Old Lad

A journey through old age

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  • Niceness

    We seem to be becoming a lot less kind and gentle as a nation. Passive aggression and overt aggression seems to be seen everywhere. When I was growing up in the fifties we were taught to be kind and courteous. Yes there were always bullies about but I don’t remember the extreme nastinesses that young people can inflict on each other, particularly on social media. A lot of this character has persisted now that I am an old lad. So I still say please and Thankyou if somebody does something for me – if I am out for a meal, for example, I automatically say Thankyou when a server clears away my plate. It’s just something automatic but it’s often greeted with a look of surprise. I still hold doors open to let a woman pass through and I still try to walk on the outside on a pavement ( keeps the sword arm free!)

    But look closely and see how much aggression is around and almost becoming normalised. Walking around the town I am struck by the language some parents use towards their children. NHS staff are increasingly sworn at and verbally abused. Yes I know it’s frustrating sitting waiting in an A&E department but does the aggression help? Watching the behaviour of some players and fans in the World Cup shows lots of examples of needless violent and aggressive behaviour, which sadly gets copied by junior footballers and their parents! Mass protest nowadays often spills over from being peaceful to outright nasty and hostile behaviour against anybody who does not share your point of view. Is it social media to blame? Or the exaggerated rhetoric used in the media – where words like catastrophic, nightmare, horror show, disaster are used to describe w things that are nothing of the sort. For example heavy rain causing a carnival to be cancelled is not a disaster on the same scale as the earthquake in Venezuela. I was out walking the dog in a local park last week and came across some local council workers collecting litter. They were dressed in all black tee shirts and trousers with baseball caps – a bit like the police. Emblazoned on the back of the tee shirts were the words “ Environmental Crime Unit”. Really? I know litter is annoying and socially not acceptable but there does seem to be a bit of hyperbole at work and to me it’s a bit passive aggressive.

    Given the state of our current political discourse and the way it is stoked by the media, it is difficult to see how we can regain an atmosphere of kindness and niceness towards each other. The late actor Paul Eddington ( star of The Good Life and Yes Minister) was once interviewed and asked what he would like to be remembered for and what he would like as an epitaph. His reply was “ He never did anyone any harm”. That doesn’t seem a bad principle to me.

  • Catastrophe

    So how did you get on with the armageddon which was 3 days of sunny weather last week.? I find myself not only being classed as an Old Lad but a Vulnerable adult. So according to the advice from HM Government I should have been holed up in my house in my string vest with all the curtains closed and with neighbours calling in to give me sips of iced water! The reality (and I speak as one who has lived in Saudi Arabia) was that I adopted the “Lets pretend we are on holiday” strategy and sat out each morning with my coffee and pieces of baclava on the patio. And in any case Oop North we know it wont last and the monsoon will come – which it did.

    Perhaps i look back to childhood with misty eyed memories but we had hot weather from time to time – probably hotter because it was in fahrenheit not centigrade – and it meant bringing out the Start-Rite sandals and khaki shorts. The TV weather forecast did not paint the country in the lurid red of a volcano and we just had the magnetic suns or clouds which occasionally fell off behind the presenter. I suppose the sun’s UV rays were not as strong because of all the air pollution in the part of Industrial Lancashire that I grew up in but I don’t ever remember getting heat stroke. The highlight of the day would be the ice cream van.

    So why do we as a country seem to react so hysterically to what was a few days of heat? My view is its all part of a wider malaise across Government and the public services that “something needs to be done”. And partly that is because of a growth in departments within bodies whose job is to churn out advice whether it is needed or not and thus justify their existence. To a degree I encountered this in my career when I worked within a Health Authority. At that time Health Promotion was a growth industry and Authorities were judged on their “Health Promotion Activities” and chief executives were given brownie points from on high. Let me give you an example. A campaign is devised to get people to brush their teeth more often and look after their dental health. (This was a time when you could actually see an NHS Dentist). Numerous meetings were held, publicity materials devised and someone had an idea to give free toothbrushes to children. Reports were sent to the Regional Health Authority about the campaign and pats on the back were given all round . Did it make any difference? Well we never actually bothered to find out! But it was deemed to prove the value of having a health promotion department. .So the communication was the thing , not the outcome And so it was with our recent “catastrophic Heatwave. Public services and the media piled in. The Met Office invested in more red paint for its charts and screamed “Red Warning”,, Public Health Doctors spoke darkly about how many of us might die, and the BBC news bulletins devoted a large part of their output with the “Phew what a scorcher” stories beloved of journalists.

