When Beer is an Aid to Diagnosis

With the FA Cup semi-final, pubs attract their fair share of crowds. Today I spotted a Spurs supporter with deposits of cholesterol around his eyes, along with a physique one can only get from eating all the pies.

This spot diagnosis took me back decades to my days as a medical student at the Middlesex Hospital, when we’d try to convince ourselves that time spent in a local hostelry was equivalent to the same amount of time spent poring over textbooks.  

Three essential texts

I say ‘we’ but the pub pathology sessions were a guy thing. There were just four women in my year. Swots that we were, however, we often tagged along to make sure we didn’t miss out on anything educational.

We didn’t just think of the pub as a causal factor in disease, though it must have been in some cases. One of doctors would regularly claim that the King & Queen had given him spider naevi (small blood vessel swellings typical of liver disease).

In the interests of presenting both sides of the story, I’d like to add that Steve from my year was convinced that impurities in the beer were to blame for all the complications of excess alcohol.

“Pints of Beer” by Simon Cocks is licensed under CC BY 2.0

Anyway, someone would go, “That’s a basal cell cancer over there.”

“Where?”

“Guy at the bar. Left cheek. Don’t stare.”

“So it is.”

“Also known as rodent ulcer,” another student might offer.

“Doesn’t spread to distant organs,” said someone else at the table. “Not ever.”

“Unlike squamous cell carcinoma,” added a show-off.

“You’d never know I had PSORIASIS – SIROIL 1959” by Nesster is licensed under CC BY 2.0

A pint or two later, one of us claimed to have spotted psoriasis. All nodded sagely, even though at that stage we barely knew the difference between psoriasis, cirrhosis, and sclerosis.

It was like winning the jackpot when a man with a stomping gait entered the pub one winter evening. This type of gait occurs in late syphilis, when foot position sense is lost, so the person bangs the foot down hard at each step. Although it’s possible that the man was just been getting the snow off his boots.

I like to think that the fictional GP Geoff from my novels will have once given pub pathology a whirl. On the whole, however, education has moved on. Sitting in the pub is not a learning method I’d recommend to my current medical students. For one thing, misdiagnosis is common. For another, it’s rude to stare.

Though sometimes it’s impossible not to. In one saloon bar, there was a man with a massive swelling down there.  So ginormous did it grow that he needed a wheeled trolley to help him (and it) get around. He finally did seek expert advice, but, it was said, only when one of the wheels fell off the trolley and needed to be replaced.

One keen student was desperate for the chance to shout, “Let me through – I’m a medical student,” but we never witnessed a medical emergency. Lucky, really, as our life support skills at the time would have done nobody any favours.

We never saw anything as dramatic as the stripper and the snake, though we all heard about it, naturally. This particular lady had a snake as part of her act, until the night her sidekick decided to hug her neck a tad too tightly. She was rushed to A & E wearing little more than a sizeable reptile, where an anaesthetist injected the snake with muscle relaxant and saved her life.

Photo FreeImages.com/Marcel Herber

As I say, we all heard about it. But we missed it. We were in the pub instead.

***

GP Geoff and other characters can be found in my novel Hampstead Fever.

You may also enjoy these posts:

What They Don’t Teach at Medical School

What Happens When You Become a Doctor

Hampstead Fever

No Mother is Perfect

This week, a friend of mine happened across a book while tidying her daughter’s bedroom.

“Did your mother write this, by any chance?” she asked me.

 

Now Le Crazy Cat Saloon, with a cast of cats and a sprinkling of French words, may be amusing, but it’s hardly literature.

Nor is it politically correct. For one thing, it features a cat who’s a stripper. As my sons pointed out, stories about strippers aren’t exactly suitable for readers of all ages, no matter what the cover blurb says.

All the same, whenever people talk about my mother’s many books, or her cat paintings, Le Crazy Cat Saloon always features in the conversation.

On Mother’s Day, I have a vested interest in thinking that mothers should be remembered in the best possible light.

If I were to choose one book to remember my mother, it would be Cocktails and Camels. Although she wrote it just after Suez, and her divorce, it’s upbeat and funny.  Here’s how it starts.

