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If I should die…

A while ago, I was asked to contribute 300 words outlining my attitude to death to a publication and for a reason that currently escapes me. As far as I know, they sank without trace, but in these days of easy online self-publication no gobbet of text, wrung painfully from my consciousness on to the hard disc, need be wasted. So here it is:

As a 72 year old who’s highly vulnerable to COVID infection, I’ve had good reason to consider my mortality recently, and while I may claim not to fear death, I do fear dying alone on the ITU, away from my family. 

In more normal times I suppose I view death as something to be postponed as long as possible, but because I can’t choose when to go, I have to (cliché alert) live each day as if it was my last. And I’m lucky – I have a good life, with a lovely family, a comfortable pension and reasonable state of health, and people inviting me to write 300 words on my attitude to death, affording me the luxury of concentrating on the here and now and making what’s left of my life a good one, in line with my humanist principles. But it’s easy to imagine circumstances where that might not have been the case, and where I would now be viewing death as a release.

Of course, if I get time to prepare for death, rather than going under the wheels of a bus, there will be regrets at the stuff I’m going to miss as my children and grandchildren’s lives unfold, but I hope there will be some good memories for those who survive me. And while I find it odd (doesn’t everyone?) to imagine the world going on without me, I remember that in a few billion years the sun will become a red giant and engulf the earth, so in the great scheme of things, mine is just one little life and my death will be equally inconsequential. From stardust we come, and to stardust we return, and while religious folk may find that a bleak outlook, I would rather rejoice while I can at the wonderful improbability of my brief existence.

And that was it. Now I realise that to some of you that reference to stardust will trigger something akin to nausea, as you recall mawkish funereal references to ‘a new star in the sky tonight’. But of course, it’s true – we do all come from stardust. When I was a funeral celebrant, I often used part of the quote that follows after I referred to our bodies “returning to the earth and air, which is the origin of all living things”. It comes from Neil deGrasse Tyson, the American astrophysicist.

The atoms that comprise life on earth, the atoms that make up the human body, are traceable to ancient stars that converted heavy elements to light elements under extremes of temperature and pressure. These stars went unstable in their later years and exploded, scattering their enriched contents across the galaxy – carbon, nitrogen, oxygen and all the fundamental ingredients of life itself. These ingredients became part of gas clouds that condensed to form the next generation of solar systems: stars with orbiting planets; planets with the ingredients for life.

So when you look up at the night sky, know that yes, we are part of the universe, and we are in the universe, but perhaps more important than both of those facts is that the universe is in us. Don’t feel small, feel big, because the atoms of your body came from the stars. Feel connected too, because everyone around you is just the same, we are all atomically connected to one another. We are, not figuratively but literally, stardust”.

I especially like the last two sentences (although I always read it as “anatomically connected”, and have to correct myself). That essential connectedness is at the heart of humanism, with its ‘we’re all in this together’ vibe. I suppose it’s at the heart of many religions too, but with religion, the dogma can get in the way of that underlying truth, and result in people flying aeroplanes into high buildings. Which is a shame.

En route to the 19th hole

Recently, scrolling through the channels to find something worth watching, I came across a golf tutorial, and it occurred to me, not for the first time, that most attempts to teach newcomers how to play golf, or anything else come to that, are delivered by people who know too much about their subject, and are consequently of little use to the true beginner. For example, the golf professional in question was starting with the assumption that his pupil was able to hit the ball. Anyone who has tried to hit that tiny ball with an equally tiny club will know that not only is it the foundation of the game – truly a sine qua non – it is also impossible to teach anyone how to do it.

I have made several abortive attempts to take up golf over the years, and I know that ‘fine-tuning the swing’, which is what the TV expert was attempting to do, can only come after hours of swearing as the ball trickles off the tee or remains resolutely unmoved. But there’s a lot of other stuff you can be addressing in the meantime, and given my serial failures, I think I have a lot to offer in this regard. As a starter, I’d like to address a few FAQs that might reasonably materialise should anyone decide to offer a true beginner’s course.

When I hit the ball, a rare enough occurrence in itself, I find that it swerves to the left, and ends up on the wrong fairway.

Solution: You are probably using the wrong coloured tee. I find that a yellow or green one is much more satisfactory than red or blue in avoiding the hook (I’m assuming you are right-handed), but this is a personal thing, and you need to experiment a bit. However, you should ask yourself if you really want to cure this tendency. You are unlikely to start hitting the ball straight any time soon, and ending up on a fairway – any fairway – is greatly preferable to being in the rough or, even worse, the car park of an adjacent Tesco. At least then you are in with a chance of finding your ball, and perhaps even hacking it back in the direction of the appropriate hole – and of course, finding your ball is one of the chief aims at this stage of your golfing career, when the number of balls required per round tends to be a more useful performance indicator than the number of strokes taken. A word of warning though: keep an eye out for people tackling your adopted fairway in the conventional direction, as novices taking this alternative approach can often be recognised by the shallow dimpled depressions on their foreheads.

NB: Sometimes, your tee shot (or your 2nd to 6th+ shot) will end up on an adjacent green. In this case, you should only play your iron shot if you are sure no one can see you, and remember to replace the divot(s).

When playing into the wind, a shot with a 7 iron which would, on a good day, go at least forty yards, only goes ten or so. Attempts to hit it harder only result in me missing the ball completely, or losing the club over my left shoulder.

