Tuesday, 1 June 2021

For those nearing the end of life's journey - the making of a Living Will

Most of us will die in hospital in old age - but the final days need not be out of your hands. In a powerful new book, consultant in geriatrics DR DAVID JARRETT, who has witnessed 3,000 deaths, reveals how you can go gently into that good night


 Doctors' strategies for their own decline

I have cared for dozens of medical colleagues at the end of their lives.

At first, I was apprehensive, thinking that I must always be on my best behaviour and discuss the full range of possible investigations and treatments. But the actual attitude of these patients was completely different.

A lifetime of clinical practice ensures there is no rose-tinted view of what can be achieved. They were rarely in favour of resuscitation and plans for ongoing treatment included clear advice on when they did not want me and my team to intervene. These instructions would often be set out in a living will.

  • A living will (or advance directive) is a plan drawn up outlining what someone wants to be done, or, more likely, not to be done, if they become ill and unable to decide this for themselves.
  • My own living will specifies: ‘If I am unable to swallow I do not want intravenous, nasogastric or other methods of feeding and hydration.’
  • You can also make something called a living statement (or an advanced statement or statement of wishes), which can be a helpful guide to care staff, especially in cases of prolonged dementia and frailty.
  • It details how you would like to live your life if you lose your mental capacity — what you like to eat, drink and wear, what type of care you would prefer, and so on. (The default option in nursing homes tends to be sweet tea and soap operas. You have been warned.)
  • My own living statement includes: ‘I would like to remain in my own home for as long as is possible. I do not take sugar in tea or coffee. I have always enjoyed the grain and the grape and would like this to continue until I die, whatever the medical advice to the contrary.’
  • Both are legal documents —although you do not necessarily need a lawyer to put them together.
  • Both need to be signed to be valid, and a living will also needs to be signed by a witness. Give copies to your family and to anyone who could be involved in your medical care, including your GP.

Thursday, 29 April 2021

Boris’s personal makeover of his official, borrowed apartment in Downing Street.

  •  I think it looks garish and reminiscent of the Ottoman Empire. Him and Carrie must be on the same wavelength.
  • However, that is not for the voters to judge but the politicos bent on mischief.
  • Chancellor Rishi could afford to pay his refurbishments out of his own pocket. Boris cannot because of his immoral behaviour, judged by the holier than thou brigade.
  • It wouldn't be an issue if his income reflected his importance to the economic wellbeing of the UK. Stop judging the man by his moral standards and see what he's achieving by sharing the essential workload to competent ministers.
  • That is the true measure of the boss-manager who assesses the country’s objectives and delegates well, like he did in London.
  • He is by nature a libertarian, but then so have many of our leaders had their flaws. See what happens to the UK over the next few years before sticking the knife in.

Sunday, 25 April 2021

Cor Blimey Cummings!

  • To get to the heart of the problem, Cummings was described by David Cameron as a career psychopath.
  • I think the definition of a Sociopath is more accurate, since people of this ilk tend to be more erratic, rage-prone, and unable to lead as much of a normal life.
  • At the heart of it all, lies an overarching personality disorder I wouldn’t be surprised to find revolves around narcissism.
  • According to the Mayo Clinic, narcissistic personality disorder can be defined as: “A mental condition in which people have an inflated sense of their own importance, a deep need for excessive attention and admiration, troubled relationships, and a lack of empathy for others. But behind this mask of extreme confidence lies a fragile self-esteem that's vulnerable to the slightest criticism.
  • “The conflict between insecurity and self-obsession causes people with narcissistic personality disorder to be generally unhappy or disappointed when the world doesn’t offer them special favours or admiration.
  • The Clinic’s site adds: “They may find their relationships unfulfilling, and others may not enjoy being around them.”
  • “The extent to which Cummings has attacked the Prime Minister is so explicit that they reflect his contempt for him, in comparison with himself, over long period.
  • Fine, Cameron saw Cummings for what he is, Boris didn’t. Now he’s reaping the fallout from his misguided sense of trust in this emphatically weird advisor.
  • We should all know that Boris is skint from his sexual adventures. The pay of the Prime Minister is woefully inadequate anyway for the key role he has to play.
  • His role is to delegate effectively to ministers, which he does to all appearances, after taking advice from his deputies, which clearly doesn’t always include Cummings. He also appears to err on the side of caution, which is no bad thing.
  • The vitriol poured on him by this adviser is meant to wound, irreparably.
  • Given the immoral, spiteful source, I’d ignore it. Boris has responded magnificently by rising to the unexpected challenges thrown at him.
  • Cummings should have shown prudence in his contemptuous attack on the PM.
  • Disloyalty like this will surely reap its own version of justice, since it’ll be a brave man who offers him employment.

