Friday 4 April 2014

The Labour Party would like me to be the first to know...

I got a chummy email from Angela Eagle MP, beginning "Hi Sarah"! 

We're not on first-name terms, actually, as we've never met, but I signed a petition about ending the Gagging Bill a while ago so now apparently we're buddies. 

Anyway, Angela (I think I can call her that now, even though she's Shadow Leader of the House of Commons) tells me that the Labour Party have promised to do just that, apparently cos I expressed my opinion that gagging charities from speaking about policies which have something to do with their remit (like food banks talking about food poverty) is profoundly undemocratic. Or possibly because they were always against it: maybe that's it.

So using my new-found power, influence and friendliness with the Labour Party - even the Shadow Leader of the House of Commons! - I made a few more suggestions.
Here's her email: 

----- Original Message ----- From: Angela Eagle Sent: 04/03/14 06:04 PM To: Sarah Subject: Telling you first:

Hi Sarah, Earlier this year, the Tories passed the so-called gagging law: an act that limits your right to campaign on the issues you care about, and curbs charities' and campaigners' ability to speak out against government policy. I believe strongly that this law is bad for our democracy, and restricts freedom of speech in our country. So I want you to be the first to know this: a Labour government will repeal David Cameron's gagging law. We have been clear from the start that we oppose this gag on charities and campaigners, which was introduced with little consultation. If Labour wins the next election, we will remove it from the statute book. In its place we will legislate for real reform of lobbying, and we will consult with charities and campaigners on the reforms we need to both ensure transparency and protect freedom of speech. Our right to campaign on issues we care about must be protected, and this gagging law needs to be repealed. Best wishes, Angela Angela Eagle Shadow Leader of the House of Commons

Here's mine.

-----------

Hi Angela! [Golly! But she started it!] Good! Well done. Could you also please re-nationalise the railways and the power companies for the benefit of the people? And end private prisons, which are a wicked disgrace to this country. And end the creeping privatisation of the NHS, even though some of your big names (like Lord Warner) stand to make lots of money out of it? Instead please could you concentrate NHS resources into medical work, not layers of bureuacracy and an 'internal market' - we know how that worked out for the BBC, after all. And pledge never again to use Capita again in any capacity? Also cancel Trident? And fund education decently? And agree to have some of your policies based on actual evidence of what works, not on prejudices and profit? And take climate change seriously as the biggest threat to our country currently existing or likely to happen in the coming 100 years? Because while this is a good start, it's only a start, and a small one at that. Best wishes Sarah Walker voter

Thursday 27 March 2014

Cycle One Day One

Yesterday was day one of the first cycle of chemotherapy. I had been dreading it. Silly, really, because it spoiled the two days beforehand (an effect exacerbated by having finished a piece of work and not having got my act together to resume another) and would not have made the experience any better.

As it happened, the experience was not too bad.

I soaked my arm in warm water to bring up the veins and was attached to a drip by a nice woman called Amanda who sat with us and added in various drugs - 3 in all - explaining to me what each one was and what to watch out for. This was sitting in a comfy armchair and after having swallowed an anti-nausea pill.

Essentially, chemo is poison that stops cells replicating. This includes the cells which renew my hair follicles, which maintain mucus membranes, which produce white blood cells to fight off infection, and which reproduce like mad things and turn into tumours.

Obviously, only one of those effects is desirable: it's a poison that likes the cancer cells even less than it likes the rest of me. The other effects are unfortunate, but can be got over: they will recover. The cancer cells, at the stage I'm at, may well not recover, though it is likely to take six rounds of chemo - six whacks at the rat with a chemical sledge hammer - to get the point across.

One of the effects is risky - white blood cells, which are the cunning little chaps that see off infection. Without them, my immune system is up for grabs. I've got to monitor my temperature every day, and every time I feel bad, because in the absence of white blood cells I can easily get infections which normally I'd knock out in a couple of days - and which can kill me! So the magic number is 37.5 - any higher, and I call the emergency phone line. They recover, though - by week 3 they should be back up and running, thanks to the superb powers of my bone marrow. Just in time to get whacked again in round 2: hey ho.

I sat in the chair chatting with B and Amanda, and felt, basically, fine - a little light-headed, but I hadn't slept much. A heat pad wrapped around my arm to keep the veins wide was very comforting. The only odd thing it was having my right arm immobilised - I'm right handed, but the lumpectomy and lymph removal was on my left side, and it's better to put the chemo in on the opposite side.