Solution: On a blustery day, only play those holes where the wind direction is favourable. On most courses, if the wind is constant, half the holes will require you to hit into the wind, and on the other half, the wind will be behind you. Agree at the start just to play the downwind holes twice, or better still, play them once then go for a drink. On the sort of course you are likely to be using, no one else will notice or care; in fact, you may well find you are not alone in taking this eclectic approach. Another note of caution is needed here though: while a following wind may indeed add distance to your shots, it will also make it more difficult to find the ball, given that it’s unlikely to be anywhere near the fairway. And as far as the adverse effects of trying harder are concerned, see next section.

Incidentally, I was glad you specified a 7 iron in your question. Never attempt to use a longer club (i.e. one with a smaller number). At this stage of your snail-like progress towards achieving a handicap, you will hit the ball further with a 7 iron than with any other club, except perhaps when you get lucky with a pitching wedge and send it soaring over the green and hit a player on the next tee. In particular never be tempted to use a wood (they’re the ones with a big lumpy end that have socks on them) – it will only bring frustration and unhappiness.

When things are not going well on the golf course, which by definition is most of the time, I find that the harder I concentrate, the worse it gets.

Solution: You noticed that, did you? I don’t want to get too metaphysical, but I think there is a lesson for us all here, golfer or not. There is a common tendency to assert that sport is a template for life; that it is somehow “character-building”. Proponents of this philosophy usually witter on about the playing of rugby at school and the taking of regular cold showers. This is nonsense of course: school rugby and cold showers produce those characteristics seen at their most refined in effete traitors, dim and unimaginative politicians and emotionally retarded bankers. However, in this one example of trying too hard at golf, I think there truly is a Lesson for Life. Your best shots will be played when you lose concentration, relax and go with the flow. Trying to do it right produces the tense muscles, anxiety and fear of failure which guarantee disaster. The answer should be easy – stop trying and just let rip – but if you’re British, that’s easier said than done. I suspect that the only answer to this particular problem, and possibly to life in general, lies in alcohol or recreational drugs.

This was just a taster: if you have found this advice helpful, please buy my book “Golf? Why?”, which will be available in bookshops shortly. If not, and especially if you regard golf as a pointlessly frustrating pastime, congratulations.

Assisted dying and the medical profession

Legislation to legalise assisted dying is currently progressing through Parliament. Now I’m a paid-up member of Humanists UK, an organisation which has long campaigned for easing of the legislation around assisted dying (AD), but this is the only issue (so far) where I disagree with their opinion.

The supposed safeguards against abuse in the proposed new law require medical involvement. The request for AD must be signed off by the patient’s own doctor, and also by a second, independent, practitioner. Sound familiar? It should, because it mirrors the requirement included in the 1967 abortion legislation for two doctors to authorise the termination before it is allowed to proceed. The intention was to allow termination only where certain conditions concerning the health of the mother or foetus were met. It was certainly not intended to allow abortion on demand, but 45 years later, that is what we have. i don’t want to get into discussions about abortion here, and I’m certainly not in the Roman Catholic/’pro-life’ camp, but it does illustrate the way in which incremental changes can occur when legislation is less than watertight (as all legislation ultimately is).

This is the ‘slippery slope’ argument advanced by opponents of changes to the AD legislation, and rubbished by its proponents. Fortunately, we don’t have to hark back to 1967 for examples of the way in which mission creep can undo the best of intentions. In 2002, the parliament in the Hague legalised euthanasia for ‘patients experiencing unbearable suffering with no prospect of improvement’. Due no doubt the open-ended and subjective nature of that criterion, a law which was aimed at patients with terminal illness has been applied to, amongst others, young people with mental illness. Perhaps the most disturbing example is the forcible dispatching of a dementia patient who had to be held down while the lethal injection was administered.

In fact, doctors in the Netherlands are becoming less willing to get involved in AD, and the number of cases has begun to decline. Their concern is summed up by Theo Boer, a Dutch ethicist, who said:

“When I’m showing the statistics to people in Portugal or Iceland or wherever, I say: ‘Look closely at the Netherlands because this is where your country may be 20 years from now.’ The process of bringing in euthanasia legislation began with a desire to deal with the most heartbreaking cases – really terrible forms of death, but there have been important changes in the way the law is applied. We have put in motion something that we have now discovered has more consequences than we ever imagined.”

Proponents of law change in the UK will counter with the argument that the new law will stipulate that the patient must be suffering from an inevitably progressive condition which cannot be reversed by treatment, and as a consequence of which they must be reasonably expected to die within six months. While this is a bit more prescriptive than the wording of the Netherlands legislation, it is still open to interpretation – not least, that ‘reasonably expected’. All doctors know that prognosticating on life expectancy is an inexact science, and the popular press delight in reporting the experiences of patients who ‘proved the doctors wrong’. It will not be long before doctors will be expected to authorise AD in patients with conditions which by their nature are difficult to predict, and where patients suffering a relapse and finding continued existence insupportable may well feel differently when in remission. It is also the case that some people suffering from terminal illness will feel pressured – either by their conscience or by their beneficiaries – to go down the assisted dying route in order to avoid being a burden on their carers.

