Friday, 30 April 2010

april film, book and TV review

FILMS

THE HURT LOCKER,2009 D- Katherine Bigelow. It was such a breath of fresh air when they gave the Oscar honours to this offering, rather than Avatar. I mean, they'd already poured every plaudit imaginable on Cameron for Titanic; they didn't need to do it all over again. This is not a great film, but its low budget belies a film of some power and thoughtfulness.
THE YOUNG ONE,1960 D- Luis Bunuel. His only English language film, set in a bigoted deep south, where, shock-horror, a priest actually emerges as a good guy, for perhaps the only time in any of Bunuel's films, where the church is usually excoriated mercilessly. Highly watchable.
NIGHT AND FOG,1955 D- Alain Resnais. A short documentary about the holocaust, made just 10 years after the war ended. The scenes are now familiar to everyone, but as always, the scene which always gets to me most deeply is of the allies using bulldozers to shovel huge mounds of corpses into mass graves. Lest we forget...
SCARFACE, 1932 D- Howard Hawks. It's 1932, and Howard Hughes puts together a stellar cast to tell a story loosely based on the life of Al Capone. In this version, our (anti) hero seems a little too interested in his sister's love life. This dark implication was only possible in the cinema prior to the introduction of the Hays code. Of her (Ann Dvorak)I can only say, hers is the most beautiful smile in the entire history of Hollywood. If, like me, you've overlooked this one so far, do so no longer.
MARRIAGE ITALIAN STYLE, 1964 D- Vittorio de Sicca. Having made, in Bicycle Thieves, quite literally one of the greatest films ever made, one's expectations are high, but we are correspondingly disappointed by this lacklustre showing. Sure, Sophia Loren looks good enough to eat throughout, but even for me that ain't enough. Probably shouldn't bother.
THE BIG KNIFE,1955 D-Robert Aldrich. Based on a stage play, and it shows. Too much talking, not enough real substance. Palance's performance, however, with his bizarre body movements and strange gurning, is somehow arresting.

BOOKS

EVIL UNDER THE SUN, by Agatha Christie. She's been translated into more languages than any other author and has sold over a billion books. So why haven't I read one until now? I couldn't say, beyond admitting there are huge gaps in my literary education. And this book is certainly fun, requiring a minimum of effort in return. Its language is so simple you can see why it is so widely read around the world, yet Poirot still emerges as a powerful force and a highly original creation.
THE FOURTH HAND, by John Irving. Notable American author turns in a workmanlike performance, but there is nothing particularly outstanding about his work. It's more than an airport book, but not much more.
A BIT ON THE SIDE (short stories), by William Trevor. He's compared favourably with his compatriot Joyce (at least on the dust jacket, but then they would, wouldn't they?)but believe me, although his stories have a soft, gentle atmosphere, almost like Irish rain itself, William Trevor is no Joyce. Nor ever will be.
THE CALL OF THE WILD, White Fang and other stories, by Jack London. These days his stories are criticised for their anthropomorphism, but I say, we forgave Walt Disney for it, so we can certainly do the same for Jack London, whose fascinating tales take us on a journey inside the "mind" of a dumb animal. This Penguin edition, oddly, did not include his story "To Light a Fire" which in this writer's opinion is one of the best short stories of the early 20th century.
ON THE YANKEE STATION, by William Boyd (short stories)A notable, if not exceptional collection of stories, which have something of the flavour of Tom Sharpe. More of a diversion than a literary experience.

TELEVISION

MADMEN, created by Matthew Wiener. The third series ended this month, sealing its reputation as the best thing to come out of American TV since "The Wire". A worthy successor to the Sopranos, with very high scores on acting, direction and writing, puts this in a very select category- unforgettable television. I cannot remember the last time I was left so full of anticipation about catching the next series of a TV programme. And even if there isn't at least one horrific scene of violence in each episode, as in its forerunner, The Sopranos, it nonetheless creates a tremendous atmosphere of tension from beginning to end. Marvellous stuff.