    But did I really need to be told that (a) it was going to be sunny and so probably hot (b) that I should wear cool clothing, (c) drink more and (d) stay in the shade in the middle of the day! We oldies are not idiots! Meanwhile the sheep in the field up the road stood around in their woolie coats and contentedly munched the grass, Anyway in preparation for the next red warning I’ve taken precautions – bought some more baclava and a bottle of Pimms! , Oh and a bag of Ice Cubes!

  • This mortal Coil

    This week I have reached another milestone in the journey as an Old Lad. I am writing a new will. My current Will is over 30 years old so I decided it was time for a refresh. It’s not a complicated Will – I have 3 children so what earthly possessions I have will be split three ways and I also want to make some charitable bequests. I know you can do DIY wills on line but I thought involving a solicitor was safer. The interesting thing about solicitors is that they conjure up all sorts of “what ifs” largely involving my three children falling out ( improbable). Or dying before me. But it’s been fairly straightforward. The biggest issue though is it’s a point in your life where you are forced to contemplate a future without you. This is difficult to get your head around but not something to dwell on too much. A solicitor I knew once advised that although everybody should write a will it should be then put in a drawer and forgotten about. After all you won’t need it!

    A second milestone in the Old Lad journey occurred two weeks ago when I had my annual MOT at the GP surgery. At the moment I am blessed with what I think is reasonable good health apart from mild hypertension for which I am taking “the tablets”. Also the fact that I am over 75 entitles me to a check up. So a nice health care assistant weighed me, measured me, took my blood pressure and asked me about exercise ( mainly walking and gardening) and how much I drank ( I fibbed a bit!). Various blood tests were done and the good news is that all the important bits seem to be working ok. My blood count is ok and tests for liver, kidney, thyroid function were all normal and I am not pre diabetic. So that was encouraging seeing as I am now in what is termed “snipers alley” – watching friends and acquaintances being picked off by the Grim Reaper and dodging the bullets! The disadvantage of being a medic of course is that we know too much and occasionally I find myself thinking of the myriad diseases that could swoop..

    So what do I do to defend myself against premature mortality. There’s certainly no shortage of advice out there in the media and on social networks like Facebook. The algorithms used by Facebook are very ageist. I get daily suggestions for walking aids, things to help me put my socks on, exercises to do in a chair (!) and regular advice about a thing called Pure Cremation as well as discreet posts about incontinence products! Basically I have a simple regime. A boiled egg each day for breakfast, an omega3 fish oil capsule and a vitamin D pill. Recently I’ve added in beetroot extract because there is some evidence that it can boost circulation. I home monitor my blood pressure, eat sensibly and walk at least 6000 steps a day. And I have a wee dram before bedtime. And that’s it.

    Oh and aim to have a laugh every day. It’s all in the lap of the gods really. But at least I have a will and my MOT test allows me a licence to go on for another year!

  • Computer says No

    Looking back I think I have tried to keep up with the IT revolution. It is quite extraordinary to realise that in thousands of years of our history this is probably one of the biggest quantum leaps humans have made – and in a relatively short space of time. I read recently of a museum hosting an exhibition of computing and looking at the various examples I could recognise my computer journey. It started with a Sinclair ZX81 – a useless gadget which only allowed you to play table tennis on a TV. I then progressed to an Amstrad word processor and was introduced to floppy discs (remember those?). My first proper PC was a Fujitsu desk top with a rather large box for the entrails, but it was a leap forward – still with floppy discs – and limited capability. I now have a laptop and an iPad and a smartphone. I still sit and remember as a medical student in the sixties, the Royal Infirmary in Liverpool had installed a computer – it took up a whole room, used reel to reel tapes and punched cards – remember those and you give your age away!

