31 July, 2014

Quill Sharpening and Other Useful Skills!

The other day I read an article relating (once again!) to Michael Gove who was, until last week, Secretary of State for Education in England. As anyone who has read my blogs before  will know this gentleman is not my favourite politician – I am not alone in that. His tenure in the post for the past 4 plus years has seen a continual war being fought between him, teachers, academics and many parents. He has been, to say the least a controversial figure. However, he has now been moved on to other spheres of influence so there will be fewer of my blogs devoted to him. You will, no doubt, cheer that fact! 
Just like the desks we sat in  when I was eleven - and the
inkwells are visible. Mr Gove would be proud!

The article that I read was a collection of memories and anecdotes by various people who had dealings with Gove over the past few years. With very few exceptions they were universally critical of the man. One item, however, caught my eye. It was written by a primary school music teacher who, over the past few years had on numerous occasions visited the Department of Education in London to attend meetings/courses etc. This is an extract from what she wrote:

I used to go to the Department for Education when it was the Department for Children, Schools and Families. Then, it was smothered in imagery of children and playgrounds. Wherever you were in the building you always knew where you were – it wasn't health or environment, it was education. After the election, Gove took this all down and put this 19th-century pupil writing desk in the foyer. It was such a clear sign of what was going to happen to schools.

As anyone who has lived through the past 4 years while the Department for Education has been under Gove’s stewardship will know the antique pupil writing desk was indeed a physical manifestation of what the man stands for - of Gove’s desire to turn the classroom clock back, for schools to be more “traditional”, to be more “academic”, to be more rigorous in their testing, to return to well tried and perhaps “old fashioned” teaching methods and discipline and to be more traditional in their values and curriculum. Well, all that is as maybe. As a teacher of forty years and at a personal level I often reflect that a bit of tradition is no bad thing. Having said that the displaying of a 19th century pupil’s desk and all that it implies about the Gove’s and government’s view of the nature of 21st century education is worrying. I also find it concerning that one man should be able to impose his own beliefs and prejudices on the nation’s education system - no matter how laudable, inspired or, in Gove’s case,  madcap they might be.
All my yesterdays - items that once ruled my world but soon became
obsolete and the knowledge redundant
But leaving all that aside let me move on. Later on the same day that I read the article I was  tidying a drawer in my office and came across one or two things from my past – things that were once very important to me and my life. Firstly, my old slide rule. Before entering teaching I worked as a design draughtsman in an engineering drawing office. In those far off days – the early 60s - a slide rule was a basic tool of every draughtsman or engineer. In those pre-computer/calculator  days it was vital in every calculation that you worked out – logarithms, sines, cosines, everyday calculations.  It was part of my daily professional world. Learning the skills to use the thing was one of the first things that I was taught when I started my career in that drawing office – John Newton, the chief draughtsman, took me into his office to guide me. When I attended college as part of my training time was devoted to ensuring that young trainees like me were fully conversant with this tool and its associated skills. And now it lies redundant and obsolete in my office drawer. As I held it in my hand the other morning I tried to remember what the numbers on each scale represented  and how I should use it to perform a simple calculation. True, its use was fairly specific, but it was of its time and has now been passed over in favour of electronic aids which, of course, require different skills. As I rummaged further through my office drawers I came across other items from my past. A set of French Curves which was also part of my everyday work in the drawing office – helping me to draw exact curves to meet certain criteria. These were not simply to make the design drawing look pretty but to ensure that the men on the workshop floor could make the required item exactly and accurately  so that it worked and fitted into its correct position to within thousands of an inch. Today, I would guess that sort of thing is all computer generated – the skills and the equipment that I practised, needed and used half a century ago have  disappeared and been replaced by others - and all my knowledge and skills in that area are now merely redundant and consigned to the waste basket of history. And finally, in my drawer, a bottle of ink. Not, perhaps, totally redundant today but still something that has been largely replaced for many people as ballpoint pens, felt tips, word processors, computers, e-mails and the like have made writing with an ink pen a marginalised activity. Just as the quill pen (and with it the skill of quill sharpening) was consigned to the waste bin when the “modern” fountain pen came along so, too, fountain pens in their turn – and all their associated writing skill requirements – are largely things of the past. As I looked at the bottle, which has probably not been opened for almost half a century, I thought how many hours I had spent in my early teaching career working with children to ensure that they could grip and successfully use an ink pen. I reflected, too, that although I have a fountain pen which I still use when appropriate, my modern pen is charged with pre-filled cartridge, and doesn’t require a bottle of ink. Times have changed. I recalled that when I was a eleven year old child at school, sitting in a desk not unlike that on display at Michael Gove’s Department for Education each desk had a little pot inkwell sitting in a whole in the desk. We boys would dip our stick pens into the inkwell as we blobbed and scrawled in our exercise books. Every Friday afternoon, my teacher, the much feared Mr Roberts, would choose one boy to be the inkwell monitor for the afternoon. We all desperately wanted to win Mr Roberts’ approval so worked diligently on Friday hoping that we would be the chosen one. If I was lucky one then late on Friday afternoon while other boys were still working I would proudly and silently creep around the classroom with the ink container carefully replenishing the ink in each of the little white pot inkwells so that all was ready for Monday morning. And, of course, inkwell refilling itself was, in its time an important skill - using the inkwell filler correctly so that no ink splashed onto the desks was crucial if one didn’t want to incur Mr Roberts’ wrath!. But no more, times have changed.

