Death In All Its Many Forms

I see dead people: lots of them. Primarily in my job as a doctor in a geriatric ward, I have issued dozens of death certificates. For the vast majority of these patients death came after "a good innings", and for a lot of these people death came as a blessed relief from pain, or other distressing symptoms. For most folk, death is something they rarely come across, and it remains very much a taboo subject for much of the UK population, even in the 21st Century. For me, and the doctors and nurses I work with, death is very much part of life. Some might see this response (or lack of it) to death as a form of desensitisation, and I certainly think my response to my father's death was influenced, and probably blunted, by my medical experience.

Today I'm on call for the Police. At 17.00, when I was thinking of going for a curry, I was asked to go and examine a 25 year old man who had put the barrel of a rifle in his mouth and pulled the trigger. He had left a suicide note. I can still see his face.

If that sort of death ever stops touching me I should probably "hang up my spurs".

The Credit Crisis Visualised

The Crisis of Credit Visualized from Jonathan Jarvis on Vimeo.

This brilliant little Vimeo video explains the origins of the credit crisis with great lucidity.

The rest, as they say, is history...

You Know It Makes Sense

As you know, I don't often find the time to blog these days but the debate about health care reform that rages in the US and simmers in the UK has finally overcome my natural lethargy. This brilliant little animated video spells out in terms that are difficult to argue with why the United States should provide universal health care that is funded by taxation and not by greedy, self-serving insurance companies. When you stand at the top of the Empire State Building in NYC some of the most lavish buildings you can see are owned by insurance companies, which should be telling us something!

These companies and their right-wing supporters have a lot to lose if Obama is successful: hence the vitriol and scare-mongering that is coming forth just now. America makes a big thing of its Christian values, but many US citizens apparently don't see that failing to provide large chunks of the population with health care is inconsistent with this.

On this side of the Atlantic, I am pleased to see that the debate is showing up major fault lines in Cameron's façade of the new "caring, sharing" Conservative Party. The Tories' commitment to the British NHS has been shown to be a total sham, but I don't know if this will be enough, in itself, to lose them the next election, unfortunately! Labour's increasing attempts to part-privatise the NHS in recent years have been shameful, and a genuine commitment to a publicly funded system, free of the need to pander to the demands of shareholders in private companies, might allow voters in the next election to chose a party that appreciates the true values upon which the NHS is based.

Taking the Biscuit

The current global financial crisis has thrown up so many examples of how morally bankrupt, if not financially bankrupt, our financial institutions have become. I have referred previously to the outrage in the UK about bailed-out banks continuing to pay staff bonuses and the ongoing "disquiet" about Fred Goodwin's pension. I think in the USA public unhappiness about the bail-outs is all the more palpable because it seems such an "un-American" thing to do.

It is perhaps ironic, then, that probably the worst example of a rescued financial institution, to use the vernacular, "taking the piss" is in the United States. According to this article in the New York Times, the insurance company AIG, which is already under fire from Congress over executive bonuses, is quietly suing the American Government for the return of $306 million in tax payments! This is the same AIG in which the government has an 80 percent stake and into which it has poured nearly $200 billion in an attempt to avert its collapse. Even more incredibly, it appears that AIG is spending taxpayers' money to pursue its case, something it is legally entitled to do!

Words fail me...

Greed is Good?

Michael Douglas as Gordon Gekko in the 1980s assured us that "Greed is Good!", but I'm not sure how many victims of the current global financial crisis would agree with him. Personally, I think much of the responsibility for the state of the World lies with each of us individually. The general population, particularly in the US and UK grew addicted over the years to easy credit, and a "buy now pay (maybe) later" mentality. How anyone could have thought that a position where personal debt in the UK exceeded the GDP of the country was sustainable I do not know! The situation where someone in the South East of England could earn more from the rise in the value of their house in a year than they could from their job clearly could not continue for long!

There is no doubt, however, that people in general, and politicians in particular, would like to make out that it was those greedy senior bankers that got us into this mess. The furore over bonus payments, particularly for RBS employees, has been closely followed by equally impotent rage over the pension that Fred Goodwin is apparently going to receive: £693,000 a year!

It is easy to take pleasure in watching Goodwin squirm when quizzed about his pension by the Commons Treasury Select Committee. Many people would like to see him suffer in a much more painful and prolonged way. However, at the end of the day, Goodwin and his cronies were really only doing what their shareholders wanted: trying to make them (even) more money.

As Lao-tzu, the Chinese Philosopher, said:

"There is no calamity greater than lavish desires.
There is no greater guilt than discontentment.
And there is no greater disaster than greed."

What Next?

