Wednesday, November 25, 2020

CORONA DIARY - Chapter 16 - November 8th to November 25th

 

Monday November 9th

 

H.M. The Queen as a poker player?  She would be a good one, judging by her expression yesterday at the Remembrance Day parade as she stood on the Whitehall balcony.  Princes Andrew and Harry conspicuous by their absence.  Her expression, was neither of sorrow nor happiness, but alert, impassive, unchanging, and not missing any detail of the elaborate choreography of the salutes and the wreath laying.  She stood also, completely alone; the Duke of Edinburgh now not being fit enough to endure the ceremony.  One of the red tops this morning had a headline which went something like ‘Harry Wreath Snub’.  This was occasioned by the fact that Prince Harry, Duke of Sussex, had commissioned a wreath, but its delivery to the Cenotaph had been officially refused, since he is neither a serving nor honorary officer, nor now an official member of the Royal family.  Prince Andrew, Duke of York, was not there for more obvious reasons.  Piers Morgan is involved in another Twitter spat with the Sussexes, for calling out their equally carefully choreographed visit to a U.S. war memorial as a PR stunt.

 

We had our own rather more subdued Remembrance Day event.  Lindsay’s father, a Spitfire pilot, used to visit his friend’s grave every Remembrance Sunday.  His friend was another pilot, killed on a training exercise in 1942.  We continue the tradition.  A light rain falls.  Poole Cemetery is in a rather hidden away spot, just off Dorchester Road, a short distance from the Ringwood Road.  There is no-one else.

 

Last week saw the final BSO concert for the time being; the programme now halted by lockdown.

 

An excellent article in The Telegraph this morning, by Tim Stanley.  Stanley is a young journalist, but has an impressive CV including a BA in Modern History from Trinity College, Cambridge, an MPhil, and a PhD.  His PhD was on Edward Kennedy and the infighting in the U.S. Democratic party.  His article today is headed ‘Trump is a louder, cruder version of America.’  His thesis is that there is nothing particularly unusual about Trump as American politics goes.  He states: ‘Trump was not the least racist president ever (his words), but nor was he the most racist.  That title might go to Thomas Jefferson, who owned slaves, or Teddy Roosevelt, who said “9 out of 10” Native Americans were better off dead, or Woodrow Wilson, who imposed segregation on the federal government.  Wilson was a Democrat, a party that was for slavery before it was against it, against civil rights before it was for them – just as Biden backed an anti-crime bill in 1994 that, its critics say, led to the mass incarceration of African-Americans for minor offences.  Now he is the candidate most aligned with Black Lives Matter, although the Democratic Party’s halo is slipping, Trump gained votes among many ethnic minorities including Muslims.’  The byline of Stanley’s article is ‘The idea that the defeated president is a shocking anomaly in U.S. national politics is a liberal delusion.’   The last word?  ’…They (liberals) seem to have an impression that pre-Trump America was fundamentally decent, but he was no alien invader who conquered the system – merely a louder, cruder version of all we ever knew.’

 

This might be an historic day.  The lunchtime news carries the announcement that Pfizer have a coronavirus vaccine, and that the trial results suggest that it prevents nine out of ten infections.

 

Thursday 12th November

 

After indifferent weather (though still mild), today is bright, sunny, and windy.  A lovely six mile walk in the New Forest, starting at a place called Janesmoor Pond.  The walk leads in a complicated fashion through the woods to emerge at the Sir Walter Tyrrell pub, and then, after a visit to the Rufus Stone, wends its way back.  For 32 years, since my removal from South London to Dorset, I have intended to visit the Rufus Stone, but never have until now.  Listen up, Americans and Canadians, it is part of your history too.  It commemorates the spot where, in 1100, William the Second, aka William Rufus, was killed while out hunting by an arrow fired by the said Sir Walter, which allegedly glanced off a tree.  He was buried in Winchester.  Very muddy conditions in a number of places on this walk, but the weak autumn sun glancing through the trees is lovely.

The glades of the New Forest

The Janesmoor Pond

The Rufus Stone

 

The UK has advance purchased 40 million doses of the Pfizer vaccine, but now (of course), doubts are being expressed.  It apparently needs to be transported and stored at -80deg C – a logistic nightmare for any practical use.  We haven’t seen the safety data yet either.  But quite a number of vaccines are nearing trial completion, so we will see.

 

Yesterday we visited Greenslade’s fish shop on the quay, and bought some halibut and scallops – lovely.

 

After finishing ‘Go set a Watchman’, the novel by Harper Lee, which certainly shocks with its much cruder depiction of the racial issues in the South than ‘To kill a Mockingbird’, I have turned to much gentler fare, which I am enjoying immensely.  It is ‘Excellent Women’, by Barbara Pym.  A novel of the 1950s.  Having languished in obscurity, and had the manuscript turned down for publication, her career was re-launched by Philip Larkin’s description of her as ‘one of the most underrated novelists of the 20th Century.’  The humour is gentle, the sarcasm beautifully understated, and it conjures those ‘lives of quiet desperation’ in the post-war world as though one was living it – which to some extent I was.

 

Mediocrities – are not we all?  With a few exceptions.

