How Could a Doctor Think of Going on Strike?

Best job in the world, thinks Geoff, at least when he’s not inspecting verrucas.

While Geoff is a fictional GP, he’s uncannily similar to a lot of real family doctors.

Right now he’s unwrapping a cheese sandwich and feeling grateful he’s not a hospital doctor facing life or death decisions.

Because any minute now BMA ballots will be plopping through their doors, asking whether they’d take industrial action.

Litmann type stethoscope

He’s not fond of strikes and instinct tells him doctors shouldn’t have them. If striking makes a perceptible impact, people get hurt. If it makes no impact, the strikers look stupid. Lose-lose, in Geoff’s book.

But what else can junior hospital doctors do?

By anyone’s clock, 7am to 10pm six days a week can’t be a standard working day. Geoff’s not sure how it squares with the European Working Time Directive which requires 11 hours rest a day. About 10 years ago the EWTD began to include junior hospital doctors. He recalls that opt-outs have to be voluntary. Is Jeremy Hunt aware of this?

It’s not about the money, say junior doctors. They’re not “trainee doctors”, by the way, despite the way the press describes them. They’re fully qualified members of the medical profession, ready, willing and (most of all) able, to resuscitate the dying or resect metres of gangrenous bowel as appropriate. 

Jeremy Hunt doesn’t look a bad guy.

Health Secretary Jeremy Hunt

He’s just wrong, thinks Geoff. That mortality paper in the BMJ has a lot to answer for. It showed that being admitted to hospital at weekends was linked with a significantly increased risk of in-hospital death. Lots more of them would be acutely ill, so that makes sense.

The same paper also showed that being in hospital at the weekend was associated with a reduced risk of death!

So where the fuck did people get the idea that having more doctors on duty would prevent those excess deaths? Geoff hurls his sandwich wrapper into the bin.

Being self-interested, as everyone is at heart, Geoff worries that the proposed new contract for junior hospital doctors will affect general practice too. It would imposes a drop of 40% in GP trainee salaries. Those ARE trainees, by the way. They’re doctors training to be GPs, and there aren’t enough of them as it is.

More importantly, the new contract jeopardizes patient safety because it removes the safeguards which protect doctors from working dangerously long hours.

scalpel

No wonder many people believe the proposed contract puts the future of the NHS at risk.

Does all that make striking a good game plan? Doctors last took action in 1975, well before his time as he’s only been qualified 15 years.  

Recently a whopping 95% who took part in a Guardian poll answered yes to the question: Should junior doctors strike over the government’s proposed contract?  He thinks there were 28,000 or so people polled, nearly as many people as there are junior hospital doctors. But obviously he can’t find the article now, what with the winter care plan, new advice about FGM, and an avalanche of other vital information.

It’s the baby clinic this afternoon in Geoff’s practice. Britain has one of the best immunisation programmes in the world, he likes to think. Geoff heads into the waiting room, beams at the parents, and wonders how long the NHS has left to live.

tombstone

***

You may also like:

GMC advice for doctors in England considering industrial action.

The doctors’ 1975 industrial action.

 

The Nuisance of Smoking Bans

Less than four weeks ago it became illegal in England to smoke in a car carrying anyone who’s under 18. As a medic, I think the new legislation is a great idea. To me, the earlier 2007 ban on smoking in indoor public spaces was a no-brainer. It has helped to bring down rates of lung and heart disease. But there’ve been consequences I’m less keen on.

FreeImages.com/Adri Claassens

Enter (or rather exit) the denizens of the local Social Club, as it calls itself.

Its cheap booze and bar billiards attract drinkers from miles around.  Except that they haven’t all come to sit in the warm convivial atmosphere. A sizeable contingent of patrons are lounging against the lamp-posts, or parking their backsides on neighbouring walls so they can enjoy their tobacco habit.

There’s not an e-cigarette user among them tonight. These are hard-core, like 18-year old Chloe whose birthday was last weekend. She spent her summer in Ayia Napa, got a cute new tat on her left buttock, and broke up with Jason cos he shagged Melanie. I know all this because Chloe has the dulcet tones of a foghorn and her fav smoking spot is under our bedroom window.

This, by the way, is Cambridge, and about as far from punting and Pimm’s as you can get.

Punts on the River Cam

I go to the window and catch a glimpse of Chloe through the blinds. She has a backside the size of a shire mare’s and I begin to fear for the wall.

