Tag Archives: bureaucracy

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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Anarchy in the UK’s National Health Service during the Covid 19 pandemic…

(Photograph: Jr Korpa via UnSplash)

Occasionally I start a blog with a variation on: 

What’s the point in  having a blog if you can’t be self-obsessed?

This is one of those blogs. But we don’t get to that bit until towards the end.

At the time of writing, England is almost out of Covid Lockdown. 

On June 21st, all restrictions may (or may not) be lifted. The chaos caused has been, of course, even worse in large bureaucracies like the NHS.

This morning I got an email from someone I know. 

“If you think you are having a rough time with the NHS,” it said, “below is a cut ‘n’ paste of an email from my son about his wife, Sue.”

I have changed the names to protect their privacy. The email he attached read:


Dear Dad,

Hope you are doing OK.

All OK here – except that Sue had an interesting unexpected phone call last week. The number was not recognised, but she answered because it was a local number. 

The person introduced himself as her consultant and said it was urgent that he speak to Sue Simpson. 

Sue said she was speaking, then the consultant asked her why she had not attended any of her appointments over the last 18 months, at which point Sue pointed out that they had cancelled her three booked appointments and she had not received any more. 

Last January Sue had some scans – CT scan, X-ray, cat scan and bone density scan because the year before she broke three vertebrae in the accident, as you know.

She never got the results due to cancellations as a certain pandemic hit. 

We wondered why the results were not passed on to her GP but the consultant said they were too important to give to the GP and had to be dealt with by themselves… But they were obviously not important enough to keep the three appointments!!!!.

 Anyway, the consultant asked if Sue was sitting down, so Sue said she could cope standing up. The doc then said that Sue should start three new medications immediately as she has been diagnosed with osteoporosis and he was sorry but this diagnosis was made after his scans nearly 18 months ago. 

It means she has missed out on 18 months of meds and it could cause permanent damage to her spine and other bones. Basically, he said that if she has a severe jolt to her body there’s a possibility of her spine being crushed and possible loss of feeling. 

We have to take it one step at a time. But it does explain why she’s lost so much weight and her bones and muscles really play her up. 

Waiting 18 months for results has meant that she’s lost 18 months of medication and her health has got worse.


That was the email which was forwarded to me. 

If you remember, there was a reference to “If you think you are having a rough time with the NHS,…”

The rest of this blog is really an aide-memoire to myself.

Feel free to abandon ship.

I have been not 100% since I was hospitalised for a week last May with a high calcium level and dangerously low kidney function. I am still an outpatient with The Kidney Man at my local hospital. They only realised I had dangerous calcium/kidney problems by taking blood tests; all other tests showed no problem.

I am booked-in to see him again, in-the-flesh, on 14th June which is reassuring because I have not had a blood test since 19th October last year.

I was also supposed to have a telephone appointment with ‘the Respiratory Team’ at my local hospital last month – on 11th May. The appointment had been made by my Calcium Man way back on 30th November last year so, on 10th May, the day before the appointment, I thought it wise to check if it really was going to be in the flesh or by phone. In fact, the Calcium Man had asked for a Respiratory Team appointment on 27th November and it had taken to 2nd January to actually confirm an 11th May appointment in writing.

When I phoned, I was told the appointment had been cancelled altogether back on 21st February because there would be no doctor available on 11th May. I had never been notified of this cancellation. But I was told would not have to make another appointment as it was now “in the system”.

Obviously, the next day, I checked with the secretary to my Calcium Man’s secretary, who said she would sort it out.

So, on 20th May, I got two letters, both dated 18th May.

One told me my 11th May appointment had been cancelled and I had a new appointment on 14th September. The other told me my 14th September appointment had been cancelled and replaced by a 9th August appointment. Both letters, as I said, were dated 18th May. Both arrived in the same post.

Now we reach the even-more self-obsessed bit.

I have had vertigo since January. Its seriousness comes and goes. When it is not serious, I just feel light-headed and not 100% in control of my balance. 

Yesterday morning, just after midnight, for about an hour, without any warning, I had very very very bad vertigo… then with added bad diarrhoea, then with added vomiting.

After that, I managed to sleep for four hours, which was quite an achievement as, since coming out of hospital last May, I have not had a single full night’s sleep – I wake up at least once ever hour, very dehydrated.

