Thursday, 2 May 2013

The Silver Chain of Sound


‘Bill – please switch that off!’
            We were approaching a junction. ‘Lost your taste for the classics?’
            ‘No. Of course not. It’s a lovely piece. Reminds me of …. But they play it at least once every day on this channel. One day they’ll play it to death.’
            I could see her point. It was an ‘easy listening’ station that certainly didn’t set out to challenge its listeners. I turned it off.
            Mary fell silent as I negotiated the traffic.
            ‘Reminds you of something, you say? Or someone?’
            I sensed her brief nod. ‘Yes. Benbo. It reminds me of a special time with Benbo. So when I listen to it, I have to be in a particular sort of mood. And alone.’
            We said little more for the rest of the journey. Both lost in our thoughts, I guess, and in our grieving. She for her husband and I for a much loved younger brother. Ahead of us lay the painful task of going through his papers and other, more personal belongings.
            The music stayed with me as we worked and sorted together. When at last she spoke again as we sipped coffee on her patio it was clear that her mind had been caught up just as had mine. It was as if our exchange in the car had happened only moments ago.
            ‘It was the day you went whale-watching, off the peninsula on the south-east coast. Benbo hadn’t the strength to join you. He said the drugs were making him quite sick enough without the effects of heaving around on an open boat.’
            ‘Yes. I remember. The gale had blown itself out overnight, and it was a fine day. But the sea was wild enough. We did see the whales, but they were miles off. It’s not something I’d do again in a hurry.’
            ‘I never told you what Benbo and I did while you were out there.’ Her expression spoke of a treasured memory.
            I waited. I sensed that she wanted to share something with me. But she didn’t speak immediately. Instead she went to a drawer in her desk and took from it a disc. I had a feeling that it was the Vaughan Williams, and I was right. This time we sat together in silence for a quarter of an hour and heard it right through to its last, vanishing cadence.
            Mary began to talk again. Softly and lovingly. ‘It cost him such an effort to walk even the half mile on to the meadows that surround the light-house. But at last we got where he wanted to. It was a place he’d always loved. I think he knew that this would be the last time. I sat on the grass and cradled his head on my lap, running my fingers through the little that was left of his hair. His eyes closed, but the look of ecstasy on his face was something that I will keep with me for always. Dear Benbo – his sight was almost gone then. But even I could not have seen what he would have sought in the sky, so vanishingly small it had become. “Poor old Bill,” he murmured. ‘He must be as sick as a dog out there. And how could whales – all the whales in the ocean, compare with that?”’
            ‘He always saw the best in the smallest things. He had a gift for it’.
            ‘Uh-huh’, Mary nodded. ‘The smallest things. And on that afternoon it was in the song of the smallest of birds that I think he had his first glimpse of heaven’.
*  *  *
He rises and begins to round,
He drops the silver chain of sound.
From George Meredith (1828-1918)
The Lark Ascending.

Wednesday, 10 April 2013

Plot or Narrative?

It is said that fiction that is any good at all must have a plot. When it does not it is mere narrative. I’ll quote an example: ‘The queen died, and then the king died’. This is narrative, a record of what happened. No reason is given or speculated upon to explain the events recorded. When the sentence is expanded to: ‘The queen died, and then the king died of grief’ the narrative becomes a plot. Plot has to do with cause and effect. It generates interest in the reader and spurs her to go on reading.
                Is mere narrative, then, second rate fiction? I can’t answer this, but I believe that narrative alone can be redeemed. For example, if there is a twist in the tale. Here’s a piece of flash fiction. It has no plot as such. It does not answer at least two questions that might reasonably have been raised – (1) how did Sam come to be homeless? and (2) how did Sam die? See  what you think, anyway.


