Category Archives: Bureaucracy

The surreal UK Covid-19 self-isolation advice: Franz Kafka meets Catch-22..

(Image by TheDigitalArtist via Pixabay)

On the morning of Christmas Day, I tested positive twice for Covid on a lateral flow test, although I had no symptoms. That same day, I was able to walk in to a PCR test area and get that more definite test. Two days later, that test, too, came back positive. 

I had taken two lateral flow tests (morning and evening) on Christmas Eve which had been negative.

Current UK government guidelines for England said I should isolate for up to ten days from my first positive test. ie until Tuesday 4th January. But, if I took a lateral flow test which was negative on Day 6 and, 24 hours later, on Day 7, the rules said I could stop self-isolating.

On the evening of Christmas Day – the day I first tested positive – I had some internal flu-like shivers overnight; and the next night some lesser internal shivers. And, for the first four or five days of self-isolation, I had a new and persistent hard-edged hacking cough. 

But, by Day 6, I was back to having no real symptoms. 

However, on Days 6 and 7, I still tested positive for Covid.

Positive, too, on Days 8 and 9.

On Day 9 – that’s today – I phoned the government’s 119 Covid advice line because my attention had been drawn to the government’s own online advice, updated on 30th December.

The online advice said (and says):

“You should not take any more LFD tests (ie lateral flow tests) after the 10th day of your isolation period and you may stop self-isolating after this day.”

But presumably only if you test negative?… No. It doesn’t say that.

It continues:

“This is because you are unlikely to be infectious after the 10th day of your self-isolation period and should not take any more LFD tests after this date.

The italics are mine. And there is no time period mentioned.

What is said – and still clearly says – is that you should stop self-isolating after 10 days come what may and, in theory at least, you should never again under any circumstances at any point take any other lateral flow test.

Obviously that cannot be the intended advice – that you should never again take a lateral flow test. 

But the advice is clearly that, whether you test negative or positive on Days 9 and 10, you should stop self-isolating and re-join society.

This sounds mad and, I thought, cannot be the actual advice so, like I said, I phoned the 119 Covid advice line set up by the government.

Their on-the-phone advice was that, as a person triple-jabbed with vaccine, if I test positive on Day 10, I should self-isolate for 10 days although I could un-isolate if I test negative on Days 6 and 7.

“But,” I said, “the government website says I should not take a lateral flow test after Day 10, so I won’t be able to know if I test positive or negative on Day 6 and 7 of the new self-isolation period without taking a lateral flow test which, the advice says, I should not do.”

“That’s right,” I was told. “You should not take a lateral flow test after Day 10.”

“But, if I have to self-isolate after testing positive on Day 10, tomorrow, how can I know on Day 6 or 7 of isolating if I am positive or negative?”

“If you are negative you can stop isolating, otherwise you have to keep isolating until Day 10, at which point you can stop taking the lateral flow tests.”

“But I would not know if I were positive or negative without taking a lateral flow test and the government says, after Day 10, I should not take a lateral flow test.”

“If you do test positive, you have to isolate for another 6 days or until you have done 10 days in isolation and then you can stop isolating and do not have to do the lateral flow tests.”

They say Frank Kafka died on 3rd June 1924. I am not sure. 

I have always been attracted to surreality but there are limits.

I am going to return to daily life after Day 10 while keeping a healthy, well-masked distance from people and will wantonly keep taking daily lateral flow tests even though I have no symptoms. If I have two consecutive days where the tests have negative results, I will feel less wary… though not of bureaucracy.

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Now the UK National Health Service wants me to attend a nuclear facility…

My last blog was about the reliability of the NHS – You can always rely on their organisational arrangements to be in total chaos.

Basically, I was told that a Renal hospital appointment I never had was being moved to a date which doesn’t exist. I was told that the new appointment was on Tuesday 20th November – but 20th November is actually a Saturday. 

The same message also said I should attend the “Kidney & Urology Dept on Wednesday”… with no time nor date mentioned.

Neither the previous non-existent appointment nor the previous non-existent new date were on a Wednesday.

None of the above has been sorted out yet.

So imagine my lack of surprise when I got home around 8.00pm last night to find I had received a letter about a totally different new hospital appointment unrelated to the other two (or it might be three) previously confused appointments.

I have ongoing calcium level and kidney function problems which put me in hospital last May and this July. 

The previous confused communication had been about the hospital Renal (ie Kidney) Dept and the Kidney & Urology Dept.

This new missive was about a forthcoming appointment with the Nuclear Medicine Dept at the same hospital with which, on Monday 29th November, I now have an appointment to have a Spine and Hip Bone Density scan or, as the letter says, “Bone densitometry DXA”.

