Saturday, October 7, 2023

Evening Hill Diary - from Midsummer to Autumn 2023

 

Mid-August 2023


The head of the British Museum has resigned.  It has been pointed out that many items have been stolen – probably by staff – and have appeared on retailing websites, and nothing has been done.  As usual, the cartoonist Matt sums it up well.



The weather remains disappointing but reasonably warm.  The news, at least the national news, remains dispiriting.  Sadiq Khan, London mayor, firmly intends to bring in his ULEZ (Ultra Low Emission Zone) expansion from 29th August.  His figures for death related to pollution are disputed by many, and the legislation will hit poorer people who own older cars more than richer people (have you noticed that the only people who drive electric cars are wealthy?).  Planned rail strikes will force many to drive (including ourselves – we were planning to catch the train to London and then cycle to the Brentford vs Bournemouth match in a week’s time).  Traffic calming measures – speed humps and chicanes actually increase fuel consumption and thus pollution.  Oh dear.  We have also had more doctors’ strikes, including consultants.  The press points to the high salaries which consultants earn.  An antipathetic strategy.

One lovely day – a Sunday – and we introduce some Swiss friends to a section of the Dorset coast which they have not seen before.  They are keen walkers and have been steadily devouring the Southwest Coast Path for some time.  Being Swiss, they had been perplexed to find that it was not possible (on a weekday) to walk from Kimmeridge to Lulworth).  Of course, the reason is that the British play war games during the week and the coast is off limits.  Starting from Whiteways car park on the Purbeck ridge, we walk along Flowers Barrow, almost to Arish Mell, the tiny beach in the midst of the Lulworth Army Reserve, and then back around the coast to Worbarrow.  A visit to Tyneham (the little village commandeered by the Army in about 1943) also engenders Swiss interest, and perhaps puzzlement.


The Dorset coast, looking towards the 'Isle of Portland'


18th August

Fly to Edinburgh for my usual delve into the Good, the Bad, and the Ugly which is the Edinburgh Festival and its ‘Fringe’.  My friend G….., from medical school, who lives in Edinburgh, and I, have been exploring this for well over 40 years.  I have to have an excuse to go these days – the Fringe is too unpredictable, though there is always a good exhibition on at the Royal Scottish Academy.  When looking through the main Festival programme, early in the year, two things caught my eye.  One, the Threepenny Opera by Bertolt Brecht/Elisabeth Hauptmann/Kurt Weill, to be performed by the Berliner Ensemble (Brecht’s original company).  Two, the Alvin Ailey American Dance Theater, a (mostly) black ballet company I saw in North Carolina in the early 1980s.  For many years, some of the great American dance companies were unable to tour Britain because they used recorded music.  Equity (or was it the Musicians’ Union?) would not allow it.  Obviously, the current troupe would not have been born the last time I saw the company (!) but it seemed too good an opportunity to miss.

But Edinburgh is a wonderful place...

Edinburgh castle from the west end of Princes Street

Edinburgh castle at night

Art everywhere - an Anthony Gormley stands in the Water of Leith


My friend’s husband is happy playing his bagpipes (last appearance on the Fringe in the wittily named ‘Game of Drones’) or practising Scottish fiddle music, and rarely accompanies us.  In the mornings, over breakfast, we study The Scotsman review pages and ring immediately to book anything that sounds good.




Some of the shows appeal by virtue of their names.

For example, ‘First piano on the moon’, ‘Ay Up Hitler!’ (which apparently is based on the assertion that Hitler escaped to Yorkshire), and the intriguing but coarse, ‘Why I stuck a flare up my arse for England’ (something to do with football).



Edinburgh is always full of ghosts for me.  Ghosts of my earlier self, ghosts of my friends who studied there in the late 1960s while I was living in Argyllshire, and ghosts of relatives.  My father was apparently born there in 1918, possibly because his father was in uniform (the family came from Helmsdale, however, in the far north east).  My mother’s cousins both studied there, one medicine, one veterinary science.  It is with a curious sense of retracement that we walk from the mound via the writers’ museum to Summerhall.  This is a fringe venue, and it is in the old Veterinary School, known as The Royal Dick.  Capable of misinterpretation, it is actually named after William Dick, originally a farrier from Cannongate, who began veterinary education in Edinburgh in the early 19th Century, and his school received the Royal Assent and title in 1906.  The old anatomy lab is now a reasonable bar, surrounded by glass cases with historic items of laboratory ware and high up on the walls, an assortment of animal skulls.  Hunker down for a coffee.

