He does all his own stunts, you know

This blog may have given the impression that I live surrounded by carrara marble (less expensive that I’d thought) and precious metals, bathe in Santovac 5 (not a practical or desirable bathing fluid, but reassuringly expensive) and have an extensive staff (below stairs) to cater to my every whim.  If so, you have been misled: I don’t have so much as a cleaner, let alone a stunt man.  Frankly, I’m not sure that in my quotidien existence I’d have enough use for a stunt double to make it worth hiring one on a full time basis: though this week one might have been handy.

Somewhere in the cloud, in an unfashionable corner of Facebook, there is a short video from Tuesday of the author performing a near-prefect back lever on gymnastic rings for a good two seconds.  The more tech-savvy among you may be able to track down this screen gem.  As the title of this post suggests, this is the actual author and has not been faked.  On this occasion, I was fully in control of my movements – or I was until the oxygen ran out (I cannot yet breathe in the full hold).

Later that evening, thanks to the malign efforts of a feline assailant, the author performed another acrobatic manoeuvre but this time without so much control.  As I was cycling up to the theatre, a ginger cat (its colour is not relevant, but is included to add substance to the account) decided to hurl itself under the front wheel of my bike.  If I am known for anything, it is for my lightening reflexes, and so I was able to stop the bike without hitting the animal assassin.  Despite liking to think of myself as a dangerous maverick, it would seem that I am still bound by Newton’s Laws of Motion.  So, while my bike stopped very quickly and efficiently, my own journey did not cease at quite the same time.  As a result, I sailed over my handlebars and landed in a crumpled heap on the road, somewhat entangled with my bike.  Sadly, there is no footage of this incident, but I like to imagine that my passage through the air was marked by its singular grace before my travels were brought to an abrupt end by the tarmac.

What happened next, says quite a lot about me – though does not necessarily show the author in the most favourable or logical light.  Having come to rest, I lay there for a moment or two cursing my assailant – who had vanished into the night by this stage (it failed to leave any insurance details or make any sort of apology, but I suppose that’s cats for you).  I then returned to my feet and checked for witnesses and whether I would need to attempt to “style-out” my unconventional dismount.  My isolation confirmed, my first concern was for damage to the bike.  This seemed ok and so I mounted it again and continued on my way.  This involved a degree of discomfort, but seemed to go alright until I came to park my bike at journey’s end.  At this point, I believe my body moved from embarrassment into shock and I felt quite unsteady on my feet.  Nonetheless, I made it to the foyer of the Nuffield Theatre looking only slightly like Banquo’s ghost.  At this stage, I went more fully into shock – which is an interesting experience, lots of tingling in the extremities, a reduced ability to form coherent sentences and feelings not unlike those that arise just before you faint.  Luckily, at this point I was surrounded by people who know me (and that I do not normally look like one of the undead) and had access to a chair: so I sat down.  Staff at the Nuffield manage to rustle up a glass of coca cola (which seems the modern, more rapidly conjured equivalent of hot, sweet tea) and so unusual did I feel that I actually drank it.  I soon started to feel much more normal (or at least like myself, which may not be the same thing) and it was only at this stage that I decided to ascertain the damage to my body (a rather long time after checking the state of the bike). There were cuts, grazes and contusions along with some minor bleeding on my legs and some discomfort from my hands which had presumably broken my fall.  Inspection of my cycle helmet, which was the only serious protection I’d provided to my body, indicated that it had not had been called upon to serve in the “incident”.

Most of the damage to the author was of a nature that he regularly inflicts upon himself by his inability to walk round objects, preferring to take the short cut through them, but the damage to my left hand and wrist was more severe.  As a result, I decided against cycling home and thought the bus would be a better option.  A friend decided that this was not appropriate either and, while was eventually convinced not to take me straight to casualty (without passing Go), insisted on driving me home and on regular text updates that I was still numbered among the living.  (*** Spoiler alert *** I survived)

I must say that if you are a Friend of the Nuffield Theatre you are not part of  a one-way friendship, or it certainly hasn’t been that way for me.  Being a “regular” definitely has its perks when it comes to arriving at a venue in a sub-par condition.

