Man Down

This is a locum blog, written by Mrs Pelagius. The reasons for this will become clear.

Last Wednesday I spent the day in London, finishing my programme of activities with a burger. This was ill-advised. It tasted slightly strange at the time, and by Friday morning I was feeling unwell and experiencing the first stages of a stomach upset. That evening we visited my mother-in-law. By Sunday evening, I was in the grip of a fearsome stomach bug that is only now beginning to recede. Yesterday evening I discovered that my mother-in-law had also come down with the same thing, and today, my husband, on coming home from work immediately took to our bed. Within an hour he was also suffering same symptoms.He remains sufficiently incapacitated to render his writing of this entry impossible.

Strange how one event, and a parcel of germs presumably from someone's unwashed little hands can cause such mayhem.

diarrhoea city

A diarrhoeal illness is sweeping the city, cutting swathes through old people's homes, one of which I couldn't avoid visiting today, as one of its residents was said to be approaching death by a panicked staff. I take meticulous care not to touch anything in there, including the patient, though it is plain to see she is scarcely moribund, and in fact quite chatty. I order a clear fluid regime for 24 hours and whisk myself out within five minutes. As of time of writing I can report no infection has yet set in.

it's finished, get over it

It is said that the hottest day of a heat wave usually marks its last day, and today has proved a case in point. At 2 PM, it was 27.5 degrees in the shade in my garden, making it the hottest day of the year. But by 4 o'clock it had clouded over and the temperature had dropped by several degrees. The glass is still high, but the "march of the depressions" across the Atlantic is relentless; soon they will push our anticyclone aside and there will be rain.

Today a man comes in for blood tests to see if the DVLA will give him back his licence. He lost it because he refused to give a breath test, claiming that the police had no right to stop him. They did, apparently, because he was driving "erratically", though our man did not agree. In fact even now he believes the whole thing was a stitch-up by corrupt police officers, and that he doesn't have a drink problem. His previous blood results contradict him, however, and I force him to concede that the results are conclusive and, moreover, without any possible taint of bias.

roo couldn't do it

After yesterday's manic round of Terfel and Wagner, we feel justified in taking a lazy day, though we begin by taking the mattress off the bed and vacuuming the floor beneath. The cats must have taken a bird under there at some point, played with it to death, as is their custom, and then removed it to another location. The whole area is covered with a thick layer of feathers of all sizes. Finally the job is done, and we relax.

Shame about poor old England, who in the event were trounced by a much better side.
What I keep wondering though, is what happened to Rooney. He didn't have a single good game; indeed, he didn't have a single good 5 minutes at a time. Is there some sort of hidden problem, say in his family, that may emerge later? I can't think of another reason why a man with usually the most highly developed killer instinct, a man who before the tournament said to one someone: "I'm born to win"
And he is too, so what went wrong? And what of the others? Really, none of the England players distinguished themselves in any way: have they all got their own deep dark reasons, or was Capello the problem?

a prince of a faux pas

This afternoon we travelled to the Wales Millennium Centre in Cardiff, there to see the WNO put on Die Meistersingers, featuring Bryn Terfel no less, as Sachs. We took our places, and then a few moments later a middle aged, balding man entered the auditorium. As he was ushered to his seat not far from us, a spontaneous, if somewhat muted applause broke out.

"Who is it?" I asked my neighbour
"It's the Prince of Wales, actually"
"Oh my God no! You know my eyes are so bad these days I didn't recognise him"
"Me too. In fact I only clocked him myself because of the ears"

But my wife was furious with me for my appalling lack of cool.

I take them to task

This evening, unusually for us, we drop over to my mum's home for a brief visit. We bring a little gift from Ireland, viz, a tiny but genuine four-leaf clover. I have also brought half a dozen of my recent photos, including some taken on our Laugharne visit. Finally, I have also brought her own copy of my "Old Man Walking" story, which she read there, and apparently loved.

We study her birthday cards, nearly ten in all, not a bad haul really, though mum points out that one from her cousin, who often comes to stay with her, bringing his family, is not among the collection. I promise to ring them when I get home around 9PM, which I do immediately upon my return.