    We oldies live firmly in the digital age and there is no going back – resistance is futile. For a long time I resisted a smartphone but eventually gave in and have to admit it has made life easier. I do find it useful to communicate with people, see the weather forecast, book train tickets and use the map to find my way round places. However I still have friends who are resisting the use of IT and see it as a badge of honour that they don’t use email or progress to a smart phone. It is exasperating and they remind me of people who resisted motor cars and wanted to stick with their horse and cart! I accept that the older we get the more difficult it is to learn new skills but with patience it can be done. Perhaps we need to help the small group of people who can’t do it and add some sort of digital helper to home care services. However as you will have gathered I am a digital enthusiast but the one area I have some reservations about is my own specialty as an ex GP. There are many aspects of good uses of IT in medicine – clear and accessible medical records, computerised prescriptions with built in safety features, access to technical information, the ability to enter data into a record remotely etc. However the bit that really worries me is that we dehumanise medicine. Although artificial intelligence is said to be able to diagnose conditions better than a doctor it has its limitations. Yes it can accurately scan an X Ray and pick up abnormalities, yes it can give an accurate probability that test results are normal and can sift through a list of symptoms and try and find linkages that will suggest a rare diagnosis. But part of the doctor patient relationship which I still feel is crucial ( and which regular surveys show people agree with) is the ability to talk with another sympathetic human being. And the skilled clinician still can use non verbal cues in a person’s demeanour that can be highly significant. There is still an old aphorism that “ The doctor is the cure”. The other big elephant in the room is that when systems crash or a major cyber attack occurs, chaos soon reigns. I know of several GP practices where this has happened and the doors were simply closed and telephone queries were met with a response that the computers were down and nothing could be done! In other words “The computer says No!” So I would say to my younger colleagues go carefully and don’t lose your interpersonal skills.

    So to all the Old Lads and Lasses out there I would say embrace the digital revolution. It will make your life easier and also has the advantage that if you know how things work, you can challenge the occasional jobsworth who blithely says “ The computer says No”!

  • Organ Recitals

    I have always liked organ music – church organ not the Wurlitzer type. The power of an organ in a cathedral or church is like nothing else. Sadly unless you live near a cathedral it is rare to be able to go to an organ recital and it’s likely that exposure to organ music may be limited to a wedding or a funeral, but even the use of organ music there is in decline. You are more likely to shuffle off this mortal coil at a crematorium to the strains of Sinatra singing “My Way”! I was fortunate that my son who is a talented musician had organ lessons when he was in his teens, so for a time I had the delight of taking him to Carlisle cathedral. Sitting in a darkened cathedral while he was high up in the organ loft and listening to his lesson is a memory I treasure. Sadly there is now a shortage of organists and church organs everywhere are deteriorating.

    However I am now frequently engaged in a different type of Organ Recital. This is the discussion that follows as a response to the greeting “How are you”? In younger days this would just elicit the word Fine, or occasionally “Musn’t grumble”, but now it’s likely to trigger a catalogue of descriptions of chronic diseases and the dreaded “tablets”! I suppose it’s an inevitable consequence of being an Old Lad. The statistics on I’ll health in older people are quite stark. Between the ages of 65 and 75 50% of adults are managing two or more chronic conditions. Over 75 this increases to 2 out of every 3 people with a chronic condition.. Arthritis and other musculoskeletal disorders affect a quarter of people over 65 and by the age of 80 it’s. 50%. Half the population over 65 are managing high blood pressure and 20% have Type 2 diabetes.. Nearly a quarter of older adults live with asthma or chronic obstructive pulmonary disease ( what in the old days we used to call chronic bronchitis). So as the saying goes – there’s a lot of it about! I suspect that because of my medical background I get drawn into these organ recitals more than most. Often it’s a description of the problem and it’s treatment with the question “What do you think”? Which reminds me that you never stop being a doctor – I still get asked for opinions in supermarkets by ex patients. I don’t mind, it goes with the territory. I am a great one for tuning into overheard conversations and hear some fascinating organ recitals, many of which are reminiscent of the late Les Dawson and Roy Barraclough in their Cissie and Ada sketches!