I could go on about the probable effects of any easing of the legislation, but what I want to concentrate on here is the unquestioning acceptance of the fact that doctors will have a central role in this process. Not only are doctors assumed to be responsible for authorising AD, as described above,  the draft legislation also requires the input of the ‘assisting physician’ at every stage of the process. Naturally, the patient’s doctors will have made the diagnosis, assessed the prognosis, and treatment will have been given. But if, when the patient has been counselled concerning further available treatment and likely progression of their disease, they still wish to explore the possibility of AD, any further medical involvement should be limited to the documentation of the discussions held with the patient, and a description of the likely course of their illness and the options for further treatment or palliation. There is nothing in medical training which equips us to rubber stamp or reject the decisions of patients in such a difficult situation. And there is certainly no need to involve medical staff in the prescription or administration of the lethal draught or injection – there are now plenty of examples of non-medical staff prescribing drugs according to an agreed protocol, and if non-medical personnel can be trained to take blood, they can also be trained to give intravenous injections where that is necessary.

Doctors don’t train for six years or more in order to kill patients, and if society wants to establish an AD service, then society needs to set up the necessary infrastructure to deliver it. This would require dedicated premises, not within a hospital but conceivably in the grounds of one, staffed by trained non-medical personnel with the necessary interpersonal skills and knowledge of the legislation and the processes that flow from it. It should allow for the accommodation of non-religious and religious patients in appropriately peaceful surroundings. There will also, of course, need to be a mechanism for delivering the service in patients’ homes. We should not allow the medical profession to be dragged into the termination process in order to allow the pro-change lobby to bury their heads in the sand, and keep their hands clean, if I can be allowed to mix metaphors. The mechanism for providing this infrastructure will need to be set up in parallel with the passage of any new legislation, but I see no sign that anyone is addressing the issue, or has even considered it.

In short, simply passing the legislation currently before parliament without any planning for the implementation process or consideration of its long-term consequences, will result in a confused situation open to abuse, and with the potential to result in even more distress for patients and their loved ones. If doctors wish to retain the trust of patients, without which the practice of medicine is difficult or impossible, they should politely decline to become involved in state-sanctioned killing.

Contested? Really?

I am that rarest of creatures, someone who enjoys rugby union (RU) and rugby league (RL) equally. I have therefore watched many hundreds of games in each code over the years.

Fans of RU will have noticed that there has been a lot of soul-searching concerning the current status of the game in recent months, and in The Times sports pages at least, the arguments have acquired Jesuitical intensity. Almost all of this relates to the refereeing of the breakdown, and most of it goes straight over my head. But it seems to me that the journalists are ignoring a very large elephant in the room, namely, the scrum.

As a RL supporter I have become used to the derision of one-eyed RU fans concerning uncontested scrummaging. For those not familiar with the game, if a scrum is awarded in RL, the opposing forwards just lean on each other without pushing, the scrum half feeds the ball into the second row and then nips round the back and passes it out to the speed merchants. It takes about 30 seconds from the referee whistling for the offence to the ball arriving in the  in the back line (well, perhaps a bit longer towards the end, when the forwards are knackered). RU aficionados take a lofty attitude to this behaviour, claiming that the scrum is a worthy centrepiece of their superior game; a battlefield for real men, not a bunch of wimps leaning on each other for a rest.

And that might once have been true, but now?  When RU fans talk of contested scrums, what exactly do they mean? It used to be simple when I were a lad; the scrum was a way of restarting the game after an offence, giving a significant but contestable advantage to the team putting the ball in. But surely no one believes that there is any contest for the ball in the modern professional scrum – when was the last time a hooker actually hooked? The scrum half, like his RL counterpart, is allowed to feed the ball into the feet of the second row, and winning the ball against the head is almost unheard of. If the ball is actually allowed to leave the scrum (a rare event – see next paragraph), the scrum half will almost invariably opt for a box kick rather than doing anything interesting with it. And of course, none of this happens until the scrum has been set and reset several times; in fact, when I watch a match, I usually record it and start watching about 30min post kick-off, so that I can fast forward through the interminable interruptions.

No, if the modern scrum is a contest at all, it is a contest to see which team can con the referee into giving them a penalty, the direction of the resulting award apparently as much of a mystery to the commentators as it is to the respective forwards. This is why, even with the ball at the feet of the back row, it seldom emerges, because the team in possession is hanging on for the penalty. From the spectator’s point of view, the only good thing about the current scrum fiasco is that it gives them a chance to go and get another round of beers in, secure in the knowledge that the referee will still be resetting it when they return.

It seems to me that if the desire is to increase the speed of the game, and reduce time-wasting, the answer is simple. Just be honest about the situation and make scrums genuinely uncontested, with no pushing, just like RL. The reason that RL is a better spectacle than RU (OK – in my opinion) is just this; that the game flows almost non-stop. The result of using uncontested scrums in RU would be less of the frustrating time-wasting and it would also speed the existing trend towards more mobile, ball-playing forwards. What’s not to like?

To end with, another conundrum of modern professional sport, and this time, it’s something that both codes of rugby get right – namely time-keeping. When the action stops in rugby, so does the clock (although it’s a pity it doesn’t stop every time a scrum needs resetting, only restarting when the ball goes in), which means that everyone knows that once the clock is in the red, the next time the ball goes out of play, the game is over. So why can’t they do this in professional soccer? The amount of time added on by referees seems to be as much of a lottery as scrum penalties in RU. In addition to keeping time, they have to decide if they dare blow the final whistle when the home team is closing in on goal. Using rugby’s approach, the ref would be relieved of the need to keep looking at his watch and keeping track of stoppages, and a team with a potential scoring chance when the clock goes red would be allowed to play it out.