His wife, My aunt, picked up, as I thought she would, and I explained what had happened, and how mum had been upset by the non-arrival of a card from them. She squirmed a little upon the hook, but I wouldn't have it. At one point she says:
"Well we never get a card from her"
"That's because she's an old lady who is gradually losing her memory. You're a lot younger and your memory is OK. No, there's been a failure of optimal behaviour here"
She began to fight back, but I was all over her:
"Look, I'm only telling you all this because I saw my mum so upset. Now I love my mum a lot, and as it happens I also love you guys. And it's only because I do love and respect you that I felt able to tell you about it. Sorry..."
If I say so myself, it was a masterful performance. All her anger and irritation evaporated, as she admitted that perhaps she did indeed drop the ball on this one. I left it by extracting a promise that she would ring mum and apologise for missing her birthday.
"It's not the end of the world, but I just think it would be nice to close it out like this"
And with that I was gone. It can sometimes difficult to extricate one's self from her on the telephone, but tonight I was able efforlessly to take my leave and leave her doubtless thoughtful over the subject for next while.

at last an ending

Wimbledon: After yesterday's titanic on one of the outside courts which remained unresolved after more than hundred games,it was my belief that today,one of the 2 protagonists in tennis's greatest contest would end quickly in the denouement. In the event it took another 20 games to seal the fate of the doubty frog- truly if there was ever a case of not wanting a loser on either side of the net it was this one. Apparently the American talkshows are agog with the match, and now even more so as it was the yank wot won it. Good for them both, I say.

The air feels a little fresher today,though my barograph is still set fair at 30.2", so more favourable weather may be expected.

This morning in work, an elderly man brings a plastic pot containing a horrifying creature that wriggled out of his rectum in the small hours of the night. 6" long, flesh coloured, and now thankfully dead, it is doubtless an ascaris, or roundworm. He says he hasn't been abroad for over a year, and then to Greece, so the infestation (and where there is one worm, there are bound to be others)may have have remained dormant throughout that time, or (and this is less likely) he could have contracted it here in the UK. I maintain an outward calm, but inwardly I am horrified- the poor man! I send it off to the hospital for precise identification, but he will have to live with his worms for a few more days before they come back with an answer and a recommendation for treatment. This latter, I am pleased to report, usually works quickly.

baby blues

There are 3 doctors in our practice; hence each one does every third baby clinic. I had calculated that this was not my week and would therefore be able to watch the crucial England match this afternoon without fear of interruption. To my horror, however, I was nonetheless informed that it was indeed my turn, so with some grinding of teeth I turned up at 2 o'clock for my session.

In the event, it was a light clinic, and I was able to get home in time to watch the second half, and see England prevail after a nail-biting 45 minutes. Not without interruption though: at the very crucible of the match, with 3 minutes of extra time being played out, I had to field a call from an OPH (Old Peole's Home) where an elderly man had become afflicted with diarrhoea and vomiting (whether due to anxiety over England's performance I did not enquire). I can tell you that I delayed until the conclusion of hostilities to return the call and advise a clear fluids regime for the next 24 hours, and was able to refrain from asking the staff if they had no awareness of the importance of the moment. Presumably they are no sports fans...

I am currently watching an extraordinary match unfolding at Wimbledon where Mahut and Isner (who they? Ed) are locked in a titanic death struggle at no less than 44 games all in the final set, It is a match which must be breaking all records for longevity, if not boredom and frustration in the spectators. Please, won't somebody crack and get the damn thing over with?

One of these days this is going to happen in a final, which I guess is what it will take to bring in a tie-break in the final set, something they should perhaps have done a long time ago.

FOOTNOTE

21.10 hrs: I misjudged thie aboved mentioned match. Now, with play suspened at an incrddible 59 games all in the final set, it has become one of the great tennis matches of all time, and even perhaps one of the greatest sporting phenomena of all time. Never mond their astonishing physical stamina, what of their unequalled mental strength- neither man giving an inch or even choking to the slightest degree, even though both had developed thousand-yard stares and looking virtually out on their feet. We have witnessed sporting history tonight.

flaming june

Last week, even in unreliable Ireland, the weather was set fair all week, and this week here at home it remains gloriously warm and sunny. Seems to me we have waited a long time for a good June; in fact as far as memory serves, the only good ones were when I was revising for exams- and that's a long time ago...

