Medical ‘exams’?

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I hope he knows where to put that finger

I hope he knows where to put that finger

Over the last 15 years, I’ve witnessed the introduction of exam regulations such that examiners may not penalize students for bad spelling, bad grammar, and the inability to muster arguments.

Now, let it be known that I yield to no one in my enthusiasm for the worship of mediocrity, but there are consequences for medicine.

One letter altered in a word can change meaning: it could be the opposite of what was intended. One letter or syllable altered can mean an entirely different drug. One letter or symbol altered can increase or decrease a dosage by a factor of 100. An inability to organize thoughts logically signals an inability to formulate a treatment plan. And so on.

Students with certain conditions are allowed extra time in exams. I wonder how they will manage when they are on duty in the emergency room. Is it unreasonable of me to hope that they will not be there when I need attention? I know of one who claimed extra time on the basis of being able to read only the first syllable of a word, then guessing the rest. Tolerating that doesn’t have much to recommend it when over 70 drugs begin with ‘chlor’.

What drives this? Partly political correctness, and partly disability legislation.

Medical education is not alone in suffering from the baleful influence of theorists who lack common sense and practical experience, but it is one of the few areas where the consequences of such idiocy can be fatal. The public needs to know. When I need the services of a medical professional, I would like them to be competent and knowledgeable.

I think I shall form a new society: the Association for Restoration of Sanity in Education. ARSE. Also a new blog for the exposure of such lunacy. I am seeking a title for the blog. A colleague suggests Rumbling Rectum. Other ideas welcome.

Trains and hosiery

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Laois Traincare Depot, Portlaoise (copyright Peter Wilkins)

Laois Traincare Depot, Portlaoise
(copyright Peter Wilkins)

Last month I had a guided tour of Laois Traincare Depot. I was like a pig in pig stuff. For whatever reason, trains have always been important to me. Playtime at Langwathby school in the 1950s was always more exciting when Glasgow and Edinburgh expresses sped past, spitting steam and sparks. And in the 1960s I gazed longingly from home as the Thames-Clyde went by: ‘take me away, anywhere’ I pleaded! And now that I am away, the railways over Shap and Mallerstang are still dear to my heart.

In my travels on Irish Rail, including the time I missed my stop in soporific stupor, I’m impressed by the rolling stock, the punctuality and the cleanliness. Well done, Irish Rail! Over the cold winter months, spare a thought for the staff. Let’s hope they don’t get too much of the wrong sort of snow—speaking of which, I saw how, because the hooter is mounted low on the chassis, it’s prone to being blocked with snow. I wonder, can you guess the way they deal with this problem?

No?

Well, girls and boys, the high-spec technological solution is to cover the hooter with pair of tights. Yes, that’s right, ladies’ nylon stockings. Hosiery. I saw it with my own eyes. I now dream about rail staff going shopping: ‘I’d like a pair of tights for my horn, please’.

John Grainger Monkhouse 1943-2013

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Some of the Monkhouse cousins in 2011. John RIP front row second from the left.

Some of the Monkhouse cousins in 2011. Back row: John, Tim, Elizabeth, Margaret, me, Michael, Andrew. Front row: Judith, John RIP, Susan, Christine, Margaret.

So, the funeral then. My cousin, 69, the first of our generation to go, brain tumour.

One of his brothers described him as an ‘expansive’ man—not his size, but his personality. He enlarged horizons. He was fun. He sparkled. I last saw him two years ago at our centenarian aunt’s funeral (see pic) and was all the better for it.

Lovely to meet cousins not seen for decades. And what gossip! All sorts of skeletons tumbling out of cupboards. Rows and fallings-out between the five Monkhouses (Monkhice I suppose) of my father’s generation meant that some of us 15 cousins never saw much of each other after the mid-1960s. So silly, and such a shame. Stories of resentments, inheritances, assumptions, fictions. A soap opera of a sort well-known to any clergyman. What a waste of energy when you might just as well let it all hang out.

Goodbye John. It was a sad end for him, a couple of weeks before his 70th birthday. But having known for some time that the end was nigh, he was at least able to ‘enjoy’ getting ready for it as best he could. Save us from dying unprepared. If I go at the same age as my parents, I’ve 8 years left at most.

We’re all be in a coffin one day, so we might as well start preparing for it now. Sparkle! There is no more worthwhile alternative.

