A year of ups and downs

I will be putting stuff into this bit later

Ups of course is Lucas, with the down of him and Emily going back to America

Up is becoming Clinical Director of Central Manchester Clinical Commissioning group, down is being made to go to see if I'm mental (which I'm not, I don't think)

Up is going to the gym more, down is finally accepting I can't be bothered playing football

Up is being single and pleasing myself, down is being single and having no one else to please.

Wishes for this year
Get back to 85 Kg and stay fit, make a difference in CCG, do the cardiology clinic somewhere else, visit America and perhaps India, get down to Devon at least three times

Radio 4 Christmas service

The night before last I went to take part in the recording of the Radio 4 Christmas service, at Emanuel church. Listen in, you might catch my voice singing heartily to some great tunes. It is actually a lovely service and John Bell was as insightful and uplifting as ever

Socrates is dead

I suppose I better start thinking about Christmas presents.
The last week or so has been a bit distracting. I had my iPad stolen in a house brake in. My work colleagues and I have not been seeing eye to eye, and Emily and Lucas have gone back to America. To cap it all, Brazilian football captain, doctor, politician and the player on whom my own illustrious career was modelled, Socrates, is dead. His smoking, excessive drinking and womanising finally caught up with him. For him football and life was an art, to be enjoyed rather than fretted about. I shall mourn him, as I mourn my own football career coming to an end.
Losing Emily and Lucas for Christmas has been the hardest to bare, but they managed the journey without trouble and are safely in their new home. Skype, for those of us in the 21st century, is a brilliant way of keeping in touch with people too far away to visit frequently.
The loss of the iPad and fixing the smashed in back patio door was hugely irritating. Unfortunately I can't really blame anyone but myself. The keys were in the glass door, the iPad was on show on the kitchen table and blinds open, and the lights were on and illuminating the whole place. The only consolation is that the insurance company has sorted everything out just effortlessly. I will need to reconfigure my new iPad, but I'm hoping someone can do that for me.
Work wise we seem to have come to an agreement about the partnership share due to my reduced involvement. I'm happy with it at any rate. Now I can focus on the job of Clinical Director in the brave new NHS.
The 'ConDem' changes seem to have sparked furious outrage from the Left who have become most indignant at the Government's effrontery in privatising the NHS. They forget that it was the Labour Government who started the process. I didn't hear their strident voices back me up in 2005. Nevertheless we are where we are, and I actually think there is an opportunity now to really give some radical thought to how services are provided. I think there is a chance for a 21st century co-operative movement within the NHS. I just hope someone has the courage, leadership and will to see it that way.
Now what shall I get everyone for Christmas?  But first, let me see if Emily is awake yet in Stanford Connecticut.

Should I stay or should I go?

I had a constructive discussion with my partners today. The reality of the possibility of me leaving may have made them review their position. They seem keener to keep me at the practice, but need to await the accounts before deciding which way to go. Meanwhile I'm exploring options myself ...it's certainly an adventure

Resignation to inevitable change

Today I resigned from my partnership with the practice. I am now free to do what ever I want, well from June anyway

Change is a foot

Dear followers,
The last few weeks have been very difficult for me and it has become very clear that I can no longer work with my partners. This space is too public to record the detail, but I fear that the relationship has broken down. My quandry is what to do now.
I have to work at least two sessions a week in a central Manchester practice to be able to undertake the job of clinical director. This is my priority. However, there are other even more exciting options which I wont go into at this stage.
It is interesting that once the fear is gone, in this case of leaving the comfort of the partnership, all sorts of options become available as your imagination begins to take change. The fear had blocked the imagination, and now it is free and wild again. So I might take a brief financial hit, but not for long. Remember I've done it before. The fear of divorce is worse than the event intself, I should know. In the end, doing the right thing by yourself is the most important thing.
There's a song that Dido, of all people, does that has helped through times of trouble like this. It is about a broken relationship, and has the words 'I promise you you'll see the sun again'. I've been playing it to myself a lot the last week.
The theme in church at the moment is 'lament' which is such a great word. i think I'm emerging from the lament phase again. We'll see

Running up to retirement

The end of an exciting week. What has become clear to me is that I do like my work, but the people I'm working with don't have either the intellectual capacity, whit or humour, to make it worth carrying on for any longer than is necessary.
So I am resolved to retire from the NHS pension scheme on my sixtieth birthday. By that time I will have made sufficient contribution to have a comfortable time of it. I will be continuing to work for the NHS, but perhaps in a more gentle way, and spend more time with my family.

The next five years in the practice is about just keeping my head down and getting on with it. Then I shall draw out the capital from the practice, and thank you very much but goodbye.

Clinical Director

Yes, it's official. I am Clinical Director of Central Manchester Clinical Commissioning Group. This means I'm in charge of improving quality in GP surgeries, and monitoring and managing performance with the local hospital. How exciting. You know what, I'm good at it too.

Meanwhile tomorrow I have to go for a 'medical' which my jealous partners have insisted I go for. They think I'm going crazy or something. It's been a spectacular display of passive aggression played at its most aggressive. As I know I'm completely sane, I don't think there'll be a problem. hahaha, hahaha, twitch twitch.

I was at a meeting today with them all, including a consultant psychiatrist. I think he'll be a good witness.
So here's to the next four years, that's how long we have to save the NHS.

Interview for CCG

I was interviewed today to test my competence for being on the new Clinical Commissioning Board. Although I say so myself, I was brilliant. The questions were unprepared, but I was on a role, man. I even impressed myself with what I was saying. I could see them thinking, 'wow, he's good' and 'I wish I'd thought of that'.
What a contrast to those idiots that I currently work with, who have no idea and take me entirely for granted. They will miss me when I no longer need them.
You see, outside the practice, things couldn't be any better. I'm achieving stuff. Making decisions. Making things better. I think my partners are jealous really. OK envious. They just don't like to think that their boring lives are carrying on just as they are.
As soon as I can I will leave that poisoned environment, and let them to rot in their own self-satisfied poo. Then they can use it to fertilise their alotments, and good luck to them. Well at least they'll have nice roses.
The sap of confidence is rising again.

Looking ahead

The greatest derby in world, the head lines blaze. Manchester United against a newly invigorated Manchester City. Spookily the league tables from the 1960s put United and City equal top of the league. Just as they are now. Still the papers may be over hyping the occasion. In other cities there seems to be genuine hatred, Glasgow, Milan, North London, but in Manchester I don't get the same sense of hatred. Sure there's rivalry, and no shortage of fervent banter, but hatred? I don't recognise that. There seems to be much more mixing of people supporting either team and the sectarian origins have been forgotten. There's a new movement spreading around the bill boards. I love Manchester, like the I love NY campaign, seems to be spreading.

Emily, Anne, Lucas and me, all went over to Leeds yesterday to see Lizzy. We had lunch in a Leeds United pub. There were photographs of the old Leeds team. Now that was a hated team.

Earlier in the week I put an offer in for a house in Chorlton. A house about half the size was going to be about the same price as I'd get for my present house. The sums didn't add up. Besides I love my present house. It has everything I need.

At work things are a little easier. I have reduced my working time to three half days a week, allowing more time to focus on other things. Principally I would like to do more writing and in due course to the Clinical Commissioning Group, and weekends in London to see Jonnie and Rachel.

Rivalry, hatred and betrayal are strong words to use in recent blogs. It's time to put those words back in their box marked 'looser', and open the box marked 'winner'. Come on you Reds! and good luck you Blues, lets hope for a jolly good contest and make Manchester the winner.

I love Manchester and my house

A dark week at work

I have lost all my trust in my partners after this week. It is difficult to put into words exactly how I feel. There is a mixture of anger, sadness, betrayal. Tim seems to dragging up everything that's upset him from the past, and all too easily believes he's put on. Avril is pretending to care and really wants to stick the knife in.
On the up side Lucas is fabulous, especially when dreaming. His little face and mouth is just amazing. He smiles and gurles to himself, and he smells just like a baby

80th on the 8th October

It was my Dads 80th birthday yesterday. We all met up in Manchester at Sacha's. Lucas was of course on show, and everyone had a fun time. These occasions don't happen that often and it's good to make the most of them. Meanwhile also I have been asked to debate with another doctor at the Renal Association in May. Quite an honour for a conservative bunch of hospital doctors. Also submitted two papers for publication. It's all go.

