May 13th, 2021
A friend's daughter practises her yoga in front of Mt. Agung, Bali
A period of wetter, slightly warmer weather, interspersed
with some lovely sunny periods. The wind
is rarely light though, and sitting outside is usually only feasible when well
wrapped up.
Interesting elections last week. In Dorset, the only person on the ballot list
was the police and crime commissioner.
Both of our electricians have recently had their vans broken into and
tools worth many hundreds of pounds stolen.
Both with complete police inaction.
So one doesn’t feel terribly enthusiastic about this vote, irrespective
of the candidate’s political affiliations.
In Scotland however, MSPs have been up for re-election
(Member of Scottish Parliament). Nicola
Sturgeon, the Scotweiler, has claimed her substantial number of seats is an
endorsement for what they call IndyRef2, another referendum on Scottish
Independence. Having lived in Scotland,
it is hard for people down here in England to realise just how significant is
the antipathy for England felt by Scots.
800 years of history doesn’t help.
Not for nothing was Edward the First nicknamed ‘The Hammer of the
Scots’. Unfortunately, the Scots are not
well-informed as to how lucky they really are.
The so-called Barnett formula gives Scotland a substantial benefit in
public services allocation compared with England. In the Health Service, it has been recognised
for a very long time that monies have been more freely available for Scottish
patients than English patients. It is
how Nicola Sturgeon chooses to spend this allocation that gives many Scots the
impression that they are hard done by.
Cycling the North Coast 500 a few years ago, it was very clear that the
only good roads in rural Scotland were the ones that had large sign boards
beside them saying ‘Built with assistance from the European Union’. In the distant past, with the focus on the
oil industry based in Aberdeen, the Scots were able to accuse the English of
‘appropriating our North Sea oil’, but this is a contracting sector of the
economy, and apart from tourism and whisky, and perhaps some fish it is hard to
see how Scotland can maintain its prosperity as an independent nation. The majority of Scottish exports are indeed
consumed in the rest of the UK, whether those exports be technical or otherwise. Finally, Sturgeon has indicated that when
Scotland gains independence, the British nuclear deterrent submarine services
will be pushed out of the Gareloch and Loch Long (both deepwater lochs), giving
us a real problem in maintaining this service, as well as losing many Scottish
jobs.
Further south, a by-election in Hartlepool has resulted in a
significant conservative majority, in what is regarded as ‘Old-Labour’
heartland. Even Laura Kuenssberg, BBC
political editor, a ‘pink’ intellectual, has pointed out that the old
demographic of highly unionised solid Labour voters has changed and gone. The fallout in the Labour party has been
bitter indeed. An old hard-line Jeremy
Corbin tail of left wingers is still trying to wag the dog, and the centrist
Labour of Tony Blair is in disarray under Sir Keir Starmer. It is remarkable that despite all the renewal
of ‘Tory sleaze’ allegations, that Boris Johnson, a man who certainly made
mistakes in his management of the pandemic, remains extraordinarily popular. The success of the vaccination campaign is
the equivalent for Boris of Margaret Thatcher’s Falklands success in 1982 in
persuading the public to keep on ‘steady as we go’.
Un bout de nostalgie. Now that I have a record player again, I have
enjoyed playing some old favourites, at random.
One such was Judy Collins’ ‘Colors of the Day’ compilation. As well of some of her own songs, her covers
of many great songs are surely some of the finest around. Her version of Leonard Cohen’s Suzanne is
fantastic; the Beatles’ In My Life’ is wonderful. The same applies to ‘Both Sides Now’ (Joni
Mitchell), ‘Who knows where the time goes’ (Sandy Denny), ‘Sons of’ (Jacques
Brel), ‘Amazing Grace’, and the folk standard ‘Farewell to Tarwathie’. This latter song, dating from the mid-19th
century, about the Greenland whale fishery, has a haunting soundtrack of whale
noises. In 1972, when I bought this
album, it seemed gimmicky. Now I find it
plaintive and appropriate.
Another parenthesis.
When sailing, many years ago, on what was at once the most enjoyable and
also horrible voyage, from Tromso to Spitsbergen, I asked our skipper why it
was that all of the whaling songs mentioned Greenland and dated from the
1800s. I knew that whaling had been a
part of the Spitsbergen (Svalbard) voyages.
His answer was simple: whaling started on the Svalbard route in the
early 1600s, the prey being the bowhead whale.