 

Saturday 14th November

 

How we will move into our house in two weeks I do not know.  Everything is half finished and the dust lies thick everywhere.  The lowering of spirits is compounded by a deeply depressing day, with continuous rain.  A third of the way around the world to the west, the weather in Georgia looks lovely, as the belated U.S. Masters golf tournament gets under way.  No azaleas, but fall colours.  Ridiculously difficult golf holes.  After early rain the course is soft and scoring is good, the halfway best total being 9 under par.  Bizarrely, the autumn home rugby internationals get under way again (we’ve only just completed last season’s games).  Dominic Cummings, the prime minister’s aide is unceremoniously sacked, after briefing against the P.M.  There has been an internal power struggle in Number 10, Downing Street.  Donald Trump has still not conceded the U.S. election.  Amusing comment from a U.S. political commentator, Anderson Cooper, after a press briefing by Trump described as ‘rambling.’  Cooper says on live TV, ‘This is the President of the United States, that is the most powerful person in the world and we see him like an obese turtle on his back, flailing in the hot sun realising his time is over.’

 

More epidemiologists on TV this morning.  One issue raised is as to whether the vaccine not only reduces the physical manifestations of Covid-19 but whether the transmission and spread of the virus is reduced – an important side issue.  Stupid queries again from interviewer, ‘How can we be sure the vaccine is safe?’  A self-evidently silly enquiry.  One of the epidemiologists, who should know better, gets the acronym for the MHRA (the Medicines and Healthcare Products Regulatory Agency) the wrong way round.

 

To return to the subject of mediocrity, a melancholy affliction which is the lot of most of us.  There is, of course, an allied question of self-esteem, something that is at a very low ebb in the heroine (probably the wrong word; narrator or central character is better) in the ‘Excellent Women’ novel.  Her name would be Mildred, of course.  I remember being shocked at the end of ‘Amadeus’, which I was fortunate to see at the National Theatre very early in its first run.  Paul Schofield, to whom one’s attention was drawn the entire time on stage, as to a magnet, faced the audience in his wheelchair (as Salieri), and said, as if in a benediction, ‘Mediocrities, I absolve you all.’  For the first time, I had not thought of it before, I realised I was a mediocrity.

 

George Eliot too, has a lot of observations on ordinariness, and mediocrity.  I struggled with Middlemarch, the favourite novel of so many.  I kept wanting to shake Dorothea and to say – ‘Snap out of it, you stupid woman.’  These remarks may bore you – as Eliot says, ‘We do not expect to be deeply moved by what is not unusual.’  This is the remit of TV programmes like Casualty and Holby City.  Situations and diseases which crop up perhaps once in a doctor’s career, or certainly, infrequently, happen roughly ten times in a single hour on the TV.  Otherwise it would not be exciting.  QED Ms Eliot.  There are certainly many fine, quotable lines in the book, but interspersed with the dreadful inevitability of the suffocation of the heroine’s hopes.  Another piercing blow suffused by a little hope comes at the end of Middlemarch.  ‘But the effect of her being on those around her was incalculably diffusive: for the growing good of the world is partly dependent on unhistoric acts; and that things are not so ill with you and me as they might have been, is half owing to the number who lived faithfully a hidden life, and rest in unvisited tombs.’  Oh dear, how many unvisited tombs are there?  Mediocrities again.

 

Time to leave the Glums and the glooms.

 

Monday 16th November

 

A grey day.  We discover that the tilers have laid tiles inside which were intended for outside.  A depressing bombshell.  The tiles look alike but have different grip finishes.  There is nothing we can do about it.  In a very low mood we leave the site.

 

A short while ago we attended the funeral of a neighbour who had been suffering from Lewy body dementia.  These distanced limited number affairs enhance the feeling of gloom too, but the service is well managed.  I discover belatedly, that this man’s cousin taught me at Haverfordwest Grammar School between 1959 and 1961.  I did not comprehend at first: the relative said that I must know cousin Leslie, but since there were several teachers with the same surname of Thomas at the school, it did not resonate.  Then I realised that he must have been Mr L C Thomas, who of course was known to the boys as ‘Elsie’.  Small world.

 

The Masters Golf ends with a triumphal round and deserved victory in a record total of 20 under par for Dustin Johnson.  England footballers look lacklustre in a 2-0 defeat by Belgium.

 

Wednesday 18th November

 

I’m conscious that I haven’t mentioned Covid numbers for a long time.  Deaths are increasing, but are nowhere near as many as in April and May.  Numbers of diagnosed cases are up hugely – but this is a reflection of the vastly increased numbers of tests.  The reduced numbers of deaths and the fact that these are already plateauing has prompted many to complain about the government’s latest lockdown.  Critics have also pointed out that Boris Johnson, who is now self-isolating following exposure to another case, is probably immune, and could be swabbed and tested every day to ensure that he is able to continue working.  If overpaid footballers can still be tested and play football, they reason, how come the P.M. and his advisers aren’t using a bit of common sense here?

 

Friday 20th November

 

Yesterday was clear and bright, today miserable and grey.  Temperature 5 deg C this morning, quickly rising as the latest batch of rain sweeps in.  I rarely mention our house build in this diary, because reactions could vary between extreme boredom and jealousy.  Nothing to be jealous about this week.  Apart from the tile disaster, the bathroom designer has allowed a washbasin unit for the cloakroom which is too large.  (One could view this as a casualty of lockdown: the CGI creators were furloughed at the time we needed the images).  As the electrician says, ‘If you have norovirus it could be useful: you could evacuate both ends without having to move from the seat.’  And another basin turns out to have a blemish and its backplate has cracked as it was fixed to the wall.  We are becoming inured to these mishaps.  Ordinarily, one would be deeply upset to lose a thousand pounds or so.  In the context of the build, one needs to place this in proportion.  Mistakes have generally been few and far between.

