Chicken suya, an emetic aid

A review from the start

A review is subjectively a random stranger's opinion of an experience they've had. I never think of an experience as one where I've been selected to receive the good or the bad of a service. This is why I take reviews seriously: the experience of many averages out to net good, net bad, or neither good nor bad.

Having a desire for something spicy, I tried to access a website on my phone. I'd forgotten it wasn't mobile-friendly; you could select all you wanted, but you'd never be presented with the checkout button because it was obscured by other webpage elements.

Now, consider this: you have an account on the said website and, having logged in and made your order, you'd expect that order to be retained for a session on another device with the same credentials. Perish the thought.

It did not get better

I made my order, supplied my phone number, email address, and home address with a view to collecting it from the shop rather than opting for home delivery. Even after paying through the banking system they offered, I got no confirmation of my order sent to any of the personal details I'd shared. I had to take a screenshot as confirmation.

Then I called an Uber to take me to the shop, and for the second time, I arrived before my order was registered on their system. My screenshot and banking transaction confirm I have a bona fide order.

Only now, what I'd ordered had run out, and I was offered an unappealing alternative that, for the journey I'd made, I tolerated. Soon, I was given my takeaway, which was a lower price compared to what I'd wanted. A bit of back and forth ensued before he realised I was due some change.

I've never suffered worse

When I tucked into it as I walked back home, it was nothing like I'd expected. I would have enjoyed a Nando's takeaway for less, with two sides and a lot of tasty bits to eat. Chicken suya is no substitute for beef suya, even on the worst of days.

And Suya Republic, Chester Road, you missed a treat: the apparently XL portion was as parsimonious as a chicken on Ozempic, and having to quibble for change when you couldn't fulfil the order I'd originally paid for was unfortunate. I'll remember this long enough not to grace your stoep with my interest again.

My lesson learnt

Never pay upfront. Have enough time to wait for your order at the shop when you visit. The food is good enough; the service, however, is tolerable to abysmal.

Alright, I happened upon this place on one of my wanderings around Manchester. This was my fifth visit.

Making much of my Sundays

My church, a community

My church, the cathedral in my city, serves as a community where I find fellowship and friendship. While I have been a steward, I have not resumed that function since I went for treatment, my energy levels are much better now, not at the stage where I could be an effective steward.

The more public activity is when one does one of the readings, the last time I was scheduled to do the reading, in December, I had to give up my place as I was going to be away in Cape Town.

The first version of the rota published a few weeks ago had me scheduled to read the only reading for Palm Sunday, I carried that in my bosom until I reviewed the updated rota, a more prominent person had supplanted me.

At church with improvements

Whether I had my natural voice back or not, I was determined that I would attend whatever readings I was scheduled for with electronic amplification for my frail voice. Each service I attend shows some improvements, such as not needing to use the conveniences until after the service or being able to fully participate in the standing parts of the sung eucharist.

The more obvious one is that I can walk the distance from home to church and back, whereas before I travelled, I needed assistance because I lacked the strength to do so.

The other Sunday, I arrived as the processional hymn was being sung, it is quite unusual for me to arrive late to church so I sat in a different place close to the children’s corner. What I racket they made; it was impossible to concentrate. Then last week, the Racial Justice Sunday had York visiting, I sat in the same row as his wife and the dean’s spouse. As in the Archbishop of York.

How things are developing

The row behind us as a child and his parents, they chuntered through the whole service, my backward glances did nothing to moderate the disturbance. The same garrulous troupe was there today, I do not know what informed them to move towards the more adequate children’s section before the service commenced.

One of the hymns had quite a discordant tune. I could not follow it until the fourth verse, and it was still a struggle. I sing all alright, but I do lag in the recitations and singing, too. In the end, I plumped for the decaffeinated coffee. Since decaffeinated tea is rarely available, I had to get on a bus for a 30-minute ride to a big supermarket to replenish my stock of decaffeinated Earl Grey tea.