She’s not talking to herself, of course. All the cool people go outside to smoke these days. Darren is a gas fitter but he was laid off last week, and his mum’s got a new boyfriend. By the light of the street lamp I make out another woman, a guy in an Iron Maiden T-shirt and what’s left of his hair scraped into a pony tail and, and a man who’s clearly thought ahead because he’s got on fingerless gloves, plus a bobble hat pulled down to his eyes.  

I jam earplugs further into my ears. It’s obviously going to be a long night. As a medical journalist, I’m often asked to reel off the dangers of smoking. Now I can add earache and insomnia to the list.

2 brands of earplugs

The Social Club has long shut but that doesn’t matter because someone’s brought tinnies. Nobody goes anywhere until about half past midnight when a taxi shows up. Whose taxi is it?  A punch-up ensues to settle this.

None of these soothing sounds feature on my app of atmospheric tracks to doze off by. There is Australian Beach, Cape Cod, and Whale Music. Oh, and Night Ambience, though it’s not anything like this. Could be a gap in the market.

beer and cider tins

After the taxi episode, I hear tins been kicked in the road, followed by a particularly good joke which has the revellers laughing like drains. Around 1.30am a car alarm goes off. We’ve had around two minutes’ sleep so far.

What will the ban on smoking in cars with youngsters bring? Hopefully only good, but I’m not holding my breath.

Warning: A Doctor Rants

Vaccines had a bad press a few years ago, but things have changed, or so I thought. That’s why I was surprised when this week a university student refused the freshers’ dose of meningitis C vaccineFreeImages.com/Antonio Jiménez AlonsoI was even more surprised when he told me that his father, a doctor in another European country, was against vaccination.

What would you have done?  

University students are at higher risk of meningitis. One in four 15-19 year olds carries meningococcal bacteria in the back of the throat, as opposed to one in 10 of the general UK population. And, if you haven’t been a fresher for a while, imagine all that mingling with hundreds of other young people, often in crowded conditions.  

There’s lots of useful info on meningitis, and on vaccines.  Alas, I only know sites for fluent English speakers, and the lad in front of me wasn’t one of them.

I jokingly told him I wanted words with his dad. But in reality that was never going to happen. In general practice there’s barely time for a long discussion with a patient, let alone with family. Photo by Jean Scheijen FreeImages.com/Jean ScheijenConsultation rates with GPs have gone up in the last 20 years to around eight consultations per person a year. Along with that, patient expectations have risen. No bad thing in itself, but it requires more time.

Many areas are bulging with an influx of new patients. London has a particularly mobile population but it’s not the only place where there are migrants, refugees, or simply new housing. Some arrivals speak little English, so interpreters are needed, and the consultation takes twice as long as a result.

The pattern of work has shifted. As hospitals shed more care onto general practice, and send patients home sooner, GPs inevitably must do more. Around 90% of medical care now takes place in surgeries, by GPs, nurses and other members of the health team.

National Health Service logo

The structure of health care has changed with the advent of clinical commissioning groups (CCGs). In my view, that work takes a lot of good GPs away from face-to-face patient care.

Professional development makes demands too. I have to keep up to date, and these days I also have to prove it via appraisal and revalidation. People believed something had to be done post-Shipman, so now we spend time counting lots of things that don’t count. I hope that changes, but meanwhile preparing for annual appraisal takes two hours a week.

Providing good medical care is now a real struggle. GPs are retiring, and a sizeable chunk of medics are leaving the country.

Australian and UK towels on the beach

There’s nobody to replace them.

Like many GPs, I teach medical students. That time too must come out of a busy week. But here’s what really worries me about teaching.  

In the last 10 years I’ve noticed that fewer students now want to be GPs. Yet not so long ago new doctors were falling over each other to join practices.

It’s no wonder that doctors in the UK are angry and fed up. New changes imposed by government are likely to make things worse. In many areas, NHS general practice can barely provide a decent service five days a week. How can it stretch to seven days?

I’m not against change. General practice changes all the time. That’s part of its attraction as a speciality. But the developments I’ve lived through now make it almost impossible to do the job properly.

doctor's bag

You may like to read: 

Numbers of NHS doctors registering to work overseas could reach unprecedented record in the Independent, September 21, 2015

A fictional GP reflects on What They Don’t Teach at Medical School

I muse on What Happens when You Become a Doctor.

