Sunday, 30 September 2012

You need friends

I've been a bit slow to catch on to the Big Bang Theory, the comedy sitcom which features four ultra bright computer nerds and a likeable waitress. Some of the dialogue is priceless. The two main characters are here discussing their limited lives, filled with Superman movies and various computer animation games,
Leonard: We need to widen our circle.
Sheldon: I have a very wide circle. I have 212 friends on myspace.

Leonard: Yes, and you’ve never met one of them.

Sheldon: That’s the beauty of it.

What a contrast with C.S.Lewis writing to his friend Dom Bede Grffiths in 1941, referring to Tolkien and others,

'Is any pleasure on earth as great as a circle  of Christian friends sitting round a good fire?'

Tuesday, 25 September 2012


Brian Moore's remarkable autobiography does indeed 'hit you like a sledgehammer' (Rugby World). He is brutally honest both with and about himself.  Although much of his adult life has been in the physically brutal world of top class rugby, the real brutality of the book is the stark telling of the sexual  abuse he suffered by a family friend and its ongoing consequences. Add to that coming to terms with being adopted,  and his anger which is never far below he surface, and then the sudden emptiness of his life after a stellar international rugby career, and his perhaps almost inevitable, marital failures. It is a salutary read, but a fascinating story.

Moore's recurrent self-loathing and self criticism (his Gollum figure) is painful to read, although I suspect many of us experience something similar, but perhaps without Moore's intensity. A large amount at the core of the book is a description of his playing career. There are great little cameos of many of the international players with whom he played. One  striking opponent was  Johan Le Roux, the Tansvaal prop. After describing Le Roux biting a chunk form the ear of England full back Paul Hull in the first test in and against South Africa, he goes on to describe in a somewhat understated way, the second test,
'the manic Le Roux came into their front row and throughout the game ran about the field putting his boot on any white shirt he could see. This approach and the fact that he had wild eyes and occasionally bellowed, 'l love it!' made me think that his play was not entirely normal'

Many of his descriptions of incidents during matches left me wincing and glad that I was a nancy three-quarter in the days when we didn't feel obliged to get involved in rucking, mauling and other dark arts!

His reflections about adoption are helpful and cautionary, especially as regards the merits or otherwise, of tracing birth parents. He still admits to some confusion over his own adoption, but nonetheless speaks lovingly of his adoptive parents, both of whom were Methodist lay preachers.

Retirement for top sportspeople brings a gaping hole for most. This was highlighted very recently when Piers Morgan interviewed Dame Kelly Holmes. This was no less true for Moore whose world almost fell apart when he realised he had poured all of his energy and self worth into being a hard man, super fit, and top of the tree rugby player. But he has since adapted to the wonder of fatherhood and a  career as a journalist and rugby pundit. This in addition to writing about and enjoying wine, as well as the thrill of skiing-he had not skied during his rugby paying days for fear of injury.

it was fatherhood that brought to the surface the unresolved sadness and pain of 'abandonment and abuse' Moore's words). His honesty and self-awareness are striking.
'I am constantly thinking about the conflicting issues that face me surrounding my adoption, and untruth I don't know what to do about them...either of the two issues, abandonment and abuse, would have posed more the enough problems for me. In unison they have been an ordeal, and continue to be so on an almost daily basis, even though there influence has diminished'

Interestingly he mentions that when his first autobiography came out in 1996 he had not seriously begun to face up to the effects of his abuse and adoption, and in that sense it contained truth, but not the whole truth. It's perhaps one reason why people should wait a while before writing an autobiography. It's one of the things that troubles me when I hear that a guest on Desert Island Discs is only 29 years old. 'But you haven't lived' I want to yell at the radio.  Ok so Moore's 'only' 50 years old-I think I'll concede that the beginning of the understanding of  life may begin at about that age!

Saturday, 22 September 2012

Get a better night's sleep

One of the most surprising ways of improving sleep is to reduce the amount of time given over to it.

Worth a fiver!
I have seen literally hundreds of patients who's lives are blighted by poor sleep, and yet for many of them a significant part of the answer could be a planned programme of sleep restriction! Of course  this seems contradictory, but Harvard Clinical Psychologist Gregg Jacobs, explains why in his excellent book, Say goodnight to insomnia.  He acknowledges that whilst  many people with poor sleep patterns try to improve things by going to bed earlier, in the hope of getting off to sleep sooner, thus catching up on lost sleep,  all this does is to exacerbate insomnia.

By going to bed earlier all one does is to increase the amount of awake time whilst in bed which increases the bed as a stronger cue for wakefulness!

Jacobs suggests the following.

1. Reduce the time in bed so that it more closely matches the amount of sleep you are averaging (you may need to keep a sleep diary for 7 days first to determine that-he gives advice on his to complete a diary).