At first I thought Sam was sleeping when I found him lying under the hedge on that bright winter’s morning. But he was quite dead. “Poor old chap” I said to myself. For some reason my first instinct was to find an old blanket and cover him, though God knows, he was hardly in need of protection from the cold any more.
Over the past couple of years he’d been a “regular” in our street, appearing on my front doorstep and those of my neighbours where he could be fairly sure he’d get food or drink. I guess we are a pretty well-disposed lot. No-one ever threatened him or sent him off. But then there was a decency, even a dignity about him. He communicated by look rather than voice, and in doing so he brought out the best in us.
I’m not sure how he came to be called “Sam”. It may have been old Mrs Dobson, two doors up from me, who had so named him. She had a stone seat in her front garden, and Sam would make himself comfortable there on occasions, often dozing for much of a sunny afternoon under the shade of her cherry tree. She referred to him as “just an old tramp with a bit of a cheek”. But she let him be.
We thought it a nice touch when she had the small brass plate made and inscribed with “Sam’s Place”, and set on the back rest of that seat. And the engraving of the cat’s head under the words wasn’t a bad likeness of the old tabby. I miss him.


Sunday, 7 April 2013

A Walk up Etchilhampton Hill

Those of you who know Wiltshire may be familiar with the countryside in this part of the county. It was a cool, bright, dry spring day today. And no shortage of skylarks!. This afternoon we did a circular walk (more accurately, a square walk) from the village of Coate, over the hill itself and back via the Ridgeway. The photo below is of the white horse on the hillside above Devizes. It was quite a a way away and is rather blurred, I'm afraid.


Saturday, 6 April 2013

Measles - A Killer Epidemic in South Wales

At the time of writing this there is a measles outbreak in South Wales. There has been a rush to get unprotected babies and children immunised, and clinics are to run over the weekend to cope with the demand. It seems that the National Health Service has reacted quickly and appropriately.

            So far, 600 people have contracted the illness. It is a nasty infection. It is quite capable of killing a few of its victims and leaving many more permanently damaged.

            Yet immunisation against measles has been readily available for many years now. Every parent will have been advised that it should be given to their children (with rare exceptions). So the question ought to be asked: why were so many children left with no or incomplete protection? It cannot be said that it had not been offered, so it may be reasonable to conclude that the advice was either wilfully refused or possible that those responsible for the children just didn’t get round to it, or forgot to attend.

            Yet amid all the publicity and concern, no one seems to have raised this question: just why was the advice not taken up? The study that claimed a link between the Mumps, Measles and Rubella (MMR) vaccine and autism was refuted decades ago. You will find few, if any, doctors who have not had their children vaccinated.

            Had the Health Service itself been similarly negligent there would be recriminations a-plenty and a demand that heads should roll.

            No – this sorry episode illustrates well a point I have made repeatedly: there is no sanction against people who ignore health promoting and disease prevention advice. The NHS is a partnership between professionals and patients, for goodness sake. Only the best is acceptable from the professionals, but precious little it seems from the customers. Little wonder that so much chronic illness and death can be attributed to deliberate lifestyle choice.

            But is it not shameful that children should suffer as a consequence of bad decisions made by those who are responsible for them.

Thursday, 4 April 2013

Hitting Back at this WEATHER!

At least when the sun shone it was just about bearable. But today is dull, drab, windy and so cold. It's not good being confined indoors. We dragged ourselves out to our local park in Chippenham - John Coles Park is attractive and has a number of quite unusual trees. We often meet and talk to dog owners and admire their pets. But today there were few enough of them about. Our favourite character is an elderly gentleman, always immaculately dressed, and his long haired dachsund 'Jim'. He told us the other day that Jim is 13. We guess that the elderly man probably lives on his own, and walking his dog in the park probably affords him the only contact with others than he gets. Dogs are a good talking point, indeed. We've never had one, believing that we aren't in a position to give a dog the care and attention that they deserve. And we're missing something, I know.

Wednesday, 3 April 2013

On Abstinence

This is somewhat predicable given the season. Yes – I gave up alcohol for Lent. The reason I’ve not drawn attention to this resolution previously is that until recently I thought I might not be able to stick to it until the end. To my surprise I did.

