Well, the asteroid, so long in the coming, is finally bearing down upon us. Whether it passes by and causes little damage, wrecks much but, capriciously, leaves random things standing in its wake or obliterates all - I will soon know.
I'm not talking about the latest celestial body (one of a seemingly longish list) that is heading Earthwards (but will eventually pass by at a 'close' distance of a few million miles). No, I'm referring to the new structures that will replace the PCTs (my employer) in April 2013. Today, the broad structures were announced and, contained within the consultation document, a table gave an overview of the likely number of posts, split by grade, that will make up the establishment of the two organisations that are my most likely landing point.
There is not enough detail at this point to be able to say if I will get to slot straight into a new role (the asteroid passes by), be able to at least compete for a post at the same grade I am currently on (not too much damage) or if I will be offered a post significantly more junior to my current position (wipeout!). Even so, I'm feeling less than confident that I have a face that fits in the New NHS. In fact, I'm more than a little depressed about the way things are shaping up.
I'm feeling like the proverbial rabbit, caught in the headlights and frozen to the spot. How does one 'proactively manage' the asteroid that is about to smash everything?
Thursday, 2 August 2012
Wednesday, 11 July 2012
My life, my choice!
After a session of playing internet hopscotch (you start on one article and, after a few clicks, you find yourself on a topic far removed from your starting point), I found myself on the website of the Globe and Mail, a Canadian news source. This is the article I landed at: "Legalized Euthanasia Only a Breath Away".
The constant reference to "assisted suicide/euthanasia" annoyed me: the benign-sounding "euthanasia" (hell, that sounds really soporific!) vs. the rather more loaded term "assisted suicide" (visions of Mrs Doyle whispering in your ear as you stand on the cliff's edge "Go on, go on, go on, go on...."). Leaving aside the terminology, let's consider the idea of a 'good death' and free choice.
'Euthanasia' has its roots (as a word, at least) in Greek and means "good death". The Hippocratic Oath (attributed to the Greek physician, Hippocrates), contains the warning that treatment should "do no harm" to the patient, The modern version of Hippocrates oath by Dr Louis Lasagna, contains the line "Above all, I must not play at God". These two quotes neatly tie together the dichotomy in 'modern' medicine: the Christian tradition in Western medicine that reveres suffering as 'saintly' (c.f. Jesus suffering on the cross) and, therefore, something to be accepted gratefully and the need of doctors to attempt to 'cure' even when all hope is gone.
Is there not a point when a good doctor should say, "I can do no more for you", to not prolong the pretence that the physician can act as God and hand down a cure? Once it is acknowledged that a patient cannot be 'cured', it should be down to all 'care' staff to ensure that a patient enjoys a 'good death', with high quality palliative care as one option. Another option, however, should be to allow me, the owner of the body I walk around in, to determine where and when I leave this mortal coil. The main nursing handbook from the 60s acknowledged that not all diseases and conditions are curable and one of the outcomes of a treatment may be death. In such a case, it advised the focus of caring activities should be to help the patient achieve a good death.
I get frustrated when those who advocate the status quo - i.e. that control over the end of our lives should remain with the state - say that allowing us, the poor, misguided people, to have this control would immediately lead to abuse by relatives wishing to hasten the death of a rich aunt or get rid of that 'difficult' grandparent! I am sure it is not beyond the whit of us humans that we might be able to develop some controls, checks and balances to ensure this kind of abuse does not happen. But this argument is invariably a smokescreen that deflects away from all those perfectly 'sane', normal, shoppers in, say, the Trafford Centre who can exercise 'free will' throughout their lives (buy this, don't buy that. buy LOTS of that etc.) but are not allowed to choose to die at a time and place of their choosing if the condition they have means that 'choice' will soon become a slightly compromised concept.