All these items and skills are now largely replaced by others. It’s the way of the world. That’s the problem with knowledge and much of what we learn – it has a massive obsolescence factor.  And it has always been thus. We cannot blame it on the modern world. A thousand years ago William the Conqueror’s knights practised their battle skills by riding at speed ducking and diving through dense forests to imitate battle conditions – but with the invention of the gun much of that became immediately redundant. Three hundred years ago, the skills of the home weavers producing cloth were major parts of life and everyday economics of every village and hamlet but the invention of the steam engine and the modern loom altered the industrial and employment landscape.  Great factories grew and the old home weavers’ skills and knowledge were no longer needed – different mind and skill sets were required. And today, it seems, knowledge is expanding and accelerating at a phenomenal rate – what is useful today will almost certainly have only a very short life span.  
Just like the inkwell filler we had in Mr Roberts' class -
the skill was to fill the little pots without makinjg a blob

My mother in law, who died in 2006 just a few years short of her century often remarked  how her generation had seen so much change. She was right and future generation will see even more – and schools have to be responsive to this. Mr Gove’s antique desk implicitly suggesting that “the good old days of education” were the best and something to return to could not be more wrong. Both in content and in approach education has to look forward and schools have to anticipate and continually change, evolve and respond to an ever changing world. I have absolutely no doubt that what is being taught to my grandchildren today in their respective schools (good though they are) will be less relevant and may, like my slide rule or French curves be redundant knowledge and skills by the time my grandchildren leave school to enter the world of work. Such is the nature of change, the world and education. Michael Gove’s desire to look back might be appealing but it is also very, very wrong and does children and society no favours at all.

18 July, 2014

"Dominus Fecit" - the Lord has made.

Fifty years on - standing on what remains of the steps to the
 main building. Flowers give a cosmetic tinge to what is now
 a graceless and tasteless educational factory farm.
Last week we had friends from Australia staying with us for a few days. Pat and I had been at teacher training college with Jacky in the mid sixties and soon after qualifying she emigrated to Australia. In the 40 plus  intervening years we have communicated regularly, visited each other in our respective countries and often relived our misspent youth in the heady days of the Beatle, Rolling Stone and Bob Dylan filled 60s! Jacky married Garry, an Australian, and they live in the wonderful city of Adelaide. While they were here, Jacky thought she might like to revisit the college we had attended all those years ago. It was a salutary reminder to all of us when we suddenly realised that it will be 50 years ago next year (2015) that we first met at what was then Nottingham teacher training college or Nottingham College of Education as it was called in those far off days. The college – now part of Nottingham Trent University – is only a couple of miles from where we live and over the past 49 years both Pat and I have visited many times to attend meetings and other local functions so we knew what to expect. We knew that it had changed mightily since our day.

Perhaps it was because on this occasion it was a nostalgic trip - a revisiting of a long past but well remembered part of our lives – this visit to the college with Jacky and Garry was, however,  different. As we drove up the entrance drive we were stopped 21st century style by security and given a day permit. We followed the myriad of roads and signs to find our way to the visitor parking – Jacky occasionally exclaiming “I’m lost.......it’s all changed”. Indeed it had – and, of course, that is what you would expect after almost half a century. In our day it was a much smaller institution catering only for the training of teachers. Today, it caters for a multitude of disciplines and faculties – the education  section is only one part – and indeed, is concentrated in only one building. The rest of the large campus is a complex web of modern buildings, sweeping roofs, vivid colours, shopping areas, traffic humps, commercially sponsored buildings, and continual  redevelopment as the University grows further. In a constant state of change it seems to have no tradition, no solid foundation. It is a learning place not a place of learning. As we left the car we came across the occasional remembered building – the “boiler house” where the old college’s central heating was run from, one or two of the old tutors’ houses now converted for other use. We approached the main building – the centre of the old college – to find it half demolished as further developments took place. In fact it was hardly at all the place we had enjoyed all those years ago. As we walked along one of the paths we followed a student – wearing shorts, vest and his arms covered in tattoos and as we walked I reflected that the college and indeed higher education in this country has changed (in my view) in more ways than simply new buildings – and maybe something has been lost.
As it was in our day - the "Great Divide" goes off to the
right in the distance

In the UK higher education is a bit of a political and educational battle ground – students now have to pay very significant amounts of money for their courses which usually means they leave university saddled with huge debts. Understandably, therefore, they question Are we getting value for money, do we have enough lectures, are the lectures providing what we want, is the accommodation suitable for our needs, which is the best course to guarantee us a job at the end of it? In other words it has become a consumer driven market. On top of that the name of the game as far of the higher education institutions are concerned is “bums on seat” – making themselves as attractive as possible to win the affections of both clientele and government funding. Higher education is now exactly the same as the supermarket where customers demand what they want and the universities, like supermarkets, strive to outdo each other to gain the custom and the money of these young people. As I looked around the college I could not escape the feeling that this was an educational conveyor belt – the educational equivalent of factory farming where young people came and were fed their globules of knowledge and came out at the end with a bit of paper but not an education. The place had no soul, no heart beat. No longer did all the students come and for a year or two at least were part of the college community by living in halls of residence  before they spread their wings and went into “digs”.

