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Hilda Townsend – a tribute to a remarkable lady

12 Jul

Hilda Townsend relaxes with (on) Jack

Hilda Gertrude Doran was born into a world on the brink of plunging into the turbulence of the Great War. It is remarkable that one of her earliest childhood memories should have been of seeing Zeppelin airships over Manchester.

On 11th July, 1940 she married Harry Townsend and the couple went on to have two daughters and a son. Whilst in hospital herself, she learned that her husband was also an inpatient (in another institution) and was gravely ill. A couple of days later she was simply informed of his death leaving her a single parent of three young children in a pre-benefits, much less tolerant society.

She would often speak of her early life, always with a cheerful smile as if looking back with fondness on some halcyon time, rather than describing the day-to-day hardships which I suspect few of us would be equipped to cope with in 2012. Reminiscing was a favourite pastime and those of us who knew her will always remember the tale of her sweeping the board in the winemaking competition, a ubiquitous story, sequel to the phrase: “I used to make wine, you know”.

In the near eleven years I knew her I never once heard her speak ill of anyone (or anything), nor complain of aches and pains. She delighted in spending time with her family (despite being so hard of hearing that 95% of all social occasions must have passed her by) and even into her ninth decade she could be found “looking after the old dears” in a local day centre. Well into her nineties, she fell and broke her hip. Visiting her in Leicester Royal Infirmary I wondered if she would recover her health or whether this assault on her frailty would spell the beginning of the end (as it has done for so many of my patients). My fears proved unfounded and she made a remarkable recovery.

Until the final few months of her life she lived mostly alone in her own home (spending time with her daughters at intervals) with a razor-sharp mind born of years of reading, meeting people and extensive travel. Her visits to our house were always enjoyable – “Can I get you a cup of tea or coffee?” would most likely be answered by: “I’ll have a glass of wine, dear”.

She always struck me as something of a Queen Victoria-type figure, the well-spoken matriarch at the head of a huge extended family, but unlike the distant monarch she was simply “Nanna” to children, grandchildren and latterly, great grandchildren. A year or so after we met she said to me one day: “I’d like to be your Nanna too if you’ll have me, Nick?” It was an honour to have been asked and quite simply a privilege to have been able to accept and to know such a remarkable person.

Hilda Townsend, born 19th February, 1913, died in hospital on what would have been her 72nd wedding anniversary, 11th July, 2012.

Too cold to snow?

10 Feb

My elderly patient looks at me earnestly (he’s not called Ernest – that’s just his general demeanor) – “It’s too cold to snow Doctor” he opines with all the sagacity of one who has seen more cold winters than I’ve had, well, hot dinners.  We survey the sky together – the clouds are heavy, black (and pendulous) the effect enhanced by the ubiquitous elderly-person lace curtain hanging limply at the window.  His carer nods in agreement.

I look out at the icy pavement  – I have already almost fallen foul of this  – gingerly stepping out of the car to my feet, I slid gracefully toward the gatepost managing to save myself at the last second.  Thank goodness the carer was there – at least she could have ‘phoned my GP to request a home visit had ended up on the concrete.

Can it really be too cold to snow?  Ever?  I mean, I’m no expert in meteorology but it seems to me that there’s lots of snow in, say, Antarctica and it’s significantly cooler there than it is here in North Yorkshire.  This is one of those problems I’ve pondered since childhood – you know the sort – it’s up there with: “Don’t be ridiculous, you know very well why you have to have your hair cut for Christmas” (I still don’t) or “Of course you have to have bread and butter with your fish fingers” (likewise).

One of the inherent problems of the “it’s too cold to snow” argument is my astute observation that when it does snow, the air temperature seems to be significantly cooler than when it’s hot and we’re smothering children in Piz Buin and standing in queues at ice cream vans.  However, my patient (who’s not called General Demeanor either – that’s just how he appears) is 92 and I’m not going to argue with him – not least because his hearing aid’s currently whistling a passable rendition of “Colonel Bogey” and he’d never be able to make out what I’m saying anyway.  “You’re right, but it does look overcast, doesn’t it?” I venture – loudly.  His carer nods in agreement again.

With any luck, now that we’re safely delivered of January and striding through the icy wastelands of February we can contemplate better weather to come.  Disappointingly, just when you’re out of the snow season and Spring teases you with a few warm days you’re into April showers.  Funny how it’s never too wet to rain.

Nocturnal Visitations

1 Feb

I’ve always been a light sleeper – so light in fact that my bedroom is fitted with sound-absorbing foam and my curtains are lined with silver foil (reflecting so much early morning sun that they can be seen from space). Quite from where this disability (if one can call it such) is inherited is anyone’s guess given that my mother is being considered for the British Olympic Team for the “sleeping through an earthquake” event and is widely tipped for gold.

