How to dissappear completely – part 2

I sleep fitfully in tents. Time passes. I’m not sure I really sleep. Otherwise it’s a wonderful experience.

Didn’t get up till after 9 and fought the chickens off to get at the food to make the breakfast. By time we had the bacon and eggs and potato bread down us and camp cleared away it was after 11.

Thankfully the wind had died a bit and we made it across the open bay of the lough on calm water with nothing but the flies for company.

The silence is overpowering. You have most of northern Ireland all round you (we never decided if it was 4 or 5 counties) and you’re here in this tiny wee boat in the middle of it all. Good times.

Lunch was at ardboe below an old ruined church. Pot noodles aren’t as good as I remember them.

In the afternoon the wind picked up and thankfully more in our backs. Unfortunately this drew up a bit of a swell which kept trying to send us more west than north west.

The waves have a tendency to catch your tail end and spin you whichever way they want you. It is possible to surf them but it takes a lot of effort to keep youself in the right direction.

In the end it was quite hard work but we made pretty impressive speed across the lough with only eel boats and sand dregers for company.

Ended up on ballyronan marina at 5 pm and got a 99 from the bored teenager at the ice cream stall.

I’d tried to book a space in the campsite about 5 days ago but was told that it was fully booked.

When we arrived there were 2 caravans on the site with at least 10 empty bays. Maybe people had cancelled. We chanced our arm with the lady in the office and gave her our sob story about canoeing for 10 days solid and how we had to eat the ships dog and she felt sorry for us and let us squeeze on the site.

We were ever so grateful.

It’s now 10 pm and there are now 3 caravans and 9 empty bays. Now either people here turn up really late to their caravan site or someone is telling little fibs.

But oh the joys of a shower. Only two days without washing and it was still so good to stand under the shower and feel it burn on the sun burn on your face. A shower is one of life’s great pleasures. So’s a ’shar’ which is the same thing but with a northern Irish accent.

For some reason the shower curtain was covered in images of little yellow ducks with the slogan ‘bobbing along’. Seemed a tad out of place in a council public toilet.

The main reason we choose ballyronan marina is that it has a great Chinese restaurant. Every marina should have one.

We asked for a table for tea near a plug socket so we could charge the phones. Just like ray mears does.

Starters and main course and some tsing Tao later we’re having a wee dander round the marina wondering what the earliest acceptable time to go to bed is.

About now I reckon.

How to dissappear completely – part 1

(i plan to add photos to this once I get home so be patient)

So

Two years ago we did this trip. Canoe from portadown to coleraine. 4 days on the river and the lough. Outdoors, doing manly things.

Two years ago I’d just arrived back from my little escapist adventure to nz. Two years ago I looked at my life and kept repeating to myslef that I was the luckiest man alive. That no one alive had the opportunities and options and experiences that I had. Alll of which undeserved.

Two years ago we did this trip with da and he’s declined to make the repeat trip with us. Some lame excuse about being dead and all that.

Two years ago and now everything is changed. So it goes.

Nice start eh? It gets better honest.

Spent all day yesterday packing and repacking trying to think of all the things we might need, trying to see if everything we need might fit into the two canoes. Being hopeful that simon’s somewhat damaged canoe might be up for the job.

Credit to liz for our new addition of braces – old man braces from matalan – that keep the spray decks high enough to stop the water leaking in.

My spraydeck is made by perception – a repectable name in canoe circles. According to the lapel the model is ‘gaybo’ which is I suppose not so respectable in many circles. Mine is ‘gaybo’. Simy’s isn’t.

The other useful addition is 3G (or more likely GPRS) and facebook which enables me to post lovely photos while the rest of you are skiving in work on facebook or reading blogs.

Hence why I’m lying in the tent at 2345 writing this while the waves lap at the shore of the island.

Anyhow. By the time we’d eaten the requisite poached egg and bacon and remembered the stuff that Simon had forgotten we were on the water shortly after lunch.

There’s nothing that exciting on the upper bann between portadown and lough neagh. It’s nice from banbridge to portadown as previously noted. And it’s lovely on the lower bann. But this bit is mainly flood plains and cows staring at you. Simy loves cows. I don’t.

