Warning: mostly not about Covid-19, but On Operations and Lockdowns

This is not a Covid-19 communique but rather a standard blog post. Don’t feel you have to read on. The reason for the change in emphasis this week is that Covid-19 events simply passed me by. The explanation is that I was engaged with the National Health Service (NHS), finally having elective surgery for an umbilical hernia. It has been a long road to get here, I am relieved to have it sorted.

I have always considered myself fit (but overweight), playing squash, touch rugby and running. A few years ago, I noticed I was developing bulge in my belly button. It was confirmed as an umbilical hernia. All the sources of advice: doctors and the internet recommend these occurrences need to be dealt with, and that means surgery. Two years ago, I arranged to have the hernia operation in Durban. It could have been a day surgery but, stupidly, I decided to spend the night after the operation in the hospital. It was that or go back to the flat. The surgery was straightforward, the hospital experience was not great. Unbelievably the morning began, at 05h30 am, with inappropriately cheerful nurses. I was on a men’s ward where all had more serious conditions and concerns, and felt somewhat fraudulent.

The original surgeon gave me options for the repair. I selected stitching rather than putting in a mesh. This was a mistake, as I realised, when the bulge reappeared some months later. This time I did more homework and consulted with medical professionals in Waterloo, Norwich, and Durban (as well as qualified friends). The consensus was it had to be redone, but with a mesh. In addition, I learnt I would have to wait at least a year before a surgeon would even consider reopening the wound.

Covid-19 meant that, after arriving in Norwich in December 2019, I have not travelled outside the UK or even on a plane for 14 months. (I am seriously tempted to go for a flying lesson as soon as it is permitted just to get in the air!) This in turn necessitated arranging to have the surgery in Norfolk. I began the process and expected to have to wait for at least a year. As it happens it was quicker than that, but my word it became a complicated process, and it has been an insight into the amazing NHS and how they function in time of crisis.

The centre for these surgeries in Norfolk is the James Paget Hospital. This is in Gorleston on the Norfolk coast, about 50 minutes (or 30 miles) away. The process involved visits for assessments, an MRI scan, a Covid test and other ancillary events. The surgery was originally scheduled for January 2021. However, the government unwisely relaxed restrictions in England at Christmas, and the number of cases soared. On 8th January 2021, they peaked at 68,192 up from just 12,386 on 12th December 2020. The hospital called me to say, regrettably, the surgery would be postponed. I expected this!

I was quite happy to wait, after all it was elective, and not urgent. The next, and unexpected development was the hospital called and offered me a date, at a private hospital in Colchester, some 60 miles away. One of the ways the NHS is trying to manage their waiting list is to outsource some procedures to the private sector. I declined the option and eventually heard from the local surgeon who said that the surgery could be scheduled for 2nd March. As an aside the number of new Covid-19 cases across the UK on that day was 6,411.

On the day, I had to get to the hospital by 7 am. Ailsa drove me down and dropped me off. I checked in to the day procedure ward and was wheeled into the theatre at 11 am. I had hoped it would be earlier. This delay was entirely my fault. When we got up, just before 5 am, I had a cup of tea with milk in it. Note to self: read the instructions carefully and follow them! I could have had water or black tea; it was the milk that was the issue!

Apart from extra hygiene precautions and wearing masks, the part of the hospital I was in appeared to be functioning normally. There is a separate terribly busy Covid section. The biggest obvious difference is visitors are not allowed at all. This makes for a very much quieter environment. The day procedure centre was active, but not manic and the nursing staff were caring, professional and calm. Everything went smoothly and, after passing urine, (a non-negotiable apparently) I was discharged in the evening. I left with a ‘goody bag’ of everything I needed for post-operative self-care.

My ‘N’ for hernia operations is now 2. The first was an incision while this second was done laparoscopically, through five places on my stomach. I had to take a few painkillers, far fewer than prescribed. Generally, I have been fine although getting up and lying down have been challenging. In addition, I was given about 10 preloaded syringes with blood thinning medication, to inject into my stomach. Not a pleasant process. I have been really impressed by the standard of service in the NHS despite the Covid-19 crisis. This also needs to be seen against the backdrop of a public sector pay freeze except for nurses, who have been offered a derisory 1%. They are furious, feeling it as a slap in the face, and I quite understand. I recognize the need for fiscal conservatism to pay for the Covid-19 response. It has cost billions, not just care costs, but also keeping families and supporting the furlough programme so people have jobs to return to. This stingy pay offer to core staff stinks.

