Chriatmas Eve 2012 - it's been a while

I think I've lost my writing mojo. I can't believe it's nearly three months. Well it's Christmas Eve and I'm up early to get things ready. The children are coming and the grandchild is coming on Christmas day. The weeks seem to come and go with every blink of the eye.
The new surgery is going great. One of them said 'well you're one of us now', which was lovely. Otherwise my commissioning work is going from strength to strength, what can I say, it's going great too. We're still managing to reinvest money in better services even though everyone else seems to be out of money. Central Manchester CCG got authorised with only one domain to complete.
You don't what to know about all that though. Relationshipwise, it's all a bit uncertain. I'm actually quite happy as I am, as they say, in between relationships. I went to London for a long weekend with Andy, we saw the Saw Doctors and a matinee performance of Richard III, played by Mark Rylance. I didn't think you could get a laugh out of Richard III, but you can.
I need a holiday so i can write about that, or maybe I'll tell you about the next few days. Come back mojo, all is forgiven. I'll put a picture of Lucas in to cheer us up a bit

The Labour Party conference - on the fringe

I spoke at the Labour Party conference fringe meeting on 'The future of the NHS' on Tuesday. It didn't take long.
The main points I made were the successes so far, our aims as a CCG, and our priorities for the future.
In the last year we managed to turn around a Manchester wide deficit of £30M to a balanced budget without cutting services. We have invested £1M in community services, reduced urgent care activity by 6% and planned care activity by 10%. We have achieved this by improving access to Primary Care, better management of long term conditions, and integration at a strategic level with CMFT and Local Authority.
I told them that ' informed by the views of local people, and working closely with other health and social care professionals, central Manchester Clinical Commissioning group will design services which are high quality, safe and affordable, and which support all communities to be the healthiest they can be'
I told them that in three years we aim to improve life expectancy by a year, reduce by a third the number of avoidable re admissions, raise the percentage of people with long term conditions to the expected rate, to develop a process for reducing harm in general practice, and to manage people at the end of life so they 80% die in their preferred. Overall, as well as balancing the budget we want to shift a significant proportion of resources from secondary care into community or primary care.

I think it went well. We didn't get into the issues of outsourcing services to the private sector, or the difficult area of resource allocation. Another day perhaps

Mauritius 2012

We've been back a week and already I'm feeling nostalgic. We were all there except for Shaun who had started a new job that week. During the stay I wrote a daily blog, but was not able to load them up. So below is what I wrote. There's probably too much to read at once.

Day 1 Mauritius 2012-09-09

Well probably day two really. Yesterday was all about getting here. We caught a 9pm flight, delayed by an hour and arrived in Mauritius at 6pm last night. It was a long flight, stopping off in Dubai, but it seemed a whole lot longer because of arriving late the next day. Seasoned longhawl travellers will know that you don’t sleep well on these flights.

Still every went smoothly, and Dinesh was waiting as pre-arranged. We took the hour drive from Plaisance airport in Mahebourg to Flic en Flac. Edwidge had arranged for the keys to be picked up and the gate, and sure enough a set of keys was waiting with the security guard. Perfect. We off loaded the van with our luggage and dragged it up the stairs.

We’ve arrived.

‘How do these keys fit?’ someone asked. Pause.

‘These are the wrong keys’ I announced after a brief try.

Luckily Dinesh hadn’t left. The security guard was distinctly unhelpful as she shugged her shoulders. The day was saved by putting the right key in the right place.

Dinesh had also booked up a meal at the Sunrise restaurant. Exhausted as we were we had to go out on our first night. The restaurant was lovely, with tables under up-lit trees and a warm tropical breeze. It was a bit chilly actually, but we were on holiday and in my country, and in my town.

 

The sun sets at six pm in the tropics. Not a lot of people know that. So it was dark by the time we got to the apartment. We’d stopped off at a supermarket to collect milk and bread, and several other things when it came to it. All fine. We got a front row circular table in front of the stage with a live Mauritian band, playing wallpaper French tunes. How was Lucas? I hear you asking. Unsettled and over-tired. When you’re about to be one year old, you don’t want to be unsettled and tired. Emily didn’t get to eat much so she and Anne went home early.

 

They went home. In the dark. In a strange country. In a town they had never seen in the dark. They got lost. Of course.

Fortunately our mobile phones work over here. Dinesh came to rescue us, not for the first time, and all ended well. We slept well on day one. All except Lucas, who decided he wouldn’t yield to the antihistamine, and needed a spoonful of paracetamol to eventually settle his troubled soul. I wonder where he gets it from.

Day 2

I was up first, well third really after Emily and Lucas. Emily was pleased to see me and before I could wipe the toothpaste from my mouth I was off taking him for a walk.

 

Flic is about 200 yards down the road from the apartment. There’s a sizable Spar, with all you could need for a two week holiday. Yes, toilet paper and everything. I reminded myself of the road we only saw in the dark yesterday.

Flic en Flac is one of the main holiday resorts in Mauritius, but it is more for Mauritians. The Europeans and South Africans tend to go to the big five star hotels in the north or west. This is a small, spread out seaside town, the size of St Anne’s. There’s only one main street that runs alongside the beach. It is lined with bars and restaurants, closed at 9am. The Spar is however, already busy with Mauritians and a few Western holiday makers. They are buying their fresh bread for the day. I’ve come for milk, can’t resist the baguettes apricot jam and Palma ham.

Back to the apartment and still no-one up. Eventually we all come round and it’s off to explore the beach. This is Mauritius, not the five start hotel version. Anne’s mind is blown. Kids love it. Lucas is impressed briefly with the sand and the sea. Not far out is the reef. I explain to the others that below the sea is beautiful Coral Sea with tropical fish of all colours darting between the seaweed.

I’ve brought my snorkel, but I don’t know if I’ll be able to use it. No fits since the first one, but when will the next one be? I didn’t risk it today

Day 3

We now have an itinery. Today we’re going to Mahebourg to the market. This is a busy and genuine market with stalls selling all sorts of produce and products. Tomorrow we’re going to visit Rosemay in Beau Bassin, Wednesday is swimming with dolphins and beach bar B cue.

Last night we had dinner at the ‘Hippocamp’ restaurant. The owner is a delightful man who immediately understood the need to relieve Emily of Lucas so she could eat. He disappeared with Lucas for twenty minutes. When he found out I was a doctor, he was even more interested. He is married to an English woman and says he will help me to get Mauritian nationality. This is essential if I want to buy property here, and the idea is becoming increasingly appealing.

I checked my emails in the morning. Not too many, then Dinesh came to pick us up at ten. In Mahebourg the market was on. It was not as big or busy as I remembered but was still interesting and entertaining. Everyone bought something. Me, I bought a T shirt and another one for Lucas. We each had a dhal purri from a street vendor and Bryani for lunch. I tried to find Guydou’s pharmacy but could only guess.

The highlight of the day was stopping off at Blue Bay on the way back. A glass bottomed boat trip across coral and some beautiful fish. The boat took us out to almost the reef. The sea seemed much rougher that at Flic en Flac. It’s been a long day and on the way back the swimming with dolphins idea looses its appeal as we learn that it will cost about £50 each as well as the cost of the taxi. Never mind, there’s plenty to do instead.

 

Day 4

Have you noticed the number of dogs here/’ she asked rhetorically, ‘and yet you don’t see any dog shit’. We agreed uncertainly. Today we were going to go to Beau Bassin and visit the place I grew up in, and go to meet Rosemay who still lives there. Dinesh was coming to pick us up at 1pm.

In the morning we went to the beach. What a great beach. Probably the best beach in the world. I don’t know of a better beach. This morning it was particularly brilliant, literally brilliant. The sun was hot with a cool sea breeze. Two sun loungers and a parasol for 300 rupees, that’s £6. They would have been ours for the day if we were staying. The reef at Flic is much closer than Blue Bay and the sea today much calmer.

It was time to have a go at snorkelling. I warned everyone and tentatively swam out to the coral. My own biased view is that the coral and the fish are even better here than at Blue Bay. I first went out for a few minutes only, but then later for a bit longer. This is the achievement of the holiday for me. I never thought I’d do it again.

The trip to Beau Bassin goes through Bamboo, so we stopped at the Catholic Church where my grandparents got married. Mme Eklezio seems to still be in charge, or else the sign is still up from when I was last here listing who is responsible for the flower rota.