I used to live in Alexandria—Egypt, that is, and not, as some Americans think, the one in Virginia. I liked Alexandria. There was no place like it on Earth, I used to think, and now, on looking back, I am quite sure there wasn’t. It was a nice, friendly little town basking in the sunshine and cool Mediterranean breeze, and in summer its streets smelled of jasmine which little Arab boys sold threaded into necklaces. Alexandria had plenty of character—characters, rather—Italian, French, Maltese, Turkish, even White Russians, to say nothing of Copts, Pashas, Effendis, and bird-brained but devoted Sudanese servants. The grocers were Greek, the jewellers were Jews, the shoemakers were Armenians, and the Lebanese were everywhere. The British Army used to play polo and complain about the heat. How they came to be there at all when they had a most roomy Empire in which to exercise is a long, sad story. For the British, though they like to look like good-natured and paternal fools, are, as every Arab knows to his sorrow, very cunning indeed, especially when it comes to taking advantage of trusting Arabs.

Happy Mother’s Day.

Note: Mother’s Day may be on the second Sunday in May in most of the world, but in the UK ‘Mothering Sunday’ aka Mother’s Day is today.

***

You may also like to read an earlier post: Dating, 1940s Style.

My London Book Fair 2017 #LBF17

Three days of trudging around Olympia with an increasingly weighty bag of goodies is too long, according to my feet, even when they’re well prepared.

well-worn Converse trainers

But two days, as I found out this year, isn’t nearly enough. While the London Book Fair is industry orientated, there’s plenty for authors to do. Here are some of my highlights.

1 Catching up with friends and colleagues, many of them from ALLi, the Alliance of Independent Authors.

With fellow author Helena Halme

with fellow author Helena Halme

 

me with cover designer Jessica Bell

with ace cover designer Jessica Bell

Making new friends is part of the fun too. Book people come from far and wide for LBF, like Aussie writer Rebecca Lang from Sydney.

ALLi authors

from L to R: Jessica Bell, me, Rebecca Lang, Glynis Smy

2 Talks at Author HQ.

Author HQ at LBF

The varied fare is excellent, and this year the seats even had proper backs for weary spines. Too bad Author HQ is once again tucked away at the far end of the first floor. You may need GPS and Kendal Mint Cake for the trek.

3 Author of the Day sessions.

They’re at the PEN Literary Salon, which is where I met the inspiring Alaa al Aswany a few years ago. Sadly, this year Roddy Doyle had to cancel his appearance, so, instead of a capacity crowd, there were half-empty benches where people collapsed to eat their sandwiches. As ever, there’s a dire shortage of seating, which is why visitors have to perch on the displays.

following the Yellow Brick Road

4 Learning more about organisations like the Society of Authors, Gardners the wholesalers and distributors, or the Booksellers’ Association. There’s a whole world outside sitting at a desk writing.

the Grand Hall, Olympia

With a bit of planning, you can also arrange one-to-ones with agents or publishers. There are other ways of publishing too. I should have spent longer talking audiobooks.

5 Admiring awesome new books. There are 20 new books published every hour in the UK. Some of them might even be yours.

General Practice Cases at a Glance

at the Wiley stand

6 Haggling over a bagel.

The sticker said £2.75 but it was £4.60 on the price list. In the end, I got it for £2.60. Nothing is quite what you expect at LBF.

salmon bagel

7 The bottle of Veuve Cliquot I won. This was thanks to Byte the Book‘s legendary networking session on the Tuesday evening. I also collected a dozen useful email addresses and a temporary tattoo.

With many friends and colleagues, I only managed snatched conversations between one meeting and the next. Others, like writers from the Romantic Novelists’ Association, I hardly saw. Next year, I tell myself as I get on the train home, it’s back to a three-day marathon.

On the subject of travel, I can’t resist a digression to add that my novel Hampstead Fever will be on special offer in selected WH Smith travel shops throughout the UK from March 30. That’s buy one, get one half price.

Did you go to the London Book Fair? What did you think of it?

Eight Things that Newbie Fiction Writers Get Wrong

I’ve lost count of the number of the people who’ve told me they’re writing a novel. I’ve also met more than my share of successful novelists. Let’s just say that first group of people is a lot larger than the second.

While there are many ways in which a newbie can go wrong, it often boils down to one or more of these common mistakes. old-books1

1 Using stock characters

The tart with a heart of gold. The tall black dude who plays basketball. The gruff schoolmaster. The academic with thick glasses. While stereotypes can occasionally be useful as shorthand, they’re only two-dimensional characters, and that’s not enough to engage readers.

