Healthcare – Page 3 – Brian Micklethwait's New Blog

The Royal Marsden and its money

One of the things Patrick Crozier and I talked about in our latest Recorded Conversation is how the Royal Marsden Hospital is more mixed economy than pure NHS. It supplies services to the NHS, but is its own boss.

And surely the reason for this is that it possesses a vast flood of charitable money, as gratefully noted on the walls of the Piano Room, here:

Those are the biggest donors. (I did some notPhotoshopping there, to make the names less impossible to read.) And here:

Still big, but not so big.

My favourite, because I have a dirty mind, is the “Lady Garden” Foundation, top photo, bottom right. This sounds like something comedian Jimmy Carr would talk about.

Patrick Crozier and I talk about death – and lots of other things

The latest Patrick Crozier Brian Micklethwait “podcast” is up, although I prefer “recorded conversation”.

Our subject was … well, basically some thoughts that were provoked by my recent lung cancer diagnosis, and by Patrick’s recent experiences ~~as a carer~~ (see first comment from Patrick) of a dying mother.

But, we did a lot of tangenting, me especially. I think this was because the treatment I’ve been having has been so successful, for the time being anyway, that I was, when we recorded this, and still am, feeling rather cheerful, considering. Thank you Osimertinib, not least for giving me back my voice. We couldn’t have done it without the magic pills I’m taking.

Patrick’s notes, with lots of links to stuff we mentioned, give you some clues about all that tangenting.

I was interested in what Patrick said about grieving. It doesn’t come in stages, said he. It comes all at once.

I honestly don’t know why you should devote an hour and a half of your life to listening to this conversation, what with there being so much else to be attending to in the world these days. If this sounds like it will appeal to you, great, go ahead. But Patrick and I keep doing these recorded conversations because we seem to enjoy them. I certainly do, and I like that I can listen again and be sure what was said. Patrick and I are good friends. We enjoy having long and thoughtful conversations, and these tend to be more thoughtful if we know that others might be listening in. For me, this is the big and immediate benefit of sharing them with potential listeners, quite aside from the matter of how many people actually do listen.

For some reason, the one we did about the Falklands War seems to have attracted the most listeners, by our modest standards. Not sure why. Maybe it was Americans, with their own opinions about what happened, but wanting to experience it from a domestic Brit point of view. Or maybe just younger people, eager to learn about an interesting drama that, understandably, gets rather less attention than bigger wars, like Vietnam and WWs 1 and 2. Or maybe older people wanting to compare our recollections with theirs.

Architectural modernism: Its triumph indoors and its battle out of doors

Today I was at the Royal Marsden, having a scan in a device that looked like this:

In other words it looked like a time travel portal in a rather bad movie. That photo’s a bit blurry, but they only allowed me one go at photoing it.

But that’s not my point here. What my point is is a hobby horse of mine, namely, well, … see the title above. The way that Architectural Modernism has totally triumphed indoors …:

…, whereas, out if doors, there’s still everything to play for:

That being my cropped version of an aerial photo of the same Marsden Royal whose insides are entirely tricked out in Modernist Vernacular. I found it hanging on a wall, somewhere inside the Marsden itself. And that’s right. The outside of the Royal Marsden is not Modernist Vernacular. Anything but. It is Victorian Ancient, just as it has always been. But the inside is now entirely tricked out in Modernist Vernacular.

And that illustrates a widely observable contrast in our world, and is why so many Ancientist facades are being held up with metal frames, while behind all that, Modernist interiors are being erected.

There are lots of reasons for this contrast, but the basic reason is that Architectural Modernism works extremely well indoors, but rather less well out of doors.

Actually, that first photo does have something to do with it, as I may or may not get around to explaining, in another posting.

Sniffer dogs and beavers – both doing well

Friday, so: animals. Obviously, I noticed this story about dogs with the superpower ability to smell prostate cancer in a blood sample a lot sooner than prostate cancer tends to be noticed now.

However, I especially liked this other story – well, a tweet – about beavers, which was accompanied by a map of Europe:

Many who first glance at this beaver map are sad and angry. Look how the beavers have declined. They used to be all over the place, but are now clinging on in just a few redoubts. Woe. Humanity, bow your heads in shame at yet another crime against nature.

But no. Look at the colour/date info on the left, and you see that the small dark brown bits were where the beavers were to be found in 1900, while the light brown expanses show where they were living more than a century later, in other words now.

