Tuesday 29 November 2011

Heroes and Villains

As we prepare for a day of national shame when tens of thousands of public sector workers see fit to go on strike, it is timely to reflect on their decided course of action.

They will abstain from work and hence pay on the urging and advice of their Union overlords. Just for clarity, the latter will not forsake their pay - which is considerable. The top heads of the unions in our country don't earn less than six figure sums - good "work" if you can get it. In addition, it is these very organisations who played the role of kingmaker in the recent appointment of the largely unknown Milliband as Labour leader. So it is fair to say that they wield no little influence in the hearts and minds of the electorate.

You will hear no protestation or condemnation from the Labour party with regard to the strike action. Interestingly though, neither will you hear unconditional support. Easier to sit on the fence and say nothing. It puts me in mind of that great quotation, "Sometimes it's better to just sit there and look stupid rather than open your mouth and remove all doubt".

Let us consider the past of the current Labour leader. He served his apprenticeship at the Treasury under the tutelage of the profligate Gordon Brown who camouflaged himself rather poorly behind words such as prudence. Let us be crystal clear about Brown. As the Chancellor of New Labour he took spending money to hitherto unimagined levels of waste, decadence and irresponsibility. Prudent he was not.

The aptly named incumbent shadow Chancellor is no less profligate in his views. The difference between him and his leader is that he does not attempt to conceal his enthusiasm for spending. With Milliband we don't know because he does not dare tell us.

Put simply, this country is in debt up to it's ears as a direct legacy of eleven years of Viv Nicholson in charge. Viv was the lady who famously vowed to spend, spend, spend having scooped the football pools in the 1960s. And she did. Spectactularly. She ended up bankrupt. The difference is that Brown and Blair have now been put out to grass with generous pensions and pay offs.

It amazes me that public sector workers choose to strike when all around them are losing their jobs. I'm aware of their grumbles and whinges regarding future pensions. However, their rose tinted Utopian view of things became a thing of the past a long time ago. You don't need to be a mathematician. All you need is realism and they seem staunchly immune.

Last week I heard a prominent journalist bemoaning the latest initiative of the coalition to promote youth employment by providing incentives to employers. Where was the guarantee of a job at the end of the contract? Job guarantee? What is this new concept. I thought we were now in 2011. Presumably, she is stuck in the Union wrecked misery of the 1970s.

There is of course one good thing which will come out of the strike. That is one day less of pay for the country to find for these people. I wonder if they might acquire a taste for it? There is always hope because I believe that youth unemployment is at an all time high so there shouldn't be too much trouble replacing them.

Monday 29 August 2011

Crossroads

In August 2004, I was walking in Cornwall with my (now) wife and she asked me what I really wanted to do with my life. Not having considered this for a long time, I gave the question great thought and then replied, law. Mindy was dumbfounded because I had never intimated any interest in this area before. As we walked along, I said that what I really wanted to do was medicine. She shook her head in disbelief and asked if I intended to change my mind again. No, this time I was quite sure. It was, after all, what I had wanted to do seventeen years earlier when I sat my A levels.

We returned home to North Wales and I made some calls to establish how I would go about it. The advice was clear; I would have to complete a science degree first and then apply to medical schools. I was now 35 years old and immediately wondered if perhaps I might be told old.

Despite having completed the first two years of an honours degree in Biomedical Sciences in 1989, I was told that this was too long ago to be considered. As a consequence, I would have to start from scratch and study for three years to achieve my first step towards medical school. This I duly achieved having lost a year on the way due to ill health.

I applied to four medical schools and was refused an interview by three of them. However, one gave me the chance and I was subsequently offered a place. Whereas my first degree had allowed me to commute from home, the medical school which offered me a place was simply too far away to do so again. I thus lived away from home to study medicine. When I went to medical school my son was just one year old and I felt a great wrench being apart from him and my wife.

It is important to point out that as each year progressed, my identity as a medical student became more and more entrenched. This is important because whoever we are and what ever we do, our sense of identity is key to who we are.

Next week I go before the Progress Committee having failed to achieve satisfactory marks in the medical knowledge exams at the end of the third year. I have spent the last week with my identity in limbo. If the committee rejects my explanation for falling short of standards, I will be out and that, as they say, will be that after seven years study, hard work and sacrifice.

It is of course entirely their prerogative who they accept and who they don't but I sincerely hope they give me the opportunity to have another go at the third year or I shall have to seek a new identity..

Friday 29 July 2011

Understanding the other guy.

It is nearly a week since Andreas Behring Brevik committed the senseless murder of at least 77 fellow countrymen in his native Norway. I have spent much of that time trying to understand his motives and their impact on a country which continues to be the embodiment of perfect living to many of its European neighbours.

