Month: December 2015

27. Poor Predictions but high expectations!

This piece introduces a caveat to “my” new NHS being a slave to optimism, the power of the curative rather than palliative label, and the power of health rather than illness. There is good evidence for staying positive and optimistic (Sandeep Jauhar, “Fighting Cancer No Holds Barred”, 2015 Book review of “The Death of Cancer”, by Vincent T. DeVita Jr. (himself a cancer victim) and Elizabeth DeVita-Raeburn, 328 pp plus Illustrations.

We need also to think about death. And, this book review article also points to knowing when the fight is no longer worth it and preparing for a “good death”.  (Article referred to me by Prof Gael MacDonald).

I for one am certainly prepared for a swift rather than a malingering demise. It has taken the present predicament for me to increasingly recognise that I have had a “good life”; nay, as we say in Yorkshire, a “great life” with Elaine, Ellen and Richard and our extended families. I count my blessings, and I am not the only one who thinks so!

Just before I share Nick Robinson’s story I should also like to point out that I am not completely “off the wall” in believing in the power of big data in the fight against illness on global scales. See the following:

Accessed 30 December 2015, http://www.aridhia.com/use-cases/precision-medicine/

Link kindly supplied by Dr Pam Sinclair and Graeme Sinclair.

Mark Beggs is leading an innovative approach to the use of informatics to assist, where appropriate, in the treatment of patients utilising genomic data (gene profiling based on the Human Genome Project).

Mark Begg 1

[“AnalytiXagility extends its services to industrialise the ability to link and analyse sequence and other data sources to support precision medicine research and initiatives.

The platform provides capability for national genomics facilities, genomics initiatives in the NHS, stratified medicine research, bioinformatics start-ups and annotation service providers.

These services are made available through the Stratified Medicine Scotland Innovation Centre (SMS-IC). This unique centre bring together experts from academia, industry and the NHS in Scotland to implement a biomedical informatics service to aid clinical and translational research, and enable stratified medicine. As the lead industrial informatics partner, Aridhia is able to offer immediate solutions on a monthly subscription, without the need for investment in infrastructure.”]

 And so, on to Nick Robinson’s story…

“After my shock cancer diagnosis I’m reluctant to make predictions, writes NICK ROBINSON, but in 2016 we Britons must finally decide who we really are”. By Nick Robinson, Former BBC Political Editor, For The Mail On Sunday. Published: 00:45, 27 December 2015 | Updated: 18:21, 27 December 2015.

Read more: http://www.dailymail.co.uk/debate/article-3375058/After-shock-cancer-diagnosis-m-reluctant-make-predictions-writes-NICK-ROBINSON-2016-Britons-finally-decide-really-are.html#ixzz3valwH2dD
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[“Even when I was told that rather disturbing news, I didn’t really learn the important lesson. Again and again I repeated what I was told. After swift surgery I’d be back at work within a month with my tumour a mere memory. It didn’t, of course, work out quite like that, as you may know if you heard my croaking on air as I started work in my new job, presenting Radio 4’s Today programme.

Nick Robinson 1

Again, I’d made the mistake of making optimistic predictions. Yes, one of my vocal cords was damaged but all would be fine given enough rest and recovery and rehab. That too was not quite right. Even after that month away from full-time work turned into seven, my changed voice meant that my prediction that I’d soon be ‘back to normal’ was a delusion.

Was that the fault of the experts – the doctors in this case – whom I listened to? Of course not. They didn’t know. They couldn’t know the future. All they could offer was their best judgment based on their years of knowledge and experience. Blaming them for the fact it didn’t all go as perfectly to plan as they and I hoped would be as absurd as shouting at the weatherman on the telly when it floods. As someone once said crudely but perceptively… s*** happens.]

Yep it does, and it happened to me too! (Author – that’s me, cmon keep up!).

[Does that mean we should ignore the predictions of those meant to know more than us? No. However, they should be offered up with a heavy dose of humility and a prominent health warning. So here goes… This, I predict, will be the year when we have to decide who on earth we think we are and who we want to be as a country.

Read more: http://www.dailymail.co.uk/debate/article-3375058/After-shock-cancer-diagnosis-m-reluctant-make-predictions-writes-NICK-ROBINSON-2016-Britons-finally-decide-really-are.html#ixzz3vajcRHAc

Follow us: @MailOnline on Twitter | DailyMail on Facebook]

 

As Buggs bunny used to (nay, still says!), “that’s all folks!”

BUGS001

 

 

Bye for now. See you again tomorrow.

It’s also nearly time for Chapter 4 of my NHS health care reform package, so watch this space if you want to finds out more about, “Preventative treatment – promotion of healthy life styles”

 

 

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26. “Les Quatres Mousequettaires” – tail piece!

4 Musketeers_tumblr_nui9nlSSuD1trkd46o1_540

How are the Four Musketeers coping now with the celebrity and high of Christmas coming? My guess is D’Artagnan (Ian) is still in search of the elusive, American dream (no bad thing). Athos (Will) will still be seeking a women of a certain age (usually 20 years younger than his good self – she’d better not be any less than 18 but he wisely picks his third wife as a stabiliser. His own natural pick (and shovel !) – his type, has long gone, so maybe the settled, relaxed life is more for him than he cares to admit. It’s pointless now anyway, the “brownie pointless” striving for what doesn’t really exist, it is much more smoke and mirrors and life seems to be getting too short for mistakes that last too long ie ‘Pointless’. “Pointless”, now there’s a little game show I couldn’t get in to for a while and now I’m hooked! Lovely Alexander Armstrong and the gigantic (6 Ft 9in) and brainy, Richard Osman.

 

 

http://www.bbc.co.uk/iplayer/episode/b03bs75t/pointless-series-10-episode-1

As for Porthos (Nigel), age and multiple episodes of unfortunate ill health have left Nig as adorable as ever, but treading carefully with heart issues. However, after the reviving banter of the weekend and the re-union, the 4 Mouseketeers do indeed ride again. Here’s some photographic proof! A summer re-reunion may be on the cards!

Eli trip Nigel Ian Elaine Will

 

Elaine Colin Crail 1

Everyone of my musical heroes apart from the 27 year old “early death club” (Brian Jones, Janis Joplin, Jimi Hendrix, Nick Drake, Jim Morrison, Keith Moon, Kurt Cobain, Amy Winehouse), have found a means of cracking some code for survival, often in what now looks like a transfused, cadaverous shell, perhaps rejuvenated by the smell of, the taste of, and actual blood!) Come to think of it, I could do with a little haemoglobin top-up myself.

Nick Drake Montage
Nick Drake (b. 1949, d. 1974)  A fragile, tortured genius who believed his mentors about how good he was (terrific in fact) and then couldn’t resolve why no-one bought his LPs – all still available in all formats.  Five Leaveas Left – My favourite.

