All posts by Keith

I’m a controversialist and catalyst, quietly enabling others to develop by providing different ideas and views of the world. Born in London in the early 1950s and initially trained as a research chemist I retired as a senior project manager after 35 years in the IT industry. Retirement is about community give-back and finding some equilibrium. Founder and Honorary Secretary of the Anthony Powell Society. Chairman of my GP's patient group.
links

Things You Might have Missed …

Another selection of links to items you may have missed, and will wish you hadn’t. In no particular order …

Worried about Friday 13th? Or scared by the number 7? Seems that 13 July is the least safe day of the year.


And now they reckon watremelon might be the next super-food. Hmmm … sounds like a load of round things to me.

An interesting article on the pointlessness of Page 3 and the pointlessness of trying to ban it. So it’s another load of pointless round things!

Interesting suggestion that psychedelic drugs, including LSD can cure depression. Not sure I’m ready for that yet!

Well if you British men are feeling depressed, this might cheer you up. Apparently (on average) we’re better endowed than many of our rivals.

So from stiff things to … prosthetics. Ancient Egypt never ceases to amaze. Apparently they not only had prosthetic toes, but they were actually functional for walking.

While in the ancient world, underwater archaeologists are to revisit the wreck the Antikythera machine was found. That could be very interesting, especially if they manage to find more pieces.

And still on the ancient world it seems they now think that Orkney was the centre of the (British) neolithic world. Was there really nowhere less godforsaken?

Finally a different aspect of body adornment. It seems there’s a lot more to tribal tattoos than I had actually realised. I’m still not tempted though.

personal, pleasures

Reasons to be Grateful: 47

Well her we are at week 47 in my experiment documenting each week five things which have made me happy of for which I’m grateful.

And what a week! I’ve not had time to turn round this week and the next two don’t look any better; I’m feeling seriously stressed and lacking “me time”. But it serves me right for volunteering!

So anyway, to my five things. This week I give you …

  1. Family Reunions. On Monday I met up with my father’s three half-sisters. The eldest I have met once before when I was 10 and she was 18. The younger two (both within a year of my age) I had never met. My grandfather’s illicit liaison, which started during the war, ended up splitting the family as my father was always seen by his brother & sister to be on grandfather’s side against grandmother, and grandmother wouldn’t give grandfather a divorce. Frankly my father was trying to be fair to everyone (even if somewhat heavy-handedly) and give his half-sisters a chance in life, especially the younger two who ended up in Barnado’s — after all their predicament wasn’t their fault. Anyway, yet again I’ve managed to put a broken piece of the family back together. My half-aunts were overjoyed as they thought their father’s side of the family was lost to them forever. We spent a great afternoon with them and a couple of my half-cousins, sitting in a London pub just catching up of family things. And here’s the photo to prove it …

    Family Reunion

  2. Norwich. It was Noreen’s birthday on Thursday and she chose to spend the day in Norwich. Fine by me as we both love Norwich. We took one of our friends and spent the day revisiting old haunts, and discovering one or two new ones. Then on the way home we dropped in to see my mother briefly. Yes, it was a good day, and even almost dry! Photos on Flickr when I get some time!
  3. PayPal. One of the things I’m doing for the literary society is building a decent online shop. And in the process we are trying to move our credit card merchant facility away from the current provider (who are charging us too much) to PayPal. After much to-ing and fro-ing PayPal finally accepted us this week! Now I just have to get the shop pages to work properly!
  4. Pork & Apple. See here.
  5. Sunshine. After a dismal start to the week we’ve had several sunny days and i even managed to spend an afternoon in the garden — actually repotting houseplants. Lovely crisp sunny autumn days!
food+drink

Recipe : Pork Escalopes with Apple, Onion and Sage

More experimental cooking tonight. We had some pork escalopes, so I tried a variation on Normandy style.

