Leavings and leaving one's mark

What's with these people who will insist on stuffing their used fast food cartons into my front garden hedge? I had to extract one only this morning and drop it into the wheelie bin. It's not as though Wiltshire Council aren't generous with litter bins on the road.

There seems to be a type of person who, as if on a point of principle, are distainful of the 'Keep Britain Tidy' motto. Actually I've not heard that one for a while. Perhaps it's gone defunct. Maybe they think litter bins are for mugs or finnicky folk. Or maybe they are anxious to keep in employment the chaps in council uniform who patrol the streets and parks with a pair of long handled tongs and a black bin bag.

But what I really think is that the littering classes are behaving in much the same way as some street mutt might: metaphorically lifting their legs and pissing against a lamp post in order to leave their mark. There may be no eliminating such behaviour. In that case I might put it to the council that between them the half dozen or so fast food outlets within a quarter of a mile of where I live should be required to employ at their own expense a litter warden to walk the streets day and night to clear up after their poor patrons who don't know any better.

Does the Medical Profession set a Good Example?

I read a report just recently stating that a fresh drive has been launched to encourage NHS staff to get the flu vaccine amid concerns of poor take up rates.

The report claimed that last year barely a third of those who work directly with patients had the vaccine.

Signatories include Dr Laurence Buckman, chair of the BMA GP committee, Dr Mark Porter, chair of the BMA consultants committee, Dr Peter Nightingale, president of the Royal College of Anaesthetists and Stephen Campion, chief executive of the Hospital Consultants and Specialists Association.

I found myself speculating upon why this state of affairs might have arisen. For the implication is that health service personnel – including doctors – do not practise what they preach.

For myself, I think that this charge is a fair one and that the notion that people working within the Health Service have such high ideals as presenting their own behaviour to their customers as the ultimate in self responsibility is a misplaced one. In some areas, yes – very few doctors would confess to not having their children immunised, and the vast majority do not smoke.

Yet responsible health behaviour in health professionals is by no means universal  - it may actually be quite patchy. Would you not think it perverse to be lectured to on the dangers of obesity by a nurse who is patently overweight herself? And smoking – well, it is not at all uncommon to see young dental nurses not far from where I live huddled in the car park and lighting up together.

And doctors as a group are, by and large, fond of a tipple. Myself included. Although in this day and age I would never drink alcohol when on duty or at any time when I would expect to have to drive a car.

And you do you know how some define an alcoholic – tongue not entirely in cheek? Well, how’s this: “an alcoholic is someone who drinks more than his doctor”.

Quite a sobering thought.

Are GPs privileged? Well, yes, I think we are ...

One of my occasional locum sessions in the twilight of my career.

A man who I see is the same age as I am comes with the most exquisite little red-headed child in tow.

Uh oh, I think to myself. One of those. Now why is he bringing his grand-daughter along with him?

He explains immediately, and apologises. Today he is child minding. He seems a nice bloke and I warm to him. The reason for coming is straightforward, easily dealt with and not in any way "inappropriate" in the context of the presence of a child. And after 4 decades in practice I am like a gimlet when it comes to hidden agendas and cues. I have something of a sixth sense for them, and I know how to extract them. Here - there was nothing.

We address the matter in hand, and when that is done we engage in some grandfatherly chat, as we old fogueys do. The little one sits quietly next to him, looking at a picture book. How old is she? Three and a bit. And her name? Esme. I remark that I had two grand-daughters aged three and a bit as well. More chat about the joys and tribulations of grandparenthood.

Here was a man who had achieved contentment at the threshold of old age if ever I saw one.

He gets up to go. I remark to Esme "Well, you've been such a good girl today" For the first time, a smile as she takes her grandfathers hand as they get ready to leave.

"Oh, she has been good, hasn't she!"

"Well, will you tell Esme's mummy from me how pleased the doctor was?"

Esme grins. Grandpa says "of course I will!"

"And tell her from me" says old Dr Grumpy "that she deserves a treat!"

And little Esme skips out of the room with her lovely red curls, laughing.