Here’s a few of these long term survivors:

BB King, Bob Dylan, Hank Marvin, Cliff Richard, Tom Jones, John Mayall, Jeff Beck, Eric Clapton, Ginger Baker, Jack Bruce (d. 2015), Spencer Davis and Stevie Winwood,(Traffic, Blind Faith) Eric Burden, Long John Baldry, Rod Stewart, Ron Wood, Stevie Marriot (The Small Faces and Faces), Georgie Fame, Mick Jagger, Paul McCartney, Van Morrison, Brian Wilson, Dave Crosby, Stephen Stills, Graham Nash, Neil Young, (CSNY), Linda Rondstat, Jimmy Page, Peter Green(baum), Ian Anderson (Jethro Tull) and Mick Abrahams (Jethro Tull and Blodwyn Pig), Paul Rogers, Andy Fraser (d, 2015) both of Free, Chris Rea, Mark Knopfler, Nanci Griffiths, Brian Ferry, The Who’s Pete Townshend and Roger Daltry, Sting, Eric Bibb, Keb’ ‘Mo’, Joni Mitchell, Jackson Browne, The Eagles, etc… where do you stop?

 Peter Green(baum) in his Peter Green’s Fleetwood Mac days (1968)

Peter Green Montage

Try the song, I Loved Another Woman – Magic!

25. I told you he was ill, didn’t I!

Spike Cartoon

Hi folks

Well, yes I’m still alive. I’m afraid my dearest darling wife, Elaine, made me promise to stay off the blog (she’s not a fan of public displays of personal information – she has only 1 friend, Ellen, on Facebook – apart from me!), at least during Christmas and whenever any of the family are with us. As Richard arrived on Friday, 18 December but left only yesterday (Monday GMT) I haven’t had the opportunity to update you. Nor is Elaine a fan of seeing my bald(y?) gray, head nodding in time to tap tapping away on my laptop. So, here I am 10 days without an entry and some poor folk who thought I might have croaked it all ready. More to come later, but here’s some key stuff:

And then Ellen arrived on Christmas Eve, and we had our traditional steak, chips and salad pre- Christmas dinner. The tardy amongst us then rapidly started to try secretly wrapping last minute presents.

Santa called and demolished the mince pies with Wenslydale Cheese whilst Rudolf did his best with one, off-side mouthful of carrot! Another Santa delivered three delicious chocolate hand – tailored sleighs. And yet a further Santa got a man of certain age’s guitar and amp all sorted, ready for the breath-holding moment when the new “Overwater Aspiration Grandart Bass Guitar” and “Fender Rumble15”, were duly located near the Xmas tree awaiting inspection and to be given a thrashing. Sadly, the latter didn’t happen – no interconnecting lead was supplied and silence rained for three days. A Sunday visit to Dundee fixed everything. We purchased not only a Fender 2.8m black (naturally) lead but also a Leather padded strap and some black picks.

Music at last, Richard discovered his future, I think, picking up the main Bass riff of Stanley Clarke’s School Days almost by the time I slipped my vinyl on to the turntable (Linn Sondek LP12 – upgraded 1970s original version with Rega cartridge in Linn Basic arm), and I walked back to the lounge where he was “noodling” to his heart content. He looked a natural to me – but developed a blister on his forefinger for his pains (as well as pleasure!). My torn-to-shreds finger tips still prevented me from having a go – what a frustrating start to Christmas. Can’t drive the BMW X3, can’t play the Electric Bass and I am still awaiting the replacement Makita Drill and Impact driver!!

Photos of the adventures of the four mouseketeers are in Blog 25 – now slightly out of synchronisation but then, who’s really checking? Though I am sorry to those of you that briefly saw a Blog No. 24 and then you didn’t!

Ian is home and well in San Diego. We Skyped on 28 December and he, and especially Marilyn, looked really well and happy!

I had my third lot of intravenous Chemo today – two thirds of EOX, Epirubicin and Oxaliplatin. I seem to coping better than last time, and infinitely better than the first time, so maybe things are looking up. More Later…

Bye for Now – more blogs to catch up with!

‘Til Later, Colin

 

 

 

 

 

 

 

 

 

 

 

 

 

24. Harry Potter and the “Goblet of Trial by Fire”

Harry Potter Goblet Fire

I’ll briefly repeat my 6 point (bullet) plan for the NHS to preface my focus for today’s section on 3 Testing.

  1. Education – underpinned by philosophy
  2. Screening – underpinned by data
  3. Testing – from birth to death
  4. Preventative treatment – promotion of healthy life styles
  5. Research –on preventative medical conditions
  6. Evaluation – led by self-scrutiny

 

  1. “Testing – from distinction (birth) to extinction (death)”

Well, what I want to try to do today is to explore the theoretical, practical, ethical and moral issues, as well as the financial implications for the people, (patients, doctors and scientists, test developers, manufacturers and distributors, and those further downstream companies, governments and crucially, the people being asked to pay for all such services and other off-shoots, some of which are yet to be even dreamt about) , that do or could shape a framework for what has become one of Medicine’s 20th and 21st Centuries’ most controversial topics, and will become an even greater debate –Testing. Some sentence, eh?

What is testing?

This includes tests used in screening, or ‘speculation tests’ as I’d refer to them, as well as a vast array of actually deliberately used tests as applied to ‘a known patients’ screening profile or ‘work-up’. In other words, at least for patients receiving care or treatment already, tests are part what is done (blood, urine, sperm/semen, saliva, poo, commonly, and less commonly, bone marrow, respiratory aspirate, skin, spinal fluid, amniotic fluid and vaginal scrapings –only if you are female), to make up a range (incomplete) of such samples.  For example, someone who suspects they may have become infected, perhaps with Human Immunodeficiency Virus (HIV), as a result of “a good night out and wanton appetite”, may decide to take themselves off for an “Acquired Immuno-Deficiency Syndrome” (AIDS) test to “re-assure themselves”.  They’d be disappointed because they would be unlikely to show signs of AIDS at all, let alone after a couple of days, say! The HIV test, however, could be positive and this could predict the future, if not entirely accurately!

 

AIDS

Early Government Advertising – warning about dangers of AIDS

Not all tests for every possible condition that could be tested would be tested, but you’d be surprised how much data is collected every time you meet and speak with a NHSHCP! Just ask F, finishing up her shift at the end of the working day. Just look at my notebook I have in hospital, making notes of every pulse, blood pressure and temperature reading, sometimes taken every 30 minutes, sometimes every 60 minutes – even during transfusion of packed red cells for alleviating my temporary (I hope!) anaemia, and to restore my haemoglobin levels and give me a little, if not entirely normal, increase in energy capacity for exercise, resisting the cancer growth or, walking down the corridor for No. 6/4 buzz cut, or whatever!