There – major improvements to two professional sports in the space of one blog. I shall hold myself in readiness, awaiting an approach from their governing bodies.

Silly seasoning

There’s no point having a blogging facility if you don’t occasionally use it to mount a hobby horse, no matter how trivial or pedantic the result may appear to be.

So, today, I want to talk about salt. We all like a bit of salt on our chips don’t we, but it won’t have escaped your attention that in all but the most proletarian of eating houses these days the  salt provided is crystalline rock salt (or sea salt). This comes (usually, at least, – see below) in a grinder, which simply enables you to render the lumps slightly smaller. It’s almost as if this is seen as a sign of the restaurant’s upmarket pretensions; a suggestion that ordinary granulated salt in a shaker is too common to merit consideration in the context of haute cuisine.

As you may have guessed, this really hacks me off. The shards of salt produced by the grinder are too large to adhere to the food, and end up on the plate, where they do nothing at all. Occasionally, of course, a chunk does make it into your mouth, where it results in a nasty, gritty saline explosion that does nothing to season the bulk of the food.

Granulated salt, on the other hand, can either be sprinkled over the food, or deposited in a little pyramid on the side of the plate, to be eked out, mouthful by mouthful, as required. I have an awkward feeling that one of these two options is so non-U as to mark me out forever as irredeemably working class, but the point is that the salt can be deployed as required, and actually achieves the aim of seasoning the food without giving the impression of eating gravel.

To summarise: rock salt is fine for treating the roads during a cold snap, but I don’t want it on my plate, thank you.

I only mention this now because yesterday, I experienced the all-time low in saline insanity. We went to try a new, upmarket steak house just up the road from where we live. Like most of these places, the decorative motif was black wood and bright chrome, but it was pleasant enough. However, the only salt available for the table (and I know, because we asked) was a bowl of rock salt crystals which you had to dip into with your fingers. Not only did the absence of a grinder mean that the chunks you had to chew on were sized more like pea shingle than road grit, but there was no way of knowing whose fingers had been grubbing about in the bowl before we arrived.

It’s that urea in the communal bowl of peanuts on the bar thing again, urban myth or not, and in the throes of a coronavirus pandemic, when we are being told to wash our hands before, during and after we do anything at all with them, it struck me a significant potential health hazard. So, we won’t be going back (although, the fact that the food was not very good and hugely overpriced also had a bearing on the decision).

Wow! – 528 words on culinary salt. Who’d have thought it?

Breastfeeding: the percentage illusion and other pitfalls.

This week, the following headline  appeared on the front page of The Times: ‘Health experts say mothers should be paid to breastfeed’. It was reporting the findings of a survey which  found that a group of new mothers offered gift vouchers as a reward for continuing breastfeeding kept their babies on the breast for longer than a control group who were given no financial inducement. This, predictably, made it on to the national radio and TV news.

There were so many things wrong with the research, and with the reporting of it, that it’s hard to know where to begin, but it does give a nice illustration of the pitfalls which exist to trap unwary readers when the mainstream media (MSM) report on science (or, as in this case, on pseudoscience).

First, as a statement of the bleeding obvious, the finding that financial inducements can affect behaviour in this way is up there with the religious leanings of popes, and the defaecatory habits of bears. Then there’s that banner headline. We don’t know which ‘experts’ it was referring to, but the only ones quoted by name in the piece both stated that the research was not sufficiently robust to have any affect on practice, and certainly didn’t support the diversion of scarce NHS resources to provide bribes to new mums. Those dissenting opinions, as is usually the case, didn’t appear until the final paragraph, and so the many readers who never got past the first couple of sentences were left with the inaccurate take-home message provided by a lazy sub-editor’s headline.

That’s my gripe about the reporting out of the way, but much more interesting is the design and results of the research project itself. Like so much of this sort of ‘soft’ research, questionnaires were used to determine the breastfeeding status of the participants. I think that most of us know how reliable questionnaire-derived information is, because we fill in so many of them ourselves. We may not actually lie (well, not always), but we do tend to put the best complexion we can on our answers. For example, when we’re asked about our drinking habits, how many of us keep a diary for a couple of weeks and religiously calculate the number of units? No, neither do I, and when I do tot up my recent intake, I tend to choose a ‘good’ week, when it was a bit less than usual.

So – data from questionnaires is always going to be potentially flaky. But if you then offer cash (or vouchers) to the study group, any tendency to give the answers the researchers clearly want will be exaggerated. In this particular case, the respondents are likely to over-report the frequency of breastfeeding, and their answers will be about as reliable as my assertion that I drink 12 units a week.

And it’s not only the data that’s a bit iffy. The first paragraph stated that the voucher system ‘improved (breastfeeding) rates by about 20%’. I think that most readers, unless they were used to critically analysing research results, will have thought that a 20% increase was a pretty good result, because they will have assumed that it meant that breastfeeding rates had risen from (say) 40% to 60%. But of course, it doesn’t mean that. It means there was a rise of 20% compared with the breastfeeding rate in the control group. The control group figure was 32%, and it rose to 38% in the experimental group, the 6% change representing 20% of 32.