    There is a serious side to all this in that I don’t think the NHS has geared up to how best to help us oldies coping with chronic disease. Political activity is all about waiting lists and operations and TV programmes seem to only major on severe trauma and heroic surgery. In TV ratings A&E is king, but of course the truth is that a significant number of A&E attendances are elderly people coping with multiple chronic diseases – or as we say in the trade Co-Morbidity.

    if your social life is increasingly leaning towards organ recitals I suggest two strategies. Firstly change the subject after 10 minutes. And secondly adopt the stance of a very wise GP who I knew who would patiently listen to his older patients tales of woe and then pat them on the shoulder and say “ It’s just the newness wearing off”!

  • Books

    From an early age I have loved books. I love bookshops and still feel guilty buying books on Amazon – there’s nothing beats browsing. I love the feel of books and particularly the feeling when you open the first page of a new book. I have tried using electronic readers but I can’t get away with them. They just don’t provide the same comfort of a proper book. I think this love of books goes back to my primary school. We had a head teacher who was passionate about us reading and every year without fail I used to get the same comment on my report- “Continue to make books your friends”. So I did, and read avidly – Enid Blyton, the Jennings and Derbyshire books, Charles Dickens, Treasure Island – and got lost in their worlds. For as long as I remember I have always read a book in bed last thing at night – no screens for me!

    So now in retirement I have the luxury of having time to read although after a busy life it has taken some time to adapt to the idea that I don’t have to be doing something all the time. And that sitting with a book is a legitimate thing to do. I suppose over the years I have taken it for granted that we always had books in the house. I remember one of my best ever birthday presents was when an aunt bought me my first bookcase – it was a Lloyd Loom one and lasted for years. When I was working as a GP it used to make me sad about how few houses I visited had books around. There are some glimmers of hope that children may be returning to books and the current Queen’s promotion of reading May help

    So what do I read now? I have always liked spy novels – John Le Carre and his ilk. It’s interesting over the years that spy novels moved away from Russia as “the enemy “ to other hotspots in the World – although I suspect now we will be drifting back to Russia. Because Edinburgh is one of my favourite places I am an Inspector Rebus fan and I think I have every copy of Ian Rankin’s novels. As I’ve got older I’ve taken to reading good travel writing especially if it involves places I’ve been to. Some of the older travel books can be very evocative. I remember when I spent the year working in Saudi Arabia reading Wilfred Thesinger’s Arabian Sands, and thinking not much had changed for the Bedouin despite the oil wealth. I currently am half way through The Worst Journey in the World by Apsley Cherry-Garrard. He was a member of Scott’s last expedition to the South Pole and was part of the team who discovered the tent where Scott perished. The book was written in 1922 but the writing is superb, easy to read and really conveys what it was like in Antarctica.. I’ve recently enjoyed the Shetland series of crime novels so much so that Shetland is now on my list of places to travel to.

    I find I like to have 2 or 3 books on the go at the same time. Apart from the variety it’s a a good mental exercise to be able to pick up where you left off. So put down your Kindle and “Continue to make books your friends”!

  • Clumsiness

    As I continue on this journey into Old Age I seem to be becoming more clumsy. I occasionally knock things over. I live in a house with low doorways and find myself bumping my head having not ducked enough. Why is this? My eyesight is OK with glasses – I don’t use those irritating varifocal lenses, bifocals for me, and my balance seems ok. Neurologically I suspect it is part of the subtle change that occurs in depth of perception in vision and slight impairment of hand-eye coordination. So it needs more care and concentration in reaching for things. Wineglasses are a particular hazard..