A fairy story

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clavicle_plate02Manchester airport last night on the way back from a funeral. For the first time EVER my metal right clavicle (collar bone) caused the metal detectors to go off. The rather grumpy security man (he’d had a long day, I expect) poked and prodded me, and seemed unwilling to accept my explanation. I was taken off and almost stripped (not a pretty sight). Eventually, he had to let me go. He could find nothing. The cupboard was bare. I was rather pleased. Such things give a warm glow of satisfaction. Beating the system.

Once upon a time in the mid 1980s Jack was cycling home in Nottingham. Jack was returning to the nest after a particularly tedious University Senate meeting followed by several particularly refreshing jars. The sky was moonlit, but the street was ill-lit. A motorcycle parked transversely was sticking out into the road. The motorcycle and Jack’s cycle became embroiled in discussion. The motorcycle fell down, and Jack fell down and broke not his crown but his clavicle. A fall onto the outstretched hand damaged not the scaphoid nor the radius nor the humerus, but the clavicle.

The treatment, a mere sling, was utterly inadequate. Any fool could see that. Jack needed a figure of 8 bandage to pull the shoulder back. Would A and E staff listen to Jack? No, they would not. So the clavicle ‘healed’ in the form of a Z.

Weeks and months went by. Drinking tea became fraught, for as the arm moved, the two mobile edges of the clavicle jammed up against each other, their sudden springing apart causing the cup to jerk and the tea to spill. Jack was not happy and neither was Jill.

So by and by Jack had had enough. Jack was cut open, part of the clavicle was replaced by a piece of metal from the planet Krypton, and chips of bone grafted in from Jack’s iliac crest.

And they all lived happily ever after. Until Manchester airport yesterday. The moral of the story is: brace yourself with jars before meetings, not after them.

It’s good to be back

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Fall-Foliage-1-LargeWe returned from 12 days in the US this morning. The weather was perfect: sunny and cool. No rain. Vermont was lovely in late autumn, enough red left on the maples. Manhattan was Manhattan.

Everything there is about present and future. We come back to this island off an island off the edge of a continent that doesn’t matter any more, to be confronted in national and church press by same old, same old squabbles. It’s all about the past here. People are still perseverating about what Christians should and shouldn’t do with their genitals, and primates are pontificating about perceptions of parochial attitudes. It seems that ‘sex and sectarianism’ is now the strapline for the Irish church.

It’s good to see that it’s got its priorities right.

The immoral church?

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450px-Gargoyle_Dornoch_CathedralMore from Windsor. Informal conversations have brought home to me, with unexpected force,  the extent to which the church is vilified by today’s young people. They see it as fundamentally unjust because of its attitudes to, for example, women and gays. The movers and shakers of tomorrow consider the church to be less just and less ethical than the society in which they live. It is no longer fit to regard itself as a guardian of standards, let alone a preacher.

I hear from an impeccable source that no C of E bishop was willing to go on air to defend the official position on gay marriage. I wonder how many C of E bishops refuse publicly to acknowledge their own sexuality, and condemn those who do.

Is this relevant to the Church of Ireland? I rather think it is. It’ll be interesting to hear how some of its bishops explain the reasons why they’re in favour of ‘exorcising’ gay people. One even hears of church people who look forward to the identification of the ‘gay gene’ so that fetuses that have it can be rubbed out.

This, it seems, is the gospel of love. Kyrie eleison.

Theology and the arts

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p3-quireHere I am on a course about Theology and the Arts. The surroundings are magnificent, Windsor Castle, St George’s Chapel, mediaeval glory, 18th and 19th century Gothick and the rest. An extension of ‘public’ (English-speak for fee paying posh, don’t ask why) school and Oxbridge.  The company is congenial and stimulating. And yet, and yet …

At the ‘consultation’ we are hearing about, among other things, the enrichment of church life by music, art, literature and so on. Very interesting and stimulating too, as ways to enchant the liturgy. But I see from Crockford’s that clergy speakers come from the rarefied heights of the church. I wonder do they think how frustrating it can be to ordinary parish clergy to have all these wonderful ideas thrown at them, then when they get home realize that few if any are likely to go down well with those who come to church and pay the bills? It’s a different world in Windsor. Those who inhabit this élite place are free of the rigours of ordinary parish life, but also of its blessings. I wonder how well they would fare in its rough and tumble? Reality does not much tarnish their fine thoughts.