Back at work today, surgery is its usual busy self as after any period of time off. People develop such a brand loyalty for their own doctors that many patients are quite happy to wait till their preferred medic has returned. This might be taken as an ego-stroke, but the fact is that people love their doctors however good or bad they might be; after all, even Dr Shipman had his loyal adherents who refused to believe any ill of him despite overwhelming evidence to the contrary. Well, the ones that weren't murdered, anyway...

a game of 2 halves

As I indicated yesterday, our Irish holiday was in 2 distinct parts- 3 nights in Dublin and 3 in Portrush, county Antrim, in northern Ireland.

The Dublin portion was a wonderful time for us; Bloomsday itself, the 16th June, was for me, and I do not say this lightly, one of the happiest days of my life; a day where everything went perfectly according to plan, and even exceeded the high expectations I had for it. Beautiful weather, warm sunshine, with wispy cirrus clouds adorning a stunning azure vault- just as Joyce envisaged in his original Bloomsday. And the events, with people in original costume reading extracts from the great book, wandering the city tracing the footsteps of the man himself, noting the things that had changed since 1904, and those that hadn't; well, it was such a perfect day; I'm glad I spent it with my wife...

The Ulster segment, however, was very different. On arriving at our bed and breakfast, we took a wrong turning and arrived at the front door of the house next door. The owner arrived just behind us, and when we asked him if this was "the cottage" he swept his hand towards the house and said: "does this look like a cottage to you?"
No "I think the cottage you're looking for is next door" or anything else. He simply turned his back on us and went inside, slamming the door in our faces.

The following day, we were looking for a parking place, when we, quite inadvertently, stole a space from someone who was not quite so quick off the mark as us. When this happens to me, I might curse under my breath, but then get on with it and find somewhere else. But this man leaped out of his car and started to bellow at us as if I'd just raped his daughter. However, I was now ensconced and wasn't going anywhere. He moved away, muttering angrily, and for the rest of the day I half expected him to track us down with a posse of heavily armed Orangemen, intent on tarring and feathering the pair of us.

The following day, we climbed a local mountain. After an arduous climb, we approached the trig point, where a group of older people were sitting with their packed lunches. As soon as they spotted us, they gathered their things together hurriedly and made a quick exit. Did we look that threatening? But they wren't quick enough. I strode up to them and said: "No need to leave on our account, we're mostly harmless, I assure you. We're not even armed"

What is it with these people? Why so unfriendly, so hostile? The contrast with their neighbours south of the border could hardly be greater. In Dublin, everyone fell over themselves to be friendly and welcoming. Well, I've learned my lesson. I shall not be returning to the six counties in my lifetime, unless I can confine myself to the catholic enclaves at least...

blogging on board

Greetings blog followers,if any! I'm reporting live from the Stena Europe, en route to Fishguard from Rosslare, county Wexford, Ireland, having completed a highly enjoyable week in the Emerald Isle; 3 days in Dublin taking part in the Bloomsday celebrations, and a further 3 days in the far north, partly in order to see one of the most famous pieces of geology in the entire world, namely the Giant's Causeway on the Antrim coast.

I intend to report on events in more detail tomorrow, but in summary I would say that the Dublin portion was one of the happiest 3 days of my life, while our stay in Northern Ireland was marked by several incidents of hostility from the local population, some of whose paranoid and unfriendly attitudes smack of the kind of vibe that you used to feel coming off white South Africans in the days of Apartheid. I guess you can see the parallels: both communities used to exert a stranglehold on a separate and dispossessed group, and I suppose they continue to feel a sense of resentment at their lost hegemony.

