May 17, 2013
The different way people approach things is fascinating. I am a problem solver. Not as in mathematical puzzles so much as in I need to find answers for problems. It is what I do. It is how I function in my entire life. Everything becomes a problem to solve. ‘Problem’ in this context is not negative. It is more of a question and answer approach. I have to be able to define the problem and then solve it.
It may be my medical training. I’m not sure if I was like it any way or if that hammered it in to me. Find out what the problem is then sort it out. Nobody comes to see a doctor unless there’s a problem, so it was all day every day. I didn’t have to invent problems to solve, they just rocked up. In Casualty (OK, A and E nowadays), in clinic, in wards, in operating theatres, in the anaesthetic room, the recovery room, intensive care…. everywhere. And one of the great joys is that it’s a new problem every time. They may be very similar to ones before, but everyone is an individual and there may be special nuances to watch out for, particular hurdles to overcome.
It is how I approach everything, not just doctoring, which is why I find it difficult doing tea and sympathy in my non-professional life. My automatic response to a friend or relative feeling under the weather/in pain/moaning is to try to determine the cause and suggest solutions such as ibuprofen and/or paracetamol, or go and see a film, or organise a night out. Depending whether the problem is medical or emotional.
And it is sometimes met with a curt and exasperated response that I am completely unsympathetic, unfeeling and uncaring. Which I feel is unjust of course! As I do care and my care is manifest in trying to solve the problem. But that’s not what they want, they just want sympathy. It took years for it to occur to me that someone might NOT want their problem solved. Or at least not at that moment, or not by be. Because if I have a problem I do everything I can to sort it out, and I want it sorted NOW. And if anyone has a decent suggestion I’ll take it if it still isn’t sorted by my own devices.
In contrast, some people just want acknowledgement. Not a solution. ”Ooh, yes that’s nasty” or “Oh dear you poor thing” , without the additional “Have you taken anything for it?” or, “That sounds muscular – have you tried this stretch? ” or ”Well I know a good lawyer.”
I can’t get my head round it. It is a complete enathema to me. Surely no one wants problems so if something is a problem you want to get rid of it? Or is it that it isn’t really a problem, you are just upgrading a minor irritation in to something bigger so you can have a whinge? But I know that isn’t true as sometimes the issue they want acknowledging and comfort for really is massive, and doesn’t have an easy answer. I try to keep it zipped but so often rather than sympathy I hear myself offering possible solutions to a small part of the problem and I know I haven’t helped at all. If anything, made them feel worse – as if they haven’t tried to solve it or as if it is their fault the problem is with them in the first place. Which of course would be the last thing I’d want to do, but I do struggle to keep my gob shut.
At work there are people who moan about their job. A specific task. A particular person. A given project. Or just everything in general. They exude a feeling of powerlessness, that this is simply the way of the world and a cross they must bear. Hello!!! Wake up and do something about it if it is that bad. Don’t just suck the energy out of everyone else with your negativity. Work out what the actual problem is and then try to solve it. For many it will be crystal clear the problem is in their power to solve. By not spending half the fucking day moaning about the amount of work they have to get through and actually focussing some time on the task in hand and getting stuff done. Taking decisions and acting on them rather than putting them off or revisiting them time and again after a decision has been taken. But that isn’t what they want to hear. They just want a sympathetic ear and a little mental stroke. I nearly have a stroke myself when they start up…
So if I am ever in your company and I tell you I’ve got a problem don’t just say “Yes, dear” – I want you to help me get it fucking sorted.
May 16, 2013
The individuals who were the inspiration for Alice in Wonderland and Peter Pan meet and talk through their lives and experiences. How it has been for them – a burden or a gift?
The sets are wonderful – initially in a library with the pirate ship perched on the top shelf – which lifts away to reveal sets that recreate the illustrations from the books and take us back in time to when they met the men who wrote about them. ‘Peter’ is wracked with discomfort and angst; never the favourite of the five Llewellyn brothers that J.M Barrie courted and idolised, but the one whose name was used. His father, who had distrusted Barrie, died and Barrie stepped in to secure the boys upbringing.
But Peter resents the whole Peter Pan thing as a sham. A lie. He returned from the Somme with post traumatic stress, having seen the most horrendous things and believes the reason for childhood is simply to supply happy memories for when you do grow up and life is neverending shit. For him, the only possible reason for Neverland and boys who did not grow up was that they were killed before they reached adulthood.