Easy tweet: What’s wrong with general practice? http://wp.me/p3uiuG-15w A #doctor rants #NHS via @DrCarolCooper

Why Do Authors Love Setting Novels in London?

There are a zillion places to set a novel, even more if you include locations that don’t exist yet, but this side of the pond London is at the top of the list.

It’s no surprise that London’s attractions shape my writing: I was born in the capital, and after a junket of a decade or two came back here to live and work. But even if you’re not a Londoner there are plenty of good reasons to set your action there.

Abbey Road crossing

1 Things happen all the time in London: knife crime, break-ins, births in hospital carparks. So you can slip in a fictional car-crash or multiple murder and it won’t seem nearly as odd as it might in a dozy village.

2 London is incredibly romantic, even in the rain. That means lots of places for your characters to wander arm in arm in Highgate cemetery, should you wish them to. 

Highgate cemetery

Or, if you prefer, to argue on the top of Primrose Hill.

Primrose Hill

3 Everyone knows something about London. Its iconic features can be used as a kind of shorthand, such as the Tower, the London Eye, and the Tube. However, if you want to include real detail, there’s no substitute for the author joining the melée and checking it out.

Tower of London, field of poppies

4 Medieval buildings can be found all over the place, including smack dab by Big Ben.

© Elvis Santana (tome213)

Then again, there’s no shortage of great new architecture, and more to come, judging from the number of cranes.

The Shard, London

5 It’s very green. Should your characters wish to stretch their legs, or their children’s, offer them Regent’s Park, Clapham Common, or perhaps just a walk by the Thames. Time it right, and they can watch Tower Bridge open.

Tower Bridge

6 London is very diverse, with some parts that are distinctly upmarket, like trendy Marylebone, where my novel One Night at the Jacaranda kicks off.

Waitrose, Marylebone High Street

I’ve also included Edgware Road, where you’d be hard put to find any newspapers that aren’t in Arabic.

There, groceries spill out onto the pavement, with watermelons as big as Beirut, and shiny aubergines, pearly white onions and wrinkly green things that I’ve forgotten the name for, all lying with fat bunches of sweet-smelling herbs.

On the street there are always clusters of young men in T-shirts and jeans, standing on corners as they shout into mobiles or talk urgently with their hands, and, during the annual Saudi summer invasion, streams of women with pushchairs, most of them in a black abaya, some veiled so you could only see their eyes. They glide by, with their Fendi handbags and large retinues of children, while older men sit outside cafés and juice bars, smoking shisha. The men stared hard at passers-by, at any passing Mercedes. They have nothing else to do.

No surprise my next novel is also set in London.

Royal Albert Hall

7 It’s full of characters, like the woman walking down Finchley Road with a black bin liner under her hat. And when I say walking down Finchley Road, I mean in the middle of the bus lane. Or the man in Goodge Street dressed from head to foot as an African grey parrot. This being London, nobody gives either of them a second glance.

8 Finally, consider the US market: to Americans, London IS Britain.

 

How to Plan a Box-Set

Today’s post is from a fabulous British author called Jane Davis.

By fabulous, I don’t mean she writes fables. In case you don’t know, her six novels to date are all wonderfully real character-led stories. This Saturday, October 3, she’s at Barton’s Bookshop in Leatherhead from 10.00am to 4.00pm for the launch of the new ‘bookshop editions’ of her novels.

And let me tell you that when you get to Barton’s at 2 Bridge Street, Leatherhead, you know you’ve arrived.

Here’s Jane with her advice on how to plan a box-set.

Jane Davis

In 2014 I experimented with producing two box-sets, first releasing my own three novel box-set, and then collaborating with six other authors on a multi-author limited edition box-set.

I called my own box-set Second Chapter as it contains what I consider to be the second chapter in my journey as an author. My first novel, Half-truths and White Lies, was published by Transworld after it won the Daily Mail First Novel Award in 2009. Second Chapter contains three full-length novels, I Stopped TimeThese Fragile Things, and A Funeral for an Owl. The idea was simple. I wanted to attract new readers by offering three books for the price of two.

Second Chapter

Single author box-sets are the perfect solution for authors who write a series, and they’re great for readers too.

As JJ Marsh explains about her European crime novels in the Beatrice Stubbs Box Set: ‘Readers often say that after reading one, they immediately want the next in the series, so a box-set is a handy way to get three at once.’