This scan has never been mentioned before at any of my chats with my Kidney Man and my Calcium Man – and neither have my spine nor hip been a source of interest – but I’m prepared to believe it’s a legitimate part of the search for what’s wrong with me. I had a PETscan at the same Nuclear Medicine Dept in August this year. A PETscan is the one where they inject radioactive material into you and then (as I understand it) look at it circulating in the body.

I have been told by two separate consultants that I am a “man of mystery” because no-one has any idea what on earth the cause or causes of my calcium/kidney problem is/are.

This means, among other things, of course, that I cannot be treated because they have no idea what they should be treating. They know the result of my problem but they have no idea of its cause.

The actual doctors seem efficient and thorough.

But the NHS bureaucracy – like all large bureaucracies – is a catastrophe of incompetence.

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More UK National Health Service chaos: my life is in their incompetent hands…

In hospital in, erm… who knows when?

As long-suffering readers of this blog will know, I was in hospital for seven days in May last year and again for seven days in July this year with a very high calcium level and (as a result) dangerously low kidney function.

No-one has been able to find out the cause. So I keep seeing consultants, mostly kidney and calcium men.

My kidney/calcium levels are pretty-much but not-quite back to normal now. But, still, no-one has any idea why they twice went dangerously haywire.

I wrote a blog in August this year when I simultaneously got three completely self-contradictory and chaotic letters about NHS hospital appointments.

Doctors, of course, like to use posh names, so ‘kidney’ staff are usually called Nephrology or Renal staff… and ‘calcium’ staff are usually called Endocrinology staff. In what follows, I have anonymised the hospital names as Hospital A and Hospital B.

In September, I was told my next appointment with the Nephrology team (my Kidney Man) would be on Monday 13th December at Hospital A.

Then, this afternoon, I got a text from Hospital B, which is part of the same group as Hospital A: 

Renal means Kidney.

The message concluded:

“Please attend Hospital B, Kidney & Urology Dept on Wednesday. TO RESPOND please follow this link…”

I did and responded:


I’m confused. Can you clarify?

I have an appointment to see Nephrology at Hospital A on 13th December at 10.30. (See attached letter.)

I had no appointment to see the Renal Dept at Hospital B on 16th November. 

And the ‘new’ date you give – Tuesday 20th November – does not exist (20th November is a Saturday).

You also seem to ‘confirm’ I should attend a Kidney & Urology appointment at Hospital B “on Wednesday” (no time given but presumably either Wednesday 10th November this week or an unknown Wednesday in December).

Could you tell me if the ‘new’ Renal appointment on Tuesday 20th November (a date which doesn’t exist) is the same as the Kidney & Urology appointment I have never previously heard about at an unknown time this Wednesday 10th November?

If I do have to attend Hospital B this Wednesday, could you give me a time for the appointment?

John Fleming


I await a reply with open-mouthed interest but little hope of efficiency or factual accuracy… It is always a tad worrying when your life and death is in the hands of large impersonal bureaucracies… All large bureaucracies are inherently incompetent…

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A slow UK handclap for the continuing bureaucratic incompetence of the NHS

A standardised NHS container designed for taking the piss

As regular readers of this blog – particularly some recent blogs – will know, I have a very high opinion of the medical staff working in Britain’s NHS.

Equally, I have a very low opinion of all large bureaucratic organisations, of which the NHS is one.

This year I have written several blogs about the NHS’ wild incompetence.

I currently have high calcium level and low kidney function problems which have been going on for over a year – since at least May last year. And the doctors have still got no idea what the cause of the problems is.

That is fine. They are trying.

But it means I have to have dealings with the bureaucratic side of the NHS.

Yesterday I received three letters in two envelopes from the NHS, all dated four days before.

I have had a longstanding appointment to see a kidney specialist in my local hospital at 1030 on Monday 20th September.

The first of the three letters was from my local hospital and cancelled that appointment.

The second letter (contained in the same envelope as the first) was from the NHS Trust/Group to which my local hospital belongs. It said I should ignore that first letter cancelling the appointment. The appointment, it said, was not actually cancelled. I had been put on a waiting list and the appointment would be rescheduled.

The third letter, also from my local hospital and dated on the same day as the previous two, said I now had a confirmed appointment at 1030 on Monday 20th September.

The eagle-eyed may have noticed that is the same time and day as the original appointment which had been cancelled. Sorry! Not cancelled but to  be rescheduled.

I am not 100% certain if the first and second letters are referring to the third letter and the appointment no longer exists.

Or if the third letter refers to the first and second letters and it is rescheduling the appointment, which is now confirmed to be once again on Monday 20th September 2021 at 10.30.