It was windy. Wind is hardly the canoeist’s friend. It just means you have to paddle twice as hard for less progress. It was a northerly wind. Kind of unfortunate seeing as we were paddling basically due north. Apart from the brief bit when due to the nature of meanders we were paddling south at one point.

The tough bit was getting out to coney. There was a fair ould swell on the lough with the wind casting up waves the full length of lough neagh. We were stuck paddling across them and it left us feeling more than a little nervous and twitchy if we were truthfully honest.

We’re into this canoeing for the scenery not the adrenaline. Waves aren’t really our thing.

But we made it. A tad damp from the splash but we made it.

Set up camp and sat round a picnic table while peter (the warden who lives on the island and a bit of an all round legend) greeted us with beer and good conversation. The man has such good stories I could listen to him all day.

BBQ and some time at the camp fire and look at the time it’s dark and we’re shattered and it’s off to bed for the Neill boys.

I haven’t even had a second to read more Churchill or try and sew my sandals back together.

Unless the lough rises 4 feet by morning or we’re killed by swine flu then we’ll still be here and I can tackle those really pressing issues then.

Bullet proof… I wish I was

On leaving no amunition available for the japenese with the impending fall of Singapore.

the obvious method is to fire the ammunition at the enemy…

Winston Churchill

History of the second world war Vol IV

It’s the end of the world as we know it

Not that I plan to turn the blog into a “swine flu is going to the end the world as we know it” blog, but some it is really quite interesting to watch it evolve.

We have changed from containment to treatment. A few days after the rest of the UK, seeing as we were a bit lower on the numbers. Which basically means that if you get flu, then it’s most likely the swine variety and we don’t test you, or we either give you the tamiflu, (which no one knows works or not by the way), and you get better or we tell you to get a box of kleenex and sit in the house for a week and you get better anyway. Or in rare cases, you actually get sick and wind up in hospital, or even rarer – you die. Which understandably what everyone is worrying about.

Currently there are mortality rates about the world quoted from anywhere in the region of 1.5% to 3%. I consider that pretty high. But remember that it overestimates the death rate cause that only counts the numbers who attend medical services and get tested. Lots of people are at home with the kleenex getting better all on their own.

We had a big meeting about in work. Lots of people in a room trying to come up with some way to plan responses. Some of whom were more useful and contributory than others. If I hear anyone else talk about “blue sky thinking” then I’ll explode.

It is reassuring to know that we have actually thought about this and if the whole thing becomes like outbreak then we do have a plan in place.

Someone managed to project figures of 400/day attending our emergency department. At the minute we see 300 on a busy day, so imagine over doubling our numbers at the drop of a hat.

Via the BMJ blogs and the NEJM I found an article (not yet published) going over some of the historical perspective of influenza outbreaks and how something like this comes about.

Regarding the reemergecne of a 1950 strain in 1977

This finding suggested that the 1977 outbreak strain had been preserved
since 1950. The reemergence was probably an accidental release from a laboratory source in the setting of waning population immunity to H1 and
N1 antigens

Sacry eh?

In a different outbreak in an american military base in 1976, there was the ideal opportunity to study th epidemiology in controlled circumstances.

[Incidentally military bases and recruits have been huge contributors in infectious disease, with studies in them revelaing links of strep to rheumatic fever and huge amounts about the bugs that cause meningitis. However it means that the applicability of the science may not hold true. In other words penicillin may not stop you getting rheumatic fever unless you're young, male, with a tendency to violence and a shaved head...]

In this case they decided to vaccinate a large proportion of the population. To the tune of 40 million. Yes that’s right – 40 million people.

To quote

The emergence of swine influenza at Fort Dix led to the implementation of a mass vaccination program, which resulted in 40 million civilian vaccinations and 532 cases of the Guillain-Barré syndrome (a rare side effect of influenza
vaccination), including 32 deaths

We killed 32 people (and gave a horrible experience to 500 others) with our vaccines. Was it worth it?

The simple question to ask if the UK were to consider a vaccination program (using purely theoretical figures – new vaccines may not cause GBS at all) is – is a 32/40,000,000 death rate acceptable in the light of a x/40,000,000 death rate from swine flu?