The last Village Church service I met in the middle of the homily, my nap ended a few minutes before the start, and just as I thought of taking a rain check, I got a message from a friend asking if I was attending. I dressed up and rushed out; it was just around the corner from my place.

The Lord’s Prayer in Yoruba, I wrote that out this morning with all the essential diacritical marks, it is what I recite when it comes to the time for prayer. I might be doing that on a recording of it for a week of the recitations of the Lord’s Prayer in other languages at a church event in May.

Church is a community I enjoy.

Àdúrà Olúwa

Baba wa tí ńbẹ ní ọ̀run,
Kí á bọ̀wọ̀ fún orúkọ rẹ,
Kí ìjọba ìrẹ dé,
Ìfẹ̀ẹ tìrẹ ni kí á ṣe ní aiyé,
Bí wọ́n ti ńṣe ní ọ̀run,
Fún wa l'óúnjẹ òjọ́ wa l'óòní,
Dárí ẹ̀ṣẹ̀ wa jì wá,
Bí a tí ń dárí ẹ̀ṣẹ̀ ji àwọn tí ó ṣẹ̀ wá,
Má fà wá sínú ìdánwò,
Ṣùgbón gbà wá lọ́wọ́ bìlísì,
Nítorí ìjọba ni tìrẹ, agbára ni tìrẹ, ògo ni tìrẹ,
Láí Láí,
Àmín.

Homeward bound from South Africa

The weight of travel

Packing your bags is not an easy task, especially if you have three pieces of luggage to evenly distribute the weight, a rucksack with kit and medication, and suit bag.

The suit bag contained a set of pyjamas that for my recent modes of travel have not felt that convenient to wear, a jacket and scarf for the abrupt change in the weather I will encounter, and a spare set of incontinence underwear. If I may reiterate an established notion, I am a traveller, not a backpacker.

Intercontinental incontinence

When you are on a plane and there is a queue for the unisex toilets, besides rocking from foot to foot, you just want to be careful no spillage occurs before you gain access to the facilities.

On both my outbound and return journeys, it has not been that bad, and I have not had to wave my "Just Can't Wait" card. The moment I feel an urge, I do not second guess it, I make my way to the toilets.

I had scheduled my Uber pick up the night before, my assigned driver cancelled, the alternative was stationary just over a mile away for 20 minutes, and not responding to my communications, that by the time Uber suggested he was late, I was assigned a third driver who then arrived within 5 minutes of the scheduled time.

The ride to the airport was easy and fast, early morning bookings before the break of dawn can be a bargain too. He helped load and unload my luggage and I took tentative steps to the check-in counter close to the entrance.

Half a day air bound

Though I have lost my Platinum and Gold loyalty status, you still get some priority service on Silver Flying Blue status. My luggage was checked through to Manchester, and I was conveyed from the customer assistance lounge, taken through security checks and passport control to the boarding gate, then wheeled to the door of the flight where I was the second passenger to board.

Seating was comfortable enough, a slight seat recline, a lounge support for my legs, and a footrest, along with a blanket and a pillow. That was the beginning of the first leg of my journey of just 11h13, I guess I have done that a few times already.

A 3-hour stopover in Amsterdam before I board another flight to Manchester had me ensconced in the customer assistance lounge on comfortable seats. They should consider serving beverages rather than have people lumber off to the shops. A nearby toilet would be helpful too.

A chat with my support person

Then I was brought to boarding desk as one of the first to board. Arriving in Manchester, I stayed on the flight until everyone was almost off, my customer support wheelchair was up a flight of stairs and then I was conveyed to passport control and then to baggage reclaim.

The support assistant was from Somalia and after informing him of why I had travelled to South Africa, I explained why as a Black man he had to be conversant with his prostate health. His uncle recently had radiotherapy for throat cancer at the Christie Hospital and he had chaperoned his uncle a few times.