Now instead of halls of residence  students, if they live on site, they live in en-suite rooms with their flat screen TV/computer/mobile. In the centre of Nottingham, near to the main building of Trent University there is a commercially owned tower block providing student accommodation. Each time I pass I sadly read the garish advertising on the outside of the building:  “Each flat  fully furnished, with leather recliner chairs and flat screen TV and  with en-suite facilities  and shared kitchen area. The accommodation has a gym and supermarket on-site and is next door to The Corner House – a complex offering a brilliant selection of restaurants, bars and entertainment venues. Across the road is the Victoria Centre, home to upmarket department stores and high-street shops”.  Sounds wonderful – clearly what students 21st century style want; but no mention of desks or library facilities or things to nurture the soul.  Just good access to designer shops, restaurants and bars! Why would you go into your college of university with all this available outside your front door. And if you don’t go into your university, except to attend the occasional lecture then in my world you would be missing a huge portion of what university is about – the social and intellectual life, the social and academic societies, involvement with like minded people, the opportunity for the institution and its members – both staff and fellow students  - to change you, in short to “educate” you. But instead, it seems today’s student all too often lives in their little en-suite world surrounded by all that they like and know – lap top, wi-fi, gym, designer shops, bars – and the university is just the learning place, not the place of learning.
As the campus is now - brazen and garish

I thought how in our day if one wanted to leave the college at weekend to visit parents, go on a trip somewhere we had to first obtain an exeat from our tutor giving us that permission.  I somehow think  that would be frowned upon by today’s youth – and definitely score against any university’s attractiveness if they tried to introduce it. As we stood outside what had, in our day, been the main college building I noticed that the steps leading up to it were now decorated with flowers – a cosmetic nicety to be sure. But maybe like so much in the modern world that was just what they were – cosmetic  froth hiding the basic tastelessness and gracelessness of the modern world. We stood in the foyer to the main building and peered through the glass doors into what in our day had been the college dining room -the place we ate breakfast, lunch and dinner. How it has changed. To be sure it is still a cafeteria  but now filled with garishly coloured plastic tables and along one wall banks of computers -  a far cry from the softly curtained and subdued  place that  we knew and  where one didn’t just go to eat – but to learn to be a person. Let me explain.

The college was opened in 1960. We went in 1965 and in those few short years it had  already established itself as one of the premier teacher training institutions of the country and a place highly thought of both academically and as a professional training centre for teachers. Without any doubt this was due to the efforts and skill of its first principal – Kenneth Baird, or “Yogi ” as we affectionately called him (after Yogi Bear who was a popular TV cartoon character at the time!). In the first  few years of the college’s life Mr Baird had established traditions, values and expectations that permeated the whole of college life and which made you very aware that your were at Nottingham College of Education and not just any college. When you arrived there you quickly got into the Baird way of doing things. Much of this we mocked – as teenagers that is what one does – but in our heart of hearts we all knew it was good. Mr Baird’s college didn’t just turn out academically good teachers it turned out mature professionals who within three years at college had turned from callow teenagers into young men and women who knew how to conduct themselves in any situation – personal, professional and social.

The students' common room 1960s style
I well remember the very first night at college. There was a “Formal Dinner” – yes, that was what they were called and attendance was compulsory. I sat there at a table with 7 or 8 other students and a tutor – I hadn’t a clue which knife and fork to use, or what I should say about the glass of wine that the tutor had provided. I watched others and learned. I learned over the next three years to feel at ease in this kind of social setting and to know the expectations and the mores. It was all so very new to me on that first night, and I know that was true about many of my peers – but we were on a learning curve which would give us skills and understandings that would serve us well for many years. Throughout our time at college every day of the week the dining room served not only as an eating place but as a social gathering place. It was not just a grab a tray and get your food place – the equivalent of McDonald’s which is what I thought of as I gazed through the glass doors of the place last week. No, it was a dining room where one “dined” chatted over a meal, said grace, largely spoke in whispers – and dressed for dinner. Each day one could have “cafeteria service” if one wanted an early meal because of some evening commitment. Or, you could opt for dinner service at 7 pm where one was expected to dress properly, sit in a pre-arranged group and maybe take a bottle of wine. At 7 pm Mr Baird and members of staff would file into the Dining Room, all we students would stand and when everyone was at their place Yogi would quietly say a short grace followed by “Dominus fecit” ("the Lord has made", the motto of the Baird family) or “Tempus fugit”. At the end of the dinner, as plates and dishes were being cleared Yogi would again stand and quietly say “Gentlemen, if you must you may” – the students were being given permission to smoke if they wished. Once a week – every Tuesday – there was a Formal Dinner. You didn’t have to go to Formal Dinner every week but had to attend a certain number – sometimes these would be times when you would meet with other members of your various teaching groups or celebrate some special occasion. At Formal Dinner evening dress was required and expected.