Further to my last post, it seems the Government now feels the need to record on a database every trip that I make! Without any consultation, as far as I am aware, computerised records of all 250 million journeys made by individuals in and out of the UK each year will be kept for up to 10 years!

As far as I am concerned, if this is the price we have to pay to try and ensure absolute security, the terrorists have already won the war...

Talk of the Steamie

There is a Glaswegian phrase "Talk of the Steamie": this refers to the chatter that people (almost exclusively women) would have while washing their clothes in a communal wash room. As you may surmise, the expression dates from the time before individual washing machines in the average home were commonplace. I always think that the Web is the ultimate steamie: providing a truly global forum where ideas and opinions can spread with breathtaking rapidity.

One of the things that is the talk of the steamie just now is Google Latitude. I have always admired Google's relentless innovation. I love Google Mail, Google Calendar, and Google Earth. However, I'm not so sure about Google Latitude. People in the UK, it seems to me, are monitored to an increasing and disturbing degree. I believe there is a higher number of CCT cameras in the UK per head of population than practically anywhere else in the World. The so-called War on Terror has led the government to propose that they should be able to read every e-mail and text message that we send, and have access to details of every web page that we visit. Although, I don't feel I've got anything to hide, my instinct is to oppose stubbornly these creeping infringements of our civil liberties. I can't really imagine why anybody would want to allow themselves to be tracked using Google latitude and it seems I am not the only one to have concerns about its privacy implications.

Clearly, use of this application is voluntary, but if it becomes widely used I would be concerned that systems like this could develop into yet another way for Big Brother to watch us.

The Milk of Human Kindness

Went with Wosog and Gdog to see the brilliant film "Milk" yesterday. Sean Penn's performance was breathtaking as Harvey Milk, the first openly gay man to achieve public office in the US. Harvey Milk has a pretty large Wikipedia entry even though I, and I suspect most Brits, had never heard of him before now. Scanning through it, it seems the film was a pretty accurate portrayal of his life, though I believe he had a reputation for being bad tempered that was not reflected in the screenplay. Acceptance of gay people has come a long way since then, in the UK and the US, but the Internet Move Database Entry on the film still recounts someone's experience of watching the film in a cinema where the audience cheered when Milk was shot and booed the film at the end. I suspect ignorance and bigotry will, sadly, always be with us.

The dramatisation of Milk's success gives the achievement of relatively minor public office almost the feeling of a presidential race. Barack Obama's success in actually gaining the presidency is several orders of magnitude more impressive. It carries at least as great a significance for the non-whites of America as Milk's accomplishment did for his gay constituents. It is important to remember that, although Obama achieved 365 electoral votes versus McCain's 173, only 53% of the electorate voted for him. Some members of that 53% are even less happy about having a black man in the White House than that cinema audience were about Milk's lifestyle.

America has a sad history of assassinations, and I fervently hope that Barack Obama survives to enjoy the fruits of his success....

Big Mac, Anyone?

I see from this article that the US Department of Agriculture is going to recall 143 million pounds of beef "processed" by a slaughterhouse accused of mistreating animals. That amounts to 2 hamburgers for every man, woman and child in the USA! When I read this, I was starting to get a bit giddy trying to get my head around how much meat this slaughterhouse must produce in a year, but it seems the recall dates back to February 2006. It appears that "the great majority" of the meat has probably been eaten already. It's unclear from the article whether all the meat was distributed within the USA

It seems that in January, the Humane Society of the United States accused Hallmark/Westland of abusing "downed" cattle, releasing video that showed workers kicking cows, jabbing them near their eyes, ramming them with a forklift and shooting high-intensity water up their noses in an effort to force them to their feet for slaughter. Cattle that have lost the ability to walk are not supposed to enter the food chain unless they have been examined to rule out chronic illnesses.

All this reminded me of a post I wrote a long time ago about Kentucky Fried Chicken. I'm proud to say I haven't had a carry out from them since.

I'm not so proud to admit that I'm still a carnivore and telling myself that the animals "don't feel a thing".

Learning the Lessons of History

Thanks to The Huffington Post for pointing me in the direction of this video. Given the lack of evidence for overall benefit from the US-led military intervention in Iraq, it amazes me that right-wingers in America can even suggest a military strike against Iran.

The video reminds us that the UK and the USA have previously interfered with the government of Iran. Then it was supposed to have the aim of stemming the march of Communism, but it was really about oil and money. This time it's supposed to be about preventing the acquisition of weapons of mass destruction (does that sound familiar to you?), but again it's really about oil and money.

Plus ça change, plus c'est la même chose!

