Monday, 22 October 2018

Ancient apples

The Nuttery

The Nuttery is a mysterious ancient woodland above Clare, beyond the Swan. It's a wonderful place to walk the dogs. Once, in days when rectors had vast houses, servants and land to support them, it was private ground providing walnuts and hazelnuts, and fish from its pond for the rectory. Now it is overgrown common woodland, part of the network of public walks here. For Edwin, it is a gentle stroll up through the fields, but for me a breathless climb and I am glad to pause in the silence. It is cold out of the sun, and glades with log seats beckon. Strange figures carved in dead tree trunks lurk in the undergrowth. 

A huge old apple tree, hidden from bygone days, hangs with glistening fruit beyond reach, but I pick a glowing red ember from among the recent windfalls, one fit to tempt Snow White. It is the sweetest, most succulent apple I ever tasted, veined with thin red streaks I’ve never seen before in any variety. It is cold from the overnight air, sweet and soft as candyfloss, quite unlike brands that boast "hard, crisp and crunchy". Even the skin was soft and could be eaten without wedging in the teeth. Perhaps it is one of those long-lost varieties that supermarkets reject. Back at the Swan, ripe walnuts have fallen on the car, remnants perhaps of that ancient wood.

Beneath the tranquility lie thoughts of what is to come. I have received a copy of the medical summary. There is little that was not discussed, but confirmation of a G3 pT2 TCC, i.e. an aggresive Grade 3 transitional cell carcinoma that has spread into the muscular wall of the bladder, grotesque and unnatural as terrible carvings in the deadwood. A large pelvic lymph node may indicate wider dissemination. Today is the Specialist Multi Disciplinary Team, or SMDT, meeting at Addenbrookes to determine management, and my fate. I await their call.




Sunday, 21 October 2018

What are the downsides of being a man?

Catlin Moran, a well-known feminist writer, has devoted her life to women's causes. In The Times Magazine today, she argues for equality in popular terms for yearning and sexuality, listing a whole thesaurus for men's arousal, and comparing it with the only word she could muster for women's desires: moist. She describes "moist" as the worst word in the lexicon, although I have always considered "damp" or "wet" to be worse words - I'd rather be moist than damp or wet. She concludes by calling for new terms for female arousal, to redress the balance in the name of equality.

Now she asks on her Twitter feed, "What are the downsides of being a man?" I feel compelled to answer, but can think of no great problems I suffered in youth from my gender, so perhaps the question was rhetorical, or ironic. If I suffered at all, the problems were from my class – an old-fashioned word, but one meaning a working class background with basic education, low in expectation or encouragement. Most in my school left at 16 to work in factories, with no thought of university or even career jobs. A good apprenticeship was an aspiration. The sixth form was a runt class, and the few of us who left for higher education knew that Oxbridge was closed to comprehensive school boys with Midlands accents. I was fortunate indeed to be selected into St Thomas' Hospital.

St Thomas' medical school was filled with the public-school sons of consultants (but was considered less exclusive than Barts, which was rumoured to only select the sons of Barts consultants). There was a quota of women, but only to fill the legal minimum, and they from Roedean, Cheltenham Ladies College, and their ilk. I was the first and only working class entrant, possibly selected to fill another political quota. The teaching was world class, but I felt an outcast.

That early prejudice is well past. Now I feel the prejudice of the young against the old. TV programmes show active, virile people, chasing adventure, or idly flirting. Even the adverts aimed at we oldies – for funeral plans, care homes, stair lifts, or equity release – have actors in their 50's who look a fit generation away from me. In shops, people are annoyed with geriatrics who fumble for their money or can't work the card readers, and assistants look at me pityingly, thinking I should be in a care home, and turn to talk past me to someone more interesting even as they scan my items.

Only now am I aware of even mild prejudice against males. I am still working, but only in a consultant role, and most of the people I work amongst are young women, and the bosses are all women, and there is no danger that they are ever going to proposition me. There is, though, a sense that the selection process is unconsciously biased, and women will be given preferential treatment – but that is more likely to be my own opinion than fact. Also, as a man, I am aware that I tend to push my opinions with a strident voice, so make myself hold back, a repressed role that is forced upon me. There is an awareness that to be a white male, and especially an oldie white male, is to be placed behind the line of women, minorities, the disadvantaged, the LGBT community and people of colour.

I hope I have these terms right - they seem to change every few years, and all the other downsides of being a man will be as empty air compared to the wrath of these groups if I mislabel them. For that is the greatest downside of all: the virulence of complaint if we men step beyond the narrow lines they prescribe for us.




Saturday, 20 October 2018

A lesson in cosmology

In cosmology, it is usual to talk of three types of universe. They are hard to envisage, because they are all three-dimensional and change with time, so it is is generally easier to hold a two-dimensional picture in one's mind, and leave the third and time dimensions to the mathematicians. The three are: ones that are flat, like a sheet of paper; ones with positive curvature, like a globe; and these with negative curvature, often likened to a saddle shape, curving in two opposite directions. Time is then "pictured" by thinking of the shapes as elastic, then being pulled equally in all directions so that if we draw little galaxies on them they will begin to move apart.

Visualizing the mysterious open Universe
What force pulls them apart? I said it was hard to imagine – indeed the force that started it all is itself described as "unimaginable" in all its attributes; vanishing smallness, infinite temperature, infinite density, and a time so small it is thought that no other time can ever be shorter. Cosmologists sum it up as the Big-Bang, though only the Universe itself could have heard it. Now imagine all that going on in three-dimensions, and the mind's eye fails. It really is easier to think of it as a great saucer carried by elephants. And how many people even handle saddles these days?

Not dead yet
We have walked the graveyard,
touched the tombstones
felt the putrid air of death
wept at the nameless wreath.
Today, we have rejoined life,
drank the sweet red wine,
eaten of the forbidden fruit
breathed the spring like autumn air,
it is our world
and we are still here.
by Annie Elliott

We may as well describe the open universe as the contrary curves of a woman's waist, usually hidden from view, everywhere quite mysterious, yet smooth and continuous. Ann is my Universe. Just don't describe the galaxies as wrinkles on the surface of time, moving apart as the curves expand, or you'll get into serious trouble!

Friday, 19 October 2018

The analysis of emotions

I am a scientist first, and a poor poet and writer second, though many reviewers rejecting my papers might say I'm a poor scientist first. Be that as it may, I do try to analyse my emotions.