Dinesh drops us off at the big church in the town. Sacre Couer dominates the centre, overlooking La Route Royale on its way to Port Louis. I recognise our street, so we cross the road and head on down to where I think our house is. On the way we pass the derelict remains of auntie Denise’s house on the right. There at the bottom is our house. There has been an extension at the front. Last time there were several maingy dogs tied up at the front. We could see them this time but they barked away to let the owners know we were there. Alongside is a row of apartments so we looked down the side and peered over the wall. Not much to see but we got the idea. I’m trying to picture it in my minds eyes, but its only faint and I’m not sure what I imagine are what was really there.

After what we have called La Rue Telephone, ‘though it’s probably Napier street, we head off to find La Rue Mosque. One of the houses at the top was Marceline’s and another was the original Benett house and one where my father’s uncle lived – surname Donald.

Dad’s picture, although admittedly ‘not to scale’ showed La Rue Pere Laval fairly close. Actually it is about three quarters of a mile up hill. We had to ask several times and always it was ‘un haute, a droit’. ‘Why don’t you phone?’ I was asked. After the fifth ask, and after finding the road, then I phoned. Rosemay met us and in we went. Later Dinesh was to say ‘c’est bien zolie’ and indeed it is. A ‘typically colonial house’. I have described it before, but it is impressively all wooden. Outside are the two Lychee trees and a large Mango tree. These I do increasing remember. I thought the mango tree was in our house, but it is this one that I recall. We must have spent more time here than I thought.

Inside there is a classic posed picture of my great grandmother whose maiden name was Clarenc. Next to her is David Davis, my great great grandfather. Thus confirming that Hector Clarence was my great great great grandfather. He was a doctor to one of the sugar cane factories and presumably worked with slaves and indentured Indians. It was to his mistress that this particular family line belongs. He ‘looked after’ them well, although there is no trace of them until gentrified by the marriage of his illegitimate daughter to David Davis.

We are tired now, and so we head off back to Flic. Later we went for a meal on the seafront and on the way back in the dark I trod in soft gooey dog poo. So that’s where the dog is. I left my flip flops outside the apartment on the grass and washed my feet in the shower.

The next day I went to clean the black havaianas, only to find someone else had already cleaned them.

So that’s what happens to the dog poo.

Day 5

We spent on the beach. Flic en Flac beach rally is the best in the world. I made friends with the beach lounger attendant and gave him a bit extra. Well it does cost much and they keep an eye out for you.

Ambre Solair really does smell of holidays, they should market it.

Lunch was at the Ocean Bar a few yards from out towels. It started promisingly with swift attention and good beer. The food was slow in coming and cold and not very nice. The bill was wrong, but the waiter apologetic.

Later on the beach a couple of odd looking boys appeared and wanted a photo of Lucas. We said ‘no’. Immediately someone appeared from up the beach and told them to ‘allez’ and apologised for them bothering us. I was a bit spooky and rather put a dampener on an otherwise perfect day. Later the beach lounger attendant could be seen slapping one of them and eventually they left. So much for non-violence, we would all have killed them if they’d touched Lucas

Day 6

Another day on the beach. Oh well, nothing much to report except an absence of mental boys. Jon went on excursion on his own and ended up in Tamarin, famous for its salt farm and the hideaway ‘ pour les blanc Mauritian’

Lucas is standing on his own now, but not quite taking his first step unaided. He won’t be long now then mayhem will rule. More to report tomorrow.

Day 7

Now today is one of the most adventurous days. We got up as usual but with grey cloud cover we decided to go to Port Louis. By bus. The first challenge was to establish exactly how you do that. It seems to be easy enough. You stand by the side of the road and hail it down. It’s a bit uncertain whether they will actually stop in these circumstances so we decide to wait at a point marked by a bus stop. How exciting. Travelling through the sugar cane lined roads is just as you might imagine. Every now and then we pass through a village and street side vegetable stalls. The bus plays loud, not particularly ethnic music, from a radio station. As we approach the Capital the road gets busier, until it is positively third worldly and bustling, tooting and noisy.

Where to first? The bus stop is just opposite the waterfront and the temptation to have a drink is overwhelming. Then off to Barclays bank to pay for the apartment, then lunch.

Caudan is a new-ish shopping centre lining the harbour and built on the site of derelict port land. We settle for the sunshine restaurant just near where there seems to be a Sega contest between local schools. The Sega, as previously reported, is music and dance created to a distinctive rhythm by the sugar plantation slaves. Slave owners banned it at one point because it was said to be inspired by the devil. Actually the Creole words were not able to be understood by the owners and did send covert messages to the listening audience. It is also fun and a courtship dance. Some of the words are really quite saucy, I’m told.

The main reason for coming to Port Louis was to go to the market and it was no disappointment. There are several sections including a vegetable section, meat section, and gift section. The first two are full of fresh stuff and really don’t look like all being sold before the close. The last has got amazing locally created things like clothes, sheets, shoes, jewellery. I bought a game of solitaire with marbles made from highly polished volcanic stone. I also got a box for vanilla pods.

The bus journey back was more traumatic. The sun was out by now and hot. The locals had taken all the seats on the shaded side so we were left with the sunny side. The traffic was jammed and so for twenty or so minutes, while we tried to get out of the city we roasted. Once the bus got going, the breeze through the window cooled us down. We still had to squash up to fit all the people in. Eventually we got back. It took about an hour.

Tonight we’re going to La Domaine Anna for a Sega show and meal. I hope it’s as good as the school performances this afternoon.

Day 8

I can’t believe we’ve only been here a week, we seems to have done so much. Today we are going to the Seventh day Adventist church in Beau Bassin, and then to lunch with the Derblay and Gueho families.

In case you were wondering, there was no Sega at Domaine Anna last night. We got the wrong night. Domaine Anna is a huge restaurant, built from scratch in the middle of nowhere. It’s been going for a while and so must be making a profit. The grounds are expansive and there are water features, streams and waterfalls all over the place. It’s difficult to see it all in the dark, but everyone was very impressed. Dinesh had got us prime seats, in an alcove by the water.

The entertainment tonight was a crooner and his band, playing yesterdays tunes. At one point, though, there was a bit of excitement as the waitress who originally served us fainted and cracked her head on the tiles. The other waiters sat her up in a chair and she remained unconscious. Step up Doctor, so I did. I got them to lay her flat to start with and then carry her to a more private area. She came round naturally and was OK apart from the bump on her head. I sent her home and returned to the table a minor hero. Unfortunately the heroism was not rewarded by a reduced bill. Now I see why the place makes a profit, it’s not a cheap night out. Dinesh came at 10.30 and took us home. Everyone had had a good night, enjoyed the food, and confessed that they had never been to anywhere so grand before.

This was the day of the trip according to Jonny and Anne, without contradiction from the others. The start was a rather prolonged service at the Seventh Day Adventist church with an unnecessarily long sermon by the scouts on Danial and his faithfulness. It was hang on the tenuous analogy between his constant prayer and an iPad – instant personal advice device – the Bible. It wasn’t that bit that was so good, it was lunch at the Ghueo house. I have described their set up before, but to remind you, the original plot was bought by Mr Derbley, Oriel I think. Since then his son and daughter, Max and Alice have lived in the house. In the grounds they built another house for his other daughter Rosemay and Son-in-law Daniel Ghueo. Daniel was the minister at the Adventist church and ended up being the sort of superintendant for the Island. The next generation girls put on a great lunch for us, so Francoise and Martine, and also Danick’s wife Aureli. Michael Ghueo’s wife also provided food. I may have got the names slightly misspelt. The food was great of course, but even better was the warmth of the welcome and the conversation. I love them all. The children and Anne got so much out of it. They were mainly surprised that people seemed to be content with life. Struggling a little, but basically happy and getting on with life.

We went back for an afternoon nap and then in search of a Sega night. We were assured there would be one at a local hotel. We didn’t find it, but we did come across a hotel music night which had involved Sega and was playing YMCA with actions to an audience of almost exclusively Europeans.

It had been a very Christian day.

Day 9 – Beach day all day. Sunday is a day for the Mauritians to come to the seaside and Flic en Flac was full of picnicking families. Lucas made us laugh by going in the sea in a boat shaped ring.