I have taken several lessons from this experience. The first is to read and follow instructions carefully. Second is that the health service is amazing. Even when it is under immense pressure, people are seen and treated. At the same time as this was going on, the government is rolling out a vaccination campaign. I was able to go online and book both the appointments I need, the first on 12th March and the second three months later. My hub is the Food Court, in the currently shuttered, Castle Mall Shopping Centre in Norwich.

I do have a few quibbles though. The main one is about ‘joined-up’ thinking. The provision of a decent health system is part of the social contract, but the major challenge faced by humankind is climate change. I have been taken aback by the use of resources in the health service, much of which probably can’t be recycled. I was given 14 disposable syringes, each in separate plastic wrapping. It may be that there are no options! However the instructions and pamphlets were on recycled paper.

I have talked before about how fortunate I feel we are. We have a home, an income, and a family close at hand. The children are coping with this as well as anyone. My extended family are all OK, although no one is very happy. In addition to that, our environment is changing in two significant ways. First with regard to Covid-19, the numbers are falling, and the vaccination programme is working very well. Second, there are signs of spring. I can see the first leaves beginning to bud on the rose bushes and today we spotted blossom on the trees in the neighbour’s garden. It is still chilly but there are signs of spring.

This good fortune was brought home to me when we walked to a local shop to get some essentials and the Observer newspaper. The rule is only one person from a household should go in and so I waited outside. There is a ‘security guard’ at the entrance to make sure people wear masks and sanitise their hands. I think he is from Norwich. I started chatting with him and this is his story: he worked on cruise ships out of Fort Lauderdale in Florida and was also paid as an American Football Player. I know this may come as a shock to readers of this blog, but there is a league in the UK and Norwich has a team which he was part of before going off adventuring. He said he played in Australia, before going on to join a team in Vladivostok in Eastern Russia. Covid put an end to this, and I think he was lucky to get back to Norwich. I would never have known any of this. What a story. The next instalment will be interesting, and I am looking forward to it. End of personal stuff, some COVID-19 coverage next.

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Pollen and polling

In my blog, posted at the end of March, I described the surgery I underwent in Durban. I also talked about going out a couple of times, with friends, to a really delightful little bakery/pizza restaurant in the neighbourhood. It does not even have a liquor licence; and this does tend to mean the evening is cheaper as one takes one’s own wine. Among those friends was Jurgen Brauninger and his family. I wrote in that blog:

‘On a personal level it is interesting to see my cohort, friends and colleagues ageing into their 60s, for the most part with grace and dignity. It is however a shock to us all – but, as I said to one friend, ‘it is better than the alternative’.’

Within two weeks of these dinners we learned, out of the blue, that Jurgen was not well. He was suffering from pancreatic and liver cancer, and was having difficulty in eating. After various consultations he was scheduled for urgent surgery to ease pressure on his duodenum. While this was not a cure, it was expected to improve the quality of his life. The surgery was carried out on 26 April (by the same surgeon who did my hernia); Jurgen did not recover and died on 6 May.

I want to pay tribute to a dear friend and colleague, a talented musician, but above all a devoted family man. I know Tania, Hannah and Brigitte will be torn apart by grief. Sitting in Canada I have felt very distant, but no less sad. I wish I had deep and meaningful forethoughts about this but I don’t, I just know I will miss him enormously. Andrew Marvell’s lines “But at my back I always hear, Time’s wingéd chariot hurrying near”, were not written about death; they do seem very apt though.

The Brauningers lived a few houses up the road from us in Manor Gardens. Their children were similar ages to Rowan and Douglas. We celebrated many milestones together; Brigitte did the most amazing Easter lunches for the university crowd and others. The families went away together for a number of short holidays in the province. Everyone enjoying each other’s company, even braaing under umbrellas during a heavy rainstorm. Their home was an original ‘wood and iron’ house, this is one of the first Durban houses and relatively few are left standing. Jurgen, I and Ullie, one of his friends, purchased the house next door when it came on the market, in order to preserve it and the jungle of a garden for a little bit longer. Jurgen and Brigitte had just moved a few kilometers to a more modern house and were planning their retirement when this devastating event occurred. This has been a deeply sad time.