From this recent Guardian report, we learn that beavers are now doing well here in the UK, despite the paucity of British beaver activity to be seen on the above map.

The popular rodent, whose dams have been shown to boost hundreds of species of insects, amphibians, birds, fish and plants, is returning to Dorset, Derbyshire, Hampshire and the Isle of Wight, Nottinghamshire and Montgomeryshire.

Last year the government allowed free-living beavers unofficially let loose into the River Otter in Devon to remain there, but all licensed releases into the wild in England and Wales are into large enclosed areas. There are, however, other unofficial beaver populations living freely on some river systems.

“Unofficial beaver populations”? I never knew that was a real thing. Makes it sound like the beavers have to apply for planning permission before they can construct a dam.

However, the key words in the above quote are, I think, the ones about this “popular rodent”. Had beavers not be so liked by humans, would they have done so well? I doubt it.

Like the man from the Wildlife Trusts says:

“… people love seeing them and their presence boosts tourism in the countryside.”

The earth is rapidly becoming a great big zoo, and whether there are lots of specimens of this or that creature is going to depend on how “popular” each creature is, with us.

And, as I have been saying here for some while, this trend will greatly accelerate once synthetic food starts to make its presence felt, and the whole raising-animals-to-eat epoch starts to wind down.

Steve Davies: Four new technologies to be optimistic about

I seem to recall a lecture, given by Steve Davies at the IEA just before Covid and the political reaction to Covid started spoiling all our lives, in which he warned that modernity might be stopped in its tracks or worse by some unforeseeable disaster, and that we should watch out. And I’m pretty sure that, during the Q&A, he even mentioned the possibility of a pandemic.

Now however, Steve Davies says, not unreasonably or inconsistently, that the future is brighter than many now, as the Covid crisis persists, assume or at least fear:

People everywhere need to recover their sense of confidence and optimism and to realise not only that this is, undoubtedly, the best time ever to be alive, but also that the future will be even better.

Davies then writes about four technologies which he says will transform life for the better: autonomous vehicles, synthetic food, artificial intelligence, and anti-aging medical treatments. So, life will not only be better; it will also last for far longer.

Regular readers of this blog will know that recently I have particularly noticed technology number two in the Davies list, synthetic food. And number one, autonomous vehicles, has long been to be an interest of mine also. I agree that both will be “epoch making”, eventually.

But I probably won’t live to see either epoch unfold. As far as I’m concerned, that last one, extended life-span, through the conquest of such things as cancer, can’t come too quickly. Which is why it almost certainly won’t come, for me, quickly enough.

However, I recently I heard some wisdom based on recent personal experience spill out of my mouth, to the effect that, now, being told that I have a potentially quite-soon-fatal disease, at my already quite advanced age, is a big deal, but not that big a deal. This just means that I will die a bit sooner. But what if such a medical mishap meant that I died a lot sooner, like about a two hundred years or more sooner? That would be a very big deal. In an age of multi-century lifespans, if that is what is about to arrive, people will surely become far more risk averse even than they are now, because they will have so much more to lose by dying.

But then again, adolescent boys have long had a lot to lose and they are notoriously prone to risk-taking, just for the hell of it. So, what do I know?

In general, will people actually be any happier? I doubt this, because happiness seems to depend more on one’s internal mood than on one’s mere circumstances. I don’t feel any more miserable now than I was a couple of years ago, when I was unaware of my medical condition and before it started or at any rate before it started hurting.

The Royal Marsden grand piano

Today I paid an actual face-to-face visit to the Royal Marsden. The Verdict was: I keep on with the magic pills, which will keep on doing me good. So: good.

Here is a photo I photoed today while I was there and just before I left:

This is my favourite place in the Marsden, because it is the one place, aside from the main entrance, where I know where I am. There is a lot of equipment in the Marsden, but I am fairly sure that they only have one grand piano. And when I see this piano, I know that I am in a particular spot very near to the main entrance.

In all other inside parts of the Marsden, the style is interior modernist vernacular. In other words, everywhere looks the same and strangers (that’s me) get totally lost. Architectural modernism has triumphed indoors. Out of doors, in London, architectural modernism is a major force, but it has not totally triumphed, and in many parts of London has not triumphed at all. But inside something like a big hospital, it’s all modern, and all modern in the same way.