I have covered the issue of screen-testing specifically so I will try not to repeat this aspect again and focus instead on the broader implications.  I have made specific mention of the idea of testing from Birth to Death.  What again do I mean?  Already, the new born are “tested”, usually a ‘heel prick to obtain a small sample of blood alright but also large enough to generate a lot of data but most often to obtain a bilirubin measurement to reveal whether there may be ongoing destruction of the child’s erythrocytes (red cells) because of maternal antibodies attacking the new born’s ‘foreign’ red cells via attachment to surface glycoproteins such as Rhesus (Rh) antigen, particularly when the mother is Rh -ve and the new baby is Rh +ve.  Mum gets a shot in the ass (USA style) if this is the case and no. 2 or no. 3 etc babies become protected against subsequent mum attacks!  Alternatively, the bilirubin could also indicate that there may be a liver problem – so, all that delayed onset crying is worth it!  A good test – two potential shots (accurate and reliable ones) for the price of one!

A good test is one where “it does what it says on the tin”, measures what it is supposed to – say blood glucose, via a measuring device and ‘strips’ (Blog 23).  This is a theoretical minimum, but it is not sufficient.  For example, there’s a test that is often carried out on us men who feel that we may be having problems with our Prostate gland and water-works, (a walnut shaped object – no shell thankfully!) wrapped around our urethra which emerges from the urinary bladder.  When it enlarges (most old men such as my good self!) it causes funny patterns of pissing! (Time variations, volume variations – including none –  even when you think you are bursting silly), not “over the wall wins”!).  One test that is used to check whether we may be having problems is the PSA test.  Blood is taken and levels of Prostate Specific Antigen (PSA) are determined.  I know, I have an enlarged prostate, and take yet another pill, Finastaride, for it every day – on top of my other 9 medications!  Anyway, PSA levels are not sufficiently accurate or reliable.  There’s a combination of too many false positives – worrying people unnecessarily, and too many false negatives – where too many people get re-assurance, in error, and may not follow up on other positive symptoms.  This is the worst of both worlds and demonstrates that a test must have a high level of discrimination to be good; to be effective at what it is supposed to do and minimise the number of people potentially adversely affected.

So we have lots of tests already and there’s likely to be whole lot more coming (and many are already here though you may never have heard of them).  For example, in a later Blog I’ll try to explain a little more about all the Scans I have already had, and even more about some of the ones I may yet have such as The PET scan, MRI scan, PET CT scan and so on.  However, that is for later.  What I want to focus on specifically is the idea of “routine” testing from birth (distinction) to death (extinction).  I have already mentioned screening and testing.

What if testing of anyone’s DNA (our genetic code or ‘blueprint’) becomes so accurate, reliable and inexpensive that it becomes possible to produce a full profile of every individual on the planet (at birth) from a heel-blood collection device that looks like a piece of Velcro and baby doesn’t feel it even?  The information can be recorded digitally and even placed on a chip which we could carry around with us on a Credit Card type device or a bracelet (like diabetics).  This could be linked to our National Insurance, Hospital or ID card and with a swipe of entering a hospital a NHSHCP could access key information about us to help them treat us in an emergency, say!  There’s a problem straight away!  Why can’t we have only one means (alphanumeric symbols) of identifying ourselves?  No mix ups -great!  I am not with the il-liberal personal information protection lobby on this issue!  One person, one card, one 12 digit encrypted digital signature!

Further data can be added throughout life and contribute to a rich source of our personal medical and scientific data all designed to predict, anticipate, determine and perhaps treat any likely future health condition.  For example, about three years ago I finally returned to the UK from Australia and I was still being treated with Warfarin (yes, rat poison) to inhibit blood clotting (Blood thinners- though not like paint thinners!), that had caused me to have two DVTs in my same lower left leg.  Deep Vein Thrombosis (DVT) can be lethal even after one event, especially if a small portion of blood clot detaches from the main site and is carried to the brain (stroke) or heart (attack) say.  It turns out, after DNA testing on me that I had a genetic condition, Factor V Leiden – an abnormal type protein that contributes to the (abnormal in my case) clotting which follows cutting yourself shaving.  I thought my favourite sister-in-law (for tonight only), Jacqueline, might say I was excluding the ladies there for a brief moment of panic (Good conscience, Jacqueline!).  However, I realise how Neanderthal I was, of course ladies shave their bits too, and too much, too often, if you ask me?

Had I known that I had inherited one defective gene from either mum or Dad, (I am heterozygous for the condition), then I could have helped out the haematologists in the hospital deal with my own DVT better.  But I wouldn’t have needed to under the new system.  This information would have been entered onto my records shortly after birth.  Of course there’ll be new stuff being discovered all the time, and we will need to have a global economy in sharing advances and for free!  And this is my vision of the future.

What about the money I hear you say!?

So now we must mention the elephant in the room! As with screening, testing (especially, if as I suggest, we view this as a lifelong process), must be done, right?  And it is going to cost someone!  As one of my fellow Geordie travellers, Sting, would say (but I also take good ‘odds-on‘ for other  Geordies Eric Burdon, Chas Chandler, Chris Rea, Mark Knofpler, and Brian Ferry), ‘If you love somebody, set them free’, (Best of Sting, Fields of Gold, 1984 – 1994).  Protecting my own information is not a priority for me.  Ask yourself, if you disagree with me, why isn’t it for me too?  I’d be interested in your comments in the ‘leave a reply’ section of this blog!

 

Sting 1

Sting 2
Sting pretending he really needs a NO. 2 buzz cut

 

Sting with it all on!

 

 

 

 

Yes, we still have a problem Houston.  Everyone is dead or dying my be and who is gonnando what ?  Could we get a philanthopist or several to club togethet and to underwritebsuch an task  sponsored by Gloria Gaynor concerts maybe?), and remenber, somebody is gonna have to pay!

 

Gloria Gaynor 1
Gloria Gaynor Live

Gloria Gaynor “I will Survive”, Accessed: , 15 December 2015.

 

So what about the money!

Actually the circle can be drawn very tightly indeed but it is going to depend on reaching conclusions and then taking actions about defining who pays (and who dis’nee! – a wee bit of Scottish there), according to Kev.i.am Bridges, is an ongoing challenge to central UK as well as Scottish parliamentary parties and their policies to deal with the consequences of astronomic levels of debt (1.5 Trillion in the UK, that is 1,500,000,000,000,000,000 (I think, or give or take 3  noughts depending upon British or American definitions of billions!). Governments (of any persuasion) would much rather us not talk about this financial measure (disturbing as it is), but rather, talk about the British Deficit instead.

The ‘deficit’ is a quantum-sized amount of money compared to our total debt, but it is what all political parties across the whole UK were bickering about in their various political manifestos that were written to underpin the financing of ‘their government’ (if successfully elected as such) to implement their values, their mission, their spending, their ‘cuts’, ‘their balancing of the ‘books’’, and how quickly and/or deeply to hit different compartments of the nation’s population to pay for, or to receive it.

Let’s look at the simplest model.  Most of us who have to manage a budget could envisage getting a ‘handle‘ on the job. My household has a total income. We spend that on the rent/mortgage, food, power, stuff – including on ‘bucket lists’ (Morgan Freeman and Jack Nicholson) as well as essentials and a few frills (tattoos, a download, cheese and chips or even savings, if we are really lucky!).

 

Bucket List

 

Morgan Freeman and Jack Nicholson in “Bucket List”, (2007).