Winkleigh - best town in England

'It's not our dogs that don't get on with others, it's other dogs that don't get on with ours', the new publican of the Kings Arms declared without any irony. We were sitting in the beer garden of the main pub in Winkleigh. The same Winkleigh that had been on National TV as the best place in England to live, only last week. The Kings Arms has always been the centre of Winkley life and the arrival of the tattooed, blinged new cockney landlord seems to have left the locals rather apprehensive about what the future holds. Earlier Ade and I had had a beer in the other pub, the Seven Stars, which seems like a safer alternative.
This week I've been at the Primary Care Cardiology Society annual scientific conference in Bristol. I  have made four presentations, displayed three posters, and done a piece to camera for one of the Primary Care journals. It has been exhausting. I am now not just the one who talks about commissioning, but also the one who one who knows about heart rate. There'll also be some publications out of it.
So instead of coming straight home I've stayed in the South West to see Sue and Ade, and the weather is glorious. Devon is such a beautiful county, with its undulating scenery and narrow lanes, and today is about the hotest of the year.
On the day I arrived, Friday, we went for dinner in Chumleigh at the Red Lion pub. The restaurant there has been revamped, and well worth a visit. It had a good atmosphere, new decor and good value food.
Today it was time to come home. I've missed Lucas and Emily. I flew back from Exeter, so on the way we called in to Tarr Steps. The walk through the wood and by the stream was hot and crowded, but worth the detour. Then on to the airport after a pub lunch, and now I'm back home with my daughter and grandson.
Its been a long week, but a very satisfying one. I'd love to spend more time in Devon, but I love being home too.

A wakeful night in prospect

I love them staying at my house. Lucas's face has changed already and lost it's new born wrinkliness. He's feeding well. Mother and baby are doing just fine. His grandfather is doing fine too. There's only one person, so far, who can call me grandpa, and he can't speak yet.
It's still only day 2 but he seems to have been around a while. He's poohing and crying and feeding and sleeping, just as he should. It's now 11.30 at night and I've been admiring my beautiful daughter admiring her newborn. She's a natural.
We've had uncles and aunts and great uncles and great aunts, and great grandmothers round.
Now I can go to sleep, but downstairs some crying has begun.
I hope they are OK.

Welcome to the world Lucas

'Come, you can come up now' she beckoned. We had gathered at Stepping Hill Hospital's Maternity Unit and were waiting outside Debbie's office. She looked excited, and we knew what that meant, so we became excited too. We hurried up stairs to the delivery suite.
Behind the door a baby cried. The bright 'I've arrived' cry of a new born. We looked at each other and beamed with joy.
'It's us, can we came in?' Debbie knocked on the door and peered round the corner. Then opened the door to let us in.
Emily waddled gingerly out of the shower. Sean was holding his new son,and my new grandson!

He had arrived safely, but not without a long overnight effort. The new parents looked surprisingly bright considering their ordeal. For now, they are on adrenalin overdrive, and cloud nine. 'Next time I'm having an f***ing epidural', but she wont, she'll soon forget.
Lucas, as his name seems to be emerging, is seven pounds and four ounces, has a slightly squashed head and big blue eyes, and gorgeous.

Fame at last

London, Paris and Lyon is where I've been over the last month or so. Since the brain infarct, which has affected a quarter of my visual field and also affected my visual awareness of where I am, I wondered whether I can get about on my own. I now know that I can and there's no need to worry about getting lost. In fact the theme of last few weeks have been about strokes.

Paris was my first stop on this mini tour. It was for the European Society of Cardiology, which stretches over the last weekend in August. I was staying at a Novotel in La Defense, a modern business centre on the outskirts and two metro changes from the conference centre. The big news of the conference was the presentation of new evidence that drugs for atrial fibrillation can prevent strokes as effectively as warfarin and as safely. The trouble is they are expensive. So much of the discussion there, and subsequently by e-mail, has been about who should go on these drugs. On one of the days, Tuesday, I went on my own site seeing. I walked from the Arc De Triomphe down the Champs Elysee to the Louvre. It's a long walk, maybe two or three kilometres, and the sun was hot. Still, I thought, the Mona Lisa would be worth it. The Louvre is closed on Tuesdays. Oh well.
One of the things I enjoy most about these conferences is meeting up with other prominent GPs with an interest in Cardiology. On the Sunday I met up with some of them and we went for a wonder around the area surrounding Notre Dame, stopping here and there for a drink in the sun. There was Terry, just written NICE guidelines on hypertension; Andreas, written extensively on Atrial Fibrillation; Matt the Atrial Fidrillation National lead; and Kathryn, the president of the Primay Care cardiology society. Between us we thought we'd be looking back on this conference as the time when anticoagulation moved into the new century and remembering the days when we used to use warfarin. I think that's a bit premature and will have to wait until the cost of the drugs fall. There is still a Luddite section of the medical community, mainly medicines management people, who can't see a good thing when it hits them in the face and seem intent on cost containment, well, at all costs.

Lyon has been my next stop. Much less well known than Paris or London, but now a centre of international affairs an a United Nations hub in Europe. I went there with my mum to visit my sister. Heather lives there with Chris her husband. Chris is the director of the UN cancer registry and so is important enough to have a personal chaufeur and carries diplomatic number plates. Cool or what? Sometimes I think Heather thinks we should be envious of this lifestyle, but frankly I'm not and i don't think my siblings are either. I have enough of living out of a suitcase. Their children are either living away or studying elsewhere as so we have them to ourselves. They live in a wonderful part of the world, and there's no doubt that city itself, and surroundings are beautiful. They live in a prestigious part of Lyon known as the Mont D'Or where the stone is a golden coloured sandstone. Lyon has a fabulous public transport system which mum and I get to know remarkably easily and by chance. We went for a walk from Heather's house on our first day, not realising the Lyon itself, was miles away. Eventually we saw a bus paaing and hailed it down. For two Euros it took us all the way to the Gare de Vaise and from there we go the metro to Vieux Lyon. We got back on our own as well.
Heather spends much of her time travelling with Chris or entertaining visiting dignitaries, but she also works on a project with the local Neurology Institute, mapping parts of the brain shown up using the latest MRI brain imaging. She has worked for many years with stroke patients, understanding which parts of the brain do what. I've often thought that since such scanning techniques have come along, we no longer need neurologists, but I suspect many would think that was going too far.

Now I'm in London, seeing Rachel and Jonny. Both now live in London. Rachel has a traing contract with a law firm, and Jonny is working as a carer while deciding what to do long term. We've done different stuff, but mainly it's about being with them. Last night though, last night was spectacular. During the day was a 'end of summer' festival on the South Bank which was to be followed at night by a firework display. The festival was busy, bright and good to be at, but there's only so many stalls you can look at. The highlight was in the evening. We booked a table at the OXO building brasserie. This is an expensive venue to eat, but is at the top of a tall building overlooking the river, and above where the fireworks were to be let off. They must do great firework displays in Sydney and Paris and New York, but this was the best I have ever seen. It went on and on, lighting the sky with greens reds blues and yellows, and banging fizzing and whirling. Brilliant, literally. Cost of the evening. £250.

Earlier in the day we got to hear that the article which had been commissioned about me had been published in the Sunday Times supplement. I haven't seen it yet. People say the pictures are good. The article is about having a stroke and what that means for me as a currently practicing GP. One thing's for sure, these new drugs are going to stop a lot of people from having strokes. If publicising it means I become famous, I'll just have to live with it, and I haven't got a single penny from it.

My birthday yesterday

I was 55 years old yesterday. I worked all day and went for dinner with Emily in the evening at Leo's. Then I went for a drink with with Tim. This morning Avril said she was worried about my health and should get a check up! What's that all about? She says I'm forgetful. I don't think so but it's really weird. The more you say you are OK, the more it sounds like you're being defensive and/or covering up inadequacies. Maybe she's right, but I don't think so. I think I just want to withdraw a little from day to day practice.
I can't remember when I last looked forward to seeing my partners!

Faith restored

I went to a church service today in St Ann's church in the middle of Manchester this afternoon. There were lots of good people there, if rather charismatic for my taste. Then I went to a peaceful, energetic and vibrant Moss Side carnival, celebrating 30 years of good community relations since the riots of 1981. That's got to be ironic.

The person of the moment though, is Tariq Jahan, a Muslim whose son was killed the other night. Such calm and grace and Godly presence. I don't think the girl next to me in St Ann's church was very pleased that I called his words, the voice of God. Someone on 'Any Questions' called for him to be knighted. I agree.

So there is hope in the City, and things we can build on.

Manchester riots

They have brought shame on our proud city.

These are mindless hopeless young thugs, but they have spread their miserable despair to the rest of us.