            The background is that I enjoy good wine. I had slipped into the habit of enjoying a glass or two … or three, every evening. In fact I don’t think a day has gone by in the last 20 years when I have not taken wine. While I never got drunk and never got into any sort of trouble through drinking, I was regularly exceeding the weekly recommended maximum units of alcohol. Because of medication I have to take, I have blood tests to check my liver function every year. The fact that they have always been normal was no incentive to cutting back or giving up.

            I wondered whether I was an alcoholic. But I don’t in fact fit in to the definition – certainly not that offered by Alcoholics Anonymous whose web site I checked. I didn’t crave alcohol during the day and was not much bothered by the wish to drink until 6 in the evening at the earliest. But I have become tolerant to the effects and my daily consumption very gradually increased as the months and years slipped by.

            The decision to give up for Lent was fairly spur-of-the-moment. My wife let slip, almost casually, two days before Ash Wednesday, ‘Well, are you giving up drink for Lent?’ I thought a moment and then said, ‘Well, I think I will’. And I did.

            Rather than sit with a glass of wine I took a glass of low calorie tonic water with ice and lemon. The bitterness of the tonic rather lessened the sensation of missing the wine.

            I felt better from the start. But I have to say that I felt pretty well before. I missed my wine, but didn’t experience what might be called ‘withdrawal symptoms’. One positive thing – I stopped snoring and so my wife felt better. Then I started to lose weight. Not surprising when you consider the number of calories there are in a bottle of white wine. I tended to avoid telling too many people about it. A few seemed almost to resent what I’d done as though it might reflect upon them. Some looked at me questioningly, as if to say ‘did you have a problem with drink, then?’

            I had my first drink on the evening of Easter Sunday. No undue effect. I hope now to avoid drinking wine every evening, or at least to keep myself to 20 units a week. We shall see.

Tuesday, 2 April 2013

A Walk in the Vale of Pewsey

A cold, bright day. We thought we’d stretch our legs and refresh ourlungs with a walk on the downs overlooking the Vale of Pewsey. Those of you familiar with north Wiltshire will know what a lovely part of England this is. There are isolated pockets of woodland there, but it is mostly a landscape of vast skies and unobstructed views to the south, east and west. It is steeped in history. The work of those amazing engineers who lived here millennia ago is still very evident – the great stone circle at Avebury, Silbury Hill, the Wansdyke and the West Kennett Long Barrow are just a few among many.

We were deceived by the fresh Spring day temperatures when we drove off from Chippenham. The car park at Knap Hill is actually 700 feet above sea level. It was several degrees colder there, and a sharp wind over the downs made us wonder whether we’d been entirely wise. But we persevered and soon, walking briskly with the wind at our backs we were warm enough. The walk took us gradually up hill in a westerly and then north westerly loop, passing just over the ears of the Alton Barnes White Horse. Then on to Milk Hill, the highest point in Wiltshire at 900 or so feet above sea level. The views from there are spectacular, extending well beyond Salisbury Plain almost to Dorset. We then turned east to walk along the Wansdyke. This is an amazing construction, built by the Anglo-Saxons about 1500 years ago, as a defence (presumably) against the West Saxons. A high bank rears up over a ditch. It must have been considerably more impressive at the time it was built and the effects of one and a half thousand years of erosion had taken their toll.

I’ll remember this walk for a long time. Perhaps most poignant memory will be the song of the skylark rising from the rough meadows. So much rarer a sight and sound now than it was when George Meredith wrote his famous verse that inspired Ralph Vaughan Williams to write one of the loveliest pieces of music ever penned by an English composer.

He rises and begins to round,
He drops the silver chain of sound …


Thursday, 28 March 2013

A Painting of Avebury Stone Circle, Wiltshire

Thought I would share this - a recently finished oil painting on board, about 10" by 14". I am trying to work on improving my technique.