A paragraph from the article:
People who support legalizing assisted suicide/euthanasia simply assume that individual autonomy is the value that takes priority. But research shows that the most likely reasons people want assisted suicide/euthanasia are fear of being abandoned – dying alone and unloved – and of being a burden on others. Surely our response to such fears shouldn’t be to help them to kill themselves or to give them a lethal injection.
"Research". Good term! Makes things sound solid, authoritative and....but, wait a minute: what 'research'? Where was it published? Who peer reviewed it? If you are going to state that research supports your case, then be prepared to include a link to it. Otherwise, be like me and just write your opinion down, but don't claim special dispensation: they are just your views.
I wholeheartedly agree that there is a fear of impending abandonment, of neglect, as I get older. That is not the factor that will send me off to Dignitas and it should not be the reason that we introduce any loosening on the the laws around assisted suicide. We need to develop better elder/dementia care, so that patients are not consigned to 'granny farms' to sit in a lounge for 12 hours a day but instead are engaged in work and play and human interaction, just as they were for the first 70 or 80 years of their lives. Having control over one's time of death is NOT about getting rid of older people. In fact, with high quality, interesting and enjoyable elder care, maybe people might actually want to go on living rather than potentially choosing to opt out of a lingering 'existence' in an unfriendly environment.
I am simply baffled that, in world where 'choice' is lauded and placed so centrally in the mission statement of every organisation, from Tesco to UK plc, we should be denied 'choice' in one of the most important points in our life's journey. Just as 'free choice' in so many other settings is little more than a chimera, so politicians blathering on about 'empowerment' and 'personal control' will mean little if this final choice is not given to adults.
The constant reference to "assisted suicide/euthanasia" annoyed me: the benign-sounding "euthanasia" (hell, that sounds really soporific!) vs. the rather more loaded term "assisted suicide" (visions of Mrs Doyle whispering in your ear as you stand on the cliff's edge "Go on, go on, go on, go on...."). Leaving aside the terminology, let's consider the idea of a 'good death' and free choice.
'Euthanasia' has its roots (as a word, at least) in Greek and means "good death". The Hippocratic Oath (attributed to the Greek physician, Hippocrates), contains the warning that treatment should "do no harm" to the patient, The modern version of Hippocrates oath by Dr Louis Lasagna, contains the line "Above all, I must not play at God". These two quotes neatly tie together the dichotomy in 'modern' medicine: the Christian tradition in Western medicine that reveres suffering as 'saintly' (c.f. Jesus suffering on the cross) and, therefore, something to be accepted gratefully and the need of doctors to attempt to 'cure' even when all hope is gone.
Is there not a point when a good doctor should say, "I can do no more for you", to not prolong the pretence that the physician can act as God and hand down a cure? Once it is acknowledged that a patient cannot be 'cured', it should be down to all 'care' staff to ensure that a patient enjoys a 'good death', with high quality palliative care as one option. Another option, however, should be to allow me, the owner of the body I walk around in, to determine where and when I leave this mortal coil. The main nursing handbook from the 60s acknowledged that not all diseases and conditions are curable and one of the outcomes of a treatment may be death. In such a case, it advised the focus of caring activities should be to help the patient achieve a good death.
I get frustrated when those who advocate the status quo - i.e. that control over the end of our lives should remain with the state - say that allowing us, the poor, misguided people, to have this control would immediately lead to abuse by relatives wishing to hasten the death of a rich aunt or get rid of that 'difficult' grandparent! I am sure it is not beyond the whit of us humans that we might be able to develop some controls, checks and balances to ensure this kind of abuse does not happen. But this argument is invariably a smokescreen that deflects away from all those perfectly 'sane', normal, shoppers in, say, the Trafford Centre who can exercise 'free will' throughout their lives (buy this, don't buy that. buy LOTS of that etc.) but are not allowed to choose to die at a time and place of their choosing if the condition they have means that 'choice' will soon become a slightly compromised concept.
