Showing posts with label John Betjeman. Show all posts
Showing posts with label John Betjeman. Show all posts

Tuesday, August 25, 2020

Corona Diary Part 12. Monday August 3rd to Tuesday August 25th

 

Monday August 3rd

 

Davina Thompson was the first person in the world to receive a triple transplant – heart, lungs, liver, in late 1986.  Her face, lovely smile, and extraordinary character came back to me in an instant when I read of the death of Professor Roger Williams, the liver specialist, who established the world famous liver unit at King’s College Hospital, where I worked for many years in the 1970s and 1980s.  I don’t know what it is about extraordinary pioneers, but there are some readily recognisable characteristics, and Roger Williams had these in spades.  Firstly, he was clearly very intelligent and gifted.  Secondly, he had enormous drive.  A twelve-hour day was the norm.  Thirdly, though there are obviously some fourthly and fifthlies, he did not care much about setbacks or criticism, and almost always overcame them.  There are some who would say that this characteristic is an ability to ride roughshod over authority, and Roger was certainly able to do this, and indeed seemed to derive some pleasure in doing this on occasion.  For example, the Professor of Medicine during Roger’s early years at King’s was a much less gifted individual who nonetheless had some reputation in bone metabolism.  He had ordered a device for cutting thin sections of bone for microscopic study, a large and expensive piece of equipment destined for an underutilised area in the medical school, but he did not follow through on his plan to supervise this himself.  As a result, some six months after the supposed installation of the bone-cutter, the Prof was showing some visiting overseas specialists around King’s.  ‘And this’, he said, as he swung the door of the lab open, ‘Is the bone-cutter room…’  The bone-cutter, unused, had been parked in a corner, and everywhere he looked, white-coated research scientists were at work, pipetting reagents into test tubes, looking down microscopes, setting up chromatographic columns.  Needless to say, this was Roger Williams’ nascent research laboratory under way.  Exit speechless Professor.

 

Another typical Williams strategy which did not endear him to other consultants on the staff at King’s was the way in which he always commandeered a car parking space in pole position at the front of the hospital.  If he had been called away to see a patient at the Cromwell Hospital, for example, when about to return, he would send his secretary down to stand outside the building in the car park and bodily block a space until Roger’s own car steamed in.  On one occasion this almost led to injury when another (nameless) consultant physically pushed the poor secretary out of the way with his own car.

 

Mrs Thompson had been admitted to the liver unit for further investigation in 1986, and a cardiac opinion was requested.  She was suffering from an advanced liver condition, primary biliary cirrhosis, and a liver transplant was being considered.  As the ‘new boy’ in the cardiac department (only two years into my consultancy) I was deputed to ‘pop up to Roger’s ward and take a look at this lady.’  Mrs Thompson was breathless as well as jaundiced and I brought her back to our department for an echocardiogram.  I went to report on the findings to Professor Williams and he asked me for a full workup of her heart which included a right and left heart catheterisation procedure.  The preliminary findings suggested that she had fibrosing alveolitis, an associated lung condition that sometimes occurs in PBC.  When we undertake catheterisation procedures the patient is conscious, but we use local anaesthetic so that the study should be pain free.  Patients are understandably always scared however, and one very underrated skill of a cardiac operator is to chat to the patient during the procedure, explain what is going on, and put them at their ease.  I always like to take the opportunity to ask the patients about themselves and give them to chance to talk freely.  In Mrs Thompson’s case, I was aghast.  She came from a mining area in South Yorkshire, had had to leave her daughter at home when she came down to London, and her husband, a miner, was effectively out of work due to the miners’ strikes.  I felt desperately sorry for her.  Not only the domestic issues, but a real life limiting major disease to cope with seemed just so unfair.

 

Roger’s clinical presentation rounds were always held in his liver unit seminar room on a Saturday morning.  Attendance from everyone who worked for or with him was mandatory.  In addition, one of the registrars would have to examine the case blind, formulate a diagnosis, and give a treatment plan.  It was like going into the courtroom to argue with Judge Jeffreys.  Roger’s style of teaching would not be condoned today, but it was certainly effective.  You never forgot an experience in that cauldron.  In view of the fact that I was both a consultant, albeit a junior one, and also from a different unit, Roger always treated me courteously and kindly.  The same politeness did not extend to his juniors.  Fortunately, the registrar that day was a very switched on individual, and he was able to detect the signs of pulmonary hypertension, the prominent right ventricular ‘heave’ as it is called, though Roger called him to task for failing to hear the loud pulmonary second sound in the pulmonary area just to the upper left of the sternum.  ‘So what are we going to do about it?’  Queried the Prof.  ‘Well, sir, we could transplant lungs as well’, came the reply.  ‘What does Dr McLeod think?’, enquired Williams.  ‘Well, sir, as I’m sure you know, in pulmonary hypertension, you have to transplant both heart and lungs.  If you just transplant a heart, it cannot cope with the high pressure in the lungs.  If you just transplant the lungs, the damaged heart will fail anyway.’  ‘So’, came the reply, ‘We would have to think about a triple transplant.  Lungs, heart, liver.’  ‘Yes, Professor.’  ‘Hmm’, was the response.  I’ll talk to Professor Calne and see what he thinks.’

