Author: jamescalumcampbell

Put my back out this week.  I gotta tell ya – my back is my Achilles heel.

How I did it was quite ridiculous.  I happened to read a letter in The Herald stating that “antidisestablishmentarianism”, 27 letters long, is the longest word in the English language.  “No it’s not!” I cried out loud. “It’s floccinaucinihilipilification!”  (28 letters).  And promptly wrote a Mr Know-it-all rejoinder to the paper.  I did make mention of “supercalifragilisticexpialidocious” (34 letters) just to pre-empt any “Dr Campbell needs to wake up and smell the coffee” retorts.  It didn’t work.  The word thrown in my face was pneumonoultramicroscopicsilicovolcanokoniosis (45 letters).  This is the sort of mindless banter we descend into for entertainment during lockdown.

I wish I hadn’t embarked on this wild goose chase.  I happen to have the Oxford English Dictionary, a vast tome and the last word in English usage, encapsulated in a single volume of considerable dimension and weight, which requires a magnifying glass to read (unless, as the daughter of a friend of mine demonstrated, you are 18 years old).  It was while I was manipulating this unwieldy volume that something in the lumbar region went twang.  Since then I’ve been wandering around like a half-clasped knife.

I did make a self-diagnosis – always a risky undertaking.  This was what we call a “mechanical back”.  Nothing to worry about.  All will be well.  I’ve lost count of the number of times I’ve experienced an episode like this.  I associate it with poor posture and overuse of the computer.  I experienced many such episodes during my career as a GP but I always managed to drag myself out of bed (supposing it took an hour) and crawl into work.  Our physiotherapist would glance at me and say, “It’s gone out again, hasn’t it?” and she would give me an instant treatment which was balsam, at least for as long as it lasted. 

In hospital, the orthopaedic surgeons hated getting patients with acute back pain referred from the emergency department, because, by and large, they weren’t going to investigate them or operate on them, but merely give them tender loving care.  They would end up blocking a bed.  Now you might say TLC is not part of the orthopaedic remit.  I couldn’t possibly comment.

But I was always very careful with patients with back pain, both in the emergency department and in general practice.  I would go over them with a fine tooth comb, looking out for the dreaded cauda equina syndrome, the missed diagnosis that appears with bleak and monotonous regularity in the pages of the medical defence journals.  99% of the patients had mechanical back pain.  I would lie prone on the surgery floor and demonstrate the exercises aimed at restoring the lumbar lordosis.  Physician, heal thyself.

I have a notion that we doctors don’t really understand back pain.  After all, if we did, we might be better at fixing it.  It’s a bit like dyspepsia.  We used to think we knew what caused gastric and duodenal ulcers, and we performed heroic procedures like vagotomies and pyloroplasties and Billroth 1 and 2 partial gastrectomies.  Then, remarkably recently, an Australian physician showed that the causative agent was Helicobacter pylori and all you really needed was a week’s course of antibiotic.  Now if John Buchan, Lord Tweedsmuir, had lived in the antibiotic age, he wouldn’t have had to endure a lifetime of tummy ache.  Then again, we wouldn’t have had his creation, the American magnate policing the world on a diet of white fish boiled in milk, John Scantlebury Blenkiron.

But to return to pneumonoultramicroscopicsilicovolcanokoniosis (an occupational lung disease, I presume, of volcanologists), it occurred to me to prolong the excruciating newspaper correspondence by coining a biochemical formula of the sort that can be more or less endless, like 2,3,dihyrdopolybenzoicethyleneglycolicorthopentocyclopentanobisblablabla….ene.  Or again, a German loan word.  The Germans have this great capacity for conjoining and amassing syllables.  They do it with numbers.  5,723,927 is fünf Millionen siebenhundertdreiundzwanzigtausendneunhundertsiebenundzwanzig.  Pithy.  But in the end, I let it go, maintained a dignified silence, shut down the computer, and went for a walk, which turned out to be far more therapeutic.

Now I read The Herald letters column and look out for the daily political diatribes from a well-known corpus of correspondents, guaranteed to make me splutter into my cornflakes.  The world is awash with anger.  Then my back starts aching again.  Maybe lumbago isn’t mechanical at all.  Maybe it’s all in the mind. 

It doesn’t do to splutter into one’s cornflakes.  Far better to read in an open-minded state of calm.  You never know; somebody might write so persuasively as to make one change one’s mind.  “I beseech you in the bowels of Christ,” said Oliver Cromwell, “consider that you might be wrong.”  But if not, and you are compelled to write back, better to do so respectfully, than to carp and snipe.  I saw a letter from a Diehard Remainer taunting the Brexiteers about the stinking fish on the lorries at Dover.  “Brexit going well?”