Pork Escalopes with Apple, Onion and Sage

I used …
Enough Pork Escalopes (about 5-10mm thick)
2 slightly under-ripe Cox’s Apples
Bunch of Scallions
Handful of fresh Sage Leaves
Half glass of Armagnac (Calvados would be better)
Salt, Pepper and Olive Oil
Large knob of Butter

And this is what I did …

  1. Clean the scallions and cut into roughly 7 cm lengths, using as much of the green top as possible.
  2. Peel and chop the apples into quarters, then each quarter into four lengthways slices. Toss these in the liquor (to stop them browning) and set aside with the scallions.
  3. Wash the sage leaves, bruise them slightly and add to the scallion/apple mix.
  4. Heat some olive oil in a good frying pan and sear the pork on both sides.
  5. Add the apple/scallion/sage mix and any remaining liquor. Don’t worry if it flambés, it’ll just improve the flavour (and test your smoke alarms).
  6. Cook, with a lid on if you wish, turning the pork occasionally until it is done — probably 5 minutes for thin escalopes.
  7. Season to taste and transfer the pork and most of the apple/scallion mix into a warmed serving dish to keep warm.
  8. Add the butter to the remaining pan juices (plus a bit of apple/scallion) and quickly reduce to a thicker sauce. Pour over the pork.
  9. Serve with steamed new potatoes and a mixed salad.

Comments …
It tasted good, but it didn’t work quite as well as I had hoped.

The apple was good and stayed in whole slices which, with the scallions, were slightly sweet and tangy on the plate, setting off the pork nicely. That was what I wanted, hence why I had used Cox’s; something like a Bramley apple would be more tart (nice for me) but would also disintegrate.

One apple might have been enough for two of us. The apple/scallion mix made quite a lot of juice; too much to reduce quickly and thicken with butter to a thick sauce. This also meant that neither the pork not the apple slices browned at all, as I had hoped. Next time I’m inclined to cook the apple/scallion separately so it might caramelise slightly. And having ended up with too much liquid it needed a little cream, rather than butter, to make it into the right Normandy-style sauce.

An alternative approach might be to breadcrumb the pork — using sage & onion stuffing mix would work well! But then you definitely don’t want much juice so you’ll need to cook the apple separately.

And it would work just as well with any other style of potato and with hot vegetables rather than salad — depending solely on your preference at the time.

Verdict …
Not quite what I had hoped for, but by no means a failure. As Noreen so politely said: I’ve eaten far worse in restaurants!

words

Word : Pavonine

Pavonine

  1. [adj.] Of, pertaining to, resembling or characteristic of a peacock.
  2. [adj.] Resembling the neck or the tail of the peacock in colouring.
  3. [Zoological] [adj.] Of or pertaining to the genus Pavo or sub-family Pavoninæ, which includes the peafowl.
  4. [Zoological] [noun] A bird of the sub-family Pavoninæ.
  5. [Chemistry, Geology] [noun] An iridescent lustre or tarnish found on some ores and metals.

From the Latin pāvōn-em peacock.

medical

Good Doctor, Bad Doctor

As some of you may know I’ve managed to get myself embroiled (at a local level and from a patient perspective) in some of the health service reforms which are now happening.

Partly as a result of this I’m reading Ben Goldacre’s latest book Bad Pharma: How drug companies mislead doctors and harm patients.

Even if only 25% of what Goldacre alleges in the first quarter of the book is true (and that seems conservatively low) there is a scary, systematic and unethical ethos pervading the whole of the pharmaceutical industry which emanates from both the drug companies and the regulators.

At the end of the first chapter [p.99], where Goldacre has discussed the problem of missing drug trial data, he issues this challenge:

If you have any ideas about how we can fix this [the missing drug trial data], and how we can force access to trial data — politically or technically — please write them up, post them online, and tell me where to find them.

What follows is my small response to Goldacre’s challenge.

— o O o —
As patients there is not a lot we can do to address these issues; they’re just too big for the man on the Chapham omnibus to be able to make, individually, a difference. Given that the drug industry, the academics, the medical professional bodies and the regulators have singularly failed to adequately address the issues, the major thrust of the resolution probably now has to come in the form of primary legislation across all territories — something for which sadly few politicians are likely to have the stomach and no government the priority. However that doesn’t mean we patients can (or should) do nothing. This is what I think we can do, at least in the UK.

  1. Through our doctor’s Patient Participation Groups (PPG), and through our local LINk/Healthwatch/Health & Wellbeing Boards, we should be putting pressure on the medical world and specifically the local Clinical Commissioning Groups (CCGs, replacements for the PCTs) to force GPs to act ethically and without bias.