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Autumn and Spring Showers

The month of April began in the Cape and ended in Canada via Norwich. In the first week we ran the scientific writing course in Stellenbosch in the Cape. There were 19 participants from across Africa. Tim Quinlan did most of the teaching and the event was excellent. We are beginning to see results in submitted and published manuscripts from earlier years. I hope the project will be renewed, but if it is not then we have achieved a great deal. As my travel was from the southern to the northern hemisphere, I experienced autumn one day and spring the next. In England the daffodils have bloomed and are past their best. In Canada, or at least in this part, they have yet to blossom and it is still decidedly chilly.

Of course visiting Cape Town is also a chance to see family. My brother and sister-in-law were away but I caught up with my aunt, various cousins and a niece for Sunday lunch. I felt that I had not talked properly to niece Sarah, and she was good enough to join me for lunch on the Monday before I flew back to the UK. We walked across from the City Lodge to a new restaurant right next door. It was good to have a decent conversation and catch up with family news. Because the flight from Cape Town is so late (after 11 pm), I only watched one film: The Great Buster, a biopic of filmmaker and comedian Buster Keaton. He was one of the few stars who transitioned successfully from silent films to sound. It was not demanding so was good to watch in the small hours.

I had a relatively short spell in England. My sister came up from London for Easter and her birthday. We went to a show at the Norwich Playhouse, where Rowan works. It was an amateur production of A Sound of Music. It was outstanding. There were a few wrong notes, but not many at all. The set was imaginative and the acting most impressive. I think amateur productions can be excellent because people really throw their hearts into the show.

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Surgery and Sunshine

I was offline for a few days in March, an interesting experience especially during the time of crisis in the UK. It was my birthday on the 18th and I celebrated by returning to South Africa on the 16th for a series of elective medical procedures. I took the 06h15 KLM flight from Norwich to Amsterdam where I connected on the 10h15 flight to Johannesburg. The journey takes nearly 11 hours. My case was one of the first to be unloaded and appear on the carousel, these little things matter.

There are no connecting flights to Durban that late. My standard operating procedure is to stay in a hotel at the airport and connect the next day. Normally the travel agent’s opening proposal for the connection is a plane at an absurdly early hour, 07h00 for example. On this trip I was sensible and got a flight a little after 13h00. It allowed me ample time to sort myself out, and have a leisurely breakfast.

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“January brings the snow: makes your feet and fingers glow”

(Title: Michael Flanders and Donald Swann’s ‘A Song of the Weather’)

The first half of January was exceptionally warm for winter. We are told not to ‘cherry pick’ weather events to argue global warming is real. When they come one after the other, however, the evidence seems to be stacking up. The weather maps showed high pressure over the UK and to the south, so the fronts seem to be further north than usual. Scotland got a battering. Sadly the potential advent of Scottish independence won’t help that situation – weather is bigger than politics.

The rest of the month saw a few hard frosts, grey days and wind and rain, as well as some gloriously sunny spells. Even in the depths of winter the sun shining through the window can be warm enough to warm the south facing rooms. We have wood / coal burning stoves in the living areas and I must admit to getting a great deal of pleasure in laying and lighting the fire: paper, kindling larger pieces of wood and the coal. If I do it right we use 10 kg of coal for four fires. It warms both the room and the house very nicely.

If January weather was not enough to keep us depressed, the all-consuming topic in the UK is Brexit. Theresa May presented her deal to Parliament in mid-January, and it was soundly defeated. In fact the margin was astonishing: MPs voted by 432 votes to 202 to reject the deal. Labour leader Jeremy Corbyn immediately tabled a vote of no confidence, which, unsurprisingly was not passed. If it had been it would have led to a general election.

The problem is both the Conservative and Labour parties are both deeply divided on leaving the EU and the deal, so there is no consensus. An election would not help, unless the smaller parties did really well, which is unlikely. It is all a terrible mess. There have been, in past few days, more votes in Parliament and the situation is even more uncertain at the end of January.

