death in packets of three

First it was a very old lady who fell at home, fractured her hip and developed pneumonia in hospital. Then it was an enormously fat man (he weighed 25 stone) who also got pneumonia, in large part due to the weight of fat pressing on his chest.

Then, finally, and worst of all, another patient, like the other 2, whom I had known since I started in general practice in 1979, also succumbed to pneumonia. But this last man was a real favourite of mine, a really excellent human being, but who like me, had smoked since childhood. Unsurprisingly, he had lung cancer, which I discovered just 2 months ago. Even for such a grim scenario as Ca lung, this was a very rapid decline. The poor bastard had come into the surgery to see me only last week, accompanied by his daughter, who informed me that it had taken him all his energy to get himself there. Slightly abashed, I agreed to visit him at home from now on. But I never got the chance. On the very day, 1 week later, when I had arranged to go and see him at home, we received a call from the hospital to say he hadn't made it.

Yet there he had been, cracking jokes with me, me telling little lies about how well he was doing, you know, considering. We spent much of last week arranging services like an oxygen supply and visits from cancer specialist nurses. In the event, none of these proved necessary.

If and when I get cancer, or some other terminal nasty (and as I like to say to my
patients, you've got to die of something, and it won't be a bit of a cold) will I be one of the ones who slip away in a trice, like this poor chap, or will I be one of those cantankerous buggers who refuse to go quietly? Or will I take a hand and take steps to cheat the terminal disease, whatever it is, and take my own life (should that prove to be possible, which of course it often isn't) No one knows until it happens...

computer schumputer

I was asked to do a locum surgery this morning at another practice in the city. 200 squid for a morning's work is too good to pass up, even when one is already comfortably off.

Considering I have been a practicing doctor for 38 years, obviously there are very few situations that will phase me. But the computer, now that's another matter.

The practice uses a software not familiar to me; with just 10 minutes training I was at sea as soon as the first patient walked in. Add to that my failing vision and the fact that even the practice computer whizkid was unable to unable to enlarge the font, the whole session was something of a nightmare. I spent half the time apologising to patients for taking so long and assuring them I wasn't really blind. So it was not the patients, not the staff, but the verdammt computer that made sure it was a thoroughly unpleasant morning. I'd better get used to it though: I've agreed to work there again next week, and they've said they'd like to have me again after that. Oh God...

TV review

DIRK GENTLY (BBC 4)

Based on characters created by Douglas Adams; series created by Howard Overman; directed by Damon Thomas.

Do you believe in the fundamental connectedness of all things? Dirk (Steven Mangan) does, and by the use of this and other concepts such as chaos theory, (which involves , for example, following the first person he sees from the window on the grounds that they must be cosmically linked to the case)somehow, miraculously perhaps, solves cases referred to his detective agency. I've been a fan of Douglas Adams since HGTG days, and this new series on BBC 4 has been a positive delight. Hilariously written and finely acted, this is a fitting tribute to Adams, who died tragically young of a heart attack in the 1980s.

I've liked Steven Mangan since his performance in the British comedy "Festival", based on the notable Edinburgh event. His supports, including Darren Boyd as McDuff, Gently's long suffering sidekick and Helen Baxendale, McDuff's GF, are excellent. I look forward to the next series with some anticipation.

Strange days as these...

Yesterday I reached another important milestone in the preparation of my memoirs. I have begun the "read out loud" draft. For 2 painstaking hours I worked through about 2000 words. It is proving to be amazing fun, as the reading brings a new insight somehow not noticed before. The correction process is quite beautiful really. I have calculated it will take 100 hours to complete. And of course I will be left with a much better book than I have now.

I was interrupted in my revision by an anguished phone call from a dear friend. It seemed the poor dab had gone totally over the top in a public place and been arrested. She was then transferred to the local bin, where they signed the necessary papers. Would I go out and see her ? What could I say? I agreed, of course, and set a time for the afternoon.

The phone call made me a little late starting to get to my dental appointment at 9.55. I missed the rush, and made it on time. There followed the usual minor series of discomforts one must endure in penance for our laziness hitherto. The stakes are going up in my case. Having all this valuable merchandise in my head these days, I'm obviously going to want to protect my investment. But God, it's a lot of hard work, ain't it?