My collaboration with six other members of the Alliance of Independent Authors was more unusual. While collaborative efforts have become more common among genre fiction authors, we weren’t aware of other multi-author collections of contemporary novels. Of course, several of the issues highlighted here also apply to single-author box-sets.

Why do it?

Simple. We wanted to explore the power of the group. A box-set aggregates reader bases and the theory was that our combined reader bases would result in cumulated sales. But we also wanted to demonstrate the tremendous quality of fiction that is being self-published.

These Fragile Things

Who to collaborate with?

The group needs to share the same values and aims. These should be set out in an agreement (more later) which, when the going gets tough, can serve as a useful reminder of why you started out on this journey.

Make sure you’re happy to champion the other authors’ books as you would your own. We were fans of one another’s fiction before we teamed up.

No two books should be too alike, but they should appeal to the same target market. Our decision was to focus on our characters and the boundary-breaking nature of our fiction.

Make sure that the other authors are eligible to participate. Better to discover sooner rather than later that they’re signed up to KDP Select.

Find out if all of the books have been professionally copy-edited and proofread. You will save time by asking this very simple question.

Do the books have a high number of 5 star reviews? You may find it very difficult to garner reviews for a box-set, especially if it is only available for a limited period, so it’s a good idea to have a stock of headline quotes to draw from.

I Stopped Time

Outline Agreement

Now comes the nitty gritty. Even though you may want to operate on trust, certain issues should be nailed down at the outset.

Set out your main aims. How else will you measure your success? 

Decide how you’ll work on a logistical level.  Will one person act as overall leader or manager, or will each author take responsibility for a different area? What issues will you put to the vote, and how will you make decisions if you are up against time limits?

There should be written agreement that each author will retain his/her own rights, but grants consent for the party taking responsibility for uploading the e-book to publish it. This really is a key responsibility. That same person will receive all of the proceeds from sales and must act as treasurer for the team. We are so grateful that Jessica Bell took on this mammoth task.

Release date – print magazines put their books and features pages to bed three months before publication. Newspapers have a faster turnaround, as do radio and TV, and two months’ notice may well suit them. While you may not have aimed for publicity via these channels when writing as an individual, don’t underestimate the power of the group. We featured in a number of major publications, The Guardian, The Sun and New Edition to name but a few.

Pre-orders – now available on most platforms. Our experience was that people want e-books instantly.

A Funeral for an Owl

How long will the box-set be available? Consider the appeal of a limited edition product v the benefits of having the product available in the longer term. If some of you have published only one or two books, they may be less keen for the box-set to remain on sale. We decided on a period of 90 days only.

How will the product be priced? Box-sets are usually value-priced, meaning that the box-set costs the reader far less than purchasing all the books individually. Generally, the more limited availability is going to be, the keener the pricing needs to be. We settled on a price that represented a discount of 75% off the price of the books if bought separately, which represented tremendous value.

What is each member is expected to contribute, both in terms of money and time? I was simply blown away by the skill-sets within our team. Having a cover designer, interior formatter and website designer in-house meant that we didn’t have to pay other professionals for these services. And there was surprisingly little overlap in skills, so we were all able to play to our strengths.

How each member will be paid and when (Pay Pal is useful).

A general statement of commitment to summarise what is expected of everyone.

Women Writing Women Box Set Cover_finalGIF (1)

Branding

Title – As well as capturing the theme that links the books together, it’s a good idea to mention the word “box-set” in the title, together with the number of contributing authors.  

Cover design – 2D v 3D? As instructed in the Smashwords Style Guide, Smashwords can’t accept ‘3D’ images (a digital rendition of a three dimensional box-set). And they are not alone. If you wish to publish on any platform other than Amazon, and you only want to have one cover image, it must be 2D. NB: All authors should be listed on the e-book cover image.

Your brand will extend to author photographs, memes, Facebook banner, website domain name and design, all the way to any Twitter hashtags you adopt. Ours also included video trailers and promotional giveaways. 

Formatting and Interior layout

You’ll combine the multiple books into a single e-book file. A Table of Contents becomes crucial for box-sets.

We listed each book and author name, and included a short bio, blurb and headline quotes after each title page. You might also add “Other books by Author Name” or “Connect with Author Name,” with electronic links.

Proof-reading – It is vital to ensure that errors have not been introduced during the formatting process. As a minimum, each author should proof their own book and one other novel.  Set a clear realistic deadline.