In the evening we discovered the Restaurant Leslie. It was there just before the big new restaurant we’d been to twice already, on the main road out of Flic. It’s a small place run by a husband and wife, and untroubled by modern fashion in restaurant design. It is clean and inviting. At low season, now, no-one much is venturing beyond their all-inclusive five start hotels, so Leslie was empty and authentic. Just what we wanted. Lucas slept and we looked quietly through the menu. Quietly, except for the noise of heavy traffic which thankfully diminished in frequency as the night progressed. Despite the age of the building and proprietor the music was surprisingly modern and not Mauritian. He must have thought we’d prefer it that way. Personally I’d have preferred some Sega, but Lucas was asleep and so we left it as it was. Two bottles of white wine later and we’d exhausted the alcohol supply apart from a remaining bottle of Rose.

The food was great, mainly seafood done either creole style or curried. Mauritian curry seems to contain a lot of Tamarin which makes it quite distinctively tasting and brown. It’s also not very hot, although there is the option of adding ‘blow-your-head-off’ pimment to it. Jonny and Lizzie had beef.

The desert chef, I’m guessing his daughter, was off sick. To round off the meal he offered us some liquor he had prepared himself. He told us the ingredients, but I forgot. As we were so delighted with this liqueur Mauricien, he gave us the whole bottle.

We gave him a large tip and promised to revisit later in the week. I think the expression is ‘we all buzzed off the scene’.

Day 10

We’re going to Montaigne Longue today. It is a small village in the mountains where my father was born and grew up in his early years. My Grandfather got his first hospital job there. Last time we met one of dad’s childhood friends. I wonder if I’ll be able to find the various places he showed us.

We saw the hospital, well the up to date version. The original building seemed to be tiny and I guess was no more than a local clinic. Montaigne Longue itself is quite large for a village. We drove past at playtime and the playground was full. One of them could have been my father, I guess. Past Montaigne Longue is Creve Couer which lies at the base of Pieter Both and Dinesh dropped us off at the end of a track. For quite a long way up there are concrete steps which eventually turn into an earth path. Looking round there is a great view of Montagne Longue and the surrounding country side. On the sloping hillside people were still tending the land and growing crops. Presumably these vegetables are sold at market somewhere, and are their living. A few goats were penned up and I guess provide milk and food. The living seems hard and difficult to sustain. The lifestyle must be dying out. However, despite this, some of the houses were quite modern and must belong to people who commute to Port Louis. All the same it is strange to think of my father running around these parts eighty years ago.

Back in Flic en Flac the weather was so-so, but we went to the beach anyway. There seemed to be a beach party for teenagers with thumping music and the audience being lead to group dance to ‘Macarena’. How disappointing.

Day 11

September 18^th – Lucas’s birthday. His first birthday. He can stand on his own, but not yet make a step. He says car, dog, mum, and makes it very clear when he doesn’t want to do something.

We went to a country park/safari park called Casela which is about fifteen minutes from Datier where we’re staying. I wasn’t expecting such an amazing trip. I saw a white tiger, a black swan with red beak, and three albino lion cubs. We took a trip into the lion park. There are two males, Aaron and Reuben. Aaron used to be the dominant male but has recently lost out to the younger and stronger Reuben. Reuben’s mane is darker signifying his higher rank in the Pride. There are four female although only three on view. One is probably pregnant and is isolated in observation. One is lying peacefully next to Reuben, and the third is in a tree keeping away from flies. This third lioness apparently has a bad attitude and won’t even let Reuben near her. The lions get fed twice a week but do also hunt for small prey that stray into their compound. In another part of the park are Cheaters and Tigers. One of the Tiger is white instead of sandy coloured and a magnificent beast. Our guide tells us that although Lions will kill when hungry, Tigers kill for fun. Also they will attack from behind, which is why in India people go into the forest with masks attached to the back of their heads. Tigers are apparently much smarter and cunning than Lions. Our Lions looked pretty lazy, although Reuben did follow us with his eyes. There were lots of other animals, of course, but the big cats are the main attraction.

We had lunch on a hill in the park overlooking Tamarin and the tallest mountain in Mauritius. I had always thought it was Le Pouce, but it turns out that Le Pouce is only the third after this one and Pietre Both. The trouble is I can’t remember its name.

Then back to the beach before cake and a sing song.

 

Day 12 starting to think about going back, but not too much. It’s another day on the beach. We’re eating with Danick and Aureli tonight at Leslie’s restaurant. No rum this time as they are Seventh Day Adventists and don’t drink. After the meal we came back to our apartment where we were shown how to us the Ravan. This is the drum element of a typical Sega band. The other elements are the Maravan, Triangle and sometimes a Guitar. Aurelie has promised to get me a Ravan before we go home.

Day 13 – Ganesh Chaturthi– This was probably the most unexpected turn up of the holiday. Little did we know that the public holiday that is today, is in order to celebrate and prey to the Hindu god Ganesh. He’s the one with the Elephant face. We started off on the beach but the day got windier and colder so went back. In the afternoon we went to the Hindu Temple along the beach. There were several discrete groups of people doing their own chants around their own statue of the elephant-face god. Then at different times they went down to the sea and immersed the statue in the sea three times. No one was able to explain why this happened, even those that were worshipping. This finale was preceded by chanting and rhythmical drumming and dancing down the street carrying the god in the air. There was also plenty of food around. The worshipers didn’t seem to mind strangers looking on and taking photographs. They didn’t look as though they’d get offended either. Although the police were present there was no sign or sense of trouble. Everyone seemed very peaceful and were having fun. There is a stage on the beach as if for a concert later. We may go down.

We didn't go down but had a last meal in the Twins' Garden. The next day was packing up and heading our separate ways. It was a long trip home, and exhausting. This has been a wonderful holiday especially for bringing us all together. It was a holiday of a lifetime.

Devon and Downpours

I'm looking out of the window of my room in the country, at the green house, the summer house - well shed really, and Ade and Sue's sloping garden. The birds are twittering, and a cockerel is crowing. Otherwise, not a sound. Peace.
Last week was the bank holiday weekend, and for me that means either the European Cardiology Conference or Greenbelt. This time it was Greenbelt.
I could have gone to the ESC again. It was in Munich, as it was about four years ago, but I have to distance myself from pharmaceuticals these days. So I have had to turn down some offers. Anyway Greenbelt is so much better and a much more sensible use of time. The speakers this year were just mind blowing.
I decided not to get a programme and be 'lead by the Lord'. This turned out to be a great strategy. For a start I wasn't worried about missing things, and secondly I saw all the best things anyway. The big names are on in one of two or three venues, and I simply joined the longest queues. This year John Deer and Giles Fraser were my main inspirations, and John Bell of course. John, he of the Iona Community and regular on 'Thought for the Day', has become a favourite at this gathering. I know they've all practiced what they're going to say a hundred times, but I just think it's brilliant when they talk, as if extemporising, without notes and with arm jestures and emotion.
I love this weekend because it is not simplistic or evangelical, but takes the complexities of faith seriously and offers sensible ways of following the Word. Issues like the use of money and power, sexuality, and what does it mean to be a seeker of Peace. Did you know that Islam means Peace? I was never told that in RE. People are not afraid to find the word of God in the other Abrahamic religions, but also in Buddhism and Hinduism and other faiths. For the first time I have understood what a revolutionary Jesus was and how radical his teaching become for every day life, the Spiritual journey and Politics.
Surely, God was in this place, but the one person I wanted to be there wasn't.
Well if He was there, then He didn't make the weather easy for us. I got a lift down from Ben and Miriam Jones. I hadn't been able to find my tent and pegs so had to go to Camperlands in the morning to get kitted out. When I arrived at the campsite I just managed to get the tent up when the heavens opened, and continued to open for the rest of the weekend. We were literally in bare feet slipping through the mud, just like those pictures you see on the TV of washed out summer concerts. It rained right until we left, as we watched Seth Lakeman on the main stage.
So here in sunny Devon the next weekend it's also time to go home. It's so chilled, as they say, I love it. We took the dogs for a walk yesterday morning and had lunch at a wonderful pub, the 'Ring of Bells'. The walk was in a forest with warm sunshine and crazy flat coats. One of them, Xante, has been putting on weight, becoming lethargic and loosing her coat. These turn out to be the classic signs of hypothyroidism in Retrievers, and so it has proved to be. Next week she's going to start on medication. Pebbles, meanwhile, is a jumpy uppy, lick you all over puppy still.
I shared my early thoughts on what to say at the Labour Party conference fringe meeting with Adie, and he offered some useful feedback and thoughts. I'm going to be letting those thoughts simmer on a low burner while away in Mauritius and wait for them to mature.
Oh did I tell you I'm going to Mauritius? I'm going to Mauritius next week, with all the family including Lucas. 
And a new series of Dr Who. What a lucky lucky person I am.

