february book and film review

As promised, here follows my book and film review for February.

MURDER MUST ADVERTISE, by Dorothy L Sayers. An immaculate little book featuring Lord Peter Wimsey, who goes under cover in an advertising agency to expose a murderer. The part where he becomes so fascinated by his work as a copywriter that it threatens to impede his criminal investigation is priceless.
GIBBON'S DECLINE AND FALL, illustrated and abridged edition. I read the unexpurgated version in 2008 and pronounced it one of the great books in the English language. I was looking forward to looking at this lavishly illustrated edition, but was dismayed to discover it only actually covered the fall of the Western Empire, leaving out the glories of the Byzantines and even more amazingly the Crusades, which formed one of the most exciting parts of the original. Very disappointing.
THE BROTHERS KARAMAZOV, by Fyodor Dostoyevsky. To be fair, I haven't quite finished this yet; I have about 150 pages to go (out of 900) so I still don't know who dunnit. What I do know is that this is one of the great novels of the 19th century and speaks eloquently to us here in the 21st. Strongly recommended.

FILMS

THE ORPHANAGE, 2007 (D-Guillermo del Toro). Del Toro set himself a very high bar with Pan's Labyrinth, perhaps the best film of 2007. Pity, then,that this doesn't attain that lofty standard.
TRANSFORMERS, 2007 (D-Michael Bay) Strangely enjoyable hocum, in spite of its ludicrous concept; Michael Bay I would suggest does this sort of thing as well as it can be done.
IRON MAN,2008 (D-Jon Favraeau) Again, I probably shouldn't have enjoyed this, but Robert Downey Jnr's performance kept me watching. Whatever else you can say about him, he's certainly got a great screen presence.
FANTASTIC FOUR, 2005 (D-Peter Story) OK, I haven't exactly reached for the heights of world cinema this month. Nonetheless, I kind of got on with this fairly pleasurably. And Ms Alba is extremely decorative, n'est pas?
MESRINE: KILLER INSTINCT,2009 (D-Jean Francois Richet) A French TV movie about the life of one their most notorious gangsters, who, a little like John Dillinger, won the affections of the public despite the nastiness of his crimes, and again, like Dillinger, was eventually assassinated by a police force frustrated with his exploits and multiple escapes from prison. A highly skilled offering in the "violent thriller" mould, equal to anything that's come out of Hollywood in the last few years, and indeed, better than most.

walking in the rain

This morning we set off to climb a nearby hill, notable for the impressive little hillfort that crowns it. Weather forecasts and local conditions appear favourable and as we arrive it is cloudy-bright and tolerably mild. It is a steep little pull of nearly 200 metres to the trig point, but at the summit the views in all directions reward the effort. For me it is an overdue cardio workout, as I have cited inclement weather as a reason not to walk for nearly a fortnight.

We stroll another couple of miles before we find a park bench at which to savour our packed lunch: Heinz mulligatawny soup and cheese and pickle rolls. However, no sooner than we had sat down when the skies darkened and a light rain began to fall. We finished lunch with some haste and made our back down the hill. Soon the rain turned to hail and then settled into a steady downpour. By the route we had taken it took nearly an hour to get back to our car, by which time, annoyingly, the weather suddenly cleared up and the sun came out. Suffice to say it was a delight to get home again, put the central heating on constant and sit in front of the fire in a welcome change of clothes.

a sharp intake of breath

A patient comes today with a series of vague symptoms including "feeling fainty", headaches and a pain in the back of one leg. With my 2 students watching I carry out a cursory examination and conclude there is nothing too much to worry about. After he has left, we discuss the patient, and one of them asks how I can be sure he hasn't got a pulmonary embolism. I finesse this issue with apparent calm, explaining that he doesn't demonstrate enough relevant features to ring my alarm bells, but inside I feel that horrible twist of fear deep in my entrails. Have I missed a PE? If so, the patient could die at any moment and he is only in his twenties. True, it is a long shot; his age is certainly on his side, but even so...