2 Writing real-life dialogue

Yes, you read that right. Realistic dialogue isn’t an echo of real conversation. In everyday life, people use a huge number of filler words and meaningless sounds. Like this.

“Oh, hi, Debbie. Lovely to see you. Yeah, come in, come in. Well, no, I wasn’t really doing anything. Just the ironing, again. It’s OK, no need to take your shoes off. I’m not fussed about the carpet, honest. Right. Now. Um, how about a cup of tea? Or, er, maybe coffee? No, I mean it. I’ve literally just put the kettle on.”

At this rate your reader will be in a coma long before Debbie gets to hear about Mary’s cross-dressing husband.

Realistic dialogue, on the other hand, is a pared-down version of a word-for-word conversation. So it’s more like this.

“Come in, Debbie. Kettle’s just boiled. Look, there’s something I want to talk to you about.”

FreeImages.com/Jay Neill

3 Scenes with overlong description

These usually creep in because the author thinks the writing is so brilliant that it can’t possibly be cut.  Sometimes it’s reams of beautiful description or essential back story. If so, find other ways to get the information across. It’s best to drip details elegantly into your story rather than dump them in bucket-loads onto the reader.

4 Stretching the reader’s credulity

Your college student heroine is a virgin, and has no laptop, or indeed any device connected to the internet? In present-day USA? You’d need your reader to be as gullible as your heroine. There are always exceptions, though, as you’ll know if you read Fifty Shades.

FreeImages.com/spydermurp

5 Using clichés

Maybe your principal character laughs like a drain at her friend’s jokes, goes green with envy at her sister’s new dress, or sweats like a pig at the gym. If so, get rid of hackneyed phrases. Clichés should be avoided like the, er, plague.

6 Ignoring rules of grammar, spelling, or punctuation

Because an editor will fix it all, right? Nope. Your magnum opus may just get binned. Please don’t insult your reader by mixing tenses of verbs, or mistaking it’s for its.

7 Telling instead of showing

His pulse pounded and the words he had rehearsed stuck in his dry mouth gives readers a better feel for your character’s predicament than ‘He was scared stiff about the interview.’

FreeImages.com/Jurga R

8 Shifting points of view

Some books are written from just one character’s perspective, whether it’s in the first person or the third. Others may have two or more. The convention, which I suggest you stick to because it helps the reader no end, is to have just one point of view per scene, or per chapter. Whatever you do, don’t switch a point of view during a scene.

But none of that is a reason to give up if you’ve got a story to tell. The most worthwhile things take effort. Ask a drummer if a drum roll is easy. It is, after the first ten years.

Here’s a selection of books I’ve found useful or inspiring.

Steven King: On WritingThere’s also a blog post from Jon Morrow about it here

Dorothea Brande: Becoming a Writer 

Jessica Bell’s Writing in a Nutshell books, including Writing Workshops to Improve Your CraftShow and Tell in a Nutshell, and Adverbs and Clichés in a Nutshell.

Roz Morris: Nail Your Novel: why writers abandon books and how you can draft, fix, and finish with confidence.

Good advice or not? Please let me know.

Daunt bookshop

Don’t Use a Semi-Colon. Period.

I can’t find it in me to use semi-colons. I know they’re useful, in theory. But since when has effective writing been about theory?

With my thirteenth book about to appear, I can honestly say I have rarely felt the need for that little key just to the right of the L. 

Yes, I see you at the back, waving your arm in the air and bursting to tell me that General Practice Cases at a Glance is full of them. But I didn’t put them there. Or, as the copy-editor would have expressed it, “I know; I did not, however, put them there.” They crept in, aided and abetted by someone who knows more than I do about proper punctuation.

Here’s what the University of Oxford Style Guide says:

Oxford

Each could stand alone as a grammatically complete sentence? Then take off those trainer wheels and let it.

A fellow author and I were discussing punctuation recently.  We’d already exhausted the usual writerly topics such as our word count for the day, and which wine bar was nearest. I think I rashly mentioned semi-colons. Her own editor, like many others, has a fondness for these little squiggles. So, when I admitted to my friend that I try to avoid them at all costs, she asked, “What do you use instead? Colons?”