I live on the outskirts of London. All three of the above letters from my local NHS hospitals were posted to me from the NHS in Bristol. 

I have no idea why and, I suspect, neither does the NHS.

The many-headed Hydra of mythology (The Farman Collection, 1987, via Wikipedia Commons)

 

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Has the UK’s National Health Service any idea about what it is actually doing?

I have blogged about the chaos in the UK’s National Health Service before. The larger a bureaucracy, the larger the potential chaos.

I was in hospital for a week in May last year – with abnormally high calcium levels and dangerously low kidney function. This was reversed by a week’s worth of intravenous bisphosphonates – a drip to you and me.

But I have not had a full night’s sleep since June last year (ie exactly 12 months ago). No-one knows why I had the calcium/kidney problems and no-one knows why now, when I eventually go to sleep at night, I wake up at least once every hour every night with my mouth as dry as the Sahara Desert, forcing me to drink water.

As no-one has been able to diagnose the cause, there is no treatment. 

Currently, I have appointments with a Calcium Man in July, a Respiratory Man in August and a Kidney man in October.

One of the 6 pages of my Blood Test results

Yesterday morning, I got a 6-page print-out of my latest blood tests. I also got a call from another man at my local hospital to arrange a ‘Water Deprivation’ test two days before I see the Calcium Man. 

The Water Man was arranged by the Calcium Man.

The Calcium Man told me that it would be an early-morning urine test and I would not be able to drink liquids for several hours before the test.

Yesterday, the Water Man (who was a tad dithery) told me I would have to do “a 12-hour fast” before the test so I would not be able to eat or drink anything after 6.30pm the previous night. He had not told me what time the test would be.

“Oh,” I said, slightly surprised, “is my appointment at 6.30 in the morning?”

“9.30 in the morning,” he replied.

A slight pause.

“Oh,” I said, with a sinking heart. “So really a 15-hour fast.”

A slight pause at the other end of the line and then some linguistic confusion along the lines of “Umm… Err” followed by some audible recalculation.

“7.00pm,” the Water Man said, having recalculated the 12 hour gap before 9.30am. “So you can’t eat or drink anything after 7.00pm the previous night.”

I know when there is no point asking any more questions.

We left it at that.

But this does not increase my confidence in the efficiency of the UK’s National Health Service. I guess each generation thinks its doctors are experts and know what they are doing. Frankly, I do wonder if giving up on the application of leeches to the body was a good idea.

“The lies, and truths, and pain?… oh! yet… Stands the Church clock at ten to three?
And is there honey still for tea?” (Photograph by Ivan Mani via UnSplash)

 

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ECCENTRIVIA – Mis-gendering, Tit-Bits, Potato Heads and Janey Godley

In yesterday’s blog, I mentioned the NHS wasting time and money sending out three letters when only one was required. That referred to a local hospital appointment I am (still) having on 11th May with the Respiratory Department.

Today I received a text on my mobile from the same hospital about a telephone appointment I have with their Physiotherapy Department on 4th March. The text tells me that my telephone appointment has been changed to a telephone appointment.

Apart from the surrealism of my telephone appointment being changed to a telephone appointment, there is the quirkiness of the fact that they could have saved money yesterday by sending me one text rather than three physical letters. The technology seems to be not unknown to them.

********

The NHS is an organisation that just keeps on giving. After reading yesterday’s blog, a care worker I know sent me a message she received from the NHS’s ‘Health Education England’ – presumably sent to all NHS workers in England who interact with members of the public – advising her what to do if she should “misgender someone by accidentally using the wrong pronoun”.

Her reaction to me was: “FFS, I think I’ll stay in lockdown”.

********

In other gender-bending news, Hasbro’s Twitter account announced that, from Autumn this year, its iconic Mr & Mrs Potato Head toys will be getting “a 21st-century rebrand” as ‘Potato Head’ so that the toy could “break away from traditional gender norms” and, when the new brand is unveiled, “kids will have a blank slate to create same-sex families or single-parent families”.

This would mean the toys would not “impose a fixed notion of gender identity or expression”, freeing kids to do whatever feels most natural to them. A girl potato might wear trousers and a boy potato might wear earrings. Hasbro would also sell “boxed sets that don’t present a normative family structure”. This approach would allow kids to project their own ideas about gender, sexuality and family onto their Potato Head toys, without necessarily offending parents who might have more conservative notions about family.

After some surprised reaction on social media, Hasbro then re-Tweeted yesterday that, although the toys would indeed be re-branded as Potato Heads, they would also still be identified as ‘Mr’ and ‘Mrs’ on the packaging.