After dismissing the students at the end of surgery I do an unscheduled house call in order to examine him more carefully. True, a call in these circumstances is something more often confined to non-realistic TV series such as the execrable "Doctors", but they have undermined my self belief and I feel I must follow it up, However, the patient is not home when I call, so I must wait until Monday to find out whether he was admitted to hospital as a desperate emergency. At least I advised him to seek help immediately if there were any developments.

lazarus fails to rise from the dead

It did not, in the event, take weeks or months to sort through the 8000 or so de-deleted files PC World provided me with. In fact only about 6 hours of increasingly hopeless scrutiny was needed to sort through them. More than half came up with zilch ("that means they're lost", the PC World guy informed me helpfully). At one point I became quite excited as I realised I had come across a batch of the photos in question, but they were irrevocably degraded: in some only a quarter of the image would appear; the remainder blank. In others just a thin band of image was preserved; enough to see what the picture was, but still totally unusable.

So with sadness and resignation I returned once more to PC World today to ask for my refund. I thought there might be a problem, as I was told I should have asked before I left the store on Tuesday. But, to their credit, they took my word that I had not downloaded any of the images (they checked a few of them themselves) and returned my £99. I am left with the 320gig external hard drive which I had to buy as part of the deal, and one single, solitary image contained within an email.

They advised me to use the hard drive to back up my existing images, which doubtless I will when I work out how to do that.

mr complainy

I feel I should say a little more about complaints; not the latest, as that would not be fair to the complainant, but in general.

On average I get 2 or 3 complaints a year, usually about my attitude (and not, thankfully, about my clinical skills). That means that about 1 in every 3-4000 customers leaves my surgery sufficiently unhappy about the treatment they have had at my hands to take it further. Usually a humble apology suffices (though not always)and we move on. Only very rarely does a patient leave the practice as a consequence, or takes the complaint further. In the latter case, and over the years there have been a few, the local PCT has always found "no case to answer", perhaps because as no one else is present during the consultation, it is impossible to ascertain exactly what happened. After a complaint about my attitude i always resolve to improve my record, though I expect to continue having occasional complaints about my approach for the remainder of my career.

The question I ask myself is, if I fail in my duty of respect once every three thousand cases, but am actually better (or certainly no worse) than the average GP in the remaining 2999, how bad is that? My approach is very much "no nonsense, call it as you see it", and I concede that it doesn't suit everybody. But in any given year, how do I rate with my peers? I know some doctors (my esteemed partner, for instance) who don't get a single complaint from one year's end to the next, while others get complaints made against them nearly every month, sometimes of a much more serious nature than the ones I have to field.

Bottom line: patients do not leave in droves; in fact the list size has grown year-on-year ever since I became a fully fledged partner back in the late 1970s. So I must be doing something right...

PC World of pain

I went in to PC World to pick up my laptop this morning. Yes, all the files have been recovered, and I mean ALL. There are thousands and thousands of files, representing every site I have ever visited, every photo I have ever looked at on the web as well as the 100 photos I am interested in recovering. Many pictures appear to have degraded, though many others seem to have survived intact. To find the pictures I want looks like a gargantuan task- if it it had been one of the labours of Hercules he would have sat down and wept; I certainly feel like doing just that.

To go through all the files could take many solid days of work. I went through a few hundred while I was there, just to make sure it was worth taking it away, and that took me over an hour. So my only recourse is to work away steadily on my grand project, which may take months to complete. I shall give the reader updates on my progress from time to time. Wish me luck!

fielding a complaint

My first complaint of the year, relating to an incident some weeks ago. Truth be told, it was not one of my better performances. I immediately frame a written response, apologising for "any offence you may have felt, however inadvertent it may have been on my part" I challenge some of the more florid hyperbole of the complaint, but offer to see the patient again to meet "in a calmer atmosphere" to put things to rights. I shall keep the reader apprised of developments.

Nothing from PC World today. I shall go in myself tomorrow to hear (what I fear will be) the worst.

lazy sunday afternoon

A lovely morning spent sipping whisky while working through "The Brothers", then at lunch off to a party held all of five doors down our street. Our friend likes to invite only neighbours, and his is a wise decision. They happen to consist of a remarkably diverse bunch of amiable, articulate and talented people.

This evening we will once again immerse ourselves in the Winter Olympics.

Does it get any better than this?

the lost pictures: the saga continues

At nine o'clock sharp I deliver my laptop to PC World. Now it's over to to the wizards in that room at the back to see if they really can work their alchemy. I am a little dismayed to be told at the counter, however, that the wait could be as long as 72 hours before the deed is done, though possibly less, so they will contact me as and when. For my part, I more or less undertook to sit by my telephone. They sound confident all will be recovered with no degradation, but I still find this difficult to believe.