2. If you are only averaging 5 hours of sleep but are in bed for 8 hours, then reduce your time in bed to roughly 5 hours, by going to bed later, getting up earlier or a combination of the two.

3. Determine your maximum allowable time in bed by adding one hour to your average sleep time.

4. Reducing time in bed is only temporary until sleep efficiency improves to 85% (ie you are asleep for 85% of the time you are in bed). Once you reach 85% efficiency you can increase the time in bed by 15 minutes each week so long as you maintain the 85% efficiency.

5. If you find it hard to go to bed later whilst you are retraining then take a walk, do a household chore or a project for a few hours before your new later bedtime to ward off fatigue. If you watch tv all evening it will be harder to delay your bedtime.

He has lots more advice in the book and of course there are many factors that can mess up our sleep (including our dear children!), but I've seen many patients for whom sleep restriction has been a revelation and has completely turned around years of insomnia.

 Less is indeed more.

Thursday, 20 September 2012

Local heroes-the Windowcleaner

David enjoying a well earned cuppa
Great to bump into David Denton this morning. I've known David since I was a little boy as he used to clean our windows, and also deliver the morning papers, and in summer he sold ice-cream from a large coolbox on his bicycle. I particularly remember him also delivering a long defunct paper called The Pink-un. He came round with about 7pm on a Saturday evening. It had all the football results and included reports of non-league games, including The Eagles (Bedford Town), the team I followed then.

It was good to have a chat with him whilst he was having his cup of tea after having cleaned the windows of my barber's (sorry, stylist). David is now 74 years old, he gets up at 5am every morning, has never had a holiday, and has never left Bedford! 'Have you never been to London?' I asked with some surprise. 'No, and why would I want to?' came his matter of fact reply.

Hard to argue with. He's certainly content and enjoys his work. He has a daily chat with his various clients in the town centre and gets satisfaction from providing a good service. A blast from the past indeed, and perhaps a reminder that valuing your community and contributing to it over the long run, brings contentment. Our well travelled, very mobile, commuting society have much to unlearn.


Tuesday, 18 September 2012

Another slow death in the NHS

The art of letter writing is dying.

Just this week I received yet another pro-forma telling me how I could refer certain patients into secondary care. It emphatically stated that the pro-forma must be completed and that, 'letters are not acceptable'.

Now I know that letters can be badly written and contain inadequate information, but when well written they are irreplaceable. Not least they are generally more friendly! The proforma just does not paint a picture of the patient. Oh yes it'll tell me their height and weight, and their ethnicity and perhaps even the number of cigarettes smoked per day (although often because of the unnecessary information requested, it is difficult to find the crucial detail on such proforma, often times I look at a discharge summary from the labour ward, I can see how long the first stage was, and who the midwife was and whether any drugs were use, but can I see what (who?) the baby was?

Prose just gives more scope for description. My former Professor of Surgery at the Westminster Hospital,  Harrold Ellis, was fond of teaching us how to give a medical history at the bedside. An American exchange student was in my group and began presenting the case to the professor, he was like an automaton,

'the patient denies constipation, denies bloody stools, denies indigestion, denies abdominal pain....'

I think he would have go on were he not interrupted by the Professor,

'Can I suggest you start by saying,  this recently divorced 38 year old Bolivian ballet dancer.....'

Now I suspect non of us had much idea about such ballet dancers but we got the point. Mere list giving is somehow hollow and impersonal, a really well written, concise letter or a statement in prose, can say so much more.

Monday, 17 September 2012

Cats and birds

A visitor outside our lounge
Most of my friends know that I struggle with cats. I realise that many people adore them, so I'll  be careful what I say, but somehow I just can't bring myself to like them.  I think if truth be told,  I'm actually a little afraid of them,  certainly I get the feeling that they sense that I am, when they're around me. Is that the reason they seem to approach me in a crowded room rather than anyone else?

Anyway, in reading a  delightful little book, An ear to the ground-Garden science for ordinary mortal by Ken Thompson, I learn that in a study by the Mammal Society in 1997,  British cats were found to kill around 250 million (yes million) animals each year. Now as he points out, many of those animals were probably sick, very young or very old and may well have died anyway. Not all the animals were birds of course, they were many mice, voles and retiles.

The book closes with some tips on how reduce bird kill,

1. Fit the cat with a CatAlert sonic collar.
2. Keep the cat in at night. This rescues the cat kill by 80%.
3. Somewhat paradoxically, by providing a bird feeder. The rationale is that larger numbers of birds together are more likely to spot the cat  and each other

Sunday, 16 September 2012

Bonhoeffer: Pastor, Martyr, Prophet, Spy


This is a stunning book. It's informative, memorable, tragic and inspiring.

I'd heard great things of the new biography of Bonhoeffer by Eric Mataxas, so got to reading it this past week. Although a lengthy read, it is magnificent.

