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

In this month’s reading list email, Ryan Holiday points out that

just some twenty years ago, everyone listed their address and phone number in a phone book that was circulated to homes for free. In fact, you had to pay to NOT be included.

These days, my parents are careful about shredding everything with their address on it, even junk mail, and they’re hardly alone. How did we get here?

For much of this week, two petrol stations which are virtually opposite each other in Newcastle priced their regular diesel differently by 19.2p per litre (170.7p and 189.9p). It is surprising that a difference that big is seemingly sustainable.

I’ve been deep into automation this week: writing Microsoft Power Automate routines to automatically rename and file certain email attachments on OneDrive, and playing with Apple Shortcuts and HomeKit on personal devices. It’s years since I last played with these sorts of tools. They have become addictively straightforward and—shock—genuinely useful and time saving now that almost everything lives in the cloud.

I mentioned last week that I was enjoying Coco Mellors’s Cleopatra and Frankenstein, and I still am, but I’m now also reading Haruki Murakami’s What I Talk About When I Talk About Running. The former has a line

”Running is for children and thieves”

which I think summarises my feelings on Murakami’s subject rather well, even if his enthusiasm is somewhat infectious.

Diamond Geezer wrote this week:

I don’t know about you but if there’s a long gap until the next bus I always like to walk ahead along the route until just before it eventually catches up.

I share this habit, and have long been frustrated that Citymapper doesn’t seem to automatically understand that behaviour—but discovered this week that Transit does, so I’m a convert.

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

Here in the Northern Hemisphere, it’s the vernal equinox, so…

I’m currently reading Cleopatra and Frankenstein by Coco Mellors, in which (at least) one of the chapters is set in Nice. Reading it made me want to visit the city again. I visited very briefly in 2018 and wasn’t all that taken with Nice, but I did take some warm-looking photographs (it was actually a bit nippy) which, I think, have had the effect of retrospectively improving my impression of the place. Maybe I’ll end up returning—and if I do, I hope I won’t be disappointed.

I’ve decided it’s spring and put the garden furniture out, which probably calls for gales next week.

A Prime Minister with a long history of using offensive and inappropriate comparisons as rhetorical flourishes is in the headlines for exhibiting that trait again. After his toadying supporters have toured the radio and television studios to tell us what The Prime Minister meant to say, we can all look forward to being told before long what a brilliant communicator he is. The merry-go-round of nonsense never stops.

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

I went for a walk in Sunderland this week, and was amazed to find a full-size sculpture of one of the Martian tripod machines from HG Wells’s War of the Worlds towering over me. I was amazed that I’d never heard about it, striking as it was, and spent a while after getting home searching the web for more information.

After initially turning up nothing, I ended up discovering that it isn’t a Martian sculpture at all, but is supposed to represent something else entirely. Most embarrassingly, I realised that I did know that this other sculpture existed, I just didn’t recognise it for what it was.

I didn’t take a picture of the sculpture, which perhaps is just as well, but if you’re near these impressive cliffs, you’re not far away from it. Hopefully, you would know it when you saw it, even if I didn’t.

There’s nothing more boring than other people’s dreams. I dreamt this week about being on a plane which was landing in heavy fog. The pilot came to sit in the main cabin, explaining that this was a new regulation for landing in fog, as human intervention in the automated landing was more frequently associated with causing disaster than averting it.

It’s made me ponder whether (or perhaps when) we’ll get to the point of banning human intervention in automated processes.

I was a couple of years late to this, but Bunga Bunga, Wondery’s nine part podcast on the political career of Silvio Berlusconi, is brilliant. Not only is the story itself simply unbelievable, Whitney Cummings’s presentation of it is perfectly pitched and laugh-out-loud hilarious while avoiding making light of serious issues. I highly recommend it.

Bus stop adverts have recently appeared for Macmillan Cancer Support, with the tagline “Whatever it takes. Donate today.”

I have a strongly negative reaction to that. People shouldn’t be donating “whatever it takes,” they shouldn’t be getting into debt to support Macmillan, they shouldn’t be diverting resources from other charities they support. It’s unduly pushy.

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

After two and a half years of subscribing, this week I reached the milestone of having funded the planting of more than 1,000 trees through Ecologi. I also found this week that I could see a breakdown of where they’d be planted: 825 in Madagascar, 136 in Mozambique, 42 in the UK, 18 in Kenya, 10 in Nicaragua and 5 in Uganda.