So Mr Potato Head will now be called Potato Head to avoid gendering the toy, but the toys will be identified on the packaging as Mr Potato Head or Mrs Potato Head.

I am undecided whether this is good publicity – lots of coverage of the brand – or bad publicity – too much ducking, dodging, diving and weaving in the PR.

Collins Dictionary currently defines ‘Potato-head’ as “[slang] a dumb or stupid person”.

********

Meanwhile, on Facebook, Man-of-All-Arts Peter Stanford has spotted a piece in a 1884 edition of Tit-Bits magazine.

Peter’s reaction was: “I so want some reputable magazine to offer this service. I would write my own, and send it off with my subscription, just in case.”

********

All publications are desperate for readers and ever have been.

In yesterday’s Daily Record (basically Scotland’s national equivalent to England’s Daily Mirror), there was a prominent article on comedian and author Janey Godley ‘dividing the internet’ by posting a picture of her dinner: a plate of toast, mince, peas and onions.

According to the Daily Record, “many were outraged by her choice of dish”.

You know you have really succeeded in the fame game when a national paper starts reporting your dinner (with pictures) for the sole reason that, if they publish your name, people will want to read the article. All the more jaw-dropping because this week Janey started writing a weekly column for the Daily Record‘s competitor, The Herald.

 

 

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Reaction to the incompetence of the UK’s National Health Service…

Yesterday’s blog was me bitching about the inefficient, mindless bureaucracy of the NHS. In particular, about how they sent me three self-contradictory letters about changing my meeting with a Consultant in June (in four months’ time) from an in-the-flesh meeting to a telephone call (because of the infection risk during the current COVID outbreak).

Inevitably, about ten minutes after posting that blog, I got a phone call from the NHS about changing from flesh-to-telephone a different appointment I have tomorrow with a different Consultant at the same hospital.

Something of a pity that I am not seeing him in the flesh because last week I had a recurrance of the vertigo I suddenly had without warning three weeks ago… and the neck/shoulder/arm pain which has recently got worse since it started back in November… and, of course, the fact I have not had a proper night’s sleep since I was in hospital in May last year – I wake up at least once every hour during the night, dehydrated, with my throat and mouth parched and having to drink water.

This means – because of the water – having to go to the toilet a lot during the night, which is not helped by falling-over vertigo or a painful and restrictive neck/shoulder/arm problem which is easier to describe visually rather than over the phone.

It also means I will not be given a blood test to see how my calcium level/kidney function is progressing or not. Those were involved in my problem last May, the cause of which is still a “mystery” (technical term).

Anyway, I got a fair number of comments about yesterday’s blog. These are a few…


Andy’s response was:


You should raise this with The Minister at The Department of Administrative Affairs. The response will be that to change a standard NHS letter issued by a single key stroke that generates three different but essential standard letters to the same person whilst informing several departments of the change is essential in effective running of the appointments system. 

Whilst admitting that this does appear to be wasteful and confusing, particularly if the three letters received by the patient are opened in the wrong order, to alter the system requires the employment of a number of consultants and support staff over a period. It’s estimated, that may extend over several years because there is no central office for administration within the NHS. 

You’ll recall the failure of the government proposed computer system to link all the the NHS computer systems into one seamless system. It’s considered that to fix this issue, which is considered mostly harmless, would take in the area of £736,000,000 and is therefore not worth doing.

In addition, all of the Ministers’ friends are all currently overstretched in other government projects they’ve been awarded so won’t be able to start work in this until at least 2037.


‘King1394’ observed:


Yes it is the efficient work of computerised automation. Once there would have been a thinking clerical worker managing your appointments. But computers are cheap to employ even if they produce three contradictory letters where one would suffice.


Alan commented:


This is the same bureaucracy that, when medics were crying out for Personal Protective Equipment, refused to deal with many suppliers who had stockpiles of exactly the right equipment, in date, authorised for medical use… They refused to purchase it because that particular supplier couldn’t be added to the procurement system due to a lack of past dealings.

Every once in a while there’s a cry-out for everyone in the NHS to receive a pay rise or bonus due to the hard work they’ve done in fighting the pandemic.

While I wholeheartedly agree that every single person in the NHS who has been right there in the hospital, facing danger, risking their own health as well as that of their families should get something, I’m still very reticent to make it a blanket award as I don’t want to reward those who made it more difficult or who simply did their job from home at no additional risk to themselves or others.


…and Sandra said:


The NHS? I have been lucky in my treatment from them in the main.

Apart from the time when I was sent for physio, when in fact my hip was on the point of fracturing.

Plus one other doctor whom everyone avoided.

As it turned out, he mis-diagnosed my condition, complained about the price of the meds he was about to prescribe, then ran after me begging forgiveness because he had given me the wrong prescription. Bastard. 

