About me

Get new posts by email.

About me

28 things I learned in February 2021

1: Lego streets have become worse for pedestrians and cyclists over the years, not least as cars and roads have widened at the expense of footpaths. But things are looking up.

2: I have long believed that TV detector vans were essentially distractors for more basic modes of TV detection such as looking through windows, but I was wrong: they had proper kit in them which could detect TVs and support applications for search warrants.

3: It might be time for those who peer review papers for publication to rebel.

4: One of the fundamental principles in outbreak management, and in incident management, is having clear lines of accountability. If I’m managing a multiagency outbreak, I have a little spiel on the topic that I give at the start of each incident management meeting, accountability for decisions is clearly documented in minutes and a section on “legal considerations” appears on every agenda for good measure.

And yet, when it comes to the national response, “we have not been able to identify who [in the Department of Health and Social Care] was accountable for major decisions, particularly where PPE is concerned.”

5: I walked past this van and thought: “What on earth is futsal?”

I inevitably ended up perusing the Wikipedia entry, and—having got a few paragraphs down—GCSE Spanish lessons, which often seemed to mention futsal, came flooding back.

6: There’s a line in Shuggie Bain about the smell of static electricity from TV screens, something I haven’t thought about in years. It reminded me of the unique power of olfactory memories.

7: Denis Norden, presenter of It’ll Be Alright on the Night, was the person who came up with the title Auntie’s Bloomers for the rival BBC show.

8: “The physician’s duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence.” It’s a few years since I read Kalanithi’s book; this blog post reminded me of the emotional experience.

9: Some people are making their own homemade covid vaccines. I wouldn’t recommend it, but it is a curious reminder of the full range of human responses to the offer of vaccines, from outright refusal to desperate home-brewing.

10: With knowledge of the treacherous frozen slush to come, it’s sometimes difficult to feel positive about snow. Yet there is something particularly beautiful about a fresh fall, and especially about the wintery quality of light it brings.

11: “A No 10 spokesman said: ‘Going on holiday is currently illegal.’”

There are moments when a simple sentence can just tip over into crystallising a bunch of feelings into something more like thoughts, and this Government line has proven to be one of those for me.

By nature, I’m quite libertarian: I don’t really like forcing anyone to do anything. This is quite an unusual proclivity in my specialty of health protection, but one which is shared (to a greater or lesser extent) by most of my immediate colleagues. I think better results are generally achieved through persuasion than through force, though of course a public health emergency like a pandemic is always going to require a multifaceted approach.

A little over a year ago, I was nothing short of astonished when returnees from China were (to all intents and purposes) forced to quarantine at Arrowe Park hospital: I remember suggesting in conversation with colleagues that this would turn out to be a “resignation issue” for the Secretary of State. Of course, I said, we should offer people supported quarantine. Of course, we should ask all returnees to quarantine at home at the very least. But of course we can’t force people. I was wrong.

So much has happened since then, much of it to my mind ethically questionable: do we really have informed consent from all care home residents for routine covid swabbing? If not, is it really in the best interests of each individual? Are we really sure we haven’t slipped into making “best interests” decisions on behalf of populations rather than individuals?—a slippery slope indeed.

We all now live under a level of legal restriction unprecedented in modern times, perhaps concordant with an unprecedented emergency. More than a hundred thousand people have died.

And yet: there is still something which sits discomfortingly about governments using on-the-hoof extreme restrictions as opposed to established ‘emergency’ approaches such as the Civil Contingencies Act. This is even more true in an era of populism and governments who have a history of riding roughshod over constitutional convention and legal limits on executive power.

Will we really find it simple to put the genie back in the bottle?

12: I know I’ve said it already, but would you look at the quality of the light?!

13: Both this podcast episode and this book make, in passing, a very clear argument about emissions being by far the most important ecological consideration of our times, and both, in passing, unflatteringly compare with the impact of most recycling. I’m really pleased to see clear communication on this, instead of a plethora of actions referred to as ‘sustainable this’ or ‘green that’ in a way that treats every action as roughly equal. I was also pleased to see that carbon offsetting, which I do all the time, is more effective than I imagined it to be!

14: When standing before the 1777 marble statue of Armand-Thomas Hue at the Frick Collection in New York, “try as you might, you absolutely will not be able to meet his eyes. I wonder if this was Jean-Antoine Houdon’s subtle aim, as it ultimately says more about his subject and is almost more of an artistic accomplishment than what he managed with Madame His—and also because it’s what most of us spend our lives actually doing.”