So, I had an unexpectedly early return home (without my bike) and decided to start icing my left hand with a freezer pack.  Yesterday morning, with my left hand/wrist still giving me gyp, I took myself to the Minor Injuries Unit at the nearby Royal South Hampshire.  On the basis of this trip, I would suggest that the NHS is now a provider of car parking with a small healthcare side business.  Signage to the various car parks was extremely clear, but that to any kind to medical facility substantially less so.  Still, having found the MIU and filling in an extensive form (not ideal with damaged hands), I was seen very quickly.  It seems unlikely that I have broken anything, I’ve just strained or sprained my wrist and I was told to continue with exactly the attempts at self-medication I was already using (on my recent performance when it comes to self-diagnosis, a career in the medical profession must be on the cards).

I have now moved on from the rigid freezer pack to the more malleable form of a bag of Waitrose Essential Peas and Beans (broad and french) to soothe my sprain (well, it was that or a pack of frozen broccoli, which I felt would be less conducive to a swift recovery).  Yes, this is dangerously middle class but I hope it is speeding my return to full function.  When required, I take painkillers – but mostly I can function without.  My left-hand is fine for typing and can play the piano and guitar a little, though fff and barre chords are currently ixnayed.  I’m right handed but make a surprising amount of use of my left (as I am now discovering), but I am slowly finding work-arounds.  Even remotely heavy lifting is currently out of the question (as are gymnastics) and buttons are surprisingly challenging: but life can broadly continue as usual while I heal.  I must admit that the lack of serious exercise is starting to get to me already, I’m trying to think of a workout that can be performed without use of my left-hand – but the options seem limited.  I may have to use a treadmill and actually run: urgh!

Pleasingly, my wrist has finally become somewhat swollen: there is little more dispiriting than being a brave little soldier when nobody knows you’re injured (another positive of this post).  I am also taking this is a sign that the process of recovery is underway…

Regrettable repercussions?

I’m sure Jeremy Hunt must have some admirable qualities.  If nothing else, his gift for concealing these qualities from the casual observer must be commended – though he may be taking his natural modesty just a little too far.  I have reason to believe that he might be a viable choice of translator on a trip to Japan, but a much poorer one if the purpose of the trip is the sale of marmalade (or other preserves) to the indigenes.

I strongly suspect that PPE followed by a career in teaching english to Johnny Foreigner and then PR may not have fully equipped him for his role as titular head of the Department of Health.  The placebo effect, along with its evil twin the nocebo effect,  are notoriously tricksy to come to terms with – even for those with the qualifications to do so.  My own knowledge of the field comes from Daniel Moerman’s very readable book Meaning, Medicine and the ‘Placebo Effect’ – so I am far from expert (but still massively over-qualified for the role of Health Secretary).  This makes very clear that the impact of medicines on a patient can be impacted by rather unexpected factors.  The size, colour and shape of a pill can all alter its clinical effectiveness, as can the number of pills taken (as with heads, two pills are better than one – even if the active ingredient is exactly the same).

The latest policy wheeze dreamt up by Mr Hunt (or his minions – but as our health Gru he must carry the can) is to print the price paid by the NHS for more expensive drugs on their packaging.  It strikes me that this information is likely to have some psychological effect on the consumers of the drugs and this suggests that some unintended clinical consequences could easily arise thanks to our spooky friends placebo and nocebo.  Will we suddenly find that cheaper drugs lose some of their effectiveness?  Could this cunning plan actually force up the NHS bill for drugs?

Even without considering such weird consequences, basic psychology might suggest that some patients taking more expensive drugs could reduce their intake out of a mis-placed sense of civic duty.  If this occurs with antibiotics, for example, we might be unwittingly feeding the growth in resistance.

Surely some drug prices will reflect better or poorer price negotiation by the NHS or on the level of competition in the marketplace.  I’m not sure this data should really be informing either prescribing or subsequent patient behaviour – it should rather be informing procurement within the NHS or regulation of drug companies or the market.

Finally, I cannot help but notice that drugs do not come in normalised quantities such that every prescription contains the same number of days (or doses) of treatment.  As a result, cheap pills bought in large quantities might appear more costly than expensive ones sold in only small doses.  This is going to hopelessly muddle the financial signal we are trying to send to patients, even if by chance they do latch on to the desired response to the new price data.