Ha!  That’s antidisestablishmentarianism’s floccinaucinihilipilification.

Time for another walk.          

There is something positively biblical about the last days of the Trump presidency.  I imagine him, holed up in the Oval Office, the phones silent, sensing his power slipping away as even his staunchest allies seek to distance themselves from him.  Looking out on to Pennsylvania Avenue perhaps he can see the bare-chested men with big beards and Davie Crocket hats, touting enormous semi-automatic weapons, but he can’t reach them as his Twitter account has been suspended, permanently.  On this side of the pond, prominent establishment people who once fawned over him now openly condemn him.  He is yesterday’s man.  Now they court Mr Biden.

I wonder if Mr Trump seriously believes that he won the election.  I think so.  If you believe, not that the truth is out there, that is, that the truth is an external reality which your own sense of self cannot bend to your own will and wish-fulfilment; but if you believe that that which you desire to be so must ipso facto be the case, then you believe that you hold within you the power to define the truth.  Toddlers believe they can bend the universe according to their own will, until they bruise themselves on inanimate objects, and discover there are other beings in the universe who operate according to a different agenda.  “The terrible twos” is the expression of rage which marks the realisation that the toddler is not, after all, omnipotent.  Mr Trump’s refusal to attend Mr Biden’s inauguration is childish and petulant, the toddler’s expression of rage.        

Perhaps delusion goes hand in hand with enormous power.  Is this why King Canute enthroned himself on the beach and ordered the tide to stop coming in?  I have a notion that the members of any exclusive establishment or élite are to some extent deluded.  They begin to believe in their own sense of entitlement.  They can shape the world according to their own will.  Make America great again.  Over here, we will make the UK “world beaters” by wishing it to be so.  Mr Gove passed that infamous remark casting doubt on the value of experts.  Why let hard facts get in the way of a good narrative? 

I believe one of the chief reasons why New Zealand did so well in eradicating Covid-19 was that New Zealand society does not have an élite.  The New Zealand parliament does not have a second chamber, an upper house.  There is no establishment.  When Jacinda Ardern closed the border last March and locked the place down, everybody complied because everybody knew they belonged to a community.  Of course the economy was going to take a hit, but New Zealanders are extremely self-reliant people and they were never going to starve.  (I heard Ian Blackford, leader of the SNP at Westminster, on Any Questions on Friday, say that the number of food parcels being handed out by food banks in South Skye and Lochalsh had increased from 25 per month in January to 180 per week in December.)  But in their reaction to Covid, the Kiwis were nimble.  There was none of the obscurity and obfuscation so beloved of la crème de la crème.  “Well, yes, we might try that of course, but it’s going to be very, very difficult…”   

No doubt 2020 was difficult in NZ.  During the pandemic, Ms Ardern owned up to a sense of Impostor Syndrome.  But then she cast it aside and thought, “Just get on with it.”  Élites are not very good at just getting on with it.  They are too bogged down in their own vested self-interests. 

Meanwhile the Trump presidency – unless the 25^th Amendment is invoked – has 9 days to run.  One thing we have learned in the last four years is that Mr Trump is a very unpredictable man.  I have a notion that he has one last trick up his sleeve, un coup de théâtre to unveil.  I wonder what it’s going to be.

I’m holding my breath.         

On Hogmanay in my local shop I was asked, “How are you bringing in the New Year?”

“Quietly.  A game of Scrabble, Horlicks, and bed by 9.30.”  In the event, I stayed up for the Bells, flicking between Jools Holland’s Hootenanny and Susan Calman’s show on BBC 1.  Sir Tom Jones is remarkable, as are Amy Macdonald and Hannah Rarity.  Hannah did not murder Auld Lang Syne.

Thence to bed.

At dawn on New Year’s Day I walked the two miles from my village to Flanders Moss, a nature reserve of great beauty, and tranquillity.  Me, the sheep, and the horses, we had the world to ourselves.  A beautiful winter’s morning.  There was a near full moon in the north-west, and I saw the sun rise over the Carron Hills in the south-east.  (Next time I saw the moon, in the evening, it was an enormous bright golden sphere rising in the east.)

Back home, I tuned in to the New Year’s Day concert from the Musikverein in Vienna.  Riccardo Muti was conducting the Vienna Philharmonic, before an empty hall.  That orchestra seems to be able to play the Viennese Waltz as nobody else can.  Before the traditional encore of The Blue Danube, Maestro Muti gave a speech, in English, reminding our world leaders of the healing power of music and the importance of nurturing culture.  Of his colleagues, he said, “We give flowers, not… things that kill people.”  Maestro Muti is in his eightieth year, though to see him you would hardly believe it.  When I was an LSO groupie I recall one of their first violinists saying to me, “Muti!  Bastard!  Absolute martinet!”  The spectre of Toscanini was summoned.  Yehudi Menuhin records in his memoirs that he rehearsed with Toscanini in his apartment at the Hotel Astor on Times Square, New York.  During the rehearsal, the phone rang – three times.  On the third ring, Toscanini rose from the piano, not to answer the phone but to disconnect it by heaving the electrical fitment off the wall in a tangle of wires, bits of wood, plaster, and dust.  This the sort of thing you can do if you are a Maestro.  

