Last week, the news paid open-ended attention to the loss at sea of the Titan submersible and its wealthy crew. Days earlier, the plight of 750 people, many of them children, on the sunken Adriana didn’t even make the top story on the bulletins I saw.

Ours can’t have been the only sofa in Britain on which the comparison was made with dismay.

On the LRB Blog, Michael Chessum suggests:

The mass drowning of migrants does not meet the media’s criteria for a human-interest story because the victims have been dehumanised. Centuries of racist conditioning have led us to this point, but there is a new strategy at work, too. Donald Trump and Suella Braverman have an air of performative stupidity, and it comforts the liberal commentariat to believe that the far right’s spell in power is a blip. But their project is deadly serious and for the long term. Trump’s ‘big, beautiful wall’ and the UK government’s plan to deport asylum seekers to Rwanda would have been unthinkable twenty years ago. The core narrative of the nationalist right, that migrants and foreigners are to blame for falling living standards, now dominates the mainstream. It feeds popular demand for the militarisation of our borders.

I’m not certain that I fully agree: I think there’s an element to which the loss of life of migrants has become normalised and ‘expected’, whereas the Titan story was unlike any story we’ve heard in recent years. Yet, the balance of coverage—not to mention the relative willingness of nation-states to spend money on each rescue effort—did feel like an upsetting new low to me.

Twenty years ago, Aaron Sorkin tried to shock us by including a ballsy line in the fourth season of The West Wing making the case that, from the President’s perspective, ‘a Kundunese life is worth less than an American life.’¹

These days, it’s no longer the shocking subtext: it’s beamed into each of our homes in full technicolour, so routine that it no longer attracts on-air comment.

1. Equatorial Kundu is one of Sorkin’s most successful fictional countries, originating in The West Wing, making a cameo in The Newsroom, escaping the Sorkin universe in iZombie, and turning up in any number of fictional exercises and assignments. Qumar never quite caught on in the same way. ↩

Yesterday, I enjoyed Jonathan Rothwell’s blog post reflecting on the motivation he derives—without realising it—from his smartwatch.

Like Jonathan, my energy levels go up and down over time, and sporadically, I benefit from a prompt to move a little more. But I’ve never been good at ‘recovering’: I had an Apple Watch ‘streak’ lasting over a year, for example, and once I broke it, I didn’t really feel motivated any more.

Over the years, I’ve found a slightly mad solution: I use many systems to motivate myself so that there’s always at least one I’m interested in. I look at Apple Watch stats, I use Gentler Streak, I use Streaks, I pay for Conqueror medals, I maintain spreadsheets, and more besides. They are all tracking, in one way or another, how much exercise I get—but all in slightly different ways based on different metrics and targets.

Jonathan says he’s worried that his motivation is a sign of addiction. My level of tracking myself is vaguely obsessive. But I think that if it keeps us both moving more than we would otherwise, then that’s probably a good thing overall.

The image at the top of this post was generated by Midjourney. Midjourney’s idea of what someone who is motivated to exercise by spreadsheets looks like is, to put it mildly, not exactly true to life. I often wear socks with my shorts.

Ruby Wax has written many books; this is the first I’ve read. I decided to read it because I’d seen from a two-line newspaper review that it was about Wax’s admission to an in-patient psychiatric hospital for a depressive episode, and was an account of her time there. I’m often interested in reading first-person accounts of this sort of thing, particularly as my experience in these settings has been entirely from the professional perspective, and it’s interesting to get the other perspective. Although fictional, Jasper Gibon’s The Octopus Man did this very well, and I enjoyed reading it back in February.

Unfortunately, this is only a small part of this book. The bulk of it is a collection of autobiographical anecdotes, many of which have no obvious connection with the mental health aspect. It’s a bit like a celebrity autobiography: a chunk of the book is a behind-the-scenes account of the making of a television documentary about Isabella Bird, there’s another chunk about working with refugees, and so on. This isn’t what I was expecting, and I’m not certain that I would have picked up the book if I’d understood the content to be so varied, but there were some interesting observations in there.

This didn’t inspire me to explore the back catalogue.

