You Know You're Getting Old When...

...you sign off on your letters and e-mails with the words "Many Thanks".

Many Thanks? Really?

Honestly, who speaks like that?
George VI?
It's not so much Wallace and Mrs Simpson as Wallace and Gromit.
What happened to me?

I'm off to Boots. They have a new range of age-defying eye toner I need to try.
Maybe I'll start gargling with it.

Bad Poetry

Why do radio voices need to read poetry as though they are haunted, leering
over the words, oilily
creeping over their fake relish. With smug pride
they grease their lecture with subjective
power, diluted
by the arrogance of a personal offering of insight. Adding
a soft American accent
the thin veil of "known" is securely parcelled.
But not revealed
except to followers.
Never upgrading their chosen selection.
Peddling a product
with no user connection.

Fold 1

A rogue patient today offered to "tear me a new one".
Looking forward to it.

I love origami.

In praise of the part timer.

I've always admired the part timer, not the cheeky wastrel who does a mediocre job on the back of large amounts of invisibility, but the multi-limbed polymorph, the learned hydra (one for the classics scholar) who can drop into any situation, acquit it, acquit themselves, and quit.

Someone who can flit yes, but not a fly-by-night.
Someone who can swoop, act while hovering and fly off.
Someone who can act yes, but not make a performance of everything.
Someone who can make a performance, but only when such a thing is called for.
Someone who is as rounded as a well oxygenated red.

Work is life.
Not to work, not to be useful, is not. It's cancer for the young unemployed.
Work can give you self-respect. But it can also take it unless you broaden your options. It grips your identity, imposes its walls, puts a face (or two) to your fears and slowly tightens the screw.
It describes your need and possessions and quantifies your hopes, dreams and holidays.
If you let it.... it owns you.
And if it envelops you, then you may lose your self.
Or just forget to develop self in the first place.

So give a cheery nod to the part timer and say a quirky "hello there" to its bigger brother, the portfolio renaissance man.
Oh... and woman, of course.

After all, this can't all be about me.

The Pricing Paradox

I was all for the government introducing a minimum price for alcohol.
But it looks as though the price is actually going to go up!

Someone's taking the Mickey.

What the Engelbert can I do for you?

In walked the prisoner,
"The last doctor gave me mirtazapine – I'm not depressed. I don't need antidepressant drugs".
I agreed with him. He wasn't exactly warm, but he didn't strike me as depressed.
"I can't sleep".
(Here we go...again) I got my volley in early. "Well of course we don't use sleeping drugs any more... but let me check what the last doctor was thinking".
"I don't want drugs", he offered.
Rather loudly.
He didn't want drugs. He mentioned that earlier.

I checked the notes. That last doctor had squeezed and forced every criteria to justify "depression", treated him for it (wrongly, with drugs alone), and started him on, well, let's say 6 to 9 months of brain altering drugs. (Isn't that the correct timeframe nowadays for these sort of drugs?)
She got the patient out of the room, managed to forget about telling him what the drugs were and the potential timeframe, and organised a review. But not with her of course. Because he is sitting in front of me.  What we call in general practice, a perfect dispatch. A home run.

"I agree with you, you're not depressed. Let me tell you about my sleep hygiene booklet".
"'I'm not reading no booklet. It is a waste of time".

"But it's the correct treatment", I pleaded.
(His elbows went up, his volume went up).
"How is your reading I ventured?", conjecturing he may be illiterate, although as far as I could tell all his tattoos were spelled (spelt) right (my Dad's favourite joke!)
"It's fine, I'm not reading no booklet".

"Good. I don't want you to read it, I want you to live, to rehearse it, to breathe it", I performed.
"You don't get better from booklets". (In principle I agreed with him, in another universe we could have been friends).

So if you don't want drugs and you don't want the correct behavioural treatment I'm looking to offer you and facilitate, and we both agreed that last doctor gave you antidepressants was well...liberal, what the Engelbert Humperdinck do you want?

The voice went up, his elbows went up, his volume went up.
He stormed out happily to explete to whoever would listen.
About me, of course.

He got away from me but I was close, so close. I nearly had him. I'd nearly broken through but the previous GP had left me a mountain to climb.
I never did discover what he wanted. (It's drugs by the way. I think the ingester prefers to call them tablets but I don't like to make it that easy for them to acquit their choices. You just hope to be able to save a few from themselves along the way).

But how much longer can I stick to the white line in the middle-of-the-road, not give up where my colleague (not my term) had sentenced him to brain altering drugs for no good reason before she was rumbled in absentia by her own patient?

