(so remember) Every picture tells a story, don’t it?

The blogging community is a supportive, creative and a largely virtual community. As such, members not only post their own blogs, but avidly follow and read fellow bloggers’ posts. For me this week was no exception. One of my fellow bloggers is Lynn Findlay @lm_findlay . She runs a bit, writes a bit and last week posted a blog that explored the growing use of instant images on social media and the possible implications for privacy and behaviour. It’s a great little blog and one of the things that I found fascinating was Lynn’s example of contrasting the reader’s reactions and feeling to both the use of images or the use of simple text to capture the moment and/or inform. You can read it here. 

I think Lynn is on to something. One has only to look at the proliferation of Christmas appeals we are now seeing on our TVs. Whether the appeal is to help provide clean water, provide warmth and a place to stay for the homeless, rescue donkeys, cats and other assorted animals, what they all have in common are the use of images that seek to evoke an emotional response. And of course, following that emotional response, to donate to the charity. 

I have always used a lot of images in my work. As an academic, my classroom presentations were predominately made up of images that I used as a framework for delivering my lectures (and every presentation contained at least one chicken picture); likewise, presenting papers at conferences would always involve carefully selecting images to illustrate the points I wanted to make. 

My long-term co-writer Professor Sue McAndrew shares my passion for surreal images and we have spent many a long hour searching for images to illustrate our work. Our belief has been that pictures often tell the story more powerfully, or at the very least, capture and keep the attention of others. Over the years, we have received some great feedback about our presentations and the images we have used.  I really pleased that after some 120 peer reviewed conference presentations made all over the world (and that is a lot of images) we have never had a complaint that they have caused offence. However, many people have told us of the other powerful emotions they experienced by some of the images seen.

     

And I had one of those moments last week. 

I was just going through my Twitter timeline, when I came across a picture posted by one of my Twitter friends. It showed a picture of a sculpture in Geneva. The sculpture was created by the Romanian artist Albert György, who now lives in Switzerland. It can be found in a small park on the Quai du Mont Blanc promenade, situated along the shores of Lake Geneva. He called the piece ‘Melancolie’ reflecting the isolation and sadness he felt after his first wife had died. It is a beautiful and evocative piece. 

Interestingly, the Twitter post had the sculpture named as ‘Emptiness’. This seems to have come from one of the many comments posted by people who had seen it and had experienced loss, particularly of a child. It is a recurring theme in many of the comments that have been posted. You can find some of these here. I found many of the comments heart-breaking in describing the context of the loss experienced, but all were powerfully demonstrating the power of love. I am not surprised to learn that the image has been seen over 23 million times since being shared on social media. Over the past few days, my Twitter timeline was packed with comments around the image – and that doesn’t always happen with many images.

The title of this week’s blog comes from the 1971 album of the same name. This was a breakthrough album for Rod Stewart. Like all good art, the songs have endured and been loved by generations over the last 47 years. In its own way, many of the songs are as poignant and evocative as Albert György’s sculpture. These are songs that talk of forgiveness (Amazing Grace), first love found, and love lost (Maggie May), of living for today (Tomorrow’s a long time), loss (I know I’m losing you) and faith (Reason to believe). If you have not heard this album in a while, find 40 mins today, sit back and have a listen.  What you might not know, unless you were around in the 1970s, is that on the original album notes, the names of two alcoholic drinks (Martell Brandy and Mateus Rose) are slipped in and listed as contributing personnel on the album. 

Be still my quivering heart, I have a plan…

In Australia, defibrillators carried in ambulances are often called ‘Packer Whackers’ – they acquired this name after Kerry Packer. Following a heart attack in 1990, from which he fully recovered, Packer donated a large sum of money to ensure every ambulance from that moment on carried a defibrillator. When he died in 2005, he was one of the richest men in Australia. I mention this as defibrillators can be expensive. I don’t mean the ones you see these days in supermarkets, community centres and so on, but the proper ‘external’ defibrillators that are to be found in most hospital wards and clinical areas. These are expensive, ranging in price from around £6,500 to £10,000 each. 

The hospital where I’m a Non-Executive Director - Wrightington, Wigan and Leigh NHS Trust - has developed a programme of re-providing all the defibrillators across the Trust – which will come in at a total cost of just under £450,000. Kerry Packer did indeed have deep pockets. We are having to do this for two reasons. The main type of defibrillator we use is currently subject to an NHS Patient Safety Alert, and obtaining spare parts is becoming increasingly difficult due to US shipping sanctions. In the short term, until these pieces of equipment are replaced, and staff trained to use them, there are a range of ‘safety nets’ in place to safeguard patients.

Surprisingly, despite defibrillation having been around since 1947 when a defibrillator was first used on a person, the exact mechanism of defibrillation is not that well understood. There are ongoing studies looking at how cardiac tissue responds to electrical shock. It is used as a treatment for life-threatening cardiac dysrhythmias, although it is only appropriate in specific dysrhythmias known as ventricular fibrillation. However, when you need it, the equipment must be there and in good working order. Increasingly, I am becoming worried that this will not be the case post Brexit. And I am not alone in having these concerns.

Last week, The Nuffield Trust published their analysis of what a ‘no-deal Brexit’ might mean for the NHS. Its analysis looked at the possible price increases for medical devices, medicines and other things such as food and blankets. Their analysis estimated that the NHS would need to find another £2.3bn by 2020 – and that is just to stand still! Their estimation also suggests that this is the sum of money freed up for improvements to patient care next year and the following one. This is not intended to be a political blog. There are other better and more able commentators than me to publish such much-needed narratives. No, I mention ‘no deal’ ‘poor deal’ Brexit concerns, as they are symptomatic of the current health and social care zeitgeist.