Thursday, 29 April 2010

drinker's remorse

A young man comes today saying he is profoundly depressed, to the point that he is considering "doing something" to himself. I know him quite well as someone who abuses all kinds of substances, though he favours opiates and alcohol. But I have never seen him in this abject state before. He tells me had to drink half a bottle of vodka this morning "to gee me up to come in here". Would he be finishing the bottle later today? I ask. Oh yes, definitely. I point out my difficulty; namely that here he is complaining of depression, while he is taking huge doses of a drug which is actually (despite the initial lift it confers)a potent depressant. He agrees with me that this is untenable.

So I start him on a "home detox" programme, giving him large doses of diazepam to protect him from the shakes, and more dangerously, the DTs, while for his part he promises not to drink. I'll see him again after 5 days, partly to make sure he's still alive.

COMMENT

Gordon's faux pas yesterday was amazing, for its stupidity and ineptness if nothing else. Now this is something for which I have oft criticised him in the past.(they say it never would have happened if Sarah had been there) But was it really so wrong? Mrs Duffy, God help her, voiced, apparently, the concerns of an entire nation when she expressed concern about the level of immigration in general and the influx of eastern Europeans in particular. But isn't blaming incomers for your problems and targeting a specific ethnic minority for your ire the very definition of bigotry? I'm sure in his heart Gordon would like to have pointed this out, but instead he made it even worse by eating the humblest of pies. Poor bugger. He's really had it now.

Wednesday, 28 April 2010

diabetes spectacular

Today, into town for a full day's intensive course on diabetes at a reasonably fancy hotel. It has to be a relevant subject for any GP- there are 3 million diabetics in Britain, and poorly controlled, it kills early and the route to death, with horrible leg ulcers, peripheral neuropathy and heart attacks is not very pretty. Well controlled, sufferers can lead an (almost) normal life, though they are set for a life of hassle, with the need for self monitoring and frequent trips to the doctor throughout their lives. But it obviously doesn't destroy people: after all, Steve Redgrave is an insulin dependent diabetic and he sort of did OK.

For myself, I spent much of the day in private reverie, trying to decide whether I should retire altogether on a full pension when I reach my 60th birthday next January, or whether to continue doing 2 sessions a week, which is my current plan. The day's study hasn't helped. I keep feeling out of my depth, dragged down by outdated knowledge (I know these sessions are supposed to remedy that, but I just kept feeling a growing sense of inadequacy) Fortunately I did notice not a few other peers who appeared similarly confused- this is reassuring at least- I do not appear to be alone. Perhaps the quality of the teaching had something to do with it: lacklustre, uninspiring and repetitive might characterise it. Yes, that's the problem: it's them, not me.

Tuesday, 27 April 2010

kitchen cabinet

Today marks the end of the cycle of workmen visiting our house with their banging and sawing. The boss gave me the final bill (about 25% of the total), but I pointed out that the floor layers had broken the door and that it should be fixed first. He didn't like it, but I said:
"Look. Our kitchen door was working before you arrived. Why should we not expect it to be working when you leave?"
He made like to spit feathers, but got on with the task of what I believe is called "making good". He made good, the door is restored and now I will pay. The whole project has come to some £16,000, and to be fair, they have taken exactly 3, rather than the 4 weeks they originally projected, so I suppose I shouldn't complain.
All that now remains is to put back the houseplants and a few other things still languishing in the garage. So before my wife leaves for the Holy Land next week, it should be pristine in all its faux-Victorian glory.

Monday, 26 April 2010

9 to 5

Monday is my full day at work, but as the quiet interlude continues I find the pace almost relaxing. There are enough free minutes here and there in the day that I am able to read over 20 pages from my book. I'd better not tell my partner though; last time I told her I was reading during surgery, she replied that she would use the gaps to do little pieces of administrative work. Then I didn't feel so good...

Sunday, 25 April 2010

sunday best

The kitchen is really taking its new shape. The chippy came this morning to fit the skirting boards, and before the sawing and banging had died away my wife was all over them with undercoat. The Welsh dresser, in its 2 parts, is returned from the garage and wiped of the thick coating of dust that has accumulated in the 19 years since I bought it. Except for a few water stains from over filled pot-plants, it remains in excellent condition.