The main one is rage. Rage at having life torn from me, and feeling weak and tired. Rage at thinking of the time I will loose from all the nasty treatments yet to come. I have always bottled up emotions, as trained to do. My background was the "stiff upper lip". Don't show your feelings. Put on a brave face. Face the world with head high, chin out, back straight, stomach in, chest out, shoulders back, look the person straight in the eye, give a firm handshake, and remember "you're British". Now I find myself swearing, raging against fate and the world, angry with my stupid body that's slowly falling apart. But thus far, it is bottled in, and I rage silently, in the darkness of my own mind.

A second one is resentment and envy. I see young people, and envy them their healthy skin, their strong limbs, their tireless energy. I yearn to be young again - and fully understand writers – such as Shaw with Back to Methusala – who imagine an elixir of eternal youth. I remember in youth I could run and climb, swim a mile, and had breath for two lengths underwater. Now I get tired walking the dog.

Pity or depression have not come, and Ann – bravely strong and wanting to keep busy to block her mind – only cried briefly on first hearing the news.  But today came a memory of the forlorn look and despair on my father's face when my mother died, and I was suddenly overwhelmed with a thought of Ann, and the grief and despair to come.  For the first time I wept today. I know her so well, I feel already her suffering and the pain she has yet to bear, and I wept for her future sorrow. But the tears were silent, and came when I was alone.

I do not write poetry now. Ann and Edwin's poetry far eclipses mine. Edwin's are introspective, exploring his own rages and frustrations. Ann's sum up the universal humanity we share in suffering or joy. She writes everyday. Here, a couple of new ones:
marriage
We are a couple,
two people sharing
a caring
simple life
which others join a while
then disappear from sight,
while we, the two who strive
to live and to survive
must face our world together
through the bleak and  cruel weather
side by precious side.

biopsy
Tummy turning 
like a wheel 
hit by a whirlwind, 
rushing, screeching 
twisting over and over, 
just waiting, 
tick tick tock, 
then the clock 
is silent.



Thursday, 18 October 2018

Post Graduation

Yesterday was Edwin's post-graduation ceremony. The omen's were strange. Walking past the Corn Exchange, we passed a foundation stone inscribed, "John Death laid this stone." In his gown and robes, we went with Edwin for a coffee before the ceremony. A woman on her own, but dressed in the blue and gold robes of Edwin's university, followed us into the arcade, then caught up with me. "Is this the way to the Corn Exchange?" she asked to my surprise, for she must have been studying in Cambridge for at least three years, and had walked past it to follow us.

Ann mentioned that her bag was very heavy, because she was carrying water and a folding walking stick in case I needed them. I commented that she'd have to fit a folding wheelchair in when the time came, but she wasn't amused.

At dinner in The Ivy afterwards, I kept looking at a strange optical illusion: a reflection of the back of a man with a black hat. He was like a ghost figure that people walked in front of, behind, and through. I got up to find the cause of the reflection; it was of a picture on the far wall. Then in an alcove I stared at a couple carrying gender equality to a new level. They were identically dressed in black suits, and homburgs that they didn't remove all evening, like a pair of Jehovah's witnesses matching a front view of the ghost image.
  
The ratio of women to men entering medicine is close to 60:40, and is probably similar veterinary medicine. The biochemistry ratio seems higher, and in the Arts, Law and Social Sciences Faculty it runs at up to 4:1 on some courses. It does begin to seem like the feminist battle has been won, and now they're just mopping up minor pockets of resistance. 

News item in The Times: Feminists object to the name "Gentleman's Relish".

Story in The Telegraph: After more than sixty years Kleenex is phasing out the Mansize tissues name, deciding instead to call the disposable handkerchiefs "Extra Large" tissues following complaints by active feminists.

Next to fall will be ladies fingers; we should just call it okra. At this rate, all differences will be eliminated, and we will wear identiclothes. There will be no more gentlemen's outfitters, or ladies fashions, just clothes shops; and women's magazines and those glossies promoting male bodybuilding must merge on the alter of true equality.


Wednesday, 17 October 2018

On advertising

I am thrilled with my new Apple i-phone. I don't like to say it too loudly, because Edwin has been pushing me to get one for years and I don't want him to think he is right too soon. It is fast, clean, and I love the facial recognition feature to unlock it. True, its keyboard lacks the row of numbers above the alphabet, but this is a minor inconvenience. Interestingly, 67% of views for this blog are from Apple devices (with 52% the i-phone); 20% are Android; only 10% are viewed from Windows.
But the main virtue of the i-phone is it doesn't support intrusive advertising.

Google will not like this post, but - I hate advertising. I don't like it on TV, though it would be hypocritical to say I only watch BBC. I don't like it when I do searches, but accept it as the price of good content and for ease of searching. My favourite site is Wikipedia; I would gladly pay a yearly rental for that site, and I send them money each year when they put their appeal out. But where advertising really cheesed me off was on my Galaxy phone.

Even before it exploded in my pocket, I was fed up with it to the point where I wanted to throw it at the dealers who sold it me. It was not a free phone. I paid good money for it, through the rental contract with EE, and a large fee every month to rent their system for calls and data. I therefore expect a clean service; but instead, I kept getting adverts thrown in my face. Full page adverts! Covering the screen after I picked it up and started to text or dial! Adverts that insisted I wait a few seconds, with a countdown before I can clear them! Adverts about irrelevant rubbish that I can't even read because I am so mad with them!! I do not expect to pay for the privilege of getting adverts!!!

Ann says I should write about my "feelings", and not keep making jokes and pretending all is well. It is not easy. I have never delved far into the dark pit of emotions. She keeps feeling shudders of shock as the news hits her in waves; I seem to have put it from my mind, and don't like to dwell on it. I suppose if anything, my emotions are of anger and apprehension - I resent having a black curtain hung before me through which I must pass. I enjoy life, and had hoped for a few more good years - there are so many things I still wish to do.
The apprehension arises from the thought of the cystectomy. I spent 6 months as surgical houseman on a GU unit. As a houseman, we didn't do much important stuff - just assisting the surgeon by holding retractors while the nurses wiped his brow. But I did see the severity of the ops, and the attempts to fashion a piece of bowel into a false bladder draing to a bag on the abdominal wall. I witnessed the failures too, where the bowel became infected, or did not graft, and needed another urgent procedure. Also, the cases of the poor men (were they always men?) with aggresive cancers, too late to halt, racing through their bodies to claim the ultimate victory.

I don't suppose my feelings will help anyone else much, but the Macmillan cancer site offers brillient support, and is Ann's first port of call when she has questions. So if anyone reading this wants to bring me their feelings, at least I'll be happy to share them, and maybe they will resonate with my own feelings and help me better to express them.


