7/7 Bombings.

Today is the fourth anniversary of the 7/7 Bombings in London in 2005. Three tube trains and a bus were bombed killing over 50 people.
I heard this on the news in the late morning of 7th July 2005 and phoned work saying that I was available if required.... I do have an 'Adult' qualification as well as 'Paediatric' and wondered if the PICU might have to act as an overflow from Adult ITU. I was asked to help cover the night shift - with the transport system closed down it was probably going to be impossible for a lot of our staff to physically get in to work anyway on PICU. I even volunteered to put up people from the day shift in our house if they couldn't get home.
As it turned out the transport system was up and running by evening, and everyone who was due in for work turned up. I wasn't actually needed. I went in anyway.
I never felt so proud to be a Londoner!

GEEZER MAIL!

I seem to have hit that difficult age when I start to receive unsolicited "geezer mail"! Just this morning I received ads for elasticated trousers, walk in baths, an adjustable bed, some sort of back support and a FUNERAL plan!

For crying out loud how old do they think I am?!

ADVANCED PAEDIATRIC LIFE SUPPORT.

I would describe APLS as a medical version of "The Crystal Maze". Imagine being ushered from one room to another with some life threatening scenario being laid out before you using a variety of mannikins and equipment.

Basic resus of infants and children are first covered and assessed. Then we moved on to the critically ill child. We coped with cardiac arrhythmias, shockable and non shockable rhythms, and defibrillation. Convulsing children, asthma, anaphylaxis, DKA and cardiogenic problems. And of course a variety of infective causes. Airway management skills are assessed.

The next day we looked at the critically injured child - head injuries, spinal injuries, penetrating chest and abdo wounds etc etc etc. Practical skills like chest drain insertion, surgical airway, emergency thoracocentisis and IO needle insertion.

The point is one expected to make a thorough assessment of the child, identify the problems and take effective action.

Today we had a final assessed scenario and an exam with an 80% pass mark. Anyway I'm pleased to report that I passed. I won't have to do APLS for another 4 years. Hurrah!

Federal Vision (again!)

I was recently told about the 'blog' belonging to David Anderson called 'More than Words' http://mothwo.blogspot.com/

He seems to share some of the same reservations I have about the whole "Federal Vision" mularkey; his blog might be worth checking out.

ADVANCED PAEDIATRIC LIFE SUPPORT!

I've been away on holiday for a couple of weeks and now I need to knuckle down and work through the APLS manual ready for the course next week at Guy's Hospital in order to renew my APLS certificate.

Jim Swift, killed in action, aged 19.

James Swift was my father's elder brother who died on the Western Front in 1918. When I was a kid the First World War seemed like ancient history to me but the older I get the time difference seems less and less significant.

Last weekend in Leeds I attended my aunt's 100th birthday party. Auntie Anne would have been 8 years old when Jim was killed; it is a remarkable idea that the records I airily pick over represent a real person that Anne knew and grieved for.

The details I have on Jim are sparse but knowing the date of his death and the unit he was with I can place him in the path of the German Spring Offensive of 1918. This was the German's final gamble to win the war outright before the Americans could intervene in force. The offensive is now known as "The Kaiser's Battle" or "Kaiserschlacht". German forces no longer required on the Eastern Front following the military collapse of Russia during the Revolution of 1917 were transferred west and the full force fell on the British front line starting on 21st March. British forces reeled under the blow, the Germans broke through and the army was forced to retreat across ground won at such a high cost in the preceding years. Eventually the British lines held and the German threat was contained.

I gather from the family that Jim had only just got to France when he was killed. This is the record I obtained from the Commonwealth War Graves Commission.

Casualty: Private JAMES SWIFT. 205628
Served With: 7th Bn. Queen's Own Royal (Royal West Kent Regiment)
Died: 28th March 1918
Commemorated: POZIERES MEMORIAL
Somme
France
Panel 58 and 59
Additional Information: Age 19
Son of Patrick and Mary Ann Swift, of 38 Exeter St.,
Bradford, Yorks.
He was born and enlisted in Bradford and formerly served in the Yorkshire and Lancashire Regiment.