The papers, or at least the ones I read, are full of commentary on the rise of the right in global politics. This is clearly happening, but just as worrying is the growth of incompetence in leadership. The events of the past few months in the USA seem to epitomise this. When this is combined with the lack of vision I worry even more.

“A politician thinks of the next election. A statesman, of the next generation.”

I knew the quote and I was writing this letter I decided to see where it was from. The answer is James Freeman Clarke (April 4, 1810 – June 8, 1888) an American theologian and author. There do not seem to be any great works by him but lots of very good quotes.

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The Meaning of Life

Half of September was in South Africa and half in Norwich. I travelled from Norwich to Cape Town via Amsterdam on the 1st September. This visit was to oversee the scientific writing course we held in Stellenbosch. The KLM flight takes over 11 hours and seemed very long, especially since these days I usually travel in economy. I am very grateful for my ‘Life Time Platinum Elite’ frequent flyer status as it gives me seating choices and lounge access. This practically means I usually get a bulkhead seat with more leg room, and that really makes a difference over long flight.

The 2nd (Sunday) was a free day and on Monday the participants started arriving. The programme is mainly taught by my friend and colleague, Tim Quinlan, whom I have known for close to 30 years. He came to Durban to teach at the University of Durban-Westville, which in those apartheid days was the ‘Asian’ higher education establishment. He subsequently joined HEARD as the first Research Director. This is the second year that he has run this programme with me. I am very lucky to also have as the main recruiter and administrator Nick Zebryk, who did a degree at the Balsillie School, and was my first (and last) full time research assistant in Waterloo. He managed the application process, and travelled to South Africa to troubleshoot. Thanks to his hard work there was no trouble to shoot!

We had 16 people from across Africa. On this occasion the largest number were from Malawi (four). I had taken some flack last year as six people were from Swaziland and this was seen favouritism. Everyone came with work in progress, and both Tim and I met with individuals to go through their manuscripts. We finished on Friday morning and on Saturday I went to Cape Town and spent a night in the City Lodge at the Waterfront. Firstly I wanted time by myself and the hotel is ideal for that; second I had a lunch meeting with the acting editor of the Global Fund Observer. This is run by a Kenyan-based NGO AIDSpan and I am on the board. As with all donor funded organisations, there is the constant need to raise funding and this means being relevant and supportable. Fortunately, so far, this has not been an issue for us.

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Farewells and Coincidences

In July 2018 I went to my last Governing Council meeting at Waterford Kamhlaba United World College (WK) where I have been a Governor for 24 years. I thought I would weep at the farewell cocktail party. To my surprise I did not. Perhaps this was because of the example of fellow Governor Derek Blackman retiring after nine years. Derek never tires of reminding me that, in the minutes of the meeting where he was nominated, a Governor (in fact me) remarked this was a mistake as he was based in the UK and would not travel to the meetings. He attended all 27 meetings during his tenure and made a great contribution. It was, however, an emotional evening. I posted my farewell remarks on my website, not because they were earth-shattering, but because I put thought into them and they are reflective.

I stayed at the Mountain Inn which has become my home in eSwatini. It is at the top of the Ezulwini Valley and has magnificent views. I was particularly glad to spend time with Quinton Reissmann, who was at St Mark’s primary school with me. He is currently a teacher at WK, having worked mainly in government schools in Swaziland. We are both grey (him more than me because he has hair). When I am with him I feel the years fall away.

The hotel has five new rooms. They were good enough to put me in the largest, not that I needed the space. The new rooms were not the biggest change, a couple of months ago it was announced that the country was changing its name from Swaziland to Eswatini. In this, and future writing I will refer to past events as having happened in Swaziland, but from now, if it is something new, I will talk about Eswatini. I had a very African experience, as I was walking down to the room one evening I felt a thump on my upper arm. I wondered what it was: a large moth? When I got to the room I glanced to down and to the left. There was a little gecko riding, contentedly, on my shoulder!

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A Dry Spell

It seems that the weather dominates the opening paragraphs of my monthly posts. At the end of June there was a very warm spell in Norwich, and no rain for over two weeks. More worrying is there is no rain in the forecast for at least 10 days. A stubborn area of high pressure has located itself over us. Of course East Anglia is the driest part of the British Isles, not widely known, but this has been quite exceptional. Some of the plants in the garden are given favoured treatment. They get water from the butts that drain off the roof of shed. The lawn, however, does not, and it is beginning to look rather the worse for wear.