Alice, on the other hand, rather enjoys the celebrity staus being Alice gives her in her dying years. Having lost two sons to World War One and outlived her husband, she is alone and friendless. But everyone remembers Alice in Wonderland fondly and therefore this reflects well on her.
The cast are wonderful, as you would expect with Dame Judi at the helm. But all the other actors play well too – there is a young Alice and Peter as the characters and younger selves and it is all cleverly interwoven throughout. But it is a sad and dark journey through unhappiness, otherness and isolation with hints of inappropriate relationships. Alice cannot persuade Peter to see any of it in a positive light and we know he is doomed.
Without the stellar cast and sets I think this play would struggle to come alive as the story, although cleverly done, is tenuous, hinted at and has more questions than answers. Three stars.
May 11, 2013
Don’t ask how my husband and I started discussing this topic, but I am so old now that the treatments we recommended for certain conditions are no longer used. Superceded by “evidence based medicine”. In the old old days a treatment or procedure might be thought to be a jolly good idea in theory and so, hey ho, it would be tried out, written up and before you know it, it would be routine. Before you had to do clincial trials and stuff and actually find objective evidence that the treatment worked better than doing nothing.
The procedure I remember in particular is known’s as Lord’s procedure. I did it as a House Surgeon and also had to keep people asleep who were having it done when I was an anaesthetist. The latter role was much much harder because the procedure was intensely, agonisingly painful and would cause people’s hearts to go in to weird rhythms, threatening to stop, so you had to make sure they were really deeply unconscious before the surgeon started.
Because the procedure was one to alleviate piles and/or fissures (splits). It was really barbaric. The patient would be in the lithotomy position – on their back with their legs up in stirrups (like in the old days birthing mothers were made to be). The surgeon would then get ready to manually dilate the anus. The aim was to insert four fingers of each hand in to the anus, with the hands being turned back to back not in the praying, palms-together position. Then you would stretch as hard as you could – pulling your hands apart at each side of the anus – so like ripping the bum cheeks apart. You only ever puleed in that direction not up and down. And basically over 3 or 4 minutes, you would stretch this poor soul’s bum until you thought you’d done enough. It was during the stretching that the heart rate would go all over the place. And I think we can all see why.
The procedure (named after the doctor who dreamt it up, not after the House of Lords routine entertainment of each other) was used for years until eventually somebody did do more robust research and found that although it appeared pretty effective straight away, 20 years on people actually had trouble not dribbling shit so perhaps knackering their sphincter maybe wasn’t the best thing to be doing.
May 9, 2013
What a life I lead. Third time in as many days that I am in the West End and going to a performance. This time it is highbrow. Not my natural metier, but one that I have gradually embraced with the diligent encouragement of my husband who is a fan of classical music and opera. I, on the other hand, enjoy diddly-dee music and all singing all dancing showstoppers.
And so it was after a day spent indoors, I emerged in to to sunlit warmth and hailed a cab. “To the Opera House my man, and step on it!” My cabbie entertained me for the 40 minutes we were in jam packed central London. A second-generation Indian (“I’m English, not white”, “Nah, never been to India. I’m not in to all that roots shit. Can’t be arsed.”), who had spent time serving in the Army under Will Carling’s Dad, then as a holiday rep in Majorca, Club 18 -30s and as a Red Coat at Butlins, (“Ooh, Butlins was the worst. Full on orgy all the time. Didn’t matter how ugly you was.”), travelled with The Firm as a football thug for years, and had written to the Royal Opera House when it got given £250 million from the lottery fund for refurbishment. “I said none of your punters ever buys lottery tickets. It’s people like us what buy lottery tickets so if I send you ten dud tickets can you give me a half price seat? But they never even wrote back.” Whereupon he launched in to a rather credible impression of a toff dismissing a pleb.
And I alighted on Bow Street and tripped up the stairs to the wonderful Paul Hamlyn Hall, where, as a friend so rightly says, all wine tastes better. It is a beautiful conservatory (where Covent Garden flower market used to be) and now it is more conservatoire I suppose. In tune with the environs, the champagne is already poured as I reach the bar and we dog a glass or two down before heading in.