Accessed at http://www.imdb.com/title/tt0825232/, 16 December 2015.

Buzz Cut Jack Nicholoson

Jack Nicholson getting his own Buzz cut – I’m guessing a No. 3 all over!

In summary, we have ‘outgoings’. In my traditional 1950s ‘mind-set’ my aim was always to ‘balance the books’ – only spend as much as I earn and save a bit towards a future mortgage to purchase a property (and some more power tools and a staple gun!). Of course even if I managed to secure a mortgage from a bank (or Building Society in my day), this then became (usually) my biggest ‘debt’ (though I had this rather nice BMW 520 series once!) and servicing that debt (my agreed interest payments, for how long etc) then contributed to my outgoings (as well as my big debt!), giving me my ‘overall’ debt (The British 1.5 Trillion GBP equivalent!).  Now that is the one I worry about and governments should worry about theirs too!

At Government level, Chancellors and their teams juggle the income (Tax ‘gather’) and outgoing spending (Tax spend). The difference between these two measures is known as the deficit or surplus – again depending. Most British Governments have run a deficit. The most recent debate involves the newly elected Tory government’s intention to reduce spending and engage in debt reduction as quickly as possible. This ‘tinkering’ with the budget – especially when it affects ‘dear-to-heart’ items such as the Welfare state, Education, The National Health Service (NHS), Work and Pensions, Defence etc. is very controversial. The House of Lords recently sent the Chancellor, George Osborne, with his tail between his legs, to revise his budget statement to implement cuts ahead of compensation in his unfair tax on welfare payments!

 

Tail between Legs George Osborne
Hello George!  That’ll teach you!

So how do we go about it?  Once again I want to hear more of your views but here is a starter:

We need a fully comprehensive insurance-based health plan for all global citizens.  This is completely underwritten by Governments but money is raised in lots of creative ways.  This would include raising levies (taxes or whatever) on known (or even suspected) harmful substances such as sugar in soft drinks, or smoking, to add extra funding to a much larger share of the tax spend for Health and Welfare.  Positive measures could include giving all multi-national companies no choice but to pay their fair share of tax wherever they set up their Tax havens.  There should be no escape.  Global governments will take their 10% or 20% or 30% or whatever tax percentage ‘pays’ companies not to try and avoid or evade, or face the same bill in fines.  And,it will not be possible to write it off against tax in future either!  This is the original Parkinson’s Law on Tax.  We can’t blame companies for working within the law on tax avoidance; I mean who likes to pay their taxes?  Me right?  No, me wrong!  But I don’t have choice, I am a pensioner on a fixed income all sorted through the PAYE (Pay as You Earn) scheme.

Governments must not give Companies a choice either.  Tax legislation needs to be changed and we must get Insurance and Investment Bankers and others out of the corridors of TAX haven power to influence legislation – like having a Vampire in charge of the blood bank.  Yes, they have an interest alright – but an unhealthy one, in my view!

Governments must take charge and get a few (actually, make that a lot!) of unemployed people on these committees.  If anyone knows how to exploit loopholes then, according to the Government, they do – cos they certainly disproportionally punish them!  And having put in place a new legislation it must be ‘future-proofed’.  We need an instantly enacted loop-hole closure clause for any future loop-hole discovered by a clever-dick insurance or (b?)anking person.  We will have our fair share of company profits! 

I don’t believe this will scatter bankers to other countries as claimed by right wing pundits whenever taxing the rich comes up.  It is bluff!  They want to live here alright, in close proximity to Government ministers, especially the teams surrounding tax legislation – check out, Owen Jones’, a left wing writer for the Guardian.  For example,

Don’t sneer at redbrick revolutionaries – some of our best leaders were terrible students

Owen Jones

Owen Jones The Establishment

 

Long live the NHS, But not as we know it!

Tomorrow I am having some me-time!  Both Steeds are going to the Blacksmiths to be re-shod with smart new winter hooves’ protectors!  And I get to drive the new BMW steed properly!

Au revoir!  Bon Nuit – and all that Franglais stuff!

 

 

 

 

 

 

 

 

 

 

23. “Les Quatres Mousequettaires” – Four Mousequeteers ride again!

 

4 Musketeers_tumblr_nui9nlSSuD1trkd46o1_540

 

The Four Musketeers (also known as The Four Musketeers: Milady’s Revenge) is a 1974 Richard Lester originial film, starring Michel York as D’Artagnan (Ian), Oliver Read as Athos (Will), Frank Finlay as Porthos (Nigel), and Richard Chamberlain as Aramis (Colin)

Quel Surprise, Samedi!

TheBoys

The (Mousequeteer) Boys (circa 1971).

That’s us lot (from the top): Nigel (Athos); Will (Porthos); D’artagnan (Ian); and me, Colin (Aramis – I am still worth it!), on the steps of one of Tong Hall’s annexes.  Tong Hall was an all-male Hall of Residence situated in the outkirts of Bradford, near Wakefield.  It was an old Mansion house converted into about 50 or so study bedrooms.  Will and Nigel shared a room in this annexe, whilst Ian and were in the main Hall!  we ‘bussed’ to University everyday, providing you woke early enough.  Otherwise it was a choice of one of two buses – a week!  Hitch-hiking worked well then!

Not only does my best friend, Ian, out of Chesterfield and via Bradford (where we met), from the good old US of A turn up (early!) on Saturday morning, but my dear wife then tells me I’ll also be joined by my other partners in crime, Nigel Bullard and Elwyn (Will) Williams later in the day, as they are also arriving for the weekend! Brilliant news – the Four Mousequeteers reunite!

Anyway, Ian’s early arrival catches us out, Ellen is still in bed (well that bit didn’t, nothing new there!). Elaine was en route to her Jazzercise class when the text message, “arriving at Cupar Station at 10:00 am, now not 11:00 am!”. So, let’s rehash the plan: Elaine picks him up; I clean and re-lay and light the Jotul multi-fuel woodburner, get breakfast quickly; (Ready Brek with randomly sprinkled Weetabix) , but most important of all, “be ready for when we (Ian and Elaine of course) arrive at 10:00 am” So there! Now have any of my readers out there the answer to this? Should I write “Readybrek” or should it be “Ready Brek?” as my Daughter, Ellen, insists – though she doesn’t always get her way despite being my Editor-in chief!). Well our plans were hatched and we set about them asap.

Ian and Elaine duly arrived and started breakfast – or they did, Ellen and I had had ours by now. Afterwards, Ian declined a sleep offer, but parked his gear in our spare bedroom. Daughter grumbled a little about “Dadda bear or something like that”. But they were fresh, clean sheets – honest, Ian!

