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Monday, February 23, 2015

44 Scotland Street, Edinburgh

One of my most refreshing pleasures is to live a while with the occupants of the flats at 44 Scotland Street, Edinburgh, and their friends and acquaintances. The latest instalment is "Bertie's Guide to Life and Mothers" in which Bertie turns 7; his appalling mother Irene wins a prize air trip to Dubai where she is confined in a sheik's harem in the desert and starts a book club for the sheik's wives; Angas Lordie's sleepwalking is cured by a single consultation with Pat's father, the psychiatrist Dr McGregor, who acquires an email-ordered companion from the Czech Republic; Pat falls in love with a handsome furniture-maker; Angas Lordie's wife Domenica is visited by their former neighbour Antonia and Sister Maria-Fiore dei Fiore di Montagna, her aphorism-prone fellow-nun; Matthew and Elspeth and their triplets Rognvald, Tobermory, and Fergus (indistinguishable except for their names, and Matthew has mixed them up at least once so their birth order is now unknowable); their au pair Anna from Denmark and their au pair's Danish au pair Birgitte, relocate from India Street to a manor house in the Pentland Hills, Big Lou takes on a foster child, Finlay, who becomes Bertie's protector; and under Alexander McCall Smith's gentle, occasionally profound plot-weaving, (almost) everyone is happy and content. This partial synopsis is my attempt to explain why  the 44 Scotland Street books are my favourites of all the delightfully inventive series by the prodigiously prolific emeritus professor of medical law at the University of Edinburgh.



The 44 Scotland Street series (9 books so far) describe the lives and times of the occupants of the 8 flats at 44 Scotland Street. Wendy and I lived in a comparable commodious flat at 22 Eyre Crescent, just around the corner from Scotland Street, for several months in 2002; there’s no #44. Bertie Pollock, the ‘gifted 6-year-old’ lives with his ultra feminist Mum and his statistician Dad in one of these flats. Other characters live in the 7 other flats in the building, or nearby. “The Sunday Philosophy Club” is the 1st book in the Isabel Dalhousie series, also set in Edinburgh, also 9 books so far; each of the Isabel Dalhousie series comes nearest to containing a ‘cosy mystery’ but that’s not why I read them. McCall Smith is a distinguished bioethicist, and he smuggles ethical conundrums into both series, and into his other books about the Number One Ladies’ Detective Agency (15 so far) set in Botswana. I’m addicted to the two series set in Edinburgh because they massage my nostalgia for that loveliest of cities, because Alexander McCall Smith writes very well, because they are gently humorous - and occasionally hilarious - and because they are about basically decent people, even the appalling Irene Pollock, who means well but is the worst mother ever for a little boy who just wants to be a normal little boy, not a gender-neutral child as his Mum aspires to mould him to be. I’d hoped to meet Alexander McCall Smith when the University of Edinburgh gave me an honorary doctoral degree in 2003, but he attended the convocation for the faculty of law, not the faculty of medicine where I got my robe, hood and parchment. He must be a remarkable man, well into his 80s now, still churning out several very well written, well-plotted, always thought provoking books every year. He types his books rather than using a word-processor, and one of his neighbours told me that on summer evenings when everyone’s windows are open, they hear his typewriter tapping away every night, far into the night. He inserts real people, other Edinburgh writers like Ian Rankin for instance, for minor walk-on parts in his Edinburgh-based stories.

Thursday, February 19, 2015

Memories - true or false?



False memories have had a lot of attention lately because a respected TV news reader has been caught telling little white lies, or great big ones - the sort called porkies in rhyming slang. I've commented in earlier posts in this blog on the physiology of memory, and I've described my memories of many experiences, often in detail. Are all my memories true? Do I have any false memories? Many experiences I've described in posts on this blog are reinforced by photos I took at the time, and some are further supported by my notes or other records. Wendy's diaries and scrap-books reinforce my accounts of some highlights. I don't think I have any false memories.

Photos in our family albums have evoked and strengthened many memories, but there's no photo of that fig tree or the man in it, or of the three policemen watching it cautiously.

I'm sure Wendy kept a diary in 1957, but my diligent search has failed to find it. She must have destroyed it. That's unfortunate, because I'm sure she would have recorded my encounter with the rifleman in the fig tree.  I told her all about it less than an hour after it ended, and she provided much needed comfort in the week or two afterwards when I was still shaking. I have all of Wendy's diaries from 1951 until she became unable to write a few weeks before her death from motor neurone disease (ALS) with the single exception of her diary for 1957. It was a stormy year (see my post of June 28, 2013) so she probably had good reasons to do away with it when tranquility - if that's the word I want - came back into our lives.