15: There are tens of roads named “Bow Street” in the UK, but it seems that the BBC considers the best way of writing about a Bow Street in Wales is through reference to one of the Bow Streets in London. It’s not hard to see why coverage like this is often judged to be inappropriately London-centric.

16: Copying and pasting between Apple devices is built-in.

17: Richard Smith reckons there have been 20 re-organisations of the NHS since 1999… and he ought to know. I haven’t even tried to keep count.

18: Energy efficiency ratings for household appliances are changing.

19: On hope so much depends.

20: The Government has broken the law again.

21: How Daft Punk’s robot outfits were made.

22: Daft Punk have split. 😱

23: Spectacularly failing to learn a lesson from promising a Christmas easing of restrictions a month in advance, the Government has chosen to make itself a hostage to fortune once again by promising an easing of restrictions even more than a month in advance.

24: “Every love story is a potential grief story. If not at first, then later. If not for one, then for the other. Sometimes for both.”

25: “It will pass. All the epidemics of the past have passed. Nobody is yet clear about the effect this will have on our lives, how disruptive it will be, how much it will cost each of us. Perhaps we will review some assumptions about the free market: even the most strenuous defenders of the total freedom of the market today cry out: “The State should help us! In times of difficulty, it becomes clear that collaborating is better than competing. My secret hope is that this will be our conclusion from the current crisis. Problems are best solved together. Humankind can survive only if we work together.”

26: “Nothing can deceive like a document.”

27: Pigs can play computer games.

28: Brexit means Brexit “Your parcel is delayed due to a Brexit related disruption. We are adjusting delivery plans as quickly as possible.”

This post was filed under: Posts delayed by 12 months, Things I've learned.

Weeknotes 2022.08

A few things I’ve been thinking about this week. The eighth post of a series.

I’m not very loyal when it comes to early morning radio stations, but for the last few months my 6am alarm has been tuned to Times Radio Breakfast: generally, there is a snatch of laughter and banter between Callum McDonald, the Early Breakfast presenter, and Breakfast presenters Stig Abel and Aasmah Mir, which feels like a lovely way to wake up.

On Thursday morning the tone was formal and serious, and even before my brain properly engaged with the world, it was clear that something awful had happened. And days later, Putin’s invasion of Ukraine continues to horrify the world.

On Friday, feeling impotent (as I think everyone does), I tried to find out what charities I could support to help the situation. One of the most recommended was ‘Come Back Alive’, a Kyiv based charity which supplies ammunition to those defending the country. Armed defence is the only option for many Ukrainians, but I was morally torn: could I bring myself to effectively buy ammunition with the sole intention of killing soldiers?

What a luxury it is to have that dilemma, rather than feeling forced into actually killing people to defend myself. What ridiculous privilege I expend by writing these words and taking up your attention with my petty dilemmas while others are senselessly losing loved ones.

A little over a year ago, Wendy and I bought a new tumble dryer, the previous one having stopped working after 7½ years. We tried to buy the most ecologically sound model we could find, and it also happened to have a Wi-Fi connection.

We were most amused: why would anyone want their dryer to surf the web?

A year on, I’ve been won over. It is amazingly convenient to have an app which shows how long the cycle has to run, and push notifications to signal that the cycle has finished beat annoying beeps hands-down.

Forgiveness is hard. Forgiveness has been a recurrent theme in my reading this week, and it has made me think. Before I really thought about it, I would have said that I was a pretty forgiving person. But the more I reflect, the more I think about those very few people who I would describe as having “antibodies” towards, and I wonder if those “antibodies” mean that I haven’t completely forgiven them for things in our shared past.

These are all people who were in positions of professional seniority above me who have behaved poorly towards me in the past. They all, I now realise, demonstrated some form of very brief, petty and unnecessary aggression against me, for which they never apologised. I’ve never recognised that common link before.

So perhaps I’m holding onto grudges without realising it, especially in those narrow circumstances. Perhaps I need to be better at appreciating others’ capacity to learn, grow, and leave bullying behaviours behind.

This post was filed under: Weeknotes.

What I’ve been reading this month

I have just four books to tell you about this month.

Conversations with Friends by Sally Rooney

Rooney’s 2017 bestselling debut is one of those books that is so wildly popular and widely read that writing about it seems redundant. In fact, I thought I’d read this book some years ago, shortly after I read Normal People. But I think I was confused: I read Rooney’s short story Mr Salary a couple of months after that.

I didn’t especially enjoy Normal People, finding it a bit flat and claustrophobic, and I didn’t think much of Mr Salary either, finding the dialogue unconvincing. Yet, I enjoyed Conversations with Friends.