Twenty years ago, I moved to Barnsley in South Yorkshire and was very much the stranger in a local town for local people to coin the much loved edict of Royston Vasey. Just before my first night out with my good friend who was a local, he gave me three pieces of advice: First of all, I was not to mention the coal miner's strike which was still fresh in the memory of many. Next, I would do well to avoid the subject of cricket and, in particular, their local son, Geoffrey Boycott, since the mere subject aroused divisions centred around love and hate. Finally, I was advised to avoid the whole area of politics since this was something of a done deal in Barnsley. When I pressed him on the latter, he kindly put his point into some kind of context. He suggested that if there was a General Election tomorrow in Barnsley and there was a man wearing a blue rosette, a man wearing a yellow rosette and a donkey wearing a red rosette, they'd vote for the chuffing donkey. This was clear enough so I managed to avoid all three subjects that night and for the next three years.

However, my deeper point here is one of tolerance and openness to change. Barnsley was parochial in the extreme. It was surrounded by Rotherhan, Doncaster, Sheffield, Leeds, Bradford, Dewsbury, Huddersfield, Halifax and Wakefield to name but a few. Each of the latter boasted large immigrant Asian populations while Barnsley alone resisted their arrival. I have often speculated on the future of Barnsley and wonder whether this picture of intransigence has since abated and given way to mild tolerance of cultures different to their own. I certainly hope so and hope that Barnsley is the winner by it.

However, back to Anders Brevik. I have read his 2083 document and I'm afraid that it is written by an unbalanced man with a rose tinted view of the past and the future. He may be resistant to change in Norway but the world is changing for ever. It may or may not be for the better but you simply can't fight change when its progress is so inexorable. The internet, cheap air flights and social networking have all conspired to reduce the geograhical constraints of the world around us. It is sad in the extreme that Anders chose to pursue his convictions in this manner and my heart goes out to the families of all those youngsters. We all of us need to accept change and it is hugely regrettable that Anders did not realise this. Perhaps his decision to isolate himself contributed to his delusions and maybe this is the lesson which we all need to draw from this dreadful event.

Tuesday 19 July 2011

Regulation

As Rupert Murdoch was being brought to account by some politicians whose peers he has traditionally manipulated, I couldn't decide whether I was struck more by the hypocrisy or the irony. Perhaps they could both be questioned by a policeman to round off the farce. Oh yes, I almost forgot - the children of the African drought continue to die of starvation.

Friday 27 May 2011

Us and Them

In 1968, Jimmy Page and his manager Peter Grant acquired the rights to the name of the Yardbirds. Wishing to give new impetus to their fading star, they relaunched briefly as the New Yardbirds. It was in this format that Page performed in the early autumn of 1968 with established music professional John Paul Jones on bass and two unknowns from the Black Country making up the quartet called Robert Plant and John Bonham. The rest is history of course but have you ever wondered how the more familiar name Led Zepellin came about? Several stories exist but the most likely involves a conversation between the two late rhythm players of The Who. Having just enjoyed a secretive recording session with Jimmy Page, Jeff Beck and Nicky Hopkins, John Entwistle joked to Keith Moon "we should call ourselves Lead Zeppelin because we'll go down like a lead balloon". The famous quintet was doomed from the outset due to the lack of a credible singer. Steve Marriott, Steve Winwood and Terry Read were all "otherwise engaged" so that was that. However, the shrewd Page took the name and Entwistle's artwork with him to launch his own group a couple of months later. Well, almost.
Have you ever wondered why Page chose to spell it Led instead of Lead? Interviewed in the last month of 1968, his answer was succinct; "If we spell it Lead, the thick Americans will mis-pronounce it" (as the implement used for walking a dog...). Very clever when you stop to consider it. He had grasped the American audience even at that stage.
It was therefore with more than a hint of mirth that I learnt of the sacking of Cheryl Cole off an American prime time TV show. Now I have to confess that my knowledge of Cheryl Cole is limited with a capital L. However, I have heard her speak.
In Britain, we have a plethora of regional dialects each with its own identity. Broadly speaking, we become used to them from the Geordie to the Taff to the Scouser to the Scot to the Cockney to the Black Country Yam Yam. The fact is that strong British regional accents don't work stateside because we become desensitised to how strong and unintelligible they can be. Cheryl Cole would have had more chance with sub-titles and one of those people doing sign language next to her to give her audience a fighting chance.
This does go to prove one inescapable fact. You can have all the looks in the world but if nobody can understand a word you're saying you have the functional merit of a chocolate teapot or an ashtray on a motorbike. I am at a loss to understand the thought process of the producers who hired her. What can they have been thinking?
To quote their President, we may have a special relationship but our differences are as strong as ever they were.