By the 1700s they had killed them all…
The initial targets were bowhead, gray, Northern humpback, and right
whales. As these were rendered nearly
extinct, other species of whale were sought.
The remnant of the Gulf Stream runs up towards Spitsbergen, rendering
the North sea, the Norwegian sea, and even the Barents sea mostly ice free. Later whaling focussed on the Davis Strait,
between Western Greenland and Baffin Island, north of the Labrador Sea – a more
dangerous and challenging environment.
Football, as well as being the ‘beautiful game’ (rarely so),
is a hugely moneyed irritation. Almost
three quarters of most sports coverage in any newspaper sport supplement in
Britain is filled with football. So when
Geraint Thomas, the Welsh cycling hero and winner of the Tour de France, won a
significant UCI tour event recently, the Tour de Romandie, there was zero coverage,
and nothing from the BBC, which focussed on the riot at Manchester United
football ground against the club’s American owners. It is very difficult to get true facts about
participatory sport. Running appears to
be very high, though it is possible that swimming exceeds it – over 2.5 million
participate every week. But cycling
weighs in at nearly two million a week.
In the past it used to be said that angling was the most popular sport,
though recent data don’t confirm this.
Football, tennis, and golf are high on the list, after athletics,
swimming, and cycling, and perhaps surprisingly, equestrianism. My point is that football is grossly
over-represented in the press. A reader
might be tempted to observe that riding hobby-horses must be up there too.
Sunday 16th May
The showery, and still not especially warm, weather
continues. An excellent walk with a
friend the other day in Wareham Forest was lovely – wildlife and
bluebells. As we circumnavigated a
puddle on one of the gravel tracks Lindsay spotted a newt. This encouraged me to post the picture on
Instagram. I used a quotation, which I
think must have come from Brian Redhead or John Timpson on the Today programme
many years ago. After an interview with
a naturalist who waxed lyrical about newts and lamented their loss of habitat,
we cut back to the studio where Brian (or John) intoned solemnly, ‘Well I do
hope that they can do something to help these little guys, because I always
say, when they’re gone, there’ll be nothing so missed as a newt’. (Transatlantic readers may not understand
this).
The Wareham Forest newt
Wildlife. We have had
several visits from a Sika deer (very common in Dorset), which seems to enjoy
tasting our new grass, and indeed any new shooting shrub. It chews the grass down to where I’ve attempted
to cut it with a strimmer. I don’t think
it is as careful as I am not to damage the seedlings.
In a week where two friends have died, well before their
time, from malignancy, it was an uplifting experience to take the open road
north to Blandford Forum and see the new lime-green colouration of the trees in
spring. One huge oak in particular, had
leaves which were almost lemon-yellow.
Much depressing correspondence in the newspapers about the
difficulty of seeing a General Practitioner.
A trenchant article by Meirion Thomas, a cancer surgeon, states that the
whole system needs reform, but that there is huge opposition from our union,
the BMA. This is true. The BMA, for all its claim to represent all
doctors, was founded by General Practitioners, and remains a union with a
strong protectionist stance (personal view).
The Royal College of General Practitioners is another bastion of the
status quo – or at least almost so.
Unfortunately, changing from a capitation fee system (with top-ups for
meeting ‘targets’) to a fee for service system) risks even more abuses. Many years ago, a friend returned from a
Canadian emergency room with about double the number of stitches (sutures) that
were needed in a skin wound. The
explanation? Doctors paid on a ‘per
suture’ basis! To end this depressing
scenario, we’ve seen this week the Department of Health state that advice for
the future should be for GPs to undertake online or video or telephone triage
before agreeing to see a patient in person.
Such was the outcry that this advice was quickly withdrawn within 24
hours, and an acceptance that the norm should be that the GP should see the
patient.
As a doctor, it is important to remain humble (unless you
are a surgeon). Sir Thomas Lewis, doyen
of early 20th Century cardiology, was a remarkable clinical
investigator. He was on the staff of
University College Hospital, where I trained.