Well, I think Maestro Muti must have mellowed; his message was beautiful.  For the gig, he was put up in Vienna’s old Imperial Hotel which abuts the Musikverein.  He, and a handful of business men, had the place to themselves.  Muti said he felt like the hero in his own apocalyptic disaster movie. 

In Scotland, Saturday January 2^nd was a sombre day, being the 50^th anniversary of the Ibrox disaster.  2/1/71 was also a Saturday, and the traditional New Year Old Firm match took place at Rangers’ home ground.  It was by all reports a dull match played in dull and bitterly cold conditions.  It only came to life in the last two minutes, when Celtic scored, and then Rangers equalised more or less on the final whistle.  One all.  In high spirits but in good humour, a crowd of 80,000 dispersed. 

There was a crush on Stairway 13, a stairway at the north-east corner of the stadium leading down to Cairnlea Drive and thence to Copland Road, the nearest subway station, and in the space of just a few minutes 66 souls suffered death by asphyxiation or suffocation.  An early theory was that the excitement of the late goals had caused the departing crowd to turn back, but this theory was later discredited.  The event only took place after the final whistle had blown.

As with so many sombre events, the assassination of JFK, the murder of John Lennon, I remember where I was at the time.  I had been at Arlington Baths, and I had got on a bus on Woodlands Road, heading west – so a 10, a 10A, or a 59.  Somebody on the bus told me a major disaster was unfolding at Ibrox.  My father, being a policeman, was on duty at the ground.  It is a mark of my teenage zero emotional intelligence that I don’t recall thinking that this event would probably be the worst thing my father would ever have to deal with in his career.  I wish I’d had the gumption to express to him my sympathy and to offer what modicum of support I could.  But I guess I was just living on another planet. 

Die Wiener Philharmoniker, und ich, wünschen Ihnen… Prosit Neujahr!!! 

Last week I posted a particularly nerdish acrostic, and I was pleasantly surprised to be contacted by a couple of people anxious to have sight of the solution.  Ergo…    

Solution to Cascade

ACROSS

1 Christmas Factor

6 sonic

9 imp

11 reagent

13 spaghetti

14 erotica

15 elope

16 isotope

17 extravert

18 Aida

19 amber

22 airy

23 despotic

25 pasta

27 Britannica

30 turtleneck

31 pombe

32 limacine

35 ages

38 adopt

39 Tsar

41 isochrone

44 iambist

25 basil

46 aerator

47 non-linear

48 italics

49 yea

50 playa

51 Tatiana Romanova

DOWN

1 Chinese cabbage

2 surgical

3 stereotypical

4 astronaut

5 roadie

6 schoolmaster

7 nitrogenase

8 Crimea

10 proctor

12 academe

13 speed

20 spat

21 Shakespeariana

26 Haemophilia A

28 impedimenta

29 Noel

33 myristica

34 Neo-nazi

36 ghostly

37 charisma

40 sober

42 kidnap

43 street

The legend deciphered

The Cascade is based on the haematologist’s classical blood coagulation model, in which a series of molecules are sequentially activated, for example in response to trauma, to prevent blood loss by forming a clot.  Classically, 12 molecules were identified.  A thirteenth was later added.  They are activated in reverse order.  The initial trauma activates Factor 12.  Activated Factor 12 is Factor 12A.  12A activates Factor 11 to 11A which in turn activates Factor 10 to 10A, and so on.  (The current working model has become rather more complex.) 

To return to the legend:

13 clues form a CASCADE in diminishing order of solution length.  Each of these clues defines its own solution, and gives its length, in an inactive form…

These solutions are, in descending order:

Tatiana Romanov

Shakespearian

Churchillian

Haemophilia

Impediment

Britannic

Myristic

Charism

Erotic

Crime

Play

Aid

Ye

These solutions need to be “activated” before entry to the grid, by addition of the letter A.  Hence Tatiana Romanov becomes Tatiana Romanova, Shakespearian becomes Shakespeariana, and so on.  In addition, the clues defining these solutions also define the next solution in the cascade in its active form.  Hence, for example, the clue to erotic (14 across) must also define Crimea:

Nightingale theatre arousing to Eric (6).