And I told him so, leaving out the word bastard…


Obviously, I realise my alleged problems are only relatively minor inconveniences, but – hey! – look – it’s my blog. It needs writing and where else can I selfishly whinge up my own arse if not in my blog?

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The mindless administrative mess that is the UK’s National Health Service…

(Photo by Bofu Shaw via UnSplash)

This week, on one single morning, I got three NHS letters in two envelopes from the same London hospital, all posted from Bristol and all written on the same day, five days earlier.

The first told me (in paragraph 2) that my appointment to see a doctor at 10.30am on Friday 18th June had been cancelled “as part of our response to the COVID-19 outbreak”. 

In paragraph 3, the letter explained that, although the second paragraph “states your appointment has been ‘cancelled’, this is not the case. You have been placed on a waiting list.”

Attached to this letter was a second letter saying: “We’re sorry but we have had to cancel your appointment” at 10.30am on Friday 18th June.

Both these letters were in the same envelope.

In a second envelope which arrived at the same time on the same day was a third letter dated on exactly the same day as the first two letters.

It said: “This letter is to confirm that a telephone appointment has been made for you at 10.30am on Friday 18th June. When you have a telephone appointment you are not required to attend the hospital.”

So basically, entirely reasonably, to avoid people attending the hospital in person during the COVID-19 outbreak, my in-the-flesh appointment at 1030 on Friday 18th June (over four months away) had been changed to a telephone appointment at exactly the same time.

To do this, I was sent a letter saying my appointment was cancelled but not cancelled… an attached letter saying my appointment was cancelled… and a third, separate letter saying my appointment had been changed from physical to telephone.

All that I needed to receive was one letter saying my appointment had been changed from physical to telephone, not three letters, all sent from the source on the same day.

Have I mentioned before how much I hate mindless bureaucracy in general and what an administrative mess the NHS is?

… CONTINUED HERE

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A pain in the neck: Why I really don’t trust the UK’s National Health Service

Bad: cut head. Good: if you have freckles, no need for hair…

I got my Oxford/AstraZeneca COVID vaccination yesterday. Apparently over 12 million people have now been given the jab.

No side effects so far except that, about half an hour after getting the jab, I fell over backwards in my back garden.

I was unable to control the fall, landed flat on my back on the concrete path and hit the back right side of my skull against the sharp edge of my back doorstep.

Now I have a very sensitive-to-the-touch large domed bump on my head and a V or Y-shaped cut. Surprisingly no blood.

Nothing to do with the vaccine, of course – I just accidentally clicked my heel against the slightly raised concrete path by the grass and fell backwards. But it’s a kinda clickbait way to start a blog.

The execution of the vaccination itself was stunningly efficient. A steady flow of people entering the venue, being rapidly processed and exiting. I can only assume the organisation of it was set up by the Army not the NHS and not politicians.

I think anyone who has ever worked with me knows that I do not get on well with mindless bureaucracy.

All large bureaucracies are inherently mindless, inefficient and incompetent, no matter how well-meaning the staff may be.

Aye and there’s the rub. 

Settle back with a nice cup of something hot. This is a lengthy, self-indulgent blog.

Early last week, I contacted my local doctor because I have a persistent pain at the right side of my neck, across my shoulder and in a straight line down the outside of my right upper arm. The pain has been there since late November. It is now early February and has been a bit worse the last month or so.

I think it is a muscular pain and the problem is really in my neck. I could be wrong. 

My shoulder was broken in 1991 – pulverised in two places

In 1991, while standing on a pavement, I was hit by a large truck. It pulverised (technical talk for “powdered”) my collar bone in two places. The back left side of my head was cut open when it hit the edge of a low brick wall as I fell.

It also turned out later that my spine had been damaged at the bottom. The same effect as a slipped disc, though I don’t think it’s medically called that. And it hasn’t mended.

After the knock-down, I was in my local hospital for a week.

I was in the bone section ward of the hospital because of the shoulder injury; but I was bureaucratically under the care of the brain section people because of my head wound. These were/are two different departments/wards on two different floors of the hospital. 

It meant that, in the hospital, although the nursing staff in the bone ward cared for me and looked out for any after effects on my shoulder and brain, the consultant supervising the bone ward ignored me.

“He is not our responsibility,” said the doctor, passing by.

One day, I heard him say, as he approached my bed with a bevy of (I presume) eager and attentive trainee doctors: “This is Mr Fleming. He is one of Mr XXXX’s patients, so he is not our responsibility.” And, as normal, he passed by my bed without stopping or talking to me. 

Mr XXXX, who was on a different floor of the hospital, never visited me.