The media always use the percentage increase or decrease in their reports because it’s easy, and it also tends to exaggerate the effect being reported. They do this whether they are reporting a benefit of treatment, as in this case, or the supposedly harmful effects of some environmental factor. You need to see the underlying numbers in order to assess the importance, or otherwise, of the effect – always look for the absolute figures rather than a percentage change, and if they aren’t included in the report, be very suspicious.

Take the example of a new drug to protect against heart attacks. If you were told that taking the drug every day would reduce your chance of a heart attack by 30%, you might be tempted to say ‘OK, give me a prescription’. If you were told that if 100 people took the drug for five years, one heart attack would be prevented, but two other people would suffer attacks despite taking the tablets, you might have second thoughts about embarking on lifelong treatment and risking harmful side effects from the drug. It’s the same drug, just different ways of presenting the information. This example is for a low coronary risk population taking a statin, and the reason that the percentage reduction figure is so misleading is that the pre-existing chance of any of the drug-takers experiencing a heart attack is small, so that a 30% reduction actually makes little difference to the numbers of people who suffer a cardiac event.

It’s the same with reports of the health effects of living near a mobile phone mast (or electricity pylons, or a nuclear power station etc etc). The alleged health issue is usually an increase in cancer; especially the more emotive childhood cancers. You will always be told that the adverse effect increases the risk of childhood leukaemia, for example, by, say, 25%. That sounds dreadful, but childhood leukaemia is rare, with an incidence in the order of 1:30,000. Detecting a 25% increase in such a small figure, and being certain that it is a genuine change and not just random variation, or due to some other environmental factor, is next to impossible. So, that scary 25% headline figure translates into an effect that is too small to measure accurately, even if it exists.

So the bottom line as it relates to The Times report, is that if if 100 new mothers were given a substantial bribe, at the end of the trial period 38 would still be breastfeeding and 62 would have resorted to bottle-feeding. Without the cash payment, 32 would still be breastfeeding and 68 would have given up. And that’s only if you trust the results of a self-reporting questionnaire survey.

Which to me doesn’t sound like an efficient way to use scarce NHS resources.

On diversity and discrimination

I haven’t posted on here for a while, largely because I’m sick of reading about Brexit, and yet it’s such an all-consuming disaster in the making that it’s difficult to write about anything else.

I’ve been prompted to break my silence by an article in The Times today (30 November 2017) pointing out that the recently released nominations for male Grammy awards did not include a single white artist. It was the first sentence that grabbed my attention: ‘Next year’s Grammy awards may prove to be the most diverse ever, with no white men nominated…..’*

You only have to substitute ‘black’ for ‘white’ in that sentence to appreciate how nonsensical it is. OK,you may say, it’s just a journalist using the wrong word – it happens. Indeed it does, but the use of the word ‘diverse’ in that sentence actually illustrates the skewed nature of the debate around inclusiveness and, in particular, the very partial way in which another ‘d’ word is used – discrimination.

It’s generally agreed, by liberal commentators at least, that discrimination is necessarily a bad thing. But of course, it’s not. We discriminate all the time. When they choose the men’s 4X100m relay team for the olympics they discriminate against people like me, who can’t run very fast (plus, I’m nearly seventy), and that’s OK, because the discrimination is being made on grounds which are relevant to the particular selection process. Discrimination only becomes bad when the criterion being applied has no relevance to the choice being made. Perhaps I’m nit-picking, and perhaps when people use the word discrimination, they actually mean inappropriate discrimination, but I’m not sure that is always the case, as I’ll point out below, when I talk about positive discrimination.

Now I can’t pretend to follow the modern popular music scene (i.e. anything more recent than Freddie and the Dreamers) but I would like to think that Grammy winners are chosen on merit, and that this black-only list is only remarkable because there is usually a mix of black and white musicians in the running (which, of course, makes this year’s selection the least diverse ever). Assuming that the selection process is based on artistic merit, this is absolutely fine, and no-one in the Times article was suggesting that it wasn’t – in which case they are raising the race issue unnecessarily, which I’m sure some equal opportunities zealots (but not me) would regard as racist.

But that brings me on to the term ‘positive discrimination’, the implication inevitably being that positive discrimination is good, and any other sort is bad. In fact, positive discrimination represents a deliberate attempt to discriminate using criteria which are not relevant to the choice being made. Equality (be it racial,  gender, or sexual orientation-based) should be just that – absolute equality – such that minorities are treated exactly the same as everyone else. This means that their success in applying for jobs, or safe Labour seats or golf club membership should depend only on their suitability for the job. The concept of quotas, and women-only lists and the like represents exactly that inappropriate discrimination that got us into this mess in the first place.

I know that some will say that positive discrimination is only a temporary measure, to get the degree of diversity in any area into balance. But I don’t necessarily buy that – who is to say what the right level is? Let’s go back to the Grammys. Assuming that the selection process was fair, and based only on artistic achievement, it’s entirely right that this year’s line-up was 100% black, and it would be quite wrong to apply a quota insisting that Ed Sheeran et al got more of a look-in. Similarly, I want the best candidates chosen to represent me in Parliament – I don’t want good applicants to be excluded from consideration because they have the wrong type of genitalia.