This afternoon, courtesy of the Skyplus planner, we settle down to watch Alan Yentob's film, "Van Gogh: a portrait in words and pictures". Based on the recent exhibition at the RA which we went to see back in January, it is what they call a "drama-doc" and I often have problems with these. But the words spoken by the actors are solely those found in the letters and testaments of the actual players, and Yentob has woven a tale of great subtlety and beauty. This strange, tortured genius has been described as one of the 10 greatest artists in history. That puts him in the company of such giants as Giotto, Michaelangelo, Vermeer and Turner. This wonderful programme reminds us why he has every right to sit at their exalted table.

Saturday, 24 April 2010

bonny tiler

It's the end of a tough week for me, having struggled with some nasty bouts of depression, but I would seem to have bounced back a little this morning.

Today we went to the tile shop to choose a variety to provide the splash-back for our new Rangemaster cooker (made by the good people at Aga) We shall incorporate into the design 2 ornamental tiles we bought in Cordoba some years ago. There are only a few things left to be done in the kitchen now, but I am worried about the huge snuggler armchair we have to move in there from our front room. Every time I mention it to any of the workers they hum and hah and then trail off. And I'm not strong enough to do it by myself. Maybe if I throw some money at the problem it will go away. That usually works...

COMMENT

I hear the Musselmen have been angered by the latest irreverent offering from South Park, where Mohammed has been represented by a bear. As it happens, I have seen this episode, and he is actually completely concealed within a bear costume. Even so, they are furious and some have even threatened the creators, Trey Parker and Matt Stone, with the same fate as befell Theo Van Gogh, who was shot for making a film which insulted Islam (I've seen that film, by the way, and it's poor quality bigoted rubbish)
Now it's a well known fact that Trey and Matt have offended almost everyone over the years since their (highly amusing) show began- that's the point, idiot! And while I defend the right of Muslims to practise their faith as they see fit, I would also defend the right of Parker and Stone to make fun of them, or anyone else.
Bottom line, there are limits to free speech, eg: you should not be free to shout "fire!" in a crowded theatre, say, (unless of course there is one) or openly incite murder. But beyond that, it should be pretty much open season to lampoon whom you will- you, me, faiths, political parties, celebs- it's ALL there to be made fun of, and the only criterion then should be: is it funny?

So I say- leave the South Park 2 alone!

Friday, 23 April 2010

neglect reflect

A day off work today, to attend a conference on the subject of neglect. Worse than physical abuse itself, because at least then you know someone is interested in you, if only to beat your brains out. And brain scans confirm the terrible damage inflicted by the process of ignoring: compared to children reared in a loving environment, huge areas of brain are dark, starved of input they will never, can never, grow. And the worst problem? Neglected children are hard to like: they don't respond to affection or indeed to any other kind of attention. So adults, even professional carers tend instinctively to walk on by to some more responsive child. Bitter experience has taught the neglected child that nothing comes of interaction with others; they become insular, isolated and irrevocably lost.

This afternoon (I funked out of the more technical post-prandial session)I settled into watching Steve Davis battle it out with another old-timer, John Higgins, at the BETFRED World Championship (isn't that revolting, by the way? their sickening logo is festooned everywhere)
I used to hate Steve, with his cock-suredness and emphasis on percentage rather than inspiration, but slowly I have learned to like him. Now, the advancing years having reduced his thatch and dimmed his arrogance, he has become a much more human character, not so much "interesting" (as Spitting Image cruelly dubbed him) as venerable and, dare I say it, lovable?

Thursday, 22 April 2010

strange man

A new patient comes to see me today. He is improbably tall with slightly wild, rolling eyes. He is accompanied by a female "carer", who is literally half his size. There is a powerful atmosphere of "something-about-to-happen" in the room. He opens with:
"So, you're the doctor, right?"
"Yes, that's right. What can I do for you today?"
"Do for me, do for me? Why would you want to do anything for me? No, wait. I know what I want to do. I want to look at that map over there"
There is indeed a large map of the country on one wall of my consulting room. I go over to it as well, and we study it together in silence for a few moments. Then I ask him:
"Are you looking for anything in particular?"
"Yes, I'm trying to find where I live. Mm, ah, there it is!"
He points accurately to our city.
"Where do you live, doctor?"
I also point.
"Will you give me your phone number?"
His carer, who has kept her own counsel until this moment, suppresses a giggle.
"No way"
"Why not, doctor?"
"Well, I wouldn't want you ringing me up at 11 o'clock at night just when I was settling down for the night, now would I?"
Surprisingly, this seems to work. He goes back to his chair and we complete our transaction without further incident.