    Of course the biggest hazard of clumsiness is falling. It is estimated that from the age of 65 onwards the average person has a one in four chance of having a fall in any given year. Over 75 the risk is much higher. Although there are obvious reasons like accidental trips, or falls on ice, or dizziness caused by some of the medicines us old lads take, it seems that the biggest cause of falls is the condition called Sarcopenia.This is a decline in muscle mass, strength and function that increase with age. As well as leading to falls the onset of sarcopenia also accounts for the sense of increasing fatigue on climbing stairs, the stiffness getting up and down out of a chair and worst of all, if a fall occurs, an inability to get up. We can mitigate some of the effects by regular exercises, especially walking, and strength improving exercises using resistance movements . But to some degree you have to be aware of this decline in muscle function and take precautions to adapt to it and avoid falling. It’s worth remembering that falls in the home are a big cause of hip fractures and also a big cause of loss of independence.

    So I find myself being more cautious doing day to day things. I take stairs a bit more slowly – although stair climbing is good strengthening exercise – and if there is a hand rail I use it. I have invested in a pair of walking poles for country walking and have been surprised at how much easier they make walking on uneven ground. I never walk around with both hands in my pockets. I recently had a trip to the north of Norway and invested in some spikes for my shoes to use in the snow and ice. And I do daily resistance exercises for my legs. So hopefully I can avoid a serious fall. But I still knock wineglasses over and this morning I bumped my head! All part of (old) life’s rich tapestry.

  • Words

    I’ve been a member of Rotary for over twenty years. It followed on from being a member of Round Table when I was under 40. The reasons I joined these organisations was twofold. Firstly it was a way of socialising with people from outside my own profession – doctors can be a bit tedious because they always talk shop! Although I have to admit I could not avoid informal consultations from time to time. The second reason was it was a way of getting involved in charitable activities for the local community. Sadly the next generation ( are they Z or Y or something) are not interested in joining any more. We recently Had a survey of Rotary members in our District in NW England. Out of some 1200 members, 700 are over 70 and 200 are over 80. I fear the writing is on the wall..

    You might be wondering why I titled this piece Words. Each year our Rotary Club recreates the old BBC TV Programme “Call my Bluff”. For those who never saw it, a team of 4 people each give a definition of an obscure word – one is the true definition and 3 are not – or “bluffs”. Because I love words and language I have been a regular player, and our team of 4 asks the audience to identify the person giving the true definition. We have had some spectacular obscure words requiring great ingenuity to describe a false definition which I have to say keeps the brain active. It also requires the ability to keep a straight face and appear to be absolutely truthful. Whether you think doctors are good at this I couldn’t possibly comment!

    Words of course are constantly changing and it is a mark of getting older that you find yourself using what to the modern generation seems archaic language. I still find myself calling the radio the wireless. I took what I termed a bedspread to the laundry to be informed that’s it’s now called a throw. And when did a black coffee become an Americano or a milky coffee become a latte or a flat white. When I was at school in the sixties we saw the rise of coffee bars and the drink known as “frothy coffee” produced by some enormous machine. Plimsolls have become sneakers, jumpers are now sweaters and tee shirts are tops. If you are a true Old Lad you probably still use expressions like “jolly good show”, “Crikey”, or one of my favourites passed on from my Gran which was “ Well I’ll go to the foot of our stairs” – an expression meant to convey wonder or incredulity!

    Perhaps I should start work on an Old Lads phrasebook.

  • Reunions

    I’m just back from a reunion with a group I was at Medical school with. It marks 60 year since we all started at Liverpool and 55 years since we all graduated. There were 11 of us plus some partners. It set me thinking what is it that keeps us all in touch and enjoying meeting up after so many years – the bonds must be strong. One thing that occurred to me was that the experience of starting the Medical course was such an intense experience, and continued to be, that we all established deep friendships as a way of mutual support. The nature of the curriculum in Liverpool was that the first year was largely devoted to the study of anatomy. So consider the impact on a group of 18 year olds, straight from school, spending their days dissecting dead bodies. I suppose nowadays there would be anguished debate about our “Mental Health and Wellbeing”, but in reality we just got on with it and the friendships formed gave us support.