As you almost certainly already know, the plot concerns two University students (former lovers) who form a friendship with an older married couple, and the complex web of relationships which develops between the four of them.

For what it’s worth, I still think Rooney’s dialogue is astonishingly unrealistic given how widely praised it is: this is a novel where everyone talks in sentences and paragraphs, and can spontaneously express complex thoughts and feelings with immediate precision. But this book did have a lot going for it in terms of characterisation and emotional complexity.

All things considered, I enjoyed this book enough to seek out the newly published Beautiful World, Where Are You.

How to be Perfect by Michael Schur

This is a recently published “popular philosophy” book by the writer of the television comedy series The Good Place. I picked it up mostly because I enjoyed that series.

The book is a guided tour of some schools of thought on ethics and philosophy, along with (mostly humorous) examples of how these relate to everyday life. I found the discussion mostly superficial, which is really a result of the structure and the decision to cram so much into a short book.

The writing style was, for my liking, far too conversational in tone, to the point where I slightly struggled to understand parts and had to go back and mentally “read them aloud” to parse what Schur was trying to say. I found that annoying.

This just wasn’t up my street (which, as you’ll see, is a bit of a theme this month: poor choices abound).

All of that said, the last chapter—concerning apologies—was a cut above the rest. It’s quite disconnected from the rest of the book, and while I still found the writing style a bit painful, I think this chapter could be published and well-received as a separate essay.

The Kiss Quotient by Helen Hoang

This 2018 gender-swapped reworking of Pretty Woman is not my usual sort of novel, but I wanted something light and easy after a run of slightly dull books that I’d struggled through.

This fits that bill. While it was never going to be a book I’d love, I appreciated its straightforward plot and implausible but easy-to-follow dialogue. The characters were lightly sketched, as was appropriate for the plot. Unfortunately, I couldn’t help but repeatedly misread the main character’s name, Stella Lane, as Stena Line, which often made me laugh.

This novel has spawned a couple of sequels: this didn’t have enough of an effect on me to consider picking them up, but that’s no real criticism given that I knew it wasn’t my usual kind of novel when I bought it.

Broken People by Sam Lansky

Published in 2020, this Is Sam Lansky’s semi-autobiographical novel about coming to terms with our own past. The plot concerns a character—also called Sam—working with a shaman who offers ‘open-soul surgery’ which fixes ‘everything that it is wrong with you’ in three days.

I thought this was an interesting concept, but the book didn’t quite live up to it. I suppose I was hoping, in the end, for a discussion on how the process didn’t work, and how life and our own interaction with our past is altogether more complex than the conceit suggests. Unfortunately, Lansky delivers the opposite.

The ‘surgery’ consists of drug-fuelled trips into angsty memories, with superficial (and really quite dull) reflections on how they have shaped the present character, somehow leading to a positive and hopeful outcome. I didn’t find myself drawn into the process or the plot more broadly.

This just wasn’t really my cup of tea.

This post was filed under: What I've Been Reading, , , , .

Weeknotes 2022.07

A few things I’ve been thinking about this week. The seventh post of a series.

Following last week’s earth-shattering news about my toothbrush, I bought a new Sonicare number this week. It’s fancy. I’ve used the Philips dental care recycling scheme for some time to recycle my toothbrush heads, interdental brushes and floss packaging, despite having no Philips dental products, so it seemed right to support them.

I finished my work notebook yesterday, and cracked open a new one this morning. I use an A4 spiral bound hardback Black n’ Red book, and use exactly one page per day, writing the date top-right. All the inserts of inspirational quotes are brutally torn out before I start using the notebook, as I find them intensely irritating.

I mostly use my notebook for writing down my schedule for the day (to keep it handy) and any jobs I need to do (to make sure I tick them off). I also write occasional scribbles of things I need to not forget. I buy the notebooks in packs of five, but rarely get to use more than one of the pack as Wendy steals them, as she uses notebooks at a much faster rate.

I’ve tried many electronic alternatives over the years, but have never found anything to rival the “look down, and it’s there” accessibility of a physical notebook. I do keep future tasks and appointments electronically, but “today” works best on paper for me. It’s also great for those “did I remember to do that?” moments, when I can flick back and see a task ticked off.

Following last week’s positive covid test, I never did go on to develop any symptoms, though did remain positive for a little while. Working from home all week and never leaving the house was a strange experience, but not wholly unpleasant. I’ve missed my walks to work, and I still haven’t got round to reading much this month.

Rumours abound that the Government will announce a substantial change to the covid response tomorrow, apparently to include the end of the legal requirement to self-isolate and the end of access to free testing. I haven’t been able to get this bit from Stuart Heritage’s Air Mail profile of the Prime Minister out of my head all week:

He is apparently telling colleagues that he “got Covid done.” Just like he got Brexit done. And that worked out O.K., didn’t it?


I finished watching After Life this week. I had avoided the series for years, thinking that it wasn’t up my street, but it turned out to be brilliant.

This post was filed under: Weeknotes.

Weeknotes 2022.06

A few things I’ve been thinking about this week. The sixth post of a series inspired by Jonathan Rothwell.

I got an email this week from a certain multinational company in which my correspondent was “really sorry to tell you the sad news” that replacement heads for my electric toothbrush are being discontinued.

“We know you are a regular toothbrush user and know that this is disappointing.”

This may be the platonic ideal of a first world problem.

This week, I overheard an annual appraisal for someone working for an IT firm, being conducted (unduly loudly) in a public place. The appraisee was asked about their personal development plan and responded that they’d struggled to work out what to include. The appraiser suggested that it can be helpful to include a plan to attend courses for things that are regular familiar tasks: sometimes people can develop bad habits which a bit of refresher training can help to correct, and occasionally people pick up shortcuts they’ve not previously discovered.

My initial reaction to this was that it was insightful advice that I’d never considered, and which is probably transferable to medicine.

Half an hour or so later, it dawned on me that while the advice was interesting, it was completely the wrong response to the point the appraisee was making. The appraisee had raised uncertainty about what professional skills they’d like to develop, and instead of exploring that topic, the appraiser just dispensed a bit of off-the-cuff “how to tick the box” advice. The appraiser had effectively shown a complete lack of interest in the skill development, and career development, of the appraisee.

It surprised me that it took me so long to notice this, and made me worry that maybe I do similar things at times in my own job. Hopefully, this experience will remind me not to.

After two years of pandemic, I’ve finally tested positive for covid for the very first time. I have no symptoms and was testing before visiting family, like a model citizen. I’m also open to all jokes about my lack of symptoms being attributable to me having no sense of taste to lose.

I know Wordless stats are dull, but I’d been successful in my first 43 days of playing, and was peeved this week to fall at the 44th hurdle (frame).

This post was filed under: Weeknotes.

Weeknotes 2022.05

A few things I’ve been thinking about this week. The fifth post of a series, which is looking increasingly like a regular thing, inspired by Jonathan Rothwell.

At the start of this week, I spent time on a number of calls about Storm Malik and Storm Corrie which battered much of the North East. Nevertheless, I didn’t expect to see this near home:

There was a piece in The Guardian this week in which “scientists admit their covid mistakes” in an effort to demonstrate that changing one’s mind is important in science. I’m not a scientist, but my life as a doctor protecting people from serious communicable diseases has been dominated by covid for more than two years now, so this article has been playing on my mind.

Most of the “mistakes” are nothing of the sort: we all have to make decisions on the evidence and information available to us at the time, and the fact that we might make different choices in retrospect with more information available does not make the initial act a “mistake” in my book. By the same token, making a decision against the evidence and proving to be correct doesn’t equate to having miraculous foresight.

But nevertheless, we do all make mistakes, every day.

One of my mistakes was to be unduly pessimistic about the probability of a covid vaccine. I’m not well read on vaccine development, and it isn’t an area I keep up to date on: it’s a little removed from my work. And so when asked early in the pandemic about the likelihood of a vaccine being developed, I drew a conclusion based not on the evidence, but on my background knowledge. Coronaviruses circulate widely, many attempts have been made to create vaccines against them, none have been successful, therefore vaccine development in this pandemic scenario is unlikely.

I didn’t test my thinking, I didn’t consult experts, I didn’t dig into the available evidence on relatively recent breakthroughs in RNA vaccines. Had I done so, I would probably have had a different view on the likelihood of development, and how the pandemic was therefore likely to play out.

I haven’t finished a book in over a fortnight, and not because I’m reading anything especially long. This is a sure sign that I’m worn out.

This post was filed under: Weeknotes.

The content of this site is copyright protected by a Creative Commons License, with some rights reserved. All trademarks, images and logos remain the property of their respective owners. The accuracy of information on this site is in no way guaranteed. Opinions expressed are solely those of the author. No responsibility can be accepted for any loss or damage caused by reliance on the information provided by this site. Information about cookies and the handling of emails submitted for the 'new posts by email' service can be found in the privacy policy. This site uses affiliate links: if you buy something via a link on this site, I might get a small percentage in commission. Here's hoping.