We had lunch and then headed for a Christmas Fayre at Fairmont new golf centre, out towards Crail. Elaine bought something (well hidden) and I was allowed to want to buy without doing so – a nice burr elm bowl, sporting 8 coats of teak oil. Ian and I were dropped at a pub in St Andrews (“The West Port”) where he could sample a local IPA real ale, and I my usual “Ready Brek sprinkled with Weetabix” (Kidding!) – I mean orange juice. We watched highlights of the Rugby 7s tournament held in South Africa (I think), whilst doing loads of “Catch up”. Elaine picked us up at 4:30pm and we ensured Ellen caught her bus home to Glasgow. We went home to Ceres and awaited Athos and Porthos and waited, and waited, and waited … Ian and I headed for Meldrum’s hostel to discover they hadn’t even registered or said they would be late, yet!

They eventually arrived at nearly 9-30pm. Elaine fed and watered the steeds! And we did more “catch up”! They left for the Hotel at 12:00am and we agreed to reconvene at 11:00am to take a tour of the Fife coast from Ceres to St Andrews but via Leven, Elie, Pittenweem, Anstruther (for world famous Fish and chips) and eventually to Crail, where we first lived on coming to the University of St Andrews, as its new Teaching and Learning Development Officer in 1996!

We eventually take off on our trusty steed (well actually Nigel’s big Cat – a Jaguar!) and head for Elie. We take in a pint or several at the Ship Inn and then on to Anstruther (A’nster – pronounced Aynster!) for Fish, Chips and Mushy Peas. I pick at a Haddock in Bread crumbs but have to give up. We check out Pittenweem, including two houses we put in “offers-over”, way back. We lost out. Crail remains its idyllic, beautiful self – reminiscent of St Ives in Cornwall, especially for the light! We head for Ceres via St Andrews. We relieve the city of more ale from its hostelry named, “The Central”, and then finally head home.

We purchase more provisions, wine, ale, chocolate, DVDs on the way and spend the rest of the evening consuming a wee Glaswegian comedian, Kevin Bridges, who has suddenly gone all ‘grown up’, and even slightly ‘educated’ on us, (though with tongue in cheek for the most part – Yippee!).

Kevin Bridges 1

Kevin Bridges in his video, “The Story Continues…”, as well as his latest (below), “A Whole Different Story LIVE 2015”.  This includes the line, “when did I didnee?”, as a retort to a bouncer asking a drunken punter when did he pay (to be allowed in)?”  A beaut!  The DVD also includes BBC1’s Live at the Referendum.

Kevin Montage 3

Everyone departs through floods of tears at 9:30pm. Elaine and Ian must be in the car heading for Inverkiething Railway station for the first train to Waverley station at Edinburgh. They made it, I understand as Elaine slides back into the Old Manse’s master bedroom at 7:00am. I sleep til 10:00 am. What a flying visit that was!

Well that is it for tonight’s homework.

I’ll add some “holiday snaps” later – promise!

Back to 3. Testing, tomorrow

What is testing, etc?

 

 

 

 

 

22. Harry Potter and the “Chamber of Secret Decisions”

Harry Potter Chamber Secrets
The Second Harry Potter novel by J K Rowling (2000)

In the end I skipped yesterday’s blog (Friday), so very early good morning to y’all, folks – it’s only 02:50 am – but I can’t sleep so what the hell, write, eh?

I’ll briefly repeat my 6 point (bullet) plan for the NHS to preface my focus for today’s section on 2. Screening.

  1. Education – underpinned by philosophy
  2. Screening – underpinned by data
  3. Testing – from birth to death
  4. Preventative treatment – promotion of healthy life styles
  5. Research –on preventative medical conditions
  6. Evaluation – led by self-scrutiny

2.  Screening – secret decision making?

Well, what I want to try to do today is to provide a few examples of where medical decisions about use of screening tests and procedures are made with the best of intentions, but in the long term may prove medically and technically inaccurate but also financially disastrous – even by ‘back of the envelope’ standards of accounting!

So, what do I mean by screening? Screening is a process usually used on large populations of people or patients to detect or determine whether disease already exists, or is likely in the near future, and designed to reduce the expensive costs of treatment very early on and before the onset of actual disease which is often more expensive to treat later – such as stomach cancer.

Lump Sequence

Cancer Research UK advert (Accessed 11 December 2015, https://www.youtube.com/watch?v=5JjA9XRT71c ) showing disregard for an obviously growing lump. Self-screening is not only possible but should be absolutely mandatory in our new liberal proactive NHS!

The presence or absence, or level, of a direct or an indirect marker of an illness or condition are used to determine patient management. You may be part of the National bowel cancer screening programme, I am! Every six months or so I receive a neatly wrapped pack from the NHS encouraging me to deposit a small knob of my mid-squeeze poo from a sterilised stick on to a little tray with a fold-over flap to cover it afterwards. I do this three days running and then send off the kit to the National Bowel Cancer screening programme. Some few weeks later, thus far, I get a letter telling me, “I’m clear”! No blood in my Poo, I suspect!  Let’s look at a few other examples.

My darling daughter, Ellen, is a Type 1 diabetic, and has been since she was diagnosed as a 17 year old in 2001. She relies totally upon human – derived insulin, prepared using technology that owes its existence to early pioneering research commencing with Banting (Frederick G), a surgeon, and Best (Charles) a medical student (1921), though Banting and Macleod (Prof John), received the 1923 Nobel Laureate for their collective work, including that of the fourth member of the team, Collip (Bertram), Biochemist and purifier of insulin from pancreas extracts. Some things never change!

Banting and Best

 

Banting Best Toronto

Banting and Best at the University of Toronto, Canada, 1921

(Accessed from http://bbdc.org/ 11 December 2015).

The recombinant, human Deoxyribo-Nucleic Acid rhDNA -derived protein synthesised from the correct sequence of amino acids that comprise the 2 chains of three dimensional peptide monomers (proteins: 1 alpha- and 1 beta- chain) are now the ‘pure’ human protein insulin required to regulate blood glucose. It is much more effective than porcine –derived insulin, a more commonly used product when my own sister, Val, was diagnosed with Type 1 Diabetes whilst only 11 years old (1965).

Ellen has to test her blood sugar prior to the injection of insulin into subcutaneous connective tissue, in order to determine the correct insulin dose. It is now much easier and more convenient to do this using sophisticated blood glucose monitors which use ‘test-strips’. Now these are not cheap, £25-30 for 50 strips but are thankfully free to all diabetic patients on the NHS, as are all prescriptions for people living in Scotland.

A few years ago Ellen moved to a new flat in Glasgow and immediately joined her local clinic. When she called into register as a new patient/resident and to renew her prescription for these strips she asked for her usual amount (about 200, I think). She uses 5-8 per day following her consultant’s guidance.

Initially, she was told she couldn’t have this amount and was asked why she needed so many at one time. Ellen explained that she could use up to 10 strips in one day and had been previously told by her diabetic nurse that better quality monitoring of her blood sugar helps minimising elevated or wildly fluctuating blood sugar and thus reduces the risk of long term complications such as long term chronic heart disease and circulatory problems.

She was referred to the GP’s own diabetic nurse by the receptionist, who eventually agreed to the increased amount but the whole process seemed counter intuitive … And it is undoubtedly an example of simply postponing sensible investment in long term preventative care.