All very old fashioned, twee maybe, and some might say quite out of sync with the heady and revolutionary days of the swinging sixties but no, it was appreciated and respected by all. We all knew that we were being prepared to become teachers, maybe head teachers or even more. We were gaining experiences and know how that most of hadn’t had at home – it was widening our horizons. And that is after all the basic thing that any educational system must do. If it doesn’t do that it is not “education” it is simply training – sadly what schools and colleges have largely become in the modern UK – training institutions not educational establishments. The schools of Michael Gove and of the National Curriculum and of OFSTED are places to get a certificate of your competence in some form or other – be it a level 4 SAT at 11,  a clutch of GCSEs at 16 or a 2:1 degree at the end of your university – and you can do all these things and still be the same person, because all you have done is an academic course and learned to get the right answers. Education is more than that. I well remember when, a few years after leaving college as a young teacher I attended a number of residential courses in venues across  the country. These were organised by HMI (Her Majesty’s Inspector) – the highly regarded School Inspectorate. Places on these courses were like gold dust and those running the courses were often national or international figures. I still remember standing having pre-dinner sherry with the other members of the course and various senior HMI. I felt comfortable being able to converse with these people and to be in their company and, as I stood there, I remember  saying a silent “thank you” to Yogi Baird and what he established for preparing me for this.
Ready for formal dinner

Times have changed. In thinking about this blog I dug out a letter that I found in my mother’s items when she died. It wasn’t new to me I had seen it many years ago. It was a letter sent by Mr Baird to the parents of all new students who would be coming to Nottingham College. Today it looks very dated and I suspect any 18 year old today would be horrified to read it. It speaks of a bygone age and long forgotten beliefs and expectations. In my view it also speaks of a greater vision and understanding for what should be expected of and presented to young people. I was a little older than the average trainee teacher when I went to Nottingham College of Education – having trained as a draughtsman for a number of years I was already 20 when I went to college. But despite that my parents still got this letter and I know they appreciated it greatly. It is too long to quote in full – three pages of “foolscap” – remember that, how strange the dimensions of foolscap look today! All tightly typed – no rushed photocopying, no cosmetic logo or advertising and above all no impersonal computer template. It was a personal letter to my parents.  Mr Bird speaks of welcoming me and committing himself to “ensuring three years of hard work, interest, excitement and happiness” – well he certainly did that. He advises my parents about the financial arrangements and support I will require and about they should try to ensure that I am wise in my use of funds. He talks of the reading lists that I will be sent and how they should try to ensure that I fulfil the various tasks on them prior to arriving at College. He talks about the many games and entertainment opportunities that will be available and how he hopes I will play a full part in the sporting and cultural life of the college and he then goes on to mention sex! “Where a large number of attractive young people are together inevitably they will form friendships with members of the opposite sex. I do not regard this as a bad thing.......I will treat them as adults.....they are starting their independent lives  and I have no doubt that you will speak to them about the need for self control.....In three years’ time they will themselves be in charge of classes of young people. They must have achieved their own moral standards before they can teach them to others in their care ”  Mr Baird then goes on to discuss the various medical facilities at the college and how in an emergency situation he would act in loco parentis  should any crucial decision need to be made about my welfare and my parents might not be immediately available. Finally he talks about a number of other things - how any motor vehicles must be registered at the college and how my parents must provide a written consent to my riding pillion on a motor bike or where and when trunks might be stored and what parents should do if they have any concerns.

 The letter looks terribly dated today – but it strikes just the right note. I know that my mother was pleased to receive it and I’m sure today any parent would still be pleased to receive the information and advice that Yogi set to paper. And it wasn’t all talk. He was as good as his word. We all knew what the rules were and although as young people there was much “testing of the water” we were allowed to develop and grow and change within the context of what had been imposed and was expected.

As we stood at the front of the main college building we looked down what was, in our day, the main drive of the college – the “Great Divide” as it was called. In those far off days the halls of residence fell on either side of the drive – women’s blocks on one side men on the other. Members of the opposite sex had to be on their own side by 10 pm each night under peril of expulsion. If a party was to be arranged we could apply for an extension on that rule but, whatever, the main drive, the Great Divide, was patrolled from about 9.45 each night by one of the college’s wardens. Any parties were checked to make sure that the required permission had been granted (usually an extension on the time limit till 11 pm). Yogi’s word in action.  We were being treated like adults, given certain freedoms but expected to obey the rules – all of which seems a pretty basic rule of all societies to me. Sadly, I too often ponder that today we may have forgotten that.
Our three years at college gave us so much – and I suspect the least important part was the academic stuff. Yes we worked hard and I think it was true that such was the college’s reputation in those early days that all those who gained a place did so on merit. Yogi Baird’s institution turned out a stream of high quality young teachers who were grabbed by schools and I know quickly rose to senior positions in both schools and wider education. But, it also turned out young people who were ready as Mr Baird said in his letter “themselves ready to take charge of young people”  We were expected to and had been given the opportunity to develop the personal, social, cultural and moral skills to enable us to take our place in our chosen profession, we had not been trained to be a teacher but educated  in the widest possible sense for life. Nottingham College of Education under Kenneth Baird’s leadership wasn’t the hallowed corridors of Oxford or Cambridge but like these two institutions it gave me and many others a framework for life. His family motto, Dominus fecit - what the Lord has made - was almost a metaphor for him and what he created and which benefited so many.  And for that I will be eternally grateful – it broadened my horizons and allowed me to enter a different world. I didn’t just get a teachers’ certificate when I left, I got a passport for life.