I wouldn't have written this today (because it's one of a thousand similar occasions) except that Liam Farrell in the BMJ told a similar tale and it reminded me that a lone soldier sometimes isn't alone. His example was the good old legend of the sore throat.
Dishing out dubious medications doesn't bother the Americans, the French, the nurse practitioner (I could go on but I'm sticking to evidence-validated information).
It is left to the GP to avoid prescription and replace it with something. Clinical acumen maybe? Honed consultation skills? Starburst?

But you can't visualise the human brain.
It is just unfortunate that there are so many situations that, unlike Liam, means I can't call after my angry patient and scream helpfully "But it's only a virus".

Jackpot

I found two 3 leafed clovers today.

I pulled a leaf off one, and with a combination of a tiny staple and a little bit of PVA glue on the back and just the smallest little strip of Sellotape over the front, it took a couple of attempts, but I managed to graft the leaf onto the other 3-leafed clover so that you could barely tell.

Yes, I make my own luck, me.

Home Truths

I was telling you about a discovery that I made about myself.
That I'm going to have to face, with whatever belated dignity I can muster.

I recently went to the cinema.
You may have heard of the award-winning silent movie that has taken all the plaudits, The Artist, a ground-rebreaking tribute to silent film of (presumably) the 1920s, an artistic tour de force, with a combination of a supremely intelligent and witty script, Oscar-winning soundtrack and impeccable performances?
Yes?
Well, I went to watch the Muppets instead. (It was great).

I'm updating my stereo system.
I'm reliably informed you're not supposed to call it a stereo system any more. Frankly I'm not sure what you are supposed to call it. Let's go for micro hi-fi with DAB and iPod dock and agree never to speak of this again. I looked at the Denon, an award-winning annually impressive class act, that will be the pride of any home. I looked at the Marantz. I remember guys at school talking about these names as they made their masturbatory pilgrimages to Richer Sounds. It was always a bit scary, a bit serious.
Gold cable? Really?
And these devices had tough competition in the market from Sony and Pioneer.
But I've just bought the Pure machine.
Largely, because it was shinier and had more lights.

I've seen an opera or two.
Good ones.
I've listened to folk music,  in a weak moment, and sometimes found enjoyable bits in there.
But what I really quite like is electro-pop.
And for that matter, pop in general.
I've occasionally visited classical music, but I could take or leave it.
Preferably leave, if I'm honest.

On occasions, I've been to the ballet and modern dance.
I wasn't blown away by either of them.
I've seen a bit of Shakespeare but enjoyed it best when there was someone I knew from TV or a great comic turn.

And if I read anything before I go to bed, I reach past the Economist and pickup the Viz for 10 minutes and invariably have a giggle.

This is my discovery.
You see as it turns out...

I'm quite trashy.

About Face

A patient came to see me today.
He said. "You don't look like you know anything about reverse psychology".

I had to take the rest of the morning off.

Feedback Loopy

I received a positive comment on my derriere yesterday.
This is becoming quite a recurring thing, because it was also pinched in a nightclub in 1987. (I never did track down the fella who did it).

It's always nice to know I haven't lost the old magic but the fact is I do receive this sort of positive feedback quite regularly.

Whenever I walk provocatively past a bunch of girls, in a pub for example, they think I don't hear them but there's always one of them that comments in a loud whisper.....
"What an arse!"

Dead Links, Good Hearts.

I sorted my favourites folder today.
I know… I should have been working, but it's a task that has been burning a hole in me for years.

It told a tale of time passing.

Not particularly of my personal tastes becoming redundant, because they are a remarkably constant thing (and I will tell you why I know this tomorrow).
I like to think of myself as a grower but I know I'm really a broken record.
At least, I am able to console myself with the idea that that record is the theme tune to Dempsey and Makepeace.
And I'm willing to bet there isn't a human alive, with that information to hand, that would then doubt my grit.

But many of the links that I have saved.....of websites I wanted to revisit, ideas that took my fancy, businesses I thought were potentially wonderful. Many of those links of technologies that I thought would enhance my life, or enhance me, many of those links were well ...dead.

I wondered why.

I initially thought they represented a huge waste of human potential, a mistimed idea, the right dream – the wrong place – the wrong time, a bubble of hope. Burst.
And then I thought, maybe they were hugely successful and they were taken over by big multinationals and they're all living in the Bahamas.
And after that I thought, 'Don't be ridiculous, you were right the first time'.

All those energies, and emotions, and relationships, and beliefs, all of those ideas, now extinguished.
Dormant.
Dead.

Do you want me to tell you that life is about dead links?
Well I'd love to. (It would make it a lot easier to wrap this up).
But I'm afraid I can't. You've got the wrong guy.

I never look at photographs.
But I live in the texture of what they represent.
I live in the album of how I got here.
I think I do that because it feels current.
Real.
Honest.