Imagine my surprise therefore, when I was stirred from sleep in the early hours of a Sunday morning last June to discover a little pool of light scanning its way over my bedroom TV. Since this is not a usual occurrence I was moved to sit abruptly upright in bed and consider whether this was part of an ongoing (and especially lucid) dream or if perhaps, someone had taken it upon himself to force entry to my chamber. The harsh, bright torchlight jumped in my direction and the sight of a slightly obese, bearded and startled individual (wearing the regulation GP-issue tweed pyjamas) was more than enough to send my guest scrabbling back down the partially-completed conservatory roof, on to the scaffolding and haring his way across the garden to freedom before I’d even had time to suggest the customary tea or [instant] coffee one instinctively offers visiting tradesmen.

My bedroom is dual aspect with four windows and so naturally, I responded in the way anyone would under such circumstances by closing the window our intruder had forced and throwing the other three wide open (it seemed logical at the time – no, I don’t know why either – I just did). Reaching for the telephone I dialled ‘999’ and requested the presence of the local constabulary at their very earliest convenience. The operator was patient and calming and clearly realising that I was in a state of some shock set about asking questions and then posing the same enquiry again using different words. This I recognised as the technique I use with patients who are flagrantly ignoring my enquiries of “How long have you had the pain?” by answering with responses such as “My next door neighbour says it might be something in the water you know.” How curious, I pondered, to find myself in the same position.

The Police of course, were quick to respond and, with the aim of stealthily cornering our intruder, made their way at top speed from our neighbouring town. Three vehicles exhibiting blue lights and sounding sirens louder than a mobile DJ plays “Dancing Queen” at a wedding reception pierced the stillness of the balmy Yorkshire night. Frankly, there was more chance of The Taliban being considered for this year’s Nobel Peace Prize than there was of apprehending someone who’d been more than adequately warned of the approaching officers by the attendant son et lumière extravaganza played out across fifty square miles of darkened countryside.

Scenes of Crime Officers attended later the same morning and being a fan of “CSI Miami” I’d fancifully expected: “Well, it’s clear that your intruder was wearing a new pair of Doc Martin’s, purchased at exactly 2.17pm three Saturdays ago from his twin brother’s eldest daughter – he had a slight limp, a Geordie lilt and a penchant for Paco Rabane – it can only be…” so it was disappointing that there was nothing to find and they left my house the better for having had two mugs of coffee (instant) and an Alpen bar (Strawberry and Yogurt).

Naturally, looking back on the event, it was traumatising – good quality sleep eluded me for three weeks (until our steel, locking, retractable window shutters were fitted) and I couldn’t help considering what might have happened had the intruder brought the axe he used to force the window into the bedroom with him.

My greatest cause for regret, however, was my conversation with the 999 operator and the exchange we had that night:

Operator: “So you say that you saw a hand pointing a very bright torch at you from the window?”
Me: “Yes, that’s right”
Operator: “Could you describe the hand?”
Me: “Yes – it had four fingers, a thumb and was holding a very bright torch.”

Bowels

28 Jan

So Dr Terry Bowley (pictured here with the big sign and the sloppy tie / top button on shirt combo) would like to know if we’ve all experienced changes in our bowel habit in the last three weeks.

This is our Government’s attempt to pick up early bowel cancers because the earlier they’re found and treated, the better the long-term outlook. This makes perfect sense of course – but three weeks? The National Cancer Referral Guidelines suggest six weeks – which seems to make more sense: after all, you need only a bout of diarrhoea (after a night on the town followed by one of those delicious kebab things which has been revolving at almost exactly 37 °C for the last two days) to have three weeks of soft and runny stools.

Never one to shy away from health-related issues, I will join in with the fun faecal facts and consider letting Dr Bowley know about my 20 years’ worth of altered bowels given my propensity to the joy which is anxiety-provoked irritable bowel syndrome. Indeed, if Mr Lansley gets his way and the [heavily slashed] NHS budget is given to GPs to spend I reckon we’ll all need Terry’s number on speed dial.

The Cinema

28 Jan

I ought to perhaps begin by declaring that I’ve not actually been to the cinema for some years – in fact it’s so long since that I can’t actually remember what we saw. You might wonder therefore, what on earth qualifies me to be blogging about the flicks now – and it would be a fair question. Well, here’s the thing: driving home from work last week I listened to an item on Radio Four’s Front Row about the emergence of new snacks on sale in cinema foyers. Along with the ubiquitous popcorn, Haribo, crisps and soft drinks (all dispensed at just under the price of gold) it seems that film buffs are to be provided with the additional choice of fresh food such as sushi and noodles.

It’s true of course that new foods might not catch on – indeed until the banks start lending more readily and attendees can more easily take out a second mortgage I suspect they will be out of most people’s financial reach anyway. Selling snack foods in cinemas originally came about in the United States in an economic downturn – in order to entice punters to continue attending, the price of admission was drastically cut, which in turn ate into theatre-owners’ profits (pun intended). To counter this, they began offering food for sale and popcorn in particular was, well, cheaper than chips to buy in and made for a huge profit margin when selling on. Only time will tell whether the viewing public will favour potato gnocchi, baby artichokes and black olives over a tub of salted popcorn and a diet coke.