Thursday, 15 April 2021

What we are surely witnessing is the implosion of the EU.

  •  The refusal of a host of countries in the EU to honour the international arrest warrant and accept criminals from the UK has brought matters to a head.
  • Now we have attempts to force the UK to accept the Northern Ireland protocol and align its trading practices with those of the EU. In other words, draw a line down the Irish sea and force NI to adopt measures that are causing riots from loyalists.
  • There are backlashes from EU countries that have no desire to honour the free movement of its citizens within the Schengen area.
  • It’s a free-for-all held together by a currency, the Euro, which relies for its survival on a political agenda. It has no fiscally appropriate way of binding those few nations that are propping it up by supporting those who have been the beneficiaries of their generosity.
  • Until now, the UK has paid disproportionately for its membership of this self-rewarding bureaucracy by acting wittingly as its milch cow. Germany is refusing to take over the role, France is afraid to because of its riotous population and the outrageous benefits it gets from the Common Agricultural Policy, and Spain is doing its best to incentivise tourism.
  • Boris is playing the EU at its own game by negotiating with EU officials on the nitty-gritty of minutiae, calling them ‘our friends’, which they are anything but.
  • They resent bitterly what we did. We have effectively dismantled their unity and withdrawn their main source of subsidy.
  • Insiders who wanted the UK to remain in the EU have insisted that change can come from within, by staying aligned to it.
  • Nonsense, it will never change its ways, like shifting between two locations for its over-bloated ruling class and associated army of servants. It is a nightmare of a liberal regime that the majority of UK voters judged to be unfit for purpose.
  • The pandemic brought matters to a head. Now watch as it implodes because of its creaking foundations.
  • The UK could play an ongoing role by spearheading a new currency to benefit itself and other, less sizeable discontented countries like Poland. Call it the Beuro, give it proper fiscal unity and a streamlined, decentralised civil service to be proud of.
  • Fortune favours the brave.

Thursday, 18 March 2021

Place your bets!

  •  Place your bets ladies and gentlemen - and those in-between!
  • Without fanfare, I predicted that the Coronavirus would turn into a pandemic.
  • Now a new virus has emerged, called NIPAH.
  • A leading scientist has claimed that it could spread like wildfire if it spreads more widely amongst humans.
  • It causes vomiting, seizures and brain-swelling and results in an over 75% death rate. 17 out of 19 people in India died from it, as it is so far confined to parts of Asia. The first recorded outbreak was in Malaysia, transmitted from infected pigs to farmers. Its incubation period is 45 days and mutations are rapid and deadly.
  • There are two leading groups who have a potentially invested interest in spreading it: those wealthy billionaires who feel the world is vastly over-populated and have said so. The other is undemocratic governments whose ruthless leaders feel more secure than the lesser, social groups.
  • Now I suspect that this contender, Nipah, is likely to succeed where its predecessor is apparently failing. The likelihood is that it will be used as a biological weapon.
  • Will an underpopulated world be a better place in which to live? Not if the potential perpetrators live to reap their rewards. Like the Roman senators who stabbed the erstwhile dictator Julius Caesar to death, they must be hunted down and neutralised, guilty of making the killer blow or not. True democracy depends on it. One point about my terminology: I see no value in punishing the guilty with incarceration. Our descendants will find ways of dealing with evil, chemically or by spiritual means that change their personalities permanently, to render them harmless and repentant.
  • The only consolation is that we all have to die sometime, a factor which many of the younger generation overlook in their naivety, as judged by their voting intentions.

Tuesday, 2 February 2021

Just When a Blue Sky Emerges

Just when you think things will soon be back to normal, Covid mutates into a variant that bypasses the existing vaccines.