My sister came up from London to visit for a weekend. Ailsa was away visiting her mother so Douglas and I were in charge. I think we acquitted ourselves well. We had thought of going to see a film, the choices at the local cinema were the ‘Happy Prince’ or ‘Oceans Eight’. In the end we did not. The weather was so pleasant that sitting inside a cinema would have seemed like heresy. What we did do was to go eat in Waterloo Park.

I have mentioned before that Norwich has some amazing municipal parks. In 1919 Captain Sandys-Winsch was appointed as the City Parks and Gardens Superintendent, and he stayed in the post until 1953. He is largely responsible for the fine public parks. There was government funding after World War I as part of a building and planting programme to provide unemployment relief, aimed mainly at ex-service men. Waterloo Park actually predated this, it began in 1904 as Catton Recreation Ground. A new design was drawn up in 1929, and in 1933 it reopened as Waterloo Park. It is 18 acres with a mixture of play areas and gardens, with lots of magnificent trees. There is, as in most of the parks, a pavilion which has a café.

There are many reasons to visit the park, but at the weekend we went for brunch. The café is run by Britannia Enterprises and most of the staff at this, and the two other sites, are serving or ex-offenders from Her Majesty’s Prison in Norwich. The project aims to offer mentoring, training, employment and rehabilitation to prisoners. They claim that just five percent of participants in the programme re-offend, compared to the national average of 46 percent. It is an excellent example of a social enterprise, and the food is good and reasonably priced. As it was such a beautiful, warm and sunny day, we were able to sit outside, and that meant we could take the dog.

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Slush and wind and rain

This final note for 2017 will be posted just before the end of the year. It was written over a couple days after Christmas, and before I travelled to Canada on the 29th December. I have been in the UK for three weeks, flying over at the end of the first week of December. We celebrated Christmas in Norwich. My sister came up from London for the holiday. On the actual day Rowan and her partner Ben drove across the city for the big meal.

Rowan had suggested we go to her house as she is, at the moment, fostering three young cats. The poor creatures were feral and they are taking time to get used to people. After much thought we decided to have everything in our house. We feared the festivities, and number of people, might have been a bit much for nervous cats. We had a really great meal. Ben introduced me to ‘pigs in blankets’, sausages wrapped in bacon, a real treat for the only two carnivores. Everyone else is vegetarian so the rest of the meal was a vegetarian feast.

Unusually everyone got gifts they really wanted. I made a point of sending out my wish list early in the month, but still had complaints because I had not specifically told the family who should buy what! One of the themes of my gifts was maps. Gill bought an old, 1952, ordinance survey map of Norfolk and a scratch World Map, the idea being that the gilt overlay gets scratched off every country one has visited. Ailsa got me a jigsaw puzzle of Norwich, which I am looking forward to assembling.

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Driving and relaxing

I finished teaching in Konstanz on Friday 3rd November. Rowan arrived on the Wednesday before this. The cancellation of a train from Zurich Airport meant she got in sometime later than we hoped. As predicted by the family, she got the bedroom and I took over the sofa bed in the apartment’s lounge. This made sense since I get up frequently during the night. She had only two full days in the town and we went to Friedrichshafen and the Spa, both second visits for me, but no less enjoyable. She came to class on the Friday, my last session. All students produced blog posts, those who wanted, have them posted with this blog.

On Saturday 4th November we flew from Zurich to Amsterdam and stayed in an Ibis Budget hotel not far from the airport. The actual hotel was very basic but entirely fine, the rooms sleep three people with a bunk bed arrangement over the double bed. There should, perhaps, be a warning “Beware of falling children”.

It seemed a very remote spot and I was not confident of our ability to get into the city. The receptionist said confidently that there was a bus stop across the road, and the bus, a number 193, went punctually every 15 minutes. I expected a lonely pole on the banks of a drainage ditch, but instead it was a busy barn sized structure with numerous buses. All we had to do was cross four lanes of traffic. We went to Leidseplein near the centre of Amsterdam, found a decent restaurant, enjoyed a good meal, and got the bus back with no difficulty at all.

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