    One way to do this would be for GPs to be given guidance on what patients expect of them. This is likely to be way beyond the minimum acceptable standards required by legislation and regulation. And indeed I’m involved at my local level in drafting just that. I can’t say more about it at present as the work is still in draft form, uncompleted by the authors, unapproved by the sponsoring group and of course not yet delivered to its expected recipients. (That it is being done is in the public domain as it is referenced in publicly accessible meeting minutes.) However we are committed to it being published, and publicly accessible, when completed. With luck this will be before the end of the year, so I hope to return to it in a later column.

    But such guidance could contain clauses like (all my wording will need tightening):

    • Clinicians are expected to behave in unbiased and ethical ways. They must declare annually and publicly on their practice’s website all benefits received (services, goods, money) worth over [[name some modest value like £50]] received from any pharmaceutical company or healthcare provider (public or private). They should demand the same transparency from those who they themselves consult or to whom they refer patients.
    • All clinical trials/research in which a clinician is involved must be publicly registered and defined prior to starting and be referenced by the practice’s website. All clinical trial data (including anonymised patient-level data) and results must be published within 12 months of study completion. Again clinicians should demand the same transparency from those who they themselves consult or to whom they refer patients.

  2. All members (medical and lay) of CCGs, Health & Wellbeing Boards, etc. must also make declarations as in 1 above.
  3. Is it possible to find an MP who is willing to put down an Early Day Motion (or Motions) in Parliament demanding legislation to:
    • require all clinical trial data and documents (including anonymised patient-level data) be made publicly accessible, without hindrance, within 12 months of the completion of the study, and within 3 months to the appropriate regulatory bodies.
    • make all clinical trial data, whoever performs the studies, funds or sponsors them, subject to Freedom of Information requests at no charge, and with no exceptions, worldwide and retrospectively.
    • make gagging and other “interference” contracts illegal?

    We should then be encouraging our MPs to support the motion.

  4. There doesn’t appear to be an e-petition to the government. What about it? The partition should require that the actions outlined in 3. above be passed into primary legislation during the lifetime of the present parliament. I guess this would need someone more skilled than I am at drafting to write the petition effectively and without allowing wriggle room.

    According to the government’s own rules 100,000 signatures on an e-petition should trigger a parliamentary debate. That ought to be achievable if everyone buying Goldacre’s book signs and gets another couple of signatures. Create a Facebook page and it could attract even more signatures.

No that isn’t actually a lot in terms of fixing a worldwide, pervasive problem with Big Pharma. But we have to start somewhere and it is probably as much as we patients can realistically do initially, at least initially. Items 1 and 2 should start a trickle up of activity. Hopefully 3 and 4 will start a hammer down.

Thoughts from anyone?

personal

Five Questions, Series 2 #5

OK, so slightly later than planned let’s look at the last of the five questions (series 2) I posed a few weeks back.

Question 5. What places would you have pierced on your body and which parts would you never have pierced?

Well there’s a very easy answer to that: Anywhere and nowhere!

But like all generalisations it isn’t entirely true as I already have a piercing.

[The squeamish, or anyone who doesn’t want too much information, should skip the following paragraph and rejoin at the next set of square brackets.]

The piercing I have is a Prince Albert with a 5mm surgical steel ball-closure ring. It had been trickling round my kind for several years but suddenly became the right thing to do about 2½ years ago, just after I retired. No I don’t know why either, but it was a sort of rite of passage. And no it wasn’t especially painful — yes, it hurt for about 10 seconds — and it healed up well. Having it stretched (necessary with this piercing; but how and why would be just way too much information) to take a larger gauge ring was more painful than the initial piercing, but even that was only for a minute or so. The key to all this is a good piercer and excellent after-care and hygiene. (If anyone wants to know more, like if you’re thinking about having this done, contact me directly — this is a family show and I don’t want to unduly frighten the unprepared.)

[The squeamish can rejoin here.]

Once you’re had cold steel stuck through bits of your body, it loses it’s fear, although not the adrenaline buzz. In consequence I would have no problems with having almost anywhere pierced, although I don’t see the point of a lot of it.

So yes there are places I would never choose to have pierced — and maybe surprisingly that isn’t at all gender-based. I would have no problem with the more girlie things like ears, navel or nipples. But I’m no great fan of metal in eyebrows and I detest both nose rings and nose studs, on anyone — somehow they always look so naff.

However I think probably the only place I would never have pierced is my tongue. I can’t think of anything worse, or actually more painful, especially as it is one piercing that is known to heal badly and slowly. Yeuch!