I strongly suspect that the results of this new initiative will bear little relation to those planned – always assuming there is a plan rather than just implementation of the ravings of a power-crazed buffoon – except to the extent that we live in an infinite multiverse and by random chance we may be living in the one of all possible worlds where Jeremy gets lucky.  However, as no-one will probably bother to measure the results properly – or honestly report them if they do – we will probably never know.

Oh, what a time to be alive!  (And preferably in good health…)

Cold comfort

Some readers may have been wondering about the break in service here at GofaDM, most (I suspect) will have just been enjoying the peace and quiet.  A few may have correctly guessed that my cold, once eliminated from my sinuses, did not do the decent thing and leave my body.  No, instead it chose to begin a seven day residency in my chest and throat – which has meant me spending much of the last week coughing (both day and night).  I have also had much reduced appetite – though in some ways, for a chap trying to base his diet on local fruit and veg, this is about the best possible time of year to eat rather less.

I am far from alone in suffering under a prolonged cough, based on my friends and family, I am thinking of naming 2015 the Year of the Cough (though I note that our Chinese friends went with the Goat).  Indeed, I spent last week staying in an unseasonably warm Edinburgh with friends who were both similarly afflicted.  Obviously, this rather limited my scope for sympathy – but the excellent Edinburgh Science Festival provided further restrictions on traditional responses to a nasty cold.

A common response is to seek an antibiotic prescription from your doctor – rarely useful as most colds are viral in nature and antibiotics can (at best) see off bacteria (and perhaps archaea? fungi?).  Having been to a brilliant talk entitled Antibiotic Apocalypse! I was fully aware of the risks to both patient and society of unnecessary prescribing of antibiotics.  I could have been suffering from “strep” throat, but since it seems to have largely cleared up with the benefit of time, some menthol sweets and a lot of hot drinks (many containing honey and lemon) that now seems unlikely.

It was also very hard to wallow in self-pity after going to a talk on Motor Neurone Disease (or ALS for any American readers).  This would tend to put one’s minor ailments in their place at the best of times, but the fact that I spent a good hour sitting within a few feet (at times less than three) of a chap who really was dying (and fast) really did make it impossible.  He – Gordon Aikman – is a one time national gymnast and is still barely thirty: which certainly reminds one of the capricious (and cruel) nature of Fate.  The talk was fascinating and rather affecting: we know neither what causes MND nor can do anything to prevent its progress and Stephen Hawking is certainly not a typical sufferer – half of all patients die within 14 months of diagnosis and very few live for as long as five years.  It is surprisingly common – with some 400 current sufferers in Scotland alone.  Given our extensive ignorance and the swift, debilitating progress of the disease, efforts focus on improving the (all too short) lives of patients and basic research to try and understand why neurons in the motor cortex and spine start dying.  Some of the former efforts can be quite simple: for example, arranging for patients to have a single appointment to cover everything rather than forcing them to waste their very limited remaining time visiting five different specialists.  Others are more complex, including an attempt to use modern technology to allow sufferers to keep their own voices – rather than a standardised electronic voice – which improves quality of life for both them and their friends and family.  It certainly made me think how important it is not to waste NHS money on things which benefit neither patients, medical staff nor tax-payers.  It marks the current government’s awful, bodged attempts at soi-disant reforms (which seemed cunningly designed to help none of the traditional stakeholders even had they worked) as particularly wicked – they have probably set back real attempts to improve the financial management of the NHS by decades.  It also threw into sharp focus the trivial nature of any of the election debates on the subject of the NHS.

Anyway, lacking a decent route to self-pity and unaided by antibiotics, my immune system has had to do some work and see off the invaders on its own.  It does finally seem to be gaining the upper hand and (according to at least one test) I am now restored to 75% of normal function.  As a result of my reduced depletion, blogging should be fully restored.

The illness was not a complete dead loss as it led me to discover Belvoir Fruit Farms’ Ginger Cordial – which I purchased for its medicinal properties (well, a chap can dream), but which turns out to be worryingly delicious (at least when taken hot, I have yet to try it cold).