Wednesday, 21 April 2010

not enough work

Is not something I say very often, especially on one of my "long Wednesdays" when I do a surgery in the morning and a baby clinic in the afternoon. But this morning there were only 13 patients to see (it's usually more like 20-22 plus)and this afternoon, just 5 babies required my attention. Damn the unpredictable workload in general practice! All I have to read is a collection of weak, middle-of-the-road short stories. I tell you, mine are better than most of these.

COMMENT

Tomorrow, we will see the second "leaders debate". Or rather, you might; I'll find something else and follow the media later to see what happened. But I imagine someone will ask about immigration, and, like last time, they'll prevaricate, saying they too are concerned about the dusky tsunami of illegals and how to stem it. They won't say that when our economy is booming we need all the Poles or whatever we can get. And they certainly won't invite the audience to consider the awful historical legacy of empire, that we might actually have a moral obligation to all those countries we exploited so expertly, leaving this insignificant little off-shore island, still, years after the dissolution of the British Empire, one of the wealthiest countries in the world.

Monday, 19 April 2010

computer blues

This morning, up late having spent the entire morning watching the TV in bed and sipping 10 year old Macallan. Delightful! Lazy? So what?

This afternoon my desktop in work went offline no less than 3 times. And these days, in the era of the so called "paperless society", the computer is our only access to information. Without it, as they say in America, we are hogtied, and forced to offer people a distinctly sub-optimal service. And talk about stressful! It took me almost all my resolve not to just stalk out of there and crawl back to bed with my whisky.

none of my business

A man comes today with his little baby of 2 months. "Where's mum?" I ask.
"I rather think that is not your concern" he snaps back.
I come back with: "Actually, it is very much my concern, because a GP should interest himself in ALL aspects of the patient's physical and emotional well being. And when a mother doesn't accompany her baby, I am entitled to ask why not"
"She isn't well"
"Anything I can help with?"
"No"
Which answers my question. Because I happen to know she's a smack addict, as he is.
I leave it alone from then on, however. There's no point in pressing the issue; besides now we all know exactly what's going on.

The anticyclone over much of western Europe, which has brought uninterrupted blue skies, though allegedly dust laden, is still in place, and the ash cloud continues to circle it slowly, though this afternoon we have had the first indication that it may soon be designated "safe to fly", at least in northern Britain. But has it ever been unsafe? I'm not saying the mass-grounding has been an over reaction. I'm just saying that future analysis may well prove that in the event, it was.

Sunday, 18 April 2010

good day sunshine

We spent most of yesterday in a sort of reverse-film process, bringing full boxes back from the garage and emptying their contents into our new cabinets. In so doing we were able to fill 2 black and 2 green sacks with stuff we've accumulated, but no longer need, in the 17 years since the previous kitchen was fitted.

In the evening we have just enough energy left to go and visit friends who have the "Let's Dance" game. Much semi-drunken fun was had by all. Over the course of the evening I described the extraordinary ashcloud events of the last couple days as being perhaps the most amazing I have lived through. Someone immediately challenged me with 911, which is certainly a contender, but my point was that this is nature asserting its dominance over the pretensions of humanity in a manner unprecedented in the modern era. 911 was an act of mass murder, and there's nothing unusual about that, in the this era or any other.

Today we both kick back in well justified repose. We settle down to watch an episode of Wallander we recorded the other night. I love the quiet, understated atmosphere it creates, to the degree where at one point a policeman, finding a family so paralysed by grief they have forgotten to eat (something I can identify with), finds the time to make them a hot meal. Do you think you'd see that in an American cop thriller?

Saturday, 17 April 2010

if you just smile

This morning, up bright and early to deliver the cardboard debris resulting from the kitchen installation. It amounts to nearly 60 kg in total and certainly fills our A3 right to its limit. I don't know what cardboard makes to the tonne, but serial kitchen fitters should check. I'm sure it's a better option than dispatching it to landfill, which is exactly where our stuff was bound had we not intervened.