Now, today, it's turning to racial tension, as if it wasn't bad enough.

God help us.

Charity Shield

The season is off to a fabulous start. 3-2 United, nothing more to say.

Kona Grill, Stamford, USA

I was sitting in this bar yesterday with my new iPad2, but couldn't type anything. I felt like the boy in the public toilet. You know.
'Here I sit, broken hearted. Paid a penny and only ...ted'
Oh well.
Speedos are not the thing to wear in America. They seem to cause much amusement. Our waiter at the Kona Grill completely cracked up when i said the reason I'd got an iPad was that the Apple shop has given it to me cut price, cos i went in there with my speedos on. He was so amused he went and told the others waiters, and they all came to look at me.
So no speedos in America.

Breakfast at Tiffany's

If you want breakfast in New York, don't go to Tiffany's. It a jeweller's shop, not a cafe. That's what we discovered yesterday morning on my first full day in Manhattan NY.
We had checked in to the Marriott Marquis hotel on Time Square. Yep, over looking Times Square itself. Even from the window of the 15th floor room the giant signs glared down, some staring impassively, some flashing insistently.
New York is certainly amazing. I had been a bit crest fallen the day before. I was expecting an article about me to be published in the Sunday Times supplement, but there was no edition this week. A bit embarrassing after letting everyone I know that this was going to happen. I am assured that it will be published sometime soon.
On that day, yesterday, Emily and Sean had treated us to a boat trip in the bay and around the Statue of Liberty. There was a buffet, with as much as you could eat and karaoke and a disco as well. Sean's mum Beth joined us and we spent a merry afternoon seeing the sights by river boat.
So the next day we wanted to do some sight seeing, starting with breakfast at Tiffany's. Instead we ended up virtually opposite at the 'Great American Health Bar, 5th Avenue' instead. A less healthy cafe I'd struggle to find, and we think the justification for the name came from the couple of leaves of lettuce that were served up with the fried food. This place is not recommended.
Then after we wandered around, we went to the Rockefeller Building and saw where the Christmas tree and ice rink are, called in to the Apple Shop, then on to Central Park. The park is huge, so with Emily being pregnant I thought we'd have a look at it in the traditional way, a horse and trap. We saw all the sights including the 'friends fountain'. The day I arrived New York was recording record temperatures, but today was lovely, in fact it rained later and nobody minded.
In the evening we met Sean's friend 'Al', the one who has been kicked out to accommodate the new arrangements. We were joined by Lydia, Emily's cousin for dinner at Tony's restaurant somewhere in Manhattan, where they serve 'family' portions. In other words plates that will feed two or three people.
After a couple of bottles of wine and too much food, the jet lag caught up. It had been a great day for family and Friends. I fell asleep instantly.

The business, it's a funny old one

I know why they call it business class now, because that's what it is. Leg room, reclining, headphones with soothing music, champagne till it comes out of your ears, first on the plane and first off and through customs. Was it worth it? Yep, I'll do it again on the way back with Emily.
She is now 33 weeks pregnant, baby growing well. We had a listen in to the heart sounds using a toilet paper tube. Brilliant.
After the slight hiccup going through customs, Sean came to pick me up. Although it's only 39 miles from the airport, it took an hour and a half to get back. The traffic was heavy and the temperature reaching record levels. The radio DJ was getting increasingly excited every time his thermometer reaches a new high.
I know you want to know what the hiccup was. It'll be an anticlimax if I do tell.
Back at Emily and Sean's flat I got to see what they had acquired at the 'baby shower'. This American tradition, seems to be where the mother-to-be gets all her friends to buy her stuff for the baby. Emily now has three buggy's and loads of cloths for the first six weeks of life. I now see why women these days want to know the gender of the baby. The poor boy is also going to have to be a Metz fan, having soon to be born into a Metz family. The Metz I'm told, are equivalent to Manchester City, in Manchester's City-United rivalry. The United version of the New York baseball teams is, of course, the Yankees.
OK, the hiccup. I told you this is going to be an anticlimax. US customs and immigration are notoriously strict and lacking in humour, right?
Well I can vouch for that.
Emily had given me strict, careful, and probably not really very complicated instructions on what to say when they ask who I'm visiting. It was something like say you are visiting 'my daughter and her husband'. It would have been better if she hadn't given any advice, but apparently it is really important NOT to did mention the pregnancy.
So I got in the queue. A short queue, as I said before because of getting off the plane first. I was pretty pleased with myself for having remembered to write down her address to fill out the entry form.
My customs officer looked young, and seemed to be being particularly efficient, well conscientious anyway, as he was taking much longer than any of the others. That's good, I thought, we don't want criminals and murders being let in. He wasn't doing much smiling though.
In fact, as it got closer to my turn he was looking pretty grim. I bet he's a great poker play. All around, the explanatory TVs screens were saying welcome, cheerily, in lots of different languages. It felt a bit like a scene from George Orwell's 1984, where 'double speak' is used to say exactly the opposite of what is meant. A bit like 'choice' in the modern NHS, to mean 'competition'.
So I'm beginning to feel like I've entered a police state, and was allowing my imagination to run, a bit. Suddenly the queues of people, were the proletariat lining up for food vouchers and the guards in uniforms and big guns were waiting for one of them to grab a handful and make a run for it. Or perhaps the border to the land of the free, and they were stopping people escaping to it. All the time the proles are handing over these bits of paper with the address that they are staying at, and declarations that they are not bringing in explosives, or huge amounts of money, food and drugs.
What, I wondered, happens to those bots of paper. I imaged and Orwellian style warehouse somewhere, with hundreds of working women, sitting at noisy type-writers, turning the hand written documents into type written documents. Every now and then a 'runner' would come and collect the accumulated pile, and take them to another room, where another lot of workers would enter them onto a manual database, so that the records could be retrieved if one of the applicants disappeared during their stay.
Then it was my turn.
'Place your right hand, palm down, on the screen' he said without expression or looking as he took my passport and papers off me. 'Look into the camera', so I did.
'What is the purpose of you visit' he asked staring at my passport.
Inexplicably I said 'visiting a friend' pause,'well my daughter actually'. I smiled at his forehead.
' Which is it, your friend or your daughter?' expressionless
'My daughter.' Straight face.
'Er, and her husband, they live here'.
He didn't reply, but kept looking at my passport, and then at a screen.
'Can you tell me your name sir?'
This is easy 'Ivan Benett'.

And as soon as I said I knew I was in trouble.

For the first time he looked up, exaggeratedly looking at the young short haired clean-shaven person in the photograph.
'You have JOHN Benett's passport, sir'
My heart sank. I do have John Benett's passport. John Ivan Benett's.
'Please wait one moment' and off he went. I could see him talking to someone else, and they kept looking up at me.
'Would you step this way sir?' He beckoned me behind a screen.
Behind the screen there were two other men. I nearly said different, but they weren't, they were exactly the same. Impassive, stern, humourless.
One spoke while Two put on some blue surgical gloves. 'I'm too young to die' I thought, and too old for an 'intimate' examination.
'Can you explain why you are using the passport of John Benett, when your ticket is for Ivan Benett, sir?' One asked. Well I could, but it involved an unnecessarily complicated and barely plausible story about being born in Mauritius and that's how it was done there.

I blamed my parents, of course.

Two, the one with the blue gloves, then asked if he could look through my hand luggage. 'Yes' I replied in a high squeak of relief 'help your self' I added unnecessarily, as he was already tipping the contents out on the stainless steel surface.
Now I wouldn't have thought there was anything suspicious in my bag, but ear pieces and dongles and a sudoku book can arouse the greatest of interest, if you are trying to foil a plot to take over the world, and so each item needed an explanation.
After this interogation and quite abruptly I was handed back my passport and told 'you may continue on your journey sir, have a nice day'. And that was it.

Just as I left the room Two said 'I hope Emily's pregnancy goes well'. I turned, but they had gone.

The BA lounge

It 7.50 and I'm sitting in the BA lounge of terminal 3, Manchester airport. It's along trip to JFK and American Airlines offered me an upgrade for £360 on way. Well you can't take it with you. So here I am indulging in a bit of luxury, while I wait for my third row, window seat. Can't wait to see my little girl, and doing a bit of sun bathing on the Long Island beach. She's not so little any more, I hear.
The journalist from the Sunday Times sent me a draft of her article. It seems OK, if rather brief, but who cares. I'm not doing it for myself, of course. It's to promote stroke prevention for people with atrial fibrillation. I'll just have to cope with the fame as best I can.
Shall I have another coffee? No I don't think I'll bother. Champagne? Bit early.
There's no Guardian to read, can you believe it? I've looked through the Times, it's all about the Norwegian killer. Not a whisper about the Murdoch's.
See you over the water.

