Wednesday, 31 March 2010

A simple prayer

'Thank you Lord that you love me. Thank you Lord that you don't only love the person I hope to be, but you love the person I am now'.

These simple words (or something like them), were prayed recently by one of the guys who is part of the church that I am a member of. They encapsulate one of the beautiful things about the Christian gospel. The apostle Paul wrote about it 2000 years ago..

'but God shows his love for us in that while we were still sinners, Christ died for us' Romans 5.8

It's such a relief. The gospel is indeed good news of what Christ has done and not merely good advice on how to live.

Saturday, 27 March 2010

No flowers please

The list of things that you cannot do in hospital is getting longer.

No longer can you take flowers to cheer the poor patient up and no longer can you sit on the patient's bed. White coats went ages ago (unless it's an American doctor appearing on Panorama) and doctors are no longer allowed to wear ties. Now the young male doctors wander around the hospital in non ironed shirts and sleeves rolled up looking for all the workd like sociology lecturers.

In a brilliant piece written in the BMJ by the excellent GP columnist Iona Heath ('Do not sit on the bed'), she bemoans the, 'lack of humanity, common sense, and even humour' which these health and safety diktats encourage. Because all the bans are based upon so called infection control.

'There seems to be something strange going on, is it all in the interests of being seen to be doing something very noticeable about the worrying levels of hospital based infections, however ineffective and otherwise disruptive? Is this some sort of virtual cleanliness-an illusion of activity with no substance?

And it is an illusion because there is no hard evidence that any of these measures make any difference! What does make a difference to patients and their experience of medical care is professionalism based upon evidence and that human dimension which is immeasurable but noticeable when absent-kindness, thoughtfulness, being valued and other virtues which although 'soft', really matter.

Environments of care matter. That's partly why so many hospices are sited in lovely countryside surroundings. Beauty, whether in trees, flowers, works of art, or whatever, humanises us and gives us hope. So flowers on a hospital ward can surely only help the healing that should be taking place.

It's the loss of the 'home' environment that Iona Heath finds so sad,

'so can we not campaign for home within the hospital and encourage flowers and sitting on the bed and every other informality, unless there is robust evidence to deter us? "Do not sit on the bed" and No flowers" are injunctions that are all too similar to "Do not walk on the grass" and "No ball games"rules that mostly diminish the joys of life rather enhance them, and such rules, unless absolutely necessary, have no place in hospitals, where joy is too often in short supply".

Oh so true.

(The full article is BMJ 2010;340:c1478-it'll be free access in a few months time or take a look at your local library-lets keep them in business).

Monday, 22 March 2010

A night visit

I did a night visit a few days ago. It felt nostalgic. It was the first such visit I have undertaken to one of my own patients (other than a few for the out of hours service a some years ago) since 1996...when everything changed.

Answering the phone-a mobile with a gentle ring-at 1.30am, getting dressed and off in my car for the 15 minutes along lonely country rounds was strangely satisfying (when I first entered practice in 1979 our bedside phone had a very loud ring with no option for quietening). I was greeted by a familiar, although now saddened, family who had cared for a wife and mother throughout a long illness. Thankfully her truly terminal days were very short and she died comfortably with a syringe driver administering her settling medication (when did they come into general practice usage?).

I stayed a while and we reminisced about their loved one. I declined a cup of tea knowing that at my age that would mean a another night visit of a different kind. I did my best to comfort and left them. I was home and back to sleep in just over one hour.

It was good. It was right and I would gladly do it again. They knew me and I believe trusted me and I just didn't feel like handing over this final medical contact to a stranger. But for all my nostalgia I would struggle with the old system of regular on-call and night visits followed by a normal surgery. The day time is just so incredibly busy. It really is non stop for anything from 10-12 hours a day. Having said that I would be willing to go back to the old system if only we could have smaller list sizes.

The government (and The Daily Mail) have it in for GPs-I wonder what the future holds for family practice in the UK in years to come.

Thursday, 18 March 2010

Christianity and Comedy

A very good friend of mine is bemused that Christians would want to arrange a comedy night such as just happened during the Bedford Passion for Life week. He doesn't feel that it squares with certain aspects of New Testament Christianity.

Of course for many people (of a certain age) comedy and Christianity evokes memories of Dick Emery or Derek Nimmo or the hapless Mr Bean struggling with the intricacies of Anglican worship. The humour comes from the ease with which to mock and satirise the Christian faith-or a least its rather effeminate followers!

So at the Corn Exchange in Bedford on Tuesday evening three comedians (Paul Kerenza, Tony Vino and John Archer) who are all professing Christians, did their stuff. It was funny and was followed by a stimulating talk on joy and laughter in the Bible by Richard Coeken.

I guess some still imagine a Jesus of unbearable earnestness with never a smile nor chuckle and who relentlessly challenged people with his message. But that's a very plastic Jesus-and certainly not a real human being.