 

And that was it.  Sadly, I never met up with Mrs Thompson again, but she survived her pioneering operation with a good quality of life for a further twelve years.  In my brief meetings with her I found her to be a truly lovely person.  Everything I have written above is true, and because of the wide publicity it is all in the public domain, so I do not believe I have transgressed any confidentiality.

 

 

Tuesday August 4th

 

Awake from about 0430.  Tried listening to some relaxing music, placed the eye cover on to block the rather too bright light from my Sony radio alarm clock, which has worked so well for about 20 years, so I have been loth to replace it.  No success.  Remember that I was woken in the middle of explaining what was going on at a cardiac catheterisation to a junior doctor who could not understand what he was seeing.  The catheter was in the left coronary artery.  A tiny amount of contrast medium flowed in to a vessel which terminated within half a centimetre of its origin.  A nub of contrast.  ‘What’s going on?  I don’t understand.’  ‘It’s all right.  The left main coronary is blocked.  All the supply is from the right side.’  ‘How do you know?’  ‘Simple, the patient is alive, isn’t he?  The blood must be getting to his heart from somewhere.’  Wakefulness put an end to the clinical scenario, and eventually I got up and started in on the next few weeks of diary entry.

 

Saturday August 8th

 

The weather has been good and getting hotter.  Temperatures in the high 30s.  Apart from some pleasant golf in midweek I was privileged to go fishing yesterday, and out on the water it was at least a little cooler than indoors.  We motored down to Christchurch Ledge and drifted with the tide.  On the way, we passed the Aurora and the Arcadia, the unused P&O cruise liners.  Both of them looked a little tired, with rusty paintwork, and the Aurora had a substantial dent in the port stern quarter.  This was followed by a lovely evening yesterday in a friend’s garden with champagne, two different Malbecs, one French, one Argentinian, and the remains of the Hauner Sicilian Malvasia.

 

The weather remains unpleasantly hot; just okay sitting outside in the shade, but in our rental house the converted roof space means our bedroom is at 31deg C.  Not good for sleeping.  Almost like North Carolina.  I remember when living there and the Fall arrived, people used to talk about ‘Good Sleepin’ Weather’, and here in Poole at the moment, it is not good sleepin’ weather.

 

Sunday August 9th

 

A five mile walk in the New Forest.  Lovely, especially in the shady inclosures.  Some thatched cottages at Hale, and the beautiful Thomas Archer designed Palladian Hale House.  A memorial to him (architect of Chatsworth, Chettle House, and St John’s, Smith Square) stands in the little church nearby.  A reminder of bygone plagues – his first wife died within a year of their marriage from smallpox.

 

Hale House (1715), New Forest

Memorial (in Latin) to Thomas Archer.  Note 'Variolarum Lue', another plague (Smallpox)



Monday August 10th

 

It is just too hot to sit up here in our little office and type a diary.  So this will be resumed another day.  Some may have noted however that I have lost interest in the coronavirus, having devoted so much space to it early on.  There is a clear cut upsurge in cases over the last four weeks, but interestingly no uptick (as it’s now known) in deaths.  Perhaps the congregating young are the cases and their mortality is low?  Don’t know.  Our heatwave is echoed on the continent (vague du chaleur, or canicule, in France), but it is worse.

 

Friday August 14th

 

We have now come out of the one-week heatwave.  The last three days have been punishingly hot.  At times I have thought I was back in North Carolina.  The Seniors golf tour to Devon went ahead this week – with numbers reduced from 32 to the ‘Valiant 9’, but social distancing seemed fairly well observed.  We stayed in the Best Western Dartmouth Golf Hotel and Spa, which I would describe as cheap and cheerful, but was good value for money.  The staff were unfailingly helpful and friendly and one felt sorry for them working and serving behind visors, especially in the heat.  The River Exe mussels on the menu were excellent, though the plaice came with cockles (to which I’m possibly allergic) and was only slightly larger than the plaice we threw back when fishing the other day.  But a good time was had by all.  Golf at Churston, which is near Paignton was excellent, but the Dartmouth course was spectacular, with a lot of climbing and descending those steep little Devon valleys.  Nice to renew acquaintance with that distinctive red Devon soil again, which now ingrains the sole and grooves of my clubs.  Our last day was at Thurlestone, which was besieged by har on arrival, but which later cleared to give those views which are so spectacular, particularly on the further parts of the course which overlook Bantham, the Aune estuary, and the famous Burgh Island with its Art Deco hotel.  The hotel, as is widely known was the location for the famous Agatha Christie book, ‘And then there were none’, which is an unusual book in that it has been through three metamorphoses of name.

A challenging par 3 at Dartmouth Golf and Country Club


The weather broke in dramatic fashion in the evening with monsoon-like thundery rain, and this morning is overcast, humid, and a touch gloomy.

 

Watching the news again this morning, there is a plethora of what I previously called ‘talking heads’, but which a friend reminded me the other day are called in the media ‘Vox Pops’.  Vox Populi, Vox Dei is surely a contradiction in terms.  Today the vox pops are related to the predicted grades for A level students which came out yesterday, and have caused many to be disgruntled.  The BBC is quick to focus on the suggestion that predicted grades for posh private schools are thought to be higher than ordinary schools.