Events at the Sunday Times

It's not been a good week for the Murdoch Empire, and in an attempt to boost ratings and reach a new audience, the Sunday Times interviewed my yesterday for the supplement. Then, just now, I've had my photo taken, I'll post them on here when they come through.
Now I'm about to go and assess some medical student projects. My own students presented yesterday and did fabulously well.
I did assess the medical student projects. They each presented for five minutes then were questionned by each of the panel. Three on the panel, two professors and me. The poor things were terrified.
They were all brilliant, and way better than I could have managed at their stage. Well done Manchester medical school.

Doing the accounts

Another week on, and I'm still peeling. Joined the gym again, I wonder how long it will last this time.
Next Saturday I'm off the the Big Apple to stay with Em, and bring her back, can't wait. In the meant time I got several commissioning talks to think about, to slightly different organisations.
I think I'll go to Mauritius in November and take whoever wants to come, we'll see.
The fish have remarkably survived the Winter and Spring without actually being fed, so I think they deserve a bit of attention. I've arranged for an electrician to come and fix the fountain and aerator.
I'm just putting off doing my accounts really. Come let's do it

World Medical Games 2011

It's the last day and we're heading home. There just hasn't been time to do a daily up date, what with all the training, playing and re-hydrating. Now it's a matter of waiting around for the flight home, and reflecting on the week. There has been the usual shirt of shame, for a non-football related offence, and the shorts of shite for a football related incident. The socks of chagrin have now also been introduced, but I haven't quite followed why you get them, except they usually go to Tim Strang.
Guilty I was, for the first shirt of shame, for asking the airplane passengers if anyone had a hair band. A red one came flying through the air. I didn't see where it came from. It proved handy in the end. The other shirt of shame awards rather fade into a blur. I didn't win it again. last year I managed to get it every day even though I wasn't playing.
There having been some champagne moments though. Perhaps the best was a chimp played on Jamie. Outside our hotel, the Hotel Cristina, on the beach a couple of artists had been making sand sculptures. Really impressive ones of Star Wars characters and people from Greek Mythology. Someone, I think Tim Strang again, had the idea of getting them to do a Sculpture of Jamie. We had been spending most afternoons at the bar just overlooking the beach, so we happened to be there while they were creating Jamie. We all were in on the joke, but Jamie remained quite oblivious. The funniest aspect of the joke was Jamie's reaction to the emerging sculpture, wondering what it was and why they were doing it. Jamie had been sent off the day before, so the final act was to place a red card in the sculptures hand. he still didn't see it until finally it was pointed out to him. How we laughed at his reaction.
Las Palmas itself was rather disappointing. It is permanently covered by cloud and has a stiff breeze. Enough sunlight gets through to get a tan, but it's not quite sunbathing weather. For this you have to go to the south of the Island of Gran Canaria, past the airport. Mark and I did this on our first rest day. We caught the bus and in a hour or so we were there. Glorious baking sunshine, and we have a lovely restful day soaking up the rays. As the day went on the tide rose. Beach space was quite tight so we were quite near the waters edge and fell asleep.
We were awakened suddenly by a big wave which completely covered us, our clothes and our towels, much to the hilarity of the fellow sun worshipers.

So the taxi is coming now and we'll be off to the airport for more hanging around. back home soon I hope.

This year my room mate was Jamie and to my surprise it went well. He saved my embarassement by providing me with a spare pair of white shorts and socks, a definite shirt of shame if I'd turned up without them.

Another new friend was Keith, well two Keiths actually. One who owns a pub and works with Budwizer, always handy to know. The other works in the cardiology department at Wythenshawe Hospital, another useful contact.

My own pweformance on the pitch? Well average I suppose. It hasn't helped picking up an achilles strain in the first game. My last kick resulted in me being clean through , only to be judged off side, by a whisker. The burst of pace however pulled the ligaments and that was that. If I'm to take away positives, it is that I can still play at this level but need to become fitter.

Next year is Istanbul. I had been thinking of going there anyway. So I have a year to prepare, and that begins today.

Time for a break

This phase of lectures is over and what a relief. it's off on holiday tomorrow, to Gran Canaria, to the World Medical games. I'm going with my team 'Stepping Hill FC, although we are known a Stockport FC in this tournament. We are representing England in the 'Seniors' tournament, so give us a cheer. There are normally several people I like to hang out with, but these days there are fewer and fewer as they get older, injured, and generally decrepit. Still I'm looking forward to it, and who knows Strangy may fill the gap.


I'll let you know.


It will be a short respite. Since I gave the London talk on commissioning I've had several invites to do similar . The thing is, it's not that one knows more than anybody else, just that one gets to be known as the speaker on such and such, so word gets round and fame spreads. So there you are, I'm now the one who speaks about commissioning especially in the Cardiology fraternity. I must be saying what they want to hear, except for the MRI where I've been quite open about saying that their department needs to reduce in size. It hasn't gone down well, but then they could have been more accomodating and less arrogant.

The last day in Prague, time for home

It's time to go home and I'm tired of being away. I think I might call a moratorium on long weekends. I feel strangely alone today and not looking forward to the long trip back.
Yesterday I did some more sight seeing and a little at the conference. There was an interesting debate on the association of Phosphate and coronary risk. I bet you wish you were there. It turns out it is associated but we're not sure what to do about it.




In the evening we ate at the Hotel Imperial which is a restaurant run by the Czech equivalent of Gordon Ramsey. The food was very average but it has an amazing tiled interior which you simply must see.

16.15 and in Prague airport 3 hours before I need to. Managed to get free Wi-Fi but it is slow. Still I'm outside and it's sunny. I wanted to get here early to book a seat away from the returning stag party. Anyway, they wont let me check-in until 2 hours before departure. At least there's something that hasn't changed since stopping being communist. Apparently it is 'not possible'. I think I'll have a beer.

Prague 2011

This is strange, the spell check is in Czech. Of course. I'm in the Czech Republic, Prague in fact, at the European Renal Association meeting. The conference itself is so focused on end stage renal disease that I'm wondering why I've come. There is nothing for Primary Care here. Still, Prague in the summer, fabulous.
We have been given a travel pass and so off I went yesterday to explore the city and find Wenceslas square.
Last time I was here I enjoyed just lazing about in the bars around what I then thought, was Wenceslas square. So imagine my surprise and amazement to find no mention of the square on the city map. So confused was I that I thought I must have mis-remembered my last stay and actually wondered if Wenceslas square was in a different city altogether. It was not until the evening when I presented my problem to the accompanied crowd, and to some merriment from them, that I discovered that Wenceslas Square is not a square at all, and definitely not the place I thought it was. It is in fact a long and wide street, somewhere else in the town. The place I thought was Wenceslas square is actually the Old Town centre.
The Old Town centre is the gathering place for tourists, and I'm sure I'm not the only one who gets the name wrong. There is the famous Tyn cathedral and the Town Hall clock, whose figures chime every hour. Yesterday, though the weather was bright, there was a sudden downpour just as the clock struck three.
Prague is a city with many memories of the communist era, reflected not least is some of the architecture on the way from the airport to the city centre. The austere tower blocks have done their best to modernise, but there's no mistaking their origins. The taxi radio, stuck in the past too, was playing White Snake, Judas Priest and other heavy metal. They may be proud of their velvet revolution, but please time to move on in musical taste too. It was during the velvet revolution that a Russian tank, standing in Wensceslas square one night was painted pink, much to the annoyance of the would-be occupiers. It was later floated on a pontoon in the river.
The underground in Prague is easy to use, and the people, like many users the world over, look grim and in a hurry. One scene, though, that cheered me up. It was in another carriage and so witnessed as silent. Two girls were having a right old giggle, about what I have no idea, but they were laughing uncontrollably at something. It made me smile. May be they are more relaxed with themselves than I thought.
After my initial attempts to find the tourist places I went back to the hotel for a nap. It had been an early start to get to the airport for an early flight. I hadn't bargained on being stuck in the middle of a 'stag do', dressed in shell suits, some a worrying pink, and already pissed. They carried on drinking all flight, and became noisier and noisier. Fortunately they didn't engage me in conversation, but some poor American girl did. Their 'conversation' went pretty close to the mark, but luckily I didn't have to stand up for her honour.
I half expected to see them all in the square that isn't Wenceslas square. I think they were probably sleeping it off, and will miss Prague altogether in a drunken haze.
In the evening we had dinner at the Lion restaurant, near Prague castle, and took in the view of Prague from the citadel. Prague Castle isn't a castle, like Wenceslas squaree isn't a square, but it is next to a fabulous cathedral. The history of Prague is the history of Europe in microcosm, OK that might be over stating it, but it seems to have been at the centre of much of the great struggles of the last four centuries. Our tour guide talked us through the Hapsburg reign, the Protestant uprising and later 'defenestration', and the martyrdom of Jan Hus, burnt at the stake as a heretic.
I offered my own heresy at the dinner table of kidney specialists. That the modern staging of kidney disease has entirely distracted attention from identifying rapidly declining renal disease (now stage 1&2) and those leaking protein. Instead we are mis-staging and over treating little old ladies, who would be better left alone. I'm not sure how well that went done. Slightly better than telling a room full of cardiologists that there are too many of them, I guess.