Conference time

In days of yore, Autumn was poetically associated with mist and mellow fruitfulness.  More recently, for those of us using the trains, it has also become associated with the menace of “leaves on the line” – the curious ability of a little vegetation discarded by some (careless – or perhaps, malicious) deciduous plants to bring the 21st century rail network to its knees (and, yes, I do realise that a network probably doesn’t have actual knees).  However, it also seems to have become associated with the conference – and not just the pear!

I found myself speaking at two such conferences last week, have another couple next week and yet another towards the end of the month.  You readers may mock (or merely ignore) my output but there is a greater call for my services than you might have imagined!  It’s not just a local audience – my victims have been drawn from across the whole of Europe, and even given positive feedback after being exposed to my “content” (proof – if proof were needed – of the reality of Stockholm Syndrome).

Actually, one of my recent gigs was held in the French Salon at Claridge’s – so a brief opportunity to discover how the other half live (I did feel dreadfully common).  It was nice – but if I needed somewhere to stay for the night, give me a student room at a Cambridge College or a budget hotel chain every time and I’ll spend the money I’ve saved on something which would give me more enjoyment.

However, it is not just me attending conferences – our political masters (and would-be masters) are at it as well.  In the past, these conferences tended to be held in remote seaside locations (presumably using similar logic to the siting of nuclear power stations), but now they infest our inland conurbations without a second thought.

Of late, some of our politicians have taken to speaking without notes – and being lauded for this as though the achievement were comparable to that of a talking dog.  In all my years of public speaking, I have only once used notes – and that was only because the conference organiser insisted on it – and even then I ad-libbed extensively.  It would seem that poor old Ed Miliband came a little unstuck with this approach and forgot one of the key strands of his speech.  I know how easy it is when talking off the top of your head to lose track of your key messages, though I’ve found this can (usually) be fixed by introducing a strong narrative element to your talk.  Still, missing possibly the most important element of your talk does indicate very poor short-term memory, a tendency to get carried away by the sound of your own voice or too many messages for a single speech (to all of which I would have to plead guilty in my own less than illustrious past).  Loath as I am to admit it, less can often by more when haranguing a crowd.

Both Labour and now the Tories seem keen to convince us that, if elected, they will spend more money on the NHS.  Now, I know I dropped biology in the 3rd form and so am no expert – but I’m pretty sure that the primary objective of the NHS is to heal the sick, not to spend money.  Money may enable it to achieve its objectives, but I think I’d rather see some promises couched in terms of health-based outcomes rather than spending ones.  One could easily increase NHS spending by purchasing a Ferrari for every senior NHS manager, but whilst this may offer a lifeline to the Italian economy (and please at least some of the NHS management) I would be sceptical that it would do much for waiting lists, antibiotic resistance or the nation’s health.  I suspect spending more money is just easier than actually tackling any of the real issues which affect the NHS which I am quite certain (as it is a large organisation established by and involving human beings) wastes vast quantities of money (if, by chance, it doesn’t then it truly is unique and should be extended to cover a far wider range of activities – it would certainly be able to teach “the man” a thing or two!).

In the last couple of days, the Tories have continued to live by the dictum that if you thought the previous Home Secretary was reactionary then just wait.  It would seem that in the pursuit of soi-disant extremists my rights and liberties as a citizen are to be still further eroded.  I did wonder if this was, in fact, nothing to do with fears about the more frothingly insane members of Islam (and the young and impressionable that they have influenced) and is in fact a package of measures targeted at UKIP.  Then again, given some of the views coming from her own party, Ms May may find she has scored something of an own goal.

Still, at least someone has finally had the courage to take a stand against the evils of human rights: as a non-human myself, I feel that far too much is being done to molly-coddle the fleshy pink and/or brown bipeds that infest this planet.  Time they realised that they are allowed to exist (if at all) at the sufferance of their political masters (and the small number of wealthy individuals and corporations that are their masters, in turn).  Rights should only exist where they can be taken and held by force – whether that be physical or fiscal in nature – which has surely been the message that the world’s religions and philosophers have been banging on about for millennia.  I’m sure none of us want to live in a world where the rich and powerful might be brought to account should they chance to murder a citizen (or several) on a whim.