Jim has no known grave.

How long is a Piece of String?... ooops Cable?!

At the conclusion of our week of heart surgery we had dinner at an Italian restaurant in Nairobi. Cliff, our 'perfusionist', held a sweep-stake where we all had to make a guess as to how long the cable was from the maintained power socket to the Cardio-Pulmonary Bypass Machine in theatre. We all put a £1 into the pot.

Ivy won! It was 29 metres or 95 feet!

Clifford Longley.


I love listening to radio 4 - unfortunately there are occasional bits of grit in my breakfast that have to be endured like "Thought for the Day" on the "Today" programme. This morning I had that awful sinking feeling as I listened to the contributor.

Clifford Longley is a journalist with a long career commenting on religious affairs so it is more with a sense of depression rather than any other emotion that I say what I am about to say. I barely know where to start in unravelling his confection of platitudes... any way here goes.

The notion that people make ethical decisions based on whether they believe they may be rewarded or punished and that atheists, having no such motive, can actually operate on a higher ethical plane leaves me speechless. This is such a childish notion.

The adult reality is that people make ethical decisions based on the worldview they hold to. If one is a thoughtful Christian one makes Christian decisions. An atheist will make choices consistent with that worldview. If it happens that one is an atheist who follows a none Social-Darwinian ethical process then one does so because one instinctively knows (by God's 'Common Grace'!) that such a course is right even if one finds oneself acting in a logically inconsistent manner. That is hardly operating on a higher plane.

The bishop CL was damning on air I suspect was actually pointing out that our values arise from the worldview we hold to be true. Reading between the lines of CL's garbled account the poor bishop was probably simply affirming a Christ centred worldview (which is his job afterall!) but that obviously went completely over CL's head.

A Christian may act unChristianly/Atheistically. An Atheist may act unAtheistically/Christianly. It all depends on the operating worldview. But this is all beside the point because merit is not earned in God's eyes by what we do. That implies that correct ethical choices put us in God's good books but that is not how it works! We all foul up from time to time - so the adult issue is how now do we get right with God given the reality of our failure? As a Christian I believe in Jesus not in my capacity to make correct ethical choices. A Christian, by definition, is someone who has come to a point of repentance rather than the media caricature of someone who is self-righteous, ie someone who believes that they always make correct choices!

As a Christian I seek to make ethical and personal choices consistent with the world as it actually is; though in my weakness I often feel brow-beaten by media pundits pushing the official line and find myself compromising against my better judgement. And when I do fail my primary concern is not fear of being punished it is the sense I have of not having 'walked worthily of Lord'. Others may make ethical choices on worldviews they are in a better place to explain. I seek to make choices which please the Lord, so reward/punishment are not the primary consideration! The ethical debate lies elsewhere entirely in the nature of reality and truth and relationship with God.

Clifford Longley's piece this morning is merely yet another example of the infantilisation of religious discussion in the country when it is crying out for informed comment and debate.

Return from Africa!

I arrived back from Nairobi a couple of hours ago. In all our "MEAK" team did 17 operations on children with congenital heart defects including some of the more complex procedures yet attempted; Truncus, TGA etc.

Sadly one of our patients died midweek which was a low point for us all. We did have our successes - a baby girl with a huge VSD and failing heart had no clear left lung fields on X-Ray. Not only was her heart huge but she also had a raging chest infection. We did physio on her and suctioned out lots of gluey secretions. This is her X-Ray now - hurrah! we have some air on the left side!

The other highlight was that we did the first ever "Switch" for Transposition of the Great Arteries ever attempted in Kenya.

I'll write more about all of this but right now I'm exhausted after a sixty-five hour week and this will have to suffice for now!

The Kenyatta National Hospital in Nairobi.

During our time in Kenya we are aiming to do three major cardiac operations each day. I was speaking to the manager here this morning who told me that they only have the resources to do two or three a week normally; so in our time here our team could clear 2 or 3 months backlog! Which is quite an amazing thought!

I am also given to understand that we did Kenya's first ever "Switch" for 'Transposition of the Great Arteries".