My vivid memories of that scary episode include details such as the fact that the man had a bandage on his wrist and the policeman in charge had bad breath. Perhaps there's a police record, if the suburban police in Adelaide keep records for that length of time. I doubt if the event made it into the Adelaide Advertiser or the News (Rupert Murdoch's paper, from which he launched his worldwide media empire). Readers of this blog will just have to take my word for it. 

Tuesday, February 10, 2015

Does facing death require courage or bravery?

I was 6 or 7 when our bouncy terrier was hit and fatally injured chasing after one too many cars. We wrapped him in his old blanket which soon got badly stained with his blood. I watched as his breathing became laboured and his obviously painful whining faded into silence. Then the sparkle disappeared from his eyes: they went sightless and without anyone having to tell me, I knew he was dead. It wasn't the first death I was aware of in my family, but it was the first time I observed and understood the difference between living and dead. I was about the average age at which children can grasp this concept, the distinction between life and death. I could comprehend the fact that the transition is irreversible. Once we are dead, there is no way back to life again, at any rate outside the pages of gothic and supernatural fiction. 

Paediatric cancer specialists with empathy know that it is cruel and wrong to withhold the truth from children over the age of about 8, when ultimately their cancer is going to kill them - and that this might happen rather soon. Children of that age have enough insight and self awareness to recognize that they are getting worse, not better.  They do not like their parents and their doctors to lie to them, and it is harmful and wrong for parents and doctors to deceive children who want to decide for themselves who will get their most treasured possessions. What's more, many children who face this fate are able to do so with courage and good humour. I have not had to care for many children facing inevitable and imminent death, for which I am thankful. In 1952 when I was a paediatric resident at Edgeware General Hospital in North London, a little girl about 9 years old was dying of bone cancer. She was cheerful most of the time, except when the pain of her cancer escaped our best efforts to suppress it.  She played happily with her doll and her teddy bear, reading aloud to them. She got sad when her parents came to see her because, she said, her Mum always cried and her Dad looked so unhappy. My chief, Dr Margaret Baber, asked the child if she knew what was going to happen to her.   I can't recall her exact words, but she knew her leg had been cut off near her hip because it had got cancer, knew that the cancer had come back, and knew that she would soon die. As far as Dr Baber, the experienced nurses, and I could tell, she accepted her fate calmly, without bitterness or anger. Was she courageous? Perhaps. She may have been in denial. I can't say one way or the other.

I've seen enough deaths to be aware that courage or bravery aren't usually important issues. Wendy and I knew immediately that the neurologist Pierre Bourque gave her a death sentence when he told us his diagnosis of her vaguely defined symptoms and signs was ALS, or motor neurone disease. She accepted it calmly, more calmly than I did, and we lived with the inevitability of her death for 14 months until it became a reality. Previously we had talked several times about the end of our lives and how best to prepare for this. In our mid-80s we were well adjusted to the certainty that death would come to us sooner or later. We were greatly reassured when our palliative care physician Louise Coulomb described how Wendy would die and what we could do to minimize distress. Philosophical acceptance of inevitability describes her attitude, and mine, better than courage or bravery. We were both profoundly grateful for long, useful, well-lived lives that turned out much more interesting, exciting, and fun than we'd have expected if we'd thought about it on the day we decided to join our lives together.

