank account, and quit OE!
However, I believe this was a ploy to leave the court with an impression of a sweet caring woman, saddened and traumatised by what she’d done to Stephanie’s eyes.
Call me cynical, but Stephanie’s eyes were damaged in 2008, more than six years ago, and she began litigation four years ago.
If Joanna truly felt regret and wanted to apologise to Stephanie, why has she waited all this time? Why didn't she write to Stephanie years ago and apologise? Why wait to do it in front of an audience in a courtroom?
Instead, Dr McGraw sided with Optical Express who employed grubby PIs to invade Stephanie's privacy, following her, filming through her bathroom window attempting to make her out to be a liar. And they pulled other dirty nasty tricks, which now won’t be discussed in court.
I understand that some of you are enjoying hearing about Joanna's wardrobe.
Today the sweet little blonde wore a scoop necked grey cotton knit dress, patterned with navy blue butterflies, a navy blue fitted jacket and black suede court shoes, with her trademark scarf loosely wound around her throat, this one dark blue with light coloured detail.
NB: A fashion tip for doctors who have to spend hours sitting in court because they’ve ruined someone’s eyes and life - cotton knit is not best the fabric to wear as it loses shape when seated.
Photo of L'il Crid (Slimon Cridland):
Day 3 in Court 17 Sep 2014 22:58 #19
This morning, both Stephanie’s mother and stepfather were cross examined by Simon Cridland.
Unfortunately for the L’il Crid, who did his best to make them out to be liars (unlike Optical Express of course), the estranged couple independently supported all of Stephanie’s claims.
L’il Crid’s well worn comment for the past three days has been: “That is not true, you are exaggerating!”.
I fear no-one, so I advise Simon to stay well clear of me at the end of this case as my arrest would simply be great publicity for my campaign!
Btw, I noticed Cridland's pate catching the light as he scuttled along the corridors during a recess today, so guessing he loves the excuse to wear a wig!
Stephanie called me this evening to tell me the Mail Online had published a story, asking me not to publish it on my sites because she and her mother were upset that the article described Stephanie's visual disabilities, portraying her as a helpless victim.
Stephanie genuinely does not seek publicity, and honestly thought that she could take OE to court, tell the truth - win or lose, and walk away unnoticed.
I explained that by going to court she had forfeited her right to anonymity, and our pride must take a fall if we are to expose this corrupt and negligent industry: that My Beautiful Eyes Campaign is fighting on behalf of tens of thousands of people damaged by Optical Express et al, and we cannot let them continue to silence us.
Stephanie appreciated what I said, and I must make it clear that she is far more sympathetic to the perpetrators of the destruction of her vision (for financial gain) than I am!
Yesterday she told me that she felt sorry for Dr Joanna McGraw, because she didn’t think Joanna had intended to destroy her vision.
Toady Stephanie told me she also felt sorry for Alison Lemarchel, the OE 'refractive technician' called as OE's witness, who sold the £2,900 surgery to Stephanie for an approximate paltry 2% commission, split with the optometrist!
I told Stephanie that she should not allow herself to feel any generosity of spirit towards Alison, who could not possibly claim to be unaware of the numbers of people damaged by OE after ELEVEN years in their employ.
Alison is the human equivalent of a Judas lamb - although a lamb can be forgiven as it's not intelligent enough to have a conscience! Having said that, Alison's badly permed hair was a bit woolly...
I asked Stephanie to consider how many people like herself Alison might have encouraged to undergo surgery during the eleven years of her employment with OE!
Alison left OE eighteen months ago and now works as a wholesale 'sales clerk’' for Cosco - and even Judge Bailey said she needed to get back to “selling coffee”. Although to be fair, I think he mistook her workplace for Costa coffee!
Wherever... safer for the world that Alison Lemarchel sell coffee than eye surgery!
In my opinion Alison - and everyone employed by OE in the sale and execution(!!) of eye surgery is as culpable as Joanna McGraw.
During the past two and a half years I have been contacted by numerous OE whistleblowers, many ex employees who all admit that they were aware of the problems but chose to ignore them in return for their pay packet!
As for Joanna, who has worked for Optical Express since leaving Optimax in 2006, just like her colleagues she left her ethics at the surgery door when she sold her soul to the devil - namely David Moulsdale.
Perhaps you need to sit in my chair for a week to appreciate the extent of the problems suffered by so many, caused by the same surgeons over and over again.
Like many of her colleagues, including David Teenan, Stefan Klopper, Andre Oberholster, Dimitris Kazakos, and Jan Venter (Joanna's fellow countryman recently returned to his ranch with a fat sack of cash) she has had a number of complaints made to the GMC by damaged patients.
Yet the GMC find excuse after excuse to dismiss these repeated complaints, allowing the same surgeons to continue damaging more innocent and trusting victims - all for £32.25 per eye!
I haven’t even begun to cover today’s events in court, and believe me, they were very eventful!
Apologies, but you'll have to wait for more details, but meanwhile, I will tell you that the Defence took a nosedive immediately after lunch, thanks to the 10 page document I persuaded Stephanie’s legal team to look at last night.
It totally supports Stephanie's claims and discredits OE. When Nick Yell produced this document L'il Crid went into apoplexy and looked fit to kill me, demanding to know where this confidential document had come from!
Arguing that it should not be admitted as evidence, he then said he needed to discuss with Optical Express to confirm its validity.
Don't worry Crid, I've got it covered, and more
Perhaps L'il Crid should have studied OERML more closely, and then he could have prepared himself by reading Ireland's Sunday Business Post three days ago.
Remember I mentioned that Joanna smiled at me yesterday? It was a momentary aberration, this afternoon she could have lasered me with her eyes!
This evening, instead of describing Mrs McGraw’s attire, I'm able to show you, because on my way to the train station Joanna failed to notice that I was walking behind both her and a very jubilant Alison Lemarchel.
As the two parted ways you can see Alison was skipping across the road with joy, presumably considering how to spend the generous expenses OE allegedly paid her, which more than made up for the discomfort she suffered on the witness stand lying to Stephanie's barrister, Nicholas Yell.
I have watched Simon Cridland do his utmost to discredit and belittle Stephanie on the witness stand, and her journey to court has been far from easy.
OE have played some dirty games, but spying through Stephanie's bathroom window must be an all time low even for them!
Stephanie told me that had she known how difficult it would be she would never have considered legal action. She has thanked me a number of times for my support in court, but I have told her it's unnecessary, because I speak for every single person like us when I tell her that it us who owe the thanks to Stephanie, for having had the strength and determination to go through with this unpleasant process.
Every time I hear the words "Optical Express" repeated by the barristers - and a real Judge, in a real court room, with so many people finally hearing the truth, it's like a wonderful dream and music to my ears
Oops - almost forgot: www.dailymail.co.uk/news/article-2759324...rss&ns_campaign=1490
URGENT! FAO patients of Joanna McGraw! 17 Sep 2014 10:04 #20
I just want to say, that it's good to have Sasha write that many of us are visually impaired; it seems obvious to us, but all too many other people do not realise just what it is like for us. Even family and friends forget about it, because we manage to get by and do chores etc. It doesn't alter the fact that we have to struggle all the time, and our quality of life is ruined.