Happy Birthday to me - yesterday

'We knew it was your birthday, so we brought a surprise' Jill said as the CMFT team walked into the Board room.

Yesterday was indeed my birthday, and probably one of the best I've had. It began with being woken by lots of texts wishing the best for the day, and backed up with several more on facebook. I text some back to say I'd be in Alberts from 8 onwards, so if they could join me that would be fun. I didn't expect many affirmative responses as it is still a 'school' day for most of us.

I had had a 'bit of a night' the night before and so wasn't looking forward to the work side of the day. I trudged down stairs rubbing my eyes and wondering why the light was so strong. There, on the kitchen table was a card and a present from Andy. He'd already gone to work. It was a modern version of the old board game 'Risk' we used to play as students.

That was nice wasn't it?

Have you noticed that when you're not feeling too good and need to get somewhere, the time seems to hurry by? So I rushed to get ready and cycled off to work. This is one of the two half days in the week when I still actually see ordinary general practice patients. My new practice are great and really appreciate me working there. Everyone wished me a cheerful 'happy birthday'.

That was nice.

I saw the patients and started to feel better again. In the afternoon I was due to chair a quarterly quality assurance meeting with representatives of the Central Manchester Foundation Trust, a group of five or six separate hospitals under one management structure. My main job now is to work with them to commission services for the central Manchester population, as Clinical Director for the Central Manchester Clinical Commissioning group. I enjoy it and I think I'm quite good at it. People say nice things anyway, like they think I'm 'the voice of reason'.

That's nice. So after surgery I set off to meet them.

This meeting is about holding them to account for quality performance. So we go through Schedule 3 and Schedule 5 which include CQUINs, SUIs, audits KPIs, NICE compliance and so on, and with Francis 2 on it's way I really have to be on the ball, as I'm sure you can imagine. Luckily we'd had a pre-meet and I have great support staff. When I first started doing this a couple of years ago it was a bit controversial with disagreements about this, that and the other. Now I would say it's a genuine enquiry after quality and patient safety issues for the good of our population. We can still disagree but usually we find a way forward. Obviously, some, like the busybodies at the Cluster, think we're a bit too cosy now. I'm aware of this risk, but I think we have a proper relationship, and we have been working much more cooperatively in the last couple of years with positive effect. Anyway, this is an important meeting.

Later, after the meeting, I had a little siesta and then Andy and I had a meal at Albert's and the rest joined us. The evening was excellent with a great mix of people who didn't really know each other but got on brilliantly. I would have expected Tim, Jen and Andy to be there, but it was wonderful to see Tony, Masud, John and Mu. We ended up playing poker, luckily not for real money or I'd have been cleaned out.

Anyway back to the meeting. I had gone to the Board room early to remind myself of the papers and run through the agenda in my head. The CMFT people arrived en-mass. Two of then were carrying bags. They put them on the table, and out of them came some juice, paper plates and plastic mugs, and a huge cake in the shape of a lion. 'We have a baking genius amongst us, we knew it was your birthday and so we've made you a cake'. It was in the shape of a lion with a more than passing resemblance to the one about to chair the meeting. On top was a candle holder which when you twisted the base played 'happy birthday'. Thanks Liz and all of the CMFT team.

Now isn't that nice?

I've since had several emails addressed to the Lion man! A perfect surprise in the middle of a perfect day.

The New World - after the Alexandra Practice

I haven't added much to my blog over the last month. Partly because of time and partly because of writers block. You should all know though that everything is going just great.

I've come back from a football trip in Turkey. We had the usual degree of success and great fun. I played all games and have reasserted my position in the team.

Work is great and I'm so pleased I've moved. The Commissioning role seems to be bounding ahead. I presented my vision of Primary Care long term conditions management to the Dementia Tsar and a load of Manchester Academics last week. Also presented at a National conference of GPwSIs in cardiology. I've been asked to speak at the Labour Party conference, but waiting for 'clearance' from the MHS bosses. I don't know if the conference knows what they're letting themselves in for. It was them who started the marketisation of the NHS.

The sun is here and summer has arrived at last. I'm also looking forward to our trip to Mauritius and to see ing lucas on his first birthday.

I will provide a more detailed commentary soon.

The Last Days

Today is the last day working at The Alexandra Practice. I shall not miss the ungrateful partners who forced me to move out, and are now wanting to say sorry. I shall miss the staff, all of whom have been great and sad to see me go. Of course they don't know the full story. I shall miss all of those patients I've grown middle aged with. Many have already moved to The Range, but I dare say many wont either.
Tomorrow I start at a new place. More space, more scope for expansion, younger, fresher and exciting.
The old is past, and the new begins again. I don't want anything to do with the old after today.

Last weekend I nearly died. No really I could have. I went for a walk in the Lakes with Andy up to Stickle Tarn. Then ' a bit of a scramble' up a ridge. Jake's rake or something. One side, a 200 foot drop, the other shear rock face. One slip and I was a gonna. Not a good place to feel faint or have a fit. It was scarry. Going back wasn't an option either, as it is too steep and no way past other ascending climbers. In anycase I didn't want to look down.

Sometimes in life you just have to look ahead, move on from the past, and trust in God.

Well I survived the 'bit of a cramble' and I guess I'll survive leaving the Alexandra Practice. At least I can say I've done it and look forward to the future.

Crow Head and the blue bell walk

Its early May bank holiday weekend, so I must be in Devon. Ade and Sue have prepared a very special day out. All the spring flowers are out and their garden is full of pink, yellow and blue. I travelled down on Saturday, by train. It took four hours but went straight through. I went first class as it was off peak and cheap. Next time I come down Friday and wont bother with first class, there was little difference and no free WiFi you get on Virgin trains. This was cross country.
Crow head is a stretch of beach in North Devon. I think it's North Devon, we went through Barnstable anyway. It feels just like Mull, with one narrow road to get to it, and constant stopping to let people go by. The sheep wander across the road as if they own it. The beach is about six miles long and it's low tide. The sun was out, the dogs were silly and it was perfect.
Then a pub lunch overlooking the sea, or was it an estuary. Steak pie, chips and gravy and a pint of beer.
Next to a bluebell walk some miles away. The farmer only opens it up for a few hours in the day. As we arrive, the cars are starting to fill the car park. Several groups of people are out. The path leads us through the trees to a blue carpeted wood. This is what I've come to Devon for. Little signs point out the other different sorts of wild flowers and the trees. There is even a deer fallow, we are told. Well more of a muddy path really and no one is very convinced.
Then on to the Eggesford Beer Festival. There's a beer tent and tables and chairs . Opposite is an orning where the jazz band are playing. The Bar-B-Cue has run out of burgers. A lady with her Downs syndrome daughter are dancing to the music, while the other twenty or so look on. We must have missed the Morris Men.
The day could have ended perfectly, but it didn't. City beat Newcastle to put them in a very strong position. You can't have everything and in the end, I'd rather have beer and blue bells. Thanks Ade and Sue.

The Second Coming

Mum and Dad are coming for lunch today. They're coming over to see Emily and Lucas before the two American passport holders go back. It's funny how you get used to people being around. I shall miss them when they are gone, but they'll be back I'm sure.

Meanwhile everything else is changing. Just one month left at The Alexandra Practice and I'm looking forward to the move. I can't stomach being in the same room as my current 'partners'. I really don't think they understand how easy I have made it for them.

Yesterday was Steve Raw's 60th birthday celebration, so we all trekked up to Crowden for a picnic. It was raining of course, but cold and windy too. Just as I remember it, and just like those days camping out in Mull. Ah, happy days. There were lots of people, considering the weather, all linked in one way or another to each other. Apparently Lucas didn't like the cold, so as soon as the birthday cake had been lit and the song sung we came home. I didn't mind either, anything to get away from TJG and his smarming presence. I think I may have said goodbye to the Men's Group for the same reason. As soon as we left the sun came out. Perhaps we missed something momentous through our lack of faith and goose pimples, but I doubt it.