Too many variables in the equation as yet.

What might be more reaistic is what will be the outcome of giving vast numbers of people tamiflu. This could be one of the largest trials of efficacy and side-effect profiles in the history of therapeutics. If there are nasty side effects of tamiflu that either weren’t known about or even sweeped under the rug (have we learned the lessons from thalidomide) then they’re gonna come out be assured.

Too young to die

Robert Frobisher on choosing death over life:

People are obscenities. Would rather be music than be a mass of tubes squeezing semi-solids around itself for a few decades before becoming so dribblesome it’ll no longer function.

Cloud Atlas

David Mitchell

The sadness

OK so i’m on a roll with my BMJ RSS feed.

I find this aspect of medicine one of the most interesting and complicated boundaries of medicine and the emotional and the spiritual and the just plain old “life”.

I am completely unclear as to what to make of psychiatric illness in the context of the human experience. I have a few psychiatrist friends who i’m sure could make much more sense of all this.

I do sick people – and pretend that that just means abnormal physiology. I avoid psychiatry, leaving it as someone else’s problem, just as i do with many of the difficult ethical medical debates.

Anyhow.

One guy puts it this way:

In truth, “depression” is a very difficult thing to define and any doctor who says that they can reliably differentiate it from sadness is deluding themselves.

Another takes issue and puts it this way:

Depression is not the same as ordinary unhappiness. It is a state unlike any other I have experienced. Ideas about being vulnerable neither made me ill nor ameliorated my distress: in truth like many twenty-year olds, before it hit me I had thought myself invulnerable. Defining suffering away does not diminish it. It insults it. Be wary what you mean when you say to patients, as Ginn does: you do not need anti-depressants, you’re a lot tougher than you think. It could be the cruellest form of paternalism yet.

Any thoughts?

Pigs, sheep and wolves

There are lots of interesting things about the mass hysteria associated with swine flu.

Part of it is genuine – that one day an influenza epidemic may sweep the planet and knock off a siginificant proprtion of the human race.

Another part of it is the fact that this current swine flu epidemic seems by all standards to be pretty benign so far. It has simply gained a lot more attention.

Our place has been involved in the management of a couple of possible cases. I’m not actually sure if we’d had a confirmed one. And they have received a disproportionate amount of attention – ie “wear this mask, follow me, bypass this queue of waiting sick people, this consultant will see you immediately”. All a little bit unfair seeing as the 80 ear old granny with pneumonia has been waiting two hours.

Everyone had a 10 minute session on mask fitting that involved a computer, some tubing, and a guy getting paid 800 quid a day to say “yes the mask fits”.

The BMJ has many wonderful blogs if you’re an interested medic, and i suppose even if you’re not. Tom Nolan has been blogging on swine flu and provided this quote from a London GP.

My feeling is that the main beneficiaries of this policy are the drug company that makes Tamiflu, who must be dancing with glee at the business.  The other aspect is that I suspect Tamiflu or similar drugs will now be considered necessary for all sorts of flu in the future – plenty of future business too.

If the word swine were removed from all of this then GPs would just be doing what they always used to do – give advice about staying at home, drinking plenty of fluids and so on. The current flu seems to be no worse (and possibly even a bit better) than seasonal flu.

So why does this attract so much significant change in practise and funding (and with good reason) when simple things like ICU beds and overall hospital capacity don’t (when they have much better reasons)?

A good man is hard to find

[As is the very nature of blogs, this is the usual ill informed ranting so feel free to interject with corrections and thoughts]

OK. So something that I’ve been thinking about for a long time is this very simple truth -  that yes, indeed it’s true, all men are bastards.

Not that I’ve turned into some kind of transgender hyper feminist or anything – but i have for quite some time carried around a distinct unease about my half of the human race. Kind of like the nagging guilt you feel for being white anglo-saxon protestant. You know you are one, and you know that as a group you’ve not always covered yourselves in glory.

Now most of this is exceptionally obvious and perhaps won’t take a great deal to persuade many of you.

