Wednesday, January 31, 2007

Gloom and despondency

Seems we have just lived through the “warmest” January on record. Now, forgive me, but the words “warm” and “January” to me do not belong in the same sentence*. Yesterday afternoon was a case in point.

Six of my eighteen booked surgery appointments were suffering with, or just beginning to come to terms with, severe depressive illness. It made the afternoon a bleak experience indeed. I normally expect one or two. It’s in the nature of my practice as one of the “cardy wearers” of the Ambridge Surgery. But in January, and most especially this January, it seems numbers escalate so the whole month has been a bit like this. Yesterday, as always, I hope they each felt they managed to be heard and understood, and that the changes in lifestyle and treatment we agreed will soon begin to take effect and put them all more firmly on a road to recovery. I’ll find out from them over the next two to four weeks. And by then it won’t be bloody January anymore, and this too might help in their recoveries.

Oddly, although the days are winding down to the shortest day, and the weather can be just as grotty, December never seems quite so bad. December is a “looking forwards” sort of a month. In Blighty we are all rushing about like headless chickens preconditioned from infancy to do the whole Victorian family Christmas thing. (This even appears to apply to my Moslem, Hindu, Jewish and, frankly, godless, acquaintances.) The whole Island seems to go into woolen-wrapped party mode. But January is a “looking backwards” month. It’s still cold. It’s still wet. There’s all the fuss around New Year and then the subsequent pressures we put ourselves under by resolving to be leaner-fitter-better-richer people than before, as though all that has gone before has somehow been not quite right, disappointing even.

Scientists have “proved” that within three weeks the cracks are already starting to show in these new-made resolutions for the vast majority and so the whole month becomes something of a let down. Still, it’s nearly February now and already in Ambridge at least things are beginning to feel quite spring-like.

This morning’s drive in to work was brilliantly illumined but a golden glow as the sun crept above the horizon turning the land pastel pink under a cornflower blue firmament dappled with fluffy white clouds. Bunnies were bunnying while squirrels squirreled and magpies went “Aaaaark!”.

Things might just be looking up.

*Would Southern Hemisphere readers please substitute January for June/July or whichever is your coldest month**.

** and would Tropically based readers just go with me on this or think “rain” when I drivel on about “cold” which I gather may be an alien concept….

Monday, January 29, 2007

The thin blue line.

Somehow "Can you speak to WPC Watmough about...." never seems to pressage good news. It's not WPC Watmough's fault. She just happens to be the one on shift who gets to make the call. It's honestly no better when any of her colleagues call either so it seems unfair to single her out, so lets pretend I didn't.

"Good morning WPC Watmough, how can I help?"

"Well Doc, it's Mrs Bloggs. She never came home last night and her family are worried. Is there anything you can tell us that might help?"

After a quick scan of her records there really isn't much. No real cardiac history. No past major psychaitric illness or current depression or anti-depressant medication. In fact no record at all since her annual flu jab in late October. I regrettfully inform the WPC of the facts, she thanks me and the day moves on.

That was Friday morning.

There was still no news of Mrs Bloggs by close of play on Friday. However this morning one of the younger Bloggses rang to inform us that all was well. It transpired that Mrs B had failed to make her Thursday Night Bingo appointment with friends. They had become concerned when there was still no sign of her at the end of the night and had phoned her home, to get no reply. After alerting first Ambridge and later Borchester Police, a Mrs Bloggs-Hunt was initaited, and after the deployment of at least one helicopter and dozens of officers Mrs B was duly fund, some miles from home and entirely unable to give an account of her last 24 hours.

She has spent a short stay in hospital for observation, and likely will require more investigations to try to better explain her nocturnal wanderings, but she is back, safe and sound in the bosom of the Bloggs family.

And all thanks to the care and dedication of WPC Watmough and her colleagues.

Friday, January 26, 2007



2014 visits since 19 December.

(I know a fair few were me in all honesty, but well done the rest of you and thank you all for stopping by).

It's been too long a day to be coherent, but I hope to be back on form next week.

And thanks again for taking the time to visit, and to comment when so moved. It's what helps keep me sane. Well sane-ish then....

As you were.

Wednesday, January 24, 2007

Smoke gets in your eyes.

Most New Years we see a brief rush of punters resolved finally to sort out their smoking / diet / other general health issues. They jam up the surgery for a week or so, competing for appointments with the dyspeptically over indulged and the early winter lurgy sufferers. Then they either relapse or decide they don’t need our help, and it all calms down again.

Not so this year. Oh no. Not by a long chalk. Still they come in their nicotine tarnished droves, wreathed in the smoke of their fiftieth absolutely-the-last-fag-I’m-ever-smoking-honest. I reckon I must have passively taken in the equivalent of a pack a day for the past three weeks, and it’s starting to make me feel a bit dizzy and sick rather like Virgil Tibbses (what is the correct possessive form of Tibbs I wonder?) son in the movie.