To distract myself I spend much of the day enjoying coverage of the winter Olympics, mainly on Eurosport, as the commentators are just as good as the beeb's and it is broadcast in HD. The women's super G was thrilling this evening, with spectacular crashes, knife edge competition and a tremendous victory for Andrea Fischbacher, who flew down the hill so fast she took off altogether for many metres at one point, but somehow kept her poise and stuck the landing perfectly. Splendid stuff! An example of the best in televised sporting experience.

bloody students

I was not looking forward to going to work this morning. January through March is traditionally the busiest time for GPs, and Friday is the only morning of the week when there is only one doctor on duty. And to be honest, I am still a little shell-shocked after Wednesday's horrendous baby clinic. Finally, it is my turn to have 2 medical students sitting in on my surgery, for we are an undergraduate "teaching practice" At one level this isn't too hard, because at their level (we take them in their 3rd year) they know virtually nothing of clinical medicine; therefore whatever comes up is new and hopefully interesting to them. But it does add another layer of pressure on my shoulders .

In the event, the surgery passes off peacefully, with no patients placing me in an embarrassing position in front of them, which does indeed sometimes happen, say, when someone decides to take me to task for something either done or not done to their satisfaction. In fact 2 or 3 patients do not turn up at all, giving me the opportunity to train them in taking blood pressure and the use of the auroscope and ophthalmoscope. I also have time to give them my stock speech on avoiding arrogance:
"You will already have seen (and they have, more than once) how some patients gush with admiration and even love for me as their doctor. Remember this sort of esteem is afforded us automatically, owing to our (in their minds) exalted position. Respect you will get almost as a given, why, even some of Dr Shipman's patients were fervent admirers (even doubtless some of the ones he murdered)but your mission in life must be to earn that respect by doing as diligent a job as you are capable"

I was going to do a hill walk today, but dark clouds loomed around the sky and as the temperature hovered at around 3 degrees, I passed. Good thing too: on the way home it began to hail in a most vigorous and unpleasant fashion. A good decision.

a quieter day

Blessedly, a much more peaceful day in the surgery. Afterwards I do a bereavement visit on a patient who lost her husband on Monday. The poor sod had suffered terribly in his last months and when I arrive the hapless widow is still in shock, ashen faced, staring uncomprehendingly at a television with the sound off. I sit down next to her to open my spiel, but am almost drowned out by a grandson prattling into his mobile phone on the other side of the room.
"Is there somewhere we talk in private?" I ask, knowing damn well there is not. Surprisingly the young man takes the hint immediately and slopes off into the kitchen to continue his conversation. He is still clearly audible through the thin walls, but it is at least a little quieter.

"I was so sorry to hear about the loss of your beloved Alf. What happened?"
And she tells me the story of Alf's last days in the hospice. This is my job, to let the bereaved tell their story. So many will not go there, preferring to skirt around the unpleasant details, even to the point of pretending nothing really bad has happened at all, but in my experience most people are anxious to tell their story. A cup of too sweet, too milky coffee is placed in my hands by her daughter, and I make all the right noises. In a few minutes, the heart rending story is over. I close with, "If there's anything I can do to help you, please let me know. Remember, the world and his wife will be round here in the days before the funeral, but afterwards they'll all melt away and you'll be left here by yourself. That's the most difficult time, believe me. And that's when I want you to get in touch with me if you feel the need. I'll be there for you"

As I leave the house wet snow is falling thickly, quickly blanketing the car. But as I drive home, the precipitation turns from snow, to sleet, and then simple heavy rain. In twenty minutes almost all signs of snow have disappeared and large puddles have developed at the kerbsides.

baby boom

Today's baby clinic was officially the busiest ever. Partly due to the half-term break, partly because my nurse, who usually does at least half of the immunisations, was on leave. This meant i saw 18 babies, and immunised 14 of them. I also saw 2 "emergency" adult cases, though in the event neither was a true emergency. I always find I am more tired after a baby clinic then any other clinic, though I also get a bigger sense of having made a positive difference to the community than for any other work I do. This time, however, I feel completely drained.

