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 in 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.

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.

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.

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.

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.

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.

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.