Snouts in the Trough

Regular readers of this blog (if there are any) will know that I am not a great fan of politicians. Any of you living in the UK cannot have failed to be aware of the case of Tory MP Derek Conway who paid his student son £40,000 of taxpayers' money for, it seems, rather ill-defined work to do with his parliamentary duties. Conway has been suspended from the Commons for 10 days and ordered to return £13,161 of the money he paid his son. According to this article, he claims that he is "not a crook", and says that numerous other MPs are doing very similar things. Another wonderful quotation from the non-crook is "A lot of students do part-time work. He was working for his father rather than working in McDonald's.". I wonder how many student workers in McDonalds are paid £40,000 per year?

Gordon Brown must be quite enjoying Mr Conway's discomfiture, which has successfully diverted media attention from the various Labour scandals about undeclared campaign contributions, although I see the same article mentions the fact that former cabinet minister Peter Hain has been claiming that his 80 year old mother works for him as a part-time secretary and she was paid £5,400 last year. You really do wonder what other amazing revelations are going to crawl out now that the MPs' Expenses can of worms has been prised open!

Recently, we had the unedifying spectacle of MPs apparently agonising over whether or not to give themselves a sub-inflationary pay award this year---like the ones they were expecting other public sector workers to swallow. They finally seemed to accept that not to do so could have very serious consequences. If these are the sort of fiddles they get up to with their expenses, though, you can see why they could afford to be so magnanimous!

We are regularly told that politics in the UK is much less corrupt than in many other countries. I wonder if it's more the case that we are a bit more subtle about our corruption in Britain?

The Scourge of Overprotectionism

Wosog got me a great little pair of Nikon binoculars for Christmas. Like many Japanese products they came with a surprising amount of documentation. This included admonition to read thoroughly the safety precautions before use. Alongside sensible advice about not looking through the binoculars while walking, I was amazed to find instructions such as:

"Do not swing the binoculars by their straps. They may hit someone and cause injury."

"If you use the rubber eyecups for a long period of time, you may suffer skin inflammation. If you develop any symptoms, consult a doctor immediately."

"Be careful not to pinch your finger when adjusting interpupillary distance or diopter."

"Do not leave the polythene bag used for packaging witihin small children's reach. Children may put it into their mouths and suffocate."

I am a great fan of TED Talks, and I spotted this one today that seemed to be on a similar subject: namely the irresistible rise of overprotectionism. The speaker advocates, far from protecting children from every conceivable threat, that we should be deliberately exposing them to activities that could be dangerous:



The activities recommended include exposure to fire, using a pocket knife, throwing a spear. dismantling electrical equipment and driving a car: all under appropriate supervision, of course. It's surprising how wild these suggestions appear to a modern audience, including myself, but then I remember how many of these things, as well as even more hazardous activities I actually did when young!

The comments on the TED site are almost universally supportive of Gever Tulley's suggestions, so why are we and our American fellow parents still overprotecting our children, and why do manufacturers feel obliged to put this ridiculous advice on their products?

Fear of litigation is undoubtedly part of the explanation, but I don't think we can lay all the blame at the feet of the despicable lawyers!

More Frightening than the Average Rollercoaster

This video represents US house prices from 1890 to the present day adjusted for inflation and plotted as a roller coaster. The equivalent graph is given here. The question is "Where to next?"

The sub-prime crisis that has already started to affect US house prices is very well explained here. The article suggests that the the effects of the crisis are likely to play out over the next 2 years. Who was it that said that "When America sneezes the World catches a cold."?

What did I say about Happy New Year?

Killjoys at Christmas

I can't actually find it on the website, but I'm reliably informed that the NHS Information Centre is able to tell us that there were 1,328 admissions to hospital in England in 2006/07 after people fell in slippery conditions. Another 4,235 were admitted after falls involving ice skates, skis, rollerblades or skateboards. The implication seems to be that crossing the threshold of your house is too hazardous to contemplate at this time of year. Indeed, staying indoors may be too dangerous if your lino is on the slippery side!

Other festive potential sources of trauma include contact with plant thorns, spines and sharp leaves (238 admissions) and climbing ladders (6,002 admissions). It's even worth giving mulled wine a body swerve since 1,638 people were admitted after contact with hot drinks.

I say all this with my tongue resolutely pressed against my cheek, but don't you get the feeling in the UK that our 21st Century politicians seem to have an irresistible urge to try and legislate any activity considered remotely risky out of existence?

To me this undoubted trend is a far bigger threat to our civil liberties than any form of terrorism.

Save the Vale

Public Opinion
Originally uploaded by Son of Groucho.