COMMENT

I was appalled to hear the results of a recent attitude survey on the subject of rape. While I wasn't surprised to hear a majority of men appear to think that rape is half the woman's responsibility, horrifically, more than 50% of women, felt the same way. Back in the seventies, I remember a famous anthem of the women's movement:

"Whatever we wear and wherever we go
Yes means yes and no means no"

What happened to that? Now we seem to be back to the medieval position where if a woman wears short skirts or a plunging neckline, then she deserves whatever she gets. This is DISGRACEFUL. It completely ignores the fact that rape is not about some ridiculous fantasy of a man's rampant sexual desire getting the better of him. The truth is very different: rape is about domination, control, power and degradation, and very little to do with erotic feelings. This is hard, apparently, for a lot of people to accept, but it is no less true for that.

Thank God legislation isn't driven by public opinion; if it were we'd still be hanging, flogging and transporting sheep stealers to Australia.

what a difference a week makes

This week's morning off could not be more different from the last. Instead of languishing in bed till noon, I am up by 9 and at PC World by 9:15 to book my laptop in for them to attempt to recover my lost pictures. It may cost anything up to £140, which I will gladly pay as a fine for my stupidity. It remains to be seen whether it actually happens. Then off to Sainsbury's to secure a half litre of semi-skimmed milk (use by 24th Feb), 400 Bennies and a bottle of 12 year old "The Balvennie" doublewood method malt whisky. The blurb reads:
"First- whisky oak cask: imparts mellowness and warming layers of vanilla spiciness-
Second-sherry oak cask: increases complexity, bringing fruity and honeyed depths"

You've got to admit it: the bullshit deployed in the "tasting notes" used to describe the flavour of malt whisky is in a class of its own.

I then embark on a little hillwalk, twice up and down our local 45 metre summit, walking as briskly as possible, partly to get the best cardio workout and partly because of the steady drizzle that falls from a leaden sky.

Then home by 11:00 to read 40 pages of "The Brothers" before lunch. If there's time I might write a paragraph or two of my own short story.

fear of hypertension

A man in his forties comes to surgery today for a blood pressure check and to pick up a prescription for his meds. As usual, I have to engage in a complex dance around the issues he raises: why do I have high blood pressure? Is it only high because of my anxiety at having to come here? Do I have to take drugs to control it? Must I take them for the rest of my life?

The answers to these questions are first, there is no specific reason, no, it isn't your anxiety (or at least that's only a small component), yes, you need drugs to reduce the risk of premature heart attack and stroke and, lastly, yes, you do have to take them for life. But this man, and he is not alone, seems to see his diagnosis as some sort of moral judgement on him, some negative reflection on his character. As usual, it takes upwards of 20 minutes to finesse all these issues (the appointment time allotted is 10 minutes per patient)

The fact is (as I tell him for the fifth time in as many months) that ESSENTIAL hypertension, as it is called, is exactly that. It is ESSENTIALLY high blood pressure- an isolated condition that is not related to any others. And it depends much more on genetic factors than environmental ones. You can be young, fit, a non smoker, not overweight, even be a relaxed, phlegmatic personality type and still have essential hypertension. That's the way it is. God invented the damn thing, not me.

dementia flood

A call late last night from my father-in-law to inform us that "something had gone wrong" with one of his bath taps and that there had been "a bit of a flood". He is never one to exaggerate; in fact if there had been a thermonuclear explosion in his neighbourhood he would probably have described as "a bit of a bang". When we arrive, we find that half his parlour ceiling has fallen in and there is water everywhere. I find the stopcock and stem the flood, then call my tame builder who is blessedly in and arrives in a whipstitch to make the tap safe. Just how it came to break in the first place is not certain, but my F-i-L is not the best of witnesses.

The poor bugger has advancing Alzheimer's, and, slowly but surely he is losing his capacity to live at home by himself. As so often happens in cases like this, such is the desire for the victim to hang on to their independence that it takes some sort of disaster to provide the lever. And this isn't it. So we'll continue to sit and worry about what he is doing and what sort of scrapes he's getting himself into between our daily visits. It's funny really: I used to feel the same sense of impotent anxiety when my son was out on the streets doing heaven knows what.

Later in the afternoon we visit my mum. She lives alone too, and is two years older than the other party, but importantly has retained most of her faculties. I am given two puzzles to solve, however: first, how to make the DVD work (simple) and how to work the windscreen washer in her new car (slightly trickier, but I got there).

