1: I’m a bit obsessed with Max Richter’s 2012 recomposition of Vivaldi’s Four Seasons at the moment. Particularly, and unseasonably, Winter 1.

2: “In 1989, Shell Oil announced it was redesigning a $3-billion North Sea natural gas platform that it had been developing for years. The reason it gave: Sea levels were going to rise as a result of global warming.

“The original design called for the platform to sit 30 meters above the ocean’s surface, but the company decided to raise it by a meter or two.”

3: The economic generational divide in the UK is something that has played on my mind a lot over the years. It was one of my early pitches for inclusion in the CMO’s annual report, but as the health impacts are mostly in the future, it wasn’t something that was readily visible in surveillance data as yet.

We’re sailing toward an unprecedented crisis, with the burden of paying for the health and social care of the unusually large number of people born from the mid-40s to the early-60s likely to result in an unprecedented liability on those of working age: it’s simple maths.

Yet the same simple maths precludes an easy fix: there isn’t a democratic mandate for rationalising the approach as the median age of voters in the UK is 53.

This Propsect article gives a good overview of recent developments in how this has played out.

During the pandemic, 88 per cent of covid-related job losses affected Britons aged 35 and under, while employment among the more vulnerable over-50s rose.

It takes an average of 19 years to save for the deposit on a first home compared with three years in the 1980s.

“Deaths of despair” (those from suicide and addiction) strike each successive generation at a younger age, and their numbers are increasing. The proportion of young people with diagnosed mental health problems is roughly equivalent to the proportion of over-65s who are millionaires: one in five.

I think it is inevitable that this will lead to social unrest. It is surely impossible to avoid while choices such as triple-locking the basic state pension paid to millionaires while funding cuts mean that student leave university an average of £50,000 in debt. But social unrest only adds to our list of problems.

I have no idea how we can fix any of this. Even if older voters (and politicians) can be persuaded to propose and support politics against their immediate best interests, those very cuts might end up making this generation less healthy and (paradoxically) more costly: four in five aren’t millionaires, and even those who are don’t necessarily have liquid assets.

It’s hard not to imagine that this, along with privacy and climate change, will prove to be one of the dominant long-term societal challenges of the first half of the 21st century.

4: Murder in outer space would be a legally knotty affair.

5: On top of the Scottish independence referendum which looks near inevitable in the next few years, an Irish unity referendum—guaranteed by the Good Friday Agreement—also looks highly likely.

6: It sometimes feels like we’re in an extremely turbulent political period, but on one measure it is remarkably stable: in my lifetime, there have only been handovers between Prime Ministers from different parties twice (John Major to Tony Blair and Gordon Brown to David Cameron). We haven’t had a similarly stable period in this regard since the 1700s.

7: “During one of those recurring leak panics, somebody in Whitehall revealed to a journalist that a cabinet minister was lying. In the uproar that followed, a civil servant was challenged to confirm that she owed unconditional loyalty to her minister. But she demurred. ‘At the end of the day, I answer to the little lady at the end of the Mall.’”

8: “‘Everyone has the right to realise their full potential.’ Quite apart from the now common inflation of the quasi-legal language of ‘rights’, there is a curious emptiness to this claim. It seeks to be at once egalitarian, relativist and positive. ‘Everyone’ has this right; no one can say what another’s ‘full potential’ might be; ‘realising’ it, whatever it is, on this universal scale will be a good thing. Yet has anyone ever realised their full potential? Could it be that in realising my potential, I might get in the way of you realising yours? And what if my potential is to become the most successful mass murderer in history?”

9: “I don’t have remorse and won’t acknowledge failure,” said President Macron in March. I don’t think I’ve ever heard a senior politician sound more like a DSM-5 entry.

10: “In 1937, the 16-year-old Philip walked through German streets for his sister’s funeral as onlookers gave Nazi salutes. His grandson Harry, meanwhile, married a biracial American actor, moved to California, and launched a podcast.

“The 20th century was a hell of a ride, and one in which men’s expectations for their lives changed as dramatically as women’s. No one encapsulated that quite as strangely, or as remarkably, as a man who lived for nearly a century himself.”

11: Jonathan Rothwell’s blog post about the London mayoral election has sent me into a bit of a spiral of thought. “It does rub me the wrong way that there appears to be so little choice—and when there is more than just a binary choice between two ancient political parties, neither of whom appear to have your best interests at heart, the machinery of national politics is willing to snatch even that away.”

It makes me worry that I’m part of the problem. I have no desire at all to get involved in politics: I struggle to imagine anything worse than spending my time having to constantly defend my basic interpretation of reality. It makes me think of heart-sink meetings with anti-vaccine councillors. I completely understand the importance of having those conversations and explaining the science to people who are making local policy decisions, but I it isn’t something I’ve ever enjoyed. The idea of a professional life that involves a lot of that is unappealing. Adding a layer of party politics, in which one has to defend positions one personally finds indefensible simply because it is the ‘party line’, just makes the prospect even grimmer.

And yet: does this not make me part of the problem? If I’m not willing to engage, why should anyone else bother? Are people who enjoy party politics really the people we want making decisions on our behalf? Shouldn’t we all engage more for the good of society? Is “I don’t want to” just a selfish whinge? How can things improve if we leave politics only to those who can be bothered? Aren’t decisions made by those who show up?

12: Work has brought a surprising amount of discussion of stevedores recently, which is a delightful crossword word.

13: It feels like there must be a story behind the placement of this sign.

14: Last week, the MHRA and DCMO used some excellent slides from the Winton Centre for Risk and Evidence Communication (David Spiegelhalter’s stomping ground) to illustrate the risk of serious harm associated with receiving the AstraZencia covid vaccine.

This got me thinking: how does the risk of the vaccine itself compare with the risk of participating in the programme as a whole? In particular—given that most people live “within 10 miles” of a vaccination centre—how does it compare with a 20-mile round trip by car?

After much searching through evidence, my boring conclusion is that they’re focusing on absolutely the right bit of the programme, and the risk of serious harm associated with the journey is orders of magnitude smaller and probably negligible, even at this scale of rollout.

I should have known better than to doubt them!

15: The last Routemasters have run in passenger service.

16: From Concretopia, I learned about Cumbernauld town centre, one of Britain’s most hated buildings. I’m amazed I haven’t come across it before.

17: Derwent Reservoir is spectacular in the spring sunshine.

And as though to prove that it’s spring, here are some ducklings.

18: People often talk to me about books, because they know I’m interested in reading and they follow me on places like Goodreads. I find these conversations difficult, never quite knowing what to say or how to say it. I had a moment of stunning clarity this week when talking to a colleague about this: their suggestion was that it’s easier to write about books because books themselves are written-word.

I think there’s something in that. I’ve always been useless at dictating because speaking isn’t the same as writing, and they need different parts of my brain. In the days when I did clinics, I was far faster at typing my own clinic letters than dictating for a secretary.

For the same reason, I got more confident at public speaking when I stopped trying to write presentations out and relied on freely talking around the key points instead. And, probably for the same reason, I find it hard when I phone a company and they ask for a security word (or whatever) that I’m used to typing instead.

So why wouldn’t the same apply to talking about books?

This conversation came back to me this morning as I read Courier Weekly: “One of the best parts about reading a book is getting to talk about it with other people.” Mmm, maybe not.

19: Fran Lebowitz says that “your bad habits will kill you, but your good habits won’t save you.” It’s possibly the most accurate public health aphorism I’ve ever heard.

20: The news that some teams want to play in a new football competition is dominating the papers and bulletins to an extraordinary extent—and no matter how much I read about it, I’m continue to struggle to understand what the problem is, mostly because I’m not really familiar with how football competitions work at the moment (and struggle to care).

21: I’m still a promising thirty-something.

22: The Government has changed its mind about holding daily televised press briefings, seemingly for reasons which were perfectly obvious from the start. I’m sure that spending 13 times more on refurbish a room for these cancelled briefings than on helping 15,000 displaced Commonwealth citizens affected by a volcanic eruption is entirely justifiable.

23: “If it occurred to the home secretary, Priti Patel, or the minister for ‘immigration compliance’, Chris Philp, that an army barracks wasn’t the best place for refugees who might well have been detained and tortured in such places, it didn’t trouble them for long. Nor did they see any problem with housing four hundred men in 28-bed dormitories with two toilets and two showers in the middle of a pandemic.”

24: That Yes Minister bit about who reads which newspaper is older than I realised.

25: “The prime minister was careless with the facts and too willing to gloss over the complexities of Northern Ireland in his rush to ‘get Brexit done.’ He applied a reckless ‘have your cake and eat it’ approach to an area where the cake had already been painstakingly shared. The irresponsibility is astonishing, and it is not as if the prime minister was not warned.”

26: One needn’t be a doctor to become one of the US’s Top Doctors.

27: “On Monday, three major news organisations – the BBC, ITV News and the Daily Mail – did something unprecedented in recent times. Despite the PM’s outright denial on camera, all three reported that sources familiar with the conversations had heard Mr Boris Johnson say, last autumn, that he would rather see ‘bodies pile high’ than take England into a third lockdown.”

For all the hand-wringing about President Trump’s destruction of any form of trust in Government communications, it seems no lessons have been applied to the UK government. When the judgement of the UK media is to disbelieve statements from the Prime Minister’s spokesperson and from his own mouth, we’re in a bit of a sorry (if entirely predictable) state. And, just like Trump, the liar remains popular with the public.

28: Starbucks has on the wall of one of its branches the claim that 99% of its coffee is ‘sourced ethically.’ I’ve been slightly reeling ever since I saw it: Who decided that acting unethically 1% of the time was boast-worthy behaviour? It seems like an active admission of guilt, which obviously doesn’t come as a surprise with that chain, but it still seems amazing that some corporate communications team signed it off. I half expect to see a ‘we’re proud to intentionally overcharge just 1 in every 100 customers’ sign in the next branch I venture into, or perhaps ‘99% of our baristas are paid in full.’ Baffling.

29: The Dixons brand of electronics stores is about to disappear for good, a little over fourteen years after I wrote that Dixons was “to stop selling anything. To anyone. Ever.” You heard it here first.

30: I have seen film posters with the line “in virtual cinemas now”—and I’m really not sure what that means. I thought it probably just meant available to stream, but then an ad for Truman & Tennessee said “in virtual cinemas and on demand now – book now” which seemed to rule that out.

I’ve six books to write about for April, and most were much better choices than in other recent months!

Companion Piece by Ali Smith

Published this month, this is another quick-turnaround book from Ali Smith in the mold of her incomparable Seasonal Quartet—referenced not just by the matching cover art but also by the main character, Sandy, saying early on “I didn’t care what season it was.”

I loved that series, and I loved this addition. There is something therapeutic about reading Smith’s take on the world’s chaos. The insight and connection she brings fees like it brings closure and clarity.

In this volume, set mostly during the pandemic, Smith blends social commentary with characters having detailed discussions about the analysis of poetry, and with a series of fantastical visitors which we are never quite sure exist.

I would characterise the main theme of this volume as being human connection and companionship (the clue is in one of the title’s meanings). It reflects on the changes wrought by pandemic living, but also the continuity of so many aspects of non-physical human connection, like connection through poetry or ideas or ancestry. It’s also about how it’s nice to be alone sometimes.

Like the whole of the Seasonal Quartet, this was a cut above almost everything else I read, and I’m already sure it will be one of my favourite books of the year.

Cleopatra and Frankenstein by Coco Mellors

This recently published debut novel set in present-day New York focuses on two characters: Cleo, a British artist in her early 20s who is struggling to find her painting form and whose student visa is running out, and Frank, an advertising executive twenty years her senior. Cleo meets Frank in a lift while fleeing a party. The two enjoy a whirlwind romance resulting in a quick, impulsive marriage. Most of the novel deals with the fall-out from their romance, as its consequences ripple through their friendship groups and families. The characters—Cleo especially—mature through the novel, albeit with some profoundly challenging but sensitively portrayed mental illness along the way.

None of the characters in this book are especially likeable, and yet I found myself rooting for all of them. I was immersed in the novel’s world and didn’t want to leave it.

Mellors has a beguilingly rich style of writing, full of imagery and metaphor, which feels like it has fallen out of fashion in recent times. The characters speak sparklingly witty dialogue. It’s hard to believe that this is a literary debut.

Boys Don’t Cry by Fíona Scarlett

This is a 2021 novel about two brothers growing up in modern working-class Dublin: a twelve-year-old call Finn and a seventeen-year-old called Joe. The novel is narrated by the brothers in alternating chapters, though on different timelines (Joe’s story takes place after Finn’s)—this was less confusing than I’ve made it sound.

Joe has secured a scholarship to a prestigious private school, but finds himself teased for being from a different social class, and there is a constant theme of the gravity of his background constantly pulling him down. Society’s expectations of him are not high.

Finn looks up to Joe, and with the naivety of his youth doesn’t fully understand everything that is going on around him, in particular his father’s role as kingpin of a local drug gang.

Both Joe and Finn are very realistically drawn: Joe’s complexity and life challenges in particular drew me into this book, and Finn’s narration always rang true.

Mostly, though, this is a book with real emotional punch, diving deep into themes of teenagers developing their moral frameworks, the struggle to define oneself independently of one’s background, coming to terms with mortality and dealing with grief. It’s heavy stuff—but lightly written enough to be moving rather than maudlin, and with some real wit weaved through the whole book.

This was 238 pages long—I raced through it, but by the end, struggled to understand how Scarlett could possibly have built such a complete world in so few pages. These are characters that will stay with me for some time.

What I Talk About When I Talk About Running by Haruki Murakami

This is Murakami’s popular account of training for running the New York Marathon in 2005, which I read in Philip Gabriel’s translation. For me to say “I’m not a runner” seems to me to be as accurate and yet absurd as saying “I’m not a pair of trainers.” Yet, this is only in one sense a book about running: there is a lot in this short book for non-runners like me.

This is really a thoughtful and reflective memoir about life in general. I was particularly drawn to Murakami’s frequent comparisons between running and writing: both fundamentally solitary activities, and both requiring total commitment driven by self-motivation. Like Murakami, I’m a person who enjoys time by myself, and “doesn’t find it painful to be alone,” so I felt a bit like a kindred spirit.

Really, this was a book that allowed me to spend time in the mind of a brilliant writer, and I thoroughly enjoyed it. It didn’t make me want to start running… thank goodness.

A Lover’s Discourse by Xiaolu Guo

Published in 2020, this is a novel inspired in part by the book of the same name by Roland Barthes, which it references a few times. Like the Barthes book, this is split into very short titled chapters. Each begins with a piece of dialogue extracted from that chapter, which I felt provided a slightly hypnotic quality.

The plot is, of course, a love story told largely through dialogue. The narrator is a woman who moves from China to the UK (or “Brexit Britain”) to study for a PhD in visual anthropology, and falls for a man of a similar age who specialises in landscape architecture. Despite the slightly unusual structure, I found this effortless to read. It has interesting themes around loneliness, even within a relationship, and the limitations of language: both of the central characters speak more than one language.

This was intriguing, enjoyable, and captured more themes than I imagined it would be.

The Second Child by John Boyne

This 2008 novella, published as part of a series for “emerging adult readers” was a fun, single-sitting affair for me. The plot follows an estranged Irish daughter visiting her parents with her partner—a successful Hollywood actor—while pregnant. As well as being very funny, it captures the complexity of familial relationships and the conflict which can emerge from clashing social expectations of different generations.

This isn’t ground-breaking, but I don’t think it set out to be. It’s just a well-written, very brief story which captures complex and conflicting emotions which can emerge in fairly universal relationships. I often find short stories unsatisfying, but I enjoyed this.

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

It’s not a new observation, but Rob Francis’s recent blog post crystallised some thoughts on the incompatibility of the two great nostalgic laments. It can’t be that life was both globally harder “in the old days,” requiring generations to be more resilient, and yet also globally easier, making a return to those times a noble goal.

I went into a small shop this week and asked for paracetamol. The assistant said they didn’t sell medicines, but offered me a couple out of her own handbag. If she hadn’t been so self-effacing about it, I may have been slightly scared; though in the event, I was just bowled over (though still politely declined).

I’ve been in a time-travelling lift this week.

Wendy and I have been thinking about sang- words this week, and their bloody connections (sanguine, sangfroid, consanguinity, sangria, exsanguinate…)

Various pages from the 1876 Annual Report of the Chief Medical Officer (though then with an older title) have appeared in my “photo memories” this week. I took them when working on the 2012 report.

The report starts with one of the most florid tributes to a predecessor I have ever read. This is Dr Edward Cator Seaton’s first report, having just taken over from the first Chief Medical Officer, Sir John Simon, who held the post for twenty-one years. It concludes:

I am deeply sensible of the disadvantage at which I stand in being called upon to follow Mr. Simon in the continuance of this great work; and the chief hope I have of being able to do this, with even the most moderate degree of success, is derived from the close and intimate association with him I have enjoyed for nearly 20 years in every matter having relation to the Public Health.

It also has brilliant photos of the Crown Glue Works:

Cator Seaton sadly didn’t last long in the role. He died in 1880.

Firearm-related injuries are now the leading cause of death for those aged 1-19 in the USA. I’m never sure where limits on personal freedom should lie in life, but surely this balance can’t be right.

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

The blossom on this tree makes me smile on my walk to work each morning.

A Prime Minister led his government to impose the most severe restrictions on basic social freedoms in living memory. He, members of his staff and members of his Cabinet chose not to follow those rules themselves, even while in the workplace where those rules were created. The Prime Minister lied about that behaviour repeatedly.

The police have found that the Prime Minister broke the law on one occasion, and it seems likely that their investigations into other events will reach the same conclusion.

Yet, the Prime Minister has not resigned, there’s no serious attempt to remove him from office. His Party think he’s the best person to lead the country through the rest of the pandemic and the Party into elections next month.

What have we become?

The HSJ’s satirical email this week ended with a suggestion that national leaders think NHS workers shouldn’t be allowed to “just get one with their jobs” because “nobody goes to work just to save lives”—and oof, that felt close to the bone in terms of how things seem to be run right now.

Most people who risk their lives with nothing but the shirts on their backs to cross the Channel are granted asylum in the UK, having escaped horrors I can scarcely imagine. Some don’t make it that far: they drown. Rather than responding with open arms, boundless compassion and warm hugs, our country proposes to fly many of these people to Rwanda, with no prospect of return.

What have we become?

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

Perhaps I’m naive, but it feels to me like ‘anti-Twitter’ sentiment is gaining momentum. In the last couple of days alone, my inbox has received Paul Bradley Carr’s article about the benefits of quitting Twitter and Megan McArdle’s year-old Washington Post article arguing for “major institutions in the media and think-tank world to tell their employees to get the hell off Twitter.”

There’s probably a degree of confirmation bias in my thinking here, given that Brexit led to my own Twexit. Yet, it does all lead me to wonder if the tide is turning, and whether by this time next year we’ll still see the same constant exhortations by television and radio programmes to follow their people on Twitter and to Tweet out our opinions. Maybe enthusiasm really is waning.

We know that the Chancellor was among those who attended a birthday gathering for the Prime Minister at a time when social gatherings were illegal. We know that he has received a police questionnaire about his activities. We are led to believe, therefore, that there is a probability that a fixed penalty notice will follow.

It’s also plain that, assuming the Chancellor has leadership ambitions, resigning in the wake of a fixed penalty notice is his only viable option. Standards in public life are sure to form a key plank of any future leadership contest, and the millstone of a lockdown-breaking conviction can only be lightened by a fulsome mea culpa.

One possible defence, which would be popular with some, is “I didn’t realise the rules were so stringent. I would never have supported them if I had. I was distracted by working on the much-praised furlough scheme. I will now resign for failing to follow the rules and for failing to hold others in Government to account in their pandemic response.”

It is plain that the resignation of a fined Chancellor makes it more difficult for a fined Prime Minister to avoid being removed from office. It’s therefore hard not to see this week’s wall-to-wall negative coverage of the Chancellor as helpful to the Prime Minister if it serves to snuff out any leadership ambition.

I’ve been reading Ali Smith’s Companion Piece this week—review to follow at the end of the month—and wow Smith’s quick-turnaround novels feel almost like therapy. Every book in the Seasonal Quartet hit the bullseye, and this latest volume is no different. The crystal clarity Smith can bring to the chaos of modern times, and the connections she elucidates between ideas, are like nothing I see anywhere else. She is just brilliant.

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

Three years on, I still think this is a tabloid exposé or social media outrage just waiting to happen.

I caught a glimpse this week of Sky News’s 2019 election branding—“The Brexit Election”—and wondered whether, given all that has happened since, anyone there regrets giving their coverage a title with such a narrow focus. Though, it’s not like Sky were alone in concentrating on that single issue.

Given the major tests of the resulting Government in terms of competence on health and foreign affairs, I wonder if journalists generally feel like the election campaign coverage rigorously tested the parties on those issues.

Having to trudge to work through ice and snow on the day before the cold weather alert service closes for the year feels like cutting it fine.