 

Michael Deacon, journalist, previous parliamentary sketch writer and now food critic, has turned 40.  In an article this week he gives 40 ‘precious pieces of wisdom.’  Some of the truest seem to me to be:

·       The best smell in the world is chip shop vinegar.

·       The greatest year for pop music was whichever year you turned 14.

·       Politics is just football for the kind of people who got picked last for games.

·       Social media was invented to undermine the faith of sensible people in freedom of speech.

·       There is no better false economy than a cheap bed.

·       The most enjoyable drink of the night is always the first.

·       Love is being able to sit together saying nothing, without feeling an anxious need to break the silence.

 

News today that Professor Tony Gershlick, of Leicester, has died of Covid-19.  A great colleague and deservedly regarded clinical scientist.  He was about three years younger than me by my reckoning.  This seems to bring the pandemic very close to home.

 

But to end today on a brighter note.  This week, Lindsay left her mobile phone somewhere on Poole Quay.  Having had one stolen in the past we feared the worst.  (N.B. if you do this, do not ring the phone.  Try ‘find my iphone.’  Once you ring it the person who has it will realise you can find them and switch it off).  Also – block the Sim card.  On this occasion however, when we located it, a call came through – it had been found and the finder wanted to return it.  I hotfooted into Poole to find two Macedonian families, obviously very poor people, who returned it, and initially refused any reward until I insisted.  As the gentleman pointed out, Lindsay’s credit card was in the inside pocket of the cover.  It had not been used.  There are still good people.

 

During this week we have had news that Moderna Pharmaceuticals have an effective vaccine; and although the efficacy data is not out for the Oxford vaccine, it has been shown to be well tolerated and to induce a good antibody response in older people.  Hooray!

 

Saturday November 21st, 2020

 

I put the year in above to remind me that we are still in this nightmare year, and how far into 2021 we have to travel before we are all vaccinated and (presumably) protected we do not as yet know.  Among the various wry comments that I receive or read, one captured my imagination.  A lady, rising from the couch after an examination by her doctor says, ‘Doctor, how long will it be before there’s a cure for the coronavirus?’  The doctor, a caricature figure with a white coat and a stethoscope, says, ‘I’m sorry I don’t know; I’m not a journalist.’

 

Do many others have a completely disrupted sleep pattern?  If I wake at any time after 4am my brain whirrs with thoughts for the day, and our impending move.  I find it best to get up, to drink Green & Black’s hot chocolate, and to exercise my brain in a crossword or tablet game of patience.  Then I go back to bed.  Tonight is a little different.  Yesterday’s dream involved walking in the Romansch area of Switzerland and trying to remember to say ‘Allegra’ for hello.  Then being told off for arriving for the evening meal in the chalet at 5.45pm instead of 5.30 (how very Swiss).  Tonight it was a flying dream.  Psychologists love flying dreams.  Looking on line you can see virtually any interpretation of them.  If the flying is easy and you soar, glide, and swoop, then this is due to a feeling of power, of conquering some problem, of freedom.  If difficult (as it was for me tonight), then it is due to being weighed down by current problems.  That is the interpretation I might take tonight – but it is a little like necromancy or fortune telling – the clever fortune teller will give you something that chimes so well with your current preoccupations that you instantly hail them as a true genius with a glass into the future.  Of course Freud and Jung had great fun with flying dreams, and inevitably sex had a lot to do with it!

 

 

Tuesday November 24th

 

Very much preoccupied with move back to our new house.  Several visits per day are now the norm.  There is always some minor item which contractors want to discuss.

 

On Sunday we had a lovely walk over on the Studland side of the harbour.  Normally we walk along the beach all the way to the village and then sometimes on to the Bankes Arms, a well situated pub with an area of lawn which overlooks Poole Bay and Old Harry Rocks.  This time we walked inland, skirting the so-called ‘Little Sea’, an inland stretch of water which is home to migrating waterfowl at this time of year.  Despite walking in the area many times before, I have never been to the Little Sea, which is a calm and peaceful place, ideal for bird watchers.  Then we walk back to the ferry using the beach, marching through the naturist area with not a naked torso in sight.  The Maritime Management Organisation wants to make Studland Bay a marine reserve, because they have discovered sea horses in the eel grass at the bottom of the bay.  This would disbar thousands of people who love to play, sail, surf, and anchor here, year on year.  Leisure anchorage has been going on here for many years, and it is only a few years ago that the sea horses have been detected by some eager divers.  We don’t know what the upshot will be.  A remarkable feature of our inland heath walk is the huge amount of lichen which covers the knolls, heather and trees here.  So it presumably remains very unpolluted.

'Trouble with Lichen' - the heather walk to the Little Sea.  An otherworldly landscape

The Little Sea, Studland

Furloughed liner, Studland Bay, and Old Harry


Sandbanks Ferry

 

News this week that the Archbishop of Canterbury is to take a sabbatical, which provokes some risibility on the part of those people who like to write to newspapers.  Some are of the questioning variety.  The Archbishop apparently wants to spend some time in prayer and reflection.  Many question, ‘Is this not what he is supposed to do anyway?’