On the whole, then, a good visit.

fun in bristol

Today my wife and I go to Bristol to see an exhibition of the work of Iranian artist Alinah Azadeh and Indo-Chinese ceramicist Rosa Nguyen. It is called "The Shape of things", and the contrast between the intimately wrapped "gifts" of Alinah Azadeh and the haunting, etiolated creations of Rosa Nguyen is both fascinating and intriguing.

Our friend Julia curated the exhibition, and it is good to have an opportunity to touch base with her again. We feel especially privileged to be shown round by her.

Later we enjoy a meal of Bouillabaise with her and her squeeze in a pleasant cafe down on the waterfront. After lunch we stride back up the steep hill to where our car is parked, perched at the top of the city near the observatory. It is a good cardio workout, by my standards at least, and takes us through the heart of Clifton, a place I always think I should be living in every time I see it. But it is only 2.5 degrees, just a wee bit too cold to enjoy it properly.

prostate trouble

Not mine, I am happy to report (though it's true I can no longer pee over the garden fence), but the title of a masterclass I attended on the subject.

Most interesting was a personal account of one family's encounter with prostate cancer. Witty, moving and informative, it was the best part of the day. But part of the account enraged me: at one point, after his diagnosis had been established beyond doubt, the patient was introduced to the treatment options, namely radiotherapy or radical surgery. The merits and demerits of each technique were outlined, then the patient himself was asked to decide which course of treatment to take.
"Well, I didn't know which was best, did I?" he stated plaintively, and he was justified. I hate this practice of even some of our most senior doctors; it is truly astonishing in its arrogance. My tip if this ever happens is to bat it straight back to the doctor and say: If it was you in the same position as me, or your father, and he asked you what was the best choice, what would you say yourself? Refuse to be railroaded into taking responsibility for a decision which you are not equipped to take. Don't let them get away with it!

Humorous note: one contributor kept using the phrase "the black afro-caribbean community". I was itching to pipe up with the fact that, the last time I checked, all afro-caribbeans are black (except for albinos perhaps) therefore the prefix "black" isn't just word redundancy, it's plain stupid. But I'm far too polite to go there...

mint imperial nemesis

This morning in surgery I see a patient for a health check. He is the professor of biochemistry at our local medical school. I ask him his weekly intake of alcohol.
"We ask everyone, you know, I'm not singling you out"
"I know, you've got to get your QOF points, haven't you?"
"Quite. So, what is it?"
"I can tell you that it's more than the current recommendations, but as you yourself know perfectly well, the W.H.O. guidelines are purely statistical, and in fact are supported by no appreciable independent verifiable research data. So whatever you say, I shall continue to apply my own rules, which, unlike yours, are based on solid scientific evidence"
I pause for a long moment, then reply:
"You know, if all my patients were as intelligent as you my job would be a hell of a lot more difficult than it is"
We decide to move on to other, less controversial areas.

In the afternoon I go to the dentist to have my crown refitted. Last week I managed to dislodge it by chawing on, of all things, a mint imperial (never again!)Afterwards, I drive out to the edge of the city to walk up a modest hill of about 400metres. I park at about 250 metres and trudge up the steep slope. The sky is a vivid blue, and the keen easterly wind is still blowing, but blessedly the route is sheltered and I am scarcely aware of the cold. Indeed, by the time I attain the trig point at the summit I am puffing and panting a treat, and feeling if anything too hot. But I experience the usual sense of achievement, the more so as I have wimped out of doing any other walks this week, citing the cold as my reason.

a better day

Today I feel better. It is one of the more wonderful aspects of my being that I do not seem able to remain miserable for long. Yesterday's evening surgery was long and difficult, with many complex issues to address; just what I didn't need, but today's surgery has been a dream by comparison; problems easily solved and people who are a positive delight to work with.

One in particular is worth mentioning: a woman who has been seeing me almost since the beginning of my career in general practice more than 30 years ago. Thought by one of my ageing female partners at that time to be a witch, she is in fact more of a seer, sage and general wise-woman. Three hundred years ago she may well have been branded a witch; today she is a respected author and a source of wise counsel to all who know her. She possesses the quality of making everyone who comes into contact with her feel affirmed and at ease. Today, for instance, she is fascinated to hear that I have read Ulysses and that I have written an essay on the subject. I agree to send a copy to her via email.