Monday 23 May 2011

Dulce Domum

I've just started reading the Wind In The Willows to my son for bedtime stories recently. As a child, it was my favourite book by far and I'm still young enough to pick it up every now and again. Its great to see the look of wonder and enjoyment on his face as new characters are introduced. There is an undoubted charm to this novel and I think at its root is the gentility and innocence of that Golden Age between the end of the Victorian era and the First World War. Class plays its part of course but its great acheivement is to make you feel as though you part of the adventures. Each character is endearing in very different ways and when I was growing up, I would think of people as Rat, Mole, Badger or Toad. If I'm honest, I still do. For what its worth, I've always identified most with the character of Badger. I hope my son garners the same levels of joy and pleasure from this book as I have. At the time of writing, he has a soft spot for Toad but I wonder if his views will change?

Wednesday 18 May 2011

Its Old Hat Now

I hear this morning that Princess Beatrice is to auction the subtle hat which she was seen sporting at the wedding of her cousin Prince William recently. A few points sprung to mind. Who would want such a hat? Does it come with a box? If so, what shape is the box because this is surely of greater intrigue than the hat itself. For what reasons do people choose to wear such garments? Let us safely disregard the safety of subtlety and move on to the more obvious motive of attracting attention. But attracting attention to what or whom? Personally, the hat made me feel rather queasy and so, transfixed, I'm afraid I payed little attention to the person beneath it. Perhaps this was the intention of Her Royal Highness. If so, this move was a stroke of genius on her part. To sell it for more than it cost shows an entrepreneurial acumen which we would not more commonly associate with her mother. Will she be attending the wedding of her cousin Zara Phillips? If so, I can't wait. At last we have a member of the Royal Family who courts rather than shuns publicity. Marvelous.May the said hat bring much joy and bewilderment to its new owner whoever it may be. My guess though is that the buyer of such a garment is more likely to be anonymous....

Wednesday 11 May 2011

The first year of marriage

Today marks the first anniversary of the ConLib coalition. The Conservatives entered the marriage with 307 seats against the 57 of their Liberal bedfellows. Of course every marriage needs compromise from both sides and politics is no different. However, to coin Orwell in Animal Farm,"All animals are equal except some are more equal than others". With 307 seats versus 57 seats the inequality speaks for itself. One year later, we have just had the referendum on the alternative voting system, the local elections and the elections for the national assemblies of Wales and Scotland. If the latter are a judgment on both sides in this coalition, the conclusions for each are in stark contrast. The Conservatives, surprisingly for a majority governing party, have been given a universal seal of approval. That they have failed so miserably in Scotland is entirely in line with expectations as the memory of Mrs. Thatcher is alive and well in the hearts and minds of the Scots. By contrast, the Liberals have been not so much chastised as assaulted! Their small gain in Wales was more a reflection of the nuances of Welsh politics. Elsewhere the message to them has been emphatic. To enter into a coalition espousing the best interests of the country is admirable but to then subsequently break most of your manifesto promises along the way is quite another. Even politicians need an element of credibility and I fear that the Liberals lost theirs twelve months ago. To agree to forfeit the lion's share of your election manifesto in exchange for a vote on something which wasn't even your preferred electoral system is at best weak and at worst stupid. In a way, they had to enter the coalition since this represented their only viable chance of being in government. A minority led Conservative government would simply have gone back to the country in the Autumn and acquired the majority which they needed. Hence, it always appeared that it was heads (the conservatives win) or tails (the conservatives win). Clegg ought to have stuck to his principles and put his money where his mouth is and demanded no less than a vote on proportional representation. He may not have won this vote but it would have had two key advantages. Firstly, PR was what his party has been campaigning for since before I was in short trousers and secondly, PR can be explained with ease to anyone - unlike the alternative voting system! I consider myself to be reasonably well informed but I'm buggered if anyone over the past month ever coherently explained how the alternative voting system actually works. That he chose to pursue a referendum on a system to which he did not subscribe and which he patently didn't understand is difficult to understand.

He speaks now of flexing his party's muscles more in government but doesn't seem to see that his strength is now akin to that of Daniel after his haircut. He is now between the devil and the deep blue sea. Flex his muscles and make himself look even more stupid (scarcely believable) or adopt a more subservient and acquiescent style with the latter removing what little credibility he may have left. To leave the coalition would be suicidal because, ironically, he would now be even weaker outside of it. Thus, I fully expect the coalition to see out its five years in government with the Conservatives being returned as the majority government in its wake.