Afghanistan in Reality evening

I needn't have worried. In the end there must have been two hundred or more, and only just enough food and chairs to go round. The venie was the 'Welcome Centre in Cheetham Hill, where regugees are dumped by the state when they arrive seeking asylum form death squads back home. Hamid, my latest lodger had been one of them.
Jonny, 'my son of whom I am well pleased', had organised an evening to 'celebrate and raise awareness' of Afghan history and culture. He was doing this on behalf of RAPAR (Refugee and Asylum Participatory Action Research group), a Greater Manchester voluntary sector organisation working for local people who have had their human rights denied. They are often refugees or asylum seekers, and many are from Afghanistan. As this is the biggest thing he's done I was sharing his anxiety that people wouldn't turn up.
In the end it was an interesting, stimulating and enjoyable evening. No one really minded the pink tinged projector slides, the slightly over long speeches, and queue for food. It was a good old lefty meeting reminiscent of the early days of CND meetings, and we were showing solidarity with the oppressed and destitute.
Well done Jonny

Commissioning 2011

Its not quite the red eye train, its 10 o'clock at night, but after a couple of glasses of wine I'm feeling relaxed and distinctly sleepy. I'm on the 21.40 form Euston to Manchester Piccadilly and travelling in first class. Cost - £35 and all the wine you can drink. Ben Jones happens to be on the train too and has sat opposite to me. He's a good guy from church and I'm pleased to be journeying with him.
We've both got up early for a meeting in London and obviously both book the cheap first class ticket back. I've been here on one of my talks at the 'Commissioning 2011' conference at Kensington Olympia. Pretty cool and on the day the government have made major announcements on the future of the NHS, the place was buzzing with excitement.
The last event was a 'panel discussion' by the good and the great, A knight and a dame of the realm, a professor, and a retired senior nurse. None of them have done a single day's commissioning, but there they were pontificating and trotting out the government line.
Anyway, I was there talking too, rather earlier, on increasing capacity and capability of primary care. They were queueing up to get into the room and I got some good questions. Several people came up afterwards and asked further questions, so they must have been interested.
Perhaps I'm quite good at this, do you think?

Summer is here

'Will you hold my stick while I have a wee?' I asked Alison after an hour and a half. 'I will not' she hit me playfully on the arm, 'oh, alright then' and took my walking stick while I disappeared behind a tree.

We were on a walk in Ingleton along the Twiss and Doe rivers. Through the Swilla Glen there is first one and then two or three coin encrusted logs. They look like ancient dragon limbs. People are encouraged to hammer coins vertically into these fallen tree trunks. One of them has an extra 10p in it now.

The weekend had promised to be glorious and so I wanted to head out a bit. I'd never been to Ingleton before and Alison knew the way, so off we set at 9.30am. I thought it would be busier but no. There were plenty people, but not too many for a gentle morning stroll. The four and half mile walk took about two hours, and back to Ingleton just in time for a late pub lunch in the sunshine. The waterfall trial has been designated a site of special scientific interest, and is definitely worth the trip. The views are great. I can't believe I've never been before. The two main waterfalls are Thornton Force and Beezly falls, pictured here.

On our way back we passed the Snow falls and massively steep gorges that are at once scary and make you want to dive in. It is as if a hot watery knife has been sliced across the limestone butter. I love limestone geology and studied it for my 'o' level, somewhere round here there'll be pot holes and hidden stalagmite and stalactite caves.

Limestone is sedimentary rock, made up of compressed exoskeletons of sea creature many millions of years old. It is amazing to think of all this below the sea, and rising up, only to be eroded flat again. The slippery, shiny limestone looks in parts like those tarnished metal statues of the saints in old cathedrals where their shoes or hand shine brightly from where people have touched them over the years.

By the time we got home I was exhausted, and so an early night. I got my first football game back today after nearly a two year lay off.

Man U vs Barcelona

How exciting. It's cup final day. Manchester United vs Barcelona. A repeat of the final two years ago when we were well and truly beaten by a much better side. This time too, they are strong favourites, but I have a good feeling. We'll see. Jonny says it's the most important day of his life in a fit of hyperbole.
It is the end of a difficult week, of course, for one United player. They're all at it, but his crime seems to be to try to conseal it.
It's been a hard week for me as well. Not in the same sense, you understand. It was the busiest of my lecture tour so far.
Wednesday was 'understanding referral rates' to a group of GP in the 'Chorlton and Whalley Range' local area group. Thursday was on Chronic Kidney Disease at the end of the Primary Care 2011 conference in Birmingham, and yesterday was a cardiology talk to a group of practices in Stockport. Now I'm utterly exhausted and have been sleeping all afternoon.
It's not that I don't like giving these talks, and surprise myself at the range of issues I find I can talk about upon. It does take a lot out of me emotionally. You're never quite sure if you've pitched it right, whether you're brilliant or boring. Brilliant usually, when I run it through my head afterwards.
The biggest and most surprising one will be on 'creating capacity and capability in primary care' and the Commissioning 2011 conference in London. I've just finished the talk and sent off the presentation. That's it now until they day. I will be nervously running through it in my head, and want to change things but I'll have to stick with what I've got. Like when you finish an exam paper.
It's nearly six o'clock and time to get psyched up. I think I'll watch doctor Who first and then settle down. I'll be watching it with Ken. Jonny's going to watch at a pub with his friends. Too noisy for me.
Come Ryan Giggs, show us why you're the best.
23.47 Out played by a better team. Next year perhaps

Averroes

After this weekend I can add Frankfurt and Zurich to my list of places I've been. Well the airports anyway. I was at our annual meeting of GPs with an interest in cardiology, in Palma De Majorca. We meet every year for a study weekend, exchange ideas, consider new studies, and above all, have fun. I don't know why I chose to go via these hubs but I did.
This year I talked about the Averroes trial. Now the trial is actually nothing to do with Averroes, for Averroes is the Western name given to to an Andalusian born Islamic scholar. He was a theologian, scientist and above all philosopher. He used Aristotelian philosophy and blended it with Islam, and somehow managed to link it all to Western philosophy. He was born in Cordoba, southern Spain and died in Marrakesh.
While I was in Frankfurt I got the call from the interview panel. Apparently they had three excellent candidate. He implied I was one of them, but didn't actually say that, and unfortunately, on this occasion, they selected someone else. Oh well, the job would have meant a whole upheaval. He offered to put me forward for a position on the committee, and I said I would really like that.

A NICE interview

I got interviewed today. Now I'm exhausted. I will tell you all about it if I get appointed.
It was a telephone interview, which is a bit weird. There was the Chief Executive of NICE, some government guy and the deputy chair. The deputy chair is a GP also so that made me feel better. It was a grilling alright but I honestly think I did OK. I wouldn't have given any different answers if I'd have known the questions before hand. I even made them laugh at the end when they asked me what I would say to the press when I became famous. I said 'I'm already famous'. Ouch, may be I wouldn't have said that bit. Still it's pretty good to be shortlisted for a job like that.
Last week I gave my talk to Sheffield doctors, and this weekend I'm going to Palma to tell them about the Averroes trial, of a new drug.
The 'making it real' workshop last week also was a great success, as widely acknowledge. I think I managed to get the GPs to see the potential of working cooperatively in this new NHS adventure. Definitely those in our area are already pulling together. I'm running a workshop with them on 'understanding referrals' next week.
So all go then, well it's better than sitting in my front room on the computer and watching back episodes of Taggart. Its murrder.