In forgotten nooks of the UCH system, such as the Temperance Hospital
and St Pancras (North wing), it was still possible to find patients’ notes in
which the Great Man had written. Early
on, I was deputed to see a lady in St Pancras’ Hospital, who was elderly and
now dementing. I was awe-struck to find
Sir Thomas’s outpatient notes. The
lady’s name I still remember: it was a Miss Ivy K. Written in Sir Thomas’ neat, small
handwriting in the early 1940s, her occupation was given as ‘Christmas Card
Ribboner’. The diagnosis was rheumatic
heart disease. The first clinical
observation was ‘Obvious capillary pulsation of the face’. Lewis diagnosed triple valve
regurgitation. At the end his summary
was: Prognosis – poor; triple valve incompetence. I found it instructive and humbling that Ivy
K had outlived Sir Thomas by a minimum of 25 years…
With regard to the General Practitioner, I will close this
homily with the words of Sir James Mackenzie (1853 – 1925). Let us hope that some GP may someday read
them. Sir James Mackenzie (born Scone,
Scotland) was the first true cardiologist in Britain, but he started his
practice life as a GP in Burnley, Lancashire.
Mackenzie is beloved by the Royal College of General Practitioners
because of this fact. In his ‘Diseases
of the Heart’, first published in 1908, he wrote, with regards to the history
of the complaint and the patient’s symptoms:
“In order to determine the value of any given symptom in
affections of the heart, a long and patient inquiry is needed…” He goes on to say that “Observations must be
made at various periods of the individual’s life…”
“It is evident that such observations can only be undertaken
by a physician who is likely to see individual patients during all these
circumstances, and that can only be done by the general practitioner. Such a line of observation I have attempted,
and I warn those who would follow this line of research that it is no primrose
path. The investigators in hospital
wards and laboratories have little idea of the difficulties the general
practitioner has to encounter. He must
ever be on the alert, prepared to make an observation at any hour of the day or
night, and may have to spend many hours in a wretched hovel watching the
changes in a woman in labour. Attacks of
illness, which may arise suddenly during day and night, must find him prepared
to take advantage of his opportunities.”
Amen to that. A
different world of medicine.
And before leaving the medical world; an anecdote.
As a medical student, at lunchtime, we dutifully trooped up
the back stairs to the observation area of the post-mortem room. Above us as we walked, in gold lettering:
‘Mors Ipsa Docet Succurere Vitae’. ‘Death
Itself Teaches Us To Sustain Life’. The
other side of the barrier was reserved for the pathologists, senior doctors,
and visiting firemen. On one occasion,
we were confronted with the body of a lady of relatively young years – perhaps
in her 40s. She had suffered from severe
SLE (autoimmune disease). The only
treatment at the time was high dose steroids, but despite this she had
developed diabetes and end-stage kidney failure. A few months before her death she complained
of difficulty with vision. This had
progressed. She had become completely
blind. It was an inexorable
process. At that time there was no CT,
no imaging of any kind except X-ray.
There was a visitor from the United States. The pathologist exposed the skull, the brain
and nasal sinuses. An indeterminately
grey mass of tissue extended from the nose up into the brain, completely
enveloping the optic nerves and indeed the orbits. The American pathologist told us that
preliminary microscopy and culture had established that this was mucor mycosis,
a very rare fungal disease, spreading up from the sinuses into the skull and
the brain. It had generally only been
described in seriously uncontrolled diabetes and severe immunosuppression. I tell this story because the spectre of this
rare disease has arisen again, in India.
Many of the fatalities from Covid-19 have been found to be due to mucormycosis,
generally of the lungs. This is probably
due to the steroid immunosuppression, which is used in India, without the
advantages of intensive care management.
In India it is known as ‘black lung’.
Finally today, a complete non-sequitur. We have been following and enjoying the Giro
d’Italia, the three week grand tour cycle race.
Feelings of longing for the spectacular destinations. The other day a French team raced into the
overall lead. In the Tour de France, the
leader wears the coveted ‘yellow jersey’.
In Italy it is the ‘Maglia Rosa’, the pink jersey. Shots of the jubilant French team bus with
the team toasting in champagne and in the background – yes, the song was ‘La
Vie en Rose’.
Monday May 24th
Very ‘iffy’ weather.
Friday blew a gale and rained. We
had a golf exchange day I could not get out of.
We survived but the golf was fragmentary. The course, Hindhead in Surrey, is an
attractive mix of heathland and downland valleys. Wikipaedia says that it is the highest
village in Surrey. During lunch I noted
a picture of Sir Arthur Conan Doyle playing golf. He was the club’s first President, in
1904. He seems to have had a good
shoulder turn judging by the photograph.
The 9th green is spectacularly surrounded by specimen
rhododendrons and azaleas. Some
conversation about how Parkstone G.C. could be made more attractive. Apparently some of the more traditional
members have been heard to mutter that it is ‘A Golf Club, not a Garden
Centre’.