 

Wednesday November 25th

 

The day before we start moving.  Very busy.  Little to add.  If our computers get up and running the other side of this move I will write more…

 

 


Sunday, November 8, 2020

CORONA DIARY CHAPTER 15 - October 12th to November 7th, 2020

 Thursday October 15th, 2020

 

Instead of Bloomsday, which is the sixteenth of June, it seems to be Gloomsday, though exactly where in October to pitch this unfortunate day is unclear.  We are no further on with the Covid-19 pandemic, and the government have introduced a partial lockdown situation, with three tiers, categorised as Medium, High, and Very High.  Note that there isn’t a Low.  Scenes of wild partying in Liverpool, prior to their being the only locality to get the severe treatment, are depressing.  I once wrote a song – many years ago, which included the lines

 

‘In the Autumn of the year

When the leaves are wan and brown

The cold wind of love’s displeasure

Takes the leaves and casts them down.’

 

And that is how it feels at the moment.  Hard to work up the enthusiasm to give a rendition of Monty Python’s ‘Always look on the bright side’, but perhaps tomorrow.  Yesterday, as we crossed the wee burn at Parkstone’s 8th hole in sparkling sunshine I observed to my friend how lucky we are, so I must take that thought forward.  But news last week and yesterday of new cancers in really close friends and relations is hard to take too.

 

I read James Joyce’s ‘Ulysses’ with a sense of duty in my 20s, but it had escaped my attention (maybe I had fallen asleep) that it all took place on June 16th, 1904.  Until I happened to be in Dublin on that June day in 2004 for a cardiology conference on rehabilitation.  Now Bloomsday is a big thing.

 

So, my mission to establish Gloomsday falls flat at the first hurdle.  I had thought of it this morning as ‘A touch of the Glooms’, and had imagined this related to some old radio show, but the only reference I could find is in a blog by author Misha Herwin, who says that her heroine, Letty Parker, uses this phrase.  Perhaps it was ‘The Glums’, a ground-breaking radio show (q.v.) which ran on the BBC in the 1950s.  As a child aged around six I remember my parents’ avid listening to this programme which featured a dysfunctional family consisting of Ron and Eth and Ron’s father, played by Jimmy Edwards, a handlebar-mustachioed comic who was a mainstay of 50s and 60s radio and TV.  In a subsequent TV series, ‘Whacko’, Jimmy Edwards played a headmaster who was always threatening to cane somebody.  How prehistoric does that sound now?  This week there was an article urging people in Scotland to inform on someone if they saw them smacking their child (smacking is illegal in Scotland).

 

Mention of Eisenhower and Dr Paul Dudley White in my last diary entry reminds me that it is said of senior doctors that as they age they become more interested in medical history, probably because they are no good for anything else.  But after so many years in medicine, we realise we need to take the long view.  In my own field, the doyen of Cardiology historians in the UK was Arthur Hollman.  Arthur was the consultant I was attached to on my first clinical firm at University College Hospital.  He had links to Sir Thomas Lewis, and a great interest in gardening.  Hence he was the warden of the Chelsea Physic Garden and in later life published a biography of Sir Thomas.  He continued as archivist for the British Cardiac Society (later the British Cardiovascular Society).  He was an abrupt man with no respect for reputation.  A favourite saying was ‘The books all say that, but the books are wrong.’  Once, during a presentation by a famous physician, of a child with severe hypertension, he was asked to look at the ECG, which showed gross left ventricular hypertrophy.  ‘He must have had a 4th heart sound’, he averred.  ‘I didn’t hear one, Arthur’, responded the famous physician.  ‘Then I think we’ll take it you missed it.’  Was Arthur’s response…

 

Although brusque, Arthur was one of the few physicians who had the entire firm to a tea party in his garden in Ealing at the end of our first year, and in later life, on accepting me to the cardiac fold, he addressed me as ‘Andy’.  When he cleared out some of Sir Thomas Lewis’s archival material at UCH he sent me one of Lewis’s early ECG recordings, dated 1913.

 

Walking down memory lane again, and far more trivially, Lindsay’s potato masher broke yesterday – a rivet had gone.  ‘I bought that with Green Shield Stamps’, she announced indignantly.  Although Green Shield stamps (q.v. if interested) lingered into the 1990s they were effectively dead in the water after Tesco’s, who espoused them, abandoned the stamps in a price war starting in 1977, preferring to ‘pile high and sell cheap’.

 

Sunday October 18th

 

Forgive me for being gloomy again.  The world has no response to Covid-19.  Previously successful countries have seen dramatic rises in cases, e.g. Germany, Italy, and France.  Substantial numbers of cases are again being admitted to hospitals across the UK.  I never knew we had so many professors of epidemiology, public health, and virology.  A new one pops up every day on the BBC.  There is a pretty one from Edinburgh.  Prof Gupta does not seem to have been given much column space this week.  An epidemiologist from Cambridge (I think his name is Chris Smith), who always appears surrounded by banks of electronic instruments does usually seem to be quite lucid, and points out that with low herd immunity at the moment, we are faced with a disease which kills perhaps half of a percent of all those infected, so this would mean something like a total of 300,000 dead in the UK (we are now approaching 50,000), and an impossible number being admitted to hospital.  But complete lockdown is also unconscionable, because of the economic cost, and every day we hear stories of other illnesses failing to be treated by our ‘Wonderful NHS’.  Even James Lefanu, GP, in the Telegraph, laments that every GP surgery seems to be surrounded by barbed wire.  My original thought was to follow Prof Gupta’s strategy of building up immunity among the young, and carefully shielding the old and vulnerable.  But I have not yet heard (as I hope to do) any clamouring for cutting to the chase in the vaccine stakes and getting on with an immunisation programme.  A paper from the National Institutes of Health this week in the NEJM reports excellent results in the achievement of immunity and indeed prevention of infection after SARS-Co-V2 administration in primates (Evaluation of the mRNA-1273 vaccine… etc).  Other papers address studies with different vaccines in humans.  A paper from two doctors at the FDA discussed the EUA (Emergency Use Authorisation) protocol and concluded that a two-month follow up period after the full course of vaccine administration to all participants would be adequate to allow use of a vaccine.  They do point out that there is a risk (of course) – trials of anti-shingles vaccines had a follow-up of three to four years before FDA approval.  Surely this is the only way ahead for most countries?