  • The government is mass-testing in the Surrey area next door to where my younger daughter and her family live. Scientist believe that the South African strain of Covid is emerging amongst those who have no connection with South Africa.
  • My suspicion is that there is no connection whatsoever, but a mutation of the Kent virus into what resembles its South African counterpart.
  • I fear that the saga is going to continue, until scientists find a general vaccine that stops it in its tracks.
  • I hope that China, the probable source of a virus that looks suspiciously manmade, suffers the consequences of its probable actions.
  • There’s no smoke without fire, nor should a country ruled by a single party and backed by an armed force be allowed to continue its aggression with impunity.
  • Not in the 21st century nor in similar countries like Russia, Myanmar, Iran, or North Korea.

Monday, 1 February 2021

The Great Plague

  •  Mindful of the current great plague, Covid, I watched a TV program about the bubonic plague that killed almost a quarter of London’s population over 18 months in 1665 and 1666.
  • It showed the outlandish garb worn by doctors featuring a birdlike leather beak holding aromatic herbs to be breathed through and a gauze to peer ahead.
  • The body was enclosed head to foot in a waxed, waterproof robe, giving full protection, along with leather boots, against infection.
  • Modern scientists tested them and stated that they were highly effective against a disease known to be spread by fleas and lice.
  • A house that contained the victims had to be emptied, a cross painted on its doors, then its interior painted with limewash and fumigated with fumes given off by water-drenched salt petre and brimstone. Quarantine lasted for 40 days, after which it could be occupied.
  • Again, scientists proved how effective these measures were. The root cause of the contagion was the total insanitary conditions in which people lived at the time.
  • Why am I telling you all this? Well, it’s because I had an experience recently that made me dredge up my wariness of rats, which were blamed by the populace for spreading the disease.
  • A lid on a large jar of pickled onions was wedged tight and couldn’t be budged, so I went into my shed to look for a rubber pad to help grip it. Poking around in a tattered plastic bag where I thought I’d put it, my finger prodded into something soft. Quickly I pulled it out, soon to be followed by a dozy-looking, plastic chewing rat that stared running around in circles.
  • I thought it looked quite cute, but fearful of being bitten, I gave it a whack with the palm of my hand to stun it, wearing gloves by now, then carried it outside, to lob it over the fence at the rear of the house. Onto the deserted walkway it soared, never to be seen again.
  • The parallel is this: it is people acting as modern-day rats who are now spreading the disease. Is it thoughtlessness on their part, indifference, or knowingly deliberate?

Friday, 22 January 2021

EU is cutting off its nose to spite its face

  •  The fun and games have started, as reported in the Daily Mail today.
  • High Street retailers and luxury brands threaten to burn products returned by EU internet shoppers rather than bring them back to Britain to avoid cost and hassle of Brexit red tape - as online prices rise by a THIRD on items from EU
  • Internet shoppers are facing extra duties and charges for goods to be delivered
  • Has meant many shoppers in UK and EU have rejected orders and refused to pay 
  • Could be cheaper for retailers to burn the goods rather than pay the return costs 
  •  In the body of the article, actual cases are reported, so it's not a case of 'could' but is happening on a wide scale.

mail article

It's called cutting off your nose to spite your face. I'm talking here about EU intransigence and the huge trade imbalance in their favour and at our expense.

Saturday, 26 December 2020

Boxing Day

  •  Have you ever wondered why it’s called Boxing Day?
  • It’s because it was the day when the rich packed presents and gave them to the poor for Christmas. It was also the day when masters of rich households gave their servants a day off.
  • So, there you have it, and there was me thinking it had something to do with boxing some poor unfortunate’s ears!
  • It was tick a tick good timing for Brexit, manipulated by the Eurocrats in Brussels to coincide with their holidays.
  • I don’t know what you think, but to my ears it’s good news. To compete on our own terms against a conglomerate of nations, most of them minnows picking off our entrails can only be to our advantage. The boss nations have always benefitted more than the UK from exporting, using a poorly performing currency.
  • This may seem to be gloating if you’re in favour of the profligate free-loaders in charge of the EU but if I’m right, watch us soar.
  • I wish us all the best for the new year, so whatever your political leanings, join me in raising a glass to beating an invisible enemy invasion.