I am on time for my afternoon liaison at the bin. Nuff said. I did my duty, stood there in solidarity, but it wan't easy.An upsetting business all round, I'd say. After 45 minutes I had to get out of there, and extricated myself with some difficulty. Then in 1 bound I was free, with time enough to get myself a trim from the the lovely Peter. He is a wonderful conversationalist. We were discussing suicide: how we might do it, why we might be driven to it, and today I asked him how well he looked after his teeth, and damn me, there he was, hygienist on the dot, every three months, careful brushing for 2 minutes x2/day, daily flossing. I take my hat off to him and the fairly low, I suspect, percentage of the population who are this diligent.. To complete the experience, he trimmed my eyebrows.

A relaxed dash over to M and S next, in order to secure provisions for the meal we will prepare for my mum this Mothering Sunday. Before going home, I popped into the bank to pay a couple of cheques in, and on an impulse signed myself up for online banking. I tell you, I'm getting a bit modern, believe it.

Dead is dead, however it happens

Afghanistan is awash with grief and justified anger following the terrible killing spree enacted by one (hopefully) demented GI yesterday.
But is what happened any worse than the forty-odd people in an Afghan wedding party "accidentally" killed by American airmen a couple of years ago? Or the twenty-one Palestinians killed yesterday (probably deliberately) by Israelis responding with completely disproportionate violence to rocket attacks launched from Gaza?

They're all dead, and they should all be aive today, were it not for the actions of the callous occupiers of the countries involved. And one thing is sure: in the case of the Afghanistan murders, they would not happened if the Americans hadn't been there.

The sooner the foreigners are out of there, the better it will be for everyone, especially the Afghans.

remembrance of things forgotten

I was hard at work all morning on the 2nd draft of my book. I broke for lunch, and relaxed with an episode of "Law and Order". I was well into my afternoon session of revision when it suddenly occurred to me: I hadn't taken my father-in-law to his lunchtime date at the church hall. At 2.30 pm itwas too late; they had all gone home by now. My only consolation? there's no way he'd remember now, at 4 pm, whether he had gone or not. People must be given respect, whether they remember it or not, and today I failed him. I'll do better next week.

1 DROP 4 TIMES A DAY EACH EYE AND A WORM AT NIGHT

Sums up the treatment regime for my Fuch's dystrophy pretty neatly. The learning curve for the drops has been steep; I got the swing of it quickly. The worm, however, is more of a challenge. One has to squeeze a "worm" of ointment from a tiny tube, which somehow must find itself into the pouch formed when the lower eyelid is pulled outwards. Is it easy getting it in there? Is it fuck. I keep either missing, or raking at my eyelid with the end of the tube, which I'm sure isn't a good thing. But I'll keep trying. After all. I've got the rest of my life to train myself to perfection.

pelagius runs true to form

Charles 11 once said an English summer is two fine days followed by a thunderstorm. I'm pretty much the same. After two glorious little days (qv), it came to a crushing halt this morning.

My wife and I went round to her dad's again to fix his upstairs landing light. After a long, irritable struggle, we gave up and yet again had recourse to seek the help of our old friend Rob. Peace be upon him. The thing is, my behaviour throughout was pretty reprehensible, and I am a bit ashamed. I was selfish, scathing of my wife's efforts though mine were no better. In short, I was an arse.

I am working o my memoirs right now, as followers are probably getting sick of being reminded. What I am trying to say is, as I review my life from the lofty hilltop that is today, I see a much calmer, well integrated and well, cooler guy who inhabited the eighties.

They say age brings wisdom. I fear it is not automatic. I am still struggling to "get over myself", if you follow, and the process gets harder, not easier, as time flows gently past.

amazing days as these

Yesterday was a near-perfect day. When I set out in the morning to my mum's place, thick fog hung heavy over the city. But within five miles of the city limits it had cleared, and a warm, hazy sun was shining.
It was the social worker's visit; yes, at last, after nine months she has reached the top of the waiting list.
Business concluded, my mum and I enjoyed a snack at a nearby cafe.
When I left her I did a strenuous 45 minute walk in the dunes near her house. Wonderfully mild for so early in March.
When I got home I worked on the second draft of my memoirs for two hours.
I then broke off to read forty pages of my book.
In the evening, out with my wife for an Italian.

Today I rose early to complete an arduous training programme on alcohol awareness. It was nearly two hours of concentration later when I finished it. The pressure was on too. I have signed up for a full day intensive on alcohol next week at the Hilton, no less, but I must obtain a score of 75% to qualify! Pressure! I got 82%. Phew!

Later on a crisis brewed up round at my father-in-law's: his lights had gone. We worked out it was one of the antedeluvian fuses, which was then followed a manic dash half way round the city on a fruitless search for 5 amp fuse wire, until we lighted on Maplin's, bless them. Problem solved. Thanks Rob, you're legend!