So why the sudden stampede of fumeurs desperate to quit? I hear you ask.

Well it’s all the “fault” of Her Brittanic Majesties Government. After nigh on a decade of prevarication they have finally decided to take the plunge and ban all smoking in public places from this coming July. At the same time day-time TV has been bigging up a new wonder drug to help quitters.

The only tiny problem with this is that no-one has bothered to actually tell us poor Tommies in the trenches about it. Good old Google informs me that it might well be called Champix, and that it probably is now licensed for NHS prescribing. But nowhere on our state-of-the-art clinical system with prescribing support software, bells, whistles and unicycling performing mice* is there any really useful information about how it should be prescribed or taken, what its mode of action might be (apparently, according again to Google, it makes smoking so boring people descend into a pit of hopelessness and despair and just quit) or indeed its side effects or interactions.

I do hope it will turn out to be better than Zyban (the last smoking cessation wonder drug- you remember, the one where the manufacturers sent round the helpful circular three months after the granting of the license saying “we know fifty odd patients have died taking our drug, but we reckon thirty of them at least would have died anyway, and at least most of them had stopped smoking like we said they would…”**).

Sorry must stop now, I feel a craving coming on.

Just send in the next smoker please!

* I think I might have hallucinated that last one. Pity, they were bloody clever performing mice too.

** O.K. they were a bit more scientific in their explanation, but that was the gist.

Friday, January 19, 2007

I've got a feeling we're not in Kansas any more!

Read any blog from Blighty written in the past 24 hours and it likely will mention the wind. Seems Ambridge has not been immune to the destabilizing effects yesterday's storm force winds had on the whole UK.

So now, today, in the post ictal calm that follows the aforementioned storm, I'm not quite sure where I am. And given my last consultation we may have been warped into a prallel dimension where the laws of Faerie apply, because I have just had a consultation with Cinderella. The fact that she came hobbling in wearing one high heeled fur* trimmed "slipper" should have been a bit of a clue. That and the fact her best mate was called Buttons...

But the awful truth is, like the fairytale character, this young lady has real confidence / assertiveness issues. Mum and Step-Dad both work long hours, and so are out of the house early in the morning, leaving poor Cinders to see to the care and feeding of her two younger step-brothers. Having got them up, dressed, fed, and ready for school she has to get of to school herself, faced with the prospect of doing the same things in reverse when she gets home.
So at home she is moody, tearful, not eating well, and Mum has decided she must be depressed. She's really not. She's just cross, hurt and fed up in equal measure, and with some justification.

Of course so far I only have this one side of the story, but from her presentation it really does appear that, like Cinderella, she has become "invisible" to her parents, and this lack of recognition and appreciation have effectively destroyed her emergent self esteem at a time when she is most vulnerable.

I have offered to meet with her and Mum to try to negotiate some sort of r'approchement, but I suspect her salvation may lie in the hands of a "man" in tights, with a thigh slapping habit and the matching fur trimmed slipper, given the way things are round here at the moment.

* Mrs Snell would want me to point out that the whole "glass slipper" thing comes from a sloppy translation from the French** story when the hapless translator took Vair for Verre and at a stroke turned fur to glass with nary so much as an alchemic grimmoire for assistance.

** She would further point out the origin of the tale is actually a Chinese fable of great antiquity appropriated by the French sometime after, and thence finding it's way to our shores.

Wednesday, January 17, 2007


Enter Julia clutching a piece of paper.

She has known for years that here eyes are no longer what they were. She can often be seen in Tesco peering intently at labels, or tottering about town, weaving to avoid the lamp posts. But somehow, today she is different. And all through the power of her piece of paper.

It transpires that after her last consultation with her ophthalmologist* he decided it was time to put her name on the Blind Register. And that is what the paper tells her, or would do could she but read it. (I presume some kindly relative or passer by has read it to her because she does know the content before she comes in).

So that’s it then. She’s officially blind. She had never really thought of herself in those terms before, so the letter, far from being the simple administrative document intended, aimed at allowing her access to more assistance and support, instead drops on the mat a harbinger of doom, foreordaining the “dying of the light”.

Her driving license has already gone, some years ago, when her sight fell below the threshold for public and personal safety, as heralded by a small contretemps with a roadside tree. She has been in to audio books for years and is a familiar sight in the Library restocking her supply, and Eastenders and Corrie are now radio dramas for her. But blind, no, surely not. Just a bit foggy is all…

Until now.

What her specialist, quite rightly, saw as a kindly act, registering her so she can be properly assessed for the aids necessary to preserve her independence, has instead had an effect somewhat akin to the “black spot” of pirate lore. Now she’s had her letter the Angel of Death lurks round every corner, but at least she qualifies for a phone with huge buttons.