My own sister, Val, died needlessly young earlier this year following years of such complications including damage to limb extremities (Not Head, but Hands and Feet!  – see Blog 6) ultimately requiring surgery; but also triple by-pass surgery on her heart, and not infrequent ischaemic heart attacks. She had a couple of strokes in her last fortnight, and died of a final heart attack on 27 August 2015 (b 3 September, 1955).

Such a waste, and guess what? If you do the sums (Math, for our USA colonial cousins!) on a spreadsheet like I have, (‘cos I’m pretty good at that, recall Blog 19!), then the all- too human reaction of rejecting an initial request for something that ‘appears’ expensive can be avoided. Honestly, the price differential is something like at least a 1000 fold. We could even devise an algorithm to determine the likely savings of providing patients with exactly what they need, right now – despite apparent additional, though often superficially higher, but not real costs; or at least compared to real costs that must be incurred because ‘normal routine’ situations become emergencies – and I find no complaint there, all the stops and probably money too, come out to save you from the brink then!  So at best,costs are deferred, and at worst, well …. Do you really need me to spell it out!?

And who is making these decisions about patients’ requests on the front line? Often it is receptionists, in my experience. Classically, this is not their fault or responsibility. Rather, it is their implementation of a General Practice (GP) procedure or rule – and part of what I call ‘poor Screening attitudes towards genuine patients’. This inadvertent policy or practice (or both) probably includes more pain and suffering, and even less gain, eventually! So it sometimes seems nonsense to me and almost always results in conflict in GP surgeries and desk areas! Does it make sense to you? I doubt it is even recognisable amongst NHS senior managers and it is certainly not a formal “Policy”.  May be, it is simply one of the things that just don’t get enough attention – Complacency should not rule, OK?

Patients generally do not want to cost the NHS a lot of money, but they do want common sense to be applied at all times, and also want their Consultant’s plans to be followed and implemented by all National Health Service Care Staff (NHSCS) in the chain of command affecting them and their treatment!

Another example, my own, should suffice for now.  I have referred to this already in Blog 4.  Previously, I mentioned that I take responsibility for putting off discovering whether I had an stomach ulcer, Helicobacter pylori, gastric reflux, or some other such condition, or even worse.  “Worse”  it has turned out to be, and I am unclear how things might have been totally different, though in my vision of the New NHS, I would be certain!

My Medical colleagues at Bradford Royal Infirmary (BRI) were a constant source of information, opinions and inspiration to me as well as unknowing mentors and teachers. I learnt most of the clinical application of my work on Na-K pumps in erythrocytes in chronic renal failure anaemia and other conditions, from Dr Liakat Parapia, Consultant Haematologist and my Co-Director of the joint BRI – Bradford University Haematology Research Unit (HRU).

My dear old friend Dr David Margerrison, Histopathologist, an inveterate smoker, and conjuror extraordinaire, could balance the ash from a whole cigarette on his Capstan Full Strength tip precariously over a cadaver whilst carrying out a post mortem – no drips, no probs! He mentioned one day that his first (and only) recollection of Lecture 1, Term 1 in Year 1, by the Dean and Head of the Medical School was that common diseases occur commonly. Not rocket science that, how come I didn’t get in to Medical School? This had served him well, he said, and I suspect it still does for both newly trained staff and those at the other end of the spectrum. Why do I mention this?

Well, it would also not be uncommon for medical colleagues to also think I’ll sort out the possibility of ‘this’ (condition) my patient is presenting with through a triage of thinking:  what’s most likely going on?  What’s next most likely , and so on?  I have a suspicion I would, especially in a busy GP practice with 10 minutes per patient to play with.   So, if you as a patient  have a rare rather than a common illness, that is likely to be diagnosed second, rather than first, then you may  indeed be unfortunate!  After all, common diseases occur commonly!

Well the rest of my story is history now, but what of the future?  In my new model for NHS screening practice, I’d love NHSHC professionals to think,“Uncommon diseases, whilst unlikely to be the explanation for my patient’s symptoms, could be an expensive mistake to misdiagnose in the long term”. I must check early and then reverse the usual pattern of thinking to something like”:-

 Current thinking Disease explanation: “Most likely”

Common > Uncommon > Moderately Rare > Rare

to

New thinking Disease explanation: “Most costly and debilitating long term”

Rare > Moderately Rare > Uncommon > Common

Now in Medicine things are rarely this straight forward or simplistically dichotomous, so the judgement of panels of NHS care professionals, perhaps with the patient together, could consider the case and contribute to highest standards of decision making – but not behind closed doors. And, thus we arrive at the Chamber of Open Decisions.

So is that it? “Short-term gain, for long term pain” – the foundation of our present NHS Screening Policy?

I doubt it; and if it is I’d be surprised, but it may be how some people experience it. I do need more examples of this type of story as well as contradictory or counterfactual ones, to explore whether we really are in such poor shape (pardon the pun!) both bodily and financially!

Now it is vitally important that you do your bit here. I’ll need as many examples of similar things that you have experienced personally (preferable), or that you know about and can be verified. I can’t use hearsay or invented scenarios – sorry, because I’m sure we all could create some of the most dramatic stories possible. I really need to complete my foundations as broadly and deeply as possible – extending our cornerstone (Education) to support the rest of this edifice.

We must say “Nope” to beurocracy and ‘standard’ less good practice whenever we see it in nour NHS. Only the best is good enough. So once again:-

Total Defiance

So now it’s your turn. I’ll still be trying to find a special spot in the web site for your ideas and suggestions, but for now what about using the comments box?  Maybe I can award prizes for those selections used to compile a final set of recommendations? What about three prizes per section (18 in all). So, come on help me out!

See you all tomorrow! (It’s actually today now, Saturday)

And specifically, I’ll be re-uniting with Ian Rule, my best friend at Bradford University 1970-1974, visiting all the way from San Diego, California, USA to Ceres, for a long weekend! Bet you didn’t know Ceres, Fife was such a draw, eh?   And, we have just returned to Ceres from a visit to St Andrews – specifically we sought out Deans Court where I was Warden for several years before our departure for New Zealand.

Deans_Court_01

Deans Court Montage

 Photo Montage of Deans Court where I was Warden from 1997-8 and again from 2002 –  2007, at the University of St Andrews (Founded 1413),

“Scotland’s first University”

Web site Accessed via http//:st-andrews.ac.uk/ on 12 December 2015.

Long live the NHS, But not as we know it!

But before I go here’s one of my favourite New Music People.  A little bit Rock and Roll, a bit Jazz, a bit Celtic and a bit damned good – Hozier!

Hozier Singing

 

 Accessed from https://www.youtube.com/watch?v=PVjiKRfKpPI on 11 December 2015.

21. Procrastinator: well maybe; or maybe not!

I must now apologise, belatedly, for diminishing your daily fix (you didn’t tell me!), to only a few lines, and oh, some music too. I’ll post the section on  Screening of “The Plan” a little later on – when dear daughter Ellen has properly edited it!

Yesterday, I reached the nadir of the post-Chemo Combo experience with EO from my EOX cocktail so bear with me ….

