Ian, Laurence, Steve, and Mick: It’s only Rock and Roll but I Like It!

It was back to work last week, and a full-on week it was too. Monday and Tuesday were consumed with playing email catch up and back to back meetings. Much of Wednesday was spent with Ian Cumming, Chief Executive of Health Education England. It was a wonderful opportunity for the School to not only showcase our achievements, but perhaps more importantly, to engage in debate over the strategic intentions of the body in the UK that spends nearly £5 billion a year on education and training for health care professionals. 

Ian’s boyish looks belie a highly intelligent and creative man, able to communicate his message with humour and evidence, a somewhat rare ability. Ian started his career as a Biomedical Scientist before moving into more general management in the NHS towards the late 1980’s. When he got his first Chief Executive post in 1995, he was the youngest ever Chief Executive in the NHS.

It was good to discover that as a School we were already addressing half of the HEEs 11 strategic priorities. The other half represented areas completely beyond our collective experience yet were exciting and challenging. None more so than what the HEE were planning around genomics. Coincidently Thursday saw me in London for a Council of Deans meeting, held at Woburn House, just a stone’s throw from the British Medical Association headquarters in London. Last week it was their Annual Representative Meeting, and the impact of genomics on the health care  of the future was discussed. 

There did seem to be other equally important issues discussed however - it appears some hospitals have had the audacity to remove the junior doctors mess facilities. Anyone who has ever endured living through their children’s ‘terrible teens’ will know what the word ‘mess’ really means – bedrooms where dirty washing is stored alongside clean washing (usually on the floor), a proliferation of bacterial cultures cunningly disguised as empty pizza boxes, and an abundance of used coffee mugs which pose a serious biological warfare threat to the human race. Well that adequately describes the average junior doctor’s mess too!

Sadly, this year’s Annual Representative Meeting also saw the retirement of Dr Laurence Buckman – definitely one of the good guys. He was the GP Committee Chairman. Always forthright, but fair in his observations of the NHS, I found him someone who was not afraid to speak his mind over the sometimes ludicrous demands placed upon practitioners by uninformed political manikins. Last week, he talked about the continuous governmental oppressive box-ticking, micromanagement and imposed changes that are often not based upon clinical evidence or in some cases, have no basis in reality, like the imposed taking of blood pressure of healthy people in their 30's. 

Now for me, being 30 is a bit of a distant memory, but my blood pressure was raised on Friday night watching Seasick Steve perform at Glastonbury 2013 – absolutely fantastic. It was raised further as a full 24 hours had to pass before the greatest rock band in the world took to the stage, the Rolling Stones. Mick Jagger famously said he couldn't imagine himself prancing around on stage singing Satisfaction when he was aged 30 years old. Last night 3 weeks, 6 days and 15 minutes short of his 70th birthday he sang Satisfaction as the final song of what was a great set. The Rolling Stones performance was sublime, they were every inch the band that all others are measured against. I know it was only rock and roll, but I liked it! 

Up the Ladders and Down the Snakes: My Suitcase of Memories.

Last week I was on holiday. Regular readers of this blog will know that means being up here in Scotland, and it was a glorious week, weather wise, to spend beside the sea, walking on the hills or through the woods. I wasn't going to write a blog, just post a message saying gone fishing or something similar. However, some of the activities of the week made me think about one of the projects I was working just before leaving to come away. This was a project on dementia, and what we as a College could do to improve the quality of life of those living with dementia.

One of the things I have been exploring is what others are already doing. One such group is the House of Memories, part of the National Museums Liverpool. The House of Memories run a programme for those working in the health and social care that recognises that to acknowledge and understand an individual’s personal history and memory is of great value and significance, especially for people living with dementia. The programme not only raises awareness and understanding of dementia but provides practical examples and fantastic resources for those wishing to develop their own memory activities. The resources include: A Memory Box, a Suitcase of Memories, and a Memory Toolkit. 

Thinking about my holiday I wondered what would be placed in my Suitcase of Memories.  One experience this week that I hope wouldn't be there was an encounter with an Adder. This was a young one sun bathing in the early morning sun. I was only wearing sandals and shorts, so slightly worrying as it lay on the path I was walking on. In the UK, adders are the only venomous snakes to be found in the wild. Worldwide, there are over 5 million snakes bites every year, resulting in 400,000 amputations and some 125,000 deaths a year. To keep the adder encounter into proportion though, over the last 100 years there have been 14 people killed as a consequence of being bitten by an adder in the UK. The last death recorded was in Perthshire, Scotland, in 1975.

The Department of Health advice if bitten is to stay calm and dial 999. Dr Robert Harrison from the Liverpool School of Tropical Medicine advises that most bites occur in coastal areas (like Kippford). The adder venom carries proteins which attack blood vessels and makes them leaky and as such can cause internal bleeding. For some reason the anti-venom used to treat adder bites in the UK comes from Zagreb, Croatia.