The cascade is cyclical because the last clue in the cycle activates the first:

49 ac: You old Bond girl! (2)

“You old” is ye, activated to yea.  The Bond girl is from From Russia with Love.  Tatiana Romanova.

The most difficult two clues in Cascade are 1 across, and 26 down, because they require specialist knowledge.  Hack these, and you’ve hacked the whole thing.     

1 across:  9, protective against 26B (9,6)

Factor 9 in the clotting cascade is “Christmas Factor”.  If you lack Christmas Factor, you develop Christmas Disease, otherwise known as Haemophilia B.  Haemophilia A is Factor 8 deficiency.  “Weightless without women” is “eightless”.  “Encumbrances” defines the next solution in the cascade – Impedimenta.

I know what you’re thinking.  I need to get out more.   

I must apologise to you, gentle reader, for Cascade, yesterday’s cruciverbalist’s overindulgence.  I am searching round for any extenuating circumstance that might mitigate this appalling lapse.  All I can say is that this is the season of overindulgence.  You consume an enormous turkey roast (in our case, pork – me and Nigella Lawson) and settle down to a Christmas crossword puzzle of gigantic proportions.  Have another mince pie, ho ho ho. 

I especially apologise that Cascade is not particularly legible.  I used a specific software package to construct the grid, but it and my blog site weren’t talking to one another.  I was minded to pack it in, but then I was on a mission, damn and blast, and determined to find a way.  Well I got there.  Bit of a Pyrrhic victory you might say.  I don’t seriously expect anybody to solve this acrostic.  Nonetheless I will post a solution – if I can figure out how – come the New Year.  Perhaps I will enlist the help of a teenager who will click the mouse on a few icons and say, “There you go.  It’s intuitive!”

Still, I’d rather occupy the twilit zone twixt Christmas and New Year doing a crossword than reading the 1243 pages of the EU-UK trade deal.  That’s longer than The Count of Monte Cristo!  And I imagine a lot less gripping.  I think I’ll stick with the executive summery. 

Christmas is traditionally a quiet day, and this year, with the travel restrictions, unusually so.  I walked up Callander Main St at dusk and it was entirely deserted.  I half expected to see tumbleweed wafting down the centre of the road.  Boxing Day brought Storm Bella.  Charlotte Bronte would have said, “There was no possibility of taking a walk that day”, but with the same stubbornness that made me post Cascade, I got happed up, went out, and got soaked to the skin.  Invigorating!  We had a light covering of snow on Sunday morning.  It was a beautiful winter’s day.      

So where are we?  Fourth Night, I think.  I always remember that come January 2^nd, my mother would sigh with relief and say, “Thank goodness it’s over for another year.”  It’s traditionally a time of resolution, but who can now resolve to do anything, other than soldier on? 

An forward, tho I canna see,

I guess an fear!

But then while I was drying out and warming up after my encounter with Bella, I read, in one gulp, Viktor E. Frankl’s Yes to Life, In Spite of Everything (Penguin Random House, 2019).  Inspirational.  Dr Frankl makes a particularly powerful case against the idea of assisted suicide.  He speaks from a position of some authority.  He did after all survive Auschwitz.  Behind the wire, I don’t think I’d last a single day.  But who can tell?  We are taught to pray to be delivered from the trial.   

All you can do is that which you are supposed to carry on doing.  When I was a youngster I was full of resolutions, but now I only make one. Keep scribbling.                       

On this winter solstice evening I will cast a glance – weather permitting – towards the western sky and try to catch sight of the predicted close alignment of Jupiter and Saturn, to form an apparent star of unusual luminescence, not seen for four hundred years.  Whatever chaos reigns on planet Earth, it is reassuring to know that the majestic clockwork still ticks along over our heads.  These planetary bodies are like the Mississippi; they just keep rolling along.  Maybe this is what the Magi saw.

I was thinking of the Magi on Sunday evening while attending a Zoom ceremony of lessons and carols.  Sometimes on these occasions – though not on this one – you hear a recitation of T. S. Eliot’s Journey of the Magi.  It is a remarkable poem, rich in imagery and symbolism.  But it is not a comfortable, far less a comforting poem.  On the contrary it is profoundly disturbing.  It closes with the expression of a death wish not unlike the death wish of another winter traveller, the protagonist of Schubert’s Winterreise, who pauses at a wayside inn, Das Wirtshaus, which is actually a graveyard.  The traveller enquires if there is any room in the inn.  Two songs later he observes a phenomenon of the heavens, much as the Magi may have observed Saturn-Jupiter.  Die Nebensonnen.  Ice crystals in the atmosphere refract the sun’s light to give an illusion that there are three suns – “mock suns” – aligned in the sky.  The traveller turns his back on them.

