I chose this cover picture which shows me in the raw — not at all the way I feel today — the book recounts the reasons why — all the bizarre experiences and formative encounters. The dodgy characters and extraordinary situations proffered by a medical education in the sixties. How the world has changed!
When I was a houseman my legs were blebbed and bubbled by the bites of the fleas from the feral cats that lived within the hospital grounds — but things have moved on.
Hospital cats are now more professional — they have come in from the cold, are properly trained and equipped, have regular health checks and probably mandatory immunisations (long before the other staff!)
The thing about cats is that you cannot exclude them if they don’t want to be excluded and some cats just have a vocation! So the NHS works with them, not against them.
Somewhere in Britain, probably everywhere in Britain, Buster here (or a cat like him) guards the confidential waste in the office of the emergency department. He keeps his wits about him as he dissipates the stress of staff, his mouth shut, the perfect confidential mentor and counsellor but as a member of the occupational health psychiatric team, as you can see, he does have his own panic button.
I read somewhere that time accelerates as you age. This is my impression and may be because as you get older you do fewer new, memorable things. Memorable things that you do for the first time populate the time-scape and as you look back, if there aren’t many it seems as if the time has flown by. I don’t suppose it matters much as it’s all just a trick of the memory but it’s good to have things to look back on and one of the reasons I blog.
There was a time I did something new almost every day but that’s not so easy now with all the restrictions. Last week I bought Saville oranges for the first time and yesterday I made marmalade for the first time and got my first sugar burn!
When we are next in Peterborough I am going to have a go on my daughter’s new adult scooter (she uses it to get to work at the hospital avoiding parking and public transport) — it’s manual like the ones we had as kids but bigger — I used to love my scooter! This will require the manufacture of padded knickers — the only proved way to avoid fractured femurs (I should have had them years ago) and I will certainly need them in Kettering when I try the new grown-up motorized scooters that whizz up and down the Headlands with some of the youngest 17 year olds (with driver’s licenses) that I’ve ever seen. Before I can do that I’ll have to get my first i-phone (that’s how you mobilize the scooter) and waylay a school-boy to help me (I’ve done that before).
A friend of mine (I won’t identify him any more specifically — you’ll see why) likes to go to work each day using a different mode of transport, it was easy to begin with, especially as they live on a waterway (that narrows identification down a bit). Car, bicycle, skate board, paddle board, kayak, walking, running along the beach… As time goes on finding new ways gets harder — swimming, sailing… Running over the dunes? (But that’s really just running). Running over the dunes naked! He could do them all again naked even if it does mean going early when it is quiet. So if you knew who it was and where to go you could see him at 5:30 am riding a child’s peddle-cycle, stark naked, along the sea-wall.
When you see me streaking down the Headlands in nothing but my padded knickers you will know that I too am running out of new things to do.
Our friend Tony told me about the flock of sheep fed on oil-seed rape, when it first became a popular crop in Britain. (It might have been in 1976 that famously hot dry summer.) The sheep gained weight like never before but lost their ears! It was a mystery.
Photo-toxicity is something I learned about in another life when a lady gardener showed me the livid, blistered scalds on her arms, as if she had been whipped with a red hot flail. In fact she had been lightly brushed by the cut, sappy ends of giant hog weed, angelica and cow parsley that had taken root and flourished amongst her parsnips that hot summer and which she had been cutting down.
Phototoxic chemicals, which occur in all these plants, increase the reactivity of the skin to ultra-violet and sometimes visible light – they are the opposite of sun screen and can produce the most bizarre patterns of sunburn. You can get them onto your skin directly, like the sap, or be effected by eating them, as with the light sensitivity that can occur with certain drugs.
Bergamot oil is another phototoxic agent, giving a puzzling blistered burn on the neck of a very smart but distressed lady who did no more than spray herself with expensive perfume on a sunny day.
I think that the sheep with the missing ears got such bad sunburn on their ears (their least woolly part) after eating or brushing through oil seed rape that they ultimately lost the tips of their ears– like our lamb here.
Two of our triplets this year seem to be effected. They are the small ones who have had less milk and, early on, foraged more widely, nibbling in the hedgerow and tasting all sorts of plants at an earlier age than usual, when their hair was thin and their skin sensitive. The bigger one has gained weight but has lost his ears!
The little one has done better, now we have worked it out, and she has had treatment and gets my sun screen (factor 20) liberally applied on sunny days!
I didn’t see the accident — just the blood on the road as I swerved to miss her as she staggered blindly in my way. I stopped and the cars behind were already pulling out to overtake me, I switched on the hazard warning-lights, jumped out and ran back.
No one else stopped — they hadn’t seen her — now she lay helpless in the gutter — I had to be quick or there would be another accident.
I could smell her blood, it was on my hands as I tried to hold her — steady her. She struggled and kicked — there were two huge gashes on her head, I could see the bone, liquid was bubbling from one of her eyes and blood was coming from her nostrils, strangely the cars whizzed past, their drivers oblivious to the drama.