On Thursday night I attended a meeting of the Didsbury Lefties. I don't know if that's really what they're called, but they have been meeting for years and are ex-academics and lecturers mainly.
The house was a good sized Didsbury semi. We gathered in the kitchen then moved into the lounge. The chairs were placed in a circle and we all sat down. It had the feel of a prayer group, like people waiting and preparing for the Second Coming.
We did a double act, Martin and I. He is the Director and sole employee of the Socialist Medical Movement, and he gave his thoughts on the NHS reforms. Well, until I suggested we perhaps moved into the twenty first century.
I told the assembled about the good stuff we have been doing in Central Manchester, and that co-operation was working despite their scepticism. They wanted to know why, if the changes were so good, was there so much opposition to them from the profession. I pointed out that the BMA has opposed every change including the very inception of the beloved socialist NHS.
In the end they seemed to have enjoyed the discussion, and I had too. They're hardly a bunch of militants. In fact I think I might start going to their meetings myself, as their youth policy.

Talking of prayer groups, I was on the Emmanuel 6.15 congregation annual weekend away, last weekend. It was good. We even had a barn dance. The new vicar is obviously wanting to make his mark and take the congregation forward. We had prayers and Eucharist etc and also his vision of where we might go. We all considered his suggestions prayerfully and agreed, like the good sheep we are, to head in that direction. That direction is to try to become more like a community of the early church. More supportive of each other and more socially cohesive, instead of just turning up on a Sunday and going away again. The early church also lived their lives as I imagine an egalitarian commune might. They also expected the return of Jesus anytime. Like the old Commies are waiting in their front room for the second coming of their Messiah.

Perhaps it is time for the Second Coming, after all. Or is it already here?

A cherry blossom tree to remember Richard

I set up a facebook group of Manchester Medics, class of '79 yesterday. The numbers doubled over night. There are now about thirty members already, and talk of meeting once a month for a beer. Admittedly this was the boys, well me and John really, who both live in and about Manchester. I thought 'the Friendhip' in Fallowfield would be nostalgic enough. Tommy Ducks, the Plaza and the Conti having closed down.
There are some names I just don't remember at all.Other people I can picture but don't recall their names, and others who's names are so common that there's no way of knowing which one was a 'class of '79er'. It'll be fun to see what happens.
We planted a cherry blossom tree yesterday, to commemorate the life of Richard. What a great way to be remembered. Much better than a gravestone in my opinion. It's what I would like for myself.

Cherry Blossom in Manchester

Back home after slick trip from Newark. Now Emily and Lucas have arrived back in Manchester to sort out their longterm visa. The blossom is starting to come out. The sun shone briefly yesterday, but it's still chilly here. Next weekend I'm going up to the Lakes again.
I went to look around my new practice yesterday and have a go on the computer system at the Range practice. It looks brilliant and much better. Altogether I am looking forward to the move. In fact, the troubles at the Alexandra Practice looks like being a blessing in disguise.
I was thinking yesterday, if I had planned how I should spend the last five years of my career before retiring, this is what I would have liked to do. In other words, a reduced clinical load, two surgeries  a week. A cardiology session a week to use my specialist skills. The rest being spent on commissioining work as Clinical Director. I am very happy with my work at the moment.
I can also spend more time with Lucas.
Spring is a time for optimism and looking forward, and I feel good

The Declaration of Independence

'We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.'

I am so glad I didn't return to Connecticut yesterday. I was going to, rationalising that I had seen what I came to see, and really wanted to spend time with Lucas. I find myself saying these words to myself in a sort of Southern American accent. I don't know why. Perhaps it's because I spent yesterday morning on a sightseeing bus with American commentary, or last night at a play called 1776.
'The bus leaves from the front of the hotel at nine, and then every hef awer' said the helpful receptionist. First stop, Union Station. At the time it was built, the largest and grandest in the World. I think Grand Central beats it hands down, but that was at the time. I hopped off and had breakfast, and took in the atmosphere. Not terribly busy, but I had missed rush hour, and lots of renovations. I ate in the cafe and would give it a bare 'average'. Then the Red Bus route.
I'll try to remember the highlights, but there were so many of them. Lots of museums [or is it musea?] and if part of the Smithsonian legacy then entry is free. Lots and lots of memorials, including the Lincoln memorial and to all the different wars the Americans have been in. The reflecting pool, I found out, was being repaired to stop it leaking, and the whole of the National Mall was being re-done to improve soil drainage and the cultivation of a lawn. The Washington Memorial had recently suffered as a result of an earth tremor, and so was also being checked over too. It wouldn't look good if that fell down.
The city was designed by a French born gentleman called L'Enfant. He must have still been a child when he came to America. He is buried at Arlington Cemetery on high ground, so he can overlook the city he planned out. We went there later and it is quite moving to see the rows and rows of white tomb stones. To get there we have to cross the Potomac river after going round the Tidal Basin to which it connects. Although my children groan, I do think this sort of tour bus is a good way of getting an overview, literally, of a big city.

I got off the bus for lunch. Wandering around I came across a handful of tents, camped out in Mc Pherson Square. They looked pretty hippyish with anarchist literature in a shabby looking orning, and books which people could 'please borrow and return them for others to use'. The sun was warm. Three people were talking 'to camera'. No one else was there. The 'Occupy McPherson Square' movement, was obviously having a day off. It is Good Friday after all. They were probably all at church.

In the evening I took a walk around. I came across a queue of people outside the Ford's Theatre. They were waiting for a play, 1776, to begin. It was too early to eat so I paid my $70 and took my seat near the front of a packed theatre. I had forgotten my glasses, but it didn't make much difference in the end.
I didn't know too much about the Declaration of Independence, only tit-bits I'd picked up randomly, and I don't know how historically accurate this play was. It turned out to be a rather amusing musical version. Mercifully the songs were few. The acting was quite good and appropriately funny when it was meant to be. It was good to see the various characters come to life

I hadn't appreciated the political in fighting, compromises, and alliances that went on. For instance, I didn't know that Pennsylvania  through their leader John Dickinson, were such loyalists to the Crown. Benjamin Franklin, the older gouty statesman was there, also from Pennsylvania. So was our previous hero John Adams, the Massachusetts agitator; Thomas Jefferson, newly wed and reluctant author; John Hancock, congressional leader; and Roger Sherman from our own Connecticut, amongst others.

For more, if interested, see italics below:
'The Declaration of Independence was a statement adopted by the Continental Congress on July 4, 1776, which announced that the thirteen American colonies, then at war with Great Britain, regarded themselves as independent states, and no longer a part of the British Empire. John Adams put forard a resolution earlier in the year which made a formal declaration inevitable. A committee was assembled to draft the declaration, to be ready when congress voted on independence. Adams persuaded the committee to select Thomas Jefferson to compose the original draft of the document, which congress would edit to produce the final version. The Declaration was ultimately a formal explanation of why Congress had voted on July 2 to declare independence from Great Britain, more than a year after the outbreak of the American Revolutionary War. The Independence Day of the United States of America is celebrated on July 4, the day Congress approved the wording of the Declaration.
After ratifying the text on July 4, Congress issued the Declaration of Independence in several forms. It was initially published as a printed broadside that was widely distributed and read to the public. The most famous version of the Declaration, a signed copy that is usually regarded as the Declaration of Independence, is displayed at the National Archives in Washington, D C. Although the wording of the Declaration was approved on July 4, the date of its signing has been disputed. Most historians have concluded that it was signed nearly a month after its adoption, on August 2, 1776, and not on July 4 as is commonly believed. The original July 4 United States Declaration of Independence manuscript was lost while all other copies have been derived from this original document.
The sources and interpretation of the Declaration have been the subject of much scholarly enquiry. The Declaration justified the independence of the United States by listing colonial grievances against King George III, and by asserting certain natural and legal rights, including a right of revolution'.

The Declaration avoided the issue of slavery, in order to get the Southern Staes on board. This stored up trouble and lead, in the end, to the bloody Civil War. They abolished slavery almost a century later under the leadership of Abraham Lincoln, a Republican. Of course, he got assassinated for his troubles, but lives on in those words of the Founding Fathers.

So now it's back to Connecticut and Lucas. I'm glad I stayed the extra day. I understand the Americans much better now. They had a point. If only they had lived up to their high ideals better. I guess they're only human. We all make pledges and declarations, and fail to live up to them.

God bless America.

Bocker T Washington

During my walk around the city I came across a brass engravings placed within the pavement. One of them was about this man. I thought I'd find out more. It may not interest you as much as it did me.