My own relationship with the cinema began aged just three when my parents took me to see Star Wars in 1977 – I recall little of the film that first time round, but lots about the magic of the dimming lights in the ceiling (ours at home were either on or off), the curtains which opened (and closed) seemingly by themselves and my first taste of Opal Fruits (now long since gone). It was a magical room where lighting and drapes – familiar to me in the domestic setting behaved in new and exciting ways (oh, and there was a screen with stuff going on with space ships too).

In my teens I discovered the pleasure of attending with friends. Most weeks we could be found in the neo-gothic “Unit Four” cinema in Blackburn. The building itself, with its castellated spires and sweeping arches was out of place in the modern shopping precinct – indeed the fabric of the place was often more interesting than the programme itself. Over the course of my two years in the sixth form we watched many and varied films, enjoying all but one (Last of the Mohicans) which we left around half way through.

For me, the cinema is no longer the place of anticipation and excitement that it once was. Now I prefer the comfort and privacy of home to the hard-backed chairs and cramped leg room of the stalls. It’s true, it lacks the “pa pa pa pa pa pa pa pa papapa” of the Pearl and Dean ad’ but you can’t have everything. Perhaps this explains my wilderness years of non-attendance of late – but, on a rare visit to Blackburn in the summer of last year, I couldn’t help but feel a pang of sadness when I noticed that Unit Four was closed and abandoned. Who knows, if it had just had a little booth selling steamed langoustine with ravioli and a spicy consommé things could have been so different.

Communication (skills)

28 Jan

“Write it down Nick,” commands my friend (who has written more column inches for various publications than I’ve scribbled prescriptions for amoxicillin) “I want 750 words by the end of the month on the subject of COMMUNICATION.”

So here it is: my first blog. Naturally, when considering the subject of communication one thinks of computers and e-mail, Skype, telephones and fax machines, pen and ink, telegrams, sign language, the written word, semaphore, Morse code, plain old speech and gesticulation (to name but a few). All of these are undoubtedly worthy subjects in their own right, but I prefer to consider communication skills tuition back in medical school in the mists of 1995.

We found ourselves around ten to a group charged with the task of interacting with an actor who had been brought in for us to interview and to whom we would each have the task of breaking bad news (I had to tell her that as a result of being typecast in one too many episodes of The Bill she was no longer to be considered for ‘third paramedic from the left’ in next week’s Casualty). For most students, the concept of role-play was, in embarrassment terms, second only to watching John Barrowman delivering a Scottish accent in a ginger wig on the never-popular Tonight’s the Night (if you haven’t – don’t) – but it struck me that simply believing the situation was real was the best way to deal with it and so took to it without much difficulty.

Watching my colleagues cope with this ordeal was particularly fascinating. As a generalisation, the more academically gifted among our number struggled the most, delivering the bad news with all the sensitivity of one of the Four Horsemen of the Apocalypse on a stressful day: “Erm, I’m afraid it’s cancer and you’ve probably got about six months. Any questions?” This would be met with (real) tears from our thesp’ before the tutor called a halt to proceedings and addressed the remainder of the assembled to query: “What do we think was particularly good about D ’s approach?” I think the answer could be summarised in two succinct words, the latter of which being “all”.

The actor interested me greatly too. I loved the fact that she would respond with complete realism throughout each student’s fumbling attempts to impart the worst. This would be followed by closure of the eyes, a rolling of the shoulders before she would smile demurely, look around the room and exhale happily – this was coming out of rôle (and yes, the ‘ô’ is important). Then would come her comments about how “she” was feeling (“she” being the character, not the actress herself of course).

For my own part, I didn’t fare too badly and generally followed the rules about “firing a warning shot” before launching in with the main event – “Well, I’m sure the fact that I’m sitting here with a list of local florists and samples of various woods has probably alerted you to the fact that I’ve not come to announce that you’ve won a fortnight for two in the Maldives?” To be honest, it seems to me that communication skills is something which you can’t teach – you can either do it or you can’t.

I always thought that I was quite good at it until some years later, when just coming to the end of GP training those who knew best put together an afternoon’s session with, you guessed it, actors and role play. The brief was to explain to the actor why he wasn’t getting antibiotics for his cold. All seemed to be going swimmingly until his hands appeared from below the desk: a cigarette lighter in one and a can of fuel in the other. He played it perfectly, his face giving nothing away and for a fleeting second I thought he was going to do it. He didn’t and left with a prescription for 30 amoxicillin, 20 clarithromycin – and smoking cessation advice.

Perhaps the finest example of poor communication I ever saw was a consultant on a ward round at our local district general hospital who was asked “How long do you think I’ve got?” Dr K smiled, dropped his head to one side and simply replied: “Well, if I were you, I wouldn’t be booking any holidays after July.”

Come to think of it, blogging is also a means of communication and I’ve had my 750 words so for blog number one, my July has come.