Wednesday, 16 December 2020

The proposed 3rd Runway at Heathrow.

  • I live within 20 minutes of a well-established airport. It has been a revelation to look up at the sky and hardly ever see a jet trail overhead. The air feels purer and the stars can now be seen with great clarity. I am more conscious than ever before of the contents of the trail descending on us from the aircraft that flew noisily overhead.
  • The jet engine exhaust contains carbon dioxide, oxides of sulfur and nitrogen, unburned fuel, soot and metal particles, as well as water vapour.

  • Today I listened to a specialist being interviewed about the need for the 3rd runway at Heathrow. His point was that the compliance by this leading airport with new regulations on carbon emissions was based on its own usage, not on the aircraft using it. The implication was that increased capacity would result in a disproportionate increase in poisonous gases being sprayed on those living below, to what gain?
  • In the new age of travel, these extra flights would largely comprise outward and inward bound passengers taking holidays abroad, plus passengers using Heathrow as a hub, without actually contributing anything to the British economy.
  • Is it worth it? Isn’t the health of local residents more important? I know where my sympathies lay.

Dominic Cummings, Strategic Advisor to Boris Johnson.

  •  I took a special interest in this alleged psychopath after hearing his rambling, incoherent, defense of his imprudent drive to and the north of England to plonk his sick son on relatives.
  • The return journey, with his assertion that he took a divergence to ‘test his eyesight’ raised a lot of eyebrows, mine included.
  • What struck me was his inability to express himself with the lucidity and articulation one might expect from a first-class History graduate at Oxford, who was also the beneficiary of a splendid private education before that.
  • Contrast that with our ebullient PM, who is equally well educated with a first-class degree in English at Oxford. Chalk and cheese they are, in reverse order.
  • I have since wondered if Cummings paid someone else to take written exams for his degree, as I suspect was the case with an American I worked for, whose actual English was clearly sub-standard. It was at odds with his post-degree thesis in early English History, also obtained at Oxford. In no way was he worthy of a Ph.D. He too seriously lacked articulacy.
  • Contrast Cummings’ menacing and dominicking behaviour behind closed doors in Downing Street, with that of the puke-inducing shrivelling ball in the garden and my wonder grows. It was a Jekyll and Hyde split personality showing a face to the world that was anything but erudite.
  • I have a deep suspicion that he would dearly love to possess the magic gene that is claimed to exist within people born to be mathematicians. Realising that he cannot, he puts them on a pedestal and loquaciously offers them job opportunities, reporting only to himself. It’s an envy complex, as revealed by the pseudo-science he spouted in his job offer.
  • I can imagine him performing in bed, shouting for all the neighbours to hear, in the singular, “I’m Cumming, I’m Cumming!”, with his disinterested wife knowing he wasn’t thinking of gratification, but of himself gaining the prefix ‘Sir’. I bet a pound to a penny that Lord Boris will undoubtedly, at a future date, bestow it on him.

