Yesterday I filled in for one my partners and covered the Friday afternoon surgery. Well known as being often the toughest gig of the week, I was certainly out of practice.
When I started out in general practice I did every Friday afternoon for 4 years. I then took my earliest opportunity to hand it on to the new junior partner, who then handed it on herself when a third partner was introduced. Yesterday's surgery showed how dramatic these things can occasionally be.
My very first patient was a 1 year old boy, said to have been unwell all week with flu like symptoms. His temperature was 40.7, and more worryingly seemed irritable, in a way very different from the tired, can't-be-arsed irritable thing little ones often get into. This can be a sign of cerebral irritation, or "meningism". I phoned the hospital to arrange admisssion and next for a taxi stat, knowing this would be the quickest way to get him there. I do hope the whole thing was a false alarm. I love making mistakes, especially ones like being too cautious.
I misjudged my brother, it seems. Within 36 hours of our little chat he had caught the train home, thanking everyone most humbly for all their help and confirming what was plain to see; namely that the sea air has done him a power of good. Good for you mate!
Today we undertook a 9 mile walk through the countryside north of Ross-on-Wye, specifically to catch 2 ancient churches: the church at Dymock, a bluff Norman edifice that even has some of its Anglo-Saxon beginnings still visible, and St Mary's church at Kempley, another Norman church, but notable for its extraordinarily well preserved medieval wall paintings. How they escaped the Puritan vandals I have no idea.I took a few shots, but it's hard to do them justice. The roof is the oldest surviving timber roof in England. I love that sort of thing. Plus it didn't rain, preferring instead to be a delightfully balmy (some call that humid) day out.
Saturday, 30 July 2011
Wednesday, 27 July 2011
the art of willful forgetfulness
Yesterday I had arranged with my brother to go out to the coast where he is recuperating with my mum. We had agreed to share a Chinese take-away. I arrived at 12.15, 15 minutes late, but he had already left, without troubling himself to consult me about my particular preferences. When he returned he had brought egg-foo-yung and sweet and sour pork. I have been allergic to eggs since my earliest childhood, whereas I have never really liked pork, and even if I did it would have been difficult to eat with my teeth in their current state. I allowed myself the luxury of calling him a "fucking idiot", though what I really meant to say, but was unable in the event to articulate, was "You fucking selfish idiot".
In the interests of general concord I let it go at that. However, seeing how much he had improved, I did enquire as to how long he would be staying with mum. He replied that it would be soon, and I had to remind him how tired mum was looking, and pointed out that it would be a shame if he recovered completely but she then collapsed with exhaustion. He took it on board, though it remains to be seen if he heeds my advice. Historically, he has been no better at taking my advice than I his. That's brothers for you...
In the interests of general concord I let it go at that. However, seeing how much he had improved, I did enquire as to how long he would be staying with mum. He replied that it would be soon, and I had to remind him how tired mum was looking, and pointed out that it would be a shame if he recovered completely but she then collapsed with exhaustion. He took it on board, though it remains to be seen if he heeds my advice. Historically, he has been no better at taking my advice than I his. That's brothers for you...
Sunday, 24 July 2011
a chat with the psych
Up to the local DGH (District General Hospital)to see my psychiatrist last Friday. I must be getting better I suppose, because the intervals between appointments are getting gradually longer. It's been nearly 3 months on this occasion, and we agreed that the next will be of the same length.
I had been a little concerned coming up to this appointment, because I really have been feeling relatively OK recently, and didn't really have anything substantive and meaty to offer him. I did talk about my recent dental disasters and the problems with both my mum's and my F-in-L's Alzheimer's. But these, as we conceded to each other, are just normal "life things". And with my writing going well I really do feel as good as I have felt for some time.
Would it be fair to call me happy at the moment? Not sure. I've never put much store by the whole happy thing. To me it's always a retrospective thing: "That time before, when I did that or that was happening, I was happy then." Right now, you're just getting on with stuff, hoping it will be trouble free and trying not to get annoyed about it if it isn't,
I don't think I have ever deliberately sought happiness. Just tried various things to do that would hold my interest. A technique, if you like, for avoiding UNHAPPINESS. Now that I do believe in, and of course like everyone, I have spent quite a bit of time there.
I had been a little concerned coming up to this appointment, because I really have been feeling relatively OK recently, and didn't really have anything substantive and meaty to offer him. I did talk about my recent dental disasters and the problems with both my mum's and my F-in-L's Alzheimer's. But these, as we conceded to each other, are just normal "life things". And with my writing going well I really do feel as good as I have felt for some time.
Would it be fair to call me happy at the moment? Not sure. I've never put much store by the whole happy thing. To me it's always a retrospective thing: "That time before, when I did that or that was happening, I was happy then." Right now, you're just getting on with stuff, hoping it will be trouble free and trying not to get annoyed about it if it isn't,
I don't think I have ever deliberately sought happiness. Just tried various things to do that would hold my interest. A technique, if you like, for avoiding UNHAPPINESS. Now that I do believe in, and of course like everyone, I have spent quite a bit of time there.
