The provision of public toilets has always been a rich seam for local journalism to tap: it seems to be one of those recurring topics that’s a surefire win for letters to local papers or calls to radio phone-ins. The seam of discontent has only grown richer as Conservative Chancellors have chosen to make cut upon cut to Local Authority funding, badly reducing the money available for non-statutory services. The resulting closure of public toilets has had upsetting consequences: disabled people and carers restricting the activities they undertake; further exclusion of the homeless; and more besides.

Here in Newcastle, we’re about to reach a decade since a lack of cash forced Newcastle Council to close its last remaining public toilets.

In a fabulously esoteric response, the City Library has worked with Newcastle University to mount an exhibition: ‘The Rise & Decline of Newcastle’s Public Toilets’. For those not able to make it to the Library (which has toilets, btw) there is an online exhibition with much of the same content.

The exhibition is very small, but a visit—even if only to the online version—is very worthwhile. I was previously ignorant of the historic gender issues associated with public toilet provision (historically, toilets for men were more prevalent than those for women). I learned for the first time the sparkling anecdote about as historic netty being re-built at Beamish Museum, but having to be closed because people assumed it to be a working facility rather than an exhibit. I had no idea that in the 1800s, the urine from public urinals was often collected for use in tanneries.

This is a wonderfully unusual small exhibition, which I’d thoroughly recommend.

‘The Rise & Decline of Newcastle’s Public Toilets’ continues at Newcastle City Library until 14 August. I’m not certain how long the online version runs for, but I hope it will be maintained for posterity.

This book, published a couple of months ago, is the first of Claire Kilroy’s novels I’ve read.

Kilroy is an Irish writer, and this book’s main characters are a new mother and her child who are living in Ireland. Despite the intensity of the bond with her child, the protagonist struggles with the transition from a working life and an independent identity to adopting the full-time role of ‘mother’. This also creates new tensions (or perhaps reveals existing tensions?) in her relationship with her husband, who continues to work. I mentioned a particularly striking passage a few days ago.

This was an intense, tough read: there isn’t a lot of plot, but the book brims with powerful emotion. Kilroy’s writing was transporting and gave me new insight into a tough life experience. It felt true. It felt like it explored an aspect of motherhood that is, perhaps, under-explored in contemporary literature: not a dislike of motherhood, exactly, but something more like a trapped ambivalence.

Another key character in the book is a stay-at-home father, a schoolfriend who the central character meets again in a playground. This provides another interesting set of insights into a relatively uncommon social situation. Kilroy incorporates this so naturally that it wasn’t until after I’d read the book that it really registered as a thoughtful bit of plot development.

This is well worth reading.

Some quotations I noted down:

Well Sailor. Here we are once more, you and me in one another’s arms. The Earth moves beneath us and all is well, for now. You don’t understand yet that what we share is temporary. But I do. I close my eyes and I understand.

I saw in the small hours of Good Friday in a black rage, a malevolent force pacing the corridors of my own home. I was an exhausted woman exhausting myself further and I seem to have broken through some barrier that night because reality ceased to be reality, not that I understood that at the time. To my mind I had experienced a staggering revelation. Namely: I was just a woman. I was just a woman! How had this not registered before?

I sat on the couch. ‘How was your day?’ I asked him and he embarked on tales of valour and derring-do from a distant galaxy. Things he had said, problems he had solved, names, many names, people I would never meet. It was too tiring to try to imagine them. ‘You’re not listening.’ I opened my eyes. May or may not have been asleep. ‘Sorry. How was your day?’ ‘I just told you.’ ‘Oh. You did. Sorry.’ ‘How was your day?’ ‘My day?’ I wondered, drawing a blank. Nothing recorded. Vegetative state. ‘Em,’ I said, ‘long.’

The day you were born a door appeared—or was revealed, really, having been there all along—the door out of life, the door when it’s over, you’re done, thank you: next, and I have to go through it first.

I always knew that, as the mother, I would get the blame for everything. If you grow up to be a serial killer, if you stash decapitated heads in your fridge like half-eaten turnips, they will say it was the mother’s fault.