Violence

from as early as bearded men in universities will tell us, we’ve been adept and keen on beating the tripe out of each other. Or if not each other, then furry creatures, and if not that then nature herself. And oh how we seem to love beating the tripe out of our women folk.

Our tendencies to violence, anger and brutality are everywhere. We have left our mark in the history of human culture smeared in the blood of everyone else.

And in every context (though no doubt i can be corrected) it will be the XYs leading the way.

Open a newspaper or a news website these days and it will be full of men doing violence to others.

Of course women do violence as well, but in proportions far out weighed by what we seem to manage to achieve.

Sex

From rape, to female circumcision (although some would argue that one) and child abuse it is men leading the way. What is most horrifying is that the majority of the sexual violence committed occurs with someone that the perpetrator is in some form of relationship with. These are not random strangers. We are raping the people we love.

The recent case of the young care centre worker and mother who was convicted of sexual abuse of children in her care attracted so much attention because it went against the stereotype.

Power

No doubt linked in many ways with the former two, but if you get asked to name significant historical figures you’ll come up with a whole lot of blokes. Be they good or bad.

In the modern age, despite a major shift in thought, there are still huge pay discrepancies and differences in who is more likely to hold a more senior position be it from academia to business to medicine.

Relationships

Now this is where it gets controversial and mainly anecdotal. You look around some times at people you come in contact with and you ask yourself the simple question – “why the flip are with you going out with that person?”

And the majority (though not nearly so over overwhelmingly as the others) of the time i find myself asking the question of why the girl is with the boy. I don’t get it, he’s an idiot, why are you with him?

I have wisely learned to keep such opinions to myself you’ll be glad to hear.

Even more anecdotally and unsupported – my limited experience with adultery (please don’t read into that too much) seems to tell me yet again it seems that the men are the bastards. Though this must be untrue to some degree because unless married men only sleep with single women then surely the split must be more equal than that.

Parenting

Where I live is one of the more socially deprived areas of town. Not that they’re eating grass or living in tents like the proper poor places of the world. But there is a huge increased prevalence of single parent house holds. And yes, almost inevitably these will be led by women.

There’s a great line in Fight Club when Tyler says that we’re a generation of men raised by women and that another women is the last thing we need. Which perhaps side steps the obvious point that it is the men who have abdicated their role in the upbringing.

Is it too facile to see some truth in this? [Genuine question, I've never quite understood the verse].

—

Is it all as simple as a social construct, that we got all the power at an early stage in human culture and we’ve simply taken it to its logical conclusion? That if women were in our position they’d be just the same?

Even if it is an accident of history and biology that we have become the perpetrators of such evil then what are we doing about working against it. We are meant to be some kind of counter-cultural force in the world.

So i suppose from this slightly ashamed member of half of the human race comes a humble apology for my association with it.

Coney Island

Last of my wee fun trips for my week off. I must say i think i’ve done well.

Have been going on about Coney Island to Gilly that he’s finally agreed to come for a trip. Him and wee Phil.

And such a cracker day we got.

Along with all the wonderful foodie goodies for a cracking BBQ. All except the charcoal of course. Not exactly covering myself in glory there. Some kind folks who were leaving as we arrived let us use the remains of their portable BBQ and in the end we were just fine.

Long evening spent chatting over the rather deafening roar of the most recent hatch of lough neagh flies making sweet love overhead. Has to be heard to be believed i suppose.

Spent a largely sleepless night listening to the herons. Who are in fact a well known nesting bird on the island and not an uber cool indie band as you might suspect.

Good times.

An Ocean and a Rock – Part 3

Woke very hot and sweaty in the tent. The sun had been shining strongly since 5am and last night’s bacon had left me with a dreadful thirst.

Otherwise a wonderful night’s sleep.

But farewell to rosse’s point and it’s overly expensive (but very pretty) campsite where the showers were one euro extra.

I had to be in greystones for 6pm, some 180 miles away. But I had time. Time I though to lie by a lough on the Shannon water way and doze off in the sun reading the Irish times.

Hunger got the better of me and I ended up eating fish and chips in a retail park car park in Carrick on Shannon wishing I had a canoe with me.