 

Cricket has resumed in the second test match against Pakistan, in Southampton.  There were rain interruptions yesterday, and a delayed start this morning.

 

During the last week I received a moving message from a close friend and former nursing colleague, who has endured multiple surgical procedures for primary and metastatic bowel cancer (chiefly liver), and for whom no more can be done.  She has always been something of a ‘wild child’, though I hasten to add, in her career, absolutely committed and professional.  She told me some time back she was looking forward to some druggy bliss, and floating away.  Subsequently, with Krukenberg tumours and drains for peritoneal ascites, she has gone through so much uncomplainingly.  Offering to visit, and/or to supply home-made marmalade which I know she loves, she writes in reply (direct quote): ‘Very weak at the moment with my two syringe drivers.  Just about able to converse for 20 mins so don’t really see anyone in real-time.  Getting weaker every day.  Just wish I could hurry up and die.  It’s very boring waiting to go!!!!!  Love to you both…’  What a person.

 

In complete contrast to the previous paragraph, and to lighten the mood, another story surfaced early this week.  An approach was made by a White House official to the governor of South Dakota, with the possible suggestion that the famous Mount Rushmore carvings of Presidents Washington, Jefferson, Theodore Roosevelt, and Lincoln be extended to include President Trump.  The governor thought this was hilarious, until she realised that the White House emissary was not joking.

 

Finally, the other day, I saw that BBC4 were to screen a recording of Mahler 8 (the Symphony of a Thousand) in a performance from the Royal Albert Hall, conducted by Simon Rattle.  It featured the National Youth Orchestra, and combined total of soloists and choirs of around 800 people.  I watched with love and awe – the scale of the orchestra was fantastic.  The young man with his mandolin, a total of four harpists, and at the end, a kiss on both cheeks from Rattle for the young leader of the orchestra – will we ever see scenes like this again?  It took me back to the only time I’ve seen it live, in 1973, at the same venue… wonderful.

 

Wednesday August 19th

 

Torrential rain today allows time to catch up on a number of things, particularly the diary.  Following many months of aches and pains (I won’t bore with detail) I have an appointment with a rheumatologist later this week.  It is the lot of ageing folk to look with envy on the exploits of the younger.  Last night we were talking about friends who have moved to Lymington and how their bike excursions take them up and around the Beaulieu river, and I was reminded of the John Betjeman poem ‘Youth and Age on Beaulieu River, Hants’ (I think that’s the title), which I first came across, not in my collected edition of his poems, but on an LP (for younger readers that stands for Long Player, a vinyl disc 12 inches in diameter which rotates at 33⅓ rpm, the transducer being a diamond mounted on a piezo electric crystal [stylus]), entitled ‘Betjeman’s Banana Blush’, a collaboration between Betjeman and the remarkable musician and arranger, Jim Parker.  Parker’s music perfectly complements the beauty of the spoken word.  You could try this link: https://m.youtube.com/watch?v=UsNliZAN_7y

And for the record, I am ‘Mrs Fairclough, sipping tea…’

 

About three years ago, my daughter and her partner completed the ‘French Divide’ (qv), a bicycle endurance event, not a race, from Bray-Dunes, near Dunkirk, to Mendionde in the Pyrenees, mostly off road.  And this year’s iteration has been happening, with the leader completing the course of 2400 Km in 9 days.  I would love to do this event – but sadly there is a time limit of 15 days.  I think I could manage it in a month or two.  It was during the briefing for this event that I learnt that if you need fresh drinking water in France, the best place to head for is a cemetery.  Apparently there is some sort of national edict requiring local authorities to provide fresh water in cemeteries– the intent being to maintain flowers on graves.

 

This week has been notable for the fallout of the catastrophic attempts to give A level results when there have been no A level exams (for US friends they are the high school graduation tests which essentially determine whether you get to University or not).  It seems the government have been desperate to avoid ‘grade inflation’ so some sort of algorithm has been used to give results, rather than the pupils’ own teachers’ predictions.  Much distress all round.  This Thursday the lower level GCSE exam results will appear, based on teacher assessments, and a week later the algorithmic results, and pupils will be allowed to choose the higher grade from the two methods.  GCSE results are of no real use to man nor beast, unless you leave school at 16, but no doubt there will be a lot of anger and aggro.  The vox pops this week have been many – angry students not getting to University etcetera.  When I was their age I used to think that Universities were only there for really bright people, but now I realise that the higher education sector is yet another Leviathan, dependent on getting ‘bums on seats’ to secure its funding, and to a large extent merely self-perpetuating degree courses to sustain so-called academics who are not particularly academic at all.  I heard an interview with a teacher who clearly did not know the difference between ‘less’ and ‘fewer’ – she referred to ‘less places at University’ for example.  I despair.

 

Language should always adapt and change, but precision is also important.  Another irritant these days is the PC attempt to desexualise words – the word ‘actor’ is now used to describe actor and actress, for example.  Hero is another word and case in point.  Nobody seems to like to use the word ‘heroine’ nowadays, no doubt for PC reasons too.  Should we be describing the unfortunate South African runner, Caster Semenya, as a ‘heroine’?  Interested parties might enjoy ‘The Conversation’, https://theconversation.com/ten-ethical-flaws-in-the-caster-semenya-decision-on-intersex-in-sport-116448

 

As I write, it is pouring with rain, so golf today is off.