I can't think of a dead link in my life that I don't see as a continuum.
Don't get me wrong. I do try to draw lines under things, but I still know that they are things that I have drawn lines under.
I am aware of the process, of my conscious imprint on events that I may have had a tenuous grip on.

So my brain is not full of dead ends. There are a lot of unexplored highways, and but only one or two loose ends awaiting fastening.

You can do a three-point turn even in a cul-de-sac.
But a road that leads to a precipice is just a bridge you haven't yet built.

Universally Challenged

Does anyone else think that the team captain in University Challenge should be allowed to substitute one of the members of his team?

Just a thought..

Forgiving, not forgetting and the greatest trick of all

What is forgiveness?
I have no reason to to be thinking about this just now but what really is it?
Wikipedia tells us that is is the process of concluding resentment, the granting of a free pardon and giving up all claim or debt on account of the offence.

So who can really do that?
Unless you're gifted with the blessing of Alzheimer's disease, in which case forgetting and forgiving would be a highly recommended approach, can you actually just forgive?
On its own?
Just like that?
Draw a line under something and relinquish all resentment?
Is that even possible?
Maybe you need to be religious, but if it takes believing in supernatural overlords and all their false prophecies to allow you to forgive, then I fear for forgiveness.
Isn't it in fact the ultimate joke that one of the commandments (and I think it's one that polls rather highly with those in the know) is not to worship false idols?
False idols!!!!
Isn't that the greatest trick god ever played?
Isn't that the greatest paradox, there is?

But forgiveness is certainly a necessary quality in these times.... as Paul McCartney would say.... "in which we live in".
Ah yes, I think I remember why I'm talking about it now. I had half an eye on a television programme last night. The man had been unfaithful to his wife, they were 'giving it another go' and at one point in the episode he said, "you have to forgive me at some point".
And I thought to myself, "No, she doesn't".

And then I realised it wasn't an instruction, it was actually really only half the sentence.
He was tacitly going on to say "you have to forgive me at some point, otherwise we don't make it, that's the end of us, I'm off". You couldn't say that of course because, to say the full sentence is to give an ultimatum. Ultimata end in fights.
Silent threats are the only way to go. (As long as you're not talking to somebody too thick or too forgiving to recognise them).

So, in fact, he was giving friendly advice. That advice being, 'on balance I (currently) want to be here' and 'on balance, I (currently) want to be with you in at least the medium-term, but if you're not going to forgive me, ever, then let's cut our losses'.

It has quite a subtext, this concept of forgiveness.
And it is wrapped in the deepest of emotions.
In terms of married life and television dramas, the dramatic event is frequently infidelity. So let's define that as well. You can have sex with 200 people before you get married but the second the ring goes on the finger, 201 is a no-no.
When you think about it, it's quite an abstract concept.

But as long as you successfully choose somebody who shares early 21st-century human sensibilities and isn't a bit of a psychopath, then hopefully this sacrifice is at least favourably mutual.
Many build that so-called security out of this mutual sacrifice, possibly even without making absolutely sure it is mutually understood. Possibly more in hope than expectation.
After all, it's the only code of practice that we can easily subscribe to that delivers this type of mutual control.

And yet, I have heard of the concept of open marriages. Indeed I once spent 5 or 6 hours on a trans-American flight talking to an international porn star who was very happily married. As a result I have yet to be convinced that the traditional approach is any more successful a recipe than a more modern one.

For me though, I am a traditional guy.
I surely don't need to prove it, but I play my internet torrent video downloads on an old 12" black and white TV and my up-tempo songs from the hit parade on what can only be described as a basic second-generation iPod.

Surely, it doesn't get much more traditional than that.

The Art

The thing about helping people is that you are a proxy for change. A prostitute for change, I suppose. They must be derived from the same root.
Like Derren Brown. He does a card trick and it is a miracle, but when he gives you the cards and gets you to do the same effect and stands back, well then miracle is too small a word.

If you are a doctor and you give the patient the tools to get better, not just pretend that you are the answer (or you are the tool!) then you're doing the best possible thing.
The subject sequences their own success. There are negotiating their own way.
They're getting better and the only person they have to really credit is themselves.
Is there any better success than that?
A success unencumbered by gratitude or, in the UK at least, cost.

And of course you as the instigator can sit there perfectly.
Perfectly ungratified.
Perfectly poor. Well, not really poor but compared to the level of achievement...

And because of the nature of the work you maybe frequently abused, insulted, invited for a fight, oh... and occasionally killed, if not you then a colleague, well… maybe this is warfare, after all.

Maybe this is what Sun Tzu was on about.
Maybe those of us cowards who've chosen a sedentary role and even shied at its claims that it is vocational.

Maybe.

Maybe some of us are soldiers after all.