Tuesday, 16 October 2018

Clearing up the mess

I am always surprised at how difficult women find it to load a dishwasher. Each time my wife tries to do it, I find myself having to reload the thing. The problem is, I believe they have no spatial awareness. Dishes are pressed against each other and come out half unwashed; cups are piled higgledy piggley, and won't fit together properly in neat rows; glasses are not proped up and topple over, so come out full of dirty water; forks are placed in tine downwards, so they stop the bottom rotator doing its job; and huge items are placed vertically to stop the top rotator from turning.
Worse still, they don't get the concept of initial rinsing to remove loose pieces, which end up coating the glasses so they have an unwanted coating of crud. I don't know what prevents them from learning, but Ann is sensible and says, "well you do it then!"   Ben says his partner is exactly the same; he has to do it every time, as she refuses to touch it anymore.

Today was crunch time with my urologist, Mr Sengupta. He is a good, serious, surgeon with a firm handshake, who speaks with clarity and looks me in the eye. The news was not good, but he had a box of tissues ready which he passed to Ann. It is stage 3, having passed through the bladder wall, with evidence of possible metastasis to a pelvic gland. I have had lighted candles, prayer meetings, and even a mass said for me! If this were a scientific experiment, I would have to say it has failed to reach statistical significance. However, it has demonstrated what a large group of  people care, and that surely gives strength and hope, even if no physical cure.

The Addenbrooke's team will meet on Monday to decide my fate: some combination of radical cystectomy, chemo and radio therapy, or possibly some experimental treatment, which they are always keen to try out at there. I will be happy to accept their advice to clear up this mess.

Ann is a rock. The last time she was passed tissues was 25 years ago, in the same hospital, when we were given news that the scan for her pregnancy showed an empty sac. But she rose above that to produce an Edwin, weighing in at 13 pounds, and with an Apgar of 10 even after the Caesarian Section. Mr Sengupta asked if she would like to take the box, but she was strong enough to control her distress.

Yesterday, Mike phoned. I have always been proud of a good head of hair. My children used to take it as a sign for a healthy genetic inheritance, but some of them are already getting a bit thin on top. When told I might need chemo, Mike said I'll end up looking like him. I had a haircut yesterday too; I could have saved the money.


Monday, 15 October 2018

I am now a BLFJ

One teacher at my medical school at St Thomas' Hospital taught that the only difference between a man and a woman was a -CH3 group and a double bond, but he was a biochemistry teacher. The physiology department was more finely nuanced and taught six distinguishing features for sex determination and sexual differentiation.

  1. Genetic sex. Usually a clear distinction with XX or XY. Rarely, specific mutations (XXY, XXX etc.), or hybrid and mosaic types are seen.
  2. Anatomical sex. Usually distinct, although hermaphroditism, hypo-genitalia, or developmental anomalies might confuse the external appearance.
  3. Hormonal sex. Do you have functional ova or testes? What is the balance between your circulating hormones at puberty: oestrogen or testosterone biased?
  4. Parental nurturing. A more fluid definition, based on parental choices, culture and expectation. What was your given name? Were you clothed in dress or trousers? Did your relatives colour preference include blue or pink? What selection of "suitable" toys did you get? Do friends see you and treat you as male or female? 
  5. Sexual orientation. Are you attracted to males or females? Here, gender fluidity begins to creep in, and bisexual or homosexual preferences may emerge. 
  6. Sexual self identification. The last of the list, yet psychologically the most important. Does the person think they are in the "wrong" body? Despite the strength and persistence of the first five types, do they desperately yearn to be the opposite of them all?
People answering yes to the last of these may be desperately unhappy in their lives, and wish above all else to assume their preferred identity. Changing clothes and name is the easy part; harder is to insist on hormonal and surgical treatments to bring (2) and (3) into alignment.

On this basis, the current trend to make self-identification a sufficient qualification is to trivialize a traumatic state of being. It will deny proper recognition and treatment for people trapped in the "wrong" body, and if allowed, will enable any peeping Tom to self-identify as female for the dubious and abusive desire to enter women's changing and shower areas with impunity. On the basis of self-identification, I can claim to identify as a black, lesbian, female jew, and claim the right of all BLFJ's to protection by anti-discrimination laws and proper recognition by society as a worthy minority.

Sunday, 14 October 2018

On entertaining

We went to a concert by Paulo Lopes and Peter Wild yesterday, with celloist Eugénie Dagan and Edwin as narrator, to a packed hall in Stoke by Clare. The first half was a selection from composers rarely heard today, including Cécile Chaminade who wrote over a thousand pieces, and was widely acclaimed in the late 19th/early 20th centuries. We hear so many complaints that women were pushed out of science and the arts by men; but even when there is a great composer like Chaminade, she seems to be pushed aside, and even today it takes a Paulo to make her known. The second half was Saint-Saëns. Both Peter and Paulo are incredible pianists, and the music of their thundering keys from the finale parade of the Carnaval des Animaux reverberated through my dreams all night. Paulo not only arranges the program and performs, he also cooks and serves the food for the interval (a choice of chili con carne or chili beans, rice and salad), and does all the organization. They're doing it again today with a young dancing troupe from Clare's school of dance.

By chance, we were seated next to the ex landlady of the hotel in Clare. She ran it for over two years, then left in the summer. She said it was growing too hard to make a living from it. With Brexit looming, prices of imported foods and foreign beers are already increasing. Also, with fewer Europeans coming over, it was getting harder to recruit staff, and wages were going up, and it was hard to pass these costs on to customers. The public were also much harder to please now, complained more often and refusing to pay for meals, and stealing more and more items. One of her off-duty staff was eating there and heard a large table next to him plotting how they would get their mains free, and only have to pay for the desserts. So she has now given up the hotel, and is unsure if she will go back into catering.

Friday, 12 October 2018

A child of my age

Ann says my blog is of my age, revealing me as a child of the 40's to anyone reading it. Well, yes - I was born in the blackouts and played as a child among the bombed ruins of Leicester and Coventry. I played in the street, walked alone across the fields to primary school from age 5, and my early memories are of austerity and rationing, but it all seemed normal then. We are each a child of our age, and must build on the past as best we may.