One good thing was to be warned that one of the drugs gives you red pee - like beetroot does - and a terrible shock when you see it for the first time. Lucky she warned me.

Then pills to take at home - anti nausea. Some to take at fixed times of the day, some to take at will. Oh, and laxatives - the anti nausea pills freeze the peristaltic waves, so stop other things than vomiting. (I've always thought that Perry Staltic and the Waves should have been a 50s surf band. Unfortunately unlikely to have played on the same imaginary bill as Death Metal band Synapse Collapse).

By 11 we were all done. Next to me a lady in an elegant black and white turban was completing her 6th and last round of chemo with her daughter by her side.

B and I got the bus back to town and went for lunch at a fave cafe, Olives, which does root hash with scrambled eggs, and spiced apple warmer. Yum, yum. I was feeling fine. Then we wobbled up the road to cruise some charity shops for headscarves and hats and books. I bought two hand made pillowcases in thick linen with lace edging and handmade buttons for £6.

Slight sensation that my mouth does not taste the normal way.

Home, take temperature (35.7) drink ginger tea, check Facebook. I've been getting so much love and support and good wishes from my FB friends. Update that I'm feeling fine. And I kind of am.

And then - oooops! Sudden extreme vomiting. Not enough warning to get to the loo. Damn. There goes lunch.

Strip bed, change clothes, wash floor, shower, brush teeth, swill mouthwash.

Bleeaaah.

Take an anti-nausea tablet. Get bucket and retire to bed. Both cats come and cuddle me. B does too.

More ginger tea. Hmmm. How am I? Not sure. I nap and read, and listen to Keith Jarrett.

B starts cooking spicy soup for supper... smells wonderful.

Take some pills with a sip of orange juice and water.

Sudden vomiting... though I managed to get it in the bucket.

Bleaaah!!!

It was mostly ginger tea this time - but a distinct sensation of the pill I had only just swallowed coming up too. Hmmm.

Read the information leaflet. If you take more than the recommended dose you can have all kind of horrible effects, including disrupted vision and distressingly irregular heart beat. However, I decide I can't really have taken the pill first time around, as it wasn't in long enough to digest. Decide to risk it and take another one.

Went to sleep without supper... no problem.

Dreamt Nigel Farage and Nick Clegg were debating, but both wearing extremely thick-framed, square, totally black dark glasses. Convinced that neither of them had eyes... Bleaahhh!!

So, for nausea read vomiting.

But, like in Michael Rosen's "We're Going On a Bear Hunt" - "Can't go round it. Can't go over it. Got to go through it."

This is one down, five to go, and I can cope.



Thursday 13 March 2014

Talking about cancer.

I have lovely friends and relations. I knew that already, but it's been brought home to me in lots of ways lately.

Early on in the process of discovering I have cancer, finding out what kind (breast), what stage (2) and what can be done about it (lots), I decided I was going to be upfront about telling people what it was. This is partly because there is still fear and stigma about cancer, and the fear certainly can work to prevent people getting diagnosis and treatment in a timely fashion.

I'm not surprised there is fear about cancer. It is a common cause of death, it is not always treatable, the treatment can be horribly debilitating and scary even when successful, and death from cancer can painful and wearying in a way that many other illnesses are not. I lost both my parents to causes which, while terrible - heart attack, stroke - were enviably quick (enviable for the person dying, that is, though shocking and traumatising for the bereaved). On the other hand, in the last couple of years I have seen good friends fight long losing battles against cancer which were incredibly wearing and painful to themselves and to their loved ones, as well as being bound to end one way only, as the cancers had reached stage 4 before they were even diagnosed.

So fear is pretty natural, and I have it myself. Stigma I don't understand at all, but that's another thing.

Anyway, I have cancer, but it doesn't have me, and I'm lucky. There is a lot that can be done for it, there is a tremendous amount of ingenuity, skill and support which goes into helping people with it, and the doctors are using the word 'curable' to me at every turn. Also I live in the UK and the NHS is underfunded and overburdened and under paid, but it's still world class and paid for from taxation rather than at the point of need. So why not tell everyone? After all, I'm going to have to explain to people why I've suddenly, for the first time since 1985, changed my hairstyle, why I might not be available for some of the things I do, why I might need to arrange cover for the classes I teach.