There is one experience from this week that I do hope would find its way into my Memory Suitcase. This week I walking Cello in a hay field where the grass was being cut and baled into those old fashioned rectangular bales. It was the sweet and very distinctive smell of the cut and sun kissed grass that sparked the memory.  For many years when I lived in Wales I would cut and gather hay in this way. All the local farmers would help each other, and I have spent many a happy hour throwing and stacking hay onto a hay cart and then transporting this back to the barn. 

It was hot, dusty and very itchy work, but also work that was about marking the seasons, fostering and renewing a sense of community and of course preparation for the winter.  And in those dark winter mornings and evenings there was nothing better than climbing the ladder to retrieve the hay for the animals, in my case to feed my milking goats. The smell of the stored hay would instantly remind me of the summer. Smelling the newly cut grass this week evoked the same kind of memory  and with it a huge sense of well being and contentment. 

Smoke and Mirrors at Piccadilly No 1 and 3, and Well Done Sue!

I was at No 3 Piccadilly Place last Thursday. It’s a fantastic building with high security and smart lifts which take you to your floor and nowhere else. The building was once the home to the North West Strategic health Authority. This ceased to exist on April 1^st 2013, with their responsibilities being taken over by Clinical Commissioning Groups and the NHS Trust Development Authority. These days Health Education North West have their home there, and I was there for a meeting of the Greater Manchester Academic Health Science Network (AHSN) Education and Training Steering Group. It was the first time we had met since the AHSN gained it authorisation.

Like many areas in the public sector these days, we were there to modify our business plan for the next 5 years given our funding has been reduced from £10 million to £4 million. It was a slightly depressing meeting as the range of changes we had envisaged were reduced. Eventually our plans were revised and the meeting ended. Walking back to pick up my car up from Piccadilly Train Station, I was intrigued to see a shop had opened in the station precinct selling electronic cigarettes. It was packed and seemed to be doing a roaring trade!

I didn't know that these cigarettes have been around since 1963 when one Herbert Gilbert patented what he described as a ‘smokeless non tobacco cigarette’. It was a Chinese pharmacist called Hon Lik who is credited with current generation of electronic cigarettes. His design produces a smoke-like vapour that can be inhaled and which delivers nicotine into the blood stream through the lungs. The nicotine release can be the same as conventional tobacco based cigarettes. However as there is no tobacco in the electronic cigarettes there is no tar, and it is the tar in ordinary cigarettes that kills.

Although smoking (tobacco based products) is the biggest cause of preventable illness and premature death in the UK, the benefits and risks associated with electronic cigarettes are still largely unknown. And whilst the dangers of smoking for the individual are well known, the choice to smoke or not has always been an individual one. It’s estimated that there are 10 million smokers in the UK, and about the same number of people who are ex-smokers. Successive UK Governments have done much to try and reduce the number of people smoking.

The use of electronic cigarettes is growing in the UK, there are now some 1 million people using them. Some in the medical profession see this as a good thing. Professor John Britton, who leads the tobacco advisory group for the Royal College of Physicians sees this growth as having massive potential public health gain. He noted that if all the smokers in the UK stopped smoking tobacco based cigarettes and started smoking electronic cigarettes, up to 5 million deaths could be avoided. Last week it was announced that the Medicines and Healthcare Products Regulatory Agency are to regulate electronic cigarettes as the UK government have now decided these are medicinal products!

Foucault (who did smoke marijuana) would turn in his grave at such social control. I was once a smoker and I used to smoke Piccadilly No 1 cigarettes. But I chose to give up. Nothing to do with any government campaign, I just got fed up with it one day and that was that – I stopped. Yesterday I saw that my friend and former colleague Sue Bernhauser was honoured for her contribution to nursing with an OBE – brilliant news and well deserved – and I have never seen her with a cigarette in her hand. 

Sailing with the Old, the Dead, and the New

Last night I went to see Rod Stewart in concert at the Manchester Evening News Arena. For a man 10 years older than me, he certainly still had lots of energy. He’s been singing since 1964 and I really admired his enthusiasm for life and his evident motivation to keep performing. The 2 hour performance was brilliant  a mixture of his old songs and a sprinkling of the new. It was high energy throughout. In a most interesting coming together of facts, Highgate Cemetery in London has featured in my thinking this week. What I didn't know until last night, was that for a short while, Rod Stewart worked as a garden labour in the cemetery.