 

A hard hitting editorial in NEJM (‘Dying in a Vacuum’, NEJM, October 8,2020) puts the blame squarely on ‘our leaders’, a clear-cut euphemism for Donald Trump.  ‘They have taken a crisis and turned it into a tragedy.’  The introductory paragraph points out that rates of death in the USA are more than double that of Canada, and exceeds that in Japan (a country with a huge very elderly and vulnerable population) by a factor of fifty.

 

Our own leadership in the UK flounders around too, but in truth, neither political party could do any better, and Britons are just too obstreperous and bolshy to behave like the Chinese and control this epidemic.

 

Oh dear.  Sorry.  Lindsay and I had a lovely five mile walk in the New Forest this afternoon, enlivened by a couple of New Forest ponies muscling in on our picnic, and by the last mile of our walk beside the Linford Inclosure, where hundreds of thousands of crab apples covered the ground between the trees.  Perhaps next week will be better.

 

New Forest pony trying to muscle in on my lunch

Another one joins the luncheon party

Nature's bounty - New Forest crab apples




Wednesday October 21st

As I type that I belatedly realise that it is Trafalgar Day, though the recent ‘woke’ responses and cancel culture insist that Nelson was a racist so-and-so and we shouldn’t be celebrating.  Memories of the Naval School in Verdala, Cospicua, Malta, where 21st October was a big day and we always sang ‘Eternal Father, strong to save, whose arm doth bind the restless wave’ in morning assembly.

 

It’s a grey rainy day, and golf is cancelled.  Lindsay has gone with a friend to Stourhead, one of the gems in the National Trust crown.  I deal with doors, hinges, and fencing and now get some time off to write.

 

A superb article by Ambrose Evans-Pritchard in the Telegraph last week is entitled ‘Macron caught in a net as he tries to hold Brexit to ransom.’  I have mentioned AE-P before (see June 8th, the ‘Modern Day Cassandra’).  He does indeed write well, his article about the EU CFP (Common Fisheries Policy) and Macron’s insistence on ‘maximalist claims on sovereign British waters’ amounting to ‘indefensible overreach and “cakeism”’.  There are signs that Germany in particular is becoming impatient with him.  ‘Handelsblatt asks how he can expect to perpetuate a regime in which French trawlers are entitled to 84pc of the catch off the coast of Cornwall while Cornish fishermen are left with just 9pc.  It marvelled at a relationship where European boats can come to within six nautical miles of the British coast while British boats must abide by the EU’s 12-mile rule.’  Most sensible economists in Germany point out that a trade war is not in the EU’s interest.  They are concerned about tariffs (à la Trump) on what amounts to £48bn of car exports and £20bn of farm goods which flow our way from the EU.  I do like the way he writes as well.  I feel ignorant as I read his clever use of French terms – en coulisse, for example, which means ‘behind the scenes’.  Démarche means a step or an approach.  But an education at Trinity College, Cambridge and the Sorbonne has obviously helped.  The article is easily found by searching AE-P Telegraph articles.

 

Cycle sport is confusing at the moment.  We are in the last week of the Giro d’Italia, but the Vuelta a España has also started.  Primož Roglič wins stage 1 of this, so he is back to form.

 

‘It will all end in tiers’ is an appropriate pun to end up today’s entry.  Local lockdowns are the new normal, in places where incidence of Covid is high (a three tier system is now in place).  Inevitably there is political argy-bargy, the left claiming that not enough financial support is being given to the lockdowned areas, and our government are cold mean bastards (that’s what they mean, even if that is not what they say – the Labour mayor of Greater Manchester, Andy Burnham is particularly choleric).  I heard snatches of an interesting Radio 4 discussion this morning on broadcasting impartiality.  I may return to this subject.  The vested interests behind the news media companies mean that most coverage is anything but impartial, and outright lies are often promulgated as a way of reinforcing a point of view.

 

I am going to go back to:

1.      Making my lunch.

2.     Playing my guitar and working on my contemporary blues song.

3.     Making some sourdough bread.

4.     Reading Robert Harris’s ‘The Second Sleep’, which is curiously relevant to today’s apocalyptic coronavirus mood.


Saturday October 24th, 2020 

When I was young, this day was celebrated – as United Nations Day – but seems to be majorly overlooked nowadays.  I remember in the School Assembly at Haverfordwest Grammar School (Pembrokeshire, Wales), we had to stand and listen to the headmaster’s peroration about the unity of the world and how it was important to acknowledge this day.  And that is all I can remember of it.  But I also remember that the whole school was given a half-day off when an old boy was playing scrum half for Oxford in the Varsity Match – and watching it with a sense of pride on a neighbour’s very indistinct black and white TV – whereas nowadays it is only on a paid for satellite channel that one can watch this event.  The school’s motto was ‘Patriae prodesse paratus’ – which means ‘Ready to serve one’s country’, though perhaps it was brought in before Wilfred Owen’s poem which gives the lie to it: ‘Dulce et Decorum Est’, which was published in 1920.