It was Luke O’Neil’s Hell World that first drew my attention to a particular section of a speech recently given by Donald Trump in Las Vegas:

And remember, Florida’s easier than other places. You have the ocean and you have the sun. There’s something about that that works. But, you have the sun, too, but you don’t have the ocean. I can tell. You definitely don’t have the ocean. Maybe someday you’ll have the ocean, you never know.

I haven’t heard how Trump delivered the line, but like O’Neil, I think there’s something appallingly poetic about “maybe someday you’ll have the ocean”.

The phrase carries a sense of wistfulness and longing, offering the promise of something near-impossible. It feels hopeful and oddly aspirational, almost like a rallying cry issued by a general facing impossible odds.

Yet, beneath the surface, this line alludes to climate change—a scenario entailing incalculable human suffering, inevitable societal collapse, and the almost certain demise of the majority of the people he’s addressing.

In its dreadful, chilling brevity, the phrase encapsulates so much about our times. It is a horrifyingly poignant—yet perhaps entirely unintentional—reflection of the modern world.

It is one for the ages.

The image at the top of this post was generated by Midjourney.

I’ve walked past this sign many hundreds of times, often feeling a wry smile creeping onto my face at the phrase “invalid carriages”.

It sounds like a relic from a past century, conjoining images that are a hybrid of a sedan chair, a gun carriage and a stretcher. I’ve long wondered why on Earth it would be included on a road sign, and what exactly the sign prohibited.

As so often, it turns out that I was simply ignorant of the law: “The Use of Invalid Carriages on Highways Regulations” were passed well within my lifetime, coming into force in 1989. The term basically refers to things like manual wheelchairs (Class 1), motorised wheelchairs and slow mobility scooters (Class 2), and faster mobility scooters (Class 3).

Intriguingly, it’s perfectly legal to drive Class 2 and 3 invalid carriages—including simple motorised wheelchairs—on a dual carriageway. Good luck with that.

All of them are banned from motorways, though, hence the sign.

I told you a few days ago about going to visit a Peter Howson retrospective. While I was there, I saw his 2006 painting of The Last Supper.

While waiting for my train home, I popped into the National Gallery and happened upon Nicolas Poussin’s 1694 painting of (essentially) the same scene, The Sacrament of the Holy Eucharist.

Generally, I prefer more abstract paintings to ones with photo-like realism, but this pairing disproves that rule.

The Howson painting is clearly more abstract, yet I prefer the Poussin. I particularly like Poussin’s use of symbolic light. I also think the composition is clever: unlike most representations of the Last Supper, Poussin has shown the disciples seated around a table. Poussin’s disciples all seem to me to have their own personalities, whereas Howson’s seem more like an indistinct group.

I’ve probably seen more exhibitions this year than in the rest of my life combined, so it’s perhaps not surprising that some of my preconceptions are being challenged—but it nevertheless feels arresting to me!

In 2019, the journalist and (then) editor of the Times Literary Supplement, Stig Abell, decided to write a diary of the books that he read on the train to work. This book is a collection of those diary entries, mostly focusing on the books, but also on some significant events in his life and in the news.

I didn’t really enjoy this. I think this was a problem of the medium more than anything else: this felt like a blog that had been printed and bound. It felt performative rather than introspective. I like reading this sort of thing in small chunks online, but reading a year’s worth of one person’s slightly random thoughts about a slightly random selection of books in one go is a bit much.

Some of Abell’s observations were interesting and some of his anecdotes were genuinely amusing, but this just didn’t feel like a particularly coherent whole to me.

Nevertheless, here are some quotations I enjoyed:

My emails—unlike my spoken words—have become a nauseating thicket of exclamation marks: ‘Hi! Thanks!’ Sounds Good!’ and so on. Exclamation marks, those miniature distress flares of chumminess, are awful, I know they are awful, and yet the medium seems to compel their usage.

A quick check of my manuscript so far shows I have used more than 620 semicolons, at a rate of about one every 180 words. Herman Melville would be scoffing right now: he used one every 52. The final word, though, on all this (as it does in the TLS article) must go to Irvine Welsh, a fine exponent of the semicolon: ‘I’ve no feelings about it—it’s just there. People actually get worked up about that kind of thing, do they? I don’t fucking believe it. They should get a fucking life or a proper job. They’ve got too much time on their hands, to think about nonsense.’

