Check up

I had my four-monthly check up with Lesley, my lovely and second-favourite physio. As readers of MDB will know, after Jane, Lesley is my primary carer, and she's brilliant. She was here this morning, and found that I was a bit stiffer than before, especially around my hips; i e I tend to bend through my back rather than from my pelvis. It's not the best news, because once your muscles get shorter you can't stretch them longer again. So it looks as though I'm going to have to let Jane be as brutal with me as Lesley is. It doesn't half hurt when she really extends my muscles! But no pain, no gain.... Something else she noticed was that I have started to tilt my head a bit to the right. Nothing to worry about, but same problem about muscles. Jane and I reckon it probably goes back to when I injured my shoulder tipping over in my electric wheelchair.

I asked Lesley whether she ever found her job depressing, because she works mainly with patients with MS and MND - who obviously don't 'get better'. She clearly has found ways of coping with it professionally. But it sounds as if the Health Trust managers have little imagination about her sort of work. After all, how do you quantify the positive 'outcomes' when your patients have degenerative neurological conditions? Proportion of patients cured? Amount of hospitalization prevented? Amount of GP/consultant hours saved? Well, I guess the recovery rate speaks for itself. But the cost benefits for the NHS (physios don't cost much) must be huge, and the care benefits for the patients of physios, OTs, speech therapists etc is GINORMOUS. After all, they're the first line of palliative care, which must be a national medical priority now - since the alternative is unthinkable.

'It's not fair!'

I do wish Alex Ferguson, knight of the realm, would grow up - and get a sense of perspective. For the third time this season that I'm aware of he's had a whinge about the referee. He sounds like a petulant schoolboy, 'It's not fair!' said with sniffling whine. This time he was upset that his team, Man United, were beaten by a single goal by Premiership rivals, Chelsea. The experts seem divided on whether there was any off-side in the melée following free kick which led to the goal, but that's really not the point. Some decisions go your way and some go against you. Referees do their best - for a great deal less reward than players, and managers - and they do a good job. That's the way it goes, laddie. Just get on and stop complaining. Stop undermining them. And stop contributing to a culture of blaming everyone else except yourself. Life is unfair, we used to be told - and, although I believe it's ultimately profoundly untrue, it's not a bad working hypothesis to be going on with! Fergie old chap, many many people have worse things to complain about. It was Remembrance Sunday, remember?

Days of rugby and sadness

Had a great afternoon yesterday watching the international from Twickenham with Peter. A glass of Dr Hexter's Healer - a very mellow brew, I must say - and some tasty oven-baked chips helped sweeten the pill of seeing England go down 18-9. I know 13 of our squad were out with injuries (which does by the way make you wonder about what rugby union professionals are subjecting their bodies to nowadays...), but I was pleased to hear that there wasn't too much excuse-making afterwards, certainly not from my companion, who knows his rugby. As Wales v New Zealand was on BBC, I was able to record that and watch it at home (round Strictly - Jane thinks rugby's a bit rough). That was a closer match and Wales COULD have won, or at least drawn, especially when Martin Roberts had an unpenalised high tackle near the end. I suppose because it was closer (19-12) Wales did more complaining - what with Leigh Halfpenny moaning about the pitch (Wasn't it the same for both sides?) and Warren Gatland, the coach, moaning about the officials being biased. The ref may have missed the high tackle, but I doubt it would have made a difference to the result. And I didn't see evidence of bias. Refs and umpires, like all of us, make mistakes, though remarkably few in my view. At school I used to be told, 'The umpire's decision is final,' and we then got on with game.

After an afternoon of escapism, I turned on the laptop and opened my emails. One had the subject 'John'. It was from our friend Jan. You may remember we met John and Jan in the spring at the MNDA Spring conference in Taunton, and then in July at Waddesdon Manor. A year ago John went to his doctor with a suspected stroke. It turned out to be MND. The email brought the message that John had died on Wednesday. It can be a vicious illness. John had an amazing degree of faith and courage, and a great sense of humour. We've lost a friend. But John would have said what my friend and co-author Jozanne says, 'Jesus is my hope and heaven is my future.'


This morning I tuned in to Morning Worship on Radio 4 (http://www.bbc.co.uk/programmes/b00nnp0k): 'On Remembrance Sunday, a programme specially recorded at Camp Bastion, the main base for British forces in Afghanistan, presented by army chaplain Rev Andrew Martlew'. It was, I thought, a far more moving picture of the real war than any others I've heard or seen. I suppose it was the measured reflection on experience by the professionals, which seemed to carry much more power and conviction than the breathless reporting of journalists or the shrill denunciations of phone-in programme contributors. Listen for example to the young soldier who gives mouth-to-mouth to a dying comrade within days of his first posting or the sergeant who lays out soldiers and children in the mortuary and reflects on his own daughter. I think it was the most potent introduction to Remembrance Sunday I've experienced.