As it is, we have filled a skip with the wreckage of our old kitchen and assorted other detritus, much of which has been added to and subtracted from by various local residents and passers-by in the days since. One close neighbour and equally close friend spotted a large piece of maple worktop and claimed it to use in his photographic studio, while our ancient (26 years old, though still functioning after a fashion) cooker disappeared the day after it was placed on it. But I can report that the construction process is proceeding at a pace, with the floor being replaced next Wednesday, marking (if all goes smoothly) the completion of the project. This will be a considerable relief to us both, as the stress has taken its anticipated toll, although I am pleased to be able to report that this is already fading. Main builder Mike (yes, he comes on a Saturday)told us, just before he left around one o'clock today, that we could begin the task of stocking the new cupboards right away.

COMMENT

You could do worse than consult an interesting website I have come across:

smileofthedecade.co.uk

which basically promotes and explains the idea of laughter therapy. If you're anything like me, however, you'll cut straight to the blog, which is where you'll find the beef. Publishing posts 2 or 3 times a week, our man, Pat Graham to give him a name, dissects the current scene, lavishing praise when he sees fit, though more often excoriating the proud and the stupid in a way that is sometimes vicious, sometimes moving, and at its best, highly amusing and original. His passion can sometimes be uncomfortable to deal with, but the effect is always invigorating. Give him a try!

Friday, 16 April 2010

quiet skies

Yesterday I reminded readers that there is nothing new about Icelandic volcanoes affecting European weather, but the response this time IS new. For a time yesterday, all Britain's airports shut down, along with those in several other countries in north-western Europe, for fear of fouling their engines with the abrasive ash from the Earth's core, as it were. I have heard reports from around airports, particularly Heathrow, where residents have enjoyed a night of undisturbed sleep for the first time in years. They should make the most of it. If the greedy airlines have anything at all to do with it, it won't last...

To me, any curtailing of air travel, for whatever reason, is good for the planet. Every time one of my patients says they're going away on holiday I ask them whither bound, and have as a result discovered the most popular destinations: Thailand seems to be number 1, despite it being half a world away. And these people are often going, not for 2 weeks, but often just for a long weekend. Australia is also very popular, and again many people seem to think nothing of only going for a week or even less. Then there's Florida and Las Vegas, and especially Mexico (usually Cancun) and various other locations in the Caribbean, with the DR coming out way ahead of the others. And why do people like go to these far flung resorts, apparently heedless of the implications for the environment? Is it the sun? Well, I hesitate to say it, but cheap booze seems to be a bigger part of the deal. What is wrong with these people?

It's true that I have been a big world traveller in the past, but in the last five years, as evidence mounts to support the link with human activity to global warming, I have confined myself to Europe, which let's face it still affords me lots of scope for variety, to say nothing of more reliable weather, and leaves my conscience just that little bit clearer.

Thursday, 15 April 2010

sister act

A few months ago, a 10 year old child was brought in with unexplained muscular weakness, to the point where a wheelchair had been organised by her parents. Although there are many possible and ominous explanations for something like this; polio, some sort of muscular dystrophy and so on, the facts are that exhaustive hospital testing had gradually excluded one after another of these possibilities, until we were left with the only viable conclusion: that it was some sort of psychological phenomenon. The parents, as we might have expected, have steadfastly refused to accept this.

Now her 8 year old sister is brought in, sporting her own wheelchair, for she has, alarmingly, developed the very same condition. I try to explain my belief that this must be some sort of "transference" situation, what used to be called hysterical conversion and what is now called primary attention seeking phenomena. She "caught" the "disease" from her sister, and by obtaining a wheelchair for her the parents have unwittingly bought into the extremely unhelpful idea that there really is something physical wrong with her. But they don't want to hear this: they stalk off in disgust, threatening to change their doctor and put in an official complaint to "the highest authority"

Who says the weather isn't interesting? This morning a plume of volcanic ash from Iceland is bearing down on the British Isles, causing numerous flights to be cancelled for fear of their engines failing as the intakes get clogged by the microscopic glass fragments. (though apparently it's too high in the atmosphere to be injurious to health) The question for me is: will this eruption spoil our summer, as has happened so often in the past? Just 18 years ago an Icelandic volcano put paid to our summer, while in 1982, Mexico's El Chicon put out so much ash it spoiled the summer for huge swathes of the northern hemisphere. Please God it will only be a small one this time around. We've endured 3 appalling summers in a row. We REALLY need a good one this year.