I have been reading Mary Renault The Praise Singer for the last two weeks. It is ideal escape literature, and easy reading, but I am a slow reader with many distractions. I loved her literature when I was young, and read her avidly in the 50's and 60's. The Praise Singer tells of an ancient Greek musician. It was published in 1978, soon before her death, and passed me by. She was all woman, and lesbian before it became a fashion. Now she is published by Virago Classics, but is an unlikely icon for feminism. She doesn't write of women's issues, or even of female heroes. Per contra, her women are slaves, ill-treated wives, or hetairas. And of men, she writes with understanding: "He was learning more about the management of his javelin than he'd ever known...." "Well it is all gone by. Aphrodite herself could not raise my old spear now." Simonides is definitely of my age.

Today came the summons to attend hospital again next week to meet the mighty Mr Sengupta, perhaps to reveal the cancer's stage and discuss best treatments. Now I must build what is left as best I may, and move into a new future.

Ann continues to write her incisive brutal poetry, like a window into a hidden mind. trouble reminds me how valuable MA has been - one phone call, and she is round to help, in anyway she can. So many good wishes from so many people, often even through their own sorrows. Of the others, "whom to curse, who is unnecessary, and who is worse" sums them up.

trouble
Learning who your friends are
is valuable,
but learning who is selfish, useless, of little point,
is an indispensable guide to how to conduct the future –
who to bless
and who to curse
who is unnecessary
and who is worse.

Wednesday, 10 October 2018

Cat is dead

Sunrise in Hundon
There is no early mist, but a clear blue-sky sunrise, perhaps the last before he continues his winter trek behind the far wood and neighbour's house. Horse is standing quiet in his field. I am back in the waiting room where first I waited with Eds to receive the bad news of carcinoma of bladder. I am first in the room, and the receptionist books me into the system.

A large, bald-headed, florid man enters, dwarfing his wife, and stands at the end of the aisle. "You have to register," his wife says.

"I can't go down there - the computer's blocking it." His wife sighs and goes to sit down, "whatever you say." He moves awkwardly round the aisle to lean over the desk corner, forcing the receptionist to move. He sits, looking self-important, then suddenly smacks his scalp hard and examines his hand. "There was a fly on my head," he explains.

The Cat is removed and its corpse thrown in the bag for the fire. The nurse is a gruff, tall man with a coarse sense of humour, who looms over me. "This is one time you're glad you've only got a small one!" he laughs, referring back to the huge three-cylinder flushing job I had before. I go to the cafeteria with Ann and we consume several drinks.

MA took her to the physio yesterday for excersises to her broken hand. Waiting there, Ann got a new pack of mints out and said, "would you like one?" MA said, "thanks, mum," opened the pack, popped one in her mouth, then dropped the pack into her bag, leaving Ann mint-less. In the shop, she buys two packs of mints.

We walk round the grounds in the warm air. It is surprising what people drop or leave. By a waste bin is a clean, new, pink phlebotomy cuff, dropped when someone cleared rubbish from their pocket. In the woods under a bench is a hard hat and hi vis jacket, left by a workman after his sandwiches. In the cafeteria, I find a bright red carrier bag with a boxed radio-controlled toy, perhaps a present for a child. I leave it with the staff, and hope the child will get the gift.

Two hours later, the nurse puts me through my test.  From over 300mL, my residual is now 16mL. He beams. "This gives a new meaning to 'Free Willy'," he explains, "you're free to go."

Later I walk the dogs - their first proper airing for a week. The air is still warm, the sky clear blue. They race like puppies. I smile, for it is a beautiful world again.

Tuesday, 9 October 2018

Getting rid of Cat

Cat has been annoying me all week. It leaks badly and smells, and claws me like hot needles whenever I move. I have to wear paper pants, and use a cushion to sit. I dare not walk too far or drive anywhere. I cannot wait to get rid of the beast. I shall tell them I no longer want it, when I go back tomorrow.

Ann has been telling me all week I must listen to them, and follow their advice if they suggest I need a new Cat, but today she changed, and said she would support me if I insisted. "It's only right," she said, "you shouldn't have control taken from you."

"No," I said, "you wouldn't listen when they said you might benefit from injections into your eye. It's the same for me. When I was eighteen, that was my eye. I saw the world through it; that's why so many men judge women by imagining them in a single way, and girls always say 'boys only want one thing'".

Ann said it was no wonder I could never get a girl friend, then suggested perhaps we could get a card celebrating 'Removal of Cat Day'. She looked on line, but kept getting pictures of other men's Cats, and nasty videos showing them being removed! MA suggested they ought to have banners and balloons, as it's clearly such a big deal. I thought that was going too far, but they did buy me a small anticipatory cake to celebrate.

Monday, 8 October 2018

Clare is a different place

Clare is a strange place. It eclipses Hundon like the sun outshines the pale moon, for it is a thriving tourist centre, with many pubs, shops and tea houses, and numerous ancient sites dating to the iron age. There was a Roman town there, and a Saxon. The heirs of the Conqueror built the castle, and it featured in Magna Carta with its baron Richard de Clare. The rites to a medieval market have been held for centuries.

Hundon was mentioned in the Doomsday book, and doesn't appear to have changed much since, in population or area, other than its housing now being mostly modern brick conformities peopled by commuters or home workers like me, rather than the tithed agricultural cottages of history.

There are no historical sites here, and I am unaware of any archaeological dig or find. Even its church, though old, burnt down in 1914. It wasn't the war! The fire started even before that monstrous event. Now, it is an empty shell of history, barely used but to keep it on the ecclesiastic rolls. Its graveyard contains no famous son. There are no tea rooms, and no tourists to demand them. Its only visitors are kind relatives or friends who call from pity for we inhabitants, to take us out to for shopping or tea. And they always have trouble finding Hundon on a first visit, even with a good sat nav. But we do have a village shop, manned by (womened by? peopled by? no - staffed by, perhaps) volunteers who keep it well stocked and well run, with a hive of knowledge for we peaceful village folk.
Great train robbery at Clare

But Clare is a town, and seems to attract petty arguments that would have no place in Hundon. Last week, a notice was posted throughout the town telling of "The Great Train Robbery". This referred to an old railway wagon that used to sit on its rails in the museum. Entry was from a mock platform, and the wagon itself contained many fine exhibits from past glory days when steam locomotives thundered through the town. The museum was a useful spot to take children or visitors, but has been closed for a while. Now someone has sold off the wagon and provoked an outrage.