Between snatches of reality and humour, he got the message and point-blank refused a tip, he felt he had gained so much from our conversation and that was enough. I called an Uber for home and ended up in a luxury car, the driver from Africa had lived in Italy for two decades before coming to the UK.

You will always be understood

He was concerned about his lack of fluency in English that he felt was a handicap. My view was as long as he could put words together, he would be understood. He should always speak his mind and besides, many of those who would typically abuse him are not as successful as him driving an E-class Mercedes Benz, he should in fact celebrate his achievements.

Obviously, on some occasions, he simply got his son into the conversation with establishments or the authorities. Every likelihood was he would get whatever he intended done.

As I arrived at home, he helped unload my luggage and brought them into the foyer, all the help I received from door-to-door of about 18 hours was the preparation for rest after such a lengthy journey. I unlocked my door, my house sitter had outdone himself this time, somewhere between it having been hit by a super hurricane and a full ransack of the house, I was soon pushing a vacuum cleaner and brushing the floors. I found the energy; it was the very last straw.

Manchester Pride 2024 - Between disinterest and stewarding

For a parade and a charade

The August Bank Holiday weekend in Manchester is for the Manchester Pride and one those of us who live on the borders of the Gay Village sometimes dread out of inconvenience and frustration. It is a time of endless cacophony that begins from Thursday night through to Monday evening with possibly a vigil in remembrance of those we lost to the AIDS plague.

For those who come the attend the events and many from out of town and even from abroad, it presents the prospect of wanton debauchery and the prescient profiteering of all the hospitality and services establishments that find the footfall irresistible to exploitation, even as punters and patrons submit themselves too willingly to the abuse of their respect and their wallets.

The Pride Parade on the Saturday afternoon is something to look forward to, though I could be inspired to residents’ rage just for the loudspeakers that get put close to my window or on the main street, not so much for the event, but for the testing of equipment that starts early in the morning when we are trying to lie-in and continues almost every quarter of an hour as if suddenly the equipment had given up. Let’s not think of if I were an American with a gun.

Diversity, not as we think it

This time they plonked down a mobile 120-seat grandstand on our street which I found out to be the judges view to rate the floats that passed by towards the end of the parade. I had a guest who had just moved to Manchester and a friend had asked me to chaperone him. Not much to be done, I would have stepped out of my apartment block with a folding chair and some bottles of water. I provided rainproof clothes and umbrellas too, when it rained.

However, I do wonder if the judges as my guest did see the diversity we observed was not as diverse as our community would suggest apart from accounting for the diversity in faces of the same identity group, like say, race? Not to talk of the fact that one float dressed up a black man in full uniform to drive their Bentley. Then the Gay Gordons in full Scottish attire had one of their contingent playing the bagpipes who was noticeably of African descent.

In the probably 250 that participated in the parade, there could not have been 10 that were representative of ethnic minorities, and this is where Manchester still fails to embrace the broader expanse of identity within this diverse community.

It was not helped by one such group removing themselves from the parade because of concerns about sponsorship in relation to the Israel – Gaza conflict. They were invisible when they should have erred on the pragmatic side of things, because there were Palestinian groups represented on the parade.

Just let me through

I was surprised that I stayed to watch the whole parade that lasted over 3 hours, and it was time to retire and that was for a good long nap. The only other times I ventured through the Gay Village that was gated off for the festivities was for church on Sunday and then the Pride Eucharist in the evening.

At least now, apart from security checks of bags, right-of-way is no longer questioned as it was even refused to people who just wanted to pass through about a decade ago.

Besides, I had on principle decided for years now, that I will not pay the extortionate prices for attending any of the Pride events even as those who find themselves shortchanged denied access to venues quickly at capacity to watch their favourite bands.