More tomorrow...

loonday lunch

My father-in-law comes for lunch today, and announces he has lost his front door key yet again. He has come here leaving his door unlocked, which in this (or indeed in any) city is surely unwise, but this is his way. One day a terrible thing will befall him as a result of this sort of thing, but so far the gods have favoured him. My wife accompanies him home after lunch to search for the key, but returns having failed to do so. This makes it 3 keys he has lost in as many months; well at least it keeps the key-cutters in business.

Tomorrow we set sail for a week in the Emerald Isle. I have considered taking my laptop along, and while this may work in our Dublin hotel, it might not help me in the remote B and B we have booked on the Antrim coast, so I have made the decision not to worry too much about posting a daily blog. So followers (if any) will hopefully show some forbearance if I do not manage to keep up my daily schedule. I shall offer a summary of events when I return home, whose highlights should include Bloomsday on the 16th June, and seeing the Giant's Causeway (to say nothing of the Bushmills distillery, which is close by)

DR PELAGIUS'S NEW HIGHWAY CODE

TRAFFIC SIGNALS: NEW PROTOCOL

RED- stop (though see below for more details)
RED AND AMBER- Accelerate aggressively away
GREEN- should the car in front of you fail to move off immediately, leave a reasonable courtesy interval (say, 0.06 nanoseconds) then sound your horn assertively- after all, the driver may be asleep at the wheel, or even dead.
AMBER- again, accelerate violently to avoid being delayed by the red light.
RED- it is now considered safe to continue on your way for up to 5 seconds after the lights have gone red. Don't worry about the possibility of collision with another driver operating the same policy and crossing your path. Traffic signals are carefully synchronised to take this into account.

saturday sense

Yesterday afternoon I set off with my mother for 24 hours in Laugharne, West Wales, the charming little town where Dylan Thomas lived for many years. We paid our pilgrimage to his boathouse, in reality a tiny potting shed where, in between large whiskies, he wrote Under Milk Wood. Our B and B was adequate, though the steeply sloping ceilings rendered it impossible to pee in the loo without leaning back alarmingly and risking staining ones trousers or bringing about a return of the bad back and neck which had hitherto receded. But all in all, under brilliant blue skies, an interesting and happy sojourn.

COMMENT

In the olden days, Any Answers used to be a right old fascist's corner: you know the sort of thing, "I am sir, yours shocked and horrified of Tonbridge Wells, signed Sir Bufton Tufton"

Well, things certainly have changed. Today, commenting on President Obama's scathing rhetoric against BP over the oil spill, we first heard from an oil exploration expert who gave evidence at the Piper Alpha enquiry, ie someone who actually knew what he was talking about. This was followed by someone who noted that the same kind of attack has never been launched from America over the disgraceful behaviour of Union Carbide in the Bhopal disaster in India in 1984- a very, very good point.

This was then followed by another contributor who pointed out that while BP is being asked to suspend its payment of dividends until the mess is cleaned up, no one in the US has ever mentioned putting the same kind of stricture on the banks, whose unbridled greed led in large measure to the world-wide financial crash- a disaster whose effects have been even more far reaching in their implications for ordinary people than even the worst oil spill.

not worried enough

This morning I get a housecall requested by the district nurses, who have visited a lady 5 days out from her amputation of left leg. This is the culmination of no less than 17 previous operations attempting to save her leg following a car crash many years before. The report is of "phantom limb pain" and constipation, but when I ring her she sounds fine, says the pain relief strategy is working and has moved her bowels only 2 days ago. All in all she seems remarkably sanguine about her plight; indeed on further questioning of the nurses, it is precisely this they are concerned about.

I begin to wonder if she isn't a case of "la belle indifference" a psychiatric condition where the patient maintains a breezy and unconcerned attitude to their condition, however serious that may be. If so, I'm not sure quite what to do: tell her to be more worried? All I do know is that I'd rather be faced with this scenario than the reverse, and this of course is much more common, where someone whose anxiety level far exceeds the seriousness of the situation. It's certainly less work for the GP!

post death episode

After surgery, I head round to see Richard Gwyn with my BIG PLAN, viz, to have him teach me writing. He told me:
"I've had this before, actually. I had an Afghani princess round here once, asked me the same question, said I could name my price"
I pointed out gently that I had not said that, rather that the fee might be negotiable should he agree to take me on as his pupil. We parted amicably, my having left my portfolio of stories for him to tear apart, should he decide to help me. I feel strange about leaving them with him; pieces of writing are a bit like your children: you feel outraged if someone doesn't like them, like someone pointing out a wart on your baby's face. But I know it's the only way I'm going to improve. Now I must sit tight and await his decision.