Notes on (many) a scandal

Scandals do seem terribly important in the world – without them the media would have to fall back on celebrity trivia, the voluminous output of the world’s PR machine and speculation for even more of their “news” content than is already the case

The media have themselves been rather mired in scandal of late which has allowed politicians, an unsavoury group that the fourth estate is supposed to keep in check, to gain the upper hand.  I’m not sure this is terribly healthy in a democracy – I was under the impression that a free press was quite an important element of maintaining a nominally free society. I’m not at all clear what this new Royal Charter is supposed to achieve – other than as a piece of political mis-direction – as all the recent press naughtiness it is supposed to prevent already seems to be covered by existing (if unenforced) laws.  Perhaps the money and time might have been better invested in improving enforcement of existing statutes rather than creating new ones not to enforce.

The press and politicos regularly come very low in measures of public trust – probably somewhere around the estate agent and second-hand car salesman of popular stereotype.  Rather than doing anything which might improve their standing, their main response seems to be to try and degrade public faith in much more popular and better trusted organisations (I’m sure attacks on Judi Dench and Stephen Fry can’t be far off).  I guess this is on the same principle that if you want to appear thinner, rather than losing weight you could save yourself effort by just hanging around with much fatter people.

Frequent targets for such attempts at public degradation would seem to be the Police, the BBC, the NHS and schools.  All have the major disadvantage that they are large, highly visible organisations heavily beholden to government (so are limited in how much they can fight back) and which have been used as political footballs for a very long time.  Being large organisations they make mistakes, sometimes terrible mistakes, as all large organisations do – but rarely receive huge bailouts using public funds in response as, to take but one example, the banks did in the not so distant past.  In common with most large organisations, they are all pretty dreadful at dealing with mistakes after they have been discovered – we don’t have to look far to see large private corporations with very well-funded PR departments making similar or worse messes.  I will, however, admit to frank amazement at how few corporate sex scandals dating back to the 1970s or 80s have yet surfaced which would suggest that some damage limitation is working very effectively (or is it just the lack of a celebrity angle preventing traction in the media?).

Many of the errors made by the public entities I have mentioned relate to, or are exacerbated by, the organisation tending to close ranks to protect apparent (or, indeed, actual) wrong doers.  Given the record of almost continuous attacks by both government and the press on these organisations for at least the 30 years when I have been (in age terms at least) an adult, this tendency to defensiveness is not so very surprising.  I have lost count of the number of major revolutions our schools and hospitals have been subjected to over the last couple of decades – any country or company treated this way would have been utterly destroyed by such treatment, but somehow education and the NHS struggle on surprisingly well.

Clearly, large publicly funded organisation require oversight – and this is, I believe, a role our elected representatives are supposed to fulfil.  However, this role seems rather incompatible with a number of other interactions between the overseers and the overseen:

  • the tendency of our representatives to use them as guinea pigs for any pet theory being hatched in the fevered mind of a cabinet minister (or his – or very rarely her – inconceivably highly-paid and unelected “advisers”);
  • their convenient status as a diversion from inconvenient political realities when the “bread-and-circuses” of celebrity tittle-tattle seems in danger of failing to placate the plebeian hordes; and
  • their role as a convenient source of savings or spending (delete as appropriate) to attract the floating voter in a very small number of marginal constituencies to allow our representatives to return to the Westminster gravy train.

Perhaps we need an apolitical elected body for such oversight, which might also be able to train its gimlet stare on the politically elected and the press?  The omens are not good, recent(ish) elections for the rather nebulous role of police commissioner were fully hijacked by the existing political lobbies and largely ignored by a disenchanted electorate.  How does one make electing an auditor seem worthwhile whilst keeping those already in power (or with hopes of quickly returning thereto) well away from it?  (Audit is always a tough sell, the role being likened to those that go around after a battle to stab the wounded).  Clearly we do not want to end up with the US system which, on recent showing, seems even worse than our own.  I’m open to ideas – or failing that, does anyone have Mary Warnock’s contact details?  She has a good track record in tackling very thorny issues as I was recently reminded by Lisa Jardine on A Point of View (discussing, as it transpires, an important issue unable to gain any attention from a scandal and celebrity-obsessed press).