My plate did overflow

As a church steward at the Manchester Cathedral, I had offered to be on the rota for duties at the Pride Eucharist which was organised by the leadership of the Village Church that meets on the 2^nd and 4^th Sundays of the month at the LGBT Foundation offices on Sackville Street. [Manchester Cathedral: Pride Eucharist pamphlet (PDF)]

Cover of the Pride Eucharist pamphlet.

The typical activities would have been handing service pamphlets to people who had come to fellowship, doing the collection during the offertory hymn, and ushering the congregation towards the altar for Communion.

Then one of the wardens asked me to take the plate of offerings to the altar for blessing and I had hardly said yes to that when the convenor of Village Church came to ask if I would participate in the intercessory prayer part of the service. She already had my name on the prayer sheet before coming to chat to me. I obliged willingly at the honour.

My part included a 30-second pause for silent prayer, my clock ticked a bit faster than it should in my head, I counted to 10 twice, losing my ways somewhere in the simplicity of the aura of scrutiny as I continued to the end of my contribution.

It’s a wrap until next year

After the service, we remained for tea, coffee, biscuits, and cake, before a young man on army leave who had asked to speak with me earlier requested if he could play the grand piano.

He had such talent but was expecting of rebuke or derision when we so readily praised him. Sadly, some people are subjected to so much criticism that even what they are so good at, they are too unsure of demonstrating.

I guess all that became the highlight of my own Manchester Pride, disinterested, uninvolved, and almost curmudgeonly, except where it mattered more in cheering the parades and serving at the Pride Eucharist, until next year when again, we suffer, or we leave town.

In gratitude

Much appreciation

It has been an interesting year for me, and whilst I did not find myself doing much of what I would have wanted to do, I have done other things I would have rarely found myself doing and been enriched by it all.

By participating in activities and volunteering, I have in many ways inadvertently met influential people and been involved in consequential decision-making forums that I would never have attended, but I found a voice and an expression that would normally not be heard.

Above all, it is how I have been sustained through some of the toughest times, the support of my partner, my best friend, my sister, old partners, my neighbours, my parents, support groups, my community, and many others who have fervently kept me in their prayers and supplications, with encouragement, entreaty, and even unwelcome and probably justifiable rebuke that has caused offense.

For service

We entertain much in how we exist, but we need to be careful about what we allow to define us. Faith and hope have set a course for the realisation of many desires, they are the complementary force of what will result in better and more uplifting stories. In many disappointments in the resolution and resolve goodness, mercies, and blessings cannot miss us.

It was only on Monday that I thought I should arrive at Manchester Cathedral early, just in case there was any help needed since I am a church steward. They had everything in hand, and I took my seat before additional rows were added to the reserved seats. I was not asked to move to another seat.

Interesting encounters

Just before the event started, a gentleman with a lady arrived, the usual small talk about the weather after pleasantries followed and a few quips on things English and so on. They had travelled in from Sale, and he needed some help getting up for the carol songs.

After the interval, he said there were so many people to meet, he had to chat to the High Sheriff of Greater Manchester and a few Deputy Lieutenants as he was one too. I suppose, if I had been more observant, a man in a pin-striped suit, his wallet so thick it needed rubber bands to hold together, a few acknowledgements from here and there, this was a community stalwart, known for his contributions and charitable activities.

At 85, I would pass for a son, his companion just 75 years old, both of whom in the inclement weather of the northwest in December needn’t have bothered but still with enthusiasm and a sense of fun made an appearance that should be appreciated. As the carol concert ended, we shook hands, and he gave his name. A very accomplished man indeed.

In all, I am very grateful, it is the last day of 57 and it is unimaginable how I could have thrived without the amazing support of Brian. You bring light and love, with joy and laughter. Thank you.

Stewarding at the Pride Eucharist

The Rainbow flag flying on the flagstaff of the Manchester Cathedral.

In the beauty of service

I am humbled by how the call to serve has brought me into proximity and recognition of the powerful. It is a distinctive antithesis of human nature where many have a quest for power rather than the desire to serve.