Into the ‘First Piano on the Moon’.  Will Pickvance, an acrobatic and brilliant pianist, essentially a show for children from 5 to 95.  Great entertainment as Will does badly at school, but then gets an invitation to play at Mozart’s birthday party in Salzburg.

The afternoon, or most of it, is spent in G’s Scottish Arts Club, a venerable institution in an old building in Rutland Square.

It seems unlikely that the American protagonist will read this (fortunately), but G, as senior member present, has the job of introducing ‘Scottish Voices’, a group of excellent singers, whose job it is to sing some modern renderings of mainly Scottish, and predominantly Gaelic poetry, to piano parts composed by somewhat minimalist composers.  One of these is a Bostonian woman who has wangled a Fulbright scholarship (no doubt all expenses paid) to live and work in Edinburgh and to compose tunes (I use the word in its widest sense) to which the poetry can be sung.

After some passable works by Hamish McCunn we are onto the Gaelic songs (typical example ‘Elegy for George Floyd’ – or ‘Cumha Sheòrais Floyd’), and eventually the major work ‘Mac-Talla’ or ‘Echo’ introduced by the earnest Bostonian.  Unfortunately it seems that the work was curtailed when the designated Hebridean poet, Aonghas MacNeacail (Angus McNicoll to you and me), died.  G leans over to me and suggests sotto voce that he was fed up with being plagued by the earnest Bostonian for more poetry.

All things, good or otherwise, come to an end, and we meander to Fountainbridge for a reasonable pub meal before heading up to the Edinburgh Festival Theatre for the main event, the Berliner Ensemble version of The Threepenny Opera.

What a bleak play.  Exciting, engrossing, and an outstanding performance by Gabriel Schneider, a charismatic Mackie Messer (aka Macheath).  Great music from the Weimar era played by a superb 7-piece band.  The main characters are self-interested and devious.  Great acting from Kathrin Wehlisch as ‘Tiger’ Brown, the corrupt Chief of Police who is Macheath’s friend from their time in the army.  She played the role as a puppet like Charlie Chaplin figure (whom Brecht was known to admire).  The most sympathetic figures are all female, undone by male duplicity.  A powerful evening.

It would be dull to detail all of the other plays that we saw.  Highlights were a Dutch group of revue multi-instrumental musicians in ‘Slapstick Scherzo’ (see them if you can, anywhere they perform), and a curious play, hard to describe, using entirely cardboard props, graffiti covered, all in mime, called ‘The Ice Hole’ – see it if you can.  We saw talented young performers – will they make it in the big bad world of theatre, music, and drama?  Who knows.



Alvin Ailey American Dance Theater was a final highlight.  Thank heavens the Equity ban has somehow been circumvented.   A joyous finale.  To see staid Edinburgh burghers on their feet clapping and dancing at the final encore was remarkable.

Best exhibition – undoubtedly the gamut of Grayson Perry’s works at the Royal Scottish Academy.  Not to be attended if easily offended, or if you might take exception to Grayson’s concept that his favourite teddy bear, Alan Measles, is really God.  There is a free App called ‘Smartify’ which gives an audioguide narrated by Grayson – worth listening to – I think it is still available.


A modern 'Rake's Progress - Grayson Perry

A Grayson Perry pot - note Alan Measles



Back in Poole, Lindsay has had a great time walking with friends in Switzerland, temperature in the 30s, and eventually this freak weather arrives with us, with September temperatures now over 30 degrees in the U.K.  This makes morning swims in the sea very pleasant.

Saturday September 2nd

To London, to watch Brentford play AFC Bournemouth.  We intended to go by train, but there was a train strike, so we had to drive with our bicycles to Kingston, incurring Mr Khan’s ULEZ charge.  We reached the stadium via the Thames path.  As we leave, curious Bournemouth supporters enquire how early we left this morning to cycle to Brentford.  Final score 2-2.

 

Richmond Park, London, September 2nd

September 7th

A hot and rather humid day again.  Oncology appointment today and PSA is undetectable (good news), though this is expected with anti-androgen therapy, and it is not until this is eventually withdrawn that one might anticipate any tumour activity to reveal itself in PSA elevation.

I visited a colleague with metastatic cholangiocarcinoma today, residing in a hospice for pain control and management of hypercalcaemia.  We lament that doctors are not as shrewd as we were – not entirely unreasonably, since she had to diagnose her own lower segment venous thrombosis herself.  She also had chemotherapy induced angina due to coronary artery spasm which she diagnosed herself.

