video: The post code lottery.

"Shoshana and Maureen are two distinct characters. Shoshana is outgoing, fast paced, engaged. Maureen, on the other hand, is rather calm and easy going. I admire Shoshana’s tenacity in making sure she has everything she needs, demonstrating a go-getter attitude that is not deterred by the bureaucracy of the health or social services in the UK.  Maureen can be admired for having a wholesome character who accepts the cards she’s been dealt in life and calmly looks forwards to each day anew. In a way, Maureen is lucky she has been well provided by her local authority as well as the health services. She is thankful for everything she has received in a most humble manner that only made me more modest as she speaks of her life with MS. Shoshana, on the other hand, speaks of her life with MS as a series of failures by the health service and paints a rather grim picture of what the situation can be like for someone with MS in the UK:

If it’s not given to you, be prepared to go and get it. Even when it is obvious to you, you may still have to fight to justify it to the health service or your local council. If a service is not available in your area, move to another one if you can.

Although Shoshana and Maureen have two different approaches and perspectives on their lives with MS, they have one strikingly similar attitude towards life in general that is quite representative of the British psyche: the ability, in any eventuality, to keep calm and carry on." 

Maximiliano Braun

Reading, United Kingdom, 12/2011 • Maureen Pankhurst was diagnosed with MS almost 50 years ago, at age 20. Although confined to a wheelchair by her mid-30s, her condition has progressed quite slowly. Now living with her second husband, Neil, she quietly asserts her need to be as independent as possible. She continues to do most of the cooking but when she needs some heavy lifting help, Neil will be at hand. Credit: Maximiliano Braun
Reading, United Kingdom, 12/2011 • Maureen Pankhurst (70) has lived with MS for 50 years, and in the same house almost as long. Over time, the local health council has adapted the home to meet her changing needs. Neil, the next-door-neighbour who became her second husband, is a retired engineer who cares for Maureen and volunteers almost daily as a driver for the Reading Branch of the UK MS Society. Credit: Maximiliano Braun
Reading, United Kingdom, 12/2011 • A retired engineer, Neil Pankhurst quickly adapts to the vast array of equipment needed by his wife Maureen, who has been confined to a wheelchair since before they were married 15 years ago. Both credit the local health council with being sensitive to Maureen’s changing needs, providing a specialised bed and mattress, a hoist and a lift between floors in their home. The Council also installed a ramp to the garden. Credit: Maximiliano Braun
Reading, United Kingdom, 12/2011 • Back from grocery shopping, Neil Pankhurst (back) puts canned goods in the cupboard while Maureen begins preparing dinner. Maureen has been living with MS for almost 50 years; she and Neil have been married for just 15. “It’s a challenge to be disabled and still assert whatever independence you have left,” says Maureen. “At first, Neil wanted to take care of everything for me. I had to tell him that I still need to do what I can. Over time, we’ve learned to balance things
Reading, United Kingdom, 12/2011 • The progression of MS has been relatively slow for Maureen Pankhurst, who was diagnosed almost 50 years ago. Drinking tea with a straw is a recent adaptation, prompted by hand tremors that make it dangerous to pick up hot liquids. Maureen considers herself “one of the lucky ones”, and encourages newly diagnosed people to hope for the best, not expect the worst. A carer, Charmaine, comes every morning to get Maureen ready for the day, for one hour, from Monday to Friday Cre
Reading, United Kingdom, 12/2011 • Neil Pankhurst, returning home, helps un-secure Maureen’s wheelchair in the back of the MS Society van. To continue to qualify as a volunteer driver, Neil had to demonstrate in a smoke & fire simulation exercise that he can evacuate two wheel-chair bound people from a burning van within three minutes. That was a test passed with no problems. Credit Maximiliano Braun
Hove, United Kingdom, 11/2011 • Sorting pills for the week ahead is part of Shoshana Pezaro’s weekend routine. Credit: Maximiliano Braun
Hove, United Kingdom, 11/2011 • Shoshana Pezaro checks emails and messages on a dating site, where her profile clearly states that she has MS. This fact doesn’t appear to deter potential candidates: in just one week, she received more than 50 contact requests. Credit: Maximiliano Braun
Hove, United Kingdom, 11/2011 • Just after lunch, Shoshana Pezaro practices “fatigue management”. If she has many appointments and meetings schedules in one week, she tries to rest most of the previous and following weeks. Shoshana felt relief when finally diagnosed with MS: it created a framework in which she could look to the future with a better understanding of what she could and could not do. She is now a public advocate for better care and opportunities for PwMS. Credit: Maximiliano Braun