Tuesday, 26 March 2013

Nurses to be made to go 'Back to Basics'

The latest vote catcher is out: nurses to work as care assistants for a year during their training in order to get them familiar with washing patients, not allowing them to starve, and learn the basics of compassion. Those more credulous among the voting public will lap up David Cameron’s latest offer no doubt. I can’t think that nurses as a whole will be particularly thrilled and by it and would predict that UNISON will ensure that the initiative will not survive to see the light of day.

While the public as a whole would like to see nurses cower once more under the thumbs of Matron and her band of Ward Sisters, the reality is that the nursing profession today just has to be what they have become: competent technicians able to use computers, take critical measurements and operate complex machinery. Far better, surely, to give the Health Care Assistants some basic relevant training so that they can at least spot problems among their patients when they occur, and give a bed bath without injuring either themselves or their charges. You don’t need a third level education (which nursing always was) to make a bed, mop a floor and keep a frail person clean.

And on the matter of compassion – sorry, it cannot be ‘taught’. It is in the nature of some people to be ‘compassionate’. Others develop it through experience. A very few don’t have it at all. But for myself, were I seriously ill in hospital I would sooner be treated by a competent technician who was rather lacking in compassion than by an airy-fairy idealist who couldn’t read a thermometer. It’s not the end of the world to be short on the attribute of compassion. The genuine medical sadist of course may exist, but I have never come across one. If one is out there, then God keep me from her or his hands.

Monday, 25 March 2013

A Report by The Patients Association

A report by The Patients Association (this appears to be an organisation that has done away with apostrophes – I just thought I would say that in case you thought it was I who were remiss) bewails its perception of GP services being increasingly difficult to get hold of. It is entitled ‘Primary Care: Access Denied’ and you can see a synopsis of it on .

Well, speaking from the perspective of a patient who was himself once a doctor at the sharp end of primary care, I can feel some sympathy. But I also know quite a bit about the constraints that bedevil general practitioners and their nursing colleagues in the community. The fact is that their political and professional masters have dumped upon them such a mountain of stuff they are expected to achieve that has nothing to do with face to face interaction with actual patients that they have far fewer hours to spend in the consulting room than they did, oh, twenty or thirty years ago when I was still hard at it: targets to be met; reports to be compiled; meetings to be held; and the complete nonsense they call ‘revalidation’ – a hugely time demanding tick-box exercise that purports to ensure that never again with a Shipman loom up among us. It is actually a joke, only not a very funny one. Harold Shipman will be laughing in his grave (we GPs know he would have passed Revalidation with flying colours).

But there are other factors too that stymie the efficient functioning and delivery of care by the NHS. For example, the monumental waste that is inherent in it, such as vast and costly IT schemes that come apart and are ditched (I was gobsmacked when I first saw a skip full of redundant computer monitors outside an office. Such a sight has become commonplace now, and I would lay odds that a goodly number of those offices are NHS premises).

But the single greatest impediment that in my view the Patients Association ought to but never does address and mean it is the way those they claim to champion actually use (and misuse) the National Health Service. What have they to say about appointments made with the GP or nurse that are never kept? What have they to say about the hundreds of thousands of pounds worth of drugs that are prescribed but never taken? What have they to say about appointments demanded by patients for the sole reason that they can get over-the-counter drugs free (paracetamol, mouth washes, moisturising creams etc.) on a prescription exempted from charge. And don’t tell me that the GP should resist such requests: as likely as not such a refusal would result in a complaint that can take hours to respond to and resolve properly. The list goes on.

There are individual instances that beggar belief. Once, when I was running a Saturday morning surgery a patient rang and asked if I could look across the street to see if the launderette was open. You don’t believe me, do you? Well, don’t if you don’t want to. The Patients Association might be happier to put it about that the reason we gave up on Saturday morning surgeries was because we wanted to spend more time on the golf course.

Believe what you want. I worked bloody hard in general practice for 40 years. Much of it I enjoyed. But like many of my colleagues, I don’t think it is a job worth doing any more.