Yesterday, when I did wake up – at around 0530, I was a bit better though, if I stood up, I was still dizzy and wobbly.

Mid-morning, a text arrived from the Kidney Team at my local hospital. My appointment with the Kidney Man on 14th June has been changed – “due to COVID19” – from a face-to-face meeting to a telephone call. “We will phone you in due course” it said.

This was – erm… – somewhat disappointing as it means no blood tests.

The Kidney Man had said when I talked to him by phone on 15th February that I would be contacted about a further blood test by one of two local hospitals, but I never was. That’s large bureaucracies for you.

Anyway, yesterday I was told my next ‘meeting’ with the Kidney Man would be by phone… so no blood test there.

That was yesterday morning.

Then, just after midday, the SEVERE vertigo came back, including my bedroom walls whizzing round, it appeared, both from right to left AND from left to right. Who knew this was possible? That only lasted for about half an hour and the rest of the day was just a bit wobbly inside my head.

This morning I feel a bit light-headed.

To be continued, I feel…

Though who knows when?

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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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ECCENTRIVIA – Political correctness, Facebook hoes, midgets and the NHS

Yesterday, my Yorkshire-born friend Lynn stumbled on this story in The Week from last month, which both of us had missed. She says: “I had to read it three times and I’m still not sure I get it. Whoever the morons are, they surely can’t be Yorkshire folk.

To be clear, the concept of the three wise monkeys became popular in 17th century Japan, before spreading to the West. It is associated with the Tendai school of Buddhism where monkeys are considered sacred and perceived as helpers for divine figures. They are “vehicles of delight”.

I always think people who censor monkeys for being racist should look at themselves in the mirror. Far be it from me to say “political correctness gone mad”… but I will.

That was yesterday.

Today, Lynn spotted this piece in Computer Active magazine about Facebook’s algorithm getting similarly censorious.

I told her: “Eat your heart out for any publican trying to make a living by running the Cock Inn, Scunthorpe.”

Afterwards, I Googled to see if there actually IS a Cock Inn, Scunthorpe.

Sadly there is not, but Google told me there is a Blythe Black Cock Inn. Arguably worse in Facebook terms, but un-censored by them.

I feel the good people of Plymouth Hoe have cause to be aggrieved about being picked-on by a US algorithm.

********

Meanwhile, in other perhaps equally dodgy news, I got an email telling me that the admirable Vaudevisuals Press, whose slogan is “Celebrating the Eccentric Performing Arts”, have published a book on Rose’s Royal Midgets and Other Little People of Vaudeville.

“…both the Dark and the Dazzling sides”

It covers the period from 1890 when Ike Rose “started living the legendary life of a top vaudeville & burlesque producer” to 1957, when Billy Barty founded his “advocacy group” the Little People of America.

Ike Rose, apparently, was “one of show biz history’s great impresarios, now forgotten but once in a league with names like Barnum and Ziegfeld as men who delivered full value for the price of a ticket.”

He seems to have rivalled Barnum is hype.

The book admits: “each component of the troupe’s name crumbles into dust by light of day.

“‘Rose’ was a pseudonym; the company held no Royal seal of approval; and the word ‘midget’ has passed out of use in polite society.”

The selling line for the book claims: ”Without pandering nor passing judgment, this book documents in detail the performers, producers, the stage routines themselves and the various venues from those straight up and upscale to others shameful and shady. This book probes both the Dark and the Dazzling sides of the American Imagination. Only rare books like this seriously confront our more bizarre past and allow the new generations of show folk to revise, to re-invent, to reform American Theater.”

Rare indeed – apparently only 50 copies of the book are being published.

Tomorrow – well, tonight at 8.00pm in New York; tomorrow 1.00am in London – there is a free online Zoom conversation between author Trav S.D. (Donald Travis Stewart) and Vaudevisuals’ own Jim R.Moore.

As I haven’t had a full night’s sleep since May last year (medical conditions) and am currently sleeping on the floor at night because my back is buggered, the possibility of my listening in on this Zoom call is iffy. But it sounds interesting.

********

I have also, this morning, just received a letter from the NHS saying that I should ignore the other letter they enclose in the same envelope cancelling  a future appointment.

Obviously, in this main letter, they don’t mention when or with whom the appointment is because that is mentioned in the letter which they are telling me to ignore.
 
They say, in the first letter telling me to ignore the second letter, that they will send me a third letter rescheduling the appointment.
 