Standards of the announcements have definitley slipped over the years. They used to be a highlight – akin to listening to Dave Lamb on come dine with me – as the accent was so plummy and the way they pronounced the names of the Operas in their original language truly enlightening and entertaining. Unfortunately now this job seems to have gone to a mediocre news announcer from Surbiton. Perhaps in an effort to be less alienating for the masses, but they would do better to lower the ticket prices if they really want to welcome ordinary folk.
But this one was worth the high price. The sets and costumes were incredible. The orchestra, as ever, is worth the price of a ticket. And then there is Simon Keenlysides playing Papageno. A physical comedy role that he is brilliant in. Not to mention his wonderful wonderful voice. I imagine Mozart was on drugs when he came up with the story. It is mental, but it doesn’t matter. it is an excuse for bizarre characters, pointless quests and perhaps reflects the evolution from boy to man. Who knows? Who cares? The first half was fabulous, the second dipped in the middle but it is always an occasion to go to the opera. I’ll give this one three and a half stars.
About 5 years ago we saw my favourite ever version. By a South African company and the orchestra were all marimbas. It was reinterpreeted with a South African theme and was absolutely mind blowing. Fantastic dancing, comedy and great joy. A real uplifter. And if I’d thought about it I would have added it to my 5 star review list.
May 5, 2013
When I was a junior hospital doctor, my first job was as a surgical houseman in a busy local hospital in North Yorkshire. Back in the day when nurses did nursing and were routinely referred to as Angels by the patients they cared for. What I hadn’t really anticipated was the physicality of the job I was about to undertake. Not just the walking around the wards and across the road (about a mile) to the geriatric hospital that we also covered. But the hard work in theatre itself.
Like all exercise, it becomes easier with practice. But the first time I had to hold a liver retractor I thought I was going to pass out. As the ‘assistant’ in theatre you are there to keep the operating field clear for the surgeon. So you have to hold organs out of the way and keep the area free of blood so the surgeon can see what they are doing. Often this is fairly simple and not too onerous. In fact surgeons often do it all without an assistant apart from the scrub nurse who has to pass the appropriate instruments when directed. But if it’s a simple enough operation, then the scrub nurse doubles as the assistant – and no doubt does a far better job than the newly qualified houseman.
But a huge part of medical life is training to be able to undertake the tasks that your more senior colleagues are doing. And the best way to do that is to be right in there and helping. In medical training the adage is “See one, do one, teach one.” And that is often literally what happens. You watch a more experienced person do something, you then have a go yourself whilst being supervised and then before you know it you are the one teaching others how to do it. I can tell you it concentrates the mind when you realise you’ll have to do it yourself. However obviously this doesn’t hold true for doing an appendicectomy. I must have seen about three or four before I was actually allowed to do one myself – and even then under very tight supervision.
But straightforward minor procedures like taking blood, putting up a drip, putting in a catheter, removal of a sebacous cyst, were basically shown to us once and then we had to get on with it. Most often with a doctor watching first time, and then you hoped a friendly nurse might come and assist. They’ve seen it all before even if they haven’t done the procedure themselves. And seemingly straightforward things like taping a drip down so it doesn’t fall out are actually trickier than they look. There is a way to do it that makes it simple, but it’s a matter of working out exactly how the doctor supervising you did it. A friendly nurse will be a godsend of knowledge on these things. And also reassure the patient that everything’s fine, even when the doctor appears to be shaking like a leaf.
I loved my ‘minor ops’ list that I did one afternoon a week. It was all kinds of things but mostly removal of harmless but unsightly lumps and bumps, ingrowing toenails, abscess drainage and stuff like that. All very satisfying. For both the patient and me. And no operation lasting more than about half an hour. And that’s a long one.
Unlike major surgery which can mean eight hours standing in theatre, pulling and heaving and sweating under the lights. Until you get used to it. But even so, I found as an anaesthetist my right arm and hand became an iron grip from holding a mask on the face and the jaw at a particular angle. Usually if you knew the operation was going to take a while you would put a tube down the throat and in to the lungs so that you could attach the gases straight to it and not need to hold a mask on. But sometimes surgeons were slow, or hit a problem and then you’d be stuck with the mask and fingers cramping, and the whole arm aching. And you can’t just leave the mask off for a few minutes while you get the life back in to your hands because it is those gases that are keeping the patient asleep. So you swap hands and become ambidextrous and your endurance improves with practice and soon it is second nature.