I do think it can be risky to over-fetishise books, and I am always suspicious of people who want to preserve them in sterile perfection. I constantly scribble on or bend or drop in the bath things I am reading. And I don’t mind seeing the surface damage of prior readings. Sylvia Plath would not agree. She once lent someone a book, and got it back a bit torn. This was her diary entry: ‘It was so horrifying and it was as if my children had been raped or beaten by an alien.’ Which we can all agree is an over-reaction, I think.

I have a theory (I always have a theory) that there are three main things in life: family; work; friends. And it is possible to do only two of them well. So I am friendless, in that I spend no time socialising with people outside work or family. My colleagues and my family have become my friends in a sense, and I am fine with that. I don’t think my dad had friends when he worked either. If I have a problem, there is nobody other than my wife I would speak to; if I have an evening free, there is nobody I would go out with other than her.

The interior designer Nicky Hallam (who, let us be clear, is no Mitford) came up with a list of ‘things he found common’. They are, one hopes, tongue-in-cheek, and are very funny: breakfast meetings; being on time; tours of the house; conservatories; self-pity; swans; mindfulness; Bono; rinsing fruit; loving your parents; not eating carbs; organic food; being ill; using dog walkers. That is not even all of them. I love the fact that loving your parents is common.

I’m predisposed to dislike Meta’s new social media app Threads. It’s years since I left Instagram and Twitter, and I haven’t missed either of them. I’m therefore unlikely to be convinced by something which seems to be a combination of the two. But equally, my lack of engagement means that I’m not well-informed, and my opinions ought to be taken with a pinch of salt.

Yet, Threads has been unavoidable in recent days, with acres of press coverage. In this post, I want to reflect on some of the things I’ve read.

In Tedium, Ernie Smith wrote:

I don’t feel particularly motivated to write about Threads, the Instagram-in-Twitter-form social network that Meta launched this week. It feels like a social network that exists to check a box for a company that owns a lot of social networks. But I do think it represents something about the moment that we’re in, where people are so desperate for a certain kind of experience that they will go from the hands of one billionaire to another, in hopes that will give them what they don’t feel like they were getting before.

It would be a bit rich of me to claim that I don’t feel motivated to write about Threads at the start of a blog post about Threads. But I do feel removed from it. I can’t imagine I’m ever going to join the service, and—in all honesty—I think the moment for this sort of short-text-based social media service has probably passed.

In his Platformer newsletter, Casey Newton interviewed Instagram’s Adam Mosseri about the new product. This bit stood out to me:

The thing that makes Twitter distinctive, Mosseri said, is that replies are given the same visual priority as the original posts. In a world where every other social network buries comments underneath posts, Twitter elevates them. And that encourages people to participate in discussions.

“The post-and-comment model is great,” Mosseri said. “But it really does not support public discourse nearly as well as the tweet-and-reply model. Elevating the reply to the same level as the original post allows for much more robust, diverse discourse.”

I fundamentally disagree with this: I think giving replies equal prominence to original posts fuels terrible discourse. It pits experts on the same level as conspiracy theorists. It encourages people to seize on the tiniest error, the most abstracted perceived slight, in any Tweet in order to ramp up engagement with the reply. It encourages attack, not discussion, and pile-ons (a natural by-product of giving responses the same prominence as original posts) squeeze out diversity rather than encouraging it.

In The Atlantic Daily, David Graham wrote about the impact of the death of Twitter on the ability of journalists to build personal brands. He said:

What comes after Twitter is a much more fragmented landscape. Many social-media sites command significant audiences, but no single platform can do what Twitter once did. A journalist can make a big bet on one platform, or they can try to hedge and be active on Reddit, YouTube, TikTok, Substack, and, as of this week, Meta’s Threads—give or take a dozen more. But who has the time? And besides, you don’t get the same reach. TikTok and YouTube command enormous but typically niche audiences.

I’ve written with boring frequency on this site about the BBC’s promotion of Twitter. This is, in my view, the wrong approach for myriad reasons, but the more the social media landscape fragments, the more unsustainable that approach becomes.

Imagine a 2024 Presidential election fought between Joe Biden and Donald Trump. Suppose Biden continues to campaign on Twitter, but that Trump restricts himself to Truth Social, safe in the knowledge that he won’t be banned or fact-checked and that his messages will find their way beyond the network anyway. Would the BBC continue to promote only the platform used by only one of the candidates? Self-evidently not. Would it promote Truth Social? No chance.

And so, the era of free promotion of a particular network ends… surely. We presumably revert to “Campaign X said Y”, rather than “Candidate A posted on social network B”. The latter has never made sense for the BBC anyway: it’s no more logical than saying “Party M has posted a press released on media repository N”, which has never been a thing.

Threads won’t benefit (in the long-term) from the free promotion that built Twitter.

FullFact recently posted about false news circulating on Facebook suggesting that animals had been released from Paris Zoo in recent riots.

This stood out to me because I well remember, in the days I was on Facebook, the frequency with which “escaped zoo animals” were reported in connection with any number of news stories. I remember this because I briefly parodied it in an email to partners after arranging rabies vaccinations for an individual bitten by a wild animal abroad.

This is a long-standing and easily disproved item of fake news which could reasonably cause unnecessarily fear among readers. Even all these years on, Meta hasn’t got a grip of this simple stuff. The idea that Threads will be a reliable source of anything, or a place for informed discussion, is clearly not rooted in reality.

In Garbage Day, Ryan Broderick wrote:

My verdict: Threads sucks shit. It has no purpose. It is for no one. It launched as a content graveyard and will assuredly only become more of one over time. It’s iFunny for people who miss The Ellen Show. It has a distinct celebrities-making-videos-during-COVID-lockdown vibe. It feels like a 90s-themed office party organized by a human resources department. And my theory, after staring into its dark heart for several days, is that it was never meant to “beat” Twitter — regardless of what Zuckerberg has been tweeting. Threads’ true purpose was to act as a fresh coat of paint for Instagram’s code in the hopes it might make the network relevant again. And Threads is also proof that Meta, even after all these years, still has no other ambition aside from scale.

If you look back at every era of the internet, towards the end of each, you’ll see a whole pile-up of forgotten apps that tried to swoop in and bring back or replace something that was dying or dead. Myspace tried to bounce back with a redesign. Vine was going to be resurrected as Byte. BeReal was marketed as a way to recapture the simple fun of Snapchat, etc. But it doesn’t really work that way. Our tastes change. We move on. And then suddenly we can’t imagine ever going back.

I’ve wrongly predicted the death of Twitter an embarrassing number of times. I even did it earlier this month. I think Broderick might be right that it’s the class of services that is fracturing and dying, not just Twitter specifically. And that bodes ill for Threads.

In The Atlantic Daily, Charlie Warzel is interviewed about the impact of Meta’s appalling privacy record on the potential success of Threads:

People are never going to be as concerned with privacy stuff as they are with I want to be where my friends are. I want to try something new and interesting and see if it works. And if that initial experience is easy, fun, and intriguing, the potential to hook a new user and turn them into a quality repeat customer is very high.

It’s fair to say that Warzel’s overall impression of the prospects for Threads is less positive than this brief quotation implies. But this quotation stood out for me because I think Warzel is right.

It was the ‘creepy line’ that drove me away from Google services. Like most people, I think I projected my views onto others, and assumed that everyone else is increasingly concerned about privacy too. Except, objectively, they are not.

Warzel’s words reminded me that I often overhear people talking nonsense about Facebook spying on them through their phone’s microphone and inserting related adverts into their feeds. Yet, none of them have deleted the app or left the service… even when they genuinely believe they are being covertly surveilled.

Privacy is not a big deal to most people, which probably works in favour of Threads.

It’s probably not in their favour that when I think of ‘Threads’, I think of this:

The image at the top of this post was generated by Midjourney.

I don’t proclaim to be an art expert, or even a knowledgable amateur. Prior to visiting this major retrospective exhibition, despite his fame and acclamation, I couldn’t say I knew who Peter Howson was.

Born in London, Howson spent his formative years in Ayrshire before venturing off to study at the Glasgow School of Art. Today, he is a highly celebrated figurative artist.

During the early 1990s, he took on the role of the official ‘British war artist’ for the conflict in Bosnia, an experience that left a profound imprint on his mental and emotional wellbeing. A decade later, he found comfort in Christianity, a shift that brought a religious focus to his work. In recent years, he has crafted artistic responses to Brexit, the pandemic, and various other contemporary events.

Admittedly, Howson’s figurative and almost cartoonish style doesn’t particularly resonate with me. However, in a three-floor mega-exhibition, there are bound to be a few stand-out pieces. Below, I’ve highlighted three artworks that captivated me more than the rest.

This is My Tale Shall Be Told, a 1995 work which is apparently based on William Hogarth’s 1730s series A Rake’s Progress. I’m not familiar enough with art history to appreciate that.

I liked this because of the surrealism and the bold colours. I liked that the girl in the background had a Munch-like scream at the scene of the bearded lady inexplicably attempting to ride a dog. I like the way that the child in the foreground is contorted in a way which looks natural at first glance, but impossible on a closer inspection. The recognisable inclusion of the ‘fat controller’ gave this a grounding in the real world.

I especially enjoyed the way that the paintbrushes were left colourless in such a colourful scene.

This is a 1994 piece from Bosnia, called Serb with Child. I was struck by the abstract nature of this piece, which isn’t typical for Howson. I thought it said something about the way that the anger and violence were more prominent for him than the specifics of the awful situation.

From the same period, this is House Warming. Here, the contrast between the horrific, violent events in the foreground and the everyday scene in the top-left of the canvas is striking.

This helped to bring home to me the reality of living in a war zone. The contrast between everyday life and the battle surrounding it has been much-observed in the current conflict in Ukraine. But, as only art can, I think this representation made me ponder the reality of living through a situation like that.

I also thought that the juxtaposition said something about how close we all are to violent conflict: it seemed like it was commenting on the fragility of society, and how easily any society can tip over into unrecognisable violence.

When the Apple Ripens: Peter Howson at 65 continues at the City Art Centre until 1 October.

Later today, NHS England will release quarterly waiting time statistics for A&E attendances and emergency admissions. This will doubtless spark political discussion about ‘reform’ of the NHS, including greater digitisation.

In the latest Wired, Yinka Makinde (Director of Digital Workforce at NHS England) talks briefly about some of the reasons that ‘digital’ projects in the NHS fail:

70 percent of digital transformation programs in the NHS, particularly complex ones, will fail to meet their desired objectives. There are many reasons for this. For one, we focus too much on technology and often forget to ask what problem our clinical staff and patients are facing and how they want things to change. We also have organizational silos, where digital is still often seen as the IT department with the office in the basement, rather than something more integral to the health service.

I’m not an expert in digital technology, and my personal experience of leading ‘digital transformation’ is limited to upgrading the router at home. Yet, as a doctor, I’ve been on the receiving end of these programmes more times than I’d like to count, sometimes in the NHS and sometimes in allied organisations. It almost always feels like something that is being done ‘to’ me—not ‘for’ me or ‘with’ me—and a seventy percent failure rate sounds about right. Some projects ‘fail’ in the sense of never reaching full roll-out, usually after a last-minute screeching emergency stop; others ‘fail’ in the sense of rolling out, but not delivering the intended outcome.

Today, I’d like to offer a few reflections on where—from my perspective—some of those programmes have gone wrong.

Failing to understand the problem

Lots of projects I’ve been involved in seem to start with process mapping. Someone might ask to interview me, or to observe me, and to diagrammatically represent what I am doing, often concentrating on the ‘information flows’ that I’m generating. This raises a practical problem and a philosophical problem.

The practical issue is that the generated process map is a subjective abstraction of reality. It does not completely record what is done, and some of what is recorded will be scenario-dependent. This ought not to be an issue, as the map ought only to be an aide memoire and understanding of the problem ought to be regularly checked back with the person observed. In my experience, this rarely happens. Worse, the opposite often happens. The process map is redrawn, refined, and reinterpreted, abstracting it further and further from reality.

I vividly remember one occasion on which someone misunderstood what was meant in a process map by ‘agreeing’ a decision. In practice, this meant chatting it over and sense-checking it with a senior member of the team, most often retrospectively, possibly up to a week or so after the decision was made. The resulting software had a mandatory field to be completed at the time the decision is made, including the name of the senior person ‘agreeing’ the decision. The team responded through a workaround, replacing the ‘name’ with a standard phrase regarding delegation; the bug was never fixed. The software misunderstood the process, and the resulting workaround means that records are slightly worse than they were before, as the name of the person providing ‘agreement’ is no longer recorded in a standardised form.

The philosophical problem is that process mapping does not always provide insight into why something is done, which can be valuable information. It appears to be common that processing mapping results in a finding that a particular process is stunningly inefficient: for example, it can be suggested that telephoning someone as part of a process is much less efficient than using some form of asynchronous communication. This is often true, but if the phone call has multiple purposes, only one of which is caught in your process map, then the phone call is still going to have to happen. The ‘more efficient’ approach will be an additional, and therefore inefficient, step.

I’m reminded of an IT-driven project in a general practice surgery which recalled patients for annual reviews pertaining to specific diagnoses—say asthma, or hypertension—using text messages, allowing them to use an automated system to book themselves in at a convenient time. The aim was to reduce pressure on receptionists. The project missed that a large proportion of the patient population had multiple conditions, and that many of them called for multiple reasons. The consequence was that patients ended up attending multiple appointments for annual reviews of multiple conditions, instead of them being covered in a single appointment. Call volumes also dropped less than expected because people were still calling about the ‘other business’ they would have completed during their appointment booking phone call.

Failing to set limits

In large organisations, everyone wants any new IT system to do something specific for their part of the business. Some requirements will inevitably be mutually incompatible—or, at least, not best suited to be completed on a single platform. All too often, the response of the developer seems to be to say ‘yes’ and add to the project cost, rather than setting limits.

This comes up in my field all the time. One common issue is the conflict between surveillance and case management. Surveillance is knowing how much of a disease is in the population at any given period of time. Case management is responding to each individual case. These sound superficially like sensible bed fellows, but they are not.

Surveillance requires very rigid, fixed case definitions: a person is a countable, confirmed case of Disease X if liver enzyme Y is above standard value Z. Absolute certain is required. The real world of case management is much murkier: the validity of interpreting a person with liver enzyme Y above standard value Z to be a confirmed case of Disease X might be questionable if their liver is already inflamed by disease A. The case might be epidemiologically confirmed, but in terms of individual case management, found to have something else entirely. Keeping those two seemingly contradictory facts in the same system is probably not advisable: the potential for confusion is endless, even with the best system architecture in the world. But that doesn’t stop people…

Failing to understand the environment

This is the error I find least straightforward to understand: people creating ‘IT solutions’ that fail to understand the environment in which they are being deployed. Some of these seemed screamingly obvious: rolling out electronic prescribing to wards with one or two computers, or asking care homes without computers to fill in an online dashboard.

Others lacked a more subtle kind of awareness: developing a system to communicate with staff across multiple Local Authorities which required the IT teams in each Authority to install specific software on their systems, for example, or expecting a website which required an up-to-date browser to be accessible in NHS hospitals running on ancient versions of Windows.

The common factor tends to be that it’s the environment external to the organisation commissioning the ‘IT solution’ that is often poorly understood. For a project to succeed, it needs to understand the limitations faced by its users, not just its commissioners.

Failing to plan to evaluate

In medicine, we’re almost obsessive about assessing outcomes. All too often, IT projects only plan to evaluate processes. This is a mistake: an inability to show that a system improves outcomes is often an inability to argue for continued funding.

I was once involved in a project which replaced emailed reports with an online dashboard. The function of the reports was to generate ‘awareness’: for example, to give people a bit of background awareness as to where in the country there might be outbreaks of a specific disease, to help inform risk assessments about individual potential cases who have travelled to the area.

The evaluation plan was entirely about the accuracy of the data on the dashboard and whether the dashboard was accessible to staff. That makes sense if viewing this as an ‘IT problem’: but the actual requirement was for awareness: moving from a model which pushed information to staff to one where staff had to pull information in from a dashboard was an unlikely way to achieve that goal. If those designing the system had planned a proper evaluation up front, that significant hurdle would have revealed itself early on, and they may have taken a different approach.

It’s interesting to reflect that these problems are not just problems with ‘digital transformation’: the broad topic areas are exactly the same as those that trip us up in outbreak management. Sometimes, we don’t understand the problem, perhaps because we misinterpret clinical results or talk to each other in language that means different things to different groups.¹ Occasionally, we don’t properly set limits around what we’re managing, and so end up with outbreak control groups that last for eternity and consider every issue under the sun. We don’t always properly understand the environment, and can give advice that makes no sense on the ground.² And we aren’t perfect at remembering to evaluate our approaches and share our learning, however much we try.

Perhaps these issues are universal. Perhaps they are problems of professional life—or just _life_—rather than anything specific to IT projects. The thing they have in common is that they seem superficially simple, but are hard to both spot and tackle in practice. Communication and teamwork are crucial to solving them: as Makinde says, organisational silos are unhelpful.

And, perhaps, we all need to be a bit—or maybe a byte—more humble in the face of complexity.

1. Communication is the hardest bit of my job. I’ve reflected before about how I’ve gone wrong by fundamentally misunderstanding what someone is saying to me. I’ve mentioned the example of ‘vulnerable’ prisoners, which are two completely different groups of people from a health perspective (likely to become unwell) and from a justice perspective (likely to be attacked by other prisoners). Another example, which often caused confusion in the covid pandemic, is ‘contact tracing’, which can sometimes mean tracing those who have been in contact with an infectious person (to see if they’ve caught it) and can sometimes mean tracing those who were in prior contact (to see where the known case has caught it. The result is that doctors in my profession spend a huge amount of time and effort in trying to make sure that everyone has a shared understanding of what we’re trying to say, but even then, we sometimes fail. ↩
2. I’m a big advocate of visiting places and seeing them with my own eyes when trying to give outbreak advice… which has made recent times challenging.
   

The image at the top of this post was generated by Midjourney.

This small exhibition covers 250 years of artistic representations of Scottish landscapes… although in a slightly odd curatorial decision, some paintings are of landscapes in other parts of the world.

This is a small exhibition, but there were a few pictures which were new to me, and which I particularly enjoyed. I didn’t take any of the pictures in this post, as photography was forbidden.

This is one of Joan Eardley’s seascapes. I think it is the one I saw in the gallery, showing Catterline near Stonehaven, but I may be mistaken. My memory isn’t photographic, and there’s no published catalogue to compare against.

I like the dynamism and emotion that this painting captures: it’s recognisably a seascape, but it strikes me that there’s much more in it to explore. I particularly like the contrast between the chaotic sea and coastline compared to the calmness of the sky. It drew me in.

This is William MacTaggart’s 1974 work, Autumn Leaves. Regular readers will know that my colour vision isn’t great, but I love the warmth of the oranges and reds of this painting. I was drawn to the inspired combination of the autumn scene with sunset, given that autumn feels a bit like the sunset of the year. There’s something peaceful and reflective about this painting.

I also like the prominence of the blue and purple elements which wouldn’t necessarily be expected, and the recognisable building in the back of the picture. It was another picture that I found absorbing.

This is The Valley of the Shadow, Loch Coruisk by Robert Burns. Represented as it is above, this painting doesn’t really move me. In the gallery, it seemed considerably more abstract, the forms of the mountains and the loch being much less clearly discernible. It turns out that it’s actually disappointingly literal.

This is, I think, attributable to something that irritated me throughout this exhibition: the lighting. The gallery seems to have positioned spotlights on each painting—so far, so normal—but they seem to be undiffused. This means that the glare and reflections on canvases makes some works really quite difficult to see: I had to duck and weave to get an impression. I’m not sure if the space has been recently refitted or something, but it’s really not working as well as it could.

Shifting Vistas: 250 Years of Scottish Landscape continues at the City Art Centre until June next year.