Just a quick word for anyone thinking about getting a piercing. Pay attention to these 6 tips:

  1. Find a good piercer, with a good reputation, who you trust.
  2. Ensure you check out your piercer’s hygiene certification and (if appropriate for your area) their licensing.
  3. Ensure the piercer always uses all new equipment and jewellery from sealed packets (just as you would with medics or acupuncture).

    4. If you’re in doubt about any of the above three, go somewhere else.

  4. Follow the after-care & healing instructions diligently or better — extra after-care attention is unlikely to go amiss.
  5. Do not pull, twist, tweak or otherwise play with your piercing, at least until you know it is fully healed. (However the after-care instructions probably will ask you to turn it carefully every so often.)
  6. At the first sign of any problem, talk to your piercer before you do anything else; they’ve seen it before and are trained to know what to do (doctors generally don’t know).

The Association of Professional Piercers website has lots more good advice.

— o O o —
So there you are. Five more questions asked and answered. I’ll maybe do another set of questions in a few months time, probably after Christmas. Let me know if there is anything you would especially like me to answer.

personal, pleasures

Reasons to be Grateful: 46

Welcome to week 46 in my experiment documenting each week five things which have made me happy of for which I’m grateful. Why is it that some weeks I really struggle to find anything much which has stood out from the crowd, and other weeks it seems everything has been special. I do try to keep a quick memory jogger of special things as the week goes along; some weeks I get to Friday and already have a list of 12 items; but in weeks like this one by Friday I have just one thing on the list. I guess it’s called “life”, which is probably why I don’t understand it! Anyway here’s some sort of list for this week.

  1. Apples. As befits this time of year this has been an apple week. I love apples when they are crisp and crunchy and juicy — but they have to be fresh and in season.
    First of all at the beginning of the week one of our friends brought us a big bag of Bramley cooking apples (below left) from a tree in one of his friends’ gardens. It seems that near us Bramleys are about the only apples that have produced any sort of crop this year; our tree has produced about half a dozen small scabby specimens due to the appalling weather in the Spring.
    Secondly our weekly Waitrose trip turned up some English apples varieties. We indulged in some Blenheim Orange (below right) — sharp, tart, almost cooking apples — and some large under-ripe Cox’s — juicy, sharp but slightly sweet, just as they should be; I can’t abide all this over-ripe pappy stuff!.

  2. Haircut. Remember how when you were a kid you hated having to go for a haircut? Well certainly all the young lads I’ve ever known have hated the barber. Earlier in the week I went for a (several weeks overdue) haircut. I quite enjoy seeing Mr Clive, my barber; he’s a cheerful sort, it is good to set the world to rights and you occasionally get interesting snippets of local gossip.
  3. £10 off at Waitrose. For some reason best known to themselves Waitrose have sent me a couple of vouchers for £10 off my shopping (as long as I spend £100; easy on a weekly shop). One for use now and another for later in October. I don’t mind if I do! Thank you!
  4. Mince Pies. ‘Tis the season of impending Christmas and there are now mince pies in the supermarkets. They seem to be cropping early this year. I will likely have eaten a regiment’s worth of them by the time we get to New Year!
  5. Chillies. My chillies continue. We’ve already had a good crop of the yellow “Hot Lemon” and the tiny red “Explosive Ember” (which I leave to dry and use as crushed chilli through the winter). And this week we have the first two ripe Scotch Bonnet type, a variety called “Yellow Mushroom” — stingingly hot in curry! And there are more of all yet to ripen, although the supply of flowers is drying up now it’s got a bit cooler. Next year I think I might grow just the “Hot Lemon”; they’re definitely the favourites; the Scotch Bonnets never do hugely well (they prefer more heat and light than even my study windowsill can provide) and I don’t need more small chillies as we have a goodly supply of dried chilli in the cupboard.
words

Word : Gugglet

Gugglet, or as the OED would have it more correctly Goglet.

A long-necked vessel for holding water, usually made of porous earthenware, so that the contents are kept cool by evaporation.

From the Portuguese gorgoleta, ‘an earthen and narrow-mouthed vessel, out of which the water runs and guggles’. Also possibly the French gargoulette which has a similar meaning.

The OED records the first English use in 1698.

Kudos to my local auction house’s catalogue for teaching me a word I really didn’t know.