Hove, United Kingdom, 11/2011 • A wooden bench that stretches across the tub allows Shoshana Pezaro to shower sitting down. Shoshana uses money from her personal scheme to have personal carers come every morning to help her get up, shower and dress, and prepare breakfast and other meals for the day. “If I tried to do all of that myself, it would use up all of my energy,” she says. “I would just have to go straight back to bed. This help lets me use my energy for what’s important to me – being an advocate fo
Hove, United Kingdom, 11/2011 • Shoshana Pezaro (left) and Jayne Flanigan have just completed the joint effort required to get Shoshana ready for the day, so stop for a cup of tea and a cigarette. Shoshana's personal budget scheme allows her to hire as much help as she needs from month to month. She has carers come every weekday morning and occasionally in the afternoon or evening, but tries to be independent on weekends. The scheme also lets Shoshana bank what she doesn’t spend. She has budgeted wisely, an
Hove, United Kingdom, 11/2011 • Shoshana Pezaro having tea and a cigarrette at her home in Hove with Jayne Flanigan, her carer on Mondays. Shoshana suspects she began to show MS symptoms in her early youth before her teens. It has taken her around 7 years to get diagnosed. After doctors confirmed that she has MS, she says she felt relieved because she could now look forwards to the future knowing what she could and could not do. She is now a public advocate for better care and opportunities for people with
Hove, United Kingdom, 11/2011 • Shoshana Pezzaro (32) thought of herself as never having outgrown the awkward stage of being a teen. UK health policy requires that people select a family doctor in the area where they live. Because Shoshana moved often while in university, each odd symptom or minor injury from a clumsy fall was overseen by different doctor. Unaware that there might be a link between numb legs and loss of colour vision, she never told doctors about her past medical history. Some 10 years pass
Reading, United Kingdom, 12/2011 • Maureen Pankhurst (70) has lived with MS for 50 years, and in the same house almost as long. Over time, the local health council has adapted the house to meet her changing needs. Maureen is grateful to be living in a country with good social services as her experience has been relatively smooth compared to other people with disabilities. She has, pretty much, been well taken care of by her local council. Credit: Maximiliano Braun
Reading, United Kingdom, 12/2011 • Neil Pankhurst “manages” much of the day-to-day work of taking care of his wife Maureen, who is now confined to a wheelchair because of MS. The couple aims to be modest in their demands on the local health council. Credit: Maximiliano Braun
Reading, United Kingdom, 12/2011 • Almost everything takes more time and effort once one becomes confined to a wheelchair. When preparing for bed, Maureen Pankhurst first transfers from her wheelchair to a toilet-type of chair on which she has spread a fabric harness. Once the harness straps are attached, Neil manipulates the electric lifter to complete the transfer into bed. Credit: Maximiliano Braun
Reading, United Kingdom, 12/2011 • Maureen Pankhurst diving in the hyperberic chamber at the Berkshire MS Treatment Centre. Maureen and the others would often dive in the chamber once a week. Although many people with MS feel the positive benefits of a dive, others don't. Many think this should be a treatment offered by the NHS, making it available to everyone with MS without paying privately, but lack of research places hyperberic treatment in the 'alternative medicine' category in the UK. Credit: Maximili
Reading, United Kingdom, 12/2011 • Ariana Adames Carrijo Silva (left) helps Maureen Pankhurst hoist herself out of her wheelchair so she can transfer her weight to the board of a stretching device. Once properly positioned, Maureen will be kept in a standing position for 20 to 30 minutes. This “passive exercise” is important to blood circulation, good functioning of the digestive system and stretching muscles that remain contracted while in a sitting position. Credit: Maximiliano Braun
Reading, United Kingdom, 12/2011 • Once lifted out of her wheelchair and strapped around her legs, Maureen Pankhurst can use her upper-body strength to hold herself upright while leaning on a stretching device. She will be kept in a standing position for 20 to 30 minutes. This “passive exercise” is important to blood circulation, good functioning of the digestive system and stretching muscles that remain contracted while in a sitting position. Credit: Maximiliano Braun
Brighton, United Kingdom, 11/2011 • Shoshana Pezaro (centre) and her personal assistant for the day head home after grocery shopping in the city centre. As not all shops are able to accommodate Shoshana’s scooter, having someone along who can go in and get what she needs is important. Credit: Maximiliano Braun
Photographer: 
Maximiliano Braun

More pictures available for Premium Users. Find out how to become one in the Get involved section

NOTE: Commercial use of any of the Under Pressure footage is restricted. For further information please visit the Get involved section