Telling folk does mean the people I tell are going to react to the information in their own ways. Everyone has their own take on it and that's fine.  Some express fear for me - which is OK: it is scary -  and some express bafflement (one dear person said "I don't know how to react to this" - to which the reply has to be "That's OK. I don't know how to react either") but all express concern and love. Someone sent jonquils, bless them, which make the whole house smell fantastic.

My friends and my family are great!

And... then there are also the odd responses.

A friend messages me with a link to a natural "cure for cancer": mistletoe. They ask me whether I've considered this as a treatment.

I reply with thanks, but at the moment (what with the doctors saying how it's curable and all) I'm going with the treatments the specialists tell me can cure my cancer, which is after all an extremely common and very thoroughly researched one. Friend replies saying "no doubt you have researched it and drawn your own conclusions."

Well, actually, do you know, I haven't researched it, very much.

Indeed, in the initial stages of my diagnosis (when I knew that I had breast cancer, but before I had seen the specialist to know whether it was operable or treatable or what kind of prognosis I might have) I was proud of not googling anything, because I knew that: -

a) what I found might not help me, and certainly wouldn't help me as much as the specialists would
b) what I found might quite likely be the worst case scenarios, which my imagination would no doubt fasten on
and mainly...
c) there would be a hell of a lot of dodgy and unsubstantiated claims popping up, from the silly-but-mild claims that something which kills cancer cells in a test tube will also kill them in your actual living body, to the frankly mad, bad and dangerous. Many of them - and mistletoe certainly falls into this category - are basically advertising by people who would like to sell you something.

"Research" is a curious word under the circumstances. Googling something may be the start of research (finding out what others have written, though only if it's online) but what comes up on the University of Google is ungraded for nonsense, charlatanry and source validity.

Research in the medical sense is rather more difficult. I don't have medical training, and I'm not, at 53, going to retrain as a scientific researcher all of a sudden, even now that I have a serious interest in an ailment and a first-hand experience of it that many researchers won't have. Also, we have a scientific profession (largely trained and funded at public expense), universities, hospitals and doctors by the hundreds all beavering away precisely so that when we are ill we do not have to chuck everything and become our own medical specialists.

While I generally agree with the idea that we take responsibility for things like keeping healthy (by for example not smoking, not drinking to excess, and trying to keep the weight down and to get out and about every day), I'm not about to reinvent medicine or come up with my own cures any time soon. I wouldn't be much good at it. I have other skills.

But among those skills are these. I can read, I can understand some serious scientific articles, and I have learnt from various sources (Ben Goldacre's wonderful Bad Science blog and books stand out) to have a certain degree of caution in interpreting evidence. I also have (and teach) approaches to assessing the reliability of sources, and a little bit about research project design validity.

It doesn't mean something from a respected source can't be flawed - the Lancet published the totally discredited and fraudulent article that started the MMR panic, for example, though they publicly withdrew it later - but at least the requirements of reputation encourage good sources to take validity seriously.

So, just for kicks, in the spirit of "research" (for a given value of research) I googled "mistletoe treatment for cancer". Millions of hits. The first one that comes from a reputable source is the BMJ - oh goody! Even better, it's a meta-analysis: a study of all the studies done that have been published. And it's by Edzard Ernst, a highly respected and very interesting man, who having been trained in homeopathy as well as conventional medicine has done more than most to test and to point out the nonsense that many 'alternative' treatments claim.

It's here:

http://www.bmj.com/content/333/7582/1282

Short summary - lots of proprietary mistletoe treatments available commercially in Europe and hundreds of thousands of websites promoting them. It's big business, worth millions of pounds, and in some countries insurance will pay for it.

And it doesn't work. The study is a meta-analysis, looking at the results and the set-up of all the different research that has been published. It rates them on findings (negative effect, no effect, positive effect), strength of result, and also on the experimental design. Bad design includes things like not double blinding, or poorly defined outcomes, or very small sample sizes which increases the chances that any changes are just random.

Here's what Ernst found about mistletoe as a cure for cancer: Where the research was badly designed, it got better results. When the research was better designed they got slight, no or negative results. This is to be read in conjunction with the fact that it is anyway harder to publish research which has slight or no or negative results: a lot of studies are started and just disappear from view, essentially because negative results make dull reading, and for worse reasons, like companies that sponsor the research deciding to only publish studies that make their products look good. (Amazingly, there is no central register that tracks what research is being done so people can catch companies dropping studies which disappoint them).  So the chances are that there have been more studies which the meta-analysis did not find because the results were too disappointing to publish.