Wednesday, 14 April 2010

gay crisis

A young Pakistani man comes in to ask for help with a really tricky problem: he is born and raised in the UK, and is thoroughly "westernised", but his family have been lining up a series of prospective brides for his consideration back in the old country. Now this would be a big enough problem by itself, for someone raised in the (relatively) enlightened west, where people have the opportunity to choose who they spend their lives with, but this poor chap thinks he "could be gay", whatever that means. At just 17, he might well be too young to know exactly what he is, but he does know one thing: he doesn't want an arranged marriage at any price. We have a long chat before I arrange for him to see our practice counsellor. Whether that will help him much I'm not sure, but I have to be seen to be doing something.

This afternoon, I go for my 3rd appointment with my physio, who confirms I have considerably increased my range of movement, whilst conceding I still have a way to go. She gives me some new new moves to work on, while I review her progress with learning to juggle 3 balls. She too would seem to have a way to go, but in that discipline there is often a period of frustrating lack of progress before a sort of "quantum leap" is achieved and you suddenly find yourself in that wonderful position of being able to say, as I told her this afternoon, "Look mum, I'm juggling!"

My next appointment is now nearly 5 weeks away; perhaps both of us will have made some breakthroughs by then

Tuesday, 13 April 2010

drill bang bang

The workers were here early today, and despite my morning off I was out of the house before nine. In continuing pleasant conditions I undertook one of my just-out-of-town hillwalks. I made it longer than usual; anything to get away from the clatter and clutter. On the way home I stopped off at Lidl's for a bottle of their 12 year old Speyside malt. It is useful, rather than outstanding, but redeems itself somewhat by being cheaper than Jameson's. When I returned some time after 11, I retreated to the bedroom and settled in for 3 hours of power outage, insistent hammering and unremitting screeching noises emanating from a variety of different heavy-duty machine tools.

In the event, I found myself quite pleased with my success in trying to block it out from my consciousness and concentrate instead on my reading. And it must be said, as I descended from my bolthole when the time came to go for afternoon surgery, I could see that the kitchen is finally beginning to take shape.

Monday, 12 April 2010

sex crime

This morning, a dementing lady in her 70s is brought in by the staff of the OPH where she lives. Over the weekend she accused a fellow inmate of sexually molesting her. The police were called, who promptly set the whole rape-kit thing in train, swabs, fingerprints, taking the bedding away for DNA analysis, etc. Today, however, and I should imagine this may impede the investigation somewhat, she remembers absolutely nothing of the incident. Thus all the old Bill's efforts will probably come to naught. Not that I don't think allegations like this shouldn't be investigated, but let's face it, she's not going to make a very convincing witness. However, if someone's semen is found on her bedding, it is suddenly going to get a lot more interesting.

As it turns out, she was only coming to me with a bad back...

Sunday, 11 April 2010

sunday best

Meaning a quiet day doing virtually nothing beyond reading, and helping my wife remove a rash of paint speckles that have appeared on her car, rather as if someone was cleaning a paintbrush and shook it off next to it. Soapy water and applying great pressure with a J cloth achieved the task and also constituted a useful upper body workout.

This afternoon I mowed the grass for the first time this year, the season being held back by the harsh winter. In recent years it has been so mild a couple of times I have even found it necessary to do it in January.

This evening some delightful neighbours, who have learnt of our domestic plight, invited us for a very nice chicken dinner. Afterwards, we sat in the dining room until almost encased in evening twilight. Then we remembered the Masters coverage begins early tonight and we broke it up. If it lives up to yesterday's excitement, with Phil Mickelson launching an extraordinary charge on the back nine, it should be brilliant- especially as 2 Brits appear to be in commanding positions as I write this.

Friday, 9 April 2010

viper room

Out today on perhaps the best day of the year so far (if you measure that, as I do, by the criteria of no rain, clement temperature and sunny skies)to walk the Sugarloaf, a mountain of nearly 600 metres, lying just north of Abergavenny in the Welsh Marches.