The Facebook pages of Clare are filled with petty squabbles. Someone posted a picture of a cigarette stub on the pavement outside the Co-op that led to a litany of accusations.
Smile Stone at Clare
There are some pretty walks in Clare, and I once spotted a Smile Stone hidden by the river bank. Shortly after were reports that 'someone has been stealing our smile stones', with many complaints and snide suggestions (no - it wasn't me. I only took the photo). But the fiercest debates are always with people who suggest Clare is a village. These are usually tourists or visitors, but this only raises a knowing smile from the residents. Then some incomer added a comment to Facebook to the effect that "they loved to live in such a pretty village". This raised over 30 replies! Clare is not a village. It is a medieval town. It was given a town charter. It has a town fair and a town market, with a High Street and Market Street. The debate was brought to an end by one resident commenting, "The difference between a village and a town is that a village has its idiot, whereas a town has two. On that basis, Clare is a city."




Sunday, 7 October 2018

My Samsung Galaxy S6 explodes!

Following the call for an explosion yesterday, my Samsung Galaxy S6 responded by exploding before I did. It was Edwin who noticed it; he wanted to check something and said, "your phone's all bent," so took it out of the case. We thought it must have been from keeping it in my pocket, but then he noticed the back had been pushed off and was badly bowed; in fact, it had been blown off its glue by the phone's innards. Closer examination showed the battery had swollen like my overfilled Cat bag, and was bulging as though about to burst. Palpation revealed a tense fluid interior that looked potentially dangerous if it had it discharged in my pants.
My Samsung Galaxy S6 blows its back off !!

By chance, Edwin had just upgraded his phone, so he passed his old Apple on to me. Now we all have Apple phones and can talk together with Apple Talk. I just have the task of learning to use the thing. I have already learnt that Apple do not play any of my recorded music! It all has to be in Apple format, or downloaded from the Apple music store. Another example of greedy profiteers putting their shareholders before us, their users.

A short while after this, I followed the Galaxy. The levels of Dulcolax and syrup of figs entering the system may have been overdone a little.



Saturday, 6 October 2018

Explosives

The downstairs toilet is patterned with book covers. There I see nothing but a row of old titles etched into my brain. One is Explosives by John Reid. The blue Pelican cover contains enticing blurb about its contents. "Tales of Explosives, their Magical Creation, their Fierce Energy, their Sudden Disruption...".  For four days I sit and stare at this, wondering when some decent explosion will happen for me to wonder at. I am taking prunes, syrup of figs, and repeated doses of Dulcolax, plus numerous cups of strong coffee on Ann's advice. But all remains silent. It is uncomfortable to be so distended, with colic and mild nausea making me reluctant to eat. But we must persevere.


The Great X offers to help

Ann has allowed me to take over her special room. This is her sanctuary, into which no-one is permitted without special and rare permission. It contains her private things, with their special meaning for place, time, or person, and is the place to which she retreats to be alone, or to recover her spirituality. Now she has put me in here to nurse. All week, she has worked tirelessly to support me, physically, mentally and medically.
The Moroccan Lamp in Ann's Room


She is having to do so many extra jobs now, for while still preparing meals, getting shopping in, cleaning, and making drinks, she has the additional burdon of jobs I used to help with: sorting the rubbish, washing up and emptying the dish washer, and cleaning the house of dog hairs and the garden of their mess. All the pain and swelling on her head where she fell and hit the pavement, with her yet broken and deformed hand still prevent driving, so she has to ask MA to take her to Clare for her hair, or to sort out ordering more catheter bags from the chemist.



This afternoon, we had a card from the Great X, covered in pink blossom and well wishes, with a message that, "she was so sorry she didn't live nearer, for she would love to help."

The Great X is a nurse who worked in a hospice, and is at her best with these cases of high dependency. She is brusk and efficient, and indifferent to medical mess. Ann said, "would you like her to come down?" Edwin offered to pick her up from the station, and MA said, "you'd love her to come. She'd be really good at looking after you."

I shuddered a little, and said I agreed that she would be very good, but I thought it might not be appropriate, and I didn't really want her fiddling with me down below.

Then the doorbell rang, and our young granddaughter, who'd been silently listening, said, "That's her; the Great X has arrived!"


Friday, 5 October 2018

I am adopted by Cat

I do not know which is more likely to become infected: residual urine, or a catheter. As a man, I know I would prefer the residual, which for a few hours gave me mobility and relative comfort. As a medic, I know catheters often leak, and are always uncomfortable and get infected. However, the surgical team decided that a pool of residual is not a good idea, so I am now confined with a catheter and leg bag for a week, which is both uncomfortable and has developed a slight leak already, so I have to have pads as well.

Patients with colostomy bags are encouraged to give them names, but this contraption is unworthy of being so distinguished. So, like Holly Golightly, I call it "Cat", for it pulls and claws my leg, requires constant attention, and I had not sought it but it adopted me. Cat feeds off me, is not house trained, and requires constant cleaning out and grooming.

Bloggers are encouraged to post photos to lighten the page, but Cat is unworthy of even a derisory photo, so shall remain incognito. I have never been attracted to cats, and this is the worst of them all. My only hope is that it will be removed from my care and put down next week; but they have already hinted that if the residual does not clear, they may foist another Cat on me, with the possibility of a prostatectomy dangled threateningly before me as well.


Thursday, 4 October 2018

A little light lie


On the day we are born, we are sentenced to death and fated to live our lives in a condemned cell. In youth, it is remote and unconsidered. With age, we learn for certainty that the sentence will not be remitted. The only unknown is the length of time in the cell. With age and cancer, the remaining time is shortened. Now I can only live each day as best I may, and enjoy those moments I am still free to explore a life yet to be lived, brief though it may be. For this is not a “clean” cancer, but a solid invasive tumour, requiring resection of the bladder wall, and eliminating the possibility of further treatment with purely intracystic local chemo.  This may require radio- and chemotherapy, or -potentially - cystectomy. 

The surgical, radiological and oncology teams will convene in two or three weeks to discuss future care. In the meantime, I continue with a bag and catheter, and such hope as I can muster. My fortune is to have such strong family support, though as yet I have not told them at work. I said, with some air of truth, that my wife would be in hospital this week, so I would have a few days off. I had not realised how racist is the phrase "a little white lie" until I started to write it; now it hits with great force, if one substitutes its opposite. I suppose this is not so little, though, as it is to protect me rather than the feelings of others. Perhaps that should be "a great red lie"; but the little ones, meant to protect rather than harm, could be called "little light lies". 



Going for TURBT


Tues 2/10/18
TURBT is "trans-urethral resection of bladder tumour". Edwin and Ann brought me to the ward in time for the 7am check in, Ann still being unable to drive. It was dark when we left, and Ann with her poor sight is unable to drive at night anyway. Eds dropped us at the door, and went back to see to the dogs.