Whistleblowing

Yesterday morning I listened to a riveting edition of The Choice on Radio 4. Michael Buerk was interviewing Paul Moore, who hit the headlines as the whistleblower of HBOS's foolish policies which eventually contributed the banking fiasco last year. As The Times reported when he gave evidence to the Treasury Select Committee, 'Paul Moore, a former partner of KPMG and head of group regulatory risk at HBOS between 2002 and 2005, accused the bank of "a total failure of all key aspects of corporate governance" and said that he was repeatedly rebuffed and thwarted when he tried to register concern.' He was sacked by Sir James Crosby, the chief executive. It was a remarkable story of faithful witness in the highest reaches of corporate finance. I've no doubt there are others. What was special about this one was the contrast between the anything-goes culture of the banks and the integrity of their head of regulation - and also the rock-like faith of his wife. Well worth listening to: http://www.bbc.co.uk/iplayer/episode/b00nk2c2/The_Choice_03_11_2009/

Today we had our friends, John and Mary, to lunch. They are two of our oldest friends. We bought our first house 35 years ago in their parish in Hertfordshire, and have remained in touch ever since. John appears in 'My Donkeybody' as the person who reassured me about MRI scans. Although he had a brain tumour, he is still going strong. We had a good meal and enjoyed catching up. Time flew by. He always blesses me when we say goodbye - I suppose that's appropriate, since goodbye means 'God be with you'.

The solemn and the trivial

We returned to Stanford today for the funeral of local legend, Richard Speed. He was an unassuming but immensely talented man whose wide influence in the creative arts and education was witnessed to by the packed church. It was nice to see former curate and now vicar of Uffington, Rosanna Martin, presiding beautifully over the celebration, and to hear old friend, New Orleans jazz singer, Lillian Boutté, sing the Lord's Prayer and 'What a wonderful world'. We also enjoyed meeting, for the first time, my successor, Tim Rose, whom we liked.

On a querkier note, as we drew up in the disabled bay outside the village hall, we noticed, in the centre the ten-metre square patch of grass opposite, a new stake with a notice saying, 'Take away your dog poo', with underneath presumably the dire penalties for failure. As we left after the service, lo and behold, there was a man wearing a musty green gilet on which were the words 'Environmental Warden'. We watched him as he closely inspected the ground before driving away in his shiny white Vale of the White Horse District Council van. 'What would he have done if he'd found some "poo"', Jane mused. 'Taken it away for DNA analysis? And then had a DNA identity parade of all the dogs in the village?' I muttered something about the canine stasi moving in, as we drove home. I grow old.

Aspirin science

I thought I'd reproduce what John commented a couple of days ago, as I thought it was rather pithy:
"One of my favourite economists, not himself a religious man, wrote this about science and values: 'Why should one be frightened, I asked, of taking a stand on judgments which are not scientific, if they relate to matters outside the world of science? To recognise the claims of science in fields where scientific method was applicable was one thing; to attempt to claim scientific sanction for judgments of questions not capable of scientific proof was another. The one was an obligation on rational man; the other, the stratagem of spiritual uncertainty. Was it not only the timidity of an age which had lost all confidence in ultimate values which led us to attempt to claim "scientific" justifications for attitudes which in the nature of things could not be justified (or refuted) by appeal to laboratory methods?'"

We heard this morning that scientists have revised their advice about aspirin as a prophylactic against heart attacks, unless you've already had stroke or previous episodes. Not so long ago, I received advice to take half an aspirin a day from a doctor (not my GP) in the light of my chloresterol. The Drugs and Therapeutics Bulletin now reports the risk of internal bleeding offset any potential advantage. According to the BBC, 'Between 2005 and 2008, the DTB said four sets of guidelines were published recommending aspirin for the "primary prevention" of cardiovascular disease - in patients who had shown no sign of the disease.
These included people aged 50 and older with type 2 diabetes and those with high blood pressure.' Many thousands have, not unreasonably, followed the 'scientific' advice. 'But the DTB said a recent analysis of six controlled trials involving a total of 95,000 patients published in the journal the Lancet does not back up the routine use of aspirin in these patients because of the risk of serious gastrointestinal bleeds and the negligible impact it has on curbing death rates.' What do you know? The scientists have changed their minds.... Last night we heard Prof Nutt on the World Tonight pontificating on politicians' inability to grasp the difference between 'belief' and 'fact'. 'They believe it, and because they believe it, because they're politicians, they think it IS true. And that's why they think they don't need experts, because they think they know the truth, and they don't. They're confused. They think their beliefs are facts and they're not....' No doubt the advice we were given about aspirin - until this morning - was given because of 'facts'. Isn't it time for a bit of intellectual humility all round? One of my favourite quotations comes from the unlikely figure of Oliver Cromwell: 'I beseech you, in the bowels of Christ, think it possible you may be mistaken', which I think he said to his fellow Puritans.

Saints and science

One of the things I have to admit I miss about non Anglican worship now is the rhythm of the church year. So it was nice to wake up this morning to a rather good service on Radio 4 from Aberystwyth. It was marking All Saints' Day, and contained a fine explanation of saints drawn from the book of Hebrews in the Bible, as well as a good variety of music - which is sadly more than can be said 'Songs of Praise' this evening. Some dire musical performances which seemed entirely at odds with with the words and of course, by and large, the old stereotyped image of saints as specially good people. Actually they're simply ordinary believers - like the McFadyens who provided the most moving interview.

I came across this in an article today. It seems to me to be germane to what I said about Prof Nutt and the supposed absolutism of science:
'Throughout the report the authors pit the objectivity, rigour and precision of ‘science’ and psychology against the subjectivities of religion and ‘values’. In so doing the report ignores the social, philosophical and value systems that the psychological sciences themselves inhabit,.... The authors seem to believe that the ‘scientific’ evidence over which they preside allows them to police the boundaries of ‘normality’ and their apparent ability to attach values (‘positive’) to psychological observations has a degree of confidence that is breath-taking.' It was in 'Changing Sexual Orientation and Identity? The APA Report' by Andrew Goddard and Glynn Harrison, on the Fulcrum website. We need to keep insisting that even 'science' inhabits social, philosophical and value systems