At one point we spot a small snake which I initially identify as a slow worm, though my wife points out the "V for viper" marking on its head. As I approach it to take a photo, it rears up threateningly and I withdraw cautiously. It was about 50 cm long and as thick as my thumb, and very, very beautiful. This is my first sighting of this relatively rare creature, despite my many years of hill walking: it thoroughly made my day.

friday's children

Today I say goodbye to my two third year medical students who have spent 2 weeks at our practice. They have proved to be bright, thoughtful girls who seem keen to learn under my quirky style of precepting: I concentrate on making them see patients as whole individuals who usually labour under a complex range of problems (as we all do) only the tip of the iceberg showing itself as the presenting problem of the day. I also try to interest them in the history of medicine, as I did this morning, when we saw a patient with polycythaemia rubra vera, a condition where the marrow is set on overdrive, making too many red blood cells, and which unchecked can lead to strokes and heart attacks. It is one of the very few conditions which, even today, is treated by blood letting, as opposed to the vast range of diseases which used to be treated in this way, often to the patient's great detriment.

Sometimes, as it were by fortuitous accident, they got it right and treated congestive cardiac failure in this way, often alleviating the condition considerably. Certainly an improvement on the treatment offered by royal physicians stuggling to treat the moribund wife of Charles II. Having tried everything else, they used their most powerful treatment: putting a number of live pigeons in her bed with her. She died the following day. I tell these stories to the girls, warning them that it will not necessarily help them to pass finals, but may perhaps put their own careers in some sort of context.

Thursday, 8 April 2010

pre mortem wake

The plasterers arrive today and set about their work with speed and precision. The older man leaves early.
"I won't be here tomorrow" he reports. "I'm going to a funeral. We held the wake before Christmas"
This seems a rather long delay between death and funeral, but he tells me this was a "living wake", a delightful idea, though only available to people whose deaths can be to at least some extent predicted. The idea is not new: I think it comes possibly from "lady death" herself, Elizabeth Kubler Ross, but there is another idea which is similar and maybe even better: the "death day party"

This is where someone is given, say, 6 months to live, so if they end up still being alive on that day, they hold a party in their own honour. I'd kinda like to do this myself, if it turns out to be feasible. The attractions of going out like a light, however, as my father did, seem somehow even more attractive. He suffered a fall while on a cruise ship, leading to a catastrophic brain haemorrhage. He lost consciousness within minutes and lapsed into a coma from which he died 3 days later

Wednesday, 7 April 2010

the squalor, the squalor

Day 2 of the kitchen. Last night we used the cooker. Today it was dumped on the skip, in all its antique (26 years old), grease laden splendour. But now there is no running water or cooking,or washing machine facility. The front room has already become a comfortable sty, with us picking our way through boxes of cutlery, tins and cat food pouches. The cats disappear all day, one deep under our sofa, the other to parts unknown. But when the workers leave and all goes quiet again, they emerge warily, driven by hunger, for they have missed their lunchtime pouch.

Tuesday, 6 April 2010

and so it begins

As promised, the builders turn up this morning and press right on with the ripping out of our old kitchen: only our welsh dresser, fridge and washing machine will survive the metamorphosis. Noises off, as it were, lived up to fears and expectation, but on returning home this evening it is mostly done. How long we will have to live like this is not clear, though the figure of 4 weeks has been offered.

And so it begins indeed. For the next month we will have to endure the weasel words and the downright lies, the cant and the grossest hypocrisy, all of which goes under the name of "electioneering". And will it all make any real difference in the end? I would direct you to a poster I used to display on my wall in my student days:

WHICH EVER PARTY YOU VOTE FOR, THE GOVERNMENT GETS IN

Monday, 5 April 2010

calm before the storm

This morning my wife and I go for a walk out on the edge of town; a varied foray through steep woodland paths and muddy fields, with an ascent of about 300 metres. We have a spot of lunch in a nearby pub (bowl of chilli for me, tuna melts for her)before going home to complete the kitchen clear-out. This afternoon, the builder (though tomorrow he will be the destroyer)rings to confirm he'll be here bright and early.

I'm mainly worried about the cats really; they hate loud noises and sudden events, as of course they all do. My wife also, is concerned I fancy, but she remains outwardly bullish. Me? I'm terrified.