It seems simple to me. The answer to inappropriate discrimination is not to load the dice in favour of one group or another, but to ensure that the selection process is fair. That will then get the right people appointed, and if that results in the selection of a preponderance of one particular subset of applicants, we can assume it’s because they happen to be best suited to that particular field of endeavour. The Grammys again: I’m perfectly willing to believe that at the moment the best modern popular music happens to be produced by people of colour, and that is why we have the list of nominations reported in The Times. And back to that 4X100m relay team; for quite some time now, there has been a preponderance of black athletes performing at the highest level. And that’s fine, because they are the fastest runners. If next year we have four white athletes in the team, that’s OK as well, as long as they have been chosen for the right reason.

Sorry, I’ve gone on a bit, because this is particular hobby horse of mine. And at least it’s not Brexit.

  • interestingly, that sentence was removed in the online version of the article.

Article 50 and Labour

A reply to my Labour MP, who kindly emailed me (and many others) explaining his intentions in the vote to implement Article 50, and commence Brexit.

Many thanks for taking the trouble to explain your intentions. I’m aware how difficult this is for Labour, and I’m familiar with the arguments you put forward. However, I think we all know that this government is not going to accept any meaningful amendments, and even if they did, the right course of action would still be to vote against the implementation of Article 50.

The first responsibility of MPs is to safeguard the welfare of the country, and the only way to do that is to stop Brexit in its tracks. It was depressing to hear people like Margaret Beckett saying that although she knew it would be a disaster for the country, she would be voting for implementation. That statement alone should disqualify her from sitting as an MP. We repeatedly hear that ‘the people have spoken’, but they spoke in an ill-conceived and unnecessary referendum following a campaign characterised by deliberate lying and obfuscation. Many of those voting leave have since, sensibly, changed their minds now that they realise what they were voting for. Many Leave voters are members of Labour’s core demographic, and will suffer the most from leaving the EU.

There is absolutely no requirement on Parliament to implement the result of an advisory referendum – particularly one which results in major damaging constitutional changes based on the votes of a minority of the population, indeed, it is Parliament’s duty to refuse to do so.

Labour’s stance, led by Jeremy Corbyn, has been pitiful, and his insistence on loyalty to his leadership, given his past voting record, strays beyond irony into hypocrisy. What the country needs from its politicians is a clear statement that Brexit will be so debilitating for the country that they can no longer recommend leaving the EU, and will continue to argue for reform from within.

I’m pleased to know that you will vote against the third reading if there are no suitable amendments, but I believe the most likely outcome will be that Corbyn, weasel that he is, will accept any crumbs tossed to him by May et al, in the mistaken belief that it will get himself, and the party, off the hook.

Like many of your natural supporters, I will never vote Labour again. If Corbyn thinks his actions are the best bet for staving off catastrophe in 2020, he has been badly advised (but then, he has made rather a thing of surrounding himself with malicious or just plain incompetent advisers). If Article 50 is invoked with Labour’s connivance, you will have lost the support of at least two generations of voters, and will have ceased to be a meaningful force in UK politics, thanks to your actions in aligning yourselves with UKIP and (effectively) Trump.

Never did we have a greater need for an effective opposition. Never did we have such a pathetic excuse for one.

All of which saddens me – you are a very effective and conscientious MP, who would normally command my support.


Just think for once, commentators!

OK – if you’re expecting a serious piece on the current state of the NHS or anything else, don’t bother reading on –  one of the best things about starting a blog like this is that it gives you the chance to get stuff off your chest, and today I want to do just that.

Mostly, the inanities of sports commentators make amusing reading, and those of us of a certain age think fondly of Colemanballs in Private Eye. But there’s one thing they do repeatedly which really gets on my nerves and which has me screaming in frustration at the TV set, and that’s why, still frothing at the mouth, I intend to unload on you all now.

I don’t know if you’ve noticed, but nearly all commentators have a tendency to simply tot up the missed chances in a game, add them to the actual final score, and say ‘If only they’d not missed those three clear chances, they’d have won 3-2’ Spot the fallacy? Of course you did, but they never do, and no-one seems to pick them up on it.

One of the worst serial offenders is Mike Stephenson, who is a regular commentator on Sky’s rugby league coverage (RL – a rough northern game that most of you won’t have heard of). Known by everyone as ‘Stevo’, he is an ex-international RL player, and his commentating style tends to be fairly dogmatic, which leads to him taking quite a bit of good-natured stick from his fellow commentators.

Stevo regularly adopts this simplistic view of missed opportunities, and their possible effect on the final score. There was a good example in the commentary on the first game of this year’s Super League programme, in which ‘my’ team, Leeds Rhinos, were beaten 10-12 at home by Warrington Wolves. As if that wasn’t bad enough, I was reduced to incoherent gibbering by Stevo’s assertion that if Leeds had kicked their three first-half penalty goals, they would have been six points better off, and would have won.


Look – if they had indeed kicked the first of those goals rather than kicking for touch and getting no return for it, the entire subsequent course of the game would have been different, because the match would have been restarted from the centre spot. Those second two penalty opportunities would therefore never have arisen, and depending on what did happen, Leeds might have lost even more heavily. Alternatively, they might have scored three brilliant tries and/or had half a dozen other penalties awarded and gone on to win handsomely, but THERE IS NO WAY OF KNOWING.

