Old Lad

A journey through old age

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  • 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!

    ,

  • Arctic Adventure

    So here’s a first. I am blogging from inside the Arctic Circle! It’s now 7 days into a voyage up and down the Norwegian Coast and round the North Cape. I know it’s traditional when age sets in to start going on cruises. But to be honest I have never fancied being cooped up with 6000 of my fellow human beings. This experience is a bit more minimalist. The ship is brand new and hybrid powered ( The charging point on the quayside at various ports is a wonder to be hold – I suppose it makes all the lights go out in the town when the ship plugs in!). There are only 170 cabins and apart from excursions ashore the only activities are food and drink and watching the scenery go by.. It is amazingly relaxing.

    It is of course cold – it is partly in the Arctic in February. Which leads me to wonder about some of the comments I have heard about it being very cold. A lady from Arizona was bemoaning the fact that she had never felt so cold. Me being from “up North” am not finding it too bad. But I ask myself, why did she come on the trip! I will be honest and say that the age range on the trip is what you would call Silver Surfers. It’s a heart warming tribute to how active you can be in old age. This morning we had the opportunity to go dog sledding – a fantastic experience even if getting Up and down off the sled was a bit of a challenge! The ship calls at 34 ports up and down the coast with some stops only be 15 minutes to take on or offload cargo. It’s a good way to see Norway especially where we have a few hours stop. By the way last time I said I would comment on litter – there isn’t any in Norway!

    You do get some idea about the hardiness of the polar explorers of years ago. The lowest temperature we have had is -20C. What it must have been like at -40 is difficult to comprehend. Another thing I have found interesting Is the story of the Nazi occupation of Norway and the effects it had. I don’t think we in the UK have given much thought to it with a lot of our history concentrating on the War across Western Europe and the likes of D Day. Very few War Movies have featured Norway. I remember as a teenager reading HMS Ulysses by Alister Maclean and watching Kenneth More in Sink the Bismark but not much else.. But the truth is that Norway suffered badly. Place like Tromso and the small ports around the North Cape had to be completely rebuilt because the Germans adopted a scorched earth policy as they withdrew and destroyed everything. So it’s been an interesting history lesson. It’s also proved that you can be an Old Lad of 77 and still go dog sledding! Time to plan the next adventure!

  • Litter

    What is it about our country that we tolerate litter and rubbish everywhere? I walk my dog each day up the small road we live on, and the verges and hedgerows are full of litter, most of it having been thrown from passing vehicles. The nerd that I now am in old age has carried out a survey of what is cast aside. In first place are Macdonalds containers, second are disposable coffee cups and third energy drink cans. Which makes me think that a lot of this stuff is deposited by late night workers – I’ve never actually caught anybody red handed during the day. Why do people do it?

    WhenI was at school we had numerous lessons about litter, usually under the umbrella of the Keep Britain Tidy campaign. And such was the indoctrination that I can’t ever bring myself to chuck anything out of the car window. Our current generation of youngsters do get taught about the environment and the importance of not polluting it. And children often go on litter picks. But something seems to go wrong as they grow up.

    I am writing this blog whilst sailing up the Norwegian coast towards the arctic. What has been striking about my brief experience of Norway is there seems to be an absence of litter. So what is different about the Norwegian psyche compared with us British? Mind you we are not the only ones in the World to leave our rubbish behind. Many years ago I worked in the Middle East for a year. Desert trips often revealed rubbish – believe it or not commonly Pepsi Cola bottles!

    We really need to tackle the problem. Or is this just my inner grumpy old man talking. I’ll let you know what it’s like beyond the arctic circle!

  • Preserving memories

    Like most of us I suspect I embraced the age of the digital camera and the convenience it brought to photography. I remember the days of the old film cameras. The ritual of taking the film out after a holiday, posting it off to a processing laboratory and then waiting with trepidation to see which photographs had come out and which were what you intended them to be. The great advantage of digital cameras and phone cameras is that the image you save is what you took at the time.

    I was scrolling through my Ipad the other day and was amazed to see that I have nearly 3000 photographs saved in this thing called The Cloud. It brought home to me the fact that we now rarely print out photographs. And yet photographs are the key to memories – along with other things like sounds, music, or smells. I have a large collection of photograph albums which record early family life and in many ways turning the pages of an album is more pleasurable than scrolling through a device. Its just a year since my wife Anne died and memories are important. She had a prolonged period of ill health in her last 3 years including, sadly, the development of dementia. So I became a full time carer which looking back was a very intense experience. In remembering Anne the problem at the moment is that my recall and memories are dominated by this period and it’s difficult to call up memories of happier times. So that is where photographs are a crucial part of remembering our long life together.

    However I now wonder about the fragility of my photograph collection that is in digital format. If and when we experience a serious cyber attack which could take out the “Cloud storage” in the massive data centres we are building, will all my digital photographs be destroyed? the tech experts claim to have back up for this sort of contingency but recent events where businesses have come under attack and be virtually paralysed does not give a lot of confidence. So perhaps we should consider printing out more photographs in the future to preserve our memories.. When I was studying physics at school we had a dark room and there was something quite mystical about developing photographs -watching the images appear out of the developing fluid bath and then printing them out, mostly black and white prints of course. I have spoken before about visiting an exhibition of Royal Photography and the power of black and white images. In fact if I am honest I get much more pleasure from visiting a photographic exhibition than an art gallery. I think it is right that the camera doesn’t lie

    I think we should all resolve to save a few more prints of photographs in an archive. Its important for the next generation who may not be able to access our digital devices after we depart. Time for a coffee and a browse through the photograph albums!