Im Dunkeln wird mir wohler sein.

I’d be better off in the dark.

Schubert’s forlorn lover travelled on foot, the Magi by camel.  We travel by Airbus A380 and we plan to travel by HS2.  The earth flashes by unseen.  It’s more a hallucination of travel, a kind of vertigo. 

Eliot’s poem seems to me to be the poem of this time, our time.  We can no longer be at ease in the old dispensation.  It has become clear even over the past twenty four hours that a vaccine is not likely to provide us with a quick fix for the predicament we are in.  The English Health Secretary Matt Hancock has said that the situation is out of control.  The Prime Minister’s bullish prediction earlier in the year that we would be back to normal by Christmas sounds more than ever like the predictions of August 1914 – Berlin this Christmas, then home.  In fact, if this thing only lasts for the duration of the Great War, we might count ourselves lucky. 

But surely the old dispensation is gone.  Surely we must not attempt to resume normal service.  Apparently not.  Last week the Supreme Court overruled the environmental objections to a third runway at Heathrow, and allowed planning to proceed.  HS2 is alive and well.  All roads lead to London.  Under the old dispensation, aeroplanes were taking off and landing at Heathrow every forty five seconds.  Why on earth would you want to cut this down to thirty seconds?  Why would you want to cut a swathe through the hedgerows of England just to get from Birmingham to London twenty minutes quicker, and make the journey sixteen times every hour?  I suppose it is because our beloved leaders are intent on making Britain great again.  London is a hub.  London is the centre of the world.  A “world leader”.  It does not seem to matter that casting an Airbus A380 into the air every minute is not compatible with the survival of the natural world, so long as we can get back to our old habits of conspicuous consumption.

There are these wonderful lines in Ben Jonson’s Volpone which exquisitely capture the death wish of the old dispensation:

…and could we get the Phoenix,

Though nature lost her kind, she were our dish.

Count me out. 

When a societal institution such as a school or a prison or a hospital is seen to be failing, the authorities, by which I mean the government, or a branch of government, or a government-appointed agency, moves in and places the institution under “special measures”.  The people running the show are either sacked or, perhaps more humiliatingly, rendered subordinate to a new dispensation.  (It’s like that scene in the movie Diehard in which the FBI descend upon the Nakatomi Plaza business tower block which has been taken over by the euro-gangster Alan Rickman.  The chief cop introduces himself to the Feds and says, “I’m in charge here.”  Special Agent Johnson (no relation to the PM) says, “Not any more.”)  So now the old guard need to do as they are told.  In the real world, the new directive from on high often takes the form a plethora of protocols under which the ousted and humiliated erstwhile seniority must cease to think creatively and merely carry out their allotted task by numbers.  They are required to stifle any initiative they may feel they have had, and function as cogs in a machine.  I say “plethora” deliberately, because the damning report that has come from the Royal Commission, or the independent judge-led report, may offer, and insist upon, a fantastic number, like three hundred and ninety six, or so, of recommendations.  

I wonder if the members of Her Majesty’s Government have any idea how close they are to being put into special measures.  It doesn’t matter whether you were a Brexiteer or a Remainer.  The idea of wrangling, for four and a half years, over the terms of the UK withdrawal from the EU, and at the end of that time coming up with nothing, is not merely unacceptable, or reprehensible, or damning, it borders on the absurd, the surreal, and the insane.

I think it was the F1 world champion Sir Jackie Stewart who once said that, while there are many people who can open a deal, there are very few who can close one.  In any walk of life, you need to be able to differentiate rehearsal and performance, training and racing, swotting for a test and sitting the test, debating and voting, coming to a decision, and enacting it.  The preparation is important.  In medicine, the doctor takes a careful history from the patient, carries out a physical examination, undertakes targeted investigations if necessary, collates data, reaches a diagnosis, considers how the diagnosis uniquely affects the patient, settles upon the proposed treatment, or management, of the patient’s illness, and then writes the prescription.  It has been a long and complex process, but in the end, the only thing that really matters is the prescription.  It doesn’t matter how elegant the consultation and diagnostic process has been; if you don’t decide on a treatment, and initiate it, the entire process has been futile. 

Of course doctors worry that their choice of treatment is misguided.  They may agonise over the decision.  They may confer with colleagues.  But in the end, that prescription still has to be signed off.  Failure to do so is an abnegation of responsibility and a tacit admission of utter failure, and defeat.

In terms of the current EU/UK negotiations, Michael Martin, Ireland’s Taoiseach, understands this.  He has said that an inability to get a deal over the line would be “an appalling failure of statecraft”.  But I do believe there are people in government who cannot discern the difference between process and progress. 