So far so boring, then suddenly at 8am constant bustle and noise with the staff change over: cleaners with commercial floor polishers; trollies screaming like sirens as they carried patients out; an alarm from the adjacent bed going like a high pitched metronome beating out 2/4 time; and chattering nurses, auxiliaries, social workers, physios, students, the anaesthetic team, and occasional doctors. This is an acute surgical ward for all surgical specialities, so different surgical teams visit each patient. Mr Sangupta came to explain and sign the consent form: basically a legal agreement to let them do whatever they wish. It’s 11 weeks since the first sign of bleeding, and 4 weeks since seeing him and being placed on his urgent waiting list.

Ann helped me into the surgical stockings; they were tight and difficult for her broken hand. I said it was a pity Edwin hadn’t stayed, for his strength, but Ann said “he doesn’t do feet!” before she had to leave to wait in the restaurant. The op started at 10am, and was completed by 11am. Visiting wasn’t until 3pm, so Ann sent a text to MA asking her “to come straight to the hospital.” Unfortunately she sent it as a round robin, so up north Lucy panicked and started to make arrangements for the children to be collected from school before Ann could enlighten her before she set off. But MA and Edwin met in the lobby, and the three then spent the morning in town, lunching together.


Sunday, 30 September 2018

Full House


Three sets of visitors make a Full House. Sam’s parents in the morning, then Ann’s friends from Up North in the afternoon. We had been going to take them to lunch, but they arrived too late, and we had no bread for sandwiches until MA came with a rescue loaf. Then  MA, Sam and the children came in the evening and brought a curry with them.

Lorna asked if Ann had her bus pass yet, so Ann checked on line. She isn't eligible until she's 68. Also, it’s only valid in Suffolk, and there aren’t many buses she could use. She would have to drive to somewhere like Haverhill to find a bus, and they probably go to Cambridge or Essex, so she couldn’t use them.

Edwin left early for his pilgrimage “Up North” visiting Chester and Liverpool, but via Manchester as it turned out, for several lines were closed for maintenance, and Northern Rail was on strike. He went to support a fellow PhD student who was presenting a paper to the Gaskell Society, and has been asked to present the key note address at their conference next year!  

Thursday, 27 September 2018

Making a splash


We went North at the weekend, to celebrate our grandson’s 16th birthday. His father had told him it was to be a surprise, then took him to the Middlesbrough match, and he thought that was the surprise. But unknown to him, we had all assembled at the house, and hid behind the door when they returned, to leap out and call “Happy Birthday!”, so he had a second surprise and was suitably thrilled by the attention he got. Everyone was there – even the Great X – but not the boy’s uncle Dan, who went to the match, but then said “If dad’s there, I’m not going!” We have never learnt the cause of his animosity – but he completely ignores Ann, Edwin and me if he meets us, and even hurts others to avoid me.

Ann was on the Embankment in London some years ago, and our young grandson was staying with his uncle and met them by happenstance, shouting "There's Grannie Annie!" The boy ran across to greet her, but Dan stayed sulking in the shadows, and would not greet her or Edwin. Now, he cannot even bear to see me, though I have a second and even more nasty cancer to deal with. Who needs such animosity in their life? People of such ilk are not worth the knowing.

Yesterday was the pre-operative assessment at West Suffolk Hospital. They had asked for an early morning MSU, and I had carefully prepared and labelled the bottle at 6am when I got up. I put it in a plastic bag, and in a folder with its forms. As we walked towards the hospital, we suddenly heard the repeating screech of a car alarm. “Is that my car?” wondered Ann. I went back, and sure enough it was! I think the low sun streaming through the window may have triggered it. Unfortunately, in my rush, the urine bottle had slipped out of the folder. I went back to pick it up to find the bag and paperwork soaking. Ann said, “the bottle has a split in it.” In fact, it was completely flattened, with urine squeezed out with great force onto everything. The only car to have followed us in must have aimed straight at it, and run it over. In the clinic, I could only apologize, and give them a mid-morning mid-stream sample in a new bottle.


Friday, 21 September 2018

On the mild side of Wilde

Stopped at a favourite watering hole for the pint that refreshes on the way back from London.  The Three Horseshoes  is conveniently placed about half way home, just after leaving the M11 to take the direct and pretty way home. After a hard day in the office, it's good to unwind and collect my thoughts before trundling back across the slow country lanes. It's a very old hostelry, no doubt a stagecoach stop long before Stansted; possibly even before stagecoaches. It's the sort of place the Romans might have used after a hard day's road building. They have a selection of ales from microbreweries, and change at least one every week. Today they had one I hadn't seen before: Oscar Wilde, a mild beer, yet brimming with a dark quality that glinted mysteriously in the low light. A most delicious ale, worth capturing, as I will probably never meet it again.


Working into retirement definitely has some purpose with stops like these, and makes a journey to London well worth the effort. The work's good too, though travelling on the tube in the rush hour grows more challenging each year, with the crush of elbows and knees on spots that are more tender, and legs that grow tireder with the standing, becomes ever more intense.

Wednesday, 19 September 2018

An Irish border

Belfast is a youthful, vibrant, wonderful city, but one holding a dirty secret. When I first visited N. Ireland, some roads from the international airport were still blocked with coiled barbed wire and towering machine gun turrets. I came each month and watched the sectarianism being slowly dismantled, the small roads opened up again, and an air of peace spread across the ground. People from both North and South worked together at Almac in Craigavon for common purpose, and there was an air of pride and achievement in their joint labour.

Marking the border in Belfast

This summer, I visited Belfast itself for the first time, and found a city still divided. The peace lines are great walls of brick and iron, reaching up to 7 meters, topped with razor wire, and emblazoned with graffiti. They have proliferated since 1969, and there are now over 21 miles of them. The police stations along this border remain fortified, and each evening great gates close many of the roads, effectively imposing a night time curfew.



These walls seemed to put the immigrant control lines of Hungary and Macedonia into context, and make the current disagreements over a customs border with Ireland laughable. In a major European city within the UK, this is shaming.