 

What a gloomy day.  The rain started in late morning and has beaten at the windows with increasing ferocity as the day has gone on.  I have now finished The Second Sleep – very good but not ideal if the atmosphere is gloomy.

 

We have not been able to visit Lindsay’s son and his wife to celebrate their wedding anniversary.  A little boy’s parents at their son’s nursery have tested positive for Covid, so I guess we are right in not going, and they will be isolating…

 

Tuesday October 27th

 

The last few days have passed in a blur of bad weather and lack of excitement.  Tao Geoghegan Hart’s winning of the Giro d’Italia in a last gasp victory in the final time trial was an enjoyable finale to a remarkable bike race in which the 25-year old Londoner and the Australian Jai Hindley contested the last stage.  Uniquely for any Grand Tour these two were on identical times going into the final stage.  Emotions were also stirred by the finish in front of Milan’s wonderful (I refuse to call it iconic) cathedral.

 

More reading, having started ‘Go set a watchman’, the only other novel by Harper Lee, I have been decoyed by the much more readable ‘Lady in Waiting’, the autobiography of Lady Anne Glenconner.  Some idea of the difference between Lady Glenconner’s world and ours can be gleaned from the fact that, when she was a child at Holkham Hall, in Norfolk, the Palladian home of the Earls of Leicester, an enormous stately pile, the footmen would place a raw egg in a bain-marie, and walk towards the children’s nursery in the opposite wing to the kitchen.  By the time the eggs reached the nursery breakfast table they were done perfectly…

 

Sometimes it is the small articles which catch one’s attention, and which remain.  Even more so than the achievement of getting to the end of some enormous but classic tome.  In this respect, I still have the cutting of Frances Wilson’s marvellous diary introduction to last December’s Literary Review, which she entitled ‘Fay Weldon Took the Light Bulbs’.  She bought the house in which Fay Weldon wrote some of her classic works in 2001 and was somewhat surprised to find that the author had taken not only the light bulbs but the oven.  This gave her scope to write about other writer’s houses, including Dove Cottage (Wordsworth), and the homes of D H Lawrence, Emily Dickinson, Thomas Carlyle, Virginia Woolf, and Iris Murdoch.  The longest section is reserved for the havoc wreaked on Dove Cottage by its subsequent (and longest) inhabitant, Thomas De Quincey, known mainly for his ‘Confessions of an English Opium Eater’.  Now this is a book which I did read (in childhood), and the reason is that as far as I could ascertain, De Quincey is, or was, the only famous alumnus of my old school, King Edward’s, in Bath.  But perhaps we should now include the comedian and musician, Bill Bailey.  General Sir Jack Deverell should probably be included too, and Professor Chris Rapley, who was in my physics group at school, who has worked doggedly on climate change at UCL, and was one-time director of the British Antarctic Survey.  I would anticipate a knighthood at some point for Chris.

 

There are significant skirmishes in Government at the moment, with ill-feeling concerning the free school meals initiative, which the footballer Marcus Rashford wants extended into half term and the holidays, and the powers that be say are covered by extra local allowances.  But the most striking thing that seems to be part of the national mood at the moment is a very distinct anti-lockdown feeling.  People (even journalists are people) say, ‘We’ve been here once before; it didn’t work.  There isn’t much point in doing it again.’  Wales has imposed an extraordinarily strict lockdown, which they are calling a ‘Firebreak’, a lockdown by any other name.  There is enormous resentment to this.  It’s clear that the lockdown measures result in the disadvantaging of the poorest in society – self-employed; those in temporary employment; those who cannot produce tax returns from consistent employment.  And it seems that there has been about £2 billion of fraudulent claiming from the initial furlough and support schemes.

 

President Trump, of course (how could I not mention him) has told us that a vaccine is only a very short time away.  This was one of the very few of his statements which was corroborated by the U.S. Health adviser, Dr Anthony Fauci, in a superb interview with Andrew Marr on Sunday’s current affairs programme.  As well as being a clear scientific speaker, Dr Fauci’s appearance was a masterclass in how to deal with awkward or rude questions.  Challenged by Andrew Marr, for example, with the direct quotation that President Trump had called him a fool and an idiot, Fauci merely said that he didn’t think answering to such a conversation was helpful, and that he was merely doing his job to the best of his ability.

 

Thank heavens that we are only a week away from the end of the ghastly process which is the U.S. election.  We have relatives in Lancaster, Pennsylvania, and there was footage of a Trump campaign rally there.  I noted an Amish straw hat prominently in the background behind the President, no doubt an example of his all-embracing devotion to any U.S. citizen.  But I also noted an interview in the last week with an unemployed steel worker saying that Trump had not turned around the fortunes of manufacturing America, and that the steel towns were still rusting.  ‘I won’t make the same mistake again’, said the interviewee.

 

Friday October 30th

 

But sadly, good news for Trump today in that there has been a 33% upturn in the U.S. GDP, so the election is still too close to call.

