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).
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