Sorry to keep shouting, but as you may have realised, this is one of those unimportant little things that can take over a chap’s waking hours. And Stevo – just in case you’re still struggling with this, let me explain more fully. Our lives (and sporting contests) are made up of a sequence of events, each one of which leads on from, and is a direct consequence of, what went before. Change one of those events by, say, missing an open goal or converting rather than missing a penalty, and you also change what comes after. So, you can’t simply look at a series of missed chances after they have occurred, add the points/goals/runs they would have generated to the actual total and produce a number that means anything.

Of course, quantum mechanics raises the possibility that there is a parallel universe in which Leeds did kick the first of those penalties, but if we had a way of seeing into that universe, we would find that we were watching a completely different game, from that point on, to the one that unfolded at Headingley last week.

I can’t surely be the only person to have picked up on this, and Stevo is certainly not the only offender. But I wish they’d stop it.



Old dogs and new tricks

When I finally retired from my career as a consultant radiologist in Leeds, I didn’t imagine for a moment that three years later, I’d be going back in to the hospital as a volunteer, and especially not as the Trust’s first humanist chaplain.  I didn’t even realise that I was a humanist until I was in my early forties – I won’t bore you with the details of my reverse Damascus road experience now, but if you’re interested, you’ll find an account here. Discovering humanism made a big difference to my life, but not much to anyone else’s, so when I retired and had more time, I looked around for ways to give practical expression to my beliefs.

I suppose before I go any further, I should define humanism, because until I saw the light, I knew very little about it, except that it was a non-theistic view of the world and our place in it. There are two basic beliefs inherent in the humanist world view. The first is that we can explain the world around us using scientific method, evidence, and reason to discover truths about the universe without invoking the existence of a supreme being. Secondly, we believe that we only have the one life to live, and that we should make that life a worthwhile and fulfilling one by placing human welfare and happiness at the centre of our ethical decision making.

So anyway, when I retired, the first thing I did was to enrol on the British Humanist Association’s (BHA) training course to be come a funeral celebrant, accredited to officiate at non-religious humanist funerals. I had naively assumed that I would find it fairly undemanding, because I’d done a lot of public speaking in the course of my career – not just conference presentations and lecturing, but after-dinner speaking as well – and I didn’t think that the actual presentation of the ceremony would be a problem. So when, during the first training session, the speaker emphasised the importance of careful preparation of your script, ensuring it was printed double-spaced in large font to ensure that you could keep your place and maintain regular eye contact with the mourners, I thought ‘what do I need with scripts? – if I can wing it in front of three hundred drunk doctors at a conference dinner, I can manage without a script at a funeral service’.

I  was quite wrong, of course and, you might think, even a bit arrogant. A funeral is much more important than any of the other public speaking I had done – after all, if you mess up a conference presentation, another one will be along in a couple of months, and there’s a good chance no-one’s listening anyway. A funeral, on the other hand, is the family’s only chance to get it right, and it matters. With only a couple of days to meet with them, write the service, including a eulogy which says everything the family and friends want to say while keeping within the strict time limits applying at crematoria, you can’t leave anything to chance. In fact, from being over-confident, I rapidly began to think that I’d bitten off more than I could chew, and came close to baling out of the training. I’m glad I didn’t, because working with bereaved families over the past few years has been one of the most challenging and rewarding experiences of my life so far.

Then, having gained that experience, my thoughts turned to hospital chaplaincy services. I’d had very little contact with chaplains during my long career in medicine, largely because I was a radiologist by trade, and radiologists are not involved in the long-term care of patients; we do the interesting bit – making the diagnosis – and then let the referring clinician worry about prognosis and treatment. So my ideas about chaplains were the same as those of most patients: I assumed that anyone styled ‘chaplain’ was a vicar (or priest, or imam or rabbi etc. in these multi-faith times), and I would have been right. Which means that the 40% or so of patients who tick the ‘no religion’ box on their admission form are effectively disenfranchised when it comes to accessing pastoral care in hospital

It occurred to me that there was a parallel here with my funeral work: twenty or thirty years ago, you would have been hard-pushed to find anyone offering non-religious funerals. In fact, I suspect that many funeral directors would have told you that there was no demand for them, and yet now that they are widely available, around one third of services fall into the non-religious category, and fewer than half of all funerals are conducted by the Church of England, Catholic and Methodist churches combined. Pastoral care is ripe for a similar revolution, because while it is true that many chaplains practise what is called ‘generic chaplaincy’ – meaning that they make themselves available to patients of all religions and none – the patients themselves are not necessarily aware of that.

Consequently, if a patient with no religious belief is troubled, anxious or scared and wants to talk to someone who is neither a member of the family or one of the medical and nursing team caring for them, they may well hesitate to ask for the chaplain, fearing that he or she would approach things from a religious point of view which had no meaning for them. This didn’t seem right, and I had been considering a direct approach to my old hospital to see if they felt that there was a place for a humanist in their pastoral care team, but wasn’t sure what sort of reception I’d get.