 

Here at home, the atmosphere is gloomy and bleak, matching the weather, with substantial upturn in coronavirus cases, and now we do know someone in the family with Covid.  The government is criticised at every turn, but there is also panic and confusion in the Labour party.  An independent report (UK human rights watchdog) has found that there is not only anti-Semitism within the party, but that the leadership broke the law in failing to stamp it out.  Corbyn has said this is gross over-dramatisation of the true position, and Sir Keir Starmer has suspended him from the party.  Part of the problem (my own view), is that the trendy lefties espouse freedom fighters everywhere (IRA terrorists for example), irrespective of whether there is universal suffrage in the country in question.  Whereas it is fine to support Palestinians in their fight for an appropriate share of their homeland, i.e. a certain degree of anti-Zionism might be reasonable; to equate this with opprobrium for Jews in general is not appropriate.  Having trekked through the Sharah mountains in southern Jordan, and viewed to the west what Israel calls Israel and the Jordanians call ‘Occupied Palestinian Territories’, I have some sympathy with the anti-Zionists.  On the other hand, it’s hard not to have some feelings for Israel too – the country is on the hit list of virtually every other Arabic nation.  Iran in particular has its own modern day version of ‘Carthago delenda est’, the famous three-word speech of Cato in the Roman senate in the second century B.C. (it translates as ‘Furthermore Carthage must be destroyed’).

 

This week I saw the obituary of Leslie Iversen, the pharmacologist, in the newspaper.  Iversen was a brilliant scientist, whose PhD thesis on ‘The uptake and storage of noradrenaline in sympathetic nerves’ was a model of scientific method.  Unusually for a PhD thesis, it became a book which we all bought.  Leslie lectured us in Part II Pharmacology.  Everyone wanted to do their final year research with him – it was clearly such a vital and interesting field.  Sadly, I did not get to do so, working on the properties of a serotonin inhibitor called cinanserin on structures such as the smooth muscle of guinea pig ileum.  Cinanserin disappeared without trace and never made it to market.  There is a lot of serendipity in research labs – my predecessor had worked on a drug called AQ110, made by Allen & Hanbury pharmaceuticals.  Research papers quickly followed, and drug became a winner – salbutamol.  Leslie Iversen and his wife, also a talented psychoactive drug pharmacologist, became Cambridge’s golden research couple in that era of the late 60s and early 70s.  I was sorry to hear that he had died at the relatively early age of 82 (seems relatively early in that I am only 10 years younger…).

 

Another BSO concert this week, with works by Fauré, Ravel, and Saint-Saëns.  Advertisements for performances at a venue in Frome which I sometimes attend – Cheese & Grain, a converted warehouse.  Most striking are the clever names which tribute bands invent to link themselves to the originals.  We all know of the Bootleg Beatles, and the Illegal Eagles, but ‘Coldplace’ and ‘The Unravelling Wilburys’ were new ones to me.

 

Monday November 2nd

 

Weather has been generally poor but we are promised high pressure and better weather from Wednesday.  This contrasts with the gloomy state of our coronavirus situation, with the government announcing a total lockdown from Thursday.  Exact details are awaited.  The schools will not close.  Predictable unhelpful response from the teachers’ unions.  I’ve avoided numbers now for some weeks if not months, but the curve of hospital admissions shows a very substantial rise, with nearly 11,000 hospitalised Covid patients, and nearly 1,000 in ventilator beds, though whether this means assisted ventilation or full endotracheal ventilation is not stated.  Deaths are rising, though it is alleged that the mortality figures are not as high as in the first wave (by this I mean the case-fatality rate).  Opposition MPs are making hay by saying the government has not reacted fast enough to the scientific advice, but the Chief Medical Officer, Chris Whitty, did say that ‘I cannot emphasize enough that there is no perfect time to introduce a lockdown.’  Several pundits have quoted the famous but misattributed Einstein saying; ‘Insanity is repeating the same thing over and over and expecting a different result.’

 

Deaths this week of two sporting heroes, Nobby Stiles, world cup winning footballer, and J J Williams, speedy Welsh rugby winger.

 

Tom Lehrer (still alive, but in his 90s), writer of wonderful and satirical songs, has released his oeuvre from copyright.  He is credited, when asked about Trump and modern political satire, as saying; ‘Political satire became obsolete when Henry Kissinger was awarded the Nobel peace prize.’  Many tributes also today to Sean Connery, the original and best James Bond, who has died at the age of 90.  A fine actor and patriotic Scot, but not patriotic enough to want to live in Scotland and pay Scottish taxes, preferring the Bahamas instead.  His memory perhaps also slightly sullied by Trump claiming that Connery intervened in the fuss over his wish to build one of his Scottish golf courses to allow him to proceed.  Also in the triviasphere today, Johnny Depp, film actor, loses his libel action against the Sun newspaper, who claimed he was a ‘Wife Beater’.  The Sun marked the passing of Sean Connery with a picture of his Bond persona and the tag line ‘Oh Oh Heaven.’

 

Tuesday November 3rd

 

Lockdown looms again.  November 5th.  Not a trace of irony it would seem.  ‘Remember, remember, the fifth of November…’  ‘Once the rockets are up, who cares where they come down.  That’s not my department says Werner von Braun.’  Grassroots sport, gym, everything, will be in abeyance, but those hugely overpaid footballers will still be in action.  Bobby Robson (Sir Bobby Robson) said: ‘”Twenty thousand a week?  I wouldn’t pay them twenty thousand a year.”  You have to remember he said that probably twenty years ago!  Multiply by around ten for current earnings.