I recently came across one of Krishan Coupland’s posts on The Liminal Residency, in which he reflects on deaths at theme parks. In part, Coupland reflects on the difference in the reaction to deaths and injuries according to the setting in which they occur. Specifically, he contrasts the giant reaction to the life-changing injuries experienced in an accident aboard the Smiler rollercoaster at Alton Towers with the muted reaction to a much higher number of injuries and deaths experienced on a particularly dangerous road to Alton Towers.

This is not a new observation: we all know that fear of flying in the aftermath of 9/11 led to people taking a much riskier car journey, perversely increasing the rate of death and serious injury among travellers. I wrote about something similar on 14 April 2021, when I did some back-of-an-envelope calculations about covid vaccine risks versus the risk of travelling to venues.

But I’ve never thought about it in a theme park context, and—perhaps partly because I’ve recently visited The Hoppings—I thoroughly enjoyed Coupland’s reflections.

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

I didn’t find out until after I read this book that Alejandro Varela is a specialist in public health. That explains the focus of many of the short stories in this collection, and also why they intersected with many of my own interests.

Verela is based in New York, which serves as the setting for these interconnected stories. The focus is on people who are at the margins of society, either as a result of being quietly introverted or due to more structural issues. The main themes in the book are around romantic relationships (particularly among men), parenting, and everyday racism.

The ‘book is also very funny. ‘Carlitos in Charge,’ a comedic piece about the absurdity of the United Nations (and the sexual encounters between the staff) stood out to me as riotously good fun, not least because the satire had the sting of underlying truth to it.

As in any collection, some stories were more successful than others. Short stories are not my favourite medium, but I enjoyed this book, and will add Varela’s much praised first book, The Town of Babylon, to my list.

Some quotations I noted down:

That doesn’t matter, Dear. My grandmother said this in response to almost everything: marital spats, earthquakes, authoritarianism, late-stage cancer. Whether it was the tone or the pith that made her words so persuasive was unclear. But whomever heard her say them understood that she knew well the distinction between problems and pain.

The transportation app on my phone flashes a warning about the F train: it’s been rerouted and delayed. In other words, one can be late for a place they never intended to visit.

In a short period of time, I learned that the United States was immune to easily interpretable, common-sense data on everything -pollution, tuberculosis, birth control, abortion, breastfeeding, war, rape, white phosphorous, blue phosphorous, red phosphorous, lithium, PTSD, GMOs, slavery, winged migration, lions, tigers, polar bears, grizzly bears, panda bears, capital punishment, corporal punishment, spanking, poverty, drug decriminalization, incarceration, labor unions, cooperative business structures, racist mascots, climate change, Puerto Rico, Yemen, Syria, Flint, Michigan, women, children, wheelchairs, factory farms, bees, whales, sharks, daylight saving, roman numerals, centimeters, condoms, coal, cockfighting, horse betting, dog racing, doping, wealth redistribution, mass transit, the IMF, CIA, IDF, MI5, MI6, TNT, snap bracelets, Pez dispensers, Banksy. It didn’t matter what it was. If the Human Rights Council (or Cuba) advocated one way, the United States went the other.

She’s wearing a gold band, but no engagement ring. I’m relieved. Literate women who wear engagement rings destabilize all my notions of feminism. I’m grateful this tradition seems to be falling by the wayside.

As if on cue, my little wombat skulks into the room with a guilty but also aggrieved turbulence in his eyes and brow. We adopted Julio, and he looks nothing like me, not his hair, not his teeth, not his marshmallow face, but he is me, almost more so than I am.

“Did you hear that, Julio?” I shout toward my son as he and his friend take off down the hallway. “One hour. I don’t want to hear any crying or screaming. I’m setting a timer too.”

Timers. Christ.

Don’t get me wrong. I’m grateful for any tools or techniques that facilitate the trauma-free domestication of our small, wild humans, but the gulf between my childhood and my children’s is vast and vertigo inducing. My parents used to set timers with the backs of their hands. Sometimes, the timers were made of leather. But those were different times, I’ve heard people say. I assume they meant different income brackets.