Monday, 17 September 2018

Country Interlude


Walked with the dogs at the weekend round the fields I see from my study, before resting half way, sitting quietly on a stile. Suddenly something breathed into my ear and pressed my shoulder. I jumped up to find a horse with its head in my face. It had been the other side of the meadow when I sat down, and I hadn’t thought more about it. 
Horsey in his field

He lives in the seven acre meadows beyond my window. The people who own it break horses, and I watch them leading their young mounts in circles on halter training. Later they graduate to the bridle and saddle, and are led past our house for their road work, ready for their new owners. The grey is one of two older horses, used perhaps to lead the young ones. The land is prime building land, and NIMBY-like I hope it is not sold for development, or instead of looking out on a meadow with spring hares dancing, and deer upon the hill, I will look out on a field of small cramped brick housing and smell the fumes of commuters.



Then, turning round, a bunch of blackberries thrust themselves into my face. Almost an inch across, dripping with juice and honey sweet, they fell into my mouth at the lightest touch. Sometimes country living has good rewards.

Saturday, 15 September 2018

Backing Labour

Have rejoined the Labour Party, to support  care and fairness rather than to support the eccentricities of the present leader. I was last a member in Middlesbrough, a town strongly labour with a massive and vocal support base that ended up so vitriolic against any disagreement that it drove me out for 40 years. But I have taken the risk, and returned to the fold.

My first meeting this morning. This meeting was gentle, caring, well led, and thoughtful calmness. One person came late - the representative for women's issues - appologising that her child was playing up this morning. He'd had his first day at school this week, and for a dare had opened a drain and jumped in with both feet. His shoes were black with oozing slimey mud, so she'd put them in the washing machine. "Luckily they were Clarkes," she said, "they came out again quite OK".

Someone raised the looming problems of Brexit and the possibility of shortages of food and drugs, and wondered what should be done. The chairperson (I am becoming conscientiously PC these days, so I won't specify chairwoman) immediately pulled the meeting back to the local issues.

"No one knows what will happen, and I can't get a position from the Central Party about the attitude we should take towards a second referendum. The important things for this branch are to build support for the struggling food banks, to publicise the increasing number of impoverished children, when the prime-minister promised to eliminated child poverty by 2010, and to pressurise for more support for the school bus service, because the poorest children are forced to use schools they can walk to rather than schools of their choice, as the parents can't afford the bus fares." All, I thought, very worthy issues. I must go again.


Friday, 14 September 2018

Anticipating Finality

Each day, Ann posts a new poem on "No Coward Soul is Mine", her poetry site on WordPress. Each poem is deeply personal or introspective, usually reflecting the mournful reaction to a soul of unease. Many reflect the people closest to her - the strained relationships or deep injustice or betrayal.

She has a unique voice: beautifully crafted simple themes, minimally rhymed, punching home a message of truth. They invariably move me deeply: to tears, or to make the hairs on my neck bristle. If challenged for their source or meaning, she cheerfully proclaims "Why does everyone think my poetry is about them? It about everywoman or man!" Today's is:

 "Finality":

He died
now it is as if he never lived,
never drew breath
or held another's hand,
he is gone
and given up to death
never more
will he taste the joy that was his home,
his garden now is but a field of weeds
all he held most dear has moved on,
the man he was is forgotten,
buried deep
now his life is lost
those he left will grieve
and then move on
It could be about the great loss suffered by all who grieve, or - with two cancers with potentially fatal endings - could it be interpreted as a life beyond my own? I will not ask. Ann would always reply, "Why must everything be about you?"

E. spent yesterday in Cambridge, removing the pain of memory by revisiting shared places. He phoned to say he would take dinner there, and be late back. Clearly there were a lot of memories for so brief a time together - let's hope they are assuaged.

Ann's cousin Allan is visiting, and over the weekend will come Ben, Lucy and their families. Last weekend it was Matthew, who wanted a picture of "me and dad". Is everyone mourning before I'm gone? Do they all share secrets unknown to me? To have a deep and hidden cancer is mentally wearing. I am tired and feel weak, and I don't know if it is physical or psychological. But I'm not on the death bed yet - I dread to think how they will behave with that finality in the air.

Thursday, 13 September 2018

A (very) short break

After walking the dogs in Clare at lunchtime, I drove back onto the drive to take Edwin's place as he was to be away for a few days. Ann came running out, phone to her ear. "You'll have to park back on the road," she said. "Edwin's coming back."

Today, Edwin should have been in Denmark. He left Cambridge and the train to London. Only after boarding the Heathrow express did we learn he had had a disagreement with the friend he was flying out to stay with. He got off at the first terminal and caught the next train back.

Monday, 10 September 2018

Someone doesn't like the music of MRI


A call from the hospital to go to MRI came the next day, as there was a cancellation. Edwin took me in as Ann can't drive with her plastered arm. Three hours later I was in a theatre gown under the great magnetic tunnel, ear plugged and headphones on listening to Abba at full volume, to drown the clicks thumps and strange buzzing of the pulsing power sweeping my bladder. It took about 35 minutes, but they wouldn’t share the results.

In the second scanner was a lady who went in with me. I know she was 84, because she had to give her date of birth. She was in a wheel chair, and very deaf – her daughter kept shouting the questions and instructions to her, before helping her from the chair to the MRI bed. She has scarcely laid down, when she started screaming and refused to continue, so they had to wheel her out again. Edwin said her daughter was furious because she’d wasted her time – not to mention the lost MRI time for another needy patient.

They gave me the appointment for a CAT scan while I was there, so two days later Mary-Anne drove me in again for that. Again, they refused to show me the pictures or discuss it. And I thought they were trying to become more transparent and share patient details with we “customers” – I horrid name for a secretive service.


Thursday, 6 September 2018

A Dismal Day


It was not the best of days. Edwin took me to hospital, Ann being unable to drive. The unit on the urology ward is new: the Johanna Finn Diagnostic Unit. The wall plaque tells us it was opened by the one Johanna Finn, just a week or two ago. Ms Finn must be well thought of – usually these units are named after former great surgeons. LinkedIn describes her as a CX at West Suffolk, but don’t explain the term, which seemingly can mean “Customer Experience” or “Chief Executive”. Perhaps she sat on the name selection committee, and someone put her name forward to save any arguments.

The waiting room was filled with rows of elderly men, all looking solemn and concerned and uncomfortable. One, clearly more tense than the others, rose to speak “in confidence” to the receptionist. “Can I be allowed to go to pee?” he pleaded. “I’m bursting and I can’t wait.”
“No,” she replied. “You have to have a full bladder. You’ll have to cross your legs”.

I said, “I think that’s good advice for all of us,” and certainly there was a lot of wriggling and a number of looks of grim determination. But she did agree to go through and see where he was on the list, and managed to get him in next. He came out grinning like a school boy, and went behind the counter to touch her shoulder and thank her. I thought he had come alone as he walked to the door, but then an even older man, stooping over a stick, got up and went out with him.