Doctors do not seem to listen properly to patients these days.  I saw an acquaintance last week (aged 65; ex-smoker) who has been from pillar to post (well, from GP to A&E to specialist advisers) with three months of ‘unexplained’ symptoms.  Perhaps it didn’t help that she first attended the GP and told him she was convinced she had gastric cancer.  Her symptoms began in June – sudden onset of bilateral jaw ache after a heavy meal, radiating down the front of her chest, lasting about 5 minutes, and sometimes accompanied by sweatiness.  Interestingly, rarely brought on by exercise – but then she doesn’t exercise much.  Now frightened to have anything more than a bowl of soup in case the symptoms come on again.  Diagnosis – prior to my seeing her - everything from costochondritis to gastritis to pulmonary embolism, even after attendance at the E.R.  She had been treated with anti-inflammatories and then antacids and acid suppressants.  The obvious diagnosis: angina pectoris (pain from coronary artery narrowing), had not been thought of.  Result of conversation: a phone call to a colleague who arranged a CT coronary angiogram which showed a critical right coronary artery narrowing.  She is on the correct treatment and is scheduled for stent insertion (now done).  In the 19th century, the great physician Sir William Osler said, ‘Listen to the patient for he (she) is telling you the diagnosis’.  I think the problem with doctors today is threefold: Firstly, lack of continuity in care.  Secondly, lack of time to sit and listen to patients resulting in snap diagnoses which are often wrong.  Thirdly, lack of the hundreds of hours a month of clinical experience which we had as juniors, together with a reluctance to actually examine patients to save precious time.

In case the reader feels I am getting too big for my own boots, here is a story against myself from 50 years ago, during my time as a junior doctor.  Some names have been changed:

“On one memorable evening, which I can remember as if it were yesterday, I admitted a pleasant, slightly cadaverous looking man in his 50s with breathlessness.  It was my first and possibly best lesson in how to get things wrong, and how to jump to conclusions.  The superb physician, Maurice Pappworth, called these Procrustean Crimes, and it’s well worth retailing this for the education of others.  Procrustes was an Athenian robber, who with his wife, lured travellers to his house on the pretence of hospitality.  Once in bed he would tie them up and if they were shorter than the bed stretch them to fit, or if longer than the bed, lop their limbs off to fit.  Either way they wound up dead and robbed.  So, according to Pappworth, a Procrustean Crime is stretching the diagnosis to fit the history, or the facts, ignoring details which may make the diagnosis untenable.

 

In this case, poor Mr Durand, for that was his name, had obviously lost weight.  He was breathless.  He had coughed up some blood.  He was a cigarette smoker.  Over the heart there was a clear cut murmur heard through the stethoscope, which was clearly audible in systole (contraction) and diastole (relaxation) of the heartbeat.  I surmised that this noise was a pericardial rub (inflammation of the sac around the heart).  On the chest X-ray was a large white mass, close to the heart.  It was the smoking and the haemoptysis that made me diagnose lung cancer.  It seemed very straightforward.  Weight loss – another sure sign.  A pericardial rub – due to tumour infiltration of the heart.

 

It was Mike Creech, my registrar, of course, who suspected otherwise.  He looked at the X-ray with me, and at the mass in the centre of the chest.  He mused ‘I wonder if that shadow is the aorta – but if so it is hugely enlarged.’  We went to talk to the patient.  ‘Tell me about the breathlessness,’ said Mike.

 

‘Well’, said the patient.  ‘I’ve been getting breathless for a while, but it seems to be at night that I get most of the trouble.’

‘Tell me how.’  Said Mike.

‘Well, I can get off to sleep alright, but then I wake up at about two or three in the morning, and I’m fighting for breath, especially if I’ve slipped down off the pillows.’

‘And what do you do?’

‘Well, first of all, it feels as though the room is terribly stuffy and I can’t get enough air.  I sit on the edge of the bed and dangle my legs over the edge, and after a little while I begin to feel a bit better.’

‘And do you do anything else?’

‘Yes, that’s the funny thing doctor, I walk over to the window and throw it open, and I stand there and take deep breaths.  That makes me feel a lot better.  When I go back to bed I find I can usually go back to sleep, but I have taken to using four or five pillows to prop myself up.’