I nearly dropped my glass of Merlot. I use full stops. Period.

FreeImages.com/Ryan Gageler

I reckon that, over the years, avoiding semi-colons has saved me huge amounts of ink. The claim may be a bit infantile, rather like the school friend who once calculated that bikini briefs saved her several minutes a week, as compared with wearing full knickers. But she made us laugh.

Why use a punctuation mark that can’t decide if it’s a comma or a full stop? It’s a tasteless hybrid. Unlike mules and hybrid vehicles, however, this one breeds. Give a couple of them house room in your manuscript and you’ll soon have them on every page.

Militant semi-colon enthusiasts can get carried away, so I’m reaching for my flak jacket to say I’ve got very few uses for semi-colons. Here’s one.

winking semicolon

Project Semicolon is another.  It’s based on the premise that a semi-colon is used when an author could have ended a sentence but chose not to. As Project Semicolon says, “You are the author and the sentence is your life.”

It’s a global non-profit movement for those who are struggling with mental illness, suicide, addiction and self-injury. You may well have seen semi-colon tattoos, which echo the theme.

There are many moving testimonies on the Project Semicolon blog. Just don’t get too hung up about the grammar.

***

At long last, Hampstead Fever breaks out on Thursday. And the cover’s pretty.

Hampstead Fever MINI FINAL EBOOK COVER MINI

The London Book Fair #LBF16

After three days of the London Book Fair, I’ve unpacked my memories and my bags of freebies. All the usual suspects were there, such as bowls of sweeties on the stands, people in unsuitable footwear, and long queues for overpriced sandwiches.

Olympia is vast, but every corner of every hall was filled.

#LBF16

Can you spot land-locked Switzerland?

Grand Hall, LBF16

Books Are My Bag grows bigger by the year.

Books Are My Bag at LBF16

The PEN Literary Salon was a popular destination, especially when the Julian Fellowes entertained with talk of Downton Abbey, his new venture Belgravia, and the eternal truths of writing (eg ‘The trick of life is to be undisappointing’).

Julian Fellowes at PEN, #LBF16

While there’s always an Author of the Day programme, authors are not the main focus of the book fair, even if publishers would find it hard to create many books without them.

Still, there was a goodly contingent of authors, including many independent authors.

Alison Morton, Helena Halme, Jessica Bell, Jane Davis, Peter Snell, Sue Moorcroft, Karen Inglis, Carol Cooper, Roz Morris,

On Tuesday, Alison Morton launched Insurrectio. If you think I missed off an N, you need to get acquainted with her Roma Nova series. 

Alison Morton launching Insurrectio at LBF16

While authors come in all shapes and sizes, there are sometimes uncanny similarities. 

3 literary sisters

Not literally sisters, but literary sisters. In the middle is Helena Halme who writes The Englishman series. Her latest title, The Finnish Girl, is out today. Children’s author Karen Inglis is on the right.

Author HQ may have been relegated to the back of the venue, but it was as packed as ever.

Audience at Author HQ, LBF16

The fair is now over, the final stragglers shepherded out by tannoy at 5pm on Thursday. But today indie authors can attend the Indie Author Fringe here.

And it’s only 11 months to go till #LBF17.

Why should I go to the London Book Fair?

As I look forward to next week’s London Book Fair, I realize I haven’t got a notebook, my comfy shoes need re-heeling, and I’ve been so busy editing that I haven’t properly checked out what’s on, let alone printed my badge. So I think fellow author Sue Moorcroft’s advice is very timely. Here it is, fresh from her blog with my thanks.

Sue Moorcroft blog

2015-04-14 12.13.44At about this time each year, writers begin to discuss whether they’re going to, or should be going to, the London Book Fair. I’ve been an attendee for years and always enjoy it but if a writer asks if they ‘should’ be going to the Fair I usually say ‘Not unless you want to’.

Here are some of the things that LBF isn’t:

  • a place to pitch to agents and editors (unless you’re an invited finalist a ‘Dragon’s Den’-type competition or an agent or editor has invited you to meet her or him there specifically to pitch. I have never heard of this latter thing happening)
  • a book shop
  • a venue in which to sell copies of your book, unless you’ve paid for a stand in order to do so
  • free to attend (unless you count your publisher/fairy godmother paying for your ticket as ‘free’)
  • a madly comfortable place

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