Regular readers of this blog will know we have been here before (see my blog of a fortnight ag0).
 
Life is but a surreal dream, a tale told by an idiot, full of sound and fury, signifying nothing….

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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 33 – An anarchist’s death, baths and sleep

… CONTINUED FROM DIARY No 32

Another weekly diary blog that’s maybe more than a bit self-absorbed. Apologies.

(Photo by 21 swan via Unsplash)

SUNDAY 30th AUGUST

For the last 3 or 4 weeks, my legs have ached when climbing long flights of stairs eg at stations. Really tiring and aching.

I had a lot of trouble getting out of the bath this morning.

But things could be worse.

My eternally un-named friend commented: “It’s a good day when you don’t have a hand grenade thrown through your window.” Something with which I cannot disagree. We think it’s a reference to the 1942 movie Went The Day Well?

As if to prove the point, both in general and a propos hand grenades, later in the day, my friend Lynn told me that (alleged) Angry Brigade anarchist Stuart Christie,whom I blogged about in October last year, died, aged 74, on 15th August. I had not noticed any obituaries at the time.

MONDAY 31st AUGUST

A couple of weeks ago, at Euston station, I heard an announcement for Inspector Sands (a coded message which means that there is a major emergency in the building).

I arrived at St Pancras station tonight and there was another Inspector Sands announcement – this time in English AND in French.

Everyone ignored it. I am still alive to tell the tale. If this happens a third time, I will be forced to conclude that the railway companies have actually been foolhardy enough to employ someone genuinely called Inspector Sands.

My yellow chum bobs in turbulent waters…

TUESDAY 1st SEPTEMBER

I had a bath this morning.

Despite my age, I try to keep mostly clean.

Also, I enjoy farting in the bath and watching my yellow plastic duck bob around in the turbulent waters.

Anyway, I had trouble getting out of the bath again, but it was not as bad as on Sunday.

Later, Ariane Sherine‘s 9-year-old daughter – never to be underestimated – told me that my birthday (28th July) is appropriately National Milk Chocolate Day.

WEDNESDAY 2nd SEPTEMBER

I slept just over 10 hours last night and woke up 12 times needing to drink water.

Today is my mother’s 100th birthday. She is dead, of course.

Ariane Sherine’s 9 yo wished my dead mother a happy 100th

Ariane Sherine’s daughter sent me well-wishes and a design she had created to celebrate my mother’s birthday.

For some reason, she had my mother’s maiden name down as McHamilton instead of McLellan, but my mother is dead, so no harm there.

Not that there would have been any problem; she would have been very happy. Very honoured.

Perhaps Ariane’s daughter is writing a musical. I would not put it beyond her.

THURSDAY 3rd SEPTEMBER

I slept from 2200 last night to 2000 tonight with a couple of short periods awake to eat and a very large number of wakings-up to drink water.

When I woke up, l had a bath and still had some trouble getting out of it. The muscles in my legs or somesuch.

“It seems to have been a Thursday for at least eight days now.”

It seems to have been a Thursday for at least eight days now.

A friend commented on my ongoing sleeping problems: “It seems quite uncope-able with, no? Not much of a life? You seem to just have an existence of being asleep, merely waking to eat or gasping for a drink.”

But maybe that description covers a very large percentage of people’s lives.

FRIDAY 4th SEPTEMBER

July… August… September… It all merges into one…

Ah! The (in)efficiency of the NHS bureaucracy!

This morning (September 4th) I received a letter from the Kidney Man posted yesterday and written on July 29th about a July 6th chat referring to a future early August appointment. It was sent to my GP with a CC to me so I presume he also received it this morning.

In the afternoon, I had a shingles vaccination at my GP’s. Because of the COVID-19 outbreak, none of the GPs are there any more. They all work from home.

The nurse giving the injection CLAIMED it was OK for me to have, despite my recent problems – cause still unknown.

Apparently, the Shingles vaccination is not annual – it’s one in a lifetime. Of course, if it kills me next week, that would still be true.

I found out too late to celebrate that today is National Fish & Chip Day.

SATURDAY 5th SEPTEMBER

Easier to get out of the bath, Almost back to normal.

Well, as far as getting out of the bath is concerned…

Like I said at the beginning, this blog is maybe more than a bit self-absorbed. Apologies.

… CONTINUED HERE

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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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