Booker Taliaferro Washington (April 5, 1856 – November 14, 1915) was an African-American of mixed race. He became an educator, author, orator, adviser to Republican presidents, and black political leader. One of the last generation of black American leaders born in slavery, he spoke on behalf of a constituency of Black Americans who lived in the South, but had lost their ability to vote through disfranchisement by the southern States. 
Washington was born into slavery to Jane, an enslaved African-American woman on the Burroughs Plantation in southwest Virginia. She never identified his white father, said to be a nearby planter. His birth father played no role in Washington's life. At the end of the Civil War in 1865, when his family gained freedom, his mother took them to West Virginia. Here she formally married the now freedman Washington Ferguson. Booker T took the surname Washington at school after his stepfather.
From 1890 to 1915 Booker T Washington became a dominant figure in the African-American community in the United States, but was not uncontroversial. His opponents disparagingly called his powerful network of white politicians, businessmen and philanthropist supporters the "Tuskegee Machine." Washington maintained influence through his ability to gain support from a wide diversity of groups. As well as influential whites, he recruited educational and religious communities nationwide. However, his accommodation to the 'political realities' in the age of the racist 'Jim Crow segregation' brought disapproval from other Human Rights activists.
Washington's 1895 Atlanta Exhibition address was viewed as a "revolutionary moment" by both African-Americans and whites across the country. Then fellow activist, W. E. B. Du Bois supported him, but they grew apart as Du Bois sought more direct action to remedy disenfranchisement and lower education. After their falling out, Du Bois and his supporters referred to Washington's speech as the "Atlanta Compromise".
Washington advocated a "go slow" approach.The effect was that many Southern Blacks had to accept sacrifices of the potential political power, civil rights and higher education they sought. His belief was that African-Americans should "concentrate all their energies on industrial education, accumulation of wealth, and the conciliation of the South."

Washington was on close terms with national Republican leaders, and was often asked for political advice by presidents Theodore Roosevelt and William Howard Taft. Washington argued that the surest way for blacks to gain equal social rights was to demonstrate "industry, thrift, intelligence and property." He also said, "I have learned that success is to be measured not so much by the position that one has reached in life as by the obstacles which he has had to overcome while trying to succeed".

Booker T Jones, and the MGs, was someone entirely different. Their tune 'Green Onions' remains a classic instrumental.

100 years of the cherry blossom festival

I got to Washington DC in good time. One of the interesting things is that this city is twinned with many capital cities around the world. No doubt it gives each of the civic leaders a reason to visit on expenses. One of the cities it is twinned with is Sunderland. Yes Sunderland.
Well of course Washington is a district of Sunderland and is the ancestral home of George himself. I can't think there's much in it for the Washington DC elite, but the Sunderland councillors must have a lot of networking visits in their schedule.
I arrived about midday, checked in, and set about taking in the city. It is a criss-cross road pattern, like many new cities. They are numbered in one direction, and lettered at right angles. The Marriott is at 12thNW and G. A few roads cut across them diagonally, like Pennsylvania Avenue, and Constitution Avenue. It makes getting about very simple.
I got to the Washington Memorial and looked at the Lincoln Memorial. The 'reflecting pool' was dry, for maintenance. Then down Jefferson Avenue and the Mall, to Capitol Hill. The White House itself is visible but slightly hidden away so I didn't see it at first. It was funny to think of the President no more than a quarter of a mile from where I was standing.

Along the walk between the Washington Monument and capitol Hill there was a stage and a steel band playing. Above the stage was a sign indicating that they were celebrating 100 years of the cherry blossom festival. The famous cherry blossom is everywhere, and I found a picture for you.

The festival marks the planting of white and pink cherry blossom trees, a gift from the Japanese people. They themselves mark the beginning of spring. Each year, for the last 100 years this festival been an occasion to show off multicultural and international cultural events. The steel band was from a local high school. As if to demonstrate how far they have come, multicilturally, here in DC, there was not a single black face in the band players, and there was no self-consciousness or embarrassment either that they were essentially playing black music. They were just having fun, and so was the audience.

I going to go on one of those hop on hop off bus trips now. Walking is good, but tiring. I'll tell you about it later.

The District of Columbia

I'm on the train to Washington DC. It's an Amtrak direct from Stamford, but is going to take five hours. So lots of time for rumination and doodling. So here I am doodling.
The District of Collumbia is governed directly by the Federal Government of the United States, in contrast to other States. It was formed when the winners of the war of independence decided they needed a separate Federal Capital. It was initially ten miles square from land that was formed from Maryland and Virginia. Later Virginia reclaimed the land.

Anyway , more of that when I get there, meanwhile a brief historical note:

'The outbreak of the American Civil War in 1861 led to notable growth in the District's population due to the expansion of the federal government and a large influx of freed slaves. President Abraham Lincoln signed the Compensated Emancipation Act in 1862, which ended slavery in the District of Columbia and freed about 3,100 enslaved persons, nine months prior to the Emancipation Proclamation. In 1868, Congress granted male African American residents of the District the right to vote in municipal elections.
After the assassination of civil rights leader Dr. Martin Luther King, Jr., on April 4, 1968, riots broke out in the District, primarily in the U Street, 14th Street, 7th Street, and H Street corridors, centers of black residential and commercial areas. The riots raged for three days until over 13,600 federal troops managed to stop the violence. Many stores and other buildings were burned; rebuilding was not complete until the late 1990s.
In 1973, Congress enacted the District of Columbia Home Rule Act, providing for an elected mayor and city council for the District. In 1975, Walter Washington became the first elected and first black mayor of the District.'

Boston MA

This is my kind of town. Less big and brash, more gentle and European. I could live here. The home of Harvard University as well, so good academic connections. We're staying at the Long Warf Mariott, over looking....well, Long Warf. Bright weather when we arrived yesterday, but now raining. We had planned to go on an historic walk. Apparently they have History here, somewhere. Well we're gonna find it. As a new American relative said 'it's where we kicked British Ass'. Not quite in the spirit I don't think, especially, like Scotland, they can have their independence if they like. Seriously, Boston waterfront and the city itself is well worth coning to...more later as have to go on the 'Freedom walk', as they call it.

Yeah, with Freedom comes Responsibility. Think on.

Well the freedom walk is worth going on indeed. It takes you through old Boston which includes mainly Irish Catholic areas, but also a street of Italian shops. The people still speak Italian and the food is all pasta and ice cream. The first Catholic church built in America is here.

The most interesting thing though is the monument itself, erected at the site of the battle of Breed's Hill, and mistakenly but popularly known as 'Bunker Hill'. Here the story is told about the battle, why it happened, who the 'victors' were, and what the consequences were. You also discover that the Boston Tea Party was not so much a protest against British rule, or even about paying British taxes, but the principle of paying taxes without representation. Fair point I think. If interested read on

'The Boston Massacre, called The Incident on King Street by the British, was an incident on March 5, 1770, in which British Army soldiers killed five civilian men. British troops had been stationed in Boston, capital of the Province of Massachusetts Bay, since 1768 in order to protect and support crown-appointed colonial officials attempting to enforce unpopular Parliamentary legislation. Amid ongoing tense relations between the population and the soldiers, a mob formed around a British sentry, who was subjected to verbal abuse and harassment. He was eventually supported by eight additional soldiers, who were subjected to verbal threats and thrown objects. They fired into the crowd, without orders, instantly killing three people and wounding others. Two more people died later of wounds sustained in the incident.
The crowd eventually dispersed after Acting Governor Thomas Hutchinson promised an inquiry, but reformed the next day, prompting the withdrawal of the troops to Castle Island. Eight soldiers, one officer, and four civilians were arrested and charged with murder. Defended by Patriot lawyer John Adams, six of the soldiers were acquitted, while the other two were convicted of manslaughter and given reduced sentences. The sentence that the men guilty of manslaughter received was a branding on their hand. Depictions, reports, and propaganda about the event, notably the colored engraving produced by Paul Revere, further heightened tensions throughout the Thirteen Colonies. The event is widely viewed as foreshadowing the outbreak of the American Revolutionary War five years later.'
'The Boston Tea Party was a direct action by colonists in Boston, a town in the British colony of Massachusetts, against the British government and the monopolistic East India Company that controlled all the tea imported into the colonies. On December 16, 1773, after officials in Boston refused to return three shiploads of taxed tea to Britain, a group of colonists boarded the ships and destroyed the tea by throwing it into Boston Harbor. The incident remains an iconic event of American history, and other political protests often refer to it.
The Tea Party was the culmination of a resistance movement throughout British America against the Tea Act, which had been passed by the British Parliament in 1773. Colonists objected to the Tea Act for a variety of reasons, especially because they believed that it violated their right to be taxed only by their own elected representatives. Protesters had successfully prevented the unloading of taxed tea in three other colonies, but in Boston, embattled Royal Governor Thomas Hutchinson refused to allow the tea to be returned to Britain. He apparently did not expect that the protestors would choose to destroy the tea rather than concede the authority of a legislature in which they were not directly represented.
The Boston Tea Party was a key event in the growth of the American Revolution. Parliament responded in 1774 with the Coercive Acts, which, among other provisions, closed Boston's commerce until the British East India Company had been repaid for the destroyed tea. Colonists in turn responded to the Coercive Acts with additional acts of protest, and by convening the First Continental Congress, which petitioned the British monarch for repeal of the acts and coordinated colonial resistance to them. The crisis escalated, and the American Revolutionary War began near Boston in 1775.

 The Battle of Bunker Hill took place on June 17, 1775, mostly on and around Breed's Hill, during the Siege of Boston early in the American Revolutionary War. The battle is named after the adjacent Bunker Hill, which was peripherally involved in the battle and was the original objective of both colonial and British troops, and is occasionally referred to as the "Battle of Breed's Hill."



On June 13, 1775, the leaders of the colonial forces besieging Boston learned that the British generals were planning to send troops out from the city to occupy the unoccupied hills surrounding the city. In response to this intelligence, 1,200 colonial troops under the command of William Prescott stealthily occupied Bunker Hill and Breed's Hill, constructed an earthen redoubt on Breed's Hill, and built lightly fortified lines across most of the Charlestown Peninsula.
When the British were alerted to the presence of the new position the next day, they mounted an attack against them. After two assaults on the colonial lines were repulsed with significant British casualties, the British finally captured the positions on the third assault, after the defenders in the redoubt ran out of ammunition. The colonial forces retreated to Cambridge over Bunker Hill, suffering their most significant losses on Bunker Hill.
While the result was a victory for the British, they suffered heavy losses: over 800 wounded and 226 killed, including many officers. The battle was indeed a Pyrrhic victory, and showed the determination of the relatively inexperienced colonial forces were willing and able to stand up to regular army troops in a pitched battle.'

“If ye love wealth greater than liberty, the tranquility of servitude greater than the animating contest for freedom, go home from us in peace. We seek not your counsel, nor your arms. Crouch down and lick the hand that feeds you; May your chains set lightly upon you, and may posterity forget that ye were our countrymen.” Samuel Adams American Patriot & Politician, 1722 - 1803

Samuel Adams was a leader of the fight against British colonial rule, and a signer of the Declaration of Independence. Adams was a cousin of John Adams who became the second President of the United States of America.

Paul Revere, was another folk hero of the American Revolution whose dramatic horseback ride on the night of April 18, 1775 warning Boston-area residents that the British were coming, was immortalized in a ballad by Henry Wadsworth Longfellow. Revere was mainly distinguished in the colonial era as a master silversmith -- a craft he learned from his father, Apollos Rivoire, a Huguenot refugee who changed his name to Revere in the New World. To support his large family, the versatile and energetic craftsman also made surgical instruments, sold spectacles, replaced missing teeth, and engraved copper plates, the most famous of which portrayed his version of the Boston Massacre.

Baba Gump

Pink and white blossom, daffodils blue sky and sky scrapers, these are what you see in Central Park. Oh and people. Lots of people. Especially on a day like this. it feels like being on a film set, and in fact while we were there someone was filming something for some film or TV programme. You kind of expect to see famous people just strolling around, or roller skating. The ice rink is still there. So is the zoo, which we visited only for a coffee. Well, it's only got one animal in it. It's a dog. Yes. It's a Shitsu.

Me and lizzie and Emily and Lucas had had lunch at Baba Gump on Time Square. We had a window seat so were overlooking the bright and busy pavement and high rises. Interestingly I don't think there was a clock to be seem anywhere.
Baba Gump, I now know, is the business Forrest Gump took over from his friend Baba after he was killed in the Vietnam war. It is a sea food restaurant, although you can get pretty much anything. Anything with fries. I had a steamed seafood platter. It was like Moules Mariniere but with lobster legs, and all sorts of shell fish, in a creamy garlic sauce. Emily had a load of prawns in batter and Lizzie had similar stuff. Lucas just posed in the window with Time Square as a back drop. Great photo opportunity, and chance to charm the middle age women.
So was the trip on the train trip back as he got passed from woman to woman, gurgling and giggling away. Even the stern face Manhattan Businessmen were able to raise a smile from their New York Times.
If only they knew of his middle-of-the-night antics, when smiling and gurgling is definitely NOT welcome. Wait 'till he starts crawling.
I just have to say again how great Grand Central Station is. It is just amazing, busy, clean and somehow romantic. You can imagine the hundreds and millions of people who have hurried through it's halls and passages doing mundane things like getting home. Some on secret assignations, and some on deadly espionage. I love it.

Glenbrook Road, Stamford, Connecticut

'Doesn't he look cute' she said to her friend as they passed, also pushing a buggy. 'Sure', I replied, 'but what about the baby?' They carried on walking without even so much as a glance. Emily groaned when I told her later.
I was pushing Lucas, of course. They call it a stroller in America. Emily says that there's a group of 'Stroller mums' that meeting to 'work out' while pushing the strollers. She's got all the gear. They meet in the 'Mall' to do this. I had offered to take Lucas around Stamford, while Emily had a rest. I was heading to the mall to see if I could meet up with them. Unfortunately, I couldn't find the right place or the right people. Shame.
Lizzy was also lying in. She nearly didn't make it due to a stomach bug, but got here in the end after changing her flight.
The weather this morning was bright and fresh. A lovely Spring day in New England. The pink and white blossom is everywhere. The smell is of wood resin from new chippings and freshly cut grass. The daffodils and crocuses are out and at a week or two behind Manchester. The gardens are being tidied up for the new growth. The birds are busy and noisy. Walking makes you take in the loveliness of this part of America. It could be a posh part of Engalnd itself.
Lucas is turning into a solid fellow. He's a growing boy, and he likes his food. He also doesn't like sleeping much. That's why I've taken him out. He hardly stopped crying the whole time, well apart from when he was looking cute for the two girls who blanked me. 'He's overtired' I have to explain to every passer by. Actually I think he is.
The news here is all about a pilot who went crazy on one of the internal flights. A disaster had been averted by the crew, especially the co-pilot, taking timely and decisive action. The other item is the small issue of Obamacare. Obamacare is being challenged in the Supreme Court, as it requires people to take out health insurance, and the Americans don't like that. We shall see what the court says, but without healthy people taking out insurance it can't pay to run the system. This is why the legal challenge is so important. The right wing press seem to be making more of a fuss, and I get the feeling that the challenge wont come off, as there is a precedent.
Today we met up with Emily's friend and employer at a burger restaurant. The burgers were sensational. Her friends husband is also into Dr Who, so we had a good old chat about that, I can tell you. They are still starting with the David Tenant doctor, so some way behind, and also have Torchwood and captain Jack.
Finally we came back. We're going to Boston at the weekend, but tomorrow it's off into 'the City'. The Broadway shows on include the Lion King, Jesus Christ Superstar, and Mary Poppins. The musical Chicago is also on. Perhaps I should go to that.

HYATT Regency on Chicago's river walk

I was a bit more anxious this year, travelling to America on my own. I kept feeling as though I forgot something.

I waved hello to Barbara at the American Airways desk at Terminal 3. 'Wallen said you were flying, but I didn't see your name down' she smiled back. 'I pretty sure I'm booked on the flight this morning' I replied uncertainly and prayed silently, 'please God may I be booked on'.

The night before had been planned as a quiet night in, after the last minute dash of the trip to Souze. Everything was paked and waiting down stairs. Andy had cooked a spag-bol, I'm not convinced he can cook anything else. A few glasses of wine, and an early night. The alarm went off on time and the taxi arrived as planned at 6 am. Better take lap top and iPad as not sure if I can use the iPad in America, and in anycase I need to do a bit of work.
T3 was starting to get busy and the Ryan Air riff-raf were gathering. For me though, no worries. The nice people from AA did their usual foresic questioning about whether I planted a bomb in my suit case and if I was a terrorist. I got through the questions without a hiccup. By now I'd learnt my lines well, 'no I haven't planted a bomb and no, no one else could have either'.
Suddenly Barbara came up to me past the others waiting to check in. It was nice to say hello, but why the sudden appearance? The anxiety levels started to rise as she approached. There was a serious look on her face. 'Can I just take you to one side' she said with a smile, but the sort of smile that is sometimes the herald of bad news. Perhaps I wasn't booked on the flight as she had said, after all she has the list of passengers, and has the power to deny travel or do practically anything she likes for flight AA55 to Chicago on Saturday morning23rd March.
'Er OK then' my heart was starting to pound by now, although my head was telling me it would be alright. I stepped out of the queue and followed her to the AA ticket desk.
' I didn't know your first name was John.' 'Oh no not that again', I thought and worried. 'It's OK' she smiled, 'I changed your seat so you've got a window seat next to the emergency exit. Now if you go to that man' pointing' he will get you checked in. I hope you have a good trip'

Yes. More leg room. Thanks barbara.