Whilst one cannot say this is something I would have gravitated to in the natural cause of things, I do remember that when I eventually found a church to associate with in Amsterdam, I found that getting involved in the basics of helping to set up and dismantle the settings for services and worship was something to do because it was needful.

In the process, I got involved during the infancy of the church in finding a new venue, providing storage space, hosting but not leading a prayer group, and was in the ushers and serving team. I however declined positions of leadership that were offered as I was in much conflict about what that entailed.

To welcome and to steward

As a welcomer and a steward at the Manchester Cathedral, positions I assumed after the long courting and persuasion of others who deemed my attendance as one that suggested enough affinity and the readiness to be involved, even more so when the dean through his wife expressed that I had to be involved because there is no reason not to be, I relented.

At the Annual General Meeting of the cathedral, I was voted on as a steward and soon after in my activities with the Volition programme became a welcomer of visitors to the cathedral.

However, yesterday, in attending the Eucharist for Pride which enjoins to bring the LGBTQI+ community into communion and worship, I arrived early to help, just in case extra hands were needed. At the Dean’s Garden Party two Saturdays ago, he, the dean said there was no way the cathedral could function without the volunteers that help in services and other activities that need doing in the cathedral organisation.

Between right and respect

I soon took over at the door to welcome and hand out the service programme to people who had come to attend the Pride Eucharist and it was notable for the fact that the Bishop of Manchester was also in attendance to welcome, bless, charge, and dismiss the congregation. The clergy that ministered at the altar were all ordained by the bishop too. [The Manchester Pride takes place in the August Bank Holiday weekend from Thursday night through Monday night.]

I had interesting encounters at the door, the cathedral is open to all visitors, and I have probably met visitors from more than 35 countries. However, when there are services in the nave, the church is closed to visitors with a big sign posted at the door informing anyone not attending the ongoing service that the cathedral is closed.

Yet, there are some that ignore the sign and come through the doors insisting they need to visit almost as if it is a matter of right. The difficult conversation that ensues between understanding that the house of God is open and the need to respect that the act of congregational worship should courteously and understandably not be disturbed is almost a battle of wits, reasonableness, and enforcement.

Stand for the open heart

To one lady who was ready to barge in, I told her, there was an ongoing service and except if she was here to attend the Pride Eucharist, the church was now closed to visitors, but she was not going quietly. With a look of incredulity on her face she asked why the church was catering to gay folk, to which I answered that Jesus died for all and the church is an open place of worship for everyone. Much as everyone needs prayer.

She understood as much before we moved on to issues of symbolism and doctrine, by which time, I had to move her from the inside of the church into the corridor of the doorway, with the hope that she would leave peacefully. Yes, we are a Protestant church, the Church of England, The depictions of Jesus or Mary are not venerated in answering other questions before she insisted her sister-in-law was attending the service and she needed to get to her.

Pointing in a direction I could hardly determine, two of a group that was initially hesitant to attend walked towards the door from the furthest part of the seating and they all left the cathedral.

The door of conflict and consent

It soon dawned upon me the precariousness of manning the door, as earlier, someone had left their rucksack at the doorway, which caused a bit of tension that it was inspected by the staff after an announcement did not elicit a response about ownership. Eventually, he returned to claim his bag, but it could have been something else.

Another could barely contain the sense of rage about the church involved in this service, and we have at times had someone come in to disrupt an ongoing service protesting that the gathering was not a reflection of true Christianity, as if disrupting other people’s devotion is Christian in any sense at all.

It was revealed when the Bishop of Manchester in his welcoming remarks stated that one of the requirements that came up in his application for the role was that he needed to be accepted by the LGBTQI+ community of Manchester. I was surprised but what makes for harmony is the welcoming of diversity to the love of Christ and therein the gospel is heard by all rather than limited to a few.