And it isn't safe. Mistletoe treatments have resulted in a large number of serious adverse reactions, including ulceration and kidney failure. In the lab, mistletoe actually enhances the growth of some cancer cells (at least turmeric seems to kill them in the test tube, if not in real bodies! Besides which, turmeric is delicious in curries).

So, 20 seconds' "research" (googling) and 5 minutes reading the results gives me a strong sense that mistletoe, in spite of the hundreds of thousands of websites promoting it, will not be any use for what ails me, and might well be bad. I have cancer already: why would I want to risk kidney failure on something that does not work? (Not that there aren't adverse effects for the treatment I'll be getting. Unlike the commercial websites, though, the doctors have been entirely upfront about these, almost to the point of putting me off, and are doing tests to understand how far I'm likely to be susceptible to some of them so the effects can be mitigated).

I sent my friend the link to the BMJ, with thanks.

Oh, but I do so understand where this friend (like me a storyteller) is coming from!

It would be wonderful to imagine I could go into nature, out into the woods, to discover for myself the secret oak grove, where the healer (with a golden sickle, perhaps?) dispenses mysterious and magical mistletoe that will cure me. In imagination the white berries glow in the darkness of the sacred grove like little full moons. The healer will pluck one berry and give it to me, a little kiss of health from the wild wood.

It becomes a pilgrimage, a ritual journey that is a far cry from getting the 11 bus to the hospital (which is how I get to my healers), and also a long, long way from the actually existing version of "mistletoe as a cure for cancer", which would be a case of me sitting at home at the computer buying some expensive pills off the internet.

Even better, with "research" I could kid myself that I had become that healer.

It would be lovely if it were true. It would be just like a story.

It isn't.


Wednesday 12 February 2014

Water, water everywhere...

We can't afford education. 
We can't afford to manage our energy supply. 
We can't afford the Arts. 
We can't afford health care free at the point of need. 
We can't afford training or skills for young people. 
We can't afford the elderly. 
We can't afford unions. 
We can't afford "Green crap". 
We certainly can't afford the sick or disabled. 
We can't afford to help people who can't find a job - but that's OK, because we don't want to help people like them anyway. 
We can't afford libraries. 
We can't afford Health and Safety. 
We can't afford soldiers' pensions, so we're sacking them weeks before they qualify. 
We can't afford woodlands. 
We can't afford Human Rights. 
We can't afford food safety inspections and anyway, why shouldn't people eat slurry? 
We can't afford the North, quite frankly, and why would we want to? 
We certainly can't afford to invest in renewables, or to put any money into mitigating the effects of climate change, or to build resilience into our infrastructure - but that is absolutely fine because there's really no such thing as climate change, honest, and we must frack the hell out of the country because there's money to be made and once again we are promising energy too cheap to meter. 
We must have permanent Austerity or else we'll become like Greece - and we wouldn't want to become like Greece, would we? 

And then - Surrey floods! Berkshire floods! Some carpets in millionaires' riverside homes get spoiled! The Queen could see flood water from the battlements of Windsor Castle, were she not staying in one of her other homes at the moment. 

And... guess what? "We are a wealthy country," says Cameron. "Money is no object."

Updated to add: apparently the unlimited cheque of our money that Cameron wrote yesterday to bail out some  Tory safe seats is going to come out of "underspend" in government departments. In other words, from cuts to social security, health, education, defence...