So much so that in fact one Monday afternoon I was doing a list after having been on call all weekend. I had managed to snatch only a few hours sleep since Friday morning when I had come in – it may even have been the infamous weekend that involved the stuck vibrator - and I was very tired. As the anaesthetist I would sit or stand at the head end of the patient; they are lying on the operating table and I am sitting at their head end, with my hand firmly clamped holding their jaw in place and the black mask on, watching the bag inflate and deflate. their chest go up and down and my finger on the pulse just in front of the tragus of the ear so I can feel the steady beat of their heart and know all is well with them. One of the issues of using a hand held mask to keep someone asleep is that tiny amounts of the gases escape if the seal around the mask edge isn’t absolutely perfect. It doesn’t usually matter. But on this Monday I was sitting down not standing because I was already exhausted. So I was even closer to the edge of the mask if any gas did escape as I relaxed my grip or readjusted the mask for any reason. The operation continued. All was going well. It was very very straightforward. The patient’s pillow was crisp and white and I thought I’d just rest my head on it whilst continuing to hold the mask, watch the bag, feel the pulse and I lay my hand on his chest so I could feel it move gently up and down. All was calm. The rhythmical breathing, the steady pulse, the warmth of the operating theatre…….
The next thing I know is that one of the Operating Department Assistants is tapping me on the shoulder and telling me one of my Senior Registrars is asking if I’d like a coffee break. It was one of the courtesies anaesthetists afforded each other; if you are working alone (as I was) another anaesthetist (who was working with a colleague) would come and offer you a break otherwise you’d never get one. I have never been as grateful to anyone for their timing. I may have only drifted off for a moment. Or it could have been minutes, I really don’t know. But thank God anaesthetists are civilised human beings who look after each other as otherwise both the patient and I could have been in deep shit.
May 3, 2013
The evening was a female triumph – in that we had a great girls night out and also saw a fabulous female lead in this play about the Queen’s weekly meetings with her Prime Ministers. It helps to be of an age or knowledge to remember many of the current affairs referenced in this play and to be able to instantly recognise the various PMs as they come on stage. It is not done in chronological order but as a series of vignettes strung together by a narrator and conversations between Helen Mirren and her younger self – beautifully played by the young actress on the night we saw it and trying to give us a glimpse of how much like other ‘gals’ she was and had independent spirit.
But Helen Mirren is a star turn. Able to play a woman from 25 to 85 and transform herself before our very eyes. How does she look so frumpy and solid in later life when we see her dazzle in her 1950s black dress as she takes over from her father? Yes clever costuming, but it was in her stance – her feet more solidly planted further apart as she aged, her shoulders slightly dropped, her voice less light and bright. And the actual costume changes done on stage are incredible. I missed them all. Suddenly she is in a different frock, a new era, greyer hair. Very clever.
And the supporting cast are great. Yes, John Major is more Spitting Image than reality, but all of them captured an essence of the man (or woman). And there are plenty of comdedy moments. Dry wit, acerbic put downs. A very easy couple of hours. For me the first half shone over the second, although the poignancy of Wilson’s concern over his mental faculties was beautifully done.
I missed there being no Blair. But there is no Heath either. But there is currency in the script – and I imagine it must evolve if there is a big newsworthy event they can throw a line in about.
This is one to take the over 40s to. Preferably with a little knowledge of British PMs and monarchy, and not looking for hard hitting political satire or anti-monarchy sentiment. It’s as British as a WI baking show and as easily enjoyable as one of their glorious home made sponges. Nearly Four stars.
May 2, 2013
What a wonderful way to spend a Tuesday night. This gentle,charming musical starts before curtain up as the musicians play in the bar that is set up on stage. Do get there early to join them on stage where you can buy your drink in a spill-proof souvenir plastic cup.
And this really is a musical. The wonderfully talented performers play and sing and deliver some beautiful choreographed moves. The band are the actors. The actors are the band. This is a story of a musician whose passion for music and life itself is rekindled by the arrival of a feisty Czech who will not take no for an answer. She pours all her energies in to getting his songs sung and for him to believe in himself. The incidental stories have poignancy and humour too and the beautiful music is performed with real heart and yearning.
It’s based on a film from about 2006 and the stage version has the feel of a low budget indie-flick in a way. A good way. This is all about the music, the people and the story. It’s not a showy number. The set is an old pub. The costumes are mostly Primark. And I’m not sure if I’ve just been to watch a band or a play. But whichever it is, I think I want to go to see it again. Four stars.