Saturday, 31 October 2020

Covid 19 - A Timely Lesson from Asia

  • An extract sourced in El Pais.
  • The Japanese finance minister, Taro Aso, responds with one word when asked how Japan has dealt with the pandemic so much more successfully than the West: mindo – literally meaning “people’s standards.” A complex term, mindo, is also used in Japan to indicate national superiority and can be translated as “cultural level.”
  • Aso says the Japanese have been vigorously complying with strict hygiene measures, despite the fact that the government has never had any intention of imposing fines. He adds that, in other countries, people would be incapable of behaving like that, even if the measures were enforced.
  • It should be pointed out that other Asian countries such as China, South Korea, Taiwan, Singapore and Hong Kong have also managed to keep the pandemic under control. In fact, in Asia, there has been virtually no reinfection and current infection rates are so low they are of little consequence while Europe and the United States are being completely overwhelmed right now by the second wave of the virus.
  • It is precisely these Asian countries that demonstrate that the pandemic can be successfully dealt with, even in the absence of a vaccine. Meanwhile, Asians watch in astonishment at the helplessness of Europeans who appear to be at the mercy of the virus, and the impotence of Europe’s governments in combating the pandemic.
  • Given the striking contrast in infection rates, it is almost inevitable that we ask what Asia does that Europe does not. The fact that China has been able to successfully contain the pandemic is partly due to the rigorous surveillance – inconceivable in the West – that individuals are subject to. But South Korea and Japan are democracies. In these countries, digital totalitarianism such as exists in China is impossible. However, in Korea, the digital monitoring of contacts is relentless and is the responsibility of the police rather than the health authorities; contact tracing is done by applying the kind of methods used by forensic criminologists.
  • Obviously, the liberal West cannot impose surveillance on individuals the way the Chinese do. And that, of course, is as it should be. The virus must not undermine our freedom. However, it is also true that, in the West, as soon as it comes to social networks our concern for privacy rights go out the window. Everyone suddenly bares all. Digital platforms such as Google or Facebook have unrestricted access to the private sphere. Google reads and analyses emails without anyone complaining about it. China is not the only country that collects data from its citizens in order to control them and keep discipline. A person’s credit rating in China, for example, is based on the same algorithms as Western credit assessment systems, such as FICO in the US or Schufa in Germany. Looked at like this, panoptic surveillance is not an exclusively Chinese phenomenon. In light of the fact that we are already subject to digital surveillance, anonymous contact tracking via the Corona-App could be considered quite harmless. But digital contact tracing is unlikely to be the main reason Asians have been so successful in fighting the pandemic.
  • It is important to have civility, collective action during a pandemic. When people voluntarily follow hygiene rules, there is no need for controls or enforced measures, which are so costly in terms of personnel and time.
  • Europe is failing to show character in the face of this crisis. Rather, what Western liberalism is showing is weakness. Liberalism appears to be conducive to the decline of civility, evident in the fact that groups of adolescents are holding illegal parties in the midst of the pandemic, that police who try to break these parties up are harassed, spat at, or coughed on, and that people no longer trust the state.
  • Paradoxically, Asian communities who voluntarily follow the hygiene guidelines actually have more freedom. Neither Japan nor South Korea has imposed a total lockdown. And the economic fallout is far less serious than in Europe.
  • One ends up having more freedom if one voluntarily imposes restrictions on oneself. For example, those who reject the use of masks as an attack on freedom end up having less freedom.
  • Boris – you need to answer the questions this summary poses, as shown in El Pais, if you are to save the economy from ruin. Self-discipline is seriously lacking in the population.

Friday, 23 October 2020

High-Speed Rail-Link Is Vastly Overpriced

  •  Given the spiralling cost of combating the ongoing pandemic, surely now is the time to reconsider the vastly overpriced HS2 Project?
  •      I repeat my assertion that the need could be met by replacing scheduled rail services with a constant loop of electric vehicles, assembled in automobile factories being declared surplus to requirements.
  •      They would take up the slack in the car market, for example, and not require the infrastructure associated with rail travel. Also, the noise blight for those living en route would be eliminated.
  •     Why oh why do I encounter a wall of silence from the government on this subject?
  • Brunel would be turning in his grave.

Saturday, 3 October 2020

Money Money Money, It’s a rich man’s world!