My knowledge of Bonhoeffer was thin, although I was somewhat aware of his courageous activity against Naziism throughout the 30s and during the war. I also knew of his, 'cheap grace' idea, and one or two others. But now  I know considerably more of this man and his lived relationship with God. Although something of an intellectual and academic theologian, he always maintained a living, breathing relationship with God,  which informed all he thought and did.

Much of the book explained the rise of Naziism, Hitler, and his gradual grasping of despotic powers. I knew something about the effect of the treaty of Versailles and the humiliation felt by the German people, but hadnt thought abut its effect upon Christians in Germany. There is fascinating detail of the complexity of the relationship between the church and the state, and the unbelievable capitulation of the state church, even to the extent of the rewriting parts of Jesus sermon on the mount. Thus Ludwig Muller, the archbishop of the state church, wrote to other church leaders, (if it were not wickedly true it would almost be funny)

'I have not attempted to translate the sermon on the mount but have Germanised it...'

And since meekness was not an acceptable Germanic attitude, Muller gave his comrades something more in keeping with the hearty Germanic image he wished to promote,

 'Happy is he who always observes good comradeship, he will get on well in the world'.

There are some big themes in the book; the relationship between church and state, when is a church not a church? When is it right to lie or to kill? The role of suffering in the Christian life, the importance of community for Christian growth, and so much more. But what stands out for me were of a more personal nature.

I was taken with his emphasis on the importance of personal times with God, which for Bonhoeffer meant daily meditation on small parts of Scripture, in addition to a regular praying of the Psalms, (it seems that unles and until we go through the sort of challenge and oppression tat Christians in Nazi Germany faced we perhaps will never truly understand some of the 'harder' psalms).

I was also much helped by his repeated emphasis upon the importance of life on earth, his was no merely cerebral or otherworldly Christianity.

God wants to see human beings, not ghosts who shun the worldin the whole of world history there is always only one really significant hour-the present. If you want to find eternity you must serve the times. 

And when writing to his fiancée from prison, his famous words abut marriage,
'Our marriage must be a 'yes' to Gods earth. It must strengthen our resolve t do something on earth. I fear the Christians who venture to stand on earth with only one leg, will stand in heaven one leg.'

I loved his whole life discipleship' emphasis (a la Mark Green and LICC), illustrated by a letter from one of his trainees in ministry. Here he  reflects upon training under Bonhoeffer at the small seminary in the German countryside,

'We had an appreciation of all that give charm to the fallen creation..... music, literature, sport, and the beauty of the earth......, a magnanimous way of living.  When I look back I can see a clear picture, the brothers sitting in the afternoon over coffee, bread and jam. The chief (Bonhoeffer!) returns after a long absence,......now we get the latest news and the world breaks into the quiet and simplicity of our country life...Does it dull the senses of your theological vision if I tell you that it was the peripheral things which were enhanced by appreciation of  the central one.'

 Bonhoeffers attitude to death and dying was not fatalistic but supremely based upon his conviction that Christ is Lord of all, and nothing could alter that fact. All we are called to do is submit to Christ and serve our times wholeheartedly.  Sounds easy.ok, ok, but what an adventure. Here is no half-hearted Christianity, but then, what's the fun in that?

Guess Id better stop for now, but all to say, do consider getting hold of this book and take time out to read it.

Thursday, 6 September 2012

What does a true leader say?

Have been looking again at the stunning book,  Six Weeks, The short and gallant life of the British Officer in the First World War. Struck again by the definition of leadership from Brigadier Crozier, who reflects upon why the officers were first 'over the top'.
A true leader says, 'Come on' and not, 'Go on'.

Wednesday, 5 September 2012

Paralympic ambivalence

I blogged recently about the incongruous nature of the Paralympics.  And now that I've been to the stadium to watch (last Saturday evening),  it strikes me more forcefully than ever.  Just below us we were able to watch a shot put competition for female paraplegics. I can't pretend it was the most exciting live sport I've ever watched, but I was fascinated by the trouble that the officials went to in order to secure the athletes in position, out of their wheelchairs but fixed on a type of podium.  It must have taken a full five minutes for about 4 officials to change the dimensions of the straps holding the podium in place for the athlete and then to transfer them from their wheelchair into the throwing position.

Here  again was a wonderful example of the lengths people are willing to go to for their fellow human beings. It's the kind of thing that crosses your mind when multiple firemen are engaged to rescue a solitary person who is precariously placed in a possible suicide attempt, or the sheer and extraordinary effort that went to rescuingD the Chilean miners.

So what is incongruous? Well the same effort that is nowadays provided for the support and flourishing and indeed protection of the disabled is directed in quite the opposite direction for the baby yet to be born who also has disabilities. As I said in my last blog post, I don't want to be simplistic here, but it seems that disability brings out the best and the worse of human beings.

The Long Walk

It's always a bit chancy to give someone a book. A little like recommending a restaurant. Will others like it? Will the service be as go...