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31 things I learned in December 2019

1: Cotton creases because it contains cellulose fibres which are held in position with nothing more than hydrogen bonds. Non-iron shirts are coated in formaldehyde to effectively fix the hydrogen bonds. And hence, A-Level chemistry is relevant to office wear.


2: The Times of India publishes an astonishing fifty-six localised daily editions, and is the most widely circulated English-language newspaper in the world. It’s a slightly deflating sign of my unconscious cultural bias that when I saw the cover promotion for this article, I automatically assumed that the most widely circulated English-language newspaper would be a US title, despite that being completely illogical.


3: When fire service colleagues are at a multi-agency meeting, there’s no option to sit back for a minute to see if the fire alarm interrupting the meeting is real: all are out in the freezing in the car park within seconds.


4: Colleagues from Teesside University told me that the campus now hosts more than 18,000 residential students: that’s more than 10% of Middlesbrough’s population.


5: I had forgotten how much I enjoy Erland Cooper’s Solan Goose album until it popped up in my Spotify review of the year. It’s extraordinary.


6: It takes less time to walk from Middlesbrough Town Hall to James Cook Hospital than I imagined.


7: UNESCO has a list of Intangible Cultural Heritage—a philosophical minefield if ever I heard one.


8: Buying Christmas cards a year in advance is only a great idea if you can remember where you put them.


9: CDC’s definition of emerging infectious diseases is “those whose incidence in humans has increased in the past 2 decades or threaten to increase in the near future”. I’m sure I must have learned this in specialty training at some point, but honestly… I don’t remember.


10: I would feel a little less stressed if I’d started my Christmas shopping before now: I usually have it done and wrapped way in advance, but not this year.


11: If people voted for Brexit because they felt that “the establishment” ignored people like them, then the failure to “deliver” Brexit in a timely manner following the vote reinforces the preconception that their views are ignored. That might seem like an obvious point, but it hadn’t really occurred to me in such concrete terms.


12: The General Election result shows that being sacked for lying twice is no barrier to gaining the public’s trust.


13: One of our registrars explained to me that recommendations on management of clusters of pertussis differ to a surprising degree between countries.


14: 90% of interactions between members of the public and healthcare workers are with nurses. 2020 is the ‘Year of the Nurse’: if you’d asked me, I would have said that was 2019, but I guess that must be because I’ve heard so many conversations about planning for it rather than celebrations actually happening.


15: Mycobacterium tuberculosis kills more people each year than any other single pathogen. I think I would probably have guessed that, but still arresting to see it there in black and white.


16: Italy has closed all of its forensic psychiatric units.


17: At work, our team has dealt with nearly 1,000 more queries this year (so far!) than last year: a 40% increase. I knew it had been busy, but that’s mad.


18: Jameela Jamil, who I previously knew only as a star of The Good Place, is quite the controversial ‘social media activist’.


19: If you’d asked me to name the biggest film of 2019 by box office revenue, I couldn’t have told you it was Avengers Endgame, even if you’d given me the first word of the title. I didn’t know that Avengers films were made by Disney. I’ve no idea even now how many Avengers films there have been. I haven’t seen any of the other movies in the top ten. In other words, I’m culturally illiterate.


20: Trigger warnings don’t help people cope with distressing material. “The results are surprisingly consistent in undermining the specific claim that trigger warnings allow people to marshal some kind of mental defence mechanism. There is also a solid evidence base that avoidance is a harmful coping strategy for people recovering from trauma or dealing with anxiety.”


21: The Telegraph‘s reviewer really didn’t like the movie version of Cats. Zero stars.


22: I really don’t understand what separates good contemporary poetry from bad. In other words, I’m culturally illiterate.


23: When asked what he planned to give his girlfriend for Christmas, Boris Johnson replied “Get Brexit done”, which is—give or take a waffling peoration—the same answer he gave to a question about banning firework sales to the general public, a question about 500 public libraries closing, and a question about abuse of female MPs. It seems it might be a sort of reverse ‘supercalifragilisticexplialidoucious’: something one can always say when one doesn’t know what to say, but which makes one sound anything but precocious.


24: I rather naively believed the much-reported story that Netflix developed House of Cards on the basis of insights gleaned from the data on what aspects of other shows attracted an audience. It turns out, in fact, that the show was developed before Netflix became involved, and was just part of a traditional bidding war between broadcasters.


25: The path of 2019 has, at times, felt quite bumpy.