This evening, we watch a new episode of the Simpsons. 22 series, over 400 episodes, has anything in TV history kept up such a consistently high standard for so long? How do they do it? Could be they started with a brilliantly realised idea, then for the next 20 years found some of the best writers in America to write it.

For me, however, each episode I watch is divided into 2 groups, one my son would have seen (he loved it too) and the ones he couldn't have, as they went out after he died. And when I watch one in the latter group, as was the case tonight, I always think, oh yes, he would have liked this one...

stiff little neck

My bad back disappeared after just a few days, but as stress must find its way of expressing itself, should the source of that stress remain unaddressed, so the stiffness has now settled on the left side of my neck- another one of my standard "stress spots". Not severe enough to keep me away from work (I am still able to drive in reasonable comfort) it is nonetheless enough to provide a "background of discomfort"- a low level nuisance which serves more to remind me of my underlying issues than anything else.

After work I went for a city hill walk, hoping to walk off the spasm, and though that ploy was unsuccessful, it was indeed pleasant to walk in the warmth and heavy humidity, which weather forecasters so often refer to as "unpleasant", but which I savour as part of "proper summer". Bring it on!

darkness at 3

Arriving at surgery at 3 PM, I find the whole building in darkness. An electrician is under the stairs, ferreting around in a mysterious way and demonstrating a magnificent workman's cleavage.

It is tricky enough to conduct a surgery when the computers are down, but if the patients themselves are barely visible, it does, shall we say, present something of a challenge to even the finest physician (and I am not the finest physician, believe me)

The first patient proved to be an old friend who is partially sighted, so it is possible she didn't notice. And thankfully, by the time the next one came to see me, the power had been restored.

while I remember

At Saturday's demonstration against the EDL, while I mentioned the ire I provoked by my photographing of 3 Asian women, I forgot to mention the footnote. Although the women made their feelings abundantly clear at the time, a few minutes later one of their associates, a young, curly-blond haired lad found me in the crowd and took it upon himself to underline the points about respecting people's privacy. I listened quietly to what he had to say, then responded that I had "taken on board" his remarks, while emphasising my right to use my camera in a public place, especially in such a highly charged situation as this one.

But this wasn't good enough for him, and he continued making the same points again and again, right down to using the exact same words.
"What part of the sentence 'taken on board' don't you understand, exactly?"
"You shouldn't use sarcasm"
At this point I have to admit I more or less lost it.
"What? Now you're telling me how to express myself? How dare you!"
And as he persisted in this additional criticism, I decided to give him some material with which he could properly come to grips: I told him to go and fuck himself.

day of clay and sunshine

After a late night last night, a long, lazy morning. The threatened break in the weather has not materialised, and it remains fine, if a little breezier than yesterday.

Following a lunch of sausage sandwiches, we settle down to see Nadal carry all before him in the final of the French Open. Truth is he's playing better than ever right now- truly he is the "king of clay"

DR PELAGIUS'S NEW HIGHWAY CODE

3. Indicators.

Some drivers may have noticed a stick-like projection protruding from their steering column and wondered what it was for. The answer is very simple. In the early days of the motor car, drivers would sometimes use a variety of strange devices to "indicate" their intention to change lane or direction. But the practice has largely fallen into disuse.
Do not worry about this. Recent research has shown that most people are in fact psychic and know perfectly well what you intend to do.

missed deadline

It is gone midnight: therefore I have failed in my original intention of posting a blog each day for 1 year. Please forgive.

Yesterday we travelled to Cardiff to register our protest at the "English Defence League" a spurious body committed to being nasty to immigrants. This is particularly galling for Cardiff, which of course has had a highly diverse, and peaceful ethnic community dating back more than 120 years.