I’m not sure that the quick fix training of today’s schools and campuses and the obsession with certificates and value for money education  as the marker of an “educated person” can or will provide the same opportunities and results. The en-suite flats, the access to designer shops and bars, the flat screens the leather recliners or the McDonalds like educational factory farm campuses merely, it seems to me, give the young students of today what they like and know – wine bars, the flat screens, Wi-Fi, gymnasiums, designer shops and the rest. They will attend the university, go to all the lectures, pass the exams and leave with their certificate - but little else. Like a visit to an educational  supermarket they will emerge with their value for money training and  with their degree tucked into their bags but  I fear they will  not have been changed.

13 July, 2014


Last week I read a report of some research done in the USA by psychologists at the Universities of Harvard and Virginia. Briefly, the research indicated that people find it very difficult to do nothing, that people seem consistently to hate being left alone with their thoughts - and this, it seems, is regardless of their age, education, income or the amount they used smartphones or social media. The researcher who led the work, said the findings were not necessarily a reflection of the pace of modern life or the spread of mobile devices and social media but might be based upon our constant urge to do something rather than nothing.

The first run of experiments began with students being put – alone, without phones, books or anything to write with – into an empty room and told to think. The only rules were they had to stay seated and not fall asleep. They were informed – specifically – that they would have six to fifteen minutes alone. The students were questioned when the time was up. On average, they did not enjoy the experience. They struggled to concentrate. Their minds wandered even with nothing to distract them. Even giving them time to think about what to think about did not help. And, in case the unfamiliar setting hampered the ability to think, the researchers then ran the experiment again with people at home. The results were the same except that people now found the experience even more miserable, and cheated by getting up from their chair or checking their phones! To see if the effect was found only in students, the scientists recruited hundreds of other people, aged 18-77. They, too, disliked being left to their thoughts.

But the most telling result was that to check whether people might actually prefer something bad to nothing at all, the students were given the option of administering a mild electric shock. They had been asked earlier to rate how unpleasant the shocks were, alongside other options, such as looking at pictures of cockroaches or hearing the sound of a knife rubbing against a bottle. All the students picked for the test said they would pay to avoid mild electric shocks after receiving a demonstration. But to the researchers' surprise, 12 of 18 men gave themselves up to four electric shocks, as did six of 24 women – each later confessed that they administered the shocks to ease the “boredom” or unpleasantness of being left completely to their own devices. "What is striking” confirmed the lead researcher, “is that simply being alone with their thoughts was apparently so aversive and unpleasant to people that it drove many participants to self harm and administer an electric shock which they had earlier said they would pay to avoid."

It is not unusual when I read reports such as this, of pieces of academic research being undertaken (usually at huge expense) for me to ruefully comment “Well, I could have told them that” but on this occasion, it really did not surprise me. I have long noted the reluctance (I think that this is an increasing phenomena) of people to be happy with their own company and thoughts. Almost five hundred years ago the French mathematician and philosopher Blaise Pascal commented upon the same human characteristic when he famously said: “All mankind’s miseries derive from him being able to sit in a quiet room alone and with only his thoughts”. He followed this up with other similar observations such as “So wretched is man that he would weary even without any cause for weariness... and so frivolous is he that, though full of a thousand reasons for weariness, the least thing, such as playing billiards or hitting a ball, is sufficient enough to amuse him”. In other words, man needs constant distractions or amusement and is unhappy with his own company and thoughts.
Blaise Pascal

I do not think that anyone could deny that Pascal’s words across the centuries or that the findings of the two US universities do not contain some elements of truth. Our inability to simply be content with our own thoughts and company manifests itself in a myriad of ways – both personal and in globally. In the modern world, people cannot simply walk down the street without constantly referring to their mobile phones – not always to make a call. So limited is their ability to be at ease with themselves and so limited their concentration span when alone that, I might argue, that viewing a social media site, the playing a game or the sending of a text for them breaks the boredom of a simple, silent walk. Joining a gym, going for a walk watching TV, writing a blog, going to the pub, reading a book and a million other things are other ways we “manage” our respective inability to be at ease with ourselves and our condition - so we need to “pass the time”. Many of these “pastimes” may be perfectly laudable and indeed ways of “self improvement” but I wonder how many are simply distractions from ourselves and our thoughts. Indeed, one of the commentators on the article made a point, that had, I believe, some merit: “I think this proves something we all greatly fear; when left alone we fall into a tumbling darkness. We are, in the majority, a desperately unhappy, Godless race. Not that I believe in God. Countless hours of our days are spent projecting an appearance, a persona, to the extent that we no longer have a central sense of self. Our Id is lost. Thus, when left with no one to project to, the realisation of the death of self is to some, unfathomable, unbearable even.”