Wednesday, 20 July 2011
getting shit in perspective
COMMENT
Yesterday we were all glued to the box as powerful people were brought to book over the failings of their subordinates (or so they would have us believe). But an aid worker speaking on this morning's Today Programme brought us back to Earth. Everyone was obsessed, he said, with a shaving-cream pie in the face trick, whilst in the Horn of Africa a famine had been called, but almost ignored.
Good old Britain has "poured" £52 million into alleviating the problem, but don't we spend nearly as much as that every week in Afghanistan? Come to that, one of the world's richest countries lies just across the narrow expanse of the Red Sea, and what are they doing to help their co-religionists in Somalia? I fear the answer is not a lot. Why not? Is it, I hesitate to ask, because they is black? Maybe they just say it's the Will of Allah. It is what they usually say when something goes wrong, like that time a few years ago when a crowd in Mecca panicked in a tunnel during the Haj and 1200 were crushed to death. I can't help finding that attitude a tad complacent, but then my maco-politics have always been a bit naive.
There is no reason on Earth why a famine should happen anywhere today. The resources are there to solve this problem; indeed, to prevent it happening in the first place. Somalia itself has lots of money, loot the pirates have purloined in the last few years. Is any of that going to be used to help their own people? I doubt it. Is any of the $40 billion of the Murdoch empire going to be aimed at it? See above.
Once again, ordinary middle-class people in the West will dip into their pockets to finance the aid agencies, and nations will donate minute fractions of their GDPs to addressing the problem. And, as always, much of this money will never find its way to ground zero, where millions of men, women and children face one of the most unpleasant fates there is: slow death by starvation and the horrible diseases that engenders. I tell you, we're a shitty planet sometimes, and I'm a part of it. So are you...
Yesterday we were all glued to the box as powerful people were brought to book over the failings of their subordinates (or so they would have us believe). But an aid worker speaking on this morning's Today Programme brought us back to Earth. Everyone was obsessed, he said, with a shaving-cream pie in the face trick, whilst in the Horn of Africa a famine had been called, but almost ignored.
Good old Britain has "poured" £52 million into alleviating the problem, but don't we spend nearly as much as that every week in Afghanistan? Come to that, one of the world's richest countries lies just across the narrow expanse of the Red Sea, and what are they doing to help their co-religionists in Somalia? I fear the answer is not a lot. Why not? Is it, I hesitate to ask, because they is black? Maybe they just say it's the Will of Allah. It is what they usually say when something goes wrong, like that time a few years ago when a crowd in Mecca panicked in a tunnel during the Haj and 1200 were crushed to death. I can't help finding that attitude a tad complacent, but then my maco-politics have always been a bit naive.
There is no reason on Earth why a famine should happen anywhere today. The resources are there to solve this problem; indeed, to prevent it happening in the first place. Somalia itself has lots of money, loot the pirates have purloined in the last few years. Is any of that going to be used to help their own people? I doubt it. Is any of the $40 billion of the Murdoch empire going to be aimed at it? See above.
Once again, ordinary middle-class people in the West will dip into their pockets to finance the aid agencies, and nations will donate minute fractions of their GDPs to addressing the problem. And, as always, much of this money will never find its way to ground zero, where millions of men, women and children face one of the most unpleasant fates there is: slow death by starvation and the horrible diseases that engenders. I tell you, we're a shitty planet sometimes, and I'm a part of it. So are you...
Tuesday, 19 July 2011
johnny doesn't lose his marbles
COMMENT
As many expected, not a lot has emerged out of the grilling of the Murdochs and the Big Haired One, apart from the fact that their media groomers have done their job well, earning their 5 (or even 6?) figure sum for their services. Except perhaps that Murdoch Snr, who hasn't retired, but looks and sounds as if he probably should. He is 80, for chrissakes. My vote for unvarnished honesty goes to Jonnie Marbles, who did what millions must have heartily wished they'd had the guts to do. Good on ya mate!
And let us remember what kind of person dear Rebakah is: a few years ago she was attending a party where she bumped into Chris Bryant. "It's after dark, Mr Bryant", she said. "Shouldn't you be on Clapham Common?"
Her husband at the time, Ross Kemp, was moved to say: "Shut up you homophobic cow."
Their marriage did not survive for long...
As many expected, not a lot has emerged out of the grilling of the Murdochs and the Big Haired One, apart from the fact that their media groomers have done their job well, earning their 5 (or even 6?) figure sum for their services. Except perhaps that Murdoch Snr, who hasn't retired, but looks and sounds as if he probably should. He is 80, for chrissakes. My vote for unvarnished honesty goes to Jonnie Marbles, who did what millions must have heartily wished they'd had the guts to do. Good on ya mate!