26: In the post-war years, there were ‘British Restaurants’ set up by the government “to serve cheap hot food for everyone so that people had enough to eat”.


27: The Premier Inn in Bangor is a surprisingly nice place for a Friday night drink.


28: The Starfish at Cairn Bay Lodge is a lovely place for lunch.


29: London has two branches of Ballie Ballerson, a cocktail bar set in a ball pit with more than a million balls. Learning of this reminded me that someone once asked me, in a professional context, how to clean a ball pit with many thousands of balls. It turns out that there are machines which claim to do that. In trying to find that answer, though, I found out that some international clinical settings have ball pits which is mind-boggling from an infection control perspective.


30: Only about 20% of bodies in England are buried in the UK as a whole; most people are cremated. The opposite is true in Northern Ireland. In most of the UK, ‘a funeral is typically held around one or two weeks after the death’. In Northern Ireland, ‘bereaved families hit out at not being offered a [Cremation] until four days after their loved one dies’. These statistics would be news to me if I hadn’t had the sad duty of attending two funerals in Northern Ireland this year: I’d far rather these had been lessons I wouldn’t have to learn for many to years to come.


31: Smokers have an increased risk of developing influenza compared to non-smokers: as much as 55% more likely to catch flu.

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Revisiting Middlesbrough’s Community in a Cube

In 2012, I wandered around the Community in a Cube (CIAC) in Middlesbrough after I had a meeting nearby. This visually striking, sustainable, RIBA award shortlisted block of 82 flats in the redeveloping Middlehaven area of the town was of particular interest as it seemed to have become flavour of the month among architects.

Fast-forward to 2019 and the development has been back in the news for rather less welcome reasons. According to local and national press reports, inspections of the building in the wake of the Grenfell disaster have revealed that the building—and, in particular, the distinctive timber claddingare not compliant with fire regulations. ‘Not compliant’ to the extent that a 24/7 ‘waking watch’ patrol has been implemented at a huge cost.

So, when fate brought me to a nearby meeting again today, I thought I’d use the lunch break for another quick wander to see how the development had aged.


Over the last seven years, CIAC has become a local landmark. Its visibility from the A66 and the nearby railway line, combined with the eye-catching “sky homes” perched on top of it, have made the building a familiar and commonly mentioned icon of Middlesbrough.

That said, the intended ‘riverside vision’ has never quite emerged, with CIAC remaining the sole residential development in the area. It seems somewhat isolated as a result. The current plan is for a £30m snow centre to be build nearby.

The surrounding ‘naked streets’, which I found “disconcerting” on my first visit, are now much more traditionally clothed, with separation of vehicular and pedestrian traffic. There’s also no shortage of weeds on display, which actually somewhat pleasingly soften the visual impact.

Close up, the building looks minimally weathered. The distinctive black stripes on the cladding have mostly worn away on the front of the building, but less so on the less exposed elevations.

The gigantic zebra crossing like paving remains in place at the rear. The geometrically patterned inset wall looks as sharp and fresh as ever. From this angle, I think I’d be hard-pressed to identify photographs taken today from those taken when the building was first completed.

And while seven years ago I said this building “isn’t quite to my taste”, gazing at it across the water of Middlehaven Dock today, I could almost change my mind. Perhaps it’s partly familiarity, but it feels less ‘alien spaceship’ than it did when it was first completed.

All things considered, it has aged pretty well. I’ve no idea how well it has done from a sales perspective: I hear tell from local colleagues that some of the flats are now let to students of the nearby Middlesbrough College, but there are certainly a fair few owner occupiers.


Of course, though, as successful as the visual impact has been, I wouldn’t have dreamed that such a modern building would now be deemed a major fire risk in need of hundreds of thousands of pounds of remedial work. I can’t begin to imagine how it must feel for the owners and residents of the flats to be living somewhere where they don’t feel as safe as they once did, let alone the financial consequences.

While I understand from the media coverage that it was compliant with regulations when built, this experience must surely raise questions about when the right things are really prioritised when landmark architectural developments are being designed.

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30 things I learned in November 2019

1: It feels great, if a little anticlimactic, to finally be able to delete “Locum” from my email signature.


2: The North Shields Fish Quay has really smartened up since Wendy and I last visited. It would be nice to live somewhere with a river view, if only it didn’t have to be near a river.


3: Going to Ikea for the 10.30 Sunday browsing opening time isn’t a successful crowd avoidance strategy.