My own first unequivocal close encounter was my departure from Paris in April 1952. I flew, to allow me to have the maximum time in Paris. As we took off from Orly to return to Heathrow, an engine caught fire, the pilot slammed on the brakes and we ended nose down, propellers buckled, in a ditch well beyond the end of the runway. I had a momentary flash of alarm as I looked out the aeroplane window and saw all the flames and smoke pouring from the engine; after that everything happened so quickly there was no time to feel afraid. I had a delayed bout of something like panic as a replacement aeroplane raced along the runway a couple of hours later, and I was shaking all over for a few minutes, but it passed off once we were airborne.  In November 1958, Wendy and I and baby Rebecca flew to New Zealand to meet Wendy's family. I was incubating a nasty chest infection as we flew across the Tasman Sea, and a few days after we arrived at Mum and Pop Wendelken's home I was delirious with a high fever.  My recollection of the next few days is very hazy and incomplete. I was admitted to a local hospital and put in an oxygen tent with a detergent mist to loosen the sticky mucus that  was choking me. For a day or two, in my lucid moments I and the young chest physician caring for me thought I might die. Well, he thought I would die; I was delirious and unaware for much of that time, but as I began to get over the worst, I became obsessed with anxiety about my seemingly imminent death - anxiety about leaving Wendy destitute with baby Rebecca not yet a year old and Wendy heavily pregnant with another one. Since the 1950s I've had several more terrifying experiences in the air or approaching a runway in bad weather. It hasn't helped when the aircraft have been in an obvious state of disrepair. Flying out of Medellin in Colombia between towering mountains, into Hong Kong in a monsoon deluge, in and out of boondock airports in Indonesia, also in monsoon rains, were nail-biting experiences but at the time none felt like my last moments. There've been near misses in traffic a few times too, and once at least when swimming in heavy surf off a North Shore beach in Sydney when I really thought for a few moments that I would drown. My life didn't flash before my eyes but as in the oxygen tent in Blenheim, New Zealand, the thought of leaving Wendy and the kids ill prepared financially made me determined to live. That didn't require courage, just muscle power enough to fight the waves and the tide rip for a few moments longer until I was out of harm's way. Courage or bravery weren't what I needed and found, just determination to survive. My father and his wife possessed it too, when they survived in a lifeboat in the North Atlantic off Iceland after their ship was torpedoed a week before Christmas in 1940. Several others in the lifeboat younger and perhaps fitter than they were didn't survive. 'Will to live' - whatever that is - accounts for it I suppose.  When we were young and middle-aged adults Wendy and I had plenty of will to live. Now, not so much.

Battlefield conditions in wartime are far from the only setting in which courage and bravery - and their opposites - are revealed and displayed. The display may be unobtrusive, low-key, or dramatic, flamboyant. The accompanying states of mind likewise vary greatly. Wendy's state of mind throughout her terminal illness can be summed up as philosophical acceptance. Mine was much the same. I had mixed emotions about facing life without her, on one hand, thankful that I was behaving as a gentleman should, letting her go first, sparing her the emotional stress of clearing up after a long, loving marriage ends; and on the other hand, sadness and even despair at the thought of life without her by my side.  Four years later, those emotions are unchanged, but I've accepted my fate and am trying as best I can to carry on without her. 



Wednesday, February 4, 2015

Courage, bravery, heroism, valour, et cetera

Robert Fowler’s talk to the Friday Lunch Discussion Club about courage and bravery on the battlefield, awakened a long forgotten memory.

It was 1957, not long after Wendy and I were married.  I was on duty at the Western Clinic, which served the suburbs west of the city of Adelaide. The police phoned. A man had climbed into a large fig tree and was taking potshots at passers-by with a rifle.  Could I talk to him, ask him to give up his gun and come down from the tree?  The policeman who phoned didn’t know whether the man was drunk or deranged, just that he was a poor marksman - he hadn’t hit anyone yet.  Knowing this did nothing for my peace of mind as I approached the fig tree, waving my stethoscope to identify myself as a doctor.  Somehow I persuaded him to hand his rifle to me and come down out of the tree.  Inspection later showed that the rifle was harmless: he had already fired his last bullet. But I didn’t know that at the time. As soon as the shooter gave me his gun and set foot on the ground, the brave constabulary wrestled him flat on his face.  I had to talk loudly to prevent them from injuring him.  They put him in their paddy wagon and took him to the psychiatric hospital.  For several days afterwards I was shaking so much I had to use both hands to hold my mug of tea. I suppose that would now be called post traumatic stress disorder.  I had forgotten all about that event until Bob Fowler’s talk reminded me.  

Was I courageous? Was I brave? I don’t think so. Stupid maybe.  

In my five years at that clinic, I had several abrasive encounters with the police, and a few with warders at the Adelaide jail, which was in our 'parish,' who were unsympathetic to the notion of mental illness as a cause of bad behaviour. At least on that occasion they recognized that medical help rather than brute force was the best solution to the problem. They manipulated or morally blackmailed me, however: if I had declined their request to talk him out of the fig tree, they said they would have to shoot him. 

I've had other experiences requiring more courage than that episode. I'll say more about bravery and courage another time.