Except when they have a grand piano to show off. When that happens, you know where you are.

I photoed the above photo with my mobile phone rather than with my regular camera, to check out if interior and rather badly lit scenes do better on my mobile than on my camera (as operated by me). And guess what, they do. I know I know, if I knew how to operate my camera properly it would do better. But I don’t and therefore it doesn’t. My camera is set on automatic. And my camera’s automatic is much, much worse than my mobile’s automatic, in other words than my mobile.

This is actually quite a big moment in my personal photoing history.

The hope of progress

Having recently received a life sentence of quite advanced lung cancer, I find myself noticing reports like this one entitled Ultra-precise lasers remove cancer cells without damaging nearby tissue. Cancer treatment is progressing fast, in all manner of directions, and I am now seeing stories of this sort every few days. Will it progress fast enough to prolong my life in a significant way? Knowing what I do of how long it takes for an innovation to go from a recent observation or discovery to a routine service, my guess now would be: not. But I can’t help hoping that it might.

In another context, I have described this sort of feeling as the torture of hope.

I came upon this above report at the Twitter feed of Steve Stewart-Williams. There being a lot more to that guy than cute animal videos.

Buggering on

According to GodDaughter2’s Dad in one of his recent emails, Churchill once said something about how we just have to keep buggering on. Either that or GD2D made this up. Anyway, that’s what I am now doing, as best I can.

Today started going to hell last night when the Royal Marsden rang to say that the telephone-appointment they had been saying for about a fortnight would be at 3.30pm might actually be at more like 11am! Which meant that cricket lag (which it turns out I am suffering from) came into play. Instead of sleeping during the small and then not-so-small hours of this morning, I instead had a succession of coughing fits, all made worse by the thought that, come the telephone-appointment, I would be struggling to stay awake. The only way to stop the coughing during the night was to get fully up, sandals, sweater, the lot, and sit for an hour or two in front of my computer like it was the day. Being vertical being the only way to stop the coughing. Maybe it’s just because I now have words for what is wrong with me, but my lungs, while I was coughing, seemed truly about to give up on me, if not now, then some time rather soon.

But at least, having got me up at the crack of 10.30am, the appointment was indeed at just after 11am, so there was that. So, back to bed for the afternoon, including a bit of sleep, and then an early evening during which various further details were sorted, to do with who would live my life for me in the event that I became incapable of living it myself. Once again my Senior Designated Friend was driving all that along. Without her, I’d not yet be dead but I’d probably be wishing I was.

Now, I am trying to avoid eating or drinking anything that might keep me awake for yet another night. Quite easy because today I consumed a massive fish pie at lunchtime. But will I sleep tonight? Weird how I can sleep through great chunks of one of the great fourth innings run chases of all time, but could not, last night, just sleep. So maybe it’ll be the same this coming night, with, again, no cricket to relax me.

Tomorrow, at a genuinely early time in the morning, I am off again to the Marsden, for a Covid jab and for research tests associated with that (they want to know how lung cancer sufferers react to the Covid jab), and I’ll also hope to be picking up an inhaler, to stop me coughing being the idea of that. We shall see. At least I’m finally getting the jab.

Just taken another daily magic anti-cancer pill. Will it ever have any effect on the cough? Like: end it. That would really be something.

Death and detail

Yesterday, my Senior Designated Friend and I communed with my lawyer, via Zoom (which my SDF organised on her laptop). All seemed to go well. I had been ignoring Zoom, until the lawyer said he needed it.

I had hoped by now to be blogging profundities, but am still at the stage of trying to arrange my affairs in such a way that, were I to die soon and without further warning, or perhaps become terminally incapable, those affairs would be, as they say, “in order”. It would be clear what everything consists of and who gets what, and what to do about switching me off, should the question arise. Thank goodness for the SDF, who is doing almost all of this arranging, and without whom I would now be in a state of gibbering uselessness. It’s an exhausting business, even though my contributions are only occasional. Maybe death soon, and taking care of details in the meantime, death being why that has to be done. I remember that same combination when my mother died. Death, detail.

Meanwhile, you must forgive the decline in blogging quality here lately, and the possible feebleness of a lot of the next lot of postings also.

The magic drug seems to be working. I think I can feel a definite improvement. But now I just want to rest up and let it work its magic.