Eventually, late one Friday afternoon, an exhausted and I presume very over-worked junior doctor who worked for Mr XXXX came down, had a brief chat with me and told the nurses in the bone ward I could be sent home. Presumably they had advised Mr XXXX that I had no long-term head problems. (Which was not the case, as it turned out.)

After I was sent home, there was no physiotherapy, no after care of any kind. Much later I discovered there should have been but – hey! – it’s a big organisation. Shit happens. Some things don’t.

For about the next nine months I had waves of inability to think properly, I presume caused by concussion. I am still unable to read books because of concentration problems. Oddly, I can write books on a computer but I cannot read printed books.

I also buggered my shoulder. Mea culpa.

Because of the fractured bone(s) in my shoulder, I could only walk very carefully and slowly. I discovered walking is quite a violent shock to the torso. Who knew? Every step was a jolt and a knife stab into flesh because my bone had broken diagonally, creating two very sharp pointed ends. And I had to sleep on my back at night. Throughout my life I had previously slept on my side.

To avoid turning over, I slept with my left arm stretched out at right angles to my torso. This meant I mostly did not turn over but also had the side-effect (not realised at the time) that my shoulder bone, fractured in two places, mended with the bits of bone overlapping rather than re-attaching as before.

Not me (Photograph by Dylan Sauerwein via Unsplash)

This, in turn, I think, had the result that my left shoulder is slightly shorter horizontally than it should be and muscles around the back of my neck are a bit bunched-up.

So, occasionally, the back of my neck gets very tense and bunched.

In November last year, this was happening again and the right side of my neck started having an occasional vertical pain. As this developed, it also went along the top of my right shoulder and, for some reason, in a straight line down the outside of the upper half of my right arm.

Currently I get a pain on the right side of my neck and in that line down the outside of my right arm. I can’t really lift my arm more than halfway up my torso without a shooting pain.

All this, I think, is muscular and related to my buggered back-of-the-neck – not anything to do with bones or trapped nerves.

So I phoned my local doctor earlier this week. We are, of course, still in mid-COVID pandemic, so seeing anyone is pretty much of a no-no. The first person I talked to put me through to a second person. She told me: “There are no appointments left today. You have to phone back at 8 in the morning to book an appointment.” I was not asked why I wanted to talk to a doctor.

The next morning, I set my alarm for 0756 and phoned back at 0800. 

This was the same number I had successfully phoned the previous day.

The answerphone said: “Thankyou for calling. This number is no longer in operation. Should you require urgent medical advice, please hang up and dial 111.”

111 is a general NHS advice number.


As an aside… In May, I was advised after a negative COVID test to contact my doctor because I had odd non-COVID symptoms.

When I phoned the GP surgery and told them my symptoms, their initial reaction was: “It is not our responsibility. Phone 111.”

When I phoned 111, they told me to phone back the local GP surgery and tell them that 111 said I HAD to talk to my doctor and he had to talk to me within three hours. I did. He phoned back just over three hours later and got an ambulance to take me to A&E because he believed I had had a stroke (although I had no symptoms of having had one). 

When A&E tested me, they took me into hospital immediately. I had dangerous kidney function/calcium levels. Someone later told me I was probably within spitting distance of being on kidney dialysis machine.

Anyway, back to this week…


I phoned back the surgery’s number again after a few minutes gap. Same message. “Thankyou for calling. This number is no longer in operation. Should you require urgent medical advice, please hang up and dial 111.” 

I went online and checked the surgery’s number. It was the correct number. I phoned back again.

“This line is no longer in use,” a different message said.

I phoned back again. The answerphone again said: “Thankyou for calling. This number is no longer in operation. Should you require urgent medical advice, please hang up and dial 111.”

I phoned back again. Same number. This time, I got a receptionist who put me through to another receptionist who asked what, in general, was wrong with me and said a doctor would phone me back “sometime today”.

Later that morning, the doctor phoned me from a very echoey room. He was either in his kitchen or a very small room with hard walls. It sounded like a toilet but I felt that was unlikely.

He listened to the symptoms I had had since November. I told him I had tried rubbing on Deep Heat, Tiger Balm (suggested by Boots chemist) and Chinese Wan Hua Oil, all to no effect.

He suggested I take paracetamol or some other simple over-the-counter pain killer.

This is why I largely distrust Western Medicine. The object is to relieve the pain and hide the symptoms… not to cure the cause which will continue, masked by the drugs.

“Pain is a sign that something is wrong, Rosemary…”

I have, perhaps, been unduly influenced in my thinking by a line in Rosemary’s Baby… “Pain is a sign that something is wrong, Rosemary.”