 

Mr Durand had just given a perfect textbook description of heart failure, and the pulmonary oedema that comes on when fluid returns to the circulation at night, especially in the recumbent position.  I remembered that the distension of small blood vessels in the lungs can give blood tinged sputum.  Mike listened to the heart and said that he suspected that the almost continuous heart murmur, my interpretation of which was a pericardial ‘rub’ was in fact the to-and-fro murmur of severe aortic regurgitation.  A dose of diuretic was given and the patient slept comfortably.  The diagnosis was confirmed by Dr Hollman the next morning.  He told us that he suspected Mr Durand had Marfan syndrome, or at least a forme fruste of the condition where the aorta becomes dilated but the other skeletal features of the condition are not obvious.  My Procrustean crime had been to assume that a cadaverous looking smoker was suffering from lung cancer – i.e. a prejudice.  I had fairly recently given up smoking myself and was, and to some extent still am, Messianic about stopping people smoking.  Then I went on to make the signs that I observed fit in with my prejudgement of the case.  This is not to say that I never made a Procrustean mistake again – but is an illustration of one of my most dramatic failures.

 

Mr Durand went to the National Heart Hospital and underwent surgery by John Parker, whom I later came to know quite well.  The aortic valve was successfully replaced and the ascending aorta was replaced with a sleeve of Dacron.  He did well, but a few weeks later he collapsed and sadly died, probably from a tear at the distal anastomosis (join to the aorta) or a fresh rupture of the dilated descending aorta which couldn’t be replaced.  His wife came in to thank us for our efforts.  I said that I was so sorry we hadn’t been able to save him.  She shook her head.  ‘No, the illness and problems that he had are over and gone.  His problems are over.  Mine are just beginning.  I have to find what to do with the rest of my life.’  So many times after this have I heard similar sentiments.  ‘His sufferings are at an end.  Mine are just beginning.’”

 

 

September 8th

One year since the Queen died, and one year since my grandson Arlo was born.

To Dorchester Museum for the one concert that we are able to attend in the Purbeck International Chamber Music Festival.  A step up from its original name which did not include the word International.  Natalie Clein’s collaborators and friends are so wide ranging that its new title is appropriate, with professors of music from many countries taking part.  The highlight (for me at least) is the wonderful Schubert quintet in C major, composed in 1828, just two months before his death, and unheard for another 22 years.  Natalie plays a 1777 Guadagnini cello (‘The Simpson’), and the other musicians are the Danel quartet, all virtuosi in their own right.  55 minutes of sublime music.


Natalie Clein and the Danel Quartet


September 9th

Arlo’s first birthday party.  As usual, these affairs are more for the adults than the recipient.  His parents (both keen cyclists) are delighted with his present of a balance bike, even more overjoyed than Arlo himself who doesn’t know what to do with it.  Some Duplo (train set) appeals more.  It is easier to put it in your mouth.

Bubbles


September 11th

For some time we have thought that it might be fun to cycle around Lake Constance (Bodensee).  The cycle route is apparently very good and often traffic free.  There are many firms which offer this holiday, we chose a German one based in Konstanz – Radweg Reisen.  As an experiment we decided to hire electric bikes.

It’s an easy hop to Zürich and a train goes directly from the airport northeast to Konstanz.  It is something of a change to roll along through rural Switzerland (the Canton of Thurgau) without mountains.  Arable farming is the main occupation, and particularly fruit and vegetables.  An occasional red kite or buzzard whirls over the farmland, and in one open field, apparently gleaning after the corn is cut, there are several storks.

Konstanz is officially in Germany, though no passport problems and we settle in to the Hotel Halm, opposite the bahnhof.  A long walk takes us to the northern section of the city where Radweg Reisen are checking over our bikes.  It is a much easier journey back.  The bikes, made by German company Velo de Ville, are very heavy and rugged, but with a small amount of power selected the riding is easy.  The settings – Eco, Tour, Sport, Turbo – give some indication of the resources one can summon up at the press of a switch (I know this is not news to aficionados).  Dinner by the lake on a beautiful late summer’s evening.

September 12th

Our first ride is westwards along the small finger of the lake (Untersee) which leads directly to the Rhine, which is crossed at Stein am Rhein.  The boundaries of Switzerland and Germany are a little confusing.  Switzerland has both sides of the Rhine here.  Stein am Rhein is heaving with tourists.  It is said to be the best preserved mediaeval town in Switzerland, with its complement of original or restored buildings, an impressive gatehouse and tower, and many beautiful wall paintings on the houses.  It looks like something out of Harry Potter, perhaps Diagon Alley, or Hogsmeade.