 

The US election campaign is hotting up with much malevolence on the Trump side following the launch of the Democrats’ initial session.  A post on Facebook by a friend speaking of the mess with A level results refers to the malevolence of the present government, thus revealing herself as a probable Guardian reader, but speaking as a hawkish Right Wing Socialist (which is probably how I portray myself) I think the correct word should be ‘incompetence’ rather than malevolence.

 

So now to something really important, and sad to report, the death of Julian Bream, one of my heroes (that word again).  Not only was he a wonderful guitarist who pioneered the classical guitar in Britain, before John Williams came along, but he also did a huge amount of good work rekindling interest in the lute and Elizabethan consort music.  Much of his consort work was in the 1960s, so I was very lucky to hear a late-night Prom sometime in the late 1970s where he reconvened many of his friends to play in a London church.  I also heard him a number of times in recital and was privileged to be introduced to him during a recital by Martin Best in the church of St James in Kingston, Dorset.  The other day I heard the new kid on the block, Sean Shibe, playing Bach’s first lute suite.  The technique was breathtaking.  But my old recording of Bream playing the work, at a much slower tempo, is much nicer.

 

Musically speaking, I am on guitar what in golf we would term a ‘handicap player’, so it was always a pleasure to me to see how hard Bream had to concentrate and to work to produce the music that he did.  I remember him playing a transcription of the 6th Bach cello suite.  He said that the cello suites got harder as they went from 1 to 6 (I don’t know if that is true), and the effort needed to play it was transfixing.  I also saw John Williams a number of times and the feeling with him was one of coldness and detachment, not that he wasn’t a magnificent player.  I mentioned this one day to a musical friend who observed in a down-to-earth nonsequitur, ‘Yes, but he bonked Anna Ford, didn’t he?’  There is no answer to that.

 

My original recording of the Rodrigo guitar concerto was the 10-inch LP by Narciso Yepes, for some years the only one available.  When Bream’s recording came out in about 1967 I bought it, but was also entranced by the section on the album where Bream’s consort played his own arrangements of the ‘Courtly Dances from Gloriana’ by Benjamin Britten.  They are fantastic.  If you don’t believe me, here is a fascinating piece of trivia: they were selected by Paul McCartney as one of his Desert Island Discs.  It’s true.  The sense of astonishment is similar to that which visited me when I heard that one of David Beckham’s choices was ‘Si Tu Vois Ma Mère’ by the jazz soprano saxophonist Sidney Bechet.  Bechet was originally a clarinettist but discovered the straight soprano saxophone during a visit to London.  The piece can be played on either instrument.  I accompanied the late John Oliver in a school concert while he played it on the clarinet and I strummed the guitar chords that he had written out for me.  A far cry from King Edward’s school concerts is perhaps the most beautiful modern version - by the French group ‘Avalon Jazz Band’ – check them out on Youtube.  Their version of Charles Trenet’s ‘Ménilmontant’ is also breathtaking.  Django Reinhart-style guitar playing.  Super.

 

My diary has wandered far from the Corona days.  Nobody seems to know where we are going with it.  There has been a significant upturn in cases without a commensurate increase in mortality.  Wider testing of milder symptoms, some asymptomatic individuals from track and trace, and the increased spread among young and therefore healthier subjects is thought to be the cause.

 

I am due to join a walking group in North Dorset.  For most of this summer we have walked in approach shoes, but following the rain I feel I should wear boots.  To be on the safe and secure side I get out my Leki walking poles – they have cobwebs on them.

 

A final shoutout for Trump.  Following the recent story of the Mount Rushmore enquiry, some wag has doctored a photo of the mountain showing the four presidents with stone hands over their faces.

 

Sunday August 23rd

 

My father would have been 102 today.  Exactly two years ago I climbed Schiehallion with a friend.  It was a favourite mountain of my father’s.  I had never climbed it.  For at least half the ascent there are boulders strewn in random fashion and there is no real path.  Although the vertical climbed is minimal – one starts at several hundred metres of elevation, the ground underfoot is better suited to mountain goats.  On the way down, we stop, and in an unguarded moment, I turn to my friend, miss my footing, and bang, fall.  The rocks are hard.  So concerned about the bash on my leg which hurts a lot and makes me wonder if it’s broken (it isn’t), I don’t notice the complete subluxation of my right little finger until I try to grip my pole.  My friend puts it back.  There is so much pain from my leg and hip I don’t notice the pain from the reduction.  So now I am left with a crooked little finger, a memento to remember my Dad by.

 

It was with a sense of ennui d’automne that I drove northwest from Poole, skirting Wimborne, and started out on the road that leads past Kingston Lacy, with its magnificent avenue of beech trees, and turned north up the Tarrant valley to join friends for a walk.  The wheat fields had been cut and neatly rolled cylinders of straw dotted the landscape.  No sheaves or stooks as I remember from my childhood but efficiently machine rolled butts of pale yellow.  The sun shone after rain and fleecy clouds drifted overhead.  In the church yard at Tarrant Monkton, beside which I parked, the beautiful small building of All Saints, built of stone and flint, stood in silent modesty.  Parts of this date back to 1400 (the chancel), but my eyes were caught by other memento mori, the weathered and lichen-clad headstones.  On the stone commemorating a woman who died in 1880, there is the following:

 

            This languishing head is at rest

            Its thinking and aching are o’er

            This quiet immovable breast

            Is heaved by affliction no more.