I somehow, perhaps foolishly, doubt that I am pregnant with the Devil’s baby, but pain is my body telling my brain that there is a problem in some part of my body, its seriousness reflected in the level of pain transmitted.

I would rather know there is a problem and try to solve it rather than not know and let it develop unknown by me.

I have a feeling that a good neck massage might help me, but – hey! – we are in a COVID pandemic where no-one wants to get to close to anyone else.

The doctor did say he would text me two NHS online exercises for neck pain and shoulder pain. And get a physiotherapist to contact me.

Whether this physiotherapist actually will contact me or not is in the lap of the Gods, but I had a look at the two pages of NHS advice as sent by the doctor.

The one for Neck Pain says: “See a GP if pain or stiffness does not go away after a few weeks”.

The advice for Shoulder Pain says: “See a GP if the pain is getting worse or does not improve after 2 weeks”.

As I mentioned to my GP, I have had pain since November.

I can’t imagine this NHS treatment happening in a pandemic…

Ah well, I should look on the bright side. I am seeing my Chinese doctor in two weeks.

The good thing about Chinese medical philosophy is that they try to cure the problem not mask the symptoms. 

Western Medicine and the NHS is a pain in the neck.

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John Fleming’s Weekly Diary – No 29 – NHS chaos, online cults, PC linguistics

… CONTINUED FROM DIARY No 28

Ariane X – ex Ariane Sherine – the palindrome queen

SUNDAY 2nd AUGUST

In my last diary blog, I mentioned that Ariane Sherine (newly aka Ariane X) said she had discovered that, since finding a new man in her life and becoming happy, she has been unable to write songs.

Inevitably, of course, as soon as I posted that, she wrote another song for her upcoming album, released on the (if you are British not American) palindromic 12.02.2021.

This is part of it:

When you’ve no money left
No love or hope or friends
And your heart it is closed
And you think that it’s the end
And you’re praying to God
Yeah to come and save your soul
Well I’ll save you instead
Bring you in out of the cold

Also last time, I mentioned Charles Aznavour’s observation that, when people are happy, they are all happy in much the same but, when people are sad, there are varied, specific reasons why, so ‘sad’ is more inspiring and more interesting.

Erudite performer and man about town Peter Stanford pointed out that Aznavour had perhaps read the first sentence of Tolstoy’s Anna Karenin (or, on my Russian college course, Karenina):

“Happy families are all alike; every unhappy family is unhappy in its own way”

All I really remember about Anna Karenina is some bloke tapping the wheels of a train and maybe that was only in the movie.

MONDAY 3rd AUGUST

NHS confusion continues.

Last week, my face-to-face appointment with the Kidney Man was changed to a telephone consultation but, having experienced this twice before, I disbelieved it.

On Friday, I checked with the Kidney Man’s secretary and it was indeed a face-to-face appointment.

When I arrived at the hospital at lunchtime today, the two security men checking arrivals (no visitors are allowed because of the COVID-19 restrictions) directed me to Reception just inside the door.

It was the same man on Reception as before – last time he said the entire Nephrology department had moved to another hospital – so I ignored him and went straight to Outpatients reception.

They directed me to the appropriate Consultation section’s Reception. The nurse on that Reception tried to find my details but couldn’t. Then the actual Receptionist arrived.

She told me all the face-to-face appointments had finished; there were only phone ones now. The nurse told the receptionist: “There’s no John Fleming on the list. In fact, there is no list. It may have been thrown away by accident.”

The receptionist said: “I will ask the doctor if he will see you.”

He said Yes.

The Kidney Man knew he was supposed to be seeing me masked-face-to-masked-face.

Apparently this is a micrograph showing a renal core biopsy (Photograph by Nephron via Wikipedia)

He told me I’m still “a mystery”. Nothing showed up on the last blood test. He may send me to see an Ear Nose & Throat man in case that throws up any irregularities. He also has a colleague who is “interested in calcium” so he might want to see me. And they might try a kidney biopsy, though that is unlikely.

“What is a biopsy?” I asked. Does it involve cutting me open?”

“We just stick a needle in your back, under local anaesthetic,” he replied, “and take a little bit of kidney out.”

My next face-to-face appointment with the Kidney Man is in two months, unless something bad were to show up on the blood test.

He sent me down one floor for a blood test. “They may be closed,” he told me. “If they are, just phone the number on the sheet and make an appointment.”

The Phlebotomy (Blood Test to you and me) Department was open.

I left the hospital and went to the National Express office at Golders Green to see how much a two-day coach trip to Edinburgh on 15th/16th August would cost. I want to see what the Edinburgh Fringe is like without the Edinburgh Fringe… and to see comedian Arthur Smith do his annual midnight tour of Edinburgh.