In Loving Memory

Richard was cremated today.
The ceremony at the Manchester Crematorium was simple and moving. I've never travelled in a funeral cortege before and was humbled to be there. I had been given the great honour of being one of the pall bearers and there I was in the back of the black limousine edging gently from Chorltonville to the Cemetery. Anne, Margaret, Steve and John in the back, with Barbara in the from. Uncle Basil was also in the car. 'He was a rum one in his time' Anne whispered.
I was surprised by the reaction of people and deeply moved. Most people look on solemnly, and at least half of them cross themselves as the coffin went by. It was a sunny early afternoon and the children at Chorlton Park juniors were out in the park playing. The whole scene was touching.
We arrived at the Crematorium a little early to be met by the slightly comical sight of the previous mourners being hurried away to fit us in. Richard would have found in amusing, as he did many things about funerals, having conducted countless himself.
Afterwards we had a wonderful memorial service at Manchester Road and then food and mingling. People had come from far and wide, but also many of our friends from Chorlton were there. Richard had touched their hearts too. It was a warm and affirming moment.
It was a memorable occasion.

Bluebells at Buckland Abbey

I am here in Devon with my dear friends Ade and Sue. We came down on Friday for the long weekend and to miss the 'Royal Wedding', which meant also that the roads were clear. Then yesterday we went on a bluebell walk.
I love this time of year, and down in Devon all the blossom is out, the gorse is out, and so are the bluebells. Knowing my love of bluebells Adrian has looked out a bluebell walk and so off we went yesterday. It was an hour's drive but worth it.
Buckland Abbey is an old Cistercian monastery which later became home to Sir Richard Grenville (must be someone famous) and Sir Francis Drake (definitely someone famous). The wooded walk was a two mile gentle path through carpets of rich blue flowers. They are so blue they have an almost purple hue. Through the trees you can see the undulating Devon countryside. Marvelous, just what you need to remind you that there is life away from the bustle of weekly work life.
We came back home via the Castle Inn and then a nap. I woke up just in time for the Chelsea Tottenham game followed by dinner. Civilised, conversational and excellent.
Xante and new puppy Pebbles were sufficiently badly behaved to be cute, although a loud thunderclap frightened them briefly. We watched a couple of episodes of Lead Balloon and an early night. I love this pace of life.
I told Ade about my thoughts on twenty four hour retirement. Oh yes, I'm thinking of doing that in a few years. Apparently I've earned too much in my career to make it worth working longer, but twenty four hour retirement means you can collect you pension and then work again if you want. I'd like that, and draw back a bit on the humdrum and perhaps stick to my cardiology stuff, we'll see. It would even be nice to retire down here, but I miss too much, I think, and my children.
It's not been possible to avoid the Royal Wedding altogether, of course, every news paper has the 'happy couple' kissing, on their front pages, and Chelsea managed to scrape a win from Tottenham. Apart from that it's been a lovely weekend so far.
Today it's a local walk and United Arsenal. It is also one on my own wedding anniversaries, so I offer her a thought and a prayer, and hope she is happy and well.

Easter Day, the Garden of Eden and the Serpent

This Easter Sunday was a strange day. I went to Manchester Road Methodists for the first time. It's where Richard went, and preached many times. He wasn't there of course, but you could feel his presence, especially during the choruses of the great Wesleyan tunes. He would always come booming in at the rousing point in the hymn.
I also had to deliver two death certificates to the families of two other people, both dying on cancer this same weekend. So three more souls in heaven.
Also just seen a TV programme on the history of Christianity. I didn't realise the history of Islam and Christianity were sooo intertwined.

Another interesting idea from a different programme is that the Garden of Eden was in fact the garden within the Holy Temple in Jerusalem, where God lived. Adam was a king who tended the Garden. When he became too worldly it lead to the destruction of the Temple. This story, 'most scholars believe' was originally placed later in the Bible, but moved to the beginning in more recent times, so giving it much more significance than it perhaps deserves. Rather than being the fall of an individual king, this story has come to represent the Fall of the whole of mankind. Wow, but without the Fall there would have been no need for the sacrifice of Jesus.

The place of the serpent in the story is interesting to me too, having been called 'the voice of the serpent'. It is well known that the serpent is also the symbol of Medicine and of Healing, the rod of Asclepius. It also represent rejuvenation and even resurrection in some cultures. Even Moses uses a bronze serpent to cure the people from snake bites (Numbers ch21v6-9). So I don't feel as bad now about being its voice.

Life after death?

Richard died today.
There could only have been one reason for a phone call at 7.10am from Anne. Well, something terrible might have happened to one the children, but apart from Rachel in London two of them were tucked up in bed below my room, and Jonnie was apparently fast asleep. No, the only reason was to tell me that Richard had died.
We have been expecting it, and indeed praying for a timely release. His massive stroke had left him densely paralysed and needing constant nursing care.
When I arrived shortly after, Anne, Barbara, Steven and Margaret were already there. Richard was lying, looking peaceful, in his bed. I lent over to close his eyes and silently blessed him with the touch.
Richard has been a great man. He presided over our wedding and had spent all his life serving his flock, his congregation. He was a Yorkshire man through and through and had ended up in Manchester to be with his daughters, after he retired. He enhanced the lives of all he touched, and even in his last illness showed strength that few could have managed with dignity and humour. Richard, despite our divorce, was my father-in-law.
Now he was dead, and everyone feels a mixture of sadness and relief. There were funny moments too, like when Steve thought he'd better let the minister know who was coming round to share communion. A certain Reverend Mutton. So at about 7.45 he made the phone call. Only he dialed the wrong number. An Asian voice replied most emphatically that he definitely was NOT the Reverend Mutton!
Then the police arrived.
The police. Why? 'It's just procedure'. It was not procedure. It was a cock up. There was no need for them to have been called, but once called they had to investigate the case. It had been 'an unexpected dead'. 'Unexpected? He's been there about a year' gasped the attending mourners. We had to make sure the death certificate was issued before midday or he would have to be taken to the hospital mortuary pending a postmortem. Utter madness. Well fortunately we got someone to do the death certificate, or I would have done it myself.
Coincidentally, I had been to another 'Apologetics' meeting last Saturday, just four days before. The subject that day was 'Did Christ rise from the dead?'. I thought I'd give them another chance. I'm glad I did. The talk started unpromisingly with a young doctor, being, as young doctors often are, a bit too medical. 'Yes we know you're a doctor' I wanted to say, but as the talk progressed he got better. Although some of the 'proof' and 'rebuttals' were a little spurious, I came to realise that even this audience were not inclined to believe in the resurrection of the physical body of Jesus. The new, heavenly body of Jesus was clearly different, since the women at the grave and the travellers to Emaeus didn't recognise him at first, but it was none the less him. It does seem difficult not to believe that something extraordinary happened to convince so many, at different times, that He had actually returned to them, albeit in a different physical form.
I don't know for sure, but I am happy to believe that Christ's Being returned to His followers in His heavenly body. The worst this can be is a benign delusion. But if it's true?
Well if it's true, well then we'll be seeing Richard again soon enough. So goodbye for now Richard, and God bless.

Father of the bride

CRAZY RELIGIOUS ADVERTS NOTHING TO DO WITH ME

‘What could possibly go wrong?’ We had successfully got into the taxi on time.
It’s about one o’clock on Friday afternoon. We are all in Edinburgh and heading into town from the Marriott Hotel to the registry office. Emily and Sean of course, me, Anne, Rachel, Jonnie and Lizzie, all in the back of the taxi. Well it would have looked a bit strange on the bus.
We’d been out the night before in the city and had a lovely meal. The only hiccup had been someone on the train who thought we'd taken her reserved seats. 'Back off' growled Emily. No one was going to take these seats. Turns out she was in the wrong coach. Anyway we got here with no nerves, second thoughts, or weepiness. In fact it seemed like a normal night out and not at all weird. Others looking on might have thought it strange, but not for us. We’d stayed up a few drinks, a sensible earlyish night and up for breakfast. A bit of fussing with the makeup and hair but altogether very low key.
It is a lovely day. Jonnie, Sean and me have a drink in the garden while we wait for the bride, the bridesmaids and the mother of the bride to come down. This is the entire wedding party. It has to be done this way due to the complexities of the marriage laws to foreign nationals. When they appear, they all look gorgeous, especially the bride. Its only now that I have little wellings of tearfulness. What is that all about? I wonder.
Emily getting married is, of course, a cause for joy and celebration. The circumstance that makes it important to do it quickly, is a blessing. A new person, a grandchild. So a double joy, and it is a joy.
So nothing can go wrong now, can it? The traffic is a bit busy, but we’re in plenty of time. Rather too much time, but better too early then too late.
Then in the busy traffic a child gets knocked off his bike. Cars stop, taxi stops, people rush out of cars. Bloody hell…Phew, the child gets up and wheels his crooked bike to the curb and people gather round. But no need for us to stop, he’s fine.
Ten minutes later and we pull up. Outside William Purve, the funeral directors. ‘Here we are’ announces the taxi driver.
'Are you sure?'
I suppose this is it. There is a sign which says ‘Edinburgh Registry Office for marriages and civil partnerships’. We all get out gingerly, so as not to crease dresses and hair.Only one problem. The door is locked. ‘Locked? Locked!’ expletes Anne. Sean and Emily exchange nervous looks. There is a registry office on George street, but this isn’t George street. No this must be right.
After much rattling of doors and the discovery of another entrance, followed by huge relief, the officials lets us know that they’ll be ready soon. ‘It’s only two o three’ says Sean, rather overly precisely, ‘We’re not due until 2.30’. ‘It’s ok’ replied the lady, who would turn out to be the Assistant Registrar, ‘we can begin a little early as you’re all here.
‘No we caint start before we’re ready’ Sean affirms abruptly.
‘Okay’ everyone thinks. ‘The photographer’s not here’ he correctly points out, as Paval, the photographer, and his assistant girlfriend appear from behind him. Paval is a little Eastern European, who is informal to the point of being casual. He's got a rucksack on his back and we discover later he likes informal poses.
‘Well it’s not two thirty yet anyway’. ’Why don’t we have some photos before the ceremony?’ Ok man, it’s your day.
We have some photos and the Assistant Registrar disappears again with instructions to reappear at two thirty.
Strange, and then we understand why Sean was not keen on starting early. From a place unseeing, we hear the sound of bag pipes tuning up, and soon she comes into view. Lorraine, the bag pipe player, in full bag pipe regalia comes marching purposefully round the corner.
What a brilliant surprise. It turns out, Sean has been on the internet and phone trying to get someone at the last moment, to pipe us into the room. A touch of perfect genius. Not just the thought, but the timing and impromptuness. It’s still not clear if the pipes will be allowed into the hall, but the Assistant Registrar is OK with it and we’re ready to go.
There are some formalities to go through, like, are they who they say they are? My name today is Ivan John, having spent last week as John Ivan. Long story. Why does she want to know? Well I’m going to be one of the witnesses. Anne is the other. Another unusual aspect to this wedding of the year. I bet Kate and Will won’t have her parents as witnesses. This, we have all come to understand, is the formal and legal part of their wedding. The proper wedding celebration will happen sometime in the future, when things are a little more settled, and all the relatives and friends, that presently feel left out, can contribute to the joy of the happy couple.
So the rest gather in the room while Emily and I wait outside ready to join them. I check that this is really what she wants and that it’s not too late to change her mind. Even now. I present her with the sapphire pennant I got her to wear with her outfit and the emotions start to rise up. I give her a big hug and tell her how beautiful she looks. As I do images of my little girl percolate through my memory cells. I see the little bubbly curly hair child playing in the sand, running after the dog, crying uncontrollably, cuddling up for comfort and holding on to my leg in the playground, all at once. I can’t cry now. Not for her sake. So I don’t.
Instead we nod to the piper, who pipes up and begins the slow march up the stairs to the ceremonial room. I squeeze her arm and hold the hand that’s linked over mine. I really am giving her away. Even though she’ll always be my little girl, she will be someone else’s charge and responsibility. ‘I’ll always be there for you darling’ I say silently with an extra squeeze. Now I really am fighting off the tears, and so, it seems, is everyone else in the hall as we enter to the strains of ‘flower of Scotland’ or something like that.
The Assistant Registrar seems really chuffed to be doing this wedding. I don’t think she’s done too many before, or if she had she made it seem fresh. The vows are simple and believable, even if Sean misheard respect and promised to ‘defend’ Emily'. We'll put it down to nerves.
‘Emily Margaret Benett, do you take Sean James Meade to be your lawful wedded husband?’ ‘I do’ she said unhesitatingly. Just at that moment I looked at her eyes. They gleamed, and said it all. She is happy and that’s all that matters right now. Where they live and bring up their children is for another time. What happens to their relationship is for the future. Right now, she is happy and that’s all I want for her.
My job of bringing her to this point, imperfect and crap as it has been, is now over. She walked into the room as Emily Benett, my daughter . She is piped out as Emily Meade, wife and mother to be.
She is still my daughter who I will always love unconditionally.

Home again briefly

Back home at last, after a long trip back from New Orleans. I'm going to have a rest I think then get a hair cut. Yes, its off to Edinburgh tomorrow for Emilys wedding

Having fun on the Bayou

Monday 16.22. Cock up on the room situation. They have me checking out today and wondering where I got to. The manager is now on the case and I’m slightly panicking that I won’t have anywhere to stay tonight.
Lucky I came back really. I’ve been on the Jean Lafayette Swamp tour and after that wandering around New Orleans Quatier Française.
The swamp tour was fun. We drove for about an hour on a coach and got to the wet lands. Louisiana is dead flat anyway but this bit is flat and low. There are natural waterways, the Bayou, but also man made canals. Once we got there we hopped on a flat boat and off we went. The trees and grasses overhang the waterway, and through the duck weed from time to time an alligator swims up to the boat. Our tour guide gives us an interesting and humorous narration of the history and myths of these wetlands. Where we are is fresh water, but further south, close to the Gulf of Mexico, is salt water. In between it is ‘brackish’. Here, the man says, you can catch both fresh water and salt water fish. It is his idea of heaven.
When we got back I went for a walk and had lunch on Bourbon Street, Cajun burgers and French fries. I had to leave most of it. They were not the best choice, but I did get to know the origin of the word Cajun. It is the nick name given to the Acadian people who were exile to New Orleans from Canada. They are French speakers and were persecuted by the British, hence the New Orleans French connection. While Lower Louisiana had been settled by French colonists since the late 18th century, the Cajuns trace their roots to the influx of Acadian settlers after the Great Expulsion from their homeland during the French and Indian War (1754 to 1763). The Acadia region to which modern Cajuns trace their origin consisted largely of what are now Nova Scotia and the other Maritime provinces, plus parts of eastern Quebec and northern Maine. Since their establishment in Louisiana the Cajuns have developed their own dialect, Cajun French, and developed a vibrant culture including folk ways, music, and cuisine.Cajun music, or Zydeco, has its distinctive rhythm and is now quite well known. I got a CD and a Tee short.

You'll know this one. Here are the Jambalaya lyrics to the Jambalaya song done by Hank Williams Sr. Hank Williams Sr copied the Jambalaya musical melody from an earlier tune recorded in Cajun French called "Grand Texas". Although Hank Williams used the earlier Cajun melody, the words to the song that we know as "Jambalaya" was written by Hank Williams Sr.

After Hank Williams Sr recorded his version with the new words, Cajuns re-recorded Jambalaya with Hank Williams' words translated into Cajun French. Cajuns now consider the song to be one of our own songs. (By the way, Hank Williams mispronounced the word "Bayou". Hank pronounced it as "by-oh" when the correct pronunciation is "by-you". I guess he needed something to rhyme with "me oh my oh". Hank Williams Jambalaya song lyrics:
'Good-bye Joe, me gotta go, me oh my oh
Me gotta go pole the pirogue down the bayou
My Yvonne, the sweetest one, me oh my oh
Son of a gun, we’ll have big fun on the bayou

(Chorus)
Jambalaya and a crawfish pie and file' gumbo
'Cause tonight I’m gonna see my ma cher amio
Pick guitar, fill fruit jar and be gay-o
Son of a gun, we’ll have big fun on the bayou'

16.50. All sorted, panic over. I can stay. Hurray!
Yesterday was the first full day of the conference. We went to register, conscientiously, had a coffee, then I looked around the posters before meeting up for lunch. We went to the Gumbo Shop on St Peter street. I had a triple combo which included Jambalaya, Etoufee, and Gumbo. I had to leave most of that too. Surprisingly, I was disappointed with the taste which was frankly bland. Several douses of Tabasco later and the food came to life. So did the sweating, which had to be dealt with with a couple of beers. It seemed by then a little too late to get back to the conference hall, so we passed the afternoon on the balcony of Muriel’s bar overlooking Jacksons Park and watching the world go by in the warm sunshine. Before we knew it, it was time for a nap then out again. New Orleans night life is pretty hectic even on Sundays, but I needed to be up early for my swamp trip. It’s a hard life