Twelve months hence, we shall all doubtless be considering the first year of marriage of the Duke and Duchess of Cambridge. I trust they both know what they seek out of their coalition and hope they have the strength to stick to their respective guns. Mr Clegg has sought popularity and the limelight and both have now betrayed him. The Duke and Duchess would be well advised to avoid both.

Friday 29 April 2011

The Dust Settles

When John Steinbeck wrote The Grapes Of Wrath he inadvertently provided great material for devotees of the pun such as I.

I write this the evening after the evening before. Permit me to explain. Yesterday afternoon at times varying between half past four and five o clock in the afternoon, over a hundred third year medical students at Keele University put down their pens for the last time at the end of our final third year exams. Medicine is a bit of a slog. Not the sort of thing one turns to to fill a couple of hours on Tuesday evenings. It is a relentless avalanche of information being exposed to a cohort of students over a five year period in the vain hope that some of it might stick. You may imagine the relief which I felt as I departed the Examination Hall yesterday with the exams now firmly in my rear view mirror. Oh yes, John Steinbeck. Rather than the Grapes Of Wrath this morning, I fear that it was the Wrath Of Grapes which exacted its revenge following the celebrations of last night - deserved though they were.

However, the fact remains that I, along with my esteemed colleagues, am rather like Kermit The Frog's nephew Robin in the 1980 song: Halfway Down The Stairs. We're not at the bottom but neither are we are the top. In other words, we still have some way to go with more exams to negotiate. The snag is that as with any ladder, the further you ascend, the further there is to fall should one lose one's grip. Do you see what I mean? The more pressure we deal with, the more pressure we generate. I wonder, could this be an allegory for life itself? Perhaps.

So how does a medical student cope when the dust begins to settle the day after the exams? Early days for me but I can freely admit it is difficult sometimes. To be a tap which can be turned on and off at will is not without its challenges. That being said I have no regrets about choosing medicine. On the 5th of June it will be five years since our beautiful daughter Thea died. If I have no other motivation to carry on studying, the memories of Thea will sustain me forever. I can't bring her back but I can't forget her unique sparkle.

To all my colleagues, I wish you a long, hot summer in the company of those you love and those who love you.

Tuesday 5 April 2011

When time stood still

Yesterday, as a third year medical student, I dutifully attended my OSCE assessment stations. I can best compare this to anyone else queueing up for the biggest roller coaster at Alton Towers. The conjecture regarding what lay ahead of us a seemingly endless series of conspiracy theory and personal nemeses. As we were led upstairs to where the examination stations were situated, the feelings of escalating upwards at the start of a roller coaster ride came flooding back. As with the roller coaster ride, it was all over so quickly - nigh on three hours! If anyone was studying medicine for the purpose of financial gain at the end of it all, this is the equivalent of those Japanese TV programmes first championed by Clive James in the 1980s. These programmes were a vehicle for people to show off their unfeasible appetites for masochism on scales hitherto unthought of. We all hope of course to have performed with few enough mistakes to be deemed worthy of progression to our next year of study were we will doubtless be subjected to ever higher levels of difficulty. No, you're quite right - logic has nothing to do with it. Ironic for a group of students considered to be of above average intelligence...

Sunday 6 February 2011

What's In A Name?

In Medicine, there exists a well established desire to have syndromes, diseases and procedures named after a particular person or place.

Liverpool has attached its name to the now familiar "end of life care pathway". For the great good acheived by this approach, Liverpool must take great pride in its association with something so meaningful.

Glasgow has attached itself to the Glasgow Coma Scale in which patients are assessed very quickly to ascertain their level of consciousness. In the sphere of Intensive Care, the GCS, as it is often abbreviated, is de rigeur.

New York is now synonymous with the assessment of gravity of heart failure and has been adopted world-wide to provide a clear pathway to teatment.

However, for all the great merit of the afore mentioned triumvirate, it is surely Bristol who have really stolen the lime-light. What drives a given researcher or physician to decide to classify anything is intriguing. However, what drove anybody to decide to grade stools with a mark of 1 to 7 is truly mind boggling. The hours of dedication assessing countless samples of effluvia is both admirable and somewhat teutonic. As a pre-clinical undergraduate I used to have visions of arriving on the wards to be greeted by a row of beds above each of which stood a numeral of judgement on their every movement - if you'll pardon the pun. I envisaged covert conversations taking place between medics and nurses along the lines of "We've got a 7 in bed 5 - watch your step" or " The poor fellow in bed 9 is a 1 and its been 3 weeks now - you have to feel sorry for him".

So hats of to Bristol for providing endless hours of mirth to medical students everywhere. Let us also spare a thought for all those grade 1 patients who dream of their next motion and all those grade 7's who would just like 5 minutes respite....