A paragraph from the article:
People who support legalizing assisted suicide/euthanasia simply assume that individual autonomy is the value that takes priority. But research shows that the most likely reasons people want assisted suicide/euthanasia are fear of being abandoned – dying alone and unloved – and of being a burden on others. Surely our response to such fears shouldn’t be to help them to kill themselves or to give them a lethal injection.
"Research". Good term! Makes things sound solid, authoritative and....but, wait a minute: what 'research'? Where was it published? Who peer reviewed it? If you are going to state that research supports your case, then be prepared to include a link to it. Otherwise, be like me and just write your opinion down, but don't claim special dispensation: they are just your views.
I wholeheartedly agree that there is a fear of impending abandonment, of neglect, as I get older. That is not the factor that will send me off to Dignitas and it should not be the reason that we introduce any loosening on the the laws around assisted suicide. We need to develop better elder/dementia care, so that patients are not consigned to 'granny farms' to sit in a lounge for 12 hours a day but instead are engaged in work and play and human interaction, just as they were for the first 70 or 80 years of their lives. Having control over one's time of death is NOT about getting rid of older people. In fact, with high quality, interesting and enjoyable elder care, maybe people might actually want to go on living rather than potentially choosing to opt out of a lingering 'existence' in an unfriendly environment.
I am simply baffled that, in world where 'choice' is lauded and placed so centrally in the mission statement of every organisation, from Tesco to UK plc, we should be denied 'choice' in one of the most important points in our life's journey. Just as 'free choice' in so many other settings is little more than a chimera, so politicians blathering on about 'empowerment' and 'personal control' will mean little if this final choice is not given to adults.
Wednesday, 22 February 2012
An extraordinary coincidence?
Somewhere in the house, I have an odd coin/medal. The obverse side features a bust of Samuel Plimsoll (he of the Plimsoll Line) and the inscription 'House of Commons 22 July 1875 London S Plimsoll' whilst the reverse shows a ship in distress with the legend "Coffin Ship". The coin/medal apparently commemorates the passing of the Merchant Shipping Act in 1875 following Plimsoll's campaign to draw attention to the number of seafarers losing their lives on overloaded and unsafe ships ('coffin ships'). I found the coin/medal in the gutter many years ago and it has lived in a box ever since.
For some reason, the memory of this coin popped into my head tonight and I decided to look if anyone was selling a similar coin on eBay. I found one (vastly inferior in terms of condition) that had recently been sold for £3.99 (hold the retirement party - that's not the fortune I was hoping for). However, that prompted a further thought: the Dead Man's Penny.
The Dead Man's Penny (DMP for the sake of my typing fingers - both of them) was a circular brass plaque, around 12cm in diameter that was issued presented to the family of a soldier who fell in the Great War (1914 - 18). The front depicts a lion and Britannia holding a laurel wreath. A simple oblong space contains the name of the deceased and no rank is indicated in order to demonstrate the equality of the sacrifice made.
My mother has two of these at home that came from the house of my late aunt and uncle. I can still remember the two DMPs standing propped up on the sill of the landing window in their house. As a child I was fascinated by them and the link to relatives long dead in a conflict concluded 40 years before I was born.
Again, I idly looked to see if anyone was selling a DMP on eBay and again, there was one example for sale: four bids and currently just over £46. The name on the plaque was 'Frederick Copeland' and in the description, the seller admitted he knew nothing about the soldier the plaque commemorated. On a whim I typed "Frederick Copeland+fell in WW1" into Google and the top result returned was a page from a site listing all war memorials that include the names of fallen members of the Yorkshire Regiment. Apparently, on the War Memorial at Billingham, a Private Frederick Copeland is listed, a member of the 7th Batallion, the Yorkshire Regiment, who died at Ypres in 1915. The date on which he died was 19th September - my birthday!
Now I realise that, statistically, in any list of dates, there will always be one that has particular significance for the reader. There's a perfectly good explanation involving a mathematical proof etc etc. But from a random chain of enquiries to arrive at the name of a soldier who died on 19th September? That feels spooky....