    So what did we talk about? Lots of reminiscing as there always is at these events. Stories of life as junior doctors and a general agreement (I think) that although it was hard work we did have some fun. And fun seems in short supply in today’s NHS. As you would expect in a group of late 70 year olds we have all had experience of becoming patients ourselves with mixed feelings about how we were treated. Its interesting that a lot of my non medical friends think that because I am an ex doctor who worked in the NHS that I will somehow have some sort of privilege and be treated better than the average customer. Not a bit of it. Sadly the personal touch from colleagues has gone so, for example, the practice I followed of giving a colleague who I was treating my home phone number is but a distant memory, In terms of our fitness as a group we are not doing too badly – a few walking aids present – but there were some sad stories of others in our year who are not faring so well. We did eat and drink well and there was some talk of craft beers – and some sampling. There was a slight tinge of sadness for me because my late wife Anne used to enjoy these get togethers and after all she was an integral part of of my medical life. So we parted after 2 days and promised to meet again.

    We met in Harrogate and I have to say I had forgotten what a nice place it is. The town centre has thankfully preserved most of its historic buildings from when it was a spa town and it does still have individuality in its shops and eating places. And if you are of a mind you can still “take the waters” foul smelling though they are. To me it was a welcome respite from all the terrible things going on in the world. If you are in need of a short break I can recommend it. And I travelled by train which I always enjoy, and even better all the trains ran on time!

  • Travel for Old Lads

    So the Arctic adventures are over and I have to say it was everything I hoped it would be. I can recommend Havila ships as the way to travel – excellent service and food, and the added advantage that being ferries they can get into the small fjords that big cruise ships can’t. I was unsure what travelling solo would be like, and if I am honest it was a bit strange. There were conversations on the voyage but a lot of the time I just sat and read and watched the scenery go by. Single travellers are discriminated against by the travel industry. Costs are much higher with single supplements adding at least 50% or more to the costs. This even applies to those companies that specialise in solo traveller holidays. Add to this the fact that travel insurance is higher as you get older and it becomes clear that travel is expensive for Old Lads.

    I travelled by train to Manchester Airport – the most relaxing way to get there without the stress of motorways. However it is 7 years since I last flew and I had forgotten what a dismal and dispiriting exercise air travel is! Dante’s Inferno describes, 9 circles of Hell. To my mind Manchester Airport is the tenth! It’s now too big and crowded, and appears to have been planned as a busy shopping mall that planes occasionally visit. The so called automatic check in didn’t work in that it did not print my bag tags. So I go to the check in desk and explain why I can’t do a bag drop, to be met with the reply “ Are you sure it didn’t work”! Security procedures are the usual nightmare – monosyllabic attendants who bark instruction – jacket off, belt off, pockets empty. They might as well be issued with cattle prods! Despite emptying my pockets and having no metal on me the new scanner sounds an alert. “What’s in your pocket” – “ It’s a handkerchief “ – “Show me!” and then I am grudgingly let through. “I’m paying you to do this” I mutter understand my breath. What happened to a bit of common courtesy? And so the long trudge to the boarding gate. I pass a sign that tells me it’s 6 minutes walk to the gate I need.

    Is it because I’m older that I find this so unpleasant? It certainly feels more exhausting than it used to.. Lots of travel is meant to be the lot of a fitter and older generation but I would venture to say that air travel is getting to be too stressful with not just the airport horrors but also the fact that modern airlines have craftily cut back on space so expect to sit uncomfortably for 2 to 3 hours. And if like me you are getting a bit stiff getting up off a chair, try getting in and out of the middle seat of 3 in a Boeing 737! I suspect it may be a while before I contemplate flying. I think I will stick to the train. It’s the only way to travel for Old Lads – and the railway sandwiches have certainly got better!

    ,