And let us remember what kind of person dear Rebakah is: a few years ago she was attending a party where she bumped into Chris Bryant. "It's after dark, Mr Bryant", she said. "Shouldn't you be on Clapham Common?"
Her husband at the time, Ross Kemp, was moved to say: "Shut up you homophobic cow."
Their marriage did not survive for long...
Saturday, 16 July 2011
awkward illness
While we were away in Budapest my mum informed me that my brother had been rushed into hospital. She didn't have any details, and I reasonably assumed it was his kidney stones again. But no. Turns out he had returned from his second home in Burgundy sporting a high fever and barely conscious. Officially he was a case of "PUO", or pyrexia of unknown origin, though their money was on some tic-borne disease such as Rocky Mountain spotted fever, which despite its name is not confined to the American mid-west. The hospital (in Canterbury, where he lives)cracked him on a range of powerful intravenous antibiotics and he improved slowly but steadily each day.
I decided it would be wise to see for myself what was going on, so I made the lengthy journey cross-country to check him out. I was shocked by what I found. He had lost weight and looked very weak and grey. The fact that he hadn't shaved for over a week probably didn't help. But he was ready to be discharged, as his blood indices had improved since his admission to the point where they had now returned to normal, and indeed all the tests failed to provide a definitive diagnosis. There had been an idea for him to come over to my mum's place to convalesce, which considering her parlous state did not seem the greatest idea, but it was clear he would be hard put to look after himself for the next few days, so I acquiesced. Irritatingly, because of the Open golf being played out only a few miles away, I was unable to secure any accommodation nearer than Sevenoaks, more than 50 miles away (my brother's own house being unavailable for reasons I do not intend to discuss here).
So yesterday I brought him back by car and deposited him at my mum's house. No moneys were offered to offset my considerable out-of-pocket expenses, though I was handed a nice bottle of 2006 sauternes for my trouble- better than nothing. How long he will stay au maman is uncertain, though I would calculate anything up to a fortnight. I wish them both well...
I decided it would be wise to see for myself what was going on, so I made the lengthy journey cross-country to check him out. I was shocked by what I found. He had lost weight and looked very weak and grey. The fact that he hadn't shaved for over a week probably didn't help. But he was ready to be discharged, as his blood indices had improved since his admission to the point where they had now returned to normal, and indeed all the tests failed to provide a definitive diagnosis. There had been an idea for him to come over to my mum's place to convalesce, which considering her parlous state did not seem the greatest idea, but it was clear he would be hard put to look after himself for the next few days, so I acquiesced. Irritatingly, because of the Open golf being played out only a few miles away, I was unable to secure any accommodation nearer than Sevenoaks, more than 50 miles away (my brother's own house being unavailable for reasons I do not intend to discuss here).
So yesterday I brought him back by car and deposited him at my mum's house. No moneys were offered to offset my considerable out-of-pocket expenses, though I was handed a nice bottle of 2006 sauternes for my trouble- better than nothing. How long he will stay au maman is uncertain, though I would calculate anything up to a fortnight. I wish them both well...
Tuesday, 12 July 2011
a trip down memory lane
This afternoon I accompanied my mum to her twice-yearly visit to the memory clinic.
The poor love is still preoccupied by her driving embargo, and indeed an appeals form was sent to her while we were away in Budapest. Despite her promising to wait for me to return before completing the paperwork, she did just that and popped in the post straight way. I find it hard to believe she filled the forms in perfectly (which of course they must be) and certainly she did not include a current photo which they asked for, on the grounds that "they've already got one". Give me strength!
Her performance at the clinic was good, although her subtracting serial sevens from one hundred was poor, but then a lot of people have lousy mental arithmetic. In the end her "mini-mental" score was 28 out of a possible 30, which sounds like there isn't a lot wrong with her, but this speaks more to the inadequacy of the test than anything else.
Humourous note: on Sunday she asked us to bring her a copy of the last NoW, having cottoned to the fact that it was closing down. On looking at the many sample headlines from their illustrious past, she saw one which ran:
"JACKO DEAD"
"Jacko dead?" she cried, incredulous.
.
The poor love is still preoccupied by her driving embargo, and indeed an appeals form was sent to her while we were away in Budapest. Despite her promising to wait for me to return before completing the paperwork, she did just that and popped in the post straight way. I find it hard to believe she filled the forms in perfectly (which of course they must be) and certainly she did not include a current photo which they asked for, on the grounds that "they've already got one". Give me strength!
Her performance at the clinic was good, although her subtracting serial sevens from one hundred was poor, but then a lot of people have lousy mental arithmetic. In the end her "mini-mental" score was 28 out of a possible 30, which sounds like there isn't a lot wrong with her, but this speaks more to the inadequacy of the test than anything else.
Humourous note: on Sunday she asked us to bring her a copy of the last NoW, having cottoned to the fact that it was closing down. On looking at the many sample headlines from their illustrious past, she saw one which ran:
"JACKO DEAD"
"Jacko dead?" she cried, incredulous.
.
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