I was recently struck by this post on Dan Cullum’s blog. A lot of my professional time is spent explaining to people why something isn’t a crisis, and why they ought not to be panicking about it. It’s not an easy skill, but it’s one that I think I’ve become quite good at over the years.

I find it much harder to do the opposite, and convince someone that something is a crisis when they’re not treating it as one. This applies as much to things that are small and specific (‘this approach to this problem is fundamentally unsafe’) as to things that are large and general (‘the planet’s climate is becoming incompatible with life’).

This is a nut I haven’t cracked.

It strikes me that this is not dissimilar to a challenge I faced in clinical medicine. One of my strengths was my ability to reassure people, to address and calm their fears. But, like most doctors, I struggled with convincing people to change their behaviour, particularly when they judged it to be acceptable, no matter the risk to their personal health.

It’s not always a crisis, but sometimes it is, even when you think otherwise.

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

This book is a collection of photographs of the Apollo missions to the moon. I managed to pick it up for £10 in a sale, while Waterstones are still listing it at £60.

The photographs taken during the missions were obviously taken on film. The film has been stored in a secure freezer ever since, the better to stop it degrading. The films were recently defrosted, cleaned, and scanned at extremely high resolution. Despite this, the quality of the images themselves remains relatively poor: for example, as they were designed to be back-lit, they tend to be underexposed.

Andy Saunders took those detailed scans and manipulated them to produce authentic yet extremely clear versions. He talks in detail in the book about how he went about this, and how he chose to judge the line between accurate representation and artistic manipulation.

I found this fascinating to flick through. I had expected to be drawn mostly to the detailed photography of the technology of the era, but in fact, that didn’t affect me much at all.

There were three things that stood out.

Firstly, the wonderful photographs of the astronauts. Many of these look like beautifully shot and lit portraits. They bring out the humanity of the endeavour, and it helped me to understand the personal risk each of them took by participating in this programme. Every human being who has ever walked on the moon is included in this book. It is also impossible not to be struck by the fact that all twelve are white American men.

Secondly, the astonishing pictures of the earth. I’ve seen many of these pictures countless times over the years, but seeing them presented in this book, in stunning clarity, gives something of a new perspective.

Thirdly, the focus on the USA. It has never really struck me before how absurd it is to have a spacecraft floating in magnificent isolation with the letters ‘USA’ painted on it. I’ve never truly considered the madness of planting an American flag on the moon. But there is something about contemplating the astonishing photographs in this book which made me think about how narrow one’s view of the world must be to ‘brand’ the mission as the product of a country.

A couple of months ago, I watched and recommended the film Apollo 11, composed entirely of archive footage of that mission. My reaction to the film was to be awed; my reaction to these photographs was more contemplative. I think both are worth seeking out.

I cannot stand workplace jargon and have developed quite a reputation for challenging or ridiculing it depending on my mood.

But as much as I abhor corporate nonsense words—inane and insane in equal measure—I enjoy being challenged on my deeply-held views. It is one of the key ways I learn and grow. I was therefore delighted to see that the Bartleby column in The Economist this week addresses the upsides of workplace jargon.

Firstly, though, I need to address an error in the column:

Doctors have a private vocabulary for patients when they are out of earshot. “Status dramaticus” is how some medics diagnose people who have not much wrong with them but behave as though death is nigh; “ash cash” is the fee that British doctors pocket for signing cremation forms.

The idea that this sort of unsympathetic, uncaring use of language is ‘the norm’ in my profession is a myth. It’s the sort of language that routinely gets called out, and which gives people an unsavoury reputation.

Regardless, the column cites two main benefits of jargon.

The first is ‘creating a sense of tribe and of belonging’. This may be true, but I do not see this as a virtue. This is essentially suggesting that an exclusive culture is preferable to an inclusive one. The column suggests that knowledge of the language confers ‘membership’, which might be fine in social groups, but is really quite abhorrent in the workplace. People ought to be included by dint of their employment in the organisation, and it is up to the organisation to welcome new recruits; they ought not to be excluded until they acquire ‘membership’ of the cult.