It was my intention to do my hill walk today, but on leaving the surgery there is a biting easterly wind, the worst wind direction for anyone with any kind of chest problem; moreover, there is a flurry of light snow which seals my decision to postpone my perambulations to a later date. Yesterday my not walking filled me with self disgust: today it simply seems an appropriate decision.

down day

Unaccountably I have had a low day today. No tears, but rather a feeling of lethargy and low morale generally. The guy who has been commissioned to fit our new kitchen called at 1 PM, by which time I had just risen from my bed (it is my morning off, in case you might be worried about my patients)and informed me I need to stump up a 50% deposit- some £7,500. I knocked him down to £5000, but then he was dismayed by the fact that I considered the term "cash" to mean a cheque. I ask him:
"Do you really think I'm going to wander the streets of a major city with 7 grand in banknotes stuffed in my back pocket?"
He walked away with the cheque.

Later in evening surgery, one of my more perceptive, and assertive, patients remarks on my mood. Somehow the fact that he noticed makes me feel a little better.

I tell my wife about my low mood, remarking that I was at least able to read 35 pages of my new big reading project, the Brothers Karamazov.

"Well at least now we know why you're so miserable" she quips. She is such a treasure. I do love her so.

anorexia blues

This morning, a distraught mum comes to see me about her 14 year-old daughter's alleged bulimia. The daughter in question is not in attendance, but mum has brought some pictures on her mobile phone (sign of the times there) for me to peruse. They are of her bedroom and indeed they are not a pretty sight. One is almost inclined to ask whether anyone was hurt in the explosion, for the scene seems to resemble nothing more than the aftermath of a roadside bomb- not that unusual for many young people of her age, I imagine, though there is one notable observation: 2 or 3 half-filled vomit bowls are dotted about the room. The room must smell absolutely hideous.

I agree to make an urgent referral to the local mental health service provider, but refuse to refer her to the Priory clinic as she requests, saying that such an "extra-contractual" referral must, according to the rules, only be made if no equivalent service is offered locally, which of course in this case it is. Mum is not best pleased, but my hands are tied. I expect a letter from the local MP before too many days have passed, unless he is also aware of the regulations; otherwise I will have to enlighten him as well.

put me in a coffin

Up to the local hospital this evening for my MRI. That's right, these days they do MRIs and scans at all times of the day and night in an attempt to get the waiting list down, and it seems to be working; it was only requested a couple of weeks ago.

I make my way through empty hospital corridors and am led, once out of my clothes and into my paper gown, into the scanning room. Last time I had an MRI it was for a skiing injury to my knee, and then I only had to put my lower body inside the scanner. But for my shoulder I must be inserted fully into the machine, and as the top slides over my face it occurs that this is the nearest rehearsal most people ever get to being in a coffin. But that that would be much quieter than this. Soon manic rhythms hammer out, as if Keith Moon were injected with metamphetamine and let loose on a massive drumkit, while other stranger sounds pervade, like some badly played theramin. I try to make songs from the manic beats; one indeed sounds a little like the Who's "My Generation", while another is reminiscent of "Purple Haze" by Jimi Hendrix. Every now and then the technician comes through on the PA to remind me to keep still, but you are already so tightly enclosed there's no room for anything more than the slightest twitch anyway. At last it is over, and I remind myself to advise my patients about to undergo the procedure: "I warn you, it isn't a very pleasant experience"

Could have been worse though. Last time they piped radio 2 into the scanning room; at least I was spared that on this occasion.

a walk in the sun

Today, for the first time in several weeks, conditions are favourable enough for a walk in the country. Under largely sunny skies, and a relatively mild temperature of 9 degrees, we head for the Gower peninsula in South Wales to find 2 iron age hillforts perched in formidable redoubts at the top of high limestone cliffs. Only s few small sections of embankments are still visible, but they are there, and the two mile walk across sodden fields is well rewarded. There is barely a breath of wind inland, but the sea still holds huge kinetic energy from storms far out to sea, and the waves, complete with tubes ideal for surfers (provided they are suicidal), crash vigorously against the foot of the cliffs.

For lunch my wife has prepared cheese and pickle rolls and Heinz tomato soup in a flask. Delightful. I pronounce it the perfect packed lunch for such an occasion.

the little epidemic that wasn't update

I had a fairly senior member of the government come to see me today, and we chatted about the latest phase of the immunisation campaign, that is the offering of the vaccine to all healthy 6 month to 5 year olds, an unprecedented move.