I don’t think the electorate will take kindly to the notion of a No Deal Brexit, not necessarily because World Trade Organisation rules are not the best, but because the government will have taken four and a half years to arrive at an arrangement which, in broad outline, could have been signed off, in 2016, on the back of a fag packet over morning coffee.  It is at that point that the electorate will send in Special Agent Johnson. 

What will he do?  Well, he will probably do all the things that governments do to failing schools, prisons, and hospitals.  He will introduce some stringent rules.  The diplomatic practice of “working through the night” at the last minute will have to stop.  Surgeons and airline pilots know they are dangerous people when they are tired.  Exhausted politicians or diplomats are not likely to make good decisions.  They need to manage their time better.  And the “working dinners” will have to stop.  Surgeons don’t munch a pie behind the sterile mask while removing an appendix, pilots don’t balance a Vindaloo on their knee while landing at Heathrow.  Of course, it goes without saying that the Palace of Westminster’s bars will have to close.  There are no bars in schools, prisons, or hospitals.  Special Agent Johnson will send in functionaries with clipboards who will perform time and motion studies.  Perhaps they will get the MPs to clock in.   

But much as the Schadenfreude of watching politicians squirm under the new austerity tempts me, I don’t really want them to don the straitjacket of three hundred and ninety six recommendations.  It always seems to me that, when a judge places an institution into special measures, the bigger the number of recommendations, the less likely it is that the judge has uncovered the real root of the institution’s problems.  He has not seen the wood for the trees.  Of course the devil is in the detail, but in any complex analysis, you need to be able to encapsulate the whole issue in terms that are simple whilst not simplistic, rather in the way that a theoretical physicist will study an immense number of apparently disparate phenomena, and come up with a unifying equation of great beauty and simplicity.  That sort of synthesis is not easy.  You need to be able to discern the fundamental structure of a problem, and then persuade your colleagues that the model you have created, and the solutions it generates, are correct.  The ability to model the world, and then convince colleagues of the model’s applicability, is what constitutes leadership.  That is as true of the problem of Brexit as it is of the problem of any ailing institution. 

Fishing rights, a level playing field, and rules of arbitration in disputes are said to constitute the barriers to a deal.  And yet the question of the Irish border remains.  It has always seemed to me that the Irish question is what has made a Brexit solution impossible.  At least it is impossible unless you are prepared to think the unthinkable, like Einstein, standing on a railway embankment watching a train being struck twice by lightning.  It’s impossible, unless you are prepared to think the unthinkable.

“The occasion is piled high with difficulty, and we must rise to the occasion.  As our case is new, so we must think anew and act anew.”  Where is Abe Lincoln when you need him?  I have a notion that if Abe Lincoln were Special Agent Johnson, he would advise us to revise these islands’ constitutional arrangements.       

MONDAY

As Christmas approaches, for the last 20 years or so I’ve been playing my viola in a ceremony of lessons and carols in Glasgow.  Each year, I take part in an elaborate gavotte of my own confection, in which I am asked to participate, and I assume an anguished air and say, “Oh I don’t know… I’m so rusty.”  Eyebrows are raised to the ceiling.  Then I agree to do it.  This theme had a variation this year as, understandably, the service will be virtual.  “Oh, I don’t know, you know, me and IT…”  Eyebrows are raised.  Then I said okay.  I had to watch the conductor and listen to the piano accompaniment, through earpieces, on one device, and record on another.  By some miracle it worked.  Greatly encouraged, I set about recording my contribution to an extended family birthday tribute to a cousin in the USA.  I was commissioned to recite a little Burns, and also to send a personal message.  I found myself quite unconsciously hamming up my Scottishness, raising a glass of particularly good Islay single malt, proposing a toast, and descending into some bastardised ancient highland patois. 

TUESDAY

Just when I thought I’d made peace with IT, I got an email from a financial institution with whom I do some business, to tell me that they had been hacked, and advising me to change all my passwords.  My first thought was, is this real?  I phoned them.  Yes, it was real.  I duly changed all my passwords, feeling a great nostalgia for the days of pen and ink, cheque books, high street banks with safes and vaults, and managers devoted to ideals of probity, confidentiality, and trust.  I’ve always thought that internet banking is a con.  The bank gets you to be your own bank teller, and so there is no need to employ one.  Everything is transacted online, so no need to have a High Street outlet.  The masters of the universe can sit back and watch the coffers swell. 