Then serendipity (or fate or the hand of God, depending on your point of view) stepped in. I clearly hadn’t been the only one thinking about this issue, and out of the blue I received an email from the BHA offering training in pastoral care to humanists wishing to work as volunteers in the hospital and prison services. To cut a long story short, I did the training, and was able to approach the chaplains in Leeds with a bit more credibility than would otherwise have been the case. It turned out that I was pushing at an open door, and Chris Swift, the Head Chaplain and a C of E vicar, welcomed the opportunity to include me on their team. I’m based on the teenage cancer unit, but make myself available to any patient in the Trust who specifically requests pastoral care from a non-religious chaplain.

It’s still early days, and of course, and as I said earlier, patients won’t ask for a non-religious chaplain unless they know that such an exotic creature exists. Still, I’m managing to publicise my presence using internal bulletins and social media, and I’m slowly becoming recognised in my new role, and receiving referrals from other chaplains and chaplaincy volunteers. Incidentally, should you be unfortunate enough to find yourself, or a family member, in hospital and in need of a bit of support, and if you are not religious, you might want to ask if there are any non-religious chaplains available. There probably won’t be, in which case you could ask why not, and just remind them of the equality agenda, because not all of those seeking to do this work have been as lucky as me, and are often rebuffed when they approach chaplaincy departments offering to get involved.

Why am I telling you all this – is it just to make myself sound like a really good person? Well, when I retired, my daughter, who has inherited my rather dry sense of humour, asked me ‘what will you do with yourself, now that you no longer serve any useful purpose’. OK, she was joking (I think), but there’s an underlying kernel of truth in her question, and while I’d like to think that altruism is the chief motivation for my voluntary work, I guess that whenever we undertake something that makes us feel good, there’s invariably an element of selfishness involved as well.  I don’t miss going to work every day, but after a busy career, and particularly in a profession like medicine, I do miss the feeling that, no matter how frustrating the job might have been, I did occasionally make myself useful to someone. The chaplaincy work has given me that feeling again, and I’m unashamed to admit that I enjoy it.

But no, that’s not the reason I’m telling you all this. I’m telling you because you might imagine that spending a significant chunk of my retirement (but not enough to interfere with the fishing) officiating at funerals and working with young victims of cancer would be fairly depressing. In fact, nothing could be further from the truth – my funeral and pastoral care work has shown me, more vividly even than forty years of medical practice did, that human beings are pretty bloody amazing, if you’ll pardon the expression.

When I meet families to arrange a funeral, I’m repeatedly struck by the extraordinary lives that have been lived by outwardly very unexceptional people. There was, for example, the elderly gentleman who had lived in Bradford for seventy years despite an eastern european name, and whose life had seemingly been a pretty mundane one, working in a factory, enjoying a weekend pint in the working men’s club and not doing anything remarkable. It turned out that at the age of seven, he had, with his parents, walked pretty much the length of Europe, fleeing first the Russians, then the Germans. Then there was the elderly lady who had been living a quiet life in her neat little house since her husband died a few years previously.  While talking to her family to get material for her eulogy, I discovered that she had been a stalwart of the early trade union movement, and a friend and colleague of the Labour Party leaders of the fifties and sixties. Singing The Red Flag at her funeral was a first for this ageing small ‘c’ conservative. I could give many other examples.

More importantly perhaps, I’ve been impressed by the amazing resilience that people demonstrate in dealing with the most distressing events, and here I think of the young couple, barely out of childhood themselves, who had just suffered the loss of their first baby at fourteen weeks gestation and wanted me to conduct a funeral service. They were just the most together and composed pair you could imagine; tears had been, and continued to be shed of course, but they were determined to provide a service that would mark their child’s all too brief life and establish her place in their family unit, and had very clear ideas on how to go about it. When I met their relatives and friends at the service, I realised where some of that strength came from. I’ve seen the same thing again in my early dealings with the patients and families on the teenage oncology unit. Their lives have been turned upside down by a disease which highlights the random unfairness of life, but they are just getting on with it and coping.

So here’s the take away message, and I’m sorry I’ve rambled on so long in getting to it, but I thought you needed a bit of background.  I have belatedly realised what humanism is all about:  my experience over the past few years has convinced me that when it comes to human behaviour, belief in a supreme being is an irrelevance. If you feel inspired by the example of Jesus (or any other prophet or teacher) to live your life in a certain way, that’s fine, but we can take responsibility for our own lives and the lives of those around us without ascribing any good we do to God, and blaming all the bad stuff on estrangement from Him, or, worse, to the Devil’s promptings. We are gradually chipping away at the apparently mysterious workings of the universe, using rational processes of enquiry without resorting to the cop-out that ‘God did it’ every time we get to the difficult stuff like dark matter or quantum entanglement (sorry, showing off a bit there – I don’t actually know what they are either, but I’m delighted that someone, somewhere is getting to the bottom of it all).

Everywhere, I see ‘ordinary’ people living as if this was their only life, getting on with things under the most adverse circumstances, and enriching the lives of those around them in the process. They do this because they think they should, and because it makes life better for everyone, not because they are told to do it by supposedly sacred texts written at a time when the sun was still thought to be hauled into the eastern sky behind Helios’s chariot every morning.

Meeting people like this at critical stages in their lives has been a privilege, and is the polar opposite of depressing, so I just wanted to say this. If anyone ever tells you (and they probably will) that a sense of awe and wonder, feelings of joy, and hope for the future can only be experienced in the context of religious faith and a belief in the world to come, politely tell them they are wrong. Tell them Bob said so.