 

Amen to that.  Our walk takes us East out of the valley up an old drove track, and looking northwest over towards Cranborne Chase.  Through fields and woodland, purpled with elderberries, where pheasants cluck and whirr, and martins flutter, to the hamlet of Manston before winding back by a more southerly route.  It’s a time to chat with walking colleagues not seen since before lockdown, and the heat of the sun is such to allow me to put the car roof down to meander back past Badbury Rings and Wimborne.




All Tarrant Monkton and above the Tarrant Valley


 

In such an elegiac mood of Weltschmerz, it would be easy to dwell on impermanence, put on Strauss’s Four Last songs, and drift away, but eventually the real world returns (‘Life is real, life is earnest’) and it is back to the here and now.

 

A front page headline caught my eye the other day.  Some academic doctor in Bristol has stated that we must not use the term ‘turning blue’ because it is racist.  To elaborate, he seems to think that because Black people cannot turn blue, we should not be using the term.  Since he is presumably a modern creature and may not have done Latin at school I suggest we substitute the term ‘cyanosis’.  Anyway, he is wrong.  If a black person is cyanotic one can see it in the mucosae and fingernail beds, the areas where we always teach medical students to look because ‘central’ cyanosis is usually more important than ‘peripheral’ cyanosis.  This political correctness is really getting me down at times.

 

Nice ‘phone call from my younger daughter who is off to Tuscany.  Great.  Sensible small Air B&B type accommodation.

 

Spend ages trying to draw to scale how I would like my walk-in wardrobe to be constructed.  With a minimalist house and no attic, there is a small room for clothes storage for each of us, and everything is to be tidied away, a bit like a well-organized yacht.  I might have to change the habits of a lifetime.

 

And a visit to a rheumatologist to discover that my hip pain is not arthritis or myeloma from my IgM paraprotein, that axillary skin tags are not mycosis fungoides (I had worked that one out), and that my backache is spinal stenosis which is not severe enough to require operation.  Anno domini seems to be the watchword for this week.

 

The end of the week has been cheered by England’s performance in the Test match against Pakistan, where after crumbling to around 100 for 4, a stand of over 300 runs by Crawley and Buttler has allowed England to declare on 583 for 8, and Pakistan are currently 77 for 5.  What is it about sport at the national level that lifts us, encourages us, and warms the heart?

                                                                                    

I must now get back to ‘To Kill A Mockingbird’, the current choice for the book club.  Re-reading and musing over it, the power of the narrative and the setting of 1935 Alabama, with the terrible miscarriage of justice, it remains such a powerful book.  But there seem to me to be huge problems with it as a text for schools.  The vocabulary of the Southern USA is completely alien to most UK readers.  Who has heard of scuppernongs, kudzu, Hoover carts, and chinaberry trees, for example?  It is also hard to get the image of Atticus played by Gregory Peck in the film out of one’s mind.  Peck justifiably won the Oscar in 1963 for best actor.  Apparently he was so entranced by the book he read it in a single night.  ‘In the Heat of the Night’ you might say.

 

Monday August 23rd

 

Ennui extends to coronavirus now.  After the initial excitement, alarm, anxiety, and significant lockdown, most people are obviously returning to normal or near normal activity.  Crowds of people flock to pubs, restaurants, and any other venue they are allowed to.  What is different still is the huge reduction in people going to a place of work rather than ‘working from home’.  WFH is a new acronym which everybody understands.  Sports venues, cinemas, and theatres are also empty.  Young people have moved on, and it is only the older generation like me which is still more or less housebound.  Two corona developments to report.  First is definite evidence of reinfection in some cases.  The second infection, recorded in Hong Kong, is a clearly genetically different strain of virus.  Then there is a suggestion that ACE or ARB blood pressure lowering drugs may reduce mortality in Covid-19 infection.  You will remember that the virus competes for the ACE-2 receptor for its ingress to the cell.  Perhaps the drugs block ingress?

 

My daughter seems to have lucked out somewhere in the middle of Tuscany.  Shots of lovely looking infinity pool…  And she’s supposed to be WFH!  Meanwhile my other daughter has just learned that the planned mountain bike event/race in northern Norway will not work out for her because all UK visitors to Norway have to quarantine for 14 days after landing.  £800 down the drain apparently.  A pity because she has been training intensively for this including an 80-mile off-road route last weekend.

 

But here in the modest surroundings of BH12 one still finds interest and amusement in the daily news.  I have written before of the remarkable ability to find humour in the most awful situations, viz. the Nazi concentration camps as exemplified by collations in the Holocaust Museum in Washington, D.C., and although one can in no way compare our current situation with that, it is pleasing to find that we can still make jokes.  My favourite today is related by the Telegraph correspondent who has been to the (socially distanced) revival of the musical Camelot.  Now, following the dictum of my closest school friend, MJW, ‘Mac, never go to a musical’, I have no intention of going to this, but the review is amusing.  King Arthur’s appearance in a shiny grey business suit is mentioned as perhaps not in keeping with the general theme, but the reviewer records the famous words of Noel Coward on attending the premiere which was supposed to last for two hours and forty minutes, but ended up in excess of four and a half hours.  Coward remarked that it was ‘Longer than Götterdämmerung and not nearly as funny.’  In view of the fact that John F Kennedy loved it however it has come to define his presidency.