The above observation can be seen often even with young children. Watch a young child in a room with a peer who is occupied with some activity or other and it often will not be long before he/she will “interfere” with what the other is involved in – not because he/she wants to play but simply to be involved, active – unable just to sit back, watch others and be themselves in silence. As the commentator above suggests the child is “projecting an appearance, a persona” and when we are left completely alone and with no one or nothing to project to it becomes quite “unfathomable” and “unbearable” for us. And, even at a national level, countries cannot bear to confront their own “self” – every vacuum has to be filled with action. Things must be done – we must keep busy, we must do something! Watch great nations (the UK and the USA?) – and see how they cannot bear the thought of non-interference in the affairs of others – Iraq, Afghanistan and the rest. The national persona has to be projected. It is not in the human psyche – certainly of the “developed” western world - to simply be content with our lot, to live in our own world. We have to keep “doing”, we have to constantly be “involved” and active. We have to project our persona.

I am reminded of the hymn that we used to sing at school half a life time away – some of the words implored the children to learn:

“.....When to speak and when be silent,
When to do and when forbear....”

Sadly, both individually and as great nations we find it difficult to distinguish between “.....When to speak and when be silent, When to do and when forbear....”!

One could, of course, argue that this is one of the essential characteristics that separates us from the animal kingdom – that we “do” and in “doing” improve ourselves to make us something that were not before. Clearly there is some truth in that – animals are not constantly ”doing”, entertaining themselves, keeping fit, communicating with others as we are. When he is hungry the lion may join with others to hunt down a gazelle but when his hunger is sated he will simply “chill out”, lie in the shade until the next hunger pang encourages him to spring into action, to do some “work”. He is not bored with himself or of “nothingness” but content to lie in the shade with his thoughts, whatever they might be.

And it is not just the animal kingdom that has no problem with solitude or lack of constantly doing. Most of the world’s what might term “primitive” societies are similar. They do what they need to do – get food or build a shelter – and with that they are largely content. Having eaten sufficient and ensured some kind of shelter then like the lion they “chill out”. But not so the more “advanced” societies – we continue to beaver away keeping occupied, being entertained, making items of desire rather than items of need. It is only these “developed” societies – often of the northern hemisphere or those adhering to the notion of the Christian work ethic - that see some virtue or need to constantly “do” or be involved or to create. And invariably, what they “do”, or are involved in or create are not life’s essentials – they are not concerned with keeping oneself alive or warm or fed but are rather concerned with making life pleasanter. That may be no bad thing but when one considers that all this hard work and effort is being expended largely to keep us entertained and to ensure that we pass our time on the planet pleasantly it might be questioned. Making a TV set in order that someone can watch that TV set, making a mobile phone to enable us to send messages of a largely inconsequential nature or to pass the time with as we sit in the doctor’s waiting room, growing more and more crops to fill our supermarkets with wider and more exotic choice – then it puts it all into a kind of perspective. It is not unusual, to read of some elderly person who has perhaps passed away and at their funeral or in their obituary they are applauded because they “never missed a day’s work in their life” or perhaps “carried on working right up to their death” when they absolutely no need to do so. All very inspiring and laudable – but is it necessary? Or, is it rather, that they could not face the thought of their own company and thoughts without the distraction of “work”.

In saying this I am reminded of the comment on a different theme in Evelyn Waugh’s “Brideshead Revisited.” As Lord Marchmain lay close to death Charles Ryder comments to the doctor that “Lord Marchmain has a wonderful will to live” . In response the doctor dryly observes, “Would you put it like that? I should rather say he has a great fear of death.” Similarly, we keep constantly busy in some way to create things and situations that prevent us being bored and which merely help us to “pass the time” because in reality we are so frightened of our own company. While writing this blog I have just read of a man who each day when he wakes he has, since his school days (he is now well into middle age), followed exactly the same ritual. On waking each morning he picks the first random subject that enters his mind as he opens his eyes. He then lies in silence and thinks about it for fifteen minutes. At the end of that period he then sits on the edge of the bed and talks for seven minutes on the subject – airing his views, clarifying his thoughts, explaining his opinions. And all this to an empty room! One might have mixed views about this and about him – but clearly he is at home with himself and his thoughts – he is a rare human.

For the rest of us, so dissatisfied with our own lives and minds are we that as the research suggested and as Pascal knew we cannot bear the thought of our own existence for as little as fifteen minutes. Instead we need to be distracted from the horror of ourselves, our condition and our thoughts by giving ourselves an electric shock. “Nothing is so intolerable to man as being fully at rest, without a passion, without business, without entertainment, without care” commented Pascal in the seventeenth century. He was right.