(Me and wee phil have great plans to canoe from Fermanagh to Limerick in September. We originally planned a week but some basic initial research makes me think two might be more appropriate. Or that a motor cruiser might be even more appropriate)

The difference between the roads in NZ and Ireland is the views. In NZ you were bowled over by spectacular scenery at every corner and there were endless view points to pull in and take photos.

It’s just that in Ireland they built all the decent roads through the flat boring bits of the country and you’re continually given glimpses of stunning vistas just round the corner or over the hedge. But they’re always just out of reach and require actual effort to see.

None of that was convenient for today’s trip. So I drove cross country listening to whatever was loud and raucous and losing my voice in the high notes getting my right arm burned as it sat out the window – the hazards of driving south west in the afternoon in the northern hemisphere.

I did make an ill advised detour round the Wicklow hills, geting horribly and wonderfully lost up shady country lanes filled with nothing but flashy looking SUVs.

I stopped briefly at the sally gap to admire the quite spectacular view and the weather. On a sunny day I’m not sure I’ve seen anywhere nicer than Ireland.

And so I pulled into Greystones about 5 pm and promptly paid 50 cent for the priviledge of almost getting locked in the public toilet at the beach. I have still no idea why the exit button was at ground level. Answers on a postcard please.

Sat in the shade trying to avoid more uv on the already crispy right forearm and waited for transfarmer to come pick me up.

After a night of volleyball, singing, pub and cigars with lots of lovely people such as soapbox and smallcorner (and lots of other people who are just as lovely but don’t have blogs), I’ve managed to score a free room with ensuite. As fun as sleeping on the beach is I’ll not complain.

An Ocean and a Rock – part 2

This is, as the saying goes almost as good as it gets. Back against the Volvo facing the sun, full belly, mumford and sons and a setting sun.

But more of that when we get to it.

Rained most of the night. Not that I noticed it. The tent did me proud. Woke to a grey but at least a dry day.

Packed up and waved goodbye to the duke of edinburgh group with their house sized packs on their backs.

I had planned originally to scale the heights of slieve league (the sixth highest sea cliffs in Europe wouldn’t you know) but the weather seemed to have other ideas.

Half a mile up the track the track ended completely and all that was visible was the mist at the end of your nose. You could hear the sea some several hundred metres below but you couldn’t see it.

To be perfectly frank (though only if I can still be garth) I hadn’t a notion where I was or which direction to walk in. I ended up with a view like this:

Caution and the voice of wee liz in my head turned me back.

I found the car park full of malcontented Frenchmen bemoaning the dreary Irish weather preventing their attempt at the summit. Though all this is assumption. They may have been talking about garlic and onions or talking about detonating bombs in the south pacific for all I know. I’m pretty sure they didn’t mention the youth hostel – beyond that is conjecture.

[brief interlude.  There's a guy on a ride on a ride on lawnmower driving in increasingly smaller concentric circles round my tent. I'm not entirely sure I want my toenails cut at this juncture]

from there I took the long and windy road (they’re all long and windy round here) back to Killybegs and beyond stopping only to lie on the beach for a while reading cloud atlas in Fintragh bay. The sun threatened an appearance.

Through Donegal town and on to Murvagh beach where I simply fell asleep with the seat back listening to whatever Sigur Ros had to offer.

I had already by this stage decided on the camp site I’m now in. By the usual method of looking at the end of the road in the map and seeing what’s there.

So at 4pm I rolled into Rosse’s point. Which may just he the definition of sleepy Irish village. The island across the bay from the camp site is for sale. I know this because there’s a big sign on it saying  ‘for sale – oyster island’. I’d love to know much. Imagine starting on the property ladder with your very own island. Beats a semi in suburbia.

There is also another Coney island just across from the oyster island. That brings my total to 4 Coney Islands now.

I opted for a camp site – the need for a functioning toilet and personal hygiene becoming of greater significance as the day wore on.

And after a quick dander round the night life (there is none) and a quick pint and the paper I’m back at the site with my back against the volvo, full belly, mumford and sons and a setting sun.

Oh yes that’s where we started wasn’t it.