 

A definite irritant, however, in the news, is a linguist who has stated that older people should not put punctuation in texts, particularly full stops (or ‘periods’ to Americans) because young people find them intimidating.  Oh dear.  Sorry Dr Lauren Fonteyn, whoever you are.  But I don’t expect you will read this.

 

Tuesday August 25th

 

Torrential rain and heavy winds hit from Storm Francis.  Major flooding in Wales.  Seems doubtful that we will get any cricket today in Southampton, and another limping draw is the likely upshot.

 

Duke University messages me to let me know that students are going back this month, with novel approaches to teaching, including spreading seminars out into the evenings to achieve smaller class sizes.  These will be so-called ‘Pyjaminars’.  At Cambridge in the 1960s, evening teaching in seminars was the rule, sometimes accompanied by a civilized sherry from the tutor, though always finishing in time to allow the dons to get to ‘Hall’ for their chance to sup at High Table.  We were required to attend these in jackets, ties, and gowns, and the question of pyjamas never came up.  In view of the modern concerns about university and school lecturers having sexual relations with their students, nobody seems to have thought about the female undergraduates appearing before their tutors in skimpy nightwear and the possible results therefrom.  Maybe it will all be by Zoom meetings?

Monday, April 23, 2012

The Scottish Medical Golfing Society

THE SCOTTISH MEDICAL GOLFING SOCIETY


Subtitle: Rye - with no mention of Henry James, Radclyffe Hall, and E F Benson
The current blog is an unashamed ‘puff’ for this venerable society, which is very much an endangered species, only eleven members attending the AGM meeting in Rye, and only eight remaining to do battle with the Rye club members on the Sunday morning.  Despite having a large number of members on the subscription list, a minority still play.  It has been suggested that any internet activity might be helpful in increasing the profile of the SMGS in our search for new members.  So here goes...
The birth of the society came to public attention in the correspondence columns of the British Medical Journal on June 9th, 1934.  Those who wish to read the original will find it at:
The first president was Bertram Shires.  The entrance fee was one guinea and the subscription one guinea per year.  The aims of the society were concisely stated:
‘On April 30th, 1934, a meeting was held at the Langham Hotel for the purpose of giving concrete form to a common desire that Scottish members of the medical profession in the London area should meet occasionally throughout each year for the express purpose of vying with one another in propelling the golf ball from tee to hole, according to the rules of golf.’
There followed an impressive list of vice-presidents, treasurer, secretaries (plural), and councillors.  One of the councillors is given as L E Barrington Ward.  Later Sir Lancelot Barrington Ward, this famous surgeon is thought to be the character on whom Sir Lancelot Spratt was based in the book and film ‘Doctor in the House’.  He was certainly a surgeon at St Bartholomew’s Hospital, which was attended by Gordon Ostlere the author, who adopted the pen name of Richard Gordon.
The BMJ was definitely different in those days: the next two letters deal with alleged poisoning by ground ivy and ‘Tests for Drunkenness’ in which, ‘J.P’, a police surgeon, provides a foolproof defence for anybody accused of being ‘drunk in charge of a car’.  I can’t see the present editor of a journal which now takes itself very seriously allowing us column space to push for members, but we are going to try it.
The first golfing meeting of the society was held at Hadley Wood golf club later in the same year.
A number of factors have combined to threaten the Scottish Medical Golfing Society.  When I first joined the society in the mid 1980s, there was a fine selection of Scottish doctors from the Home Counties, and we counted pathologists, coroners, surgeons, physicians, and general practitioners among our number.  GPs made up the backbone of the society, and their contract favoured the meetings of the society because most of them had a half day off during the week, and they were able to extend this to a full day by doing a Saturday morning surgery in lieu of this extra time.  Changes to the contract spelt the death knell of this relaxed and sensible system.  Under the ‘new’ contract, which came about some time in the 1990s, it became mandatory for GPs to be present in surgery on every day of the working week.  Further changes in their contracts have not been conducive to improving this situation.  But another and more important factor is the parochialism of the current system of medical training.  Registrar rotations are now organized such that only local graduates stand much chance of being accepted into their local deanery training rotations.  Scottish graduates are thus an increasingly rare sight south of the border.  At the time when I was seeking middle grade training (what Americans and Canadians would call ‘residencies’), jobs were sporadic, few and far between, and could be as far afield as Inverness.  The Society exists for Scottish doctors (who may have graduated elsewhere) or for doctors who graduated at Scottish medical schools and universities.  It is becoming increasingly uncommon to find Scottish doctors in any posts ‘down’ here in England.  We either need better publicity or an influx of Scottish doctors to the Home Counties.
In considering publicity, our new website will we hope improve our profile, and it is available at:
Unfortunately, if one puts SMGS into Google, the first entry is the San Miguel Golf Society, and this is followed by pages and pages of entries related to ‘submachine guns’ – otherwise known as SMGS.  St Michael’s Grammar School in Melbourne manages an entry lower down the first page, but that’s it.  Firearms occupy thousands of entries thereafter.
If you try ‘Scottish’, then Scottish Power has the top line.  Scottish Medical produces Scottish Medical Training, and adding the G hits the spot (sorry about the double entendre), though Guidelines feature as well.
It’s been suggested that our name needs to feature in as many internet articles as possible, and anything one can do to make this piece ‘go viral’ would be welcome.
Perhaps, since this is usually my ‘letter to America’, my collaborators can do their best to increase its profile.  Let me describe to you the feeling of this year’s Rye meeting...