“He’s a funny escort,” I mused, “he doesn’t look fit to care for anyone.”

“They’re a gay couple,” Edwin explained. “It’s sweet.”

Gradually men were called in, and left, generally looking relieved and smiling. Then my turn came. The radiologist was white-coated, brisk and efficient. “Lie on your right side,” she commanded as the cold jelly slid across, looking for one kidney, then the other. She turned me to the screen. “Those are the kidneys,” she pointed out. They both have cortical cysts, but that’s normal at your age. No masses.” Then she lay me on my back and scanned the bladder. Her silence was an ominous portend. “Right that’s all done,” she said. “You can go back to the waiting room.”

The surgeon was a turbaned Sikh, and clearly both knowledgeable and confident. “Do you know what’s involved?” he asked.

“Well, I did six months' house surgery on a GU ward,” I said guardedly, “so I did a lot of catheterisations, but I always hoped I would never have to go through one.”

He did the necessary, but I can’t pretend it wasn’t painful – like having a knitting needle pushed up, with sharp pains all the way. Then when it was over, he turned me to face the screen, “There’s a growth,” he explained. “You will need to come in to have it removed. Do you have a relative here you would like present?”

I said, “Yes, my son, Edwin. You’ll spot him. He’s the only young one, with a beard.” The nurse went out to call him.

Edwin later told me he knew it was bad news when she put her head round the door and called his name. “I thought, ‘I’m not on their list!’”, and looked round hoping there was another Edwin. But there wasn’t one. When we came out, I was the only one told to sat down, and given a pad to fill out all my details. Everyone in the room looked sympathetic, but relieved that it wasn’t them.

We went for a meal in the evening, to the Red Lion at Horseheath. There was nothing on the menu for Ann or Edwin that was both gluten-free and vegetarian, so we retired to the bar to finish our drinks before moving on to the local Indian. Then the waitress came through with a hand-written list the chef had drawn up, of dishes he could put together for them, so we all trooped back in. 

The food was wonderful, and we decided to split a bottle of wine. The waitress said the wine would be complementary, as an apology for not having a suitable menu, so the dismal day finally ended on a good and positive note, and I returned home to a good dose of my favorite medicine: Bruichladdich Islay Barley, at 50% proof and unwatered – as sweet as honey dew, and the very best amnesiac.


Wednesday, 5 September 2018

The cystoscope awaits.


Death is the price we pay for life. It is non-negotiable and paid in full equally, whatever the living brought. I await my scan and cystoscopy dreading  the discomfort and unknown results equally, aware that fear or hope changes nothing. The outcome is dictated by fate's throw, but gives me pause in a hectic schedule to gather morbid thoughts like these.

Ann sought to distract me by putting the TV on. It opened with an advert for the MacMillan Nursing Fund - "support someone you love through cancer". Oh oh! Then the news item came on about the wonderful life of Radio 4 presenter Rachael Bland, who has just died at the age of 40 from breast cancer. Double oh oh! With Ann's arm in plaster, and her swollen bruised eyes, she cannot drive, so Edwin will take me to the OP for the scan and cystoscopy.

Sunday, 2 September 2018

A Tsunami of Trouble


Yesterday became surreal. We took the two grandchildren to London for the day, to sample an Escape Room and a special tea on Park Lane. We arrived at St Pancras platform when Edwin got a call: “This is the Escape Room. There has been an incident. A woman has been stabbed outside the building on the Caledonian Road, and the road is cordoned off.” Sure enough, the police tape would not let us enter the scene of crime, so after a long detour we entered Caledonian Road from the other end. The police finally escorted us through the cordon to the Escape Room door with minutes to spare from our time slot. But "Revenge of the Sheep" was one of the best Escape Rooms we have done, although one of the padlocks had jammed and the controller had to come in with a massive set of bolt cutters to clip it off! and we completed it (with a little help) thanks to two very observant young girls.

Then, walking back up the Caledonian Road to the tube, Ann caught her foot and fell splayed out on the pavement. I saw her strike her head, and her glasses were scratched and very bent. But as she tried to sit, we could see her right hand swollen and distorted with the finger twisted out at an unnatural angle. I told Edwin to call us a taxi at once, and asked him to complete the day with the girls, they being instructed not to let him out of their sight, then asked the taxi driver to take us to the best A&E. He took us to UCH on Gower Street, and despite the crowd on a Saturday afternoon, they could not have given better of more prompt treatment. The Senior Nurse did the reduction and straightening under local, then plastered the whole thing with “an Edinburgh Gutter Slab”, possibly named for a technique developed to treat all the Scottish drunks who fell in gutters and fractured fingers! The repeat X-ray showed good position, and we were sent home with a referral letter for WSH. The virtual X-ray images would be sent automatically – one benefit of modern technology.


Finally, at home again, with the girls about ready for bed, Edwin came in and said my cousin Ed Marston of Paonia, Colorado, had died suddenly from complications of West Nile fever. He and his wife Betsey were wonderful people, always a joy to be with, and so full of life and vigour. Troubles certainly do come as great tsunamis, to attack and overwhelm on all fronts simultaneously.


Saturday, 1 September 2018

The Cry of Prostatic Anguish


Sex is a powerful hypnotic. Pre-coitus is tension, desire, shaking, like the symptoms of any craving. Then with achievement, the whole body relaxes, and the smile of peace and pleasure descends as of a great accomplishment, and one slips away in sleep as deep as after a day of fruitful toil. The smile would remain throughout the following day, my step a little lighter, my head a little higher. It was the narcotic to which I was addicted, and yearned to return for my next fix.

Today, all is still. Nothing stirs but the frustration of unfulfilled desire, for impotence has struck. It is the great pain of age, adding mocking anguish to the already ailing body. It is not a happy prospect, unhelped by unbidden frustration for my wife also, who bears the brunt of my pain.

Next week I go to hospital for cystoscopy and a scan, so this now is the triple blow, adding to the first of prostatism and haematuria, and to the second of having knowledge of all that may be involved. For as a post-grad medical student, I spent six months on a GU ward in my surgical house job, inserting catheters and peering through the telescope attachments of cystoscopy tubes, assisting the surgeon as he cut or fried the tissue. 

Now the only morning rise is to the toilet for a 4 a.m. pee, and watch as it dribble in the pan, and hope all is voided before I pull up the pyjama pants. The frustrations of age are endless, and seem to grow with the lengthening shadows, assuaged only by writing this in the pre-dawn of another restless night.