Communication within the team

We found it very helpful to set up a closed Facebook Group, as well as a shared Google spreadsheet which was effectively a diary of all of our marketing. This ensured that we didn’t duplicate efforts and that we weren’t all asking favours of the same contacts!

Joni Rodgers

Publicity Campaign

We were fortunate to have our product endorsed by respected industry professionals, including Alison Baverstock and Dan Holloway, who gave us amazing quotes which we were able to use on our cover and in press releases.

We utilised social media to full effect, adopting #womenwritingwomen as our hashtag, setting up a Public Facebook Group and targeting reader groups.

Press Releases – we designed three separate press releases with slightly different emphasis in order to suit the bias of the publications we intended to approach.

We wanted a fresh idea for giveaways that would cost very little but treat the winning readers to something of genuine value. Joni Rodger’s daughter (Jerusha Rodgers of Rabid Badger Editing) created a fabulous digital swag bag that included a critically acclaimed novel by Joni, a free music album download by Jessica Bell and a host of delightfully fun and artsy surprises. We also gave away a couple of Kindle Paperwhites. Giving away upscale prizes in a promotion builds awareness, and brought us email addresses and other benefits.

Joni is also experienced in audio editing, so she created our book trailer – again using one of Jessica’s songs. She also made a 60 second review for each book in the set.

Blog tours – we adopted a dual approach, pulling in favours and paying for a blog tour.

Jane Davis

What we will take away from the experience

Joni Rodgers: ‘I’ve learned a lot about marketing and production, and that’s something I’ll gratefully take with me when our 90 days is done.’

Roz Morris: ‘Certainly I learned that promotion in a group gives you more courage. I find it agonising to write assertive press releases on my own behalf, but it was dead easy for our ensemble. I’ll channel that when I start bumbling through a release for my next book.’

ooOoo

A big thank you to Jane. Here’s more about her:

Jane Davis’s first novel, Half-truths and White Lies, won the Daily Mail First Novel Award and was described by Joanne Harris as ‘A story of secrets, lies, grief and, ultimately, redemption, charmingly handled by this very promising new writer.’ She has since published five further novels.  Compulsion Reads describe her as ‘a phenomenal writer whose ability to create well-rounded characters that are easy to relate to feels effortless.’

Visit her website: www.jane-davis.co.uk and subscribe to her blog
‘Like’ her Facebook page: https://www.facebook.com/JaneDavisAuthorPage
Follow her on Twitter: https://twitter.com/janerossdale
Follow her on Pinterest: http://pinterest.com/janeeleanordavi/boards/

And don’t miss seeing her at Barton’s Bookshop on October 3.

 

What the Dalai Lama Didn’t Say

As invitations from a financial adviser go, this one was a tad unusual. But I was looking forward to what His Holiness the Dalai Lama had to say about compassion.

We’d been to the O2 Arena before. As I passed the famous balls at the entrance, I wondered: where on the spectrum between Monty Python and Ed Sheeran would this ageing religious rock star fit in?

blue balls in O2 entrance

I’d never met His Holiness, as he is called, but I’ve been on first name terms with one of his dogs. As a teenager, I earned pin money walking Chota Peg, a Lhasa Apso given by the Dalai Lama himself to a neighbour of ours. The breed’s distinguishing feature as far as a 13-year old dog walker is concerned is that its back end looks just like its front, which may explain why I never knew which way we were going.

Now, what to wear to hear His Holiness at the O2? My son assured us that the Dalai Lama would surely be content if we rolled up in yellow sheets, but the good people in hospitality would probably expect us to be in clothes.

So, clothes it was.

Protesters formed a tidy encampment outside the venue.

protest against 'False Dalai Lama'

I can’t fault the O2, especially if you’re hungry or thirsty. We poked our heads into the VIP lounge which has a 70s vibe and possibly the best Bloody Marys in the world, though that wasn’t what we’d come for.

VIP lounge at O2

The Dalai Lama’s warm-up acts were an amazing singer and a young choir. In appreciation, His Holiness bestowed garlands and pats on the head. There’d have been suspicions had he been a Catholic priest or an iconic DJ.

The real disappointment of the day was the Dalai Lama’s address. Martin Luther King he wasn’t. And I should know

The audience was there to hear about compassion as the foundation of well-being. But the man was rambling and inaudible, and, without surtitles à la Glyndebourne, almost incomprehensible. Was the sound system at fault? We cupped our ears, straining to catch the words, trying hard to work out which way he was going.