An Ocean and a Rock – Part 1

I am somewhat addicted to the road trip. I am also somewhat addicted to my Volvo. I am yet to get round to sleeping in it but plan to make every effort on this trip.

But first some background.

It’s not like I have any idea where I head to. I lay the map out on the table the day before and look for the bits with the fewest roads and go there.

Turns out there are an exceptional number of places in Ireland with little bays and little beaches and not very many roads.

But I have to picture what all of these look like in my head. And in my head they’re always sunny – which is always hopeful in Ireland. Either that or look them up on google and inevitably there will be lots of photos from flickr or videos on YouTube by some german guy. It gives you the gist of the place.

So anyhow. I’ve now ended up in Malin Beg. Somewhere west of the west of Ireland. West donegal to be precise. I don’t think there’s much between me and the Americas. Except the Atlantic ocean of course.
I drove 3 hours solid to get here through mist and fog – just to get here and find that it’s, well misty and foggy…

I still think it looks pretty sweet.

At the car park a duke of Edinburgh group were pitching their tents, a slightly concerned but impatient school teacher in attendance – “have you put the water on to boil yet, what are you two planning to have for tea?”. All that kind if thing.

The two blokes seemed to be loving it. I’m not sure the same good be said of the girls. Though I can’t really blame them if I had to walk Slieve League in the fog and rain I’d be pissed off too.

Funnily enough that’s what I have planned for tomorrow.

The beach is about a 100 yds below the car park (it may only be 50 but I’m kind of crap with vertical distances and 100 yds sounds like the kind of thing someone might say) and was thankfully deserted apart from the dying embers of a camp fire that I presumed someone had left.

So I pitched the tent. The nice new one I treated myself to for the birthday. The one I’ve only put up the once when me and skeeno tried it out in the living room.

So of course I put it up wrong to start with. It was to be expected.

Stoked the fire has best I could with the conveniently stacked fire wood and lit the mini grill and got the burgers going.

Only to find a rather sheepish young polish woman walking towards me wondering if she could maybe have some of the firewood that her and her boyfriend had collected for their camp fire this evening.

Oh dear. I appeared to have stolen not only their lit fire but also their firewood and ideal camp site on the beach.

I felt immensely bad about this. Not that they had left anything to suggest that it was their camp fire. It was just a fire and a pile of wood.

I decided against an ill advised rant about possession being nine tenths of the law – being somewhat uncertain as to how the law stands in relation to ownership of a fire already in progress.

After recent events in Belfast I could just picture the news headlines – Norn Irish prick steals vital heat source from homeless immigrant.

Turns out she’s polish and the boyfriend is Irish so all round I think I’m in the clear.

I did feel bad enough to go round the beach and collect them some new fire wood. It salved the conscience somewhat.

So with tent erected and burgers cooked and fire blazing – well maybe not blazing, more ’smoking intensely’ – I can finally settle down to read the book in peace. Though it does seem like an awful lit of effort just for that.

Nice places to walk the dog – No. 10

Seeing as Simy has abandoned the puppy for the weekend (she was crying little puppy tears, all dishevelled in a pile of her own excrement when i rescued her, the RSPCA have been informed) – i figured i’d give her a taste of the good life and bring her to a bog for a day.

I also managed to find her a new friend in the form of a rather mental, and unsurprisingly much more intelligent springer spaniel called Annie.

I remember being in Peatlands Park once as a kid, on some school trip or something. I remember it had a train.

I had forgotten how wonderful a place it was.

Apparently it “was specifically established to promote and facilitate peatland awareness and issues”. I was unaware that I needed to be made aware of the issue. Or indeed that peatland had any issues to start with.

This year they’re holding the 5th annual bog snorkling champonships there. Nuff said

The dogs had their own version today. Just without the snorkels. Never have i seen the dog more muddy. She loved every minute of it. Though I’m not sure she’s quite self-aware enough to love – she did seem to be mighty content all the same.