It seems to me there is an overabundance of rhetoric and a wealth of reductionist ambition, and a lack of economic coherence and investment in the current world view of health and social care. A great example might be to look at the current chaos around this year’s flu vaccination programme. With the flu season just around the corner, many GPs are still having to turn away patients because of a lack of flu vaccine; particularly the catchily-named ‘adjuvanted trivalent flu vaccine (aTIV)’ that is recommended as the preferred vaccine for those over the age of 65 years old.

NHS England last week blamed GPs for the mess, suggesting that they should have ordered more of the drug earlier on in the year, when their advice had been published. This seems a little harsh as the manufacture Seqirus is only making supplies available on a phased basis; the last phase being towards the end of November. In Scotland, the situation is even worse, as the Scottish government failed to get enough stock and are restricting the aTIV vaccine to those aged over 75! Despite Seqirus (and NHS England) claims of increased demand this year, Public Health England’s official data show that the number of patients over the age of 65 receiving the vaccine has dropped significantly this flu season compared with last year. The same is true for the falling uptake among all at-risk groups. It feels like a mess that could have been avoided. 

More generally, the supplies of all medicines might become a lot more difficult and expensive after we leave the EU. Ash Soni, the president of the Royal Pharmaceutical Society noted earlier in the year that the UK simply does not have the manufacturing capacity to supply all the drugs that are prescribed. Many of the medications used in the UK are manufactured and supplied by pharma factories across Europe. When we consider that more than one billion items are dispensed annually, costing £17bn a year, it’s a very worrying thought as to the consequences of interruptions to this supply chain. It’s so worrying, I can feel my heart quivering… 

…hold on, a heart that quivers instead of pumping, results in a cardiac arrest – I hope we have some anti-arrhythmic drugs and a ‘Packer Whacker’ handy…

I'm a man with a child in my eyes (with apologies to Kate Bush)

Some weeks it can feel like everything is conspiring to make you feel your age. For example, on Thursday, I bought us tickets to see Tubular Bells for Two next year at the Royal Northern College of Music. Unlike the original album where Mike Oldfield played all the instruments himself, using a crude mixing system to bring them all together, this show involves two men playing all the instruments live to reproduce the music. It should be an interesting show. The original Tubular Bells album was released in 1971. It sold over 30 million copies and was the founding album for Richard Branson’s Virgin Records company. In some ways, I think the intervening 47 years have perhaps been kinder to Mike and Richard than myself – although I still have the original LP and I can’t really complain; it just made me feel my age. 

Likewise, I read a story last week of a new phenomenon sweeping through Finland. It was a story of how people of all ages were rejecting buying new in favour of recycling older objects; furniture, clothes, artwork and so on. Giant supermarket-style shops specialising in selling such not-for-profit re-use items are reportedly springing up everywhere. They are called Kierratyskeskus. It is said they are so popular that they are even challenging the Swedish furniture company, IKEA for ‘market share’ (other furniture stores are available). One Sunday, some 20 years ago on a very early ERASMUS visit to Turku in Finland, I asked if there were any car boot sales that I could go and look at. I was told no, but there was this new ‘shop’ that had just opened selling second-hand items. I went and was well satisfied. I even found yet another chicken to add to my collection. Reading the story of how much of a social movement the Kierratyskeskus had become in the last 20 years was very interesting, but it made me feel my age. 

Equally interesting last week, was an item at the Greater Manchester Health and Care Board. This was a report into the Mental and Emotional Wellbeing in Education Settings programme. The report brought folk up to date with where the programme had got to – and I wrote about some of these activities as they related to the four universities in Greater Manchester and the work of the CAMHs services in Wigan a month ago – (see here). 

To illustrate the progress of the programme, two young people had been invited along to talk about their experiences of being part of the Mentally Healthy Schools Pilot. Hearing first hand from those with current experience of something is always better than reading a written report (however well written it might be). They were good presenters and told their story well. The pilot involved 30 schools and was aimed at helping young people to better look after their emotional health and wellbeing. In addition, it also provided teachers with the advice and support they need to either give mental health first aid or if required, more expertly refer young people on to specialist services. I was impressed with the progress, the level of engagement, and the integration of approaches achieved across many agencies and organisations. The full report is worth a read and can be found here.  

  

In the Twitter discussion after the meeting, there was one tweet that caught my attention: ‘[A] really interesting point made @GM_HSC health and care board today that young people’s well-being and resilience would be better supported by protecting sport and performing arts in secondary schools. I totally agree’ – and so do I, and I’m so glad to see the daily mile being taken up by so many schools. But I was saddened that we are now having to replace much of the stripped away common sense approaches to keeping children and young people healthy in their early years education, and that made me feel my age.  

However, on Friday, I was glad to feel my age! It was the annual Recognising Excellence Awards night at Wrightington, Wigan and Leigh NHS Trust. Reflecting the NHS70 celebrations, the theme for the night was 70s and fancy dress was the preferred option. Now at the start of the 70s, I was just 15 years old and so as a young person I grew up and shaped a great deal of myself during that decade. So last Friday I rooted through my wardrobe and found everything I wanted (except my silver platform, knee high boots) and complete with beads and the obligatory black hat I set off and joined the party! It was a fabulous evening. Awards were given for innovation, collaboration, compassion, unsung heroes, leadership and a new one for our apprentice of the year. We had a great dinner, the conversation and fizz flowed, and the room was full of colour and noise – it was straight out of the 70s as I remember them. Once the awards were made, the meal finished, the dance floor was cleared, and the band began to play – I decided it was time to leave, which after years of dancing at various do’s, made me feel my age.