I’ve heard that HH has spoken eloquently on many occasions. Saturday was not one of them. The unstructured address was punctuated by his trademark chuckling at his own jokes. The question and answer session at the end was even worse. If this was the poster boy for peace and harmony, no surprise the world is in such a mess.  

However the day was not a total loss. The weather was kind and we’d met some interesting people at the event. Fortified by vodka and friendship, we went on the Emirates Air Line

cable car

It’s only a ten minute journey in a cable car, during which you can see Docklands and indeed much of London clearly, including the City and the Thames Barrier. I watched the Thames flow, barges glide past, people amble, trains roll by. 

view of O2 and Docklands

We got off at Victoria Docks and visited the Oiler, a bar on a barge. Next to it, people squeezed themselves into wetsuits and tried out water-skiing.

The Oiler, Docklands

It’s a good place to sit and reflect on peace, and on where to find it.

ooOoo

Easy tweet: What the Dalai Lama Didn’t Say at the O2 http://wp.me/p3uiuG-14C @DrCarolCooper strains to hear him

You may also like:  Dalai Lama says female successor must be ‘very, very attractive’ otherwise she is ‘not much use’; in Times of India.

 

What They Don’t Teach at Medical School

Today GP Geoff gets a new group of medical students to teach. The names may change from week to week, but there’s always at least one swot from Germany or the Far East, a home-grown rugger bugger who is too big for his chair, a student in a hijab, a gay man, a babe who fiddles constantly with her iPhone, and an argumentative leftie.

HP Rapaport Sprague stethoscope, circa 1981

Geoff is a character from my novel One Night at the Jacaranda.  I made him up, but, if you know much about medicine, he seems real enough.

Education is not a vessel to be filled, Geoff muses, but a fire to be lit.  He has forgotten who said, it, but he’s pretty sure the fire should stay lit for the whole of their careers. So the students need a dose of reality.

fire in the political belly

Geoff reflects on his fifteen years of practice. The reality is that patients wangle sick notes because they don’t like their work. They get prescriptions for things they could have bought from the chemist. Well, par for the course.

They also suck you into their lives and dump their shit.  So you get involved when they tell you about their affairs that went wrong, the drugs they score on a Friday night, or how much they hate a sister or brother.

Or when they’re still driving even though they shouldn’t be.

FreeImages.com/Juan Miguel Rodriguez

Case in point: nice Mrs Thingy. Geoff is not too hot good on names, but he knows he advised her very clearly not to drive until her seizures were under control.

The snag is her three children. Geoff instantly forgets what she says her husband does, but he gets the gist. Mr Thingy has to get to Ealing Broadway station by 7am so he can’t do the school run.

“Can you walk them to school instead?” asks Geoff, ready to extol the benefits of blue skies, fresh air, exercise, autumn leaves, and the rest.

suburban street

“Doctor,” she says in a wheedling tone, “if I did that, it’d be a mile and half each way just for the boys. And Poppy is at a different school. There’s just no time. I’d run myself ragged, and that’s not good for my seizures.”

“Perhaps a neighbour can help?” suggests Geoff.

She gives a pitying look. “They’re all pensioners near us.”

“What about asking at the school? You may find a parent of a child in another class who lives near enough to you.”  Geoff is aware he’s running late now.

FreeImages.com/Vikki Hansen

“Well, I don’t know,” says Mrs Thingy.

“Why don’t you talk to the school secretary?” Geoff suggests. He may even need to involve Mr Thingy, find out if he can start work later during term-time. This is as far as one could possibly get from looking through the test results and reminding her about her smear. Geoff makes a mental note to do all this later.

Mrs T says nothing. She stares as if the GP is the baddie who makes up the laws.

Geoff continues, “If you have a seizure at the wheel… Well. It hardly bears thinking about.  Remember the Glasgow bin lorry crash last year? The driver blacked out at the wheel and killed six people.” 

“I know, I know.”  Her glance at the door shows she’d like to end the conversation as soon as possible.

Geoff leans back in the chair, which isn’t far as he has a cheaper model than his partners. “You realize, don’t you, that I’m obligated to contact the DVLA myself if you don’t.”  (For readers outside the UK, this is the Driver and Vehicle Licensing Agency.)

Her expression freezes.  “But I thought confidentiality…”

“Doesn’t extend to situations where the public is in danger.” He shakes his head slowly as he pulls a sympathetic face.

“Oh,” she says in a small voice. “Right.”