Into the void

Sometimes i’d yell questions at the rocks and the trees, and across gorges, or yodel – “what is the meaning of the void?” the answer was perfect silence, so i knew.

no man should go through life without once experiencing healthy, even bored solitude in the wilderness, finding himself depending solely on himself and thereby learning his true and hidden strength – learning for instance, to eat when he’s hungry and sleep when he’s sleepy

Jack Kerouac

Lonesome traveller

Put the book back on the shelf

I should not be allowed to read books like this. They cannot be healthy reading for a chap of a certain disposition.

It began with the dressing station, a book I borrowed off another young, idealistic south african doctor while I was over there on placement.

If doctors have a tendency to have some kind of saviour complex then I whole heartedly sign up to it. Part of the reason I got into this job is this odd, naive notion that I am going to save the world.

The practice of medicine for me is one big emotional rollercoaster. You have to be of a certain disposition to really go and seek out misery, but that seems to be what I do. Enjoy is the wrong word for it. But at least it seems honest and real. At least it reminds me of what it is to be alive.

So reading six months in sudan was just tapping into someone elses experience. Empathising and feeling every moment, understanding every reaction.

I am honest enough to admit that part of me wants to do the same – live in a hut in deepest, darkest Africa, get paid nothing, eat crap, sleep little and work myself into the ground till I slowly come to pieces.

I have a tendency to self-destruction, and a tendency to pious self-righteousness. What better way to combine them?

The very reasons that I’d be really quite good at this kind of thing are perhaps the very reasons to stay away from it.

If I want to save the world I’d be better giving my money to people here. If I want to save lives, I’d be better off as a water and sanitation engineer than a doctor. But no one makes books or TV programs about that.

Health care may indeed be a noble profession but I know full well that I do it mainly cause it makes me feel good. There is something so much more self-satisfying about resuscitating an infant with meningitis in a bush hospital than there is about putting in an effective sanitation system in a refugee camp and saving 2000 lives at a stroke.

Different names for the same thing

Americans do medicine differently. I’m not saying better. Just differently.

Sometimes they do it a whole lot better, if you have the money, they seem to do it a whole lot better. Your symptoms will get investigated, and investigated, and investigated some more till they’ve taken so much blood you need a transfusion and you’ve had a camera in every orifice.

You’ve seen House. Well it’s kind of like that. Without the humour, sarcasm and the saving lives.

Sometimes they do the whole medicine thing a lot worse. Like when you don’t have a great deal of money. Which when you look at it is really quite a large number of people.

It is the inequality in the medical care in the USA (or any wholly private system) that offends my little bleeding heart.

On the other hand i’d like to have the resources to stick all the patients through the answer box (also known as the CT scanner…) who i think actually need one.

Anyhow.

The medical literature is the source of all these rather academic articles that study fancy new tests and recommend how best to look after your sore toe.

One of my favourites is the case records of the Massachusetts General Hospital (MGH) in the New England Journal of Medicine. These are records of case discussions by groups of erudite doctors who speak very politely to each other (presumably they know they’re being published…) about complicated histories and tests of sick people.

Invariably they go through countless blood tests, consultations and scans till either the patient dies or someone actually gets the diagnosis. And quite often they still die because the disease that is finally diagnosed is so rare that no one actually knows how to treat it.

The most recent I read was from a MGH affiliated hospital in South Africa where the MGH sends its trainees to teach them actual clinical medicine – as opposed to just putting them through an answer box.

The case describes the gradual and slow decline and ultimate death of a young woman with HIV and TB. It is depressingly familiar.

There is then this absurd commentary by renowned experts on what should have been done, and all the fancy tests they could have done to work out was going on. All this with references to the difficulties faced in resource-limited environments.

The sheer gulf between the level of care that that young woman would have got in the MGH compared with what was available in South Africa is staggering.

And perhaps unlike the usual case reports this woman died, not because she had some horrible, rare disease that it took a billion tests to diagnose.

She died because she had a nasty but common and treatable disease in South Africa.

Storm in a teacup

My church had a special wee service to commemorate the 1859 revival that happened in Ulster in… well 1859 i suppose. I know very little about it. I wasn’t born at the time.

The original plan was to have it down beside the wee bowling green in town. You would think in the midst of the Northern Irish summer that you’d be guaranteed a clear, dry summer’s day and there’d be BBQ’s and jumpers for goalposts and it would all be lovely.