It took a good twenty minutes to persuade her that her sight was no worse since the letter came, and that being on “the register” did not mean she had to start being “ill”, just because her eyes have aged a bit quicker than the rest of her. Finally, and with a cheery farewell to the hat-stand as she passes she bustles off in search of more audio literature.

Not quite ready to “go gently into that good night” yet then.

* after a few stiff gins these chaps all become "eye specialists" for some reason.

Wednesday, January 10, 2007

Five things...

... you didn't know about me.

Having been tagged by the lovely Sooz and after some thought here goes:

1. My fledgeling acting career came to an abrupt halt at junior school when an unkind girl passed rude remarks about my Pharaoh's kilt, and the fact that it showed my pants. What a great artist the world lost* that day.....

2. That said I** did later perform a sell out gig in the Boston Symphony Hall. Yes, really, Boston Mass. not Boston Lincs.

3. Until age 14 I had always seen myself destined for a military career. So I could have been Colonel J by now. Brigadier even. That or dishonourably discharged.....

4. If I wasn't doctoring I would own and run a Hot Air Balloon business. If I knew anything about flying them, which I don't, had a fleet of support vehicles and a balloon, which I haven't, and didn't have to meet repayments on the mortgage for Jest Acres for the next 500 years, which I do... looks like it's more doctoring for me then.

5. I quite like venison***.

* Usual cyber hobnob for the first to spot the allusion.

** Well me and around 200 others. Did I mention I used to be in a choir?

***Which makes me descended from royalty, an outlaw, or possibly both.

Friday, January 05, 2007

Eating sweets can be bad for your knees.

I know what you’re thinking.

“No no no, that’s teeth surely? He means teeth doesn’t he? Yes it’s got to be teeth. Poor old thing’s gone a bit dotty. We should have seen it coming really, after all he’s been behaving a bit oddly for a while now. I expect it’s the rum truffles that finally tipped him over the edge….” and so forth.

But no. I do mean knees, or perhaps knee to be more exact, and prosthetic knee at that.

Allow me to explain.

A couple of days ago I saw a chap who had had a boiled sweet over the Christmas festivities. Hardly something to reproach him for you might think. And normally you would be quite right. But on this occasion things went rapidly “pear-shaped” as they say*.

You see the sweet in question shattered, lacerating his gum in several places. He gave the initial, albeit far from transient, pain little thought. However, by the next day he was beginning to feel a bit hot and a bit poorly. After a couple of days in bed with “the flu” the pain and heat settled in his knee replacement which remained hot and very very tender the day I saw him.

Now as anyone with any implanted prosthesis will tell you, they are all given a dire warning to watch out for gum injury during dentistry by seeking antibiotic cover. The thing is, even fairly minor gum injury, such as can be occasioned by the humble scale and polish, can introduce showers of bugs into the blood stream. From here the bugs can hop a ride like so many tourists on the underground, to any part of the body. They especially like prosthetics as they lack the normal defences of organic tissues.

So this poor lad appears to have a septic arthritis in his knee replacement and all for the sake of a boiled sweet.

I’ve told him to stick to chocolate in future. After all it’s kinder to the gums.

* In the absence of information to the contrary I am assuming the offending confection was a Pear Drop.

Tuesday, January 02, 2007

Why I can't play piano.

It was a lovely New Year weekend at Jest Acres. We saw the New Year in proper at midnight with a couple of left over fireworks from the November 5th debacle ( just combine the words “Whopping” “Rocket” and “Ground-burst” and you’ll get the gist), and then back into the warm to hootenanny along with Jools. The sit down banquet beforehand went spectacularly, helped no end by the two, yes I do mean plural here folks, chocolate fountains that had been separately gifted us by generous souls. The cava fizzed prettily as we “Auld lang syne’d” in ’07. After a rather late start to Monday we sat down to lunch at 2 and got up from the table at around 6.30, so you could say we’ve spent more hours in ‘07 feasting than sleeping so far!

There are now even the odd few gaps in the fridge which had not hitherto seen daylight this past ten days. (And the recycling bin clinked its tipsy way down the drive this morning when I put it out first thing, before setting out for the surgery. I myself have been, as you would all expect, the model of sobriety and decorum throughout this past festive season however.)

* Perceptive listeners will make out the strains of Tom Waits’ “The piano has been drinking” throughout that last parenthesis*

Then someone said it, late last night over rum truffles. (Well o.k. what really happened was that somebody tried adding rum to the preheated chocolate for the fountain and found out empirically how to make Rum Truffles- ahem…)

Specifically they said, “You ought to get one of them Blog thingies you know.”

So now I’ve had to perjure myself and I’m sitting here wondering if I feel more like Clark Kent or Anthony Burgess.

You see this thing only really works if I know no one I know is looking. If I thought for one minute they were then I’d go all self conscious and fat fingered and keep hitting all the black notes. So if you see them please don’t tell them or I might have to shut up shop.

Oh, and Happy New Year by the way.