Geoff knows what he will discuss with his students today. Confidentiality.

And the knack patients have of sucking you into their lives.

***

Easy tweet: “What They Don’t Teach at Medical School http://wp.me/p3uiuG-14k via @DrCarolCooper” #medicine #students

How Romantic Can August Bank Holiday Get?

The August Bank Holiday weekend is at its best when (a) it doesn’t rain and (b) you get propositioned. Three years ago, I spent a sunny day at the seaside with an old friend I hadn’t seen in a while. We were outside the Red Lion Hotel in Cromer when I rashly asked what he’d like to do next.

Red lion by Matthew Strickland

“If I tell you, you’ll slap me,” came his response.

Reader, I married him. And this Bank Holiday weekend we returned to East Anglia and the sand and the sea to revisit that day.

It was very romantic and very English.  Now I will share some of the very Englishness of the Bank Holiday with you, starting with Cromer pier

Cromier Pier, Norfolk

What’s a pier without a proper end-of-the-pier show?

Cromer end of the pier show

It starts at 4pm on Saturdays, instead of the traditional time of 2.30pm, according to two disgruntled pier show veterans who told me over their limp sandwiches how the change in schedule had spoilt their day.

Fish and chips are staple fare. Belly not bursting yet? The No 1 fish and chip shop also sells ice cream.  

No 1 Fish and Chips, Cromer

Windbreaks are de rigueur. Somewhere not far away, there’s usually a man with a knotted hankie protecting his bald pate. 

windbreak

Very few UK towns or villages have no war memorial.  This one’s in Burnham Market.

War Memorial, Burnham Market, Norfolk

A select few sport decorative village signs. There are more of these in Norfolk than in any other county, but Suffolk comes a close second.

Freckenham, Suffolk

Some have pink-washed houses (the colour’s less pretty when you realise it’s from pig’s blood). 

pink washed house, Swaffham Prior

And pubs complete with ornamental signs and wonky walls. 

Red Lion pub, Swaffham Prior

We caught a traction engine idling outside this one. 

The White Swan, Stow cum Quy

Sunset in late August comes all too soon, so it was time for one last bit of Englishness.  

chicken tikka masala, Saffron Brasserie, Cambridge

I know. Chicken tikka masala was probably invented in Glasgow. It may no longer be the UK’s favourite dish, but it’s the perfect end to a nostalgic day. 

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PS You might enjoy more quintessential Britishness on the Romaniacs blog.

Easy tweet: How English can a Bank Holiday get? http://wp.me/p3uiuG-13S a romantic look back with @DrCarolCooper 

Seven Reasons Why August Sucks

While the name ‘August’ comes from the Latin for dignity or grandeur, the reality is somewhat different.  Yes, it’s still high summer, but when you compare it to its neighbours June and July, I don’t think the month of August makes the grade. Here’s why:

1 The days are already noticeably shorter. As if that’s not bad enough, the weather thinks it’s October.

Rain by Valentina Degiorgis

2 You can’t move for tourists in London. Have you been to Marble Arch lately? It’s heaving. Luckily I know just enough Arabic to move dawdling visitors out of the way.

And in Cambridge, there are even bigger queues to get into the colleges. As here.

Clare College gardens

And here. 

queue at Kings College Chapel

Even more competitive than it is for prospective students, it seems.

Clare College gardens

3 It’s the silly season for news. That’s why the papers carry stories about donkeys rescued from seven-feet deep storm drains.

rescued donkey

And stories about Morris dancers having a punch-up with blind footballers. If you’re wondering, that one’s a spoof.

The biggest silly story of all? Must be the Labour party’s leadership contest. 

4 Kids in Scotland are already back at school. They’ve given up pretending it’s still the holidays.

5 When the August bank holiday weekend is over, that’s it. There are no more official holidays until Christmas. And any minute now, Christmas merchandise will hit the shops.

by Raquel Santos

6 It’s high season for kittens. In north-west London, the Mayhew Animal Home’s kitten cabins are overrun with furry bundles that need forever homes. Can you help? 

posed by model. photo by Roger Heykoop

7 Everyone is away (except for tourists). If you’re an adult, your inbox is full of automated away messages. If you’re a child, there’s nobody around to come to your birthday. I should know. Mine’s tomorrow. Are you going to be there? Thought not.

Roll on September.

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Easy tweet: 7 Reasons Why August Sucks http://wp.me/p3uiuG-13z according to @DrCarolCooper