Thursday 6 February 2014

The New News: Hair today and bald tomorrow


Thirteen days ago some highly skilled people injected me with a combination of drugs that made me unconscious and kept me like that while other highly skilled people cut me open in two places, put their hands inside the cuts, and took pieces out of my body.  Some of the bits they took out were located by earlier injecting me with radioactive material, and then using a small geiger counter, ticking away like an insane watch, to trace what they were looking for: the sentinel lymph gland in my armpit. 
Then, while the surgeon was rummaging in my breast for the original lump, some other highly skilled people with astonishingly advanced equipment studied the gland to see whether this cancer I’ve got had spread. It had, and so they concluded the operation by removing all thirteen lymph glands from my armpit. Then they sewed up both the cuts they had made,  and I was awake and back home by 8 that same evening.
“I am fearfully and wonderfully made” says the psalmist. Yes, the fearfulness quotient is increased when one has cancer, and knowing that it had spread as far as my lymph glands ratchets up the fearfulness considerably. The lymph appears to be a kind of distribution network for the body, with the lymph glands as the central sorting office from which unpleasant parcels of tumour cells can be dispatched to all locations. If it has reached there, where else has it got to?
So, two days ago, more radioactive material was pumped into my arm and a few hours later (I made a flying visit to the Norfolk Community History Club in the meantime) I lay fully clothed but with empty pockets on a gurney while a flat screen in a box hanging from a gantry clanked and crunkled its way very very slowly from my head to my toes. It started off about a centimetre above my nose, so close that the cross-hairs on the black screen blurred out of focus, and made adjustments (clunk) and shifts (crunkle) as it edged along to keep the same distance throughout. The point of this was to scan my bones, which the radioactive material would show up, in order to find out whether any cancer cells had set up shop there.
Now, bone cancer is easily the most frightening possibility I’ve had to contemplate so far, in this little vortex of “how bad can it get?” that we have been living in since December. Bone cancer is pretty fucking bad. So it’s extremely pleasing to report that the scan shows I don’t have it. (It shows I’ve got arthritic knees, but that I knew already).  Hurrah.  (Amazing how one’s perspective changes: in October 2013 I’d have been horrified to be told I had cancer: by February 2014 I’m delighted not to have a worse one).
This pleasing news was delivered to me yesterday by Mr Pain, the wonderfully-named surgeon who did the lymph and breast cancer removal. He’s wrongly named, too, because not only are the scars extremely neat and unobtrusive, I’ve had surprisingly little pain and my arm is fine (there’s sometimes loss of movement after lymph removal, but not for me).
Since then he’s been looking at the bits he cut out, or talking to the people who have, and the news is not so bad. 3 out of 13 lymph glands had cancer cells, and I still have to have a CT scan to check that those busy little distribution centres haven’t distributed them anywhere else. The cancer itself was about the size of the top joint of my thumb: it was medium aggressive, and responsive to oestrogen, which means, as I’d already been told, I’ll have to take an oestrogen blocker - but that it should help.
First though I’m going to have to have chemotherapy, starting quite soon. It’s going to make me feel like crap, I’m probably going to lose my hair, and we can’t go to New York in March as we planned, dammit. But it has a good chance of killing off the remaining cancer cells lurking about the place. After that I’ll have radiation on my breasts, and an oestrogen blocker to take for the rest of my days. 
But - and this is important - we’re still in the territory signposted “curable”.
So quite soon, probably before the end of this month, I’m going to cut all my hair off and shave my head. 
My hair is, at this present moment, waist length, last cut by someone other than myself in September 1985, when Sarah Peters trimmed my fringe for me before a job interview, and it will be strange to be without it. I was last bald in 1960, when I was a few months old, and I suspect my nut on my shoulders will look like a pea balanced on a drum, but there it is. It may regrow some day, though it will quite likely come through white this time.
Oddly enough, shaving my head has been a fantasy of mine for some years. I intend to keep my hair, plait it, and sew it into hats and things. 
I may also get a tattoo on my scalp, just for kicks. 
Gotta do something.

Monday 13 January 2014

Better

A better day today.

Still no sleep - haven't had a proper night's sleep since last Tuesday, and last night had no sleep at all. This hasn't been anything directly connected with this cancer thang, but to other stuff going on. A crisis, to which I reacted badly.

OK, so I went to the allotment and saw - not what I had feared I'd see, which was a disaster area - but quite a lot needs doing.

Some of it looked kind of fun.

There were also some rewards: treats. Picked sprouts, and pulled some gorgeous fat carrots. Then came home with booty after chatting to the old chap with the blue blue eyes (I can't remember his name).

I like the allotment when it's just a big larder, essentially, the weeds are not growing much, and all we have to do is walk up and get stuff. I'm more a forager than a grower.

But we stocked the larder: hard work last spring and summer got us this.

Then... something else I'd been dreading, easing back into the novel. And I quite enjoyed it.

I tend to beat myself up a bit with writing as duty, especially at the moment when it's my job. BUT oh Lord when it's pleasurable it's really really pleasure. Lots of ideas, suddenly. Too many, of course, to pursue, but the last 4 days I've had none except dark ones unrelated to writing or researching.

It's said that Iris Murdoch and another writer whose name escapes me once got into a conversation about how much they enjoyed writing. Murdoch said 'Oh yes - but you must never tell anyone.'