WEDNESDAY

Got home at dusk to see the multi-coloured flashing lights of two fire engines on the street, awfully near where I live.  But it wasn’t me.  It was a neighbour.  And it wasn’t a fire.  A carbon monoxide alarm had gone off.  It turned out to be a false alarm.  Now I don’t use gas, so I don’t have a carbon monoxide alarm.  But I wondered if I were being cavalier.  I do have a gas heater which I keep in reserve in case the electricity gets cut.  So I duly invested in a CO meter.  It came along with a heat detector.  At home, I have high ceilings.  I will spare you the excruciating description of my hapless attempts to install the heat detector.  I’m thinking of writing a series of tales about an inept antihero who barges through life leaving a wake of destruction behind him.  Captain Maladroit.  It will be largely autobiographical.  Up at the ceiling, I worked myself into a lather until I was overcome by a wave of intense nausea.  Maybe that was the effect of the carbon monoxide.  Whatever.  That’s it, with me and DIY.  Finito. 

THURSDAY

Got my overseas Xmas cards off.  It crossed my mind to include a Round Robin update that would be entirely confabulated.  “Elizabeth and Barbara are hugely enjoying life at Magdalen, and Gonville and Caius…”  I asked a fellow Glaswegian if he knew the nearest post office that would be open.  Have you noticed the way we Glaswegians have a habit of putting the accent of any denoting word on the second syllable?  “There’s a Post Office in Renfield Street.”

FRIDAY

On BBC Radio 3’s Composer of the Week, Donald Macleod reached the end of his year-long study, 250 years after the great man’s death, of Beethoven.  The week has been dominated by the late string quartets.  Somebody asked me to guess which Opus Mr Macleod would choose to end this huge project.  The end of the last quartet Opus 135?  I thought not.  Too quirky.  Muss es sein?  Es muss sein!  I went for the second movement of the last piano sonata, Op. 111, with its ethereal, other-worldly quality.  Music from beyond the grave.  In the end, Mr Macleod chose the last movement of the fifth symphony.  Good choice.  I will seize fate by the throat! 

SATURDAY

After Strictly (n my pnn, HRVY&Jntt r gng t wn), caught a snatch of The Wheel with Michael McIntyre.  It took me a while to figure it out, and I was reminded of Pointless, which took me forever to figure out because I’d flick on the telly to catch the six o’clock news and would only catch the dénouement.  Why would you want to score zero?  Pointless.  In The Wheel, helpful or sometimes helpless celebs orbit the contestant, one of three brought up from a dungeon, to choose one out of four answers in a series of multi-choice questions based on a variety of topics.  If the contestant gets the answer right, he or she lodges a considerable sum of money in the bank, and proceeds to the next question.  Get it wrong, and the contestant is sent back to the dungeon and the next contestant is selected at random (another revolving wheel).  Winner takes all, and can double the purse with a final question if not risk averse, or perhaps half it, or even leave with nothing.  Who devises these premises?  I’m sure if I’d heard the pitch on Dragons’ Den, I would have been like the man at Decca who turned the Beatles down, or the man in a hundred publishing houses who turned J. K. Rowling down.  “Let me get this straight.  You stick the contestants downstairs and may never see two of them at all?  That could cause resentment.  It’s like that Michael Caine movie The Prestige, in which an illusionist is despatched to an underworld and can only distantly here the appreciative applause of the audience.  I’m out!”

Yet I was gripped.  The man who eventually won £28,000 had a warm television personality.  He was devoted to his daughter, and also happened to be vertically challenged.  He had the audience vote, and their sympathy.  I was willing him to win.  Well, it wasn’t the Reith Lectures (Mark Carney this year I think).  Lord Reith must be spinning in his grave.                        

SUNDAY

It has been called “the last throw of the dice”.  David Frost still talks to Michel Barnier, and Boris Johnson still talks to Ursula von der Leyen, but they are running out of time, and Westminster is glooming us up that the UK and the EU may reach the end of the year without a deal.  If so it be, may I say I find this to be as utterly incomprehensible as it is utterly reprehensible.  Imagine taking four and a half years to do, precisely, nothing.  From the point of view of a medical practitioner, and especially an emergency physician, failure to make a decision is disgraceful.  That is not to say that in a given situation, doing nothing might not be the right option.  In medicine, this is called “masterly inactivity”.  I used to say to the anxious worried well, “Let’s hold our nerve, and keep a watching brief.”  You might even decide to stop doing something in order to do nothing.  An elderly patient on polypharmacy (is that a description of the UK, or the EU, or both?) is failing despite your best efforts, so you decide to withdraw all treatment to see what happens.  We call it “a trial of life”.  But making such a decision is not the same as indecision.  You have to make up your mind, and do so under the pressure of time constraint.  It seems to an emergency physician striving to make a difference within “the golden hour”, that to strive for four and a half years to do something, then fail to do anything, is to be weighed in the balance and found wanting.  That begs the question, whose fault is it?  “Ours”, or “theirs”?  I would say both.  It’s a collegiate failure, an inability to compromise, to find a way.  It’s a damning indictment of the ruling class.  Every day, refuse collectors pick up the refuse, nurses tend, carers care, teachers teach, midwives deliver, and undertakers bury, while government ministers shuttle diplomatically to and fro, and do, precisely, nothing. 