  •  You betcha it is! Especially for the likes of Bookbub for whom it is all about the money, honey.
  • Founded in 2012 and privately owned, it employs 120 people. It is described as a book discovery service featuring free and discounted books, selected by its editorial team.
  • Largely, it was a channel for the major publishers and best sellers as reported in leading newspapers.
  • I say WAS, because the well must have run dry. They’ve discovered that advertising by authors desperate to get noticed is also potentially lucrative. Those same authors, like me, who are called INDIES are independent of the mainstream publishers and cannot attract conventional literary agents. These have been swamped with a backlist of previous authors whose books they cannot shift and are a barrier to emerging authors. I had the most helpful correspondence with one, who represented J K Rowling in her early days but had since retired and couldn’t help me incisively.
  • I suspect that Bookbub has exhausted its mainstream revenue because, in common with many other INDIES, the complaint was we didn’t stand a cat in hell’s chance of crossing Bookbub’s threshold whilst it continued.
  • By my calculations, it costs thousands in whatever currency to advertise, as a ‘partner’ with them, with scant chance of a decent return. This was confirmed on the 1st of October when one of their blurbs landed in my email inbox.
  • To quote: it gave an example of an author who combined BookBub Ads campaigns with a ‘Chirp’ Deal. He sold over 2,000 copies of the audiobooks in his science fiction series in a single month! 35% of those sales came directly from the ad campaigns. These combined promotions generated enough revenue for him to earn back more than half of what he invested to produce these three audiobooks.
  • The key here is 35% of what it COST him to advertise! Like with Amazon, Bookbub is the true winner when it comes to ‘investing’ in advertising.
  • During the Coronavirus epidemic, I gave away all my ebooks via Smashwords, to satisfy the demand from a new readership anxious to do something to fill their spare time. The ebook requests invariably started with one book being requested, then all the others I’ve written were ordered in quick succession. Even though, at the end of each book, I request an impartial review from the reader, not one ever materialized.
  • Despite my output being given really good reviews by the industry leaders like Kirkus (itself backed by leading publishers), Bookbub has consistently rejected my stories. Now, they want to generate extra revenue from another source, INDIES.
  • So why bother to write? The answer is it’s because I have stories to tell that I enjoy creating and are worth telling, to me at least.
  • Have any of you seen a film called The Spider’s Web – Britain’s Second Empire? It’s on YouTube and is an eye-opener on why the EU can never hope to follow the terrible example set by the UK and the USA. It forms part of my latest book about a future detective.
  • Bookbub and its ilk are, in my opinion, leeches to be removed with a lit fag end. The book publishing industry is full of bloodsuckers, so take care where you tread, if you follow this path.
  • The illiterate vultures are on the lookout to fleece the gullible literate.

Monday, 28 September 2020

A view of the ongoing debate on Covid 19

  •  This morning, on the offchance of Kay Burley having something worthwhile to ask about Covid 19, I listened intently to her interview with Minister of state for Social Care, Helen Whately. Here is a person of impeccable background; her father was a surgeon and her mother is a physician; educated at a private Catholic school for girls, she entered the sixth form at the independent Westminster School in London; thereafter, she went to Lady Margaret Hall at Oxford and became a member of the Oxford debating Society. So it goes on: a star in the making, intent on ‘getting things done in healthcare as a whole’.
  • Even with an early career at PriceWaterhouse Coopers as a trainee Management Consultancy and thereafter as a manager at Mckinsey’s in their Healthcare Division, something is lacking in her personality. She entered politics in 2015, has been savaged in various key interviews and has clearly been tutored in the art of answering questions.
  • On the other hand, Kay Burley was brought up in Wigan and has had a lifetime in the media. She was recruited by, so Wiki reports, heaven forbid, Andrew Neill, who will shortly be heading new channel GB News. With luck, she’ll be joining him, which means to me I can ignore the pair of them at one go.
  • Controversies? She’s full of them, as listed on Wiki. Like,
  • It started in 2001, with her claiming that there’d been a terrorist attack that had decimated the USA’s entire eastern seaboard. She was referring to the September 11 attacks in Manhattan.
  • The list is endless, such as when, in 2018, she commented on the use of the Burka to hide facial recognition by comparing it to the lack of facial expressions by Simon Weston, the war hero whose face had been disfigured in the Falklands War.
  • Bearing her repeated gaffes in mind, when interviewing Whately this morning, she insisted on getting an answer about students being forbidden to return home for Xmas, to be with their families.
  • This is where I began to get frustrated. Why on earth didn’t Whately respond by personalising her response? She could have thrown the question back at the inept Burley by asking what if the student concerned has Covid 19, and the rest of the household will assemble with mixed age groups? What then? Do you risk killing the older generations?
  • No doubt, Burley will retort, ‘I’m only asking on behalf of my viewers!’ to which Whately could smack her down by replying, ‘No you’re not! You could have said it yourself, instead of asking me, if you’d thought of it!’
  • Really, the pair of them are well-matched in gormlessness.
  • Three hours per selected weekday of Burley is more than I can stand. How much of this elected minister are we going to have to endure, when she clearly cannot think incisively? In political terms, no matter the pedigree, one cannot make a silk purse out of a sow’s ear.