02 July, 2014

Accident & Emergency - self fulfilling problems?

As Pat and I left our house on Sunday morning we saw an elderly local lady who had missed her footing and fallen heavily onto the pavement whilst walking to church. She was sitting there looking dazed while another lady was trying to help her to her feet. The fall had obviously shaken her up – a badly cut lip, various other grazes and a particularly nasty sliced cut to her hand were the wounds we could see, but I suspect she would have also been rather shaky for a few days as a result of her fall. We helped her to her feet, gathered up her belongings – including her walking stick - and discussed what to do next. Fortunately, another neighbour came along who knew the lady and said he would make sure that she got home safely. “I’ll have to put a plaster on that cut on my hand” the lady said. Clearly something had to be done with it and although it wasn’t bleeding too much it was in desperate need of cleaning and I suspect needed a couple of stitches. “You might need to see a doctor” we agreed but her reply was “Well it’s Sunday, and the doctors aren’t open today”. It never occurred to her that it might be necessary to go to the local A&E department at the hospital – for older people that is often the case, they don’t want to bother emergency services with what they see as a trivial complaint.

Within that short conversation was highlighted one of the problematic  issues confronting our medical services in this country – the ability of the health service to meet demand and listening to the old lady made me think.

Sister Jen Du Prat whose humour and down to earth
way of managing patients have made her a
real celebrity. She comes over as the sort of person
you would want on your side when in difficulties!
A week never goes by without there being some media coverage in the UK about the health services available. It will be a brave government who considers abolishing the National Health Service – I have absolutely no doubts that it would bring any government down. It is widely praised and rightly revered. Equally, however, it can never meet demand and expectation – understandably when we or our loved ones are sick we want the very best treatment available – and instantly. In fact, the NHS is an almost no win situation; on the one hand revered and to virtually the whole population an almost sacred institution whilst at the same time vilified by those same people  when something goes wrong. When a hospital, nurse or doctor fails to respond in what the tabloids see as the way it should then the dogs of war are set loose. When a particular form of treatment is deemed too expensive or of dubious worth the “faceless bureaucrats” of hospital management are blamed. When necessary economies are suggested then “bureaucratic fat cats” are blamed for their salaries taking all the funds that should be put into patient care!

No system, I believe, can ever meet modern expectations, there will always be something else wanted. In our modern world, an ageing population, the costs of high tech medicine and drugs, the economic balancing of books, the availability and expense of highly qualified staff and all the rest mean that whatever system is used there are always going to be disappointed people and huge pressures built up. In the UK our “free” health service provides unquestioning care to all and in doing that is facing higher and higher costs as more and more people expect more and more. Because of my heart condition I visit the doctor occasionally for check-ups, blood tests and the like -  my every need taken care of. Each time I sit in the waiting room or pick up my repeat prescription I am amazed that all this comes “for free” – I would have no problem with making a regular donation towards the costs. I also sit there and reflect, when I read the notices in the waiting room, on the wide range of services that, in this modern day and age, are expected by the public and offered by the service.......... and I reflect, too, on  the necessary bureaucracy that this must cause.In short these things don’t just happen by magic!  I often think of the old village doctor we had for many years – Dr MacLaren.  He was of the “old school”. He ran his surgery with an iron rod,  no-one got past the dragon like receptionist unless they really were ill. The good doctor  was held in the highest esteem within the locality but, I have absolutely no doubts that he would not have survived today with the demands being put upon those involved in the modern service. And it all costs money.

 Many people take out private health insurance to help them access facilities quicker or to ensure what they perceive as better provision. There may be many ethical questions about that but even private companies face the same problems of too much demand – they however can resolve this by putting up fees or limiting the service unless people pay up front. In the end, it all comes down to money. There are as many views about what should be done to ensure the future of the NHS as there are people – we all have an opinion. Many politicians see some form of privatisation and outsourcing as a solution – others see greater investment as the way forward. Different involved parties have different viewpoints – doctors, nurses, patients, relatives, economists, politicians and the rest all argue their position and I am sure that all have some validity. But in the end these are only temporary solutions, in my view the pressures to some degree will always be there in some form or another. We are not unique on the UK – in America for several years President Obama has been battling to get his health care legislation through. When we look at other nations the grass might appear greener, but all, to some degree or other, face the same sorts of problems – too many people want better and better care which costs more and more. It is as simple as that and there are no easy solutions.

The many options and perceived solutions to the problems of health provision were again put into focus last week when a former government health minister commented that in his view the current health service would begin to critically fail within the next five years – something, he suggested had to be done and done quickly. Of course he had his solutions – as I am sure that we all have – but his comments were quickly followed up by an entirely separate item of news that said that attendance at A&E departments throughout the country were at an all time high and that they were having increasing difficulty in coping with the demand. For a variety of reasons people increasingly see A&E as a quick fix solution to their health problems. The situation seems to have got worse in recent years because allegedly it is now often difficult to get to see the local doctor within a few hours or days – sometimes one might have to wait for a week or more for an appointment. So, in “desperation” people turn up at A&E for immediate help.