"It might be something to do with the fact that we over-ordered vaccines; in our region to the tune of 1.5 million", he told me. This hasn't stopped the powers that be more or less insisting that we write to each and every one of the parents in question to invite them to bring their little ones in to be jabbed.

As I have already intimated, if asked by parents what my own view is, I have done my best to dissuade them. Today I find with some satisfaction that, the uptake (from the government's point of view, if not mine) has been decidedly disappointing. Good.

hole in the wall gang

I went to the cash dispenser this morning, and found one customer already using it, and another lady some ten feet away from it, who was bending over her pram to attend to her baby. I slipped in front of her and waited behind the man currently withdrawing cash. When he had finished I moved into place, only to find the woman behind me bleating that it was in fact her turn next.
"As I'm in a good mood this morning" I said, "I'll let you go first"
"It's nothing to do with whether you're in a good mood. I was next in the queue in case you hadn't noticed"
"Well I hadn't noticed, actually, because you were so far away"
"I think it's courteous (looking at where I was standing, which was indeed just behind her, I not wanting anyone else to think I wasn't in the queue either)to stand well back so I don't need to worry that you're trying to look at me entering my PIN"
At this point I admit I became exasperated.
"Look. I've told you I didn't think you were in the queue because you were standing so far away. Anyway, I'm not looking at you. Why on earth would I want to do that?"
She glared at me in a very hostile manner at this, but I simply reflected her hostility in my own steady stare back into her eyes.
When she had finished, she turned to me and said:
"Tell me, are you always as rude as this?"
"Oh no" I replied. "Sometimes I'm much worse"

I'm free

Today something big happened. I was driving, listening to a great dance music track. I've always loved its cadences and its beat, and the lyrics also seem to speak to me:

So you're free
To do what you want to do
You've got to live your life
Do want you want to do

It's a sort of anthem for me, and as I listened to the track, cranked at high volume, it occurred to me that it was indeed my great good fortune to be free and to live my life, so sad, so desperately sad that my boy did not have these precious things. And I began to cry like a baby. A bit dangerous at 70 mph, I thought to myself and cautiously slowed to 50, which I found was the safe maximum speed while weeping. In a few minutes it was over and I switched to radio four.

dr goes to brain school

A day off work to attend a neurology study day. All doctors must do at least 30 hours per year of "CME"- "continuing medical education" And as the secretary acidly reminded me as I collected my all-important proof of attendance sheet, it is not the attendance per se that is important, but the reflections upon that study that are most critical to the annual appraisal, where we all undergo a lengthy peer review of our clinical and professional progress. So, what are my reflections?

Well, firstly, may I say that going right back to my student days, I have been impressed, awed even, by the way a neurologist can learn so much about a patient's problem by examination alone. The slightest weakness in this finger, the transient twitching of that muscle, frequently leads them to a diagnosis that is as reliable as one made with a range of all the most sophisticated scans available. Hence my belief that neurologists are the most intelligent breed of doctors (thickest? it's a toss-up between venereologists and orthopaedic surgeons, but that's my own prejudice)
Part of the session was taken up with this precise area, where an unfortunate individual volunteered to be scrutinised by the doctor in front of the crowd, as it were. Even I could see he was terribly damaged; he seemed as weak as a kitten, with stick-thin arms and a whispery voice. With supreme elegance, the neurologist elicited one sign after another to prove that he had that awful slow-motion killer: motor neurone disease.

lucky guy

Some of my patients are such good people, so interesting and diverse and warm spirited, that once the consultation proper is completed I will spend a few minutes discussing non medical issues. One of them is a professional editor of long standing, and when I told her I was writing short stories she expressed great interest, to the point of suggesting I send her a "final draft" of my latest one and make comments as appropriate, This is gold!

Today she has responded, saying she liked the story, but offering a number of observations (thankfully fairly minor ones) that might improve it. As I say, I'm a lucky guy. TE Lawrence had GBS to help him with proof reading and the result, "Seven Pillars of Wisdom" is now a legend in English literature. I do not aspire to those dizzy heights, but this wonderful lady will do just fine for me! On a slightly annoying note, some of her suggestions were almost identical to the ones made by own wife. I must pay more attention to her in the future...