Here is an old track from Paulo Nutini who Elaine and I saw in July with Ellen –an old one but a good one – definitely different version played with gusto at his concert in the SSE Scottish Hydro, Glasgow.

paolosplash2

And of course the track just has to be, “Jenny don’t be Hasty” from “these streets, Paulo Nutini, 2006.

Accessed from https://www.youtube.com/watch?v=fBBKZ3i-_9I, 12 December 2015.

 Bye for now and see you tomorrow!

My Dear friend Ian has just put me straight!  I have been CYA (cover your ass) when I thought I was see ya’!! for the last three weeks – sorry!

 

20. Harry Potter and the ‘Philosophy Stone’

Today I embark on the “Plan”.  I’ll commence with education as the first and cornerstone of this plan, one that is underpinned by my views of the philosophy necessary to sustain a values and mission driven approach.  I will be using The Harry Potter series of books by JK Rowling to link the themes together.  So, today’s education section is linked  to “Harry Potter and the Philosopher’s Stone“.  Others will be linked accordingly!

 Harry Potter Philosopher's Stone

First of the Harry Potter Novels by J K Rowling, (1999)

 So, it’s the day after, the day after the night before and I’m feeling like diarrhoea, marginally better than constipation, but an improvement on shite! A note here is needed. Shite is a much more expressive word than shit (ask Kevin Bridges, Glaswegian Comedian).

Kevin Bridges, “The Story Continues  …”, (2012).

Shit means anything these days: “Do you want to smoke some of that shit?; I’m really diggin’ your shit!; I need to go home and pack my shit. You can never put shite in thay (sic) sentences …. Do you want to smoke some of that shite?; You’re really diggin’ my shite; You’re going home early to pack your shite?” (Kevin Bridges, The Story Continues …  2012.)

Shit can also be used to refer to excrement, of course, but usually in posher circles of England. However shite! is preferred in Edinburgh, Dundee, Aberdeen, Stirling, Inverness and other Scottish places, but especially Glasgow. Bet you didn’t know that; I didn’t before migrating to Scotland either.

Before I begin to try and expound a philosophy of education let me try to capture it as succinctly as possible – not a strong suit in most academics – me included!

When faced with complete disaster

TOTAL defiance is the only answer!

 

Total Defiance

To introduce my next thought ramblings I’ll briefly repeat my 6 point plan for the NHS. Say nope to complacency! I will be seeking immediate proactive, radical solutions to the major medical issues outlined below (or similar; I’ll be seeking your input too):

  1. Education – underpinned by philosophy
  2. Screening – underpinned by data, information (including economic) and rapid, open publication
  3. Testing from birth to death – coupled to universal insurance to block selective and extortionate premiums
  4. Preventative treatment – promotion of healthy life styles
  5. Research – focused on preventative medical conditions but financed and front-loaded, from National Profits on curative treatments and drug sales as well as taxes on harmful products
  6. Evaluation – led by self-scrutiny, and assisted by sympathetic managers and especially mentors, with an emphasis on honesty, openness, timely feedback and no recriminations except for criminal neglect and unscrupulous Health Care Staff.

So,  on to  …..

Education

If you want to achieve anything (at all) you need an education, try not having one! As former Professor and Director of the Institute of Teaching and Learning at Deakin University, Melbourne, Australia; Dean (Vice President) of Teaching and Learning at Unitec NZ, Auckland, New Zealand, and Director of Learning and Teaching Development, SALTIRE, University of St Andrews, St Andrews, UK (don’t put an apostrophe anywhere near this word when referring to the town, oh no! ) I suppose I know a little about teaching as well as learning, but most of all, I’m still learning. We all are. Education has been a football amongst political parties for decades, ever since the Robbins Report (1963) and much time, money and effort has been needlessly wasted, and opportunities missed. But, let’s move on ….

Robbins Report

 

 

I’m unashamedly and passionately committed to helping others learn. My first teaching job (fresh out of the University of Bradford, BSc in Biology; University of Leeds – Graduate Certificate in Education, GCE and no other source of income) was as a private tutor of mathematics to a student who had failed ‘O’ level maths. This gave me my first insight into realising I couldn’t teach her to understand mathematics, but I could help to design exercises with explanations that led her to an improved understanding and eventual technical ability to solve problems. Oh, and pass her ‘O’ Level at the next attempt!

I also grew to understand the unique abilities of genius Mathematicians whom have little understanding of those who don’t ‘get it’, and who also, unfortunately and often, don’t have this magic ability of helping others to learn – mores’ the pity!  Now I am a million miles from being even a beginner mathematician, though I am pretty good at ‘sums’ on a spreadsheet!  I also learnt a lot about the power of one-one work – mentoring I’d call it now!

I have built on these early beginnings over the last 40 years and have made at least a small contribution, alongside, particularly my scottish colleagues in the Scottish Higher Education Developer (SHED) community, to the support provided and inspiration used to help Higher Education academic teaching staff through promoting learner-centred approaches, whenever appropriate.

Shed 1

The SHED Community in Scotland share resources, tools and services to facilitate educational development activities for all Scottish universities as part of the group Universities Scotland group.

Universities Scotland 2

So, these experiences shape my own philosophy of education: a liberating and ‘freeing’ experience; a fun and amusing, playful underpinning of everything; and an absolute right to challenge perceived wisdom, orthodoxy, and ‘establishment’ positions and views. This has cost me dearly on many occasions, but would I do it again?  YES! Yes! Yes! OUI! Oui! Oui!

Additionally, I went on to graduate with higher degrees, an MSc in Experimental Pharmacology (1976) and then, via part-time research, a PhD (1987) in, “Anaemia in Experimental Chronic Renal Failure”, both from the University of Bradford. It was also there where I went on to teach from 1976 – 1997 before leaving for St Andrews. I taught a vast range of subjects whilst at Bradford, most of which I had not even met in my undergraduate or postgraduate programmes let alone knew a great deal about. But hey, this is academia -don’t you know? Yes, academics arrive in their first posts fully formed – or at least some give that impression! Everyone knows it’s a case of the Emperor’s new clothes, but will anyone ‘fess up – not many, in my experience! I did a lot of learning the night before my classes in my Bradford days! Still happens now, I’m a bit of a procrastinator!

My Biomedical Science background has given me a career-long interest and fascination in cell biology, histology, anatomy, physiology, pharmacology, immunology, pathology and haematology, my ultimate academic specialism. So, if you’ll forgive me, I think I am at least entitled to comment on what an (Medical) education for all in the 21st Century should look and feel like. You are not only entitled to disagree and suggest your own ideas, I absolutely request that you do! I have challenged authority in nearly all my work-roles and well, you win some, you lose some – that is life! I almost dare to challenge authority in my home-life too, but that is another story!

So, if I try to summarise the underpinning philosophy of my views of education I can capture it in no better way than to quote one of my heroes, Paulo Freire, “Speak Truth to Power”. More glibly, “the truth will set you free”, works pretty well too, but if you want the ‘real deal’ then – “a picture is worth a 1000 words”, and worth seeing again (below).