Stein am Rhein


Diagon Alley


Here, the electric bikes display their advantages.  There is a beautiful old covered trestle bridge across the Rhine, some 10 km downstream – a detour – but it doesn’t seem to be a hardship.  Gailingen, where the bridge is situated, has, as many towns or villages on the lake and river do, an area called the Strandbad.  This is a riverside or lakeside public park, always beautifully maintained, where one can picnic, sunbathe, and swim.  There are many locals floating down the Rhine on their ‘noodles’, and presumably they get out somewhere and walk back.  The river current looks quite fierce.

Gailingen trestle bridge over the Rhine


I won’t dwell on all the minutiae of our holiday except for a few curious and interesting highlights.  The next morning, we stop in the neighbouring village, Hemmenhofen, and visit the house of the artist, Otto Dix.  I have wanted to learn more about Otto Dix because his early (Weimar) paintings capture beautifully the contrasts of rich and poor in 1920s Germany.  His triptych, Metropolis (Die Grossstadt), painted in 1928 is a good example, contrasting Cabaret like scenes in the centre panels with the grotesque images of the down and outs seen in Germany after the first World War.  Surely the producer and director of the film Cabaret, must have had his figures in mind when devising the setting for the Kit Kat Club?

All I knew about the painter before going to his house was that Hitler had a great antipathy for his work, his paintings being selected for the infamous Entartete Kunst (Degenerate Art) exhibition held in Munich in 1937.  But he had been dismissed by the Nazis from his Professorship post in Dresden some years before.  In 1936 therefore, mindful that he might need to escape Germany, he and his wife built the house which overlooks Lake Constance, and is only a mile or two from the Swiss border.  The photogravure reproductions of his paintings are present in every room, and the experience is enhanced by an audioguide in which his son, Jan, talks about their life together as a family in Hemmenhofen.  It seems that most of his great works are in the Art Gallery in Stuttgart.  Dix lived here until his death in 1969.

Die Grossstadt, Otto Dix


This painting by Otto Dix sits in the Museum of Uncertain Provenance, above the Zeppelin museum.  It belonged to a family named Strauss and was almost certainly purloined by the Nazis.  Research to find the possible descendants of the owners is ongoing.


The northern rim of the lake is in Germany, mostly in Baden-Württemberg, and it seems like Germany’s ‘Gold Coast’.  Beautiful villas and apartments rim the lakeside.  Inland we cycle past hundreds of apple orchards, and find it strange that we never seem to see German apples in our shops.  There are many vineyards as well.





Friedrichshafen is a must see for aviation (or dirigible) enthusiasts.  It houses the Zeppelin museum.  Count Zeppelin launched his first airship in Friedrichshafen (LZ1) in 1900 for a 20-minute flight over Lake Constance.  Lindsay and I get two reductions in the entry fee.  One for being senioren and a further reduction for having travelled there by bike.  It is very popular, with Germans as well as other tourists, though there is no irony for them, it seems, in looking at German military top brass quaffing champagne in the Graf Zeppelin and the Hindenburg in the 1930s.  Another happy snap catches Ferdinand Porsche and friends trying out a new tank destined for the German army in 1943.

Aeroplane food isn't like this any more - items from the Zeppelins


Further on we stay on the island in the lake which is part of Lindau, and then cycle through the very small part of Austria which borders the lake, namely the City of Bregenz, capital of the Vorarlberg.  We are too late for the famous Bregenz opera festival, held on the seebühne (sea stage).  There is a cable car in the city which whisks you up the Pfänder mountain, to a height of 1064m.  This is well worth the trip, and there is a variety of bicycle routes down from the top which are very straightforward.  In the sunshine at the top of the lift it seems strange to look at the mountains to the east, for example the Valluga above St Anton, only 40 km away.

Crossing the Rhine again takes us into Switzerland, and our last night on the route is spent in Arbon, which was important as the site where the Irish monk, St Gallus, set up his ministry.  We ponder how St Gallus managed to travel there…  He then moved a short distance away to found the monastery of St Gallen.



Pfander cable car above the lake at Bregenz


Not a blot on the landscape.  Henry Moore outside the Wurth gallery in Rorschach


No caption required

Sunset on the Untersee



The dog days of September back in Poole are interrupted by weather systems from the Atlantic.  At one moment sitting to eat lunch outside, at another driven in by thunderstorms and torrential rain.

It’s hard to know what to make of politics at the moment.  Rumours that HS2 (a high speed rail network from London to the north, now billions over budget) will be watered down or even abandoned.  Nervous politicians because we are now entering the party conference season.  All with an eye on a General Election, a little more than a year away.