For some reason, the memory of this coin popped into my head tonight and I decided to look if anyone was selling a similar coin on eBay. I found one (vastly inferior in terms of condition) that had recently been sold for £3.99 (hold the retirement party - that's not the fortune I was hoping for). However, that prompted a further thought: the Dead Man's Penny.
The Dead Man's Penny (DMP for the sake of my typing fingers - both of them) was a circular brass plaque, around 12cm in diameter that was issued presented to the family of a soldier who fell in the Great War (1914 - 18). The front depicts a lion and Britannia holding a laurel wreath. A simple oblong space contains the name of the deceased and no rank is indicated in order to demonstrate the equality of the sacrifice made.
My mother has two of these at home that came from the house of my late aunt and uncle. I can still remember the two DMPs standing propped up on the sill of the landing window in their house. As a child I was fascinated by them and the link to relatives long dead in a conflict concluded 40 years before I was born.
Again, I idly looked to see if anyone was selling a DMP on eBay and again, there was one example for sale: four bids and currently just over £46. The name on the plaque was 'Frederick Copeland' and in the description, the seller admitted he knew nothing about the soldier the plaque commemorated. On a whim I typed "Frederick Copeland+fell in WW1" into Google and the top result returned was a page from a site listing all war memorials that include the names of fallen members of the Yorkshire Regiment. Apparently, on the War Memorial at Billingham, a Private Frederick Copeland is listed, a member of the 7th Batallion, the Yorkshire Regiment, who died at Ypres in 1915. The date on which he died was 19th September - my birthday!
Now I realise that, statistically, in any list of dates, there will always be one that has particular significance for the reader. There's a perfectly good explanation involving a mathematical proof etc etc. But from a random chain of enquiries to arrive at the name of a soldier who died on 19th September? That feels spooky....
Monday, 20 February 2012
Health Warning
Tory MP Mark Simmonds was recently caught failing to declare his interest in private health provider Circle when he spoke in favour of the health service 'reforms' in a debate in the Commons. He is employed as a 'strategic adviser' to the company for which he is paid £50K a year.
Now, either Mr Simmonds forgot because he is so vastly wealthy that a mere trifle of £50K failed to register as significant enough to mention or he 'forgot' in the same way that the Tories 'forgot' to put massive top-down NHS reorganisation into their manifesto - a selective forgetting that makes me believe that privatisation - and the greater involvement of Mr Simmonds mates at Circle - is the real agenda for 'reform'.
Now, either Mr Simmonds forgot because he is so vastly wealthy that a mere trifle of £50K failed to register as significant enough to mention or he 'forgot' in the same way that the Tories 'forgot' to put massive top-down NHS reorganisation into their manifesto - a selective forgetting that makes me believe that privatisation - and the greater involvement of Mr Simmonds mates at Circle - is the real agenda for 'reform'.
Wednesday, 11 January 2012
I *heart* My Car
On the way home from work this evening, I was listening to an episode of 'This American Life', a truly excellent podcast from the Public Broadcast System in Chicago which, each week, features stories from people centred on a particular topic. The subject of this podcast was cars.
The first short section began with a phone call that was recorded on a voicemail or answerphone. The message was something like "Hi. I'm calling you from my car. I am upside-down in a ditch and unable to release my seatbelt, so I guess I'll just have to wait for help to arrive. I have called 911 so the police should be here soon." The caller suddenly stopped detailing their predicament to announce, totally out of the blue, "I love my car." before resuming the previous narrative.
Afterwards, there followed an interview with the woman who had left the message. After a couple of other questions, the interviewer got around to addressing the question that anyone listening to the tape would have asked: why did you suddenly announce "I love my car"? The woman answered as if it was absolutely self-evident: she was, in effect, apologising to the car for putting it in this undignified position - upside-down in a ditch. She said that it had been the perfect car - never let her down, was exactly what she wanted in a car - and she realised at that moment that she would never again drive it.