Earlier in the week, while out with dinner with colleagues, I was tentatively offered a Horse Chestnut tree seedling grown from a conker picked off the ground in Highgate Cemetery. I have already planted a seedling Monkey Puzzle tree I've grown from a seed, and 3 Grape Vine seedlings, a birthday gift, in the new and embryonic Kippford Garden, and I really like the thought of starting the new garden off with plants that will eventually mature and transform the landscape. This in some ways is a bit like the origins and life story of Highgate Cemetery.  Not that I think the Kippford Garden will ever become a Grade 1 garden on the English Heritage Register of Parks and Gardens!

As well as its beautiful gardens and edifices, Highgate Cemetery is also just as famous for some of the people who are buried there. They include the British painter Lucian Freud, Stella Gibbons and Douglas Adams, authors of 2 of my all-time favourite books; Cold Comfort Farm, and The Hitchhikers Guide to the Galaxy, Herbert Spencer who was both an evolutionary biologist but also an economic philosopher and perhaps most famous of all Karl Mark, philosopher, historian, sociologist and economist.

And on Thursday of last week I got to meet some living philosophers and sociologists, part of a group of colleagues who will be joining the School in August this year to form a new directorate of Social Sciences. This was my first opportunity to meet with them and discuss their interests, aspirations and hopes for the future. It proved to be a lively and interesting meeting and the conversation highlighted some exciting challenges and opportunities.

On Friday I held an extra-ordinary School Congress and shared these latest developments in the Schools evolution with the rest of the School. Generally there was a widespread welcome for these changes, something I was really pleased to see. Today, there are two other little ‘seedlings’ I am really looking forward to seeing. The New Twins (now 10 days old) have come out of hospital and are back home, and this afternoon its off to Leeds to see them. Thinking about finally getting to see them has brought about a spring in my step bigger than that of Rod Stewart's last night - and if I may Maggie, notice is hereby given, this Head of School is not going anywhere else any time soon. As we continue to grow as a School there is still plenty for us all to do!

Facebook, Family Tales and the Coming of Age

A life time ago I joined Facebook. Not sure why, it seemed a good idea at the time. It was one Christmas when my parents were coming up to stay and they wanted to know what their children, grandchildren and great children were up to. After joining and collecting a number of ‘friends’ it became clear that letting my parents see what the aforementioned family were up to was not the best idea I have ever had. I stopped using Facebook by tea time on the Boxing Day. However, and I don’t know why, Facebook seem happy to send me alerts when one of these 'friends' posts a message.  

Last Monday, they told me Natalie Ann was watching ‘the Bare Necessities’ from Jungle Book with her daughter. Natalie Ann is herself the eldest daughter of my youngest sister Sarah. Sarah reminded Natalie Ann that her Granddad Roy, my Father (obviously) used to watch this with her over and over again when she was a small child – an interesting sense of continuity.

Thursday, sitting at my desk, sipping my first cup of coffee, I got a text to say that my eldest daughter had given birth to her newest son and daughter at 05.35. Great news! They are number 7 and 8 grandchildren – and as I am writing this, so far un-named. Surprisingly, they were the first twins in the family – ever, and they are non-identical twins. What I didn't know until last week was that there are approximately 125 million twins in the world (apparently 1.9% of the world population). If anyone knows how it is possible to agree this figure it would be good to know.

I was reminded by one of my friends (a real one that is) that there have been absolutely lots of ‘twin studies’ which have helped us better understand many social, health and behavioural issues. In the UK, the majority of these studies are conducted through the Department of Twin Research & Genetic Epidemiology (DTR) at Kings College London. Known as TwinsUK, it is the biggest UK adult twin registry, with some 12,000 twins aged between 16 and 98 who help in the study of genetic and environmental factors that might cause disease and ill health.

TwinsUK was set up by Tim Spector in 1992. Its patron is the delightful Baroness Betty Boothroyd (a dancer with the 'Tiller Girls' dancing troupe in the 1940s), who was the first UK female Speaker of the House of Commons. TwinsUK is the UKs only adult twin registry and the most clinical detailed in the world. Their research looks at osteoporosis, osteoarthritis, melanoma, baldness, cardiovascular disease, ageing and sight, diabetes, asthma and musculoskeletal problems. By using the DNA profiles of identical and non-identical twin pairs, the importance of genetic and environmental influences on many common diseases can be better understood.

Next week (the 8^th June to be precise) TwinsUK celebrate their ‘coming of age’ 21^st anniversary party. It will be held at St Thomas’ Hospital, London, which, interestingly is where my eldest daughter did her nurse training! As for Facebook, well yesterday's Times described it as a ‘passing fad’. Membership is down to only 14 million people, each of whom on average use Facebook for only 8 hours a week. However I do wonder what my daughters new twins will be writing about in 15 years time, and will my children ‘censor’ my viewing of whatever is going to be the next generation Facebook. Perhaps more importantly, will they be inviting me for Christmas?