They even have pictures of some of them: here’s a Rowan, an Alder and a Silver Birch they planted for me in Scotland last year, none of which are species I’d have a hope of recognising even once fully grown if they weren’t labelled:

You might imagine that this would produce a warm, fuzzy feeling, but in fact it leaves me a bit conflicted. Half the stuff I read seems to say “trees are wonderful and we should plant gazillions of them” and half seems to say “mass tree planting projects destroy biodiversity and mess up the planet” (which Ecologi obviously denies). Who really knows whether I’m doing the right thing, or just assuaging my climate guilt in a way which is actually making things worse? Surely trees are basically great?

There have been flyers around town this week advertising a protest with the headline “We’ve heard enough climate change bullshit.” I’m confused as to what the protest is about. Do they think that politicians have been spouting “bullshit” while taking inadequate action? Or do they think that climate change itself is “bullshit” which doesn’t actually exist?

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.

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?

Ho-hum.

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.

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).

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.

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

Mention of the phrase “fat head” in AJ Pearce’s Dear Mrs Bird made me miss my grandma, who died last month, and whose rare use of that insult was the stuff of family legend.

The cheapest standard single adult fare on Metro, paid by a contactless debit card, rises to £2.30 from 1 April, compared with £1.70 on the London Underground. But the Metro doesn’t offer a contactless discount, whereas there is a discount for paying with the Oyster-ish Pop card, which reduces the fare to £1.65.

Median weekly earnings in London are £736 compared to £533 in the North East, which might suggest that fares here should be cheaper, but Tyne and Wear isn’t the whole North East, and it’s not necessarily fair to assume that the ridership of the Metro and the London Underground are similar segments of the population.

Parking in free in many Newcastle car parks after 5pm, while there’s no Metro discount in the evenings, which doesn’t reflect the environmental impact of these forms of transport. But not all Metro journeys are destined for Newcastle City Centre, the Metro has higher marginal costs to run in the evening versus opening a car park for a bit longer, and active transport is effectively free.

It’s really hard to define what “right” means in terms of transport policy, let alone to achieve it, and I’m glad I’m not in charge.

The second series of Diane Morgan’s Mandy on BBC iPlayer was just as fun as the first.

I don’t listen to BBC Radio 3, but somehow stumbled across and enjoyedPiano Flow this week, which introduced me to Tokio Myers.

On a web search, I found out that Myers won Britain’s Got Talent in 2017. I don’t regularly watch that programme, but would have confidently said that I was ‘generally aware’ of it, unavoidable as it is. And yet: I had no idea that a pianist had ever won.

A few things I’ve been thinking about this week. The third post of a trio, which may or may not become a regular thing, inspired by Jonathan Rothwell.

Thanks to a leisurely trip on the Caledonian Sleeper this week, I’ve showered on a moving train for the first time. Reflecting on the experience, I think a quick late evening trip up to Scotland to catch the sleeper is probably preferable to those pre-pandemic early mornings when I occasionally had to catch the 0526 to London for a 0900 meeting (and still often arrive late as it only gets into King’s Cross at 0839).

One of the many thankless duties of the most junior of junior hospital doctors is to write a summary of a patient’s hospital admission to be faxed to their GP at discharge. At least it was a decade or so ago, when I was in that position.

On one occasion, I summarised that a patient had been admitted with “dehydration secondary to a diarrhoea illness.” I was surprised a couple of days later to find the GP on the phone to remonstrate with me.

The GP wanted the note to be amended to clarify that they had sent the patient into hospital because of the diarrhoea, not because of dehydration. The dehydration had only been detected on blood tests that I had done as part of the patient’s clerking on arrival at hospital.

My fellow junior doctors and I found this hilariously pedantic: after all, people with diarrhoea don’t necessarily need to be in hospital; people who are unwell with diarrhoea, perhaps because they are dehydrated, may need to be in hospital. It was a distinction without a difference.

In retrospect, the GP was correct about what had precipitated the admission, and was entitled to make their view known given that they had arranged it and knew what information they had at the time.

This experience has been swirling around my head this week because of the media discussion of admissions to hospital ‘for COVID’ and ‘with COVID’, as though the two are completely distinct entities. For most patients, this is patently untrue.

Suppose a patient has been admitted in a diabetic crisis after being thrown off their routine. Suppose a patient has been febrile, a little confused, and has broken their hip in a fall. Suppose a patient’s mental health reached crisis point after months of social isolation. None of these patient needs admission ‘for COVID’—they don’t need antivirals or monoclonal antibodies or respiratory support—but all of their admissions are, at least in part, because of COVID, rather than merely ‘with COVID’.

Many patients in hospital ‘with COVID’ rather than ‘for COVID’ wouldn’t be there ‘without COVID’.

Medicine is rarely black and white.

Wendy and I are both really lucky to live within walking distance of where we work, and also to have a lifestyle that allows us to walk. We’ve both walked for years, and in fact have changed home and work locations and carried on regardless. There’s nothing that clears my mind as completely or reliably as a decent walk.