Old Man River

Day 2 in New Orleans. I’m sitting in bed at 6.30 am local time looking out of my Riverside Hilton third floor room onto the Mississippi. It’s misty and grey and quiet. Life hasn’t yet come to the banks of the river this morning. The river streamer, no more than thirty yards away, is moored up, its lights subdued, recovering from the night before. Here, in New Orleans, it is always the morning after the night before.
I’m here as guest of one of the pharmaceutical companies. They have a new drug and keen to influence opinion formers in the field. Yep, that’s me. We are at the annual conference of the American College of Cardiology one of the three largest cardiology conferences each year. The other two are the American Heart Association meeting and the European Society of Cardiology. The balance of influence has tipped towards the Europeans even in the short time I have been coming to these meetings.
As well as being held in exotic places, well I’ve never been to New Orleans, it is also fun. It’s a chance to hear the breaking new research, which is usually embargoed until these meetings, and then simultaneously published in the New England Journal of Medicine (my favourite journal) or the Lancet. You also meet the top guys, they usually are guys, in the field. You get to know them personally and what they are up to. Two of my favourites were due out yesterday, but their flights were cancelled, Kathryn and Terry, the present and past chairs of the PCCS. We have a laugh, as well as get a chance to talk about and push forward Primary Care Cardiology.
One of the people who is here, and was on my flight, is Leonard. Leonard works in Rotherham and does much the same as what I do in Manchester. He’s a lovely bloke of mixed Georgian and Turkish background. After getting over the work discussion we get onto what it’s like to have young adults as children and the difficulties of holding everything together.
A hooter goes off over the river somewhere, it is waking up. 6.48, it’s still hazy and I can’t yet see any movement, but I can hear it, a low chugging somewhere out there.
There are two beds in my room. ‘ I’m sorry you have two queen size beds in your room’, Britany the check in receptionist had said. Britany, surprisingly, is a young helpful black woman, and I can’t help thinking that her bright enthusiastic demeanour should have her doing something much more high powered. Maybe she’s a student and earning her passage through college. I hope so.
I have to say I was expecting to see more fat people than I have. You know they say there are three ways to look thin? Yes, eat less, dress in black, or move to America! I don’t know it that’s true, but here everyone looks as if they could be in Manchester. I guess I expected to see more black people as well, but not so far. Apart from the accents and the fewer Asian faces, you could easily be in Manchester (England).
I was also surprised by their relative lack of humour. Why, when I asked a young lady in the street if she would like her photograph taken with me, she looked at me as though I was weird. Unbelievable.
7.00 and the sun is beginning to break through. I’m up ‘early’ because I went to bed early, about 10.30 last night. Remember there is a six hour time gap so in England it was 4.30 the next day, and now it one o’clock in the afternoon and I’m wide awake. Leonard and I went to the conference centre to register last night but we were too late, so we’ll do that this morning. Then look at the programme and plan the next couple of days. At the same time I’m going to think about my presentation in Palma de Majorca in a few weeks’ time. I’m doing a critique of a paper on one of these new drugs and will be comparing it with the other two competitors on the market. They are the new anticoagulant drugs. To be honest they all look much the same as each other. All look as if they work. All look safe in the short term, with a still open question about long term safety. The only difference will be cost. The company I’m with are clearly aware of the issues. They also know that, all else being equal, I, like everyone else will go for the cheapest, once it’s licenced.
Now, I better get rolling, like the Old Man River himself.

Mumbo Gumbo

THE ADVERT FOR SCIENTOLOGY IS NOTHING TO DO WITH ME OR ANY OTHER ADVERT COME TO THAT

I'm starting my international tour next week. For some reason I have agreed to go to New Orleans, but was staying for only two days. I was going to be arriving and leaving more or less straight away. So I changed it. Remakably easily. Now staying an extra day. I'm going to the American College of Cardiology congress. Of course it's a scientific meeting but I intend to have some fun too.

Things to do in New Orleans:
The Cajun Bayou and Swamp Tour
Steamboat Habor Cruise
Plantation Tour
Evening Steamboat Jazz Cruise
Cemetery and Gris Gris walking tour

I'm guessing New Orleans history and culture is not very different to Mauritian culture. The language, they say, is similar and so is the food. We'll see. I can't wait. The classic dish is the Gumbo

'Gumbo is a spicy soup or stew. It derives its name from the word Kigombo, an African word which means okra. The Gumbo recipe is in fomously associated with Louisiana and New Orleans but is also popular throughout the Southern States of America. It has it's roots and origins, like the people of Louisiana, in a fusion of European, especially French and Spanish, Indian and African.Gumbo is made using a thick stock, a thickener, meat and/or shell fish and vegetables like bell pepper, celery and onions. This soup is traditionally with rice. The rice served along with gumbo is cooked separately. Just before serving, gumbo is ladled over a heap of rice kept in a serving bowl. Gumbo is very popular during winter - ideal to beat the biting cold.

The stock or broth is prepared very rich and is prepared with whatever blends well with that particular variety of gumbo (chicken stock for chicken gumbo and seafood stock for seafood gumbo). Okra or roux is used as a thickener for this soup. Roux is often used as a thickening agent. Roux is prepared by heating up oil in a pan and roasting flour to it till it turns brown.

A traditional gumbo broth is made from either one or more kind of poultry, shellfish and smoked pork. Poultry chosen for preparing gumbo is usually chicken, duck or quail. For seafood gumbo, shellfish is the popular choice though freshwater crawfish, crabs and shrimps are also used to make gumbo. A vegetarian variety of gumbo is prepared during Lent where mashed greens are used instead of meat. Gumbo Z'herbes (with herbs) was a traditional dish was served on Good Friday containing at least seven herbs. Seven was considered lucky thus seven different types of greens like spinach, mustard leaves etc were used to prepare this dish.'


Sounds a bit like buryani. Like Mauritius, the history of New Orleans is defined by Imperialism and the Slave Trade

Apologies for Apologetics

'What a shame, another Muslim child is to born'. He meant born into a Muslim family rather then a Christian one. Still I was shocked. In fact it's taken me a whole week to actually believe that's what he said. A colleague, an eminent local cardiologist. I've kept telling myself I must have heard it out of context or incorrectly. I really hope I did.

Last Saturday morning was the second meeting of the 'Apologetics' group. According to Wikipedia 'Apologetics (from Greek απολογία, "speaking in defense") is the discipline of defending a position (usually religious) through the systematic use of reason. Early Christian writers (c. 120-220) who defended their faith against critics and recommended their faith to outsiders were called apologists...Christian apologetics is a field of Christian theology that aims to present a rational basis for the Christian faith, defend the faith against objections, and expose the perceived flaws of other world views. Christian apologetics have taken many forms over the centuries, starting with Paul of Tarsus, including writers such as such as Origen and Augustine of Hippo, and continuing currently with the modern Christian community, through the efforts of many authors in various Christian traditions such as C.S. Lewis. Apologists have based their defense of Christianity on historical evidence, philosophical arguments, scientific investigation, and other disciplines.'

So that's where I was last Saturday, intrigued by the title. I have always wanted to find out more about Islam. It has seemed to me to be so close to Christianity and Judeism, that I have wanted to understand the differences. I can't claim a full understanding but I have become convinced that we all worship exactly the same God. We believe the final revelation was delivered by different people, for sure, but they pray to God and so do we. Same God.

The problem with this meeting, and again it started OK, the problem is, the premise was that we need to convert Muslims to Christianity. Starting from that position it is difficult to get very far, since they believe just as passionately that theirs is the true and final revelation.

What I did learn was the the Qur'an, the word of God revealed through his servant Muhammad (died 632AD age 62yrs), recognises the books of Moses and the Gospels as Holy texts. It refers to Mary, the most revered woman in the Koran, and to Jesus as a mighty prophet, but not God incarnate. They believe Jesus foretold the coming of Muhammad, incorrectly as our speaker demonstrated triumphantly. They also claim that the Bible has been altered at Nicaea (325 AD), which it was of course.

So there's plenty actually to argue about. Disappointingly again I didn't feel I could join in the arguments, as I had thought was the point of Apologetics. So I kept quiet. I didn't want another 'serpent' incident, but I really wanted to ask a question.

I really wanted to ask these Christian bigots 'Which God do they think Muslims are praying to, and do they believe He answers their prayers too?' So why do they need to believe in Jesus? CS Lewis, the greatest of modern Christian Apologists said that we are all sons and daughters of Adam, even those white middle class brats of the Narnia stories.

Why, JC himself said 'Love the Lord your God, and your neighbour as yourself' He also said we are all children of God, including, presumably, Muslim children.