Now, some listeners might have been thinking scornfully at this point "But it's just a car...". I, on the other hand, was reminded that I too have a strange emotional response to these mere pieces of machinery. Although it does not apply to every car I have owned, I have actually felt guilty when I part-exchanged or sold one or two of the cars I have owned. Definitely the Jaguar and the MGs (F and ZT) and possibly, although less strongly, some of the other cars I have had. I can still think of them and feel genuine regret that someone else is enjoying their company now. In fact, about a year ago, I was visiting a local hospital as part of my job and there, in the car park, about three spaces from where I had parked sat my old MG ZT. She looked exactly as she had done when I last saw her, around four or five years before. Again, there was that feeling of regret, but followed by a warm burst of happiness because she still looked good. It was like meeting an old friend or former lover and having memories and associated emotions avalanche down on you.
And that's the moral of the tale: most cars are just cars - things that take you from A to B with varying degrees of efficiency. They are merely acquaintances. But some cars - ah! - some cars are more than that. Some cars are soulmates, friends, lovers, the stuff of dreams or just so deeply embedded in our lives that they have become 'family'. Right now, I have a perfectly good, reliable and frugal car that makes the journey from A to B happen in reasonable comfort at a reasonably low cost. But - the big 'but' - perhaps I want unreasonable? Give me a car that guzzles the gas and doesn't give a damn. The car that costs £300 to fix a 25p bulb. The car that stirs the imagination a bit. In short, a car I can fall in love with.
The first short section began with a phone call that was recorded on a voicemail or answerphone. The message was something like "Hi. I'm calling you from my car. I am upside-down in a ditch and unable to release my seatbelt, so I guess I'll just have to wait for help to arrive. I have called 911 so the police should be here soon." The caller suddenly stopped detailing their predicament to announce, totally out of the blue, "I love my car." before resuming the previous narrative.
Afterwards, there followed an interview with the woman who had left the message. After a couple of other questions, the interviewer got around to addressing the question that anyone listening to the tape would have asked: why did you suddenly announce "I love my car"? The woman answered as if it was absolutely self-evident: she was, in effect, apologising to the car for putting it in this undignified position - upside-down in a ditch. She said that it had been the perfect car - never let her down, was exactly what she wanted in a car - and she realised at that moment that she would never again drive it.
Now, some listeners might have been thinking scornfully at this point "But it's just a car...". I, on the other hand, was reminded that I too have a strange emotional response to these mere pieces of machinery. Although it does not apply to every car I have owned, I have actually felt guilty when I part-exchanged or sold one or two of the cars I have owned. Definitely the Jaguar and the MGs (F and ZT) and possibly, although less strongly, some of the other cars I have had. I can still think of them and feel genuine regret that someone else is enjoying their company now. In fact, about a year ago, I was visiting a local hospital as part of my job and there, in the car park, about three spaces from where I had parked sat my old MG ZT. She looked exactly as she had done when I last saw her, around four or five years before. Again, there was that feeling of regret, but followed by a warm burst of happiness because she still looked good. It was like meeting an old friend or former lover and having memories and associated emotions avalanche down on you.
And that's the moral of the tale: most cars are just cars - things that take you from A to B with varying degrees of efficiency. They are merely acquaintances. But some cars - ah! - some cars are more than that. Some cars are soulmates, friends, lovers, the stuff of dreams or just so deeply embedded in our lives that they have become 'family'. Right now, I have a perfectly good, reliable and frugal car that makes the journey from A to B happen in reasonable comfort at a reasonably low cost. But - the big 'but' - perhaps I want unreasonable? Give me a car that guzzles the gas and doesn't give a damn. The car that costs £300 to fix a 25p bulb. The car that stirs the imagination a bit. In short, a car I can fall in love with.
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