After that everything went smoothlyish, except my lap top ran out of battery. So I found a plug in the airport longe and plugged it in. The wire trailed across a walk way, but I figured people could step over it, and most did. One didn't. Oh haughty looking air hostess with an American accent and a middle aged sturby, African-American attitude. She tutted and said 'excuse me'. I said ' oh no that's fine' before I realised she was telling me off. Anyway, at least I would not be seeing her again, as she tottered on her heels, Dick Emery style, away down the corridor.

I know, you've guessed already. Yes she was my air hostess, which made boarding and the first part of the flight a bit awkward. When she came round with the first lot of drinks I asked for a bloody Mary. She looked down at me and sucked her teeth as if to say 'at this time in the morning?' Actually what I meant was a tomato juice with Worcester sauce. They didn't have Worcester sauce and I'd have to pay for 'liquor'. 'Oh well never mind then' I smiled back. 'We have have spicy Tomato Juice' said her colleague, giving my hostess a siteways look. 'Ok then' I replied sheepishly.

We came to an unspoken truce after a couple of hours, and the rest of the flight was fine. Actually, because of the absence of wind, we arrived an hour early at Chicago's O'Hare airport. Now for the fun. There were the usual queues for immigration and customs. I joined the one that everyone else did, as there were no signs. After about half an hour, a man in a uniform said, 'why don't you go to Hall B, the queue is much shorter there' So I followed the stampede to Hall B where to queue was indeed shorter, much shorter. Mainly because there were three times as many customs officer and no one new to go there.

I got through alright, met up with someone else who was going the the Riverside Hyatt Regency Hotel, and shared a taxi. I checked in. My room wasn't quite ready yet 'will that be OK, or would you like me to see if we have another room, sir?' the helpful man said. 'Well another room would be good, if it's ready' I replied, feeling a wave of fatigue sweep over me. Then hopefully 'perhaps one with a view'. 'Certainly sir, but we charge an extra $20.' 'Oh well that should be OK' I said. 'A night' he went on. Oh well perhaps not then. 'We have an extra large room' he said tapping at the computer 'it overlooks the river, and I can offer you that at a complimentary rate.' he said expressionless and still looking at the comperter screen. Excellent. I accepted. The only problem with the room was that the bed, king size, was a pull down bed from the wall. The room is sometimes used as a sitting room for an adjacent room. Today it is mine, and it is brilliant. It is at least twice the size of my front room at home, the bed is fine, and I can look out onto the river below. And there's wi-fi.

I lay down and two hours later woke up for dinner. I still hadn't checked into the conference but hey, I'll do that tomorrow. I better join the others in the bar.

I wondered lonely as a cloud

Wordsworth's wife was Mary Hutchinson, right? His sister was Dorothy and they all lived at Dove cottage in Grassmere. Annette Vallon was his French lover and mother of one of his children. Yesterday I went up to the lakes in search of daffodils. This was the wrong decision. First of all there are very few daffodils in the Lake district and secondly it caused no end of trouble. Ade and Sue were are up for the weekend and I should have spent time with them. I made a mistake. Back home everyone seemed to fall out with everybody else, especially me.
Today I'm going to watch them play football and wander up and down the touch line shouting encouragement. It's mothers day too, so hello mum, and I'll call you later. Also Anne mother of my children, and Emily, mother of my grandson. Love to you all and hope to see you later.
I wonder why life has to be so complicated?

Sauze Doulx 2012

Sammy the barmaid from Sauze Doulx
Had a favourite drink of Iron Bru
That's because she's a Scot
Which we certainly are not
Except Syko who hasn't a clue


This was one of the questions at the quiz night on day 2. Jonnie and I had gone out after dinner, and bumped into some people we met the night before. One of the tasks was to form a Limerick from the ingredient given. This was our attempt. It didn't win. A much more saucy one did.
The skiing is of course great. The other three in the party are Dave, Mort and Peter. This year it's Peter's turn to room with me. He,s a good roomy and never complains.
Skiing is a bit more worrying than it was even a year ago. although my sight can cope perfectly well, I am constantly anxious especially if I get isolated, or have to go on a lift on my own. I have done four days skiing, but skipped yesterday and also today.
The sun is out, and the snow is melting. Today is Saturday and the prediction is of crowds coming up from Turin for a weekend break. So I decided to go for a walk in the hills yesterday. Brilliant, hard work and scary. Well a little bit scary. I lost the track high up in the mountain, but decided to keep my bearings and hold my nerve.
The great thing about being lost, is that you are never quite sure where you are going to end up. Amazingly I ended up pretty much where I wanted to be. So I set off again today. I got lost again today. Finally I found myself about fifty yards from the hotel. don't ask me how.
Skiing is skiing, but in the sunshine, with right deep blue sky's it is exhilarating. Fortunately the bar we meet in for lunch is within walking distance so in about half an hour I'll head for there by foot.
Tomorrow we'll be home again, and needing to face a small storm about the quality indicators we need to set the hospital trust. Oh well, Sauze is a lovely place, with fabulous pistes. I would come again, even in the summer.
Sammy, the Scottish barmaid may not, after some of the more rude Limericks

Spring seems to be here

I've just been for a fabulous run along the river, and back through Fletcher Moss park. The crocuses are out and the daphs are poking up though the grass. Egg and bacon for breky. The sun is shining and all is well with the world.

All is very well.

I can't believe its been so long

It looks like it's been about six weeks since I wrote anything. Well the Blog master doesn't lie.

About three weeks ago I had a fit, seizure, epileptic turn, whatever you want to call it. I was about to give a presentation to a regional NHS committee called 'the Cluster'. They have taken over from the PCT and are overseeing the development of Clinical Commissioning Groups. I was to deliver a talk aimed at satisfying them that we have systems in place for preventing a recurrence of the Mid-Staffordhire NHS disaster. Here the over viewing body, the PCT then, did not have proper systems in place for holding the hospital Trust to account. There was a failure, if you like, of appropriate scrutiny and regulation. The 'Francis report' was the result of an enquiry into what went wrong and so we have to now satisfy the 'Cluster' that as a CCG we wont fall into making the mistakes of 'mid-stafs'. We wont, but we had to demonstrate it. I was looking forward to showing off how good we are. Which we are.

As I was about to stand up I started feeling very peculiar, weirdly weird. My eye sight was going crazy, in the zone where I was not able to see normally. The next thing I knew I was waking up in the back of an ambulance on it's way to the MRI. I had bitten my tongue. There was no doubt what had happened. There had been a room full of witnesses.

We joked after that I had taken the Francis report thing about scrutinising hospital services a bit too far. I did actually get pretty amazing treatment, including a visit from the deputy chief executive and the medical director. I don't think every A&E attendance gets such high level visitors. The news spread like wildfire and within a day or two I was getting messages from far and wide.

Fortunately, it hasn't happened again and I'm on medication. Brain scans are OK, so no new event.

All this has happened at the same time as my partners are making life difficult for me.

Good news though. I have got a post and accepted it, at another practice. Its a salaried post but who cares. I will see normal patients for two sessions and do a third cardiology session. Meanwhile I have also discovered that I am the contract holder for the current NHS contract, so if I go from my present practice then it has to be put out to tender. Oh dear what a responsibility. I have used my newly realised bargaining power to argue for a continued presence at my current practice to see the patients that still want to see me. Suddenly I have the best of all worlds.

The CCG stuff is going from strength to strength. We are getting widely praised for our collaborative work with the hospital, redesigning and integrating care in the community. The practices are also starting to see the benefits and becoming more enthused.

Oh, and I'm going to Mauritius again with the children and hopefully grandchild, in September.

So, it's not that nothing has happened that there has been a pause in the blog, rather the opposite. Life is good and changing all the time. God is good, but no more fits please.