Déjà choo

Following a series of posts tackling the major issues of the day to surprising critical acclaim (though, if I’m honest, any degree of critical acclaim is pretty surprising), today I return (unashamedly) to the domestic front.

The author once again find himself subject to the all-too-common cold: that’s the second one in a month!  Normally, my physical health is pretty solid (in marked contrast to its mental counterpart) and I only fall victim once a year.  This time, there is a rather obvious smoking gun in the form of the vast quantities of germ-ridden youngsters that shared my personal space last Tuesday.  I think if I start uncling on a regular basis I may need to take more serious precautions: a mask, gloves and a supply of disinfectant should cover most eventualities (and may have the useful side-effect of prompting the kiddiewinks to give me a wider berth).

Anyway, as I live alone there is little point moping around the house, sighing and looking pathetic as there is precious little obvious sympathy to be extracted from an orchid (which is by far the largest of my house-mates by size).  Nor should you, dear reader, view this post as an appeal for a sympathetic response to this debilitating bout of the man ‘flu – no, it only exists at all as a result of the wizard title that came to me as I was mooching around Waitrose in search of victuals to form the basis of the next few days of comfort eating.  You will be pleased to know I managed to obtain suitable nourishment, and in particular, chillies: I’m a big believer in the curative (or at least placebo) powers of hot food on the unwell – both in the sense of serving (or, as it has been known since the Budget, taxable) temperature and on the Scoville scale.

As a brief aside, on my way to the middle-classes’ supermarket of choice, I passed a car with what I felt was an inappropriate number plate.  The car was a large black Rolls Royce, one of the very modern, equally ugly type rather than anything more classic or attractive (in fact, it might even have been a Bentley as I’m quite rusty on my Eye-Spy Book of Ludicrously Expensive Cars) but it bore the plate: NHS 9.  Presumably the owner has the initials NHS or perhaps a loved one had been saved by a public hospital and this was his attempt at a tribute; I’m not sure why I should object, I suppose I just wanted some sort of nominative determinism for vehicles.  Ho hum…

Anyway, the choice of title does not just reflect the second cold and the tendency to sneeze, oh no, it goes far deeper.  This second cold began at the same time as the last (the wee small hours of Friday morn) and I have subsequently had exactly the same errands to run on both Friday and today.  Once again, I spent this morning working both in and on the garden – today more pruning and the planting of my first crop of 2012, the spuds (Rocket, since you ask) – and then had an afternoon trip to buy food while I was still fit enough to cycle (as I’d hate to use the car for such a frivolous reason – and it’s already been out this month to buy large quantities of peat-free compost).  The symptoms are also following exactly the same course at the same pace as last time.  It is all rather spooky – it’s as though the author of my life has run out of new ideas and is just recycling old ones in the hope I won’t notice.  Ha!  I have noticed!  I think it’s time go all Alan Sugar on the incumbent and recruit a new auteur to start scripting my existence – if we are all very lucky, it might lead to an improvement in the quality (or at least the range of subject matter) of future posts.

Downhill

Last year I discovered that I was at the unhappiest time of my life (according to studies), but today’s news brings a further hammer blow for those of us in their very late thirties (I failed my 39+, and so have been held back).   A major research project published in the BMJ has revealed that cognitive faculties, like memory, vocabulary and reasoning, start to decline from 45 – substantially earlier than previously believed.  So, it would seem that it’s all downhill from here for yours truly- and as this blog will attest, I was starting from a pretty low base.  It can only be a matter of time before this blog is brought to a premature end by the declining mental faculties of its author or by his drooling shorting out the computer.

Still, I suppose there was a hint of good news for those of us who may now find ourselves being cared for by the NHS rather sooner than expected.  The same 6Music news bulletin, which brought confirmation of my rapid decline into senescence, revealed plans by our freshly-scrubbed PM to place patients at the centre of care in the NHS.  Perhaps it is due to my declining mental state, but I did find myself wondering what (or who) has been at the centre of care in the NHS prior to the Coalition taking decisive action (or, at least, drafting a decisive sound bite or two).