The Pride Eucharist was attended by about 150 people, it was a celebration of Christianity, and many stayed behind for refreshments. Later, the bishop thanked us for serving and stewarding, which included taking the offering and ushering to the communion. A welcoming church allows Jesus Christ and the Holy Spirit to do their work rather than become gatekeepers and sentries to the grace and gift of the gospel of Jesus Christ.

The cover of the Pride Eucharist programme.

Celebrating 75 Years of the NHS

A steward at the table

I was being wooed and propositioned in an unrelenting recruitment drive to become a church steward for over a year. It was last weekend that I had a baptism of fire as it were. It was a weekend of ordinations of priests and deacons known as the Petertide in the Anglican Church calendar.

With a church brimming with high clergy, the ordinands, well-wishers, and visitors, I was to collect the offertory from a section of the seating in the church and then direct congregants to a communion station away from the altar. It was managed even if a bit chaotic.

Though these assignments were out of rota, I had volunteered as more hands were needed than what was required for regular church services. Today, I presented myself to steward the service of Thanksgiving for 75 Years of the NHS.

The programme pamphlet for the service celebrating 75 Years of the NHS.

Attending to attendees

As there was no offertory or communion, this was a civic service, and it became apparent that we needed fewer stewards. There were a few things to do, including putting inserts in the programme pamphlet that required attendees to write a reflection about the role of the NHS.

After that, I stood with fellow stewards at the door to hand out the pamphlet to arrivals for the service informing them of the insert for their reflections. It was not a crowded gathering, and it did seem we had a fair share of NHS chaplains attending, we all might have felt out of place and of sorts without a dog collar.

The service began

Just before the start of the service, Andy Burnham, the Mayor of Greater Manchester arrived, I handed him the programme and informed him of the insert, he was smiling, engaging, and appreciative before the Canon Pastor led him to his seat and the service began.

There was one other act to steward, the collection of the inserts after people had scribbled down their reflections, I stood at the end of one row waiting as one congregant wrote on both sides of the card, as if a whole thesis of thoughts needed an urgent revealing.

My reflections

I had written my own reflection early because of the duty I was assigned to the effect: “I was born on a Tuesday morning unexpectedly at 26.5 weeks, the NHS facilitated my transfer for incubation in a major city. I was the size of a hamster in the hand of my father.

At 57, I stand taller, much taller than my parents. I owe my existence then and daily now to the amazing NHS, the people whose humanity makes a difference to many lives.”

My reflections on the NHS.

Andy Burnham who was the last Labour government Secretary of Health gave an address before representatives of faiths rose to give a talk, there was a homily, a hymn and then the sending out by the Canon Pastor.

As the event was quite passive, I began to wilt, when I got home, I was ready for bed and there ensued a long afternoon nap.

Essential Snobbery 101: An Eton mess of people without virtue

A failed assessment

Privilege, entitlement, and omniscience are the qualities or virtues that former Eton master, John Claughton, regretted he had failed to manage or curtail in his wards who have now become leaders in many spheres of life, especially politics. [The Independent: Boris Johnson and ‘entitled’ Tory Etonians have damaged Britain, admits former Eton master: ‘I failed’]

In my view, I think the master is still reading the script wrong, as privilege might come by circumstance beyond our control, and what really matters is to recognise one’s privilege and then use it to the benefit of others.

Entitlement is an interesting issue that could be borne of an environment of privilege. To have entitlement is not entirely wrong, but where it is exercised should be in the support of fairness, justice, and what is right. Though entitlement is usually a vent of the supercilious, it could normally be seen in a negative rather than a positive light.

Omniscience, however, is definitely to be tamed and trammelled by every means possible; the thought that you are unassailable and infallible, incapable of error, all-knowing, and the master of the universe with a God-like complex is dangerous, whatever the degree. It should never have been fostered or helped to develop to the extent that such people should have power or influence over others.