Not quite.

There was really quite a lot of thunder and lightning. Some people used to see that as an omen of the gods. When it comes to running a PA rig outdoors then I suppose I still do.

So we packed everything back in the van and went back to the church and unpacked it all in the hall (this was plan B).

Of course at that point it then became very sunny and pleasant. And being the nice, enthusiastic church people we are, everyone plodded back down to town to stand in the sun for a few minutes and hear the moderator speak.

And of course the thunder and lightning came on again and they all got very wet.

I stayed in the hall with the sound monkeys eating the biscuits.

Anyhow. After all the wetting and drying and the singing there was the obligatory cup of tea and a chat.

Standing on the stage packing up the drum kit I decided that there is often more grace and humility and love in a bourbon and a cup of tea than there is in so much of the rest of what we do.

This is a radical concept, but during this point of our time together, people actually smile. They laugh, they even embrace. It is perhaps at this point more than most that we seem together.

As cynical I can be about how the church does the business of church – it is often in the cups of tea and dear old men and ladies wiping tables and young guys packing up sound gear that I find myself most content and happy to be part of all this.

Yes, as zoomie rants, it would be easier to walk away, to gripe and to moan and disengage but under (and it may really be quite far under…)  the politics, and the bureaucracy and the conservatism there is pure gold. And surely that’s something worth sticking around for.

Perfect love, gone wrong

[Some thoughts, only very briefly and incompletely considered.]

There’s this rather uncomfortable bit in Acts 5. Where up to now everyone has been all, “hope, renewal, restoration and the resurrection”. Then we have this slightly jarring bit where the now infamous Ananias and Saphhira hold back some money for themselves and lie about it and next thing you know they’re dead and buried. (Sorry if i paraphrase that too much.)

And it leaves many of us deeply uncomfortable. We’ve just been getting used to this nice, new fluffy god, who seems really quite unlike that wrathful, angry god in the OT (though of course both are just caricatures) – and then this happens.

We are mostly struck by how disproportionate it seems. Yes they fibbed about the money, but being struck dead is perhaps a bit over the top. We are still addicted to our own legalism and sense of justice it seems. Perhaps we’re just too scared for our own skins.

But when you think about it people were probably doing much worse throughout the church at the time and they weren’t dropping dead. So why these two?

Leaving aside, the interesting references to the OT (in the use of the greek nosphizein and perhaps reference to the holiness of the ark), we got into a bit of a discussion this morning on what happened and what the underlying  point (if there was one) was.

Though GOD does seem to punish certain sins in very specific, easily recognisable ways – this is more the exception than the rule. In general we trust (or at least are meant to) GOD for justice, in his time and his way.

We tread on very thin ice when we try to link certain individual happenings to certain individual sins – think of those who feel the holocaust is just punishment for the Jewish people for crucifying JESUS, or those who feel that HIV is a just punishment for homosexuals.

So if they didn’t die for this one particular sin, what what then did Ananias and Sapphira die for? What, almost unforgivable sin had they committed to bring about such a direct and obvious punishment.

And this leaves us with one of those quite basic fundamentals of faith, basic though not exactly simple. That in many ways people get exactly what they want. Like Renton says in trainspotting – choose life , or indeed choose not to choose life.

That at one level we get exactly what we want. Those who choose themselves get just that, they get themselves, shut up and locked inside themselves, like the hell depicted in the great divorce.

And is what happened in Acts 5 just that – the outworkings of choice in someone’s life? The final step and decision of a life that had chosen self over other, self over beauty, and self over all else?

Almost forget myself

if the world exists not chiefly that we may love GOD but that GOD may love us, yet that very fact, on a deeper level, is so for all our sakes

CS Lewis

Problem of Pain

I don’t want to spoil the party

Despite having a Paul that looked more like a mixture of the office and David Brent, the Beatles tribute act we went to see last night were pretty sweet.

Note the, middle aged, overweight, grade IV mallampati giving it dixie up front.

I could watch live music till the cows come home, covers or not.

Not so fussed on watching your mates mince it up to I Will Survive afterwards though. Bless ‘em.