In the event, highly organised police action kept the opposing factions over 100 metres apart: their insurance against serious trouble. Here and there a group of protesters would make a break across the "no-go" zone between the 2 groups and the police would move in very quickly with the horses. I got in amongst it at one point and snapped away at anything that looked interesting. At one point I found I had 3 Muslim women in my viewfinder and pressed the shutter. They were incensed, and later some young chap found me in the crowd and expressed his disapproval of taking photographs of the women without their permission. We had a lively debate about the limits of privacy when appearing in a public place; the rights of a journalist to record events on the street as they happen, and so on. When I got home I realised it was inevitably the best image out of the 100 or so I took that afternoon.

It occurs to me what was wrong with their attitude. If you go a demonstration, then your very intention is to be seen demonstrating, is it not? If you want to protect your privacy, what the hell are you doing there in the first place?

not bad friday

Work went well this morning with no unpleasantness to speak of. There was one housecall I couldn't avoid by recourse to a phone call; an old Barbadian lady who's been with me since the beginning. A carer had reported a black spot on her foot, and she being diabetic, thought it best to seek my opinion. One of my staff asked me, how could I see, well, a black spot on a, well, black person. We all had a good chuckle about that one.
Footnote: it was fine.

This afternoon I pop out to the coast to see my mum for an hour, before racing back to see the semi-finals of the French. We drank Grolsch and capped a perfect evening with a Domino's pizza. medium size basic, with added jalapeno peppers)Verdict: I've had worse pizzas. Lots of them...

blue sky thinking

Last night I pigged out relentlessly, gorging on cherries, pineapple slices, toast plastered with hummous, yoghurt and hunks of mature cheddar. I must have looked like some hysterical bulimic. I paid for it around 3 AM though, when I awoke with a savage colicky pain which was only relieved by a succession of copious bowel movements. This morning I felt as if hung over by alcohol, though as it happens, on this occasion I did not imbibe.

However, I was able to give my patients proper value for money and had enough energy left over for a hillwalk in spectacularly fine conditions. Now I am spent, reposing on my sofa watching the girls thrash it out in the French Open semi-finals.

dirty boy

Donning my standard summer apparel of cream cotton jacket and trousers, I go into work. Midway through my first consultation I notice to my horror that the entire right side of my clothes is spattered with cloying, almost black, mud. I manage to get the patient out of the room fairly easily and spend the next 20 minutes sponging it off, spot by smear, with a dampened towel. Fortunately I am eventually able to remove enough of it to be fairly presentable. But I find the whole episode quite unreal and almost dreamlike in its intensity, and the sense of unreality persists for the rest of the morning. I cannot for the life of me account for what happened. Then an idea occurs. Was it on the roll-up door of my garage; But if not that, then what?

I go home for lunch. But first I have to go out the back to inspect the door, but it is soon apparent this wasn't the source of the mud: it seems clean enough. So just how this bizarre event came about remains a mystery to me. The symbolism, however, is not lost on me, and I squirm with this realization.

private medicine

This afternoon, I see a South African national visiting as a guest lecturer. As he is not an EU resident I charge him £40 for the privilege, though I do tell him that if he needs to be seen again within the next week I will not charge him further. Seems like a nice enough chap. Later I see one of my own patients positively stinking of alcohol, and offer him a "home detox", where he will take reducing doses of diazepam while he stops drinking, thereby avoiding the risks of the shakes, or worse, the DTs. But will he co-operate with the regime? They often don't, and I have my doubts this time too. But I have to give him the benefit of the doubt.

COMMENT

Even the Israelis are sounding a bit sheepish after the aid convoy raid- hence this whole thing can go down as a brilliant PR victory for the Palestinians. Pity it took the lives of a number of good, well intentioned civilians to achieve it, but thus is always the way in combating tyranny. What must happen now is for the world to boycott Israel, a la South Africa, severing economic, cultural and sporting ties unless and until the Palestinian people within "greater" Israel are afforded full and equal human rights with the Israelis. Only in this way can a lasting peace be found in this agonised region.