I had nothing with which to do anything. I ran back to the car and found some carrier bags and the dog’s lead (no first aid kit of course) — anyway there was no time for that. I tore the bags flat and wrapped her in them, swaddling the little duck like a baby and trussed her up with the dogs lead so that she would not injure herself any more — she calmed. I lay her in the dark boot of the car wedging her in so she wouldn’t roll about then closed the lid.
Now I could have driven to town, to the vet — yes, she was (and still is) a duck — a little mallard, hit by a car — well she probably flew into the moving vehicle — she was, is after all, female — but I did not. I’ve seen the expression on their faces when you present them with a wild thing and I’ve paid the price!
No, I took her home. My husband groaned and, once again, our wet-room came into it’s own.
Trying to walk, she repeatedly toppled over to the right but in the half light of the darkened shower room she settled and sat quietly all that day and all the next. Nothing ate her. She moved around a little but would not eat the slugs which I had collected for her and which climbed their slimy way circuitously to the ceiling , nor did she try the bread in water which she spilled, nor the caterpillars that pupated on the tap.
On the third day, she was thin, dehydrated and matted but walked more steadily and looked up at me as if she saw me. We had to go away to a funeral the next day so first thing in the morning I carried her to our pond and put her down gently by its side. All the way there she was looking from side to side as if getting her bearings.. Next thing she topples forward and plop! She’s in the water, she lowers her head so that the pond water flows into her beak and she takes a long cool drink and paddles off purposefully around the margin of the pond.
On the far side she climbs out onto the bank under the muddy cliff where the water from the spring runs down in a curtain. She settles there washed by the tiny waterfall.
Next evening when we return she is still there. She watches me throw bread on the water then stands up straight and flaps her wings two or three times to test them, shakes herself and settles down again.
Next morning the bread is gone and so is she, flown away or carried off by a fox. But wait…
There she is, sitting near the path, ready for breakfast.
We have a friend who is a farmer, when asked if he has to get up a lot in the night for his animals he says, ‘No, God does the night shift.’
‘What you need is a scan’
‘What, like you have when you are pregnant?’
‘No, a CT scan, computer tomogram — that’s the only way they can really tell what’s going on — but they’ll try to fob you off with painkillers, they always do!’
My friend’s bad knee continued to be discussed in the pub, no one said she ought to lose weight, change her footwear or work on her quads. Everyone quoted their own experiences, all were unanimous — what she needed was a scan.
That’s equivalent to 8 chest X-rays –okay, probably worth the risk.
But I went to see a gastro-enterologist recently to discuss my mild indigestion during which consultation I mentioned that a relative had died of pancreatic cancer — ‘then you had better have a CT scan!’
He reached for his pad, it was 7.30 pm, I was his last patient, he looked tired.
‘Hang on a minute — what dose of radiation will that involve me in?’
‘About 8 milliSieverts, same as about 400 chest X-rays.’ He said this very quickly, ‘equivalent to sitting at home for three years watching the telly, enjoying the background radiation.’
‘That seems a bit extreme. I mean having a scan.’
‘Everyone has a CT scan these days, it’s the only way to be sure,’ he said, ‘I don’t mind — you can have one. It will almost certainly be negative but then you won’t have to worry.’
But I do worry — 3 years back-ground radiation — that sounds like I’m suddenly 3 years older — three years nearer whatever I do die of. So I went home to wait for my appointment and looked up one or two things…
Did you know that the average person in Great Britain is exposed to 2.7mSv per year? This is from radon in the air, radioactivity in the rocks, soil, and plants and manufactured radiation, largely medical. The radiation in the soil gets into plants that we eat — you can get 0.005 mSv from one little packet of Brazil nuts (135g). My CT scan is worth 1200 packets of nuts — there’s a thought.
The background radiation is largely unavoidable and varies a bit according to where you live — radon from the ground in Cornwall gives an annual exposure of 7.8 mSv — so my CT scan is equivalent to a year in Cornwall — that doesn’t sound too bad — unless you live in Cornwall.
Radiation exposure also depends on how high you live, the nearer you are to outer-space, every transatlantic flight you take racks up 0.07 mSv (just over 3 chest x-rays or more than 5 packets of Brazils!) If you live in Denver, Colorado (mile high city) your background radiation will be twice as much as some other places.
Tobacco contains Polonium-210 and Lead-210, these are radioactive and become concentrated in he lungs of smokers, the US Environmental Protection Agency quote that smoking 20 a day gives a radiation exposure equivalent to 300 Chest X-rays or 6mSv/year
Without smoking, the average person in the USA is exposed to 6.2 mSv of radiation per year, more than double the British level (unless you live in Cornwall) If you look at the different components of these figures, most of the difference is made up by, guess what — medical radiation.
When I first visited the US 20 years ago, I saw a lot that was strange to me — shopping malls, retail parks on the edges of towns with neon signs, ice machines, burger bars and super-sized paper cups, stacks of pancakes with syrup and ice-cream and Tommy Hilfiger clothes — all are now common-place in Britain. From jazz and rock-‘n-roll to obesity, what starts in the US comes to us in 15 years or less.
So I guess this trend for scans will continue and I will watch the cancer rates in the US for indications of what is to come here. In the meantime, I think I might cancel my scan because, do you know, I think I feel better.