Many commentators have pointed out the remarkable use of humour which Jesus demonstrated in his life and teaching. Indeed Elton Trueblood noted '"The widespread failure to recognize and to appreciate the humor of Christ is one of the most amazing aspects of the era named for Him. Anyone who reads the Synoptic Gospels [Matthew, Mark and Luke] with a relative freedom from presuppositions might be expected to see that Christ laughed, and that He expected others to laugh, but our capacity to miss this aspect of His life is phenomenal" (Elton Trueblood, The Humor of Christ, p. 15).

It's yet another case of ignorance of the personality of Christ, aided and abetted by great artists down the centuries who although oftentimes inspirational, generally leave us with a one dimensional view.

There's much to be sad, concerned and troubled by in this world but thank God for the ballast of joy and laughter. There is indeed a time to mourn and a time to laugh.

Thursday, 11 March 2010

'First do no harm'

For medical doctors this well known phrase is often attributed to Hippocrates and his oath, however it is likely that it has other origins although no-one would dispute it's value.

I spoke to a lady today who had gone to her GP for the first time in 5 years. She did not find it a good experience. When asked why she had attended she haltingly opened with, "just a couple of things" (she told me that she was struggling to find the right words to describe what she wanted to say and so just used this rather vague opening, to warm her up as you might say. Before she could go any further the doctor informed that she only had a 10 minute appointment. This completely flawed the patient who had had to to summon up courage to go to the doctor at all. The 'two things' were in fact just two symptoms related to the same problem. Nothing was resolved and the consultation lasted about 5 minutes.

We do not only harm our patients by the drugs we use and the surgery we perform but also with that lethal weapon, the tongue. Good ears are more use to a doctor than an active tongue. Listening is such an important part of doctoring. I know it can be frustrating if the patient simply has too many issues to resolve at one consultation, but it's best not to jump straight in with a time check before gaining some idea of the ideas concerns and expectations of the patient. Peter Tate has written expertly on the subject. As it says in the old English churchyard

Beneath this stone,
a lump of clay,
Lies Arabella Young,
Who, on the twenty-fourth of May,
Began to hold her tongue

Being 'slow to speak' (James 3.19) remains excellent advice.

Wednesday, 10 March 2010

Passion for Life

Passion for Life is a nationwide series of events which has the aim of introducing people to 'real' Christianity. I say real because for so many people Christianity is off the radar largely through the mistaken idea that it is irrelevant or simply untrue (thanks to Richard Dawkins and others). But what has often been rejected is in fact a caricature of the Christianity believed by millions of people throughout the world. That's not to say that much that passes for Christianity isn't ugly or just downright crazy!

There's much more to say about that, but I wanted to draw your attention to the events that are happening in Bedford beginning Monday March 15th. Do take a look and get along. They vary from a Comedy night to an interview with Diane Louise Jordan.

I never liked brussel sprouts as a child. But as my mother frequently pointed out to me, 'I'd never tried them'! As G K Chesterton said,“Christianity has not been tried and found wanting; it has been found difficult and not tried.”

Thursday, 4 March 2010

One of life's great mysteries

Our alibaba washing basket has finally given up after 32 years service. It was one of our few remaining wedding presents (I only got rid of my wedding tie last year)!

It's a magical thing because I place all sorts of rather soiled and creased shirts, pants and 'others' into it and a few days later they reappear looking like new. How grateful I am to my wife Liz.

Leading up to Easter and for the rest of the period traditonally known as Lent I am reading each day one of Charles Spurgeon's sermons on the Cross of Christ. The events of that first Easter continue to have an extraordinary impact on our world and many millions of it's inhabitants.

I'm one of the grateful beneficiaries. I don't understand how it happens, but I come to the cross weary, soiled, 'screwed up' and needy and I come away renewed, cleansed and ready to go. I guess magical is not the right word. It's certainly a mystery and a fact to be pondered long and hard.

In the current climate of debate about whether or not there really is a God, or whether evolution does away with belief in a creator God it's important to focus on the centre of Christian faith-the death and resurrection of Jesus Christ of Nazareth.

Tuesday, 2 March 2010


'It's healthier to eat chocolate cake with a friend than eat broccoli on your own'

I came across this phrase in a medical textbook in the section, 'How to help patients feel less lonely'. It seems an eminently sensible comment and i think is borne out in practice. Indeed the same textbook gives a reference to the fact that unconnected people are more likely to develop dementia (and die) sooner.

Its on my mind because the church family I belong to had a 'hospitality Sunday' last weekend. To it's credit the church is very hospitable at the best of times, thanks to the great example of our senior pastor, Ray Evans. But this Sunday a special effort was made to bring people together and to host people for Sunday lunch who perhaps you wouldn't normally get the chance to meet..

My wife and I had a fabulous time being hosted by a delightful Jamaican family who treated us to a great lunch of blended traditional English and Caribbean food. It was delicious.

Being part of a church family is good for your health! Hospitality is such an important them in scripture. Writer Lauren Winner has a good chapter on the subject in Mud House Sabbath-you can read an excerpt

A message from the other side

No, not that side! But thank God got through surgery ok yesterday. And thanks to all for love support and prayer.