Today I and over 10,000 others attended a protest regarding the proposal by NHS Greater Glasgow & Clyde to downgrade severely the services provided at the Vale of Leven Hospital. The hospital has had its services reduced over several years first by Argyll & Clyde Health Board and latterly by NHS GG&C. Many in the local population feel that if further cuts are made this will ultimately lead to the death of the hospital.

The turnout exceeded the expectations of the organisers and gives a clear indication of the local strength of feeling on the subject. An independent review of the proposal is being undertaken at the moment and we can only hope that the new SNP administration in the Scottish Parliament pays more than lip service to listening to the wishes of the people.

Global Worrying

Reasons to be Cheerful
Originally uploaded by Son of Groucho.

I have previously confessed to being a terrible worrier. It should be fairly obvious from my various geeky activities that I am also a great enthusiast about the internet, and other forms of mass communication. Acres of text have been produced in the last year or two about the perils of Global Warming, but I think Global Worrying is an equally disturbing modern trend.

War is awful, and every death in combat is a tragedy for the person involved and their family, but deaths in war are inevitable. Modern mass communications mean that if even one or two British soldiers are killed in Iraq it is splashed across our newspapers and computer screens almost immediately. You could argue that this is a good thing, and makes us constantly aware of the reality of the conflict, but there is no doubt in my mind that it also raises anxiety levels in the countries affected.

Recently, concerns about the American mortgage market led to huge effects on stock markets throughout the Globe within days. Central banks have felt obliged to pump huge amounts of money into the system to stabilise the situation. Opinion is divided on whether this is a temporary blip or represents a fundamental weakness in the US economy. Only time will tell, but the speed and the magnitude of the short-term effects only serve to remind us what a connected World we live in.

Sometimes it's true that "ignorance is bliss".

Oh The Irony!

I recently mentioned that Wosog and I were going to Egypt, but I was slightly concerned about the risk of a terrorist attack there. We are due to fly to London tomorrow from Glasgow Airport so we can catch a flight to Luxor from Gatwick the next day. Many of you will already know that on Saturday there was a terrorist attack on the very terminal that we were due to check in at tomorrow. Subsequently, a bomb was found, and destroyed in a controlled explosion, in the car park of the hospital to which a severely burned terrorist from the airport attack had been taken. It seems that Egypt may be a safer place to be than Scotland at present!

I used to work at the hospital mentioned and I can imagine the damage that a bomb exploded by terrorists in the car park might do. Fortunately there were no innocent victims of the outrage at the airport. Personally, I would have great difficulty bringing myself to treat someone who had carried out one of these attacks.

There is no "cause", no grievance so great, that it justifies detonating a bomb next to innocent men, women and children.

Teenage affluenza

This is a clever video that gently makes its point.

Is That The Time?

Part of my work is being the medical officer for a rehabilitation ward for the elderly. I've been doing the work for around 12 years, and even over that relatively short space of time there has been a noticeable increase in the average age of the patients admitted. Some of these older patients are remarkably fit: in fact a 91 year old patient that I admitted the other day could easily have passed for 71 years. However, many of them are very unfit, significantly demented, and appear to have a very poor quality of life by most people's standards.

This article about the oldest man in the world, a 111 year old Japanese guy, states that he joked that he is sorry to have lived this long. Maybe he was really kidding, but I'm a great believer in the saying "Many a true word spoken in jest". I've certainly met several very elderly frail patients who have calmly expressed the wish that tomorrow would never come.

With improved social conditions, nutrition and medical care in the developed world increasing longevity is not difficult. The trick is producing a life that is not only longer but also worth living.

Still A Political Football

Patricia Hewitt is an idiot in so many ways. My spirits picked up a little when I heard last year that Gordon Brown was said to favour handing over day-to-day control of the NHS to an independent board - in the same way he gave up control of interest rates to the Bank of England in 1997. At last, I thought, I might work for an organisation that is run by people who have some idea what they are talking about instead of suffering the consequences of being run by feeble-minded politicians who have no experience of the NHS, either as managers or, in many cases, as consumers. In my experience, politicians often have poorly thought-through ideas that seem to be based on gaining short-term popularity through headlines in the tabloid press.

According to this article, however, that plan has fallen out of favour. I note Hewitt's comments about the putative benefits of "competitive pressure" within the NHS, but I would like to see the evidence for such benefits especially outwith major cities, IE in places where the local hospital has no effective competitor.

Hewitt is said to back an NHS constitution, which could cover behaviour expected of NHS patients and people's personal responsibility for their own health. This is another area where political rule falls down. It's not exactly a vote-winner to tell people that they should be more responsible in the use of the service.

It seems Hewitt is likely to go when Brown takes over the helm, but it appears that the poor staff of the NHS will continue to work for a "polical football".