Perhaps I should think of it as my guilty secret hedonistic pleasure, rather than my guilty undischarged responsibility...

Friday 10 January 2014

Choices, choices

I have a life-threatening illness.

It is currently curable, they think. With an operation, maybe with more than one. With radiotherapy. Maybe, if needed, chemotherapy. Curable. It may not even affect my life expectancy.

But if it went untreated it would certainly kill me, in time.

So at times when life does not seem worth living, instead of knowing what I would have to do in order to cease, I know that all I have to do is refrain from doing things.

Don't go to hospital. Don't let them operate. Wait. Do what I'm good at: lie low, give no trouble, wait.

And things will happen, of their own accord, and I will not need to trouble myself - before long, will need to trouble nobody.

Wednesday 1 January 2014

My news in 2013

So, the news with which I ended 2013 is that I have breast cancer. It is operable, and both the consultant and the support worker made great stress of the word curable.

In a couple of weeks the surgeon will remove a small chunk of me - a cancer and some surrounding tissue - and also a bit of lymph gland from my armpit. I imagine they grab the lymph first, as this gets whisked away to the laboratory while I'm still unconscious. If they find anything dodgy there they can then take all the lymph glands away in the same operation, which is convenient all round. They may later come back and take the lymph away in a later operation, after they've had time to have a really good look.

The next thing is to give me some radiation - locally applied - to make sure any spare cancer cells that may be lurking get knocked out.

If that doesn't work, there is chemotherapy, which will make me feel considerably crappier, but still a good deal better than cancer would, in the long run.

As the cancer is what is described as 'oestrogen fed', I then have to take an oestrogen blocker for probably the rest of my life. This will be a novelty, as I've taken very little medicine in my 53 years, and nothing day after day since my 20s when I was briefly on the pill. I daresay I can get used to it, and (having spent since November when I first noticed the lump wondering about different possible futures) am relieved that I may have time to.

Before Christmas, I went in for some samples of tissue to be taken from the lump which I had become aware of, and from the other lump I hadn't known about which the screening had identified, and the slightly suspicious lymph glands showing up, like knots in wood grain, on the ultrasound.

The sampling is done with a small spring-loaded gun type device which shoots into you, snatches a little core of flesh, and withdraws it through a shaft not much larger than a needle. It's like being punched hard by an incredibly dense and tiny fist, but means all you're left with is a small puncture wound and a bit of bruising. The consultant clicked it a few times first to get me used to the sound so I wouldn't flinch when it was actually being used - obviously, if you flinch, you're going to have worse bruising. I didn't and had only very tiny bruises.

This is all a part with the extraordinary amount of inventiveness and ingenuity that has gone into trying to stop people dying of cancer. About 250 years of treating breast cancer and finding out what works and what doesn't, from Fanny Burney walking alone to her mastectomy with no anaesthetic and hearing the surgeon's saw grate on her own ribs, to this.

In amongst the ingenuity, the language used is interesting. The support worker, Valerie, talking about possible effects, referred throughout to "ladies" - "some ladies find that this or that". Not being a lady myself, makes me wonder what I'm doing there. Conscious efforts are made to include one's partner, and B had the pleasure of hearing himself referred to as "hubby".

Certain phrases recur I suppose as formulae for getting us all through the social transactions involved. The surgeon read me a form in which he explains what he's going to do, and what he might have to do (for instance, if he needs to take all the lymph instead of a bit), and what effects it might have, and then hands it to me to take away, read and sign, with the words "My gift to you". About 15 minutes later, the support worker, piling information into a big file in case I fancy a bit of light reading, said the same thing.

 Both concluded by saying "Well done" to us both several times. Buoyed on this wave of congratulation we made our way to our bus before I wondered what exactly it was we'd done well - possibly, well done for not breaking down? Or refusing to countenance treatment? Or refrained from punching the surgeon?

Or perhaps it was just a signal that the interviews were over and we had leave to depart, without using words such as 'goodbye' or 'that's your lot', which might, under the circumstances, make people nervous.

So 2013 ends as it began, with a visit to hospital. Last January it was B who had a scare, which turned out to be nothing. Come to think, the last few Januaries have involved visits to hospitals, though always for other people.

This time it's for me, and I'm glad and grateful we have such good hospitals, and the NHS in general - there for us when we need it... still.