The second is ‘practical reasons’ such as ‘increasing efficiency’. It’s hard to understand how jargon increases efficiency if it excludes some staff members and—as the article cites elsewhere—frequently leads to errors and misunderstandings.

One of the organisations I currently work for is in the process of rolling out a programme to improve wellbeing, morale and a sense of inclusion in the organisation. Let’s imagine that they called it ‘Inclusion for Excellence’, which is not a million miles away from reality. I’m now deluged with corporate communications for the ‘I4E programme’ and seemingly no-one recognises the irony.

The most dangerous jargon of all is the language we don’t even recognise to be jargon. Some years ago, I led the response to an outbreak in a prison. The health services, me included, talked about ’vulnerable prisoners’, meaning those at higher risk of serious illness if they contracted the infection. The prison services heard us talking about ‘vulnerable prisoners’ and thought we meant those in special protection due to the risk of attack from other prisoners. We used identical shorthand for different groups of people.

I concede that I’m not totally opposed to jargon: it can indeed be a useful shorthand in situations where one can be certain that everyone understands what is meant. Everyone uses it, to some degree, every day.

But it is my fervent and unshakeable view that jargon is, for the most part, best avoided. Where unclear language is used and not understood (or misunderstood) it is a failure of the speaker.

And your chosen deity help you if you ever send me an email saying, without further explanation, that you’d like my input into

an innovative outsourced supply chain solution that will drive strategic alignment as we recalibrate towards business as usual

You’re unlikely to receive the reply you’d hoped for.

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

As I’ve written many times over the years, The Hoppings has descended on Newcastle’s Town Moor for a week or so in the summer of most of the last 150 years. For some years now, it has formed the largest travelling funfair in Europe.

Wendy and I went for our annual wander. A close comparison of the carousel compared with last year’s photograph reveals a 17% annual rate of inflation on rides.

I vaguely remember having a conversation with someone once about the different between the Red Cross and Médecins sans Frontières.¹

The Red Cross focuses solely on the individuals in need. It will work with corrupt regimes to get access to prisoners of war, and it will summarily ignore any wrongdoing it comes across beyond its narrow focus on the immediate needs of the people it is there to serve. This means that the Red Cross can provide care to people in some of the most extreme circumstances, across boundaries and within facilities that no-one else might ever be able to access.

Médecins sans Frontières tries to do the greatest amount of good for the greatest number of people. It published reports condemning wrongdoing it has seen. In extreme circumstances, it will pull out of facilities and territories rather than be complicit in silence. This means that it can bang the drum, or threaten to do so, to secure safety and health for whole groups of people.

In practice, the Red Cross and Médecins sans Frontières coordinate to make sure that they can both meet their goals while leaving as few people unserved as possible.

This has been playing on my mind recently in the context of health protection. Sometimes, for example, hospitals have outbreaks of infectious diseases, and sometimes, they ask for my advice and support. I approach these situations in a very ’Red Cross’ manner: as in, “your secrets are safe with me, let’s talk openly, honestly and frankly, and let’s fix the problem.”

Others in my role would approach these situations from a more ‘Médecins sans Frontières’ perspective: as in, “I want you to listen to my advice, make an action plan to fix this problem and report to me on progress regularly, or I’ll escalate my concerns to your commissioner.”

These two approaches aren’t as mutually exclusive as they might first seem: even with the ‘Red Cross’ approach, the reality might be that I’d have to involve regulators or commissioners eventually if I was deeply concerned.

Yet, I see my primary role is to be a friendly independent source of help and advice to help steer things in the right direction; others in the same role see it differently.

I convince myself that my approach is based on experience and evidence, and that it’s the most effective approach for me. But I can’t deny that it also aligns with my personality and preferences, and that almost certainly colours my thinking.

I suppose my reflection is that different approaches work for different people, probably in part because they suit different personalities and contexts. There is often a drive in life to standardise things, but sometimes, greater things can be achieved through having two opposed approaches working in harmony, just like the Red Cross and MSF.

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

1. The details of this might be a load of misremembered rubbish. ↩