Total Defiance

Finally, so what does this translate into?  You will not be surprised that the horror I experienced outside Ninewells Hospital in their well intentioned, “No Smoking” open-aired garden (see Blog 17) has stimulated many of the above thoughts and others that will follow in parts 2, 3, 4, 5 and 6. So, it is clear that some aspects of smoking education are not working at Ninewells Hospital, Dundee. “It” wasn’t working in Dunfermiline Hospital either, when I had to attend a specialist clinic there.

Smoking 10 Tips

Accessed 10 December 2015: (http://www.nhs.uk/Livewell/smoking/Pages/Betterlives.aspx)

But the great news is that Victoria Hospital, Kirkcaldy, to which I paid an unexpected visit (Blog 17) last Saturday night, at least appeared to be getting some things right. “NO SMOKING” that appeared to be obeyed – no overflowing ash trays and butts on pavements – it’s a start!

So now it’s your turn. What would you advocate for in an education, particularly aimed at improving the health and reducing the ‘illness’ of our fascinating, diverse and smart (street-smart, mostly, and often better than ‘trained’) population?  I’ll be trying to find a special spot in the web site for your ideas and suggestions, but for now what about using the comments box?  Maybe I can award prizes for those selections used to compile a final set of recommendations?

And now for something completely different!!

 And Now for Something Completely Different

We are now the proud owners of our 4th BMer, but it was absolutely lousy weather yesterday, so no cleaning was permitted, or even sitting in the driving seat and fiddling with the buttons!

 This is me with my new edited version of the Buzz Cut

 Colin 09122015

(Now, Top No.5; Sides No.3)

Power to the NHS- people power!

Bye all!

19. Gray Matter, Dark Matter, Black Hole!

So, it’s the day after the night before and I’m still feeling shite!

black hole
Image of what a black hole might look like

I’ve tried exercising the gray (grey strictly!) matter but to no avail. This is fastbecoming a dark, depressing matter and turning rapidly into what feels like what one might imagine what a black hole should feel like – “Nothing”, “nada”, “infinitesimal”, or just plain “nowt”, as we say in Yorkshire!

I can’t muster a thought let alone a creative idea so you’ll have to settle for a postponed series of seminars on The NHS – not only, as we don’t currently know it, or how it might be, but also how we could go about effecting change now.  I’m not talking about in the near or short term future; or even after some strategic edict finally emerges from Government established vestigial left and right wing think tank. We need a “crowd-sourced” movement of clamouring patients and all health care staff to demand that our NHS is just that, a National Health Service, and not a NIP, a National Illness Pit!

So, I say Nope to complacency! I will be seeking immediate proactive, radical solutions to the major medical issues in the six point plan outlined below (or similar; I’ll be seeking your input too):

  1. Education – underpinned by philosophy
  2. Screening – underpinned by data, information (including economic) and rapid, open publication
  3. Testing from birth to death – coupled to universal insurance to block selective and extortionate premiums
  4. Preventative treatment – promotion of healthy life styles
  5. Research – focused on preventative medical conditions but financed and front-loaded, from National Profits on curative treatments and drug sales as well as taxes on harmful products
  6. Evaluation – led by self-scrutiny, and assisted by sympathetic managers and especially mentors, with an emphasis on honesty, openness, timely feedback and no recriminations except for criminal neglect and unscrupulous Health Care Staff.

Will expand this tomorrow – if I can draw myself away from my sparkling new (to me) vehicle! This will be my 4th BMer, but my 1st SUV, 4 wheel drive, which we are looking forward to taking camping in Cornwall and France next summer!

colin hat

This is me with my new Buzz Cut (Top No.6; Sides No.4)

in my new (to me) hat!  Thanks Craig.

Colin 09122015

This is me with my new Buzz Cut (Top No.6; Sides No.4) sans chapeaux!

Power to the NHS- people power!

Bye all!

18. You’ve lost that (loving) feeling

Yes, I have!  In my fingers, especially.

RIGHTEOUS BROTHERS 001B_250
The Righteous Brothers, “You’ve Lost that Loving Feeling”, (1962)

Now who can beat the Righteous brothers, “You’ve Lost that Lovin’ Feeling” (or Scott Walker’s version, for that matter?) for a version of ‘that’ song – not many – I grant you.  But, I still trust my instinct here – it’s gotta be The Firm – very temporary super-band comprising Jimmy Page and Paul Rodgers. (“The Firm”, 1985, and “Mean Business”, 1986). Together with Chris Slade (Drums) and Tony Franklin (Bass) they (Jimmy and Paul) make up the band, with occasional backing vocals and other percussion. Only two LPs made on Atlantic Records – to my knowledge!

The_Firm
The Firm, “The Firm”, 1985

The Firm, “The Firm”, 1985.  You’ve lost that loving feeling!

Yes, I have!  In my fingers, especially. That’ll be the Oxaliplatin, then! But also in one spot over my right thigh, from knee to mid-femur and from the leading edge of patella arcing right across to left and right upper muscle group to the mid -point of my femur.

Right then, short blog today.  I’m just having my packed red cells (A, Rh+) prior to starting my Chemo, EOX.  Should be good to go in a couple of hours.  I trust today’s timings are better than yesterday.  Yesterday, we set off to Dundee at 8:30 am and arrived home at 18:30pm.  Car Accident near Tay Bridge; detour to Newburgh, Perth, and then to Ninewells .  Blood delayed and transfusion only started at 15:00 pm.  Still, I managed a Buzz Cut No.6 and Buzz Cut No. 4 as well.

Discovered I had now purchased our new car, BMW X3 2.0 l Diesel 4×4 SUV!  when we arrived home.  Picking it up tomorow – Whoop, Whoop!  Still lots to repair/replace and clean, but hey, I purchased a Thane H2O HD Steam Cleaner Mop via the internet.  It’ll be sparkling in no time!

Starting on the reform of the NHS series of blogs tomorrow – so watch this space.

Meantime, here’s something fresh for your ears, though still a blues band, King King.  (Try any of their CDs, “Take my Hand“, Standing in the Shadows“, Reaching for the Light“.  They are all good, though “Take my Hand” does have one of the best versions of an old Eric Clapton song, “Old Love“, that you’ll ever hear – especially if you see them live.

Take my Hand KK
Apologies – clipped art work!

Elaine and I have, twice, once with John Mayall in York (November 2014) and at the Sage Arena, Newcastle in March 2015, for my Birthday!  Three signed CDs – nah, nah,nah-nah, nah!!  And, I’m pretty sure Alan Nimmo could play for the Scottish Rugby Front row as a prop!

King King

Alan Nimmo not only writes, plays lead and rhythm guitar but has one of the sweetest and most powerful voices since Paul Rodgers of Free, back in 1968 (Top Rank Suite in Sunderland – my home town, well nearly!).

And so afer a long wait, I can start to get political – tomorrow.

Long live the NHS, but not as we know it!

Bye for now