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| The 9th green at Hindhead G.C. (in the rain). Note the river running down the middle of the green. |
Nationally and Internationally there is great concern about
‘The Indian Variant’. Of course, the
reader will immediately realise that I am talking about coronavirus. In a pre-pandemic world he or she might have
thought that I would be about to discuss the game of chess. Another faux
pas by the government was the announcement that flights to the UK from
India would not be allowed but failing to implement this with immediate
effect. Many Indians who can afford to
have of course flown to the UK, if only to escape the risk and devastation in
India, where the pandemic is out of control.
Evidence this week that our current vaccines have reasonable protective
effect against the Indian variant.
There is also virtual war in Israel/Palestine. Rocket attacks by Hamas from Gaza on Northern
Israel. Retaliatory strikes into Gaza
City. Many more Palestinians than
Israeli dead. Joe Biden is seen as a
weak President, and has given both sides the equivalent of a slap on the wrist;
but at last there seems to be a ceasefire.
Major news this week is the new report into the Martin
Bashir affair, which finds the BBC culpable in not realising his crooked ploys
to gain the attention of Earl Spencer and Lady Diana in the 1990s. The then DG of the BBC, Tony Hall, clearly
got it completely wrong, but so far has not been called to account. Prince William has stated that the BBC’s
actions fostered the paranoia and press frenzy which ultimately led to his
mother’s death. It would seem that there
is only a minor grain of truth in this.
A well presented interview with the official personal protection officer
for Diana points out that her fatal mistake was to reject official protection
and to rely on the dreadful (my word) Fayed family’s personal protection
system, which unfortunately included a drunk chauffeur.
Alternating sunshine and heavy showers today. Still rather unseasonable late May
weather. We are promised warmer weather
for the late May Bank Holiday weekend.
Two friends have died in their 60s from malignancy this last week – one
not affected by the pandemic, but the other presenting late, and possibly not
investigated due to the barbed wire fence which surrounds our GP surgeries. Carpe
diem.
The weather relented sufficiently for a small group of us to
join our Sicily tour guide on a walk from Lymington to Brockenhurst. Although we have walked this area before, it
was fun to meet up with him again, and one of his team. On the way we re-explored Boldre church, and
saw the memorial to HMS Hood, sunk by the Bismarck almost exactly 80 years
ago. A devastating loss for the Royal
Navy and a significant effect on national morale at the time, the explosion of
the aft magazine triggered an immediate sinking and the loss of all but three
of her 1418 personnel.
HMS Hood memorial, Boldre church
Arriving back in Brockenhurst we also explored the little
church to the south of the main village.
A sign stating ‘Commonwealth War Graves’ directed us into the
churchyard. An unusually large number of
the classic WWI headstones surprised us.
These turned out to be almost all New Zealanders. A substantial ‘tin city’ existed south of the
village from 1916 primarily to rehabilitate New Zealand soldiers wounded in
battle. One can only wonder at the
mental drive or stimulus that took young men in their early 20s from New
Zealand to fight in a meaningless war on the other side of the world.
Commonwealth War Graves, Brockenhurst churchyard
Final link to World Wars: a recent review of an excruciating
play in the paper recalled a famous story which I hadn’t seen for many years
about a production for the stage of the ‘Diary of Anne Frank’. The actress (a loose term here), Pia Zadora,
played Anne. The play was so bad and her
acting so poor that early in the second half, as the Gestapo entered the house,
one wag in the audience yelled out ‘She’s in the attic!’
Wednesday 2nd June
A beautiful day, as it has been now for a week. Last night we re-established our (all male)
book club, sitting outside in a friend’s garden to the north of Wimborne and
discussing Nevil Shute. Life seemed
almost normal. Two joined by Zoom from
the Shetland Islands (new trendy destination for staycationers), one from
London and one from his boat. This
latter was wearing rather curious braces, which could have been deep sea
yachting trousers, could have been a cookery apron, but turned out to be
genuine braces, having just emerged from court (he’s a barrister), and
obviously the uniform still includes the ‘Masters of the Universe’ attire. Nevil Shute was a rollicking good read. Next time we have a joint meeting with a
ladies’ book club – the choice – Bernardine Evaristo’s Mr Loverman, which is
likely to be a bit different.
Last week saw a brief, 24 hour, visit to Bridport to stay
with friends (now allowed), and the start of this good weather. Lovely to walk the Jurassic Coast again. Impossible to get into the Anchor Inn at
Seatown – even on a Wednesday, such is the pressure from stay at home holidays.