 

At least today is clearer and sunnier after all that rain.  The United States goes to the polls today.  Footage of President Trump’s campaign visit to Fayetteville, North Carolina.  Huge, uncritical, unrelenting and unrepentant support for him there.  At Duke in the 1980s we used to call it ‘Fayette-nam’, an epithet coined for it because of its redneck character and the fact that it is essentially the city which is linked to the enormous U.S. army base of Fort Bragg (yes, named for a Confederate general).  Many of my colleagues at Duke used to moonlight down at the hospital there.  It gave them excellent experience of dealing with Friday and Saturday night violence and shootings.  A colleague told me an extraordinary story about his moonlighting there.  He was an Ivy leaguer (name withheld), who in college (name withheld), dated a very attractive woman, but they subsequently drifted apart.  Some years later, after he had married, he was attending an ambassador’s reception in Washington, where he met this girl who had obviously gone up in the world.  She looked a million dollars, was wearing the most expensive designer dress, festooned with diamonds, and was on the arm of a somewhat older Washington politician.  She greeted him warmly, and in response to questions about her career post Ivy league, she vaguely mentioned modelling and the movie industry.  My colleague was somewhat in awe and dumbfounded.  Back at Duke, he did the usual weekend sojourn down in Fayetteville.  Sleeping in the on-call doctor’s room, he idly turned to one of the provided magazines as reading material.  They were obviously intended for those intent on a solitary good time and suffering from Portnoy’s complaint.  Suddenly he found the ex-girlfriend within the pages.  Not only was she completely naked and indulging in a variety of sexual acts and unusual positions, but animals featured too.  A chastening experience, but just a flavour of what was on offer in Fayette-nam…

 

A relative in Pennsylvania has been shopping, not because of a lockdown on the horizon, but because he thinks it might be safer to stay indoors for a while after the U.S. election.  (I think that above juxtaposition as a figure of speech is called bathos).

 

Saturday November 7th

 

I had intended to write something about the U.S. election, but had no idea that it would drag on for so long – nearly 5 days now and counting; apparently there are still some votes to come in.  But it is clear that Biden has enough votes to be declared the 46th President of the United States.  The only person who disagrees it would seem is Donald Trump, who has threatened legal action to contest some of the individual state results.  But whether he goes quietly or loudly, it now seems certain that he will go.  A recent interview with a government minister by Andrew Neil, the highly intelligent and well informed TV journalist was a substantial grilling.  Neil pointed out that Trump was for Brexit while Biden was against Brexit.  I feel sure that a degree of pragmatism will attend any new White House regime, and Europe will be the least of his worries for the moment in such a deeply divided country.  In the meantime, an excellent article in the Business News of the Telegraph by Matthew Lynn states ‘Trumpism without Trump is what the world needs right now.’  He points out the very real economic achievements of the Trump administration (probably undertaken by some very savvy economic advisers rather than the Donald himself).  The Corporate Tax system, one of the least competitive in the world was reformed at a stroke.  The rate was cut from 35pc to 21pc, inviting corporate monies to return to the USA.  The rising tide of regulation was attacked – a slew of regulations was repealed.  Finally, enterprise zones did achieve the revitalisation of some (but not all) urban areas.  Other achievements include trade and continued improvement in volumes of trade with China.  As Lynn says, nobody is going to miss the bullying, the narcissism, or the temper tantrums.  Nobody will be sad to see the back of his divisive language, his ugly attitudes towards women, or his rambling attempts at rhetoric.  But…

 

Nonetheless, for me and for many the days of the deeply unattractive 45th President will hopefully soon be just an unpleasant memory.

 

In the meantime, the weather this week improved so that we had enjoyable autumn days with cold mornings but bright clear sunshine.  I seem to spend quite a lot of time on the obituary columns, but this is because I have reached an age where so many people who have taught me, who have formed my thinking as a physician and cardiologist, are leaving us.  This time it was the turn of Professor Peter Sleight, aged 91, Oxford cardiologist and researcher, who showed us that large scale trials could be done quite simply, if they were not exclusive.  The power of these trials came from the fact that their results could be generalised to all patients, and not just a highly select ‘safe’ treatment group.  A heart attack trial that I recruited for him (among many other hospitals) was presented at one of the big U.S. cardiology congresses in the early 1990s.  A famous American doctor stood up and said it was ‘low tech’, whereupon Peter took off his shoes and socks and presented at the lectern as what he called a ‘barefoot doctor.’  He was no respecter of reputations either.  He led a teach in on cardiac pacemakers for many of us senior registrars in Oxford one day.  A famous lady cardiologist vehemently expressed an opinion.  Peter asked her how many pacemakers her unit had put in in the last year.  The answer was about a fifth of what Oxford and some of the centres that we worked at was.  ‘So I think we can take it, …..,’, said the Prof, ‘That yours is a minority view.’  I enjoyed his company at meetings, in lectures, and on the golf course.  He was an original and stimulating thinker, and he challenged you.  His style of cardiac trial was rightly mentioned as being the forerunner of large simple trials such as the NHS study which has shown the value of dexamethasone in the treatment of Covid pneumonitis.  R.I.P.

 

It is time to finish this chapter of the Covid diary.  We are back in lockdown.  No golf, no pubs, no restaurants.  The tantalising prospect of a vaccine looms, we are told.  But not yet.

 

Meanwhile, as The Donald sinks slowly in the West, in a welter of lawsuits, we cannot like Malcolm report of the Thane of Cawdor, ‘Nothing in his Presidency became him like the leaving of it.’  (Macbeth).