As we drove away from the old lady, who was by now hobbling to her house on the arm of our neighbour, something else occurred to me that was new in my thoughts. It never occurred to her that her injuries were serious enough to warrant going to A&E at the local hospital – and, as I noted above, this is typical of older people. And whilst the problems of funding and resourcing the health service in general and the increasing demands made upon A&E services in particular are clearly complex and costly, I just wondered whether, in fact, we are unknowingly making things very much worse because of one small trend in recent years which is making the whole thing a self fulfilling prophecy.

In the UK today you can turn on the TV any night of the week and be almost guaranteed to see at least one hospital based programme. I don’t mean fictional series, although they are there in abundance, but “fly on the wall” documentaries. They all follow the same general format – the exciting, dedicated and tiring lives of the doctors, nurses and ambulance staff; the fact that no matter what your problem you will never be turned away; the vast majority of patients are successfully treated; only it seems those that you might expect to die (the aged and the very seriously ill) die, and those only very infrequently. The vast remainder, often against all odds, are successfully treated.  It is unashamedly  ”feel good TV” reminding us of the success of our system, the innate goodness of those who are there to care for us at times of distress and the fact that no-one is ever ”let down” by this system. I have absolutely no doubts that an advertising executive wanting to sell a product could not better the media coverage given to these situations – the overwhelming message is “come and you will be helped, no questions asked”. It’s an advertising executives dream! And it works – people do come in vast numbers – the local A&E department is something that nearly everyone wants to buy into!!!!!!

Of all such programmes none reflects this better that the hugely successful Channel 4  programme  “24 hours in A&E” – of almost cult status, it has had numerous series with more planned. Centred on King’s College Hospital in London it has made household names and given almost celebrity status to the various staff who we see each week overcoming the odds, giving of themselves and quite unintentionally sending the hidden message “Come, we are open for business and all who come will find succour – you will find kindness, a welcoming smile and the best treatment that money can buy”. And one sees a whole range of people who come – the old, the very young, and everything in between. They come with injuries ranging from the truly horrific and life threatening to the banal and unimportant – and, whatever, they are all given the same generous treatment. Just as it should be.
Dr Firas Sa'adedin - one of the A&E consultants whose
skills, calmness and commitment ensure success.

Much of the success of the programme is based, I believe, in the fact that it is indeed true to life – anyone who has experienced a busy A&E department will recognise that and in so doing it again reinforces the feeling that this is real life. It is what “real people” do both as patients and carers: when we are seriously injured in a road accident and our life is slipping away then we will be rushed into a department such as this and people will work to the limits to try to save us. Equally, however, when we feel a little “off colour”, or when our child has had a tummy upset for a few hours and won’t stop crying or, when we have, in the early hours, got drunk in a night club and fallen from the table on which we were dancing (and sprained our ankle) then we, too, can also turn up and expect the same support, kindness and help – whether we actually really need it or not – for we have seen others do it on TV each week. People just like us! Week after week we see elderly people brought in apologising profusely for being there when in reality it is manifestly obvious they are in serious need of assistance but at the same time we see younger people dropping in for the most trivial of conditions. As we watch many of the patients sitting in the waiting room passing the time in a myriad of ways: chatting, texting on their mobile phones, playing games, telling jokes, complaining because the coffee machine isn’t working properly or because  there is only a certain kind of sandwich available it is difficult not to conclude that the service is perhaps at the very least misunderstood and all too often being misused. It all begs the questions when is an accident and accident and when is an emergency a true emergency.
Waiting for our treatment - but are we all real emergencies?

The staff, of course, are quite correct to act as they do – they are bound by their professions and indeed, probably by their own code of ethics and beliefs to act as they do – not to discriminate, certainly not when the person needs help. They must be Good Samaritans, ever willing and able to help without fear or favour.  It is the very basis upon which our health service is founded and no-one would want to change that. But I do wonder if in portraying on TV the essential “goodness” of the facility and its associated hidden message that all will be treated without question just for a bit of exciting and feel good TV is not rather counter-productive. It legitimises casual use and in doing so somehow diminishes it. Accident and Emergency Departments are, I believe, for the cases which are by their very nature extreme, or thought to be extreme. They are not, nor should they be warm cuddly places which can be viewed as a soft option. This does not mean they should change their approach and become brutal or harsh places – the staff should carry on just as they are doing, providing a caring and warm atmosphere to all who come needing help. But equally, as the old lady who fell down in my street knew they should be viewed as a place of last resort which, undeniably, for many in modern Britain they are not. Rather, they are the first port of call for many – especially the young -  and the daily TV programmes displaying their very many benefits and kindnesses  are not helpful in ensuring that only those in there are indeed real emergencies and their needs the result of real accidents, not simply, every day events. Just, maybe, fewer TV programmes of this type might make these places a little more remote from peoples’  minds and experience and in doing so reduce the unnecessary use of them and thus free up personnel and resources for other important uses.