Jurassic coast, looking west towards Lyme Bay
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| Morag and Lindsay, looking east towards West Bay |
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| Colmer's Hill, aka 'Tufty' |
Having woken at 6am this morning (broad daylight), it seemed
appropriate to write something today – yesterday was the first day since the
pandemic began that there were no Covid-related deaths in England and
Wales. There has been a recent surge in
Bolton, related to the importation of the ‘Indian Variant’. Possibly due to the lamentably low
vaccination uptake in ethnic minorities.
It remains surprising that so many hospital employees in some areas of
the country have not been vaccinated, and the government is toying again with
the idea of making vaccination of health workers compulsory.
A frightening episode the other day, with the aligned
Western nations, and the EU, powerless to do anything about it. A Ryanair flight en route Athens-Vilnius was
diverted to Minsk after the pilots were informed there was a possible bomb on
board. A jet fighter from Belarus
shadowed it. Once on the ground, a
Belarus dissident and critic of the strongman leader (dictator) of Belarus was
arrested together with his girlfriend. A
state-sponsored hijack.
And the theory that Covid-19 may have been synthesised in
the Wuhan virus research institute has re-emerged. Sir Richard Dearlove (ex-MI5) says that one
can be sure any evidence that this is the case will have been expunged by China
long ago.
Finally, Boris Johnson married Carrie Symonds in a secret
wedding ceremony at Westminster Cathedral the other day. This has helped to defuse the fallout from
yet another Dominic Cummings effusion of vitriol about his time as special
adviser in Downing Street. Highly
critical of the PM (unfit for office), and the health secretary (Matt Hancock),
‘He should have been fired at least 15 to 20 times’, his splenetic outpourings
have probably damaged his hopes of a revelationary book because everything that
might have been a surprise has now been revealed. His main point about Hancock is the
disastrous events early in the pandemic where hospitalised Covid patients were
sent back to care homes to lethal and devastating effect. In his defence, Hancock’s team have indicated
that our testing capacity at that time was so poor that this would not have
been feasible. Nonetheless it remains a
disaster, but Cummings of course is blessed with 20-20 hindsight; curious in
view of his need to drive to Barnard Castle to test his eyesight.
It was noted that Boris and Carrie married in a Catholic
cathedral. A Telegraph letter writer
(always plenty of good material in these) notes that Oscar Wilde’s late
conversion to Catholicism was explained by the writer as joining a church where
‘Every saint has a past and every sinner has a future’.
Last week we visited a friend who has been treated for bowel
cancer, and were asked to do the Covid rapid tests (known as lateral flow
tests) before visiting. The little
testing strip is rather like a pregnancy test.
After a throat and nasal swab, the cotton bud is dipped in a special
buffer solution and then two drops are placed in the testing well. The result is read after 30 minutes. Negative.
We were also visited by my daughter and her partner who routinely did
the tests at home in London before coming down to stay with us. The new normal.
Another sign of a different normality. Cricket (Test Match Cricket that is) starts
today with England vs New Zealand.
Thursday
June 3rd
A day off from house problems. Walk over in Purbeck. Lucky to see the ‘endangered’ sand lizard on Godlingston Heath. Lovely views: Swanage bay, the Isle of Wight, Poole harbour.
The chalk stacks, near 'Old Harry'
Ballard Down and Poole Harbour 
Sand Lizard, Godlingston Heath
Yesterday
evening a lovely session with friends.
Richard and I played guitar duets together (Carulli; nothing too
challenging). It’s so long since we have
been able to play together that we were virtually sight reading the piece. I remember the sleeve notes to the John
Williams and Julian Bream ‘Together’ album.
Chopin is reported as saying once that there was no sound more beautiful
than the guitar, save perhaps two guitars.
Anybody who does not remember vinyl or does not possess 12” LPs will not
know what ‘sleeve notes’ are.
A
mysterious acronym was reported the other day.
A woman journalist, divorced, has entered the fray of online
dating. She reports that one man,
seemingly quite pleasant and a possible match, stated that he was ‘Not
interested in ONS’. She was surprised
that somebody should be so upfront about his lack of interest in the Office for
National Statistics. Admittedly they
have been in the news quite a lot lately, what with their gatherings of data on
Covid deaths, spread of variants, etc.
Further enquiry revealed that in this context, ‘ONS’ is an acronym for
‘One Night Stands’.
