Lake District Adventure.

Most years I try to get away to do some walking in the English Lake District. I usually camp and do a series of walks over a week long period. This year I based myself at "Hillcroft" camp site near Pooley Bridge and used this as my base to do the following walks.

On Sunday 6th September I walked the length of Lake Ullswater from Pooley Bridge to Patterdale and around the south of the lake to Glenridding; I took in Hallin Fell (388m) en route. Ullswater is England's 2nd largest lake at 14.5km.

On Monday 7th I climbed "High Street" (828m) via Pasture Bottom and returned by way of Angle Tarn.

Wednesday 9th I went up "Fairfield" (873m) via St Sunday Crag and returned via Dovedale.

Thursday 10th I climbed up "Helvellyn" (950m/3,117ft) via 'Striding Edge' from Glenridding and returned by way of Nethermost Pike and Dollywaggon Pike and Grisedale.

CHILD PROTECTION!

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Today was a 'Team Away Day' mainly dedicated to a variety of mandatory training issues. We covered things like 'Infection Control' and 'Pain Control in the Paediatric Intensive Care Unit'.

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We had a couple of major sessions on 'Child Protection'. One of the most distressing aspects of PICU is coping with the aftermath of a "non accidental injury". Sadly not all the kids make it!

"I'm not 52, I'm 18 with 34 years experience!"

"Striding Edge" in the English Lake District is a narrow ridge on one of the approaches to Helvellyn (950m/3,117ft), it is a tricky traverse and over the years several people have fallen to their deaths.

One noted instance is that of Charles Gough who was killed there in 1805 made famous by the fidelity of his dog which guarded his body until the skeleton was found some months later. The romantic poets wrote that the dog was sustained by "love sublime"............................. are you thinking what I'm thinking?

AMBIGUITY WARNING!
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While I was away in the Lake District recently I came across this bottle of beer in a shop there and immediately thought of Dawn and what an apt gift to send on to her.
I wasn't sure whether to laugh or cry about the surreal 'spin' she put on the birthday card I'd sent to her. I figured God was saying 'laugh don't cry!' So today I posted this gift to her but I did take the precaution of adding a warning.......and a special offer which I hope she will take me up on. The labels I added read as follows;

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AMBIGUITY WARNING!


It should not be inferred from this beer bottle label that I have ever participated in or approved of animal cruelty. No conclusion should be drawn from the kilted figure that I am anti-Scottish or racist. or that I condone the Highland Clearances. The gender of the animal is not intended to imply misogyny or indeed prejudice against any other engendered or transgendered sheep. Just enjoy the beer.

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Pete.
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ps GENUINE OFFER!
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Sometime when you are next in London I can give you a tour of where I work and you can get to know a bit more about me.

WHAT KIND OF GOD WOULD ALLOW A THING LIKE THIS TO HAPPEN?

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post-script dated 31st August 2009 at 09:10 am.

Dear Dawn,

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When I included this cartoon in the homemade birthday card I sent to you I was expressing my impish sense of humour and I was not trying to make some wider point.

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I was not making out that human suffering is a suitable subject for mirth nor was I suggesting that in God's eyes all such suffering is seen as equally trivial.

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First off; John Callahan is an American cartoonist who is quadriplegic following a car accident. He cannot grasp anything with his fingers and so he draws by holding the pen between his hands. And 'yes' his humour can be dark, which I do indeed quite like.

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Secondly; the humour here is not aimed at human suffering but is found in the cartoon character's inappropriate sense of moral outrage at God over what the self-regarding cartoon character perceives to be a major existential crisis.

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I guess some things just aren't funny if you have to explain them!

God Bless,

Pete.

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PPS: 3rd September 2009. It has been pointed out to me that the Callahan cartoon suggests that all human suffering is somehow beneficial to the sufferer (it is fair to say that the cartoon character could probably afford to lose a few pounds!). But - in all honesty - it never crossed my mind that that was the main conclusion to draw from either Callahan, or by adoption, the birthday card I made. I do feel that to attribute such sentiments to me on this basis is surreal.

Gym Update.

Ran 2.63Km in 15 minutes on the treadmill. I'm trying to get reasonably fit for my Lake District walking trip in September.

Jubilee Line Blues.............

Last weekend (as usual) some part of the Jubilee underground line was suspended for engineering works which means that I had to take the bus to work instead. From Jamaica Road I caught the 381 to Waterloo and walked the rest of the way to St Thomas' Hospital.

On Sunday the bus journey was dominated by the banter of a small group of youths who permeated the atmosphere with vulgarity and menace.

I prefer the sullen silence of the tube journey!

Richard Dawkins' Summer Camp.

There is a superb cartoon from "Private Eye" about Richard Dawkins' Summer Camp aimed at teaching children the joys of atheism.

A camp leader is counselling one of the children, "I'm sorry Cuthbert but because you came last in the running race.... you must die!"

That 'One Small Step'...

Fot those of us on this side of the Atlantic Neil Armstrong's first step on the Moon came at about 3.30 in the morning of 21st July 1969. As an excited 11 year-old I came downstairs from bed to watch this event on TV.

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".