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| Early morning swim, Branksome Chine beach, 9th October 2023 |
We visit a friend in Somerset. She lives in a tiny village near Castle Cary. In the afternoon we walk the tracks and lanes in the steep sided valley of Hadspen, which lead towards Bruton (the trendy place for bucolitropic London celebrities who don’t wish to move to the Cotswolds). Current residents include Stella McCartney, George Osborne, Alice Temperley, Sam Taylor-Johnson, Don McCullin, and other movers and shakers.
Our walk is interesting not
because of the distant views of this little town but because our friend knows many
of the farmers who allow us to walk through their apple orchards, heavily laden
with apples destined for cider. I try
several different apples – all taste awful and it seems strange that
nonetheless they will make wonderful cider.
Very close by is Hadspen House,
formerly owned by the Hobhouse family – childhood friends of our host. Relatively recently taken over by a South
African industrialist who has transformed the gardens of the estate, which he
has renamed ‘The Newt’ as a treasure house of apples from every county in
England and a repository of rare varieties.
Fabulous cider on sale at fabulous prices.
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| The Newt |
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| Cider orchards near Hadspen |
October 7th
For the south (not Scotland) a
dreamy spell of Indian Summer with temperatures set to reach 25 degrees
today. A visit this week to the
wonderful West Sussex golf club. The
signature hole, a long drive across a lake, still has a marvellous show of
water lilies.
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| 6th Hole, West Sussex Golf Club |
Some Swiss friends visited and
had never seen the Agglestone – so here it is.
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| Agglestone Rock, Isle of Purbeck |
And a regatta off Old Harry rocks (Handfast Point)
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| Old Harry rocks |
And more hot weather. But though we enjoy a few more days of record
October temperatures, there is a major convulsion in the World Order on
Saturday October 7th. A
substantial incursion of HAMAS fighters into Israel, and slaughter of many
innocent families and children, including a summary massacre of some 250 or
more people attending a music festival, irrespective of nationality. One Israeli military commander likens it to
‘Our Nine-Eleven’, and when the body count is finally totted up the numbers
will indeed likely be in the thousands. Addendum: currently estimated 1400.
Israel, unsurprisingly responds
in kind. No doubt also irked by their
intelligence failure to predict this coming.
We are now (October 10th) into the 4th day of a
new middle-east war.
As if we needed another war…
October 17th
Over the last few days the
temperature has plummeted. We have gone
from T-shirts to windproofs and beanies.
The Dorset Gentlemen’s Walking Society today braved chill temperatures and
storm force winds, but bright sunshine.
Storm Babet arrives tomorrow, currently wending its way across the
Atlantic. Lovely Country trails with
distant views of Crichel House and crossing and recrossing of the chalk stream
River Allen, where some sizeable trout can be seen, tails waving in the
current.
In these confusing times, and I speak
of gender issues now, I have come across a quotation from Henry James in 1894,
who was so perplexed at the new incursions of enlightened feminists (many
wearing men’s clothes, or openly bisexual, and published in the famous ‘Yellow
Book’) that he wrote in ‘The Death of the Lion’, a short story, of a character
complaining: ‘In the age we live in, one gets lost amongst the genders and the
pronouns.’ Perhaps reassuring to the
heroic J K Rowling? (Item courtesy Sara
Lodge, Senior Lecturer in English at St Andrew’s University). I saw an interview with Frederic Raphael
recently in which he was asked about ‘woke’ issues and in particular about J K
Rowling and the hate mail she has been subject to since her pronouncements on
gender. He did not hold back,
particularly when asked about the attempts to dissociate themselves from, and
criticise her views by the Harry Potter film franchise stars, Emma Watson,
Rupert Grint, and Daniel Radcliffe.
‘Little s…s’ was his verdict.
‘She’s made them millionaires and this is how they reward her’. (I may have slightly misquoted – but the
expurgated phrase is exact).
October 29th, 2023
The day when the clocks go back
and daylight is greater in the morning but less in the afternoon. Terrible weather and appalling floods in
Scotland recently. Golf course closed
frequently. I braved the rain last
weekend to cycle to the Bournemouth match against Wolves. Lost 2-1.
Attended again yesterday – first win of the season versus Burnley, 2-1,
though a neutral would have observed that they tried hard to lose it.
Main event this week was attendance
at the hospital trust’s Governors Board meeting. The minutes of the first part are in the
public domain so I feel I can report my reactions fairly and without risk of
breaching confidence.
I am not quite sure why I want to
continue to be a Governor, other than at least trying to contribute in some
small way, though the Governors’ role legally is restricted and very different
from the role that other governing bodies fill, for example at schools and
other institutions. (In NHS Trusts, the
non-executive directors are the direct supervisors of the CEO and Executive
Board). Perhaps it is a need to continue
to try to do my best for local healthcare.
But I always find these meetings a little depressing. Review of the hospitals’ performance is
neatly contained in a monthly report called the IPR (Integrated Performance
Report). To keep things simple, a
traffic light system indicates performance against national criteria
(targets). Frankly, it is a sea of
red. There are few areas where we reach
what we are supposed to. Financial
report – gloomy – again. There is always
discussion around what we used to call ‘bed blockers’, subsequently the less demeaning
term ‘patients medically fit for discharge’ and now a new slightly more woke
term which is something like NCTR (No Criteria to Reside), the officially
approved NHS term (honestly it is, you can Google it). This gives a ‘Discharge Ready Date’ which of
course differs from the actual discharge date.
We are apparently something of an outlier, and it is not related just to
the age of our population. We have some
200 patients who can be discharged but have nowhere to go to.
While musing about this, I
recalled sitting in my first Fellows’ welcome and address speech at Duke
University Medical Center, in 1981. The
address was given by the hugely famous Professor James B. Wyngaarden (expert on
inborn errors of metabolism), Chairman of the Department of Medicine. Wyngaarden was soon to be summoned from Duke
to head the National Institutes of Health at the request of President
Reagan. This is a paraphrase of
something he said: ‘At the time I am speaking to you new fellows and residents,
the occupancy of our beds in Duke Hospital is 57%’, he said. ‘And I am relying on your energy and
competency to substantially increase that percentage over the coming year’.
To a refugee from the NHS (bed
occupancies in excess of 98%), to say that I was dumbfounded would be an
understatement. But in the USA, empty
beds make no money…
Along with our perusal of the IPR
there is a new initiative mentioned. It
is called Patients First, and is apparently a national initiative together with
the (inevitable) training modules. I can
scarcely believe my ears. ‘Isn’t this
what I have spent my medical life trying to do?’ is the thought bubble which
floats above my head and is fortunately not noticed by others present. The meeting draws to a close just after 7pm. There is an American rock band called ‘Rage
Against the Machine’, a feeling which comes to mind. And Jonathan Swift’s epitaph, ‘He lies where
savage indignation can no longer pierce his breast’. I am not courageous but sometimes I feel that
I wish I were a modern day Jonathan Swift.
Heads and brick walls also come to mind where the Leviathan of the
Health Service is concerned.
I then go to visit a 78-year-old
friend who is in the Acute Medical Unit with pneumonia. He is on oxygen but able to talk. There is an incessant beeping from his
intravenous infusion which shows a high pressure alarm. When I leave him I go to the ward desk and
tell the nurse about this, and request that something is done about it. ‘Yes’, she says, ‘But we’re just about to
have report’. Refraining from asking
whether she has done the ‘Patients First’ module I leave the ward fuming. ‘Report’ has been the bugbear of my life as a
consultant. Following the Salmon report
many years ago into nursing practice, it was decreed that patient handover
should be more formalised. But in our
hospitals nowadays, the poor continuity of staffing in many cases, and the very
high turnover of patients, mean that many staff coming on for their shift have
never met many of the patients now under their care. In practice, this means that the entire
nursing staff withdraw to an office for a long (sometimes up to an hour)
handover, leaving patients to fend for themselves. Handover used to happen when I was a house
physician, but it was done by the bedside, the ward sister moving from bed to
bed and briefing the next nurse to take charge.
It was not necessary for the entire ward staff to stop work and ‘have a
meeting’ – the curse of the NHS.
Well, that is one hobby horse
addressed. Where next? The England cricket team? But some topics are beyond saving…
The war in Gaza is
appalling. Israel, by virtue of what
seems to be very arbitrary bombardment in Gaza (civilian and children’s lives
lost) would seem to be losing the propaganda war, despite the horrendous
atrocities inflicted in the raid into Israel by HAMAS. The BBC has stopped short of labelling HAMAS
a terrorist organisation, using the phrase ‘Labelled as a terrorist
organisation by UK Government and others’.
The new phase is on the ground incursion by Israeli military. The unrest has spread, with Lebanese
Hezbollah fighters now attacking Israel.
There is concern that Iran will now become more overtly (formerly
secretly) involved. The most worrying
headline of the week has been that HAMAS representatives have been welcomed to
Moscow by Putin. A recent social media
post revealed a telling quote from Mahatma Gandhi: ‘An eye for an eye leaves
the whole world blind’ (the quote is probably by Gandhi’s biographer, Louis
Fischer).
Maybe there will be some better
news someday.
Saturday November 18th,
2023
A seemingly never ending sequence
of storms has deluged much of the UK and caused significant disruption. Parkstone Golf Club has measured rainfall
from 1st October to 16th November at 350mm (14
inches). Storm Ciarán (more in a moment)
has been replaced by Storm Debi. It hit
this week and represents the earliest time in the storm season that we have
reached the letter ‘D’ in the meteorological alphabet. Such storms mean that swimming can be dangerous due to the overflow from an overloaded sewage system, and as usual, Matt has the 'mot juste'.
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Matt, the Daily Telegraph |
There is little to report in the
way of light relief from the Middle East.
The phrase ‘In war, the first casualty is the truth’ has been attributed
to Aeschylus. He meant of course, the
deceptions practised in the Ancient World by opposing armies and did not live
to experience the rise of propaganda. In
the word strewn wars of the internet, claims and counter-claims on this phrase
particularly push the claims of some U.S. Senator called Hiram something in
originating the phrase. One of these internet
warriors, interestingly, tells us that Aeschylus lived from 456 BC to 524 BC,
i.e. backwards.
The best recent example of
propaganda or misinformation was an explosion in Gaza which HAMAS claimed was
an Israeli missile strike on a hospital.
Israel counter-claimed that the explosion was due to a misfiring
Palestinian missile which had landed not in the hospital but in the car park. U.S. surveillance suggests that the latter is
true, but we cannot be certain. What is
undoubted is that there are substantial civilian casualties in Gaza. Now that the Israeli Defence Force has invaded
it may be that warfare will be better directed against HAMAS fighters, though
there are stories of their gunmen downing weapons, and stealing hospital
clothing in order to escape the on the ground fighting.
Propaganda, is of course, as
classicists will know, the neuter plural gerundive (or gerund) form of the verb
propagare to spread or
propagate. Mention of gerunds reminds me
inevitably of Nigel Molesworth and his struggles with most school
subjects. Molesworth thought that the
Gerund was some sort of animal. Here is
Ronald Searle's illustration from the Molesworth books:
The original use of the word propaganda,
as in Congregatio de Propaganda Fide was
an attempt by the Vatican in 1622 to spread the Christian (Catholic)
message. As such its original use was
neutral, i.e. a simple attempt to spread an ideology or a message. Its later use, incorporating the sense of
manipulation goes much further than ‘being economical with the truth’ and
includes falsehoods to achieve an aim. Its
progeny would now include ‘Fake News’, ‘Misinformation’ and ‘Disinformation’.
Enough. My step grandson (aged 6) came home from
school the other day. Indignation was
painted across his face. ‘Mummy, what do
you think the school play is this Christmas?
Jesus again!’ He has seceded from casting in this year’s
event. He is something of a character,
and the headmaster has accepted this without demur.
On a mission to visit football
grounds where AFC Bournemouth are the visiting team, my wife announced that we
should go to Manchester to see the Etihad stadium. I object to merely travelling there and back,
so we have a mini-break,.
Day one was meant to be climbing
Moel Famau, a hill on the northern section of the Offa’s Dyke path. Storm Ciarán had other ideas, so we explored
Chester in the rain. A University
graduation ceremony was taking place in the cathedral (ancient but remodelled
by Sir Gilbert Scott 1868-75) and there was some fine organ music being
played. The bass notes caused even the
massive stone pillars of the building to vibrate.
Moving on we debate how to spend
the next day when the weather forecast is better. From our hotel on the shores of the Irish Sea
we walk into Prestatyn to discuss this and dine at the Crispy Cod (highly
recommended). Dessert courtesy of
Tesco’s across the road. The last of the
big spenders. Our meal the following
evening in ‘Bryn Williams at Porth Eirias’ (a TV chef who is of course not
there) costs four times as much and is ‘okay’.
The only chardonnay on the wine list by the glass is from Conway (North
Wales) and is a little sharp…
Our Friday therefore begins with
a trip taking our bicycles on the train to Bangor. As we arrive, the heavens open and the
charming (?Victorian) station is deluged with water as rain cascades into the
(?Victorian) iron pipes which have probably not been cleared for years. Huge gouts of water backflow at the bends of
the pipes and the platform resembles a lake.
‘Didn’t we have a luvverley time, the day we went to Bangor’ I
carol. A passenger standing nearby
reminds me that the song is about Bangor, Northern Ireland, but I think he gets
my drift.
We begin the first of 44 miles,
saving grace being a backwind. The cycle
route is mostly excellent, National cycle route 5 (Sustrans), and lies largely
along small roads and some remarkable cliff skirting bike paths. Eventually we reach the Conway estuary, with
the dark grey castle looming over the town and blending into the dark grey
landscape. It would be possible to
glance at the town from the estuary and miss it, despite its immense size. A quick pit stop and then on over the
headland past Llandudno into the sweep of Colwyn Bay. More persistent rain and we are soaked by the
time we get back to The Beaches hotel. A
sense of achievement nonetheless, the longest bike ride for us on normal road
bikes for a very long time.
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| 'Didn't we have a luvverley time?' |
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| OK |
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| Looking East near Penmaenmawr |
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| Conway Castle |
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| The Smallest House, Conway |
Saturday is our trip to watch the
football. A veil can be drawn over
Bournemouth’s performance here. But in
the evening, staying with my cousin, a retired brewer, we have a pub meal and
some excellent beer.
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| Armistice Day respect at Manchester City |
Any readers will deduce that we
have been short of excitement to write about recently and they would be
right. So, on to discuss ‘Book
Club’. After nearly five years in our
all male book club we have read 40 books.
The most recent choice was ‘The Loved One’ by Evelyn Waugh (1948). As a 17-year-old I loved the gallows humour
and satire and probably missed a lot of the nuances. I was surprised but pleased to enjoy it on
re-reading. I was struck by the pithy
satire, e.g. at Sir Francis Hinsley’s house, the narrator states ‘English
titles abounded now in Hollywood, some of them authentic.’ And some of it is prescient, for example,
with regard to funeral services in America, ‘Liturgy in Hollywood is the
concern of the stage rather than of the Clergy’. One cannot help thinking of the elaborate
pantomime of Michael Jackson’s funeral – broadcast worldwide.
Waugh comes up with names worthy
of Dickens, ‘Mrs Leicester Scrunch, Mrs Theodora Heinkel, Mr Joyboy, Aimée
Thanatogenos, Sophie Dalmeyer Krump’. I
noted a fair whiff of anti-Semitism. I
had to look up the slang when one character says of Hollywood directors: ‘Your
five-to-two is a judge of quality’. And
I loved the definition of Hogmanay, ‘People being sick on the pavement in
Glasgow’. Waugh’s cruel sense of humour
extended to mistreatment of his own family, in many well documented
accounts. ‘The nastiest tempered man in
England’ was one description. On the
other hand, no less a critic than Clive James wrote: ‘Nobody ever wrote a more
unaffectedly elegant English…’
At our discussion of the novel,
it scored highly. On to my own choice of
book!
I had in mind to choose Brecht’s
‘The Threepenny Novel’, which again I read as a teenager, and after recently being
dazzled by the Edinburgh Festival’s ‘Threepenny Opera’. But I was dining with several cardiological
friends, and we talked of book clubs.
‘There is a book club’, announced a friend, ‘Based, I think, in Moscow,
where they only ever discuss one book.’
Immediately thinking of how much time we could save, not to mention cost
in ordering our books, I was immediately intrigued. The book turned out to be ‘The Master and
Margarita’ by Mikhail Bulgakov. Written
under threat of Soviet repression and censorship in the 1930s, it eventually
surfaced after the Second World War in samizdat
copies in Russia, but these were incomplete and portions were suppressed or
redacted. The full novel appeared only
in the 1970s, by which time Bulgakov had been dead for many years. I obtained a copy and read it in three days
(it runs to 450 plus pages). I urge you
to read it – I would describe it as extraordinary. But I would also accept that it is a little
like Marmite – some may not like it at all, particularly as it predates and
presages much 20th Century Magical Realism. I have worked hard to provide my club members
with a list of characters – Russian names: given name, patronymic, family name,
together with nicknames or shortened and diminutive forms are always a source
of difficulty. This is available to
anybody who would like it!
And on Wednesday November 15th,
the only day recently with good weather, the walking group toured the New
Forest trails around Lyndhurst and Rhinefield. Oblique sunshine glinting through golden leaves made us all feel better about life. Fording some of the streams was difficult but we repaired to The Oak Inn
at Bank afterwards for good beer and food.
As we approached a tiny hamlet, we were met by a family of pigs foraging
for acorns – an ancient right in the New Forest protected in law as ‘pannage’.
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| New Forest, November 15th |
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| 'Your tiny streams are swollen' |
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| Porky 'pannage' |
And during another rainy day of
Lindsay’s absence when I gained unrestricted access to the kitchen, I attempted
to recreate a wonderful Breton pastry which we have enjoyed while cycling in
France – the Kouign-Amann (Breton for ‘Butter Cake’). Here is the result:
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| Kouign-Amann |
In my personal opinion, ingestion
of one of these could substitute for a GTT (glucose tolerance test) - if anyone
does those any more.
I sent the picture to our friend
Maggie who was a contestant on ‘The Great British Bake-Off’ two seasons
ago. She came straight round. ‘The important thing is that you gave it a
go’, she said. A delightful double-edged
compliment.
And I expect the next diary entry
will be for Christmas…