Sunday, 4 April 2010

easter funday

Today we go off to my mother's seaside home for lunch. Arrangements having been confirmed (see yesterday's blog,)we duly arrived, armed with the dessert, viz a very pleasant apple crumble from the hand of my wife. My mum seemed tired, almost sleep deprived somehow, but she managed to put on a brave show.

After a very serviceable lunch we walked for a couple of miles along the beach, in bright sunshine, but with a chilly north-westerly breeze. My father-in-law, whatever his mental faculties may be failing him, certainly kept up with our normal walking pace with apparent ease. Later he fell asleep whilst still holding his cup of tea and I was only just able to rescue it before it fell from his nerveless fingers. As it was some did fall right into his lap, giving him the appearance of having wet himself.

Tonight we'll watch the Doctor Who from yesterday which we completely forgot about. Maybe it's a sign. I'm worried anyway: they say the new bloke (producer, that is) hasn't got what Russell T Davies had. But we'll give it a try.

Saturday, 3 April 2010

faith restored

I didn't mention that I went back to my physiotherapist last week for my return visit. I was able to report, with considerable surprise, not to say relief, that my shoulder had improved substantially following the very simple movement programme she had devised. I have always been a little sceptical of the claims of that particular ancillary service, but this is magic! The pain is less, the range of movement greater. She told me I could resume juggling and produced 3 tennis balls with which to demonstrate my skills. Now these are not the ideal balls for juggling, but I am quite experienced and gave her a passable little show. To my delight she then asked me if I could teach her how to get started, which is something I love to do, though I haven't taught anyone for years. I gave her the basic steps; now she and I will meet again in 2 weeks, each working on their own programme.

Friday, 2 April 2010

quite good friday

On a day where brief intervals of sunshine are shot through with much longer periods of rain and gloom, we begin the preparations for the kitchen people who are arriving next Tuesday, to rip out our old one and put in a new one. My contribution: I filled eight cardboard boxes with stuff and carried them down to the garage at the bottom of the garden. That's my mini-workout for the day, if you like. Then later, my wife had to take several forays down there to retrieve things I shouldn't have moved (vinegar, glasses, coffee mugs) that we are going to need prior to Tuesday. Tomorrow is the big day, when we take most of the furniture down there. It's a big space, but I am already doubtful it will be big enough to take everything that needs to be stowed. And the house itself is already crowded.

I had arranged with my mother for us, plus my father-in-law, to go to her house for Easter Sunday lunch, but last night she phoned to say she had "double booked" and could we go on Monday instead. I agreed at the time, but this morning I phoned back to say the kitchen people were coming on Monday (a lie) therefore we would have to cry off. She concedes, but 5 minutes later rings again to say that that wouldn't work. We batted the issue back and forth for a few minutes, before she finally agreed to stick to our original (Sunday) arrangement. I'd like to say this is all about her gradually failing powers of memory, but it isn't. She's been pulling stunts like this all my life, changing arrangements then blaming me (as she did on this occasion) for getting them wrong. It is part of her highly manipulative way, but she forgets that both I and my wife are used to manipulating on a daily basis as part of our job descriptions, and also that we are skilled in resisting manipulation. Nice try, mum...

Thursday, 1 April 2010

mourndy thursdy

Things have been very quiet over the last few days as people gear themselves up for the "spring break". But someone did come in with shoulder girdle pains and a high ESR. I lost no time in prescribing a high dose steroid regime for him. I've made that mistake before, as my readers will know- and no one else is ever going to go blind like that again on my watch.

COMMENT

Unseasonal snowstorms have affected much of Britain, particularly northern Scotland. We'll all have heard of the tragic death of a young person in a bus crash caused directly by the blizzards, but another story from there will be less well known. A seal in a seaside aquarium was washed out to see by a huge wave, and the owners have expressed concern because he is 20 years old and has never known life in the open ocean. Poor thing! Imagine his fear, his bewilderment. In America recently, a killer whale drowned someone in its "pool". A pool! Seals are used to ranging over hundreds of miles of territory; whales thousands. To incarcerate these magnificent creatures in goldfish bowls for our amusement is wrong, and should be stopped.