Rye is an elemental place.  One of the arbours in Golf heaven.  It was Henry Longhurst who was credited with saying ‘If I could play one more round of golf before I die, I think it would have to be at Rye’.  (Sir Peter Allen has said the same about Deal, the Royal Cinque Ports Golf Club, but I think Longhurst may have precedence).  Despite the despoliation of the Romney Marsh to the east by an enormous wind farm, the elevated position on the two main ridges of dunes that make up the main course gives a wonderful perspective when we visit it in April.  New born lambs, with that perfect creamy white colour that they carry for the first few months of life, lie contentedly in the polders of the marsh, the occasional bleating carrying on the breezes, while above, the glorious song of the Rye skylarks announces to the world that the Scottish Medical Golfing Society is here again.  To the northwest the unmistakable silhouette of a town that is now two miles from the sea, having been lapped by the waters in the 14th century.  To the west, the headland towards Hastings, and the remarkable sight of sailing boats apparently skimming through the fields, though of course they are down at water level in the River Rother on their way out to the sea.  I have occasionally played at Rye when the winds have been gentle and light, but even when the sun is shining there is usually a stiff breeze blowing.  The humps and hollows of this classic links course mean that it is famous for rarely giving one an even stance.  Bernard Darwin, grandson of Charles Darwin, and the man who could be said to have invented golf writing, was captain of this club on two occasions, separated by an interval of 50 years!  He is famous for inserting quotations from Charles Dickens into his writings – often leaving the reader to guess the origin of the sentence.  When he wrote about Rye he was unequivocal, and he did not need the assistance of the great Dickens when he wrote, ‘Surely there can nowhere be anything appreciably better than the golf to be had at this truly divine spot.’
On Saturday 21st April, the fortunate few gathered in the clubhouse, exchanged a few words, drank coffee and emerged to do battle with both each other and the elements.  The sun was shining, the larks sang, but the wind was chill, and slow moving and substantial showers were forecast.  My partner and I hacked manfully up the first and retrieved par by dint of holing a long putt to which we had no claim of expectation.  Thereafter the usual in and out experience of golf on these links contrived to put us out of contention in the competition, but the most remarkable feature of the round was the dramatic hailstorm which attacked us on the 10th tee and continued for a further two holes.  A very satisfying five on the dramatic 13th hole with its blind second shot (third in our case) over the ridge of the dunes towards its exposed green was our main reward for our efforts.  ‘It is the constant and undying hope for improvement that makes golf so exquisitely worth the playing’ as Darwin observed, and we clung to this hope like drowning men at flotsam.
A substantial lunch was followed by our afternoon singles round in competition for the Shires cup.  On some previous occasions I have been so depressed by my performance in the morning that I have sought solace in the Rye club bitter and claret at lunchtime, making my apologies early in the afternoon by an air shot on the first tee.  With eagle eyed and equally determined members of our society beside the tee it has been impossible to pass this off as an extravagant practice swing, and the die has been cast.  Today however I only drank ‘Gunners’ and water, and was passably pleased by 17 points on the front nine holes, substantially enhanced by a birdie three on the 9th.  But a vicious and unpleasant shower which lasted longer than the morning’s visitation by the elements put paid to my hopes, though I eventually only lost the competition on a count back to our secretary Iain Dow, who also scored 27 points (poor I know you will agree, but anybody who has played Rye will have feelings of companionship over this).
Our evening meal together in the George Hotel was an occasion for great company and that fellow feeling of bonhomie of those who have striven and at least succeeded in reaching the clubhouse intact, even though their cards have been ruined both metaphorically by their score and literally by the ingress of water.
Our President, Professor Lindsay Symon was in the chair.  Known as ‘the neurosurgeons’ neurosurgeon’ he must have been a ferocious chief, but his bark is now somewhat worse than his bite, and he is full of wit and anecdote, including one scatological story which I can’t include.  Perhaps his best throwaway remark this evening was when the discussion turned to the SMGS club tie, which is dark blue and carries a wreath and the Scottish thistle as its emblem.  On occasion it has been mistaken for the tie which members of the Scottish rugby football team are entitled to wear.  I asked whether it had proved an entrée to the VIP areas at Murrayfield, to which Lindsay responded that it had not, but it had been a topic of conversation when he had ‘put Gavin Hastings up for membership of the R&A’ and had garnered a certain amount of respect.  Any non-golfers who have followed me thus far might need to know that the ‘R&A’ is an abbreviation for the Royal and Ancient Golf Club of St Andrew’s, both the most famous of golf clubs and the body responsible for the administration of the rules of the game.  Gavin Hastings is of course a famous Scottish ex-international rugby player.
Our guest for the evening which follows our AGM is always the captain of the Rye club, a strategy which we think is likely to allow us to continue our privilege of visiting the club every year, but which also allows us to hear some news about the club.  Occasionally there are good jokes to be had.  Nigel Wilkinson, the captain elect of Rye, a barrister and an expert on medical malpractice (sic) did not disappoint.  Although I have heard this before, he produced a fine joke about talking to his wife when his nomination to the captaincy was announced.  He asked her: ‘Darling, did you ever imagine in your wildest dreams that I would one day be the captain of Rye.’  To which she responded, ‘Darling, I’m afraid that you don’t feature in my wildest dreams.’
At some of our finest meetings, the repartee and the recitations of Rabbie Burns have ‘set the table on a roar’ as Shakespeare would have it.  I remember once that one of our members recited the whole of Tam O’ Shanter as a party piece.  I mentioned to Mr Wilkinson that Lindsay Symon, despite being over 80 years of age could not only recite the famous Betjeman ‘Seaside Golf’ poem but also the less well known parody of the poem, which is equally enjoyable.  Overhearing, our President did not disappoint, and duly delivered both.  Some discussion about the authorship of the latter followed.  Lindsay correctly identified it as being by Robin Butler, subsequently Sir Robin Butler, thereafter Lord Butler, best known by the epithet ‘The Butler Report’ apropos of Iraq.  Butler, like Betjeman before him, is a member of St Enodoc, the club in Cornwall which is the subject of the poem.  Here are both, reproduced below:


Seaside Golf
How straight it flew, how long it flew,
It clear’d the rutty track
And soaring, disappeared from view
Beyond the bunker’s back –
A glorious, sailing, bounding drive
That made me glad I was alive.

And down the fairway, far along
It glowed a lonely white;
I played an iron sure and strong
And clipp’d it out of sight,
And spite of grassy banks between
I knew I’d find it on the green.

And so I did. It lay content
Two paces from the pin;
A steady putt and then it went
Oh, most securely in.
The very turf rejoiced to see
That quite unprecedented three.

Ah! Seaweed smells from sandy caves
And thyme and mist in whiffs,
In-coming tide, Atlantic waves
Slapping the sunny cliffs,
Lark song and sea sounds in the air
And splendour, splendour everywhere.

John Betjeman





Seaside Golf – a parody:
How low it flew, how left it flew,
It hit the dry-stone wall
And plunging, disappeared from view
A shining brand new ball –
I’d hit the damned thing on the head
It made me wish that I were dead.

And up the fairway, steep and long,
I mourned my gloomy plight;
I played an iron sure and strong,
A fraction to the right
I knew that when I reached my ball
I’d find it underneath the wall.

And so I did. I chipped it low
And thinned it past the pin
And to and fro, and to and fro
I tried to get it in;
Until, intoning oaths obscene
I holed it out in seventeen.

Ah! Seaweed smells from sandy caves
They really get me down;
In-coming tides, Atlantic waves
I wish that I could drown
And Sloane Street voices in the air
And black retrievers everywhere.

Sir Robin Butler

The St Enodoc website is a vision in immaculate green sufficient to make one drool, and to wonder why we do not spend more time in the UK for our holidays.

http://www.st-enodoc.co.uk/the-club/

The George Hotel is an obvious venue for our dinners, attended by history (Rye Golf Club was first proposed and discussed there), but it is certainly expensive.  Our previous secretary, Alasdair Short had chosen three very fine wines for our dinner, much superior to what was available at the George, though with a mouth-watering corkage charge of fifteen pounds a bottle.  We drank two wines of Bouchard Finlayson – a sauvignon blanc and a chardonnay; a Rioja Riserva, and another South African red from Rustenberg.  All were greatly appreciated.
On Sunday 22nd April, eight remaining members met the Rye Club in our time honoured competition.  The minutes will show the true date of origin, but as far as one can tell this match has existed for around forty years or more.  A brief shower as we started cleared, and we played the course largely in sunshine, but with a steadily freshening westerly breeze, eventually reaching force 6 or thereabouts.  These foursomes games are all enjoyable, friendly and sociable.  Although Tony Strong and I won our game 2 up, SMGS were roundly defeated 3 matches to 1.  A final lunch in the dining room (jackets and ties mandatory) allowed us to carry fond memories back up the road from Camber Sands, and the promise of even better things next year.
If you have enjoyed this blog, please pass it on to any golfers or medics that you know.  Please spread the word of the Scottish Medical Golf Society, and visit the site to make your presence known to our secretary, Iain Dow.

I apologise to those of my few regular readers who may have no interest at all in golf.  Golf like cricket is however a metaphor for how to conduct oneself in life, and how to bear the vicissitudes of what life can throw at you.  Even for those who cannot play, to study the ebb and flow of fame and fortune during the last nine holes of a ‘major’ championship is an object lesson in fortitude and stoicism.  ‘If you can meet with triumph and disaster’ was never more true than in golf.




Above is a view from the western side of the river Rother, showing Rye clubhouse in the distance standing above the dunes.  Below is a tranquil view of the Rother further inland at Rye town.