MONDAY

December 7^th.  On this day, 79 years ago, “a day that will live in infamy”, the Japanese attacked Pearl Harbour.  And we all know how that ended.  So let us hope our politicians keep talking to our neighbours.  As Kate Bush said to Peter Gabriel, “Don’t give up.”              

St Andrew’s Day.  “Official” winter starts tomorrow, but here in the heart of the Trossachs, yesterday was really a winter’s day.  1 degree Celsius.  The floods have receded in the Callander meadows, and I was able to walk by the banks of the River Teith, to the confluence of the two rivers that drain Loch Lubnaig and Loch Venachar, and then round Tullipan, a crescent of handsome villas nestling under the Callander Crags. The trim gardens border the road without fence or hedge, giving the neighbourhood a North American feel.  I could have been in Canada.  There wasn’t a breath of wind.  Nature is hunkering down.

Some people dread the winter, this one more than most, so full of uncertainty and anxiety as it is.  It’s not just Covid; there is the small matter of our departure into the mid-Atlantic in one month’s time, with as yet no sign of a deal with Brussels, and, more importantly, no convincing solution to the problem of a border between Northern Ireland and the Republic.  I admitted to somebody the other day that it had crossed my mind to buy in a few tins of sustenance just in case the supermarket shelves were suddenly laid bare.  I was asked, “How many tins?  Couple of hundred?”  The trouble is, if everybody does it, the shelves will be bare.  Hoarding is not good.  But maybe our angst is misplaced.  Do you remember the Millennium Bug?  At midnight on 31/12/99 aeroplanes were going to drop out of the sky.  The only excruciating thing that happened was that Tony Blair held the Queen’s hand to sing Auld Lang Syne.

I quite like winter, though I wish it didn’t last so long.  But I’m always struck by a sense of readiness for change as one season morphs into another.  Time to embark on the winter journey, wherever it will take us.  With this in mind, I got out my recording of Schubert’s Winterreise, sung by Jon Vickers, accompanied by Geoffrey Parsons, a rendition of great beauty and simplicity, with none of the portentous gravitas that is so often laid on with a trowel.

Fremd bin ich eingezogen,

Fremd zieh ich wieder aus. 

I came here as a stranger, and I will leave as a stranger.  It’s that Schubertian jilted lover again.  Sometimes I get impatient with him.  So she chucked you!  Get over it, mate.

Was soll ich länger weilen,

Daß man mich trieb’ hinaus?

Good question!  Why should I tarry here any longer, so that I can be thrown out?  In his Schubert’s Winter Journey, Anatomy of an Obsession (Faber & Faber 2015), Ian Bostridge translates weilen, to tarry, as “hang around”.  The last thing unrequited man ought to do is hang around.  Gute Nacht.

The trouble is, he never really gets over it.  What are we to make of Der Leiermann, the twenty fourth and last song in the cycle?  The Hurdy-Gurdy Man.  It’s so bleak. 

Talking of unfulfilled love, I happened to catch Brief Encounter on the telly the other night.  (And incidentally, talking of the telly, I couldn’t help noticing that BBC 1 put on Shakespeare’s Coriolanus at 12.50 last night.  I wonder what the viewing figures were.)  But back to Brief Encounter.  Trevor Howard and Celia Johnson fall for one another in a railway station tea room, embark, or nearly embark, on a furtive affair, and make one another thoroughly miserable.  Ms Johnson is married to a rather dull man who does crossword puzzles.  The Howard character, a GP with an interest in preventative medicine, finally departs on his own Winterreise, to Johannesburg.  At least he chose a good climate.  The soundtrack to Brief Encounter is, of course, Rachmaninoff’s Second Piano Concerto.  Rachmaninoff had suffered a nervous collapse because the composer Cui had written a vicious and damning criticism of his First Symphony at its première.  It might have finished Rachamaninoff for ever.  He went off on his own Winterreise, attended a therapist, recovered, and composed the second concerto.  Maybe this music explains why Yehudi Menuhin greatly admired Brief Encounter.  There is a story – perhaps apocryphal – that during the film’s first night, somebody addressed Trevor Howard from the back stalls.  “When are you going to **** her?”  I don’t think that would have been Lord Menuhin. 

Anyway, as we all embark on our Winterreise, we must make sure we don’t get down in the mouth.  But personally I think we should postpone Covid Christmas until we get a vaccine.  As King Lear said to Gloucester, “Thou must be patient.  We came crying hither.”