4: Barriers between healthcare organisations can make simple things—like arranging urgent vaccinations—more difficult than they ought to be. Perhaps someone should invent some sort of national health service which provides care based on need rather than budgets, contract provisions and organisational mission statements.


5: Telling patients that they look far too young to have donated blood 61 times makes them want to go back and donate again as soon as possible to receive more flattery.


6: Sometimes, people who use irritating business chatter do actually understand what they’re on about.


7: Business planning isn’t my bag.


8: Th Guardian Daily app doesn’t work properly on Kindle tablets.


9: Loud Christmas music in coffee shops makes settling down with a coffee and a good book difficult. Headphones and white noise on Spotify are an imperfect and antisocial solution.


10: It’s not easy being green: should I buy second-hand books and support the planet or new books and support the author?


11: Durham County Council has meeting rooms with quite spectacular coastal views in Seaham:

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12: Dementia friendly parking spaces are now a thing… at least in Hemlington:

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13: “At this time of year, it is not uncommon for viruses including influenza and norovirus to circulate in schools. The risk of infection can be reduced by practising good hand hygiene, particularly after using the toilet, after using a tissue to catch a cough or a sneeze, and before eating.”


14: Our TV needs re-tuning. Broadcasts are moving away from the 700MHz band of frequencies to free up spectrum for mobile data instead. Given the profitability of mobile data services and the proliferation of home broadband (especially in the context of PSTN switch-off), I wonder how long over-the-air television broadcast have left?


15: Arguments opposing the Public Libraries Act 1850 included a Conservative view that people “have too much knowledge already” and that “the more education people get the more difficult they are to manage.” In fairness, I suppose people now carry the sum of human knowledge in their pockets and do have a tendency to be rebel against authoritarian control, so perhaps he had a point.


16: The TLS has relaunched with a rather stylish new look. Dr Brian Klass’s comparison of politics in Trump’s America and that in Brexit Britain through the medium of cheese was a particular highlight of this issue for me.


17: Coffee shop Christmas music irritates Wendy even more than me. It’s depressing, or so I’m told.


18: A replacement wing mirror for a 2009 Aygo costs less than £50. I was expecting a much bigger bill after someone completely snapped mine off (and didn’t leave a note!)


19: The brand new Sunderland medical school has some impressive facilities.


20: Colleagues at Middlesbrough Council taught me that routine air quality monitoring still uses diffusion tubes fixed to lampposts; people have to go up in cherry pickers to change the tubes every month.


21: Research into treatments for interstitial lung disease includes a lot of discussion about disease taxonomy and the problem of lumping and splitting: considering diagnoses with the same underlying pathology together (lumping) or as distinct entities (splitting).


22: Cleveland Fire Brigade taught me about their Stay Safe and Warm free one-hour response service for boiler breakdowns where they lend people emergency electric heaters.


23: A wet and dreary Saturday can be a good prompt to light the fire and relax at home.


24: I didn’t know that Sheffield had a hybrid tram-train system until I read this Wired article.


25: Purdah rules can be really annoying sometimes, especially when I’ve done a lot of work to prepare for a meeting I’m no longer able to attend.


26: I thought I learned the etymology of the word “syndrome” after it was featured in a lecture. Yet after thinking about it for a while, the suggestion that it was derived from words for “before” and “diagnosis” didn’t ring true, so I looked it up in the OED online. The lecture version was thus proven to be completely wrong, so I suppose I learned not to take the content of lectures on trust.


27: Only a decade late to the party, I learned that Ecosia—the search engine that plants trees—is a thing.


28: People really don’t know what I do all day. This month, in my health protection role, a meeting of vascular surgeons has invited me to talk about knife crime, a univeristy course has asked me to teach about rural medicine, and a meeting of intensivists has invited me to present on recreational drug toxicology. They may be disappointed at me turning down their kind invitations, but they’d be far more disappointed if I accepted given that I know naff all about any of those topics.


29: Via Lana Greene’s column in 1843, I leaned of the German word “Multioptionsgesellschaft”. It was apparently coined by Peter Gross, a Swiss sociologist, in the early 1990s. It refers to a world swamped by choice, which feels very current: I frequently open Netflix for something to watch and close it a few minutes later with the resignation of not being able to decide.


30: I heard a snippet of a radio programme in which an older person was being interviewed and the subject of loneliness among the elderly came up. The interviewee suggested that while lots of attention has been paid to loneliness recently, too little has been paid to the loss of solitude for many other older people, such as those in care homes. I’d never heard that point made before, and I suspect it will stick with me: solitude is something very important to me.

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