It was £76 return by coach. Much, much cheaper than a railfare.

Nobel Prizewinning Irish politician John Hume

TUESDAY 4th AUGUST

Irish politician John Hume died yesterday. He won the 1998 Nobel Peace Prize for his work trying to bring peace in Northern Ireland.

A BBC commentator said that, the first time Hulme met the IRA leadership face-to-face, he (Hume) said it was like meeting a cult. They were genuinely shocked to find out people genuinely had different views to them. Before then, they had only talked to themselves and their supporters. Anyone outside that circle who disagreed were not seen as people with genuinely different opinions – they were seen as evil.

I immediately thought: Corbynistas… Brexit… almost anyone on Twitter… To hold any opinion different to what you and ALL your friends have is not valid because it is not possible. If you disagree, you must be total evil, must be silenced.

Just me on that one, then?

There was an explosion in Beirut today – around 150 dead and over 4,000 injured. It turned out to be not a bomb but fertiliser. Of the kind used in bombs. Shit happened.

I was going to book an airfare to Edinburgh, after searching cheap price comparison websites. The cheapest return was £65 via Easyjet – cheaper than a coach and a journey time of only 90 minutes as opposed to 10 or 11 hours in a face mask.

My eternally un-named friend suggested looking on the actual EasyJet website. She was right.

It was £65 on the cheap price comparison websites and £55.98p on the EasyJet site itself. (Same flights.)

Arthur Smith was scuppered and scunnered by coronavirus

WEDNESDAY 5th AUGUST

Arthur Smith cancelled his tour of Edinburgh because of the Scottish government’s COVID restrictions on outdoor events. Shit happens.

THURSDAY 6th AUGUST

I got a letter saying my next face-to-face hospital appointment with the Kidney Man is on 19th Ocober. Inevitably, a few days before this, I will get an erroneous text saying it has been changed to a telephone appointment.

Talk of dabbicals, gangbangs, carjacks, bums and fags… (Photograph by Dmitry Ratushny via UnSplash)

FRIDAY 7th AUGUST

I spent the afternoon with my eternally un-named friend.

At one point, an arrangement went wrong. She said: “It’s a dabbical.”

We both looked at each other. Neither of us knew what the word should have been. I suggested it was a reasonable-sounding word so should be in common use.

Later, I was in conversation with someone totally different and it came up in conversation that, in the US, she had been told the British word ‘gangbang’ means ‘carjack’ over there.

Later still, I looked it up online and, as far as I could find, on both sides of the Atlantic, gangbang = gangbang and carjack = carjack. A very odd misunderstanding.

I do always wonder, though, what would happen if an Eastender from London said to someone in Kansas: “I want to bum a fag”.

Late night: my eternally un-named friend phoned to say: “Debacle…”

The offensiveness of phral and bhrātṛ

SATURDAY 8th AUGUST

Continuing with linguistic problems, in the new ultra-PC, non-binary world, a performer posted the following on Facebook:


QUESTION: I’ve been working very hard on replacing gendered collective terms like “dudes” & “guys” with “folks” whenever I address groups. I occasionally slip up. But I’m trying.

I was convinced that “pal” was non-gendered but I’ve just looked it up and it isn’t.

Its etymology is:
First recorded in 1675–85; from English Romani: “brother, mate,” variant of continental Romani phral, ultimately from Sanskrit bhrātṛ “brother”.

Does anyone know a non-gendered equivalent, please?

I’ve just found out that by using “pal” with a trans friend (who calls me “pal”), I’ve been unintentionally mis-gendering her and I don’t want to.

“Alright, friend?” feels odd.

There must be a non-gendered equivalent? Surely?

That said I’m struggling to think of a feminine version and the lack of that might be the reason I assumed it was non-gendered.

It’s two things:

a) Does this have the capacity to hurt someone?

b) Is it easily within my gift to avoid even the potential of causing that hurt and it cost me nothing more than the tiniest bit of thought?

If the answers to both of those questions are “Yes” then I’d feel like an utter arsehole if I didn’t at least try.

It’s my job as a decent human being to try to make extremely minor and trivial accommodations to avoid the possibility of hurting someone.


I may be revealing myself as an utter arsehole here but – admirably caring and commendably sensitive though his aim is – I think if someone is linguistically sophisticated enough to be offended by the 17th century Romani or ancient Sanskrit roots of perfectly commonplace 21st century English words, then they are probably intellectually resilient enough to cope with being called “pal”… although, frankly, I would be wary of using the word without care in Glasgow (where “cunt” is a genuinely commonly-used conversational term of affection).

… CONTINUED HERE

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