And Donald Trump, ever popular with Republicans, has been indicted on numerous charges, the clearest of which seems to have been that his assets were falsely inflated to gain loans at reduced rates.



The news has been dominated by BBC fixations.  One day it is a prisoner at Wandsworth prison who has escaped by holding on to the underside of a kitchen delivery lorry; on another day it is King Charles speaking execrable French but seemingly going down a storm in Versailles; or a British made missile in use in Ukraine; or more doctors’ strikes and the cancellation of hospital appointments.

While we were away, the Vuelta a Espana ended with a popular win for the American rider, Sepp Kuss.  His team, Jumbo-Visma, have won all three grand tours this year with three different winners.

But more sport, the Solheim Cup (golf) has just ended with jubilation for the Europe team in retaining the cup, but surely this should be tempered with the result that the final score was Europe 14 - U.S.A. 14?  And the rugby world cup now features.  A titanic match between Ireland and South Africa ends with a narrow win for Ireland.  Wales thrash Australia 40 points to 6.

October 1st, 2023

Very mild though overcast.  September temperatures have been much above average and October continues this.  Swim in the sea where the temperature is holding up, websites suggesting that it is still 18 degrees C which is remarkably high.

The last three days have been punctuated by many hours of adherence to the TV showing the Ryder Cup, held at golf course Marco Simone, outside Rome.  Europe get off to a storming start and although America come back strongly, the final day sees honours even in the singles competition but Europe had done enough to win by a margin of 5 points, 16½ to 11½.  Much breast beating to come from the U.S.A. golf pundits.  In two years’ time we are in Long Island at Bethpage Black, and U.S. revenge is strong possibility.

 

Something to dwell on in the next edition of the blog – chatting with my Edinburgh friend, and the changes in things that preoccupy us, compared with when we were medical students.  Looking back on 50 years since we qualified as doctors.  As a trailer for our musings, here is something that came to me recently:

In the 1960s, when we imagined ourselves adult and mature, incorrect on both counts, I watched a black and white TV programme, a 1966 play of the sort that the BBC do not make or show these days.  It was called ‘The Snow Ball’ and was based on a 1964 novel by Brigid Brophy, which has re-emerged (reissued recently) as a cult classic.

The play starred Patrick Allen (an acting hero of mine), who played the main character, at a New Year’s Eve masked ball, where he was impersonating Don Giovanni.  An encounter with a masked woman dressed as Donna Anna resulted in a tantalising and sexually charged conversation, but as I recall we don’t discover what the outcome is (though the implications are obvious).  The most charged dialogue that I remember is that these two characters ask one another, ‘What do you think about?’  In my memory of the scene, Patrick Allen asked Donna Anna this question.  She replied, ‘Mozart, and sex.  What do you think about?’  The reply was, ‘Mozart (pause), sex (pause), and death.’  According to current reviews of the novel, I have this the wrong way round, and the first reply is that of Don Giovanni.

Later in the night a young couple have their first sexual experience in the back of a Bentley, during a snowstorm (yes, perhaps wishful thinking played a part in my juvenile appreciation of the drama).

All this seemed extraordinarily sophisticated to an 18-year old.  But then I read the novel and found it extremely pretentious.  After the reissue of the novel recently, and reading the adulatory reviews, I seem to be in a minority of one…

 

Our musings?  We were eating in a reasonable Italian restaurant in the heart of Edinburgh.  G said to me, ‘You know, when we were students, all we ever thought about was sex.  But now my food and this menu in front of me seems much more important.’  A remarkable frank confession, but then G does not pull punches when describing some of our erstwhile colleagues, for example: ‘Very consultoid and dreadfully dull.’  Or another, ‘She was very bright, married X’s (Surgeon’s) son who only did medicine to please his bullying father.  He subsequently did history and became an expert on the Battle of Trafalgar.’  Again, ‘… dull and boring; looked like a stooped old man, even as a student.’  And finally, ‘Original Hooray Henry, didn’t like his posh overbearing manner when I was a student, but then found I rather liked him and we did ‘share a moment’’.  I presume the latter to be a euphemism.

I suppose as students we did find time for other things, art, culture, music – and packing away an enormous amount of medical knowledge and experience, with its attending humour and pathos, in a short time.

 

So now we move into Autumn, perhaps literally and metaphorically, and yes, I do enjoy looking at a good menu.