Of a man of no character

In that crop of the poshly-educated at Eton College, come many former Prime Ministers of the United Kingdom, and the one that excites the greatest notoriety today is Boris Johnson, who exited the House of Commons last Friday, pre-empting the sanction of the Privileges Committee that would have recommended a 90-day suspension for misleading Parliament.

Boris Johnson would suggest he is a man hard done by, but like many would say, despite his popularity, Boris does things only for the sake of Boris and nothing more. Boris Johnson’s storied career shows that he has no acquaintance with the truth or any semblance of it. He is both a compulsive and a pathological liar who believes so assuredly that he is a man of trust and candour.

Granted chance after chance

Delusional is what would be attempted because, for all the jobs that he has risen to through various applications of meritocracy and charm, he has several times been relieved of his positions because of a lack of character, candour, values, and virtue.

That sense of omniscience seems to have equipped him with daring impunity for which his privilege appears to confer immunity from sanction or accountability. It is one exclusionary act of nature that, rather than be schooled by the infractions and punishments of the lower cadres, it is at the pinnacle of powers, prestige, and popularity that a man has been held to full account for his dishonesty and missteps.

Duty and service tames us

Before we get to the lesson to be learnt of men who throw caution to the wind, daring the whirlwind to a whistling contest, anyone can attend Eton with privilege, entitlement, and omniscience. What Eton College has patently failed to do for more than a generation is imbue its wards with a sense of responsibility, duty, and service to their fellow man. A willingness to face up to their failings and be held accountable where necessary, without questioning the fairness and justice of due process.

The lesson, it is always necessary for such flawed men to be met with a catastrophe of their own making; each downfall Boris Johnson has had has been by the hapless engineering of his own hand. His pomposity denies him the introspection necessary for self-awareness and self-correction. What leaves one more baffled is the fact that to some, he can do no wrong, no matter how wrong he is.

Opinion: Getting good medical outcomes is a fight to be heard - II

Up against the system

When I wrote last week that my NHS rating is a 6 on a scale of 0 – 10, a series of conversations with users of the service and most especially, my personal experience highlighted issues I have overlooked rather than pursued.

Blog - Opinion: Getting good medical outcomes is a fight to be heard - I

There are organisational inefficiencies that consequently impact the patient at the point of contact and the bureaucracy demands those who people the establishment that they need more time to address issues and where they do, they should be more attentive.

In some cases, those who choose to address ineffective processes that result in poor outcomes are deemed, termed, and labelled difficult and troublesome. The person's suffering is forgotten as the Hippocratic oath of service becomes a perfunctory recitation without heart or mind involved. The patient is a customer on a fast-moving conveyor belt to the exit than to wellness.

Organisational failings that fail us

In my other blog, I talked of when I had to relay my medical record to a doctor because my file was not available to check my notes for the consultation. It would appear, every patient that visited on that day, if they were not as clued in and read up on their condition would have received attention below par.

I have high praise for the department that has taken on my case for almost 8 years, but they are not perfect and not all the consultants I have met give due heed to the wider issues of who the person they are seeing is and I can understand their limitations. However, one has to question how with that knowledge of who was attending for the day the essential documentation was not provided to the consultants for review and understanding as they met their patients.

It might have been a one-off situation, but I have the feeling there is a rot that pervades the system that is seething and creeping almost unaware to those with the responsibility to ensure things work better for the desired outcomes of their patients.

Seeing but not perceiving

Then, it was the lassitude that greeted my need for treatment of a co-morbidity condition that they knew of for more than two years, but never sought to address until I challenged the thinking in the department. You could almost feel they were more ready to express sympathy after your demise in the knowledge you were one less problem to deal with than face the complexity of the person-problem conundrum.

When they advocated for the change of my drug regime for a new medication, the consultant inelegantly let slip that the decision was being made on a cost basis as my medication was still under patent protection. This was reinforced with a contrived neurological test as I did mention absences in thought that could be side effects on my memory, much of which I had compensated for as I noticed changes in how I remember things, especially in the short-term memory space.

The struggle of outlay over outcome

The new medication was a hellish 7-week experience that they were keen to fix me to after the second week which I thought was too short a period to understand its effects. I dare say, one of the side effects that was on a label you could tear off from the packaging included sudden death. Each day, I recorded every funny symptom from tingling in my extremities, to insomnia and nausea – those were the prominent ones.

I walked into the department with 42 pages of side effects recorded for each of the 42 days and demanded I be put back on my old medication that I had tolerated well for over 8 years. The year after this sordid experiment, there were generics of my medication available, and I have been on those since then.

Obviously, there is a cost to medical provision, and I cannot ignore the towering cost of the 12-week medication for treating the co-morbidity 7 years ago with new drugs for which I am grateful, but it is never comfortable to be in the hearing of cost rather comfort and outlay rather than outcomes.

Being there but not with me

It was my last consultation that inspired these blogs as my doctor’s notes created on the day of my visit or thereabouts get sent to both my GP and me. Now, after that consultation, I was given a survey to fill in about attending the consultation that day. After receiving the note, I would like to review my earlier commending comments.

This is for the simple reason that I discussed a number of issues with the consultant that should have superseded the talk we had 6 months ago. On review, there is little of what we discussed in the new note, I can also put it down to either the consultant being distracted or inattentive. That conclusion is easy to arrive at as when he said he had refilled my prescription, it was one of two medications that he prescribed, and I had to return the next day for the other medication.

The notes can be consequential

Doctor’s notes might hold no particular significance as a simple administrative process, but when one is engaging with the system and some decisions are predicated on what the doctor’s perspective is of you and your situation, there can be no room for error or variance between how you describe yourself and your doctor's observations. I can only wonder what it would take to rectify this without creating a crisis of confidence and trust within that team of medical personnel.

Indeed, I do make demands on the NHS for better outcomes which have much room for improvement, but there are only so many things you can overlook before you realise something radical is needed to ensure you do not become a mere conveyor belt statistic.

It is a fight to be heard and listened to, beyond which you hope that they would respond and act on the situation, with your interests to heart and in your favour.

Opinion: Getting good medical outcomes is a fight to be heard - I

Not operating at full potential

On a scale of 0 – 10, I would probably put the quality of the service I get by default from the National Health Service (NHS) at a 6. If I want better outcomes, I need to challenge the system and the process to do much more.

Comparing my experience with those of others who interact with me about their issues and challenges, I seem to be getting a much better deal than them in the responsiveness of the institutions and establishments and more particularly from the personnel that man the points of access I utilise.

General practice without practicals

I do have a GP, but I never met her even though I have been registered at the surgery for close to 8 years, the only times I visit are usually to get the annual flu jabs if I need anything else; it is impossible to get through on the phone and when you use their website, my most recent application took 10 days to get a response and that was to ask me to pay for a possible referral from the GP who was to call me in another 3 weeks.

Ah! The GP in whose docket I was, retired from the practice 18 months ago, and it was when the surgery contacted in the response that I found out who my new assigned GP was. My main engagement with the NHS is actually elsewhere, my GP just gets informed of and updated on the observations and recommendations.

It is my body first

As I have had to fight for better personal outcomes in pain management, suggested treatments, and delayed intervention both in the Netherlands and the UK, the lessons I have learned personally and from others reviewing issues with healthcare delivery can be useful to others.

One key point I always make is, “It is my body first, before it is your guinea pig.” That was what I told a team of consultants and an insistent neurologist when after months of chemotherapy they wanted to perform a lumbar puncture, which I was not keen on. They relented.

At another time, the pain medication was insufficient, and I had to disabuse the notion that black people have a higher pain threshold and can endure much more suffering that the medical establishment defaults to think we are becoming junkies rather than people who need simple relief. Yes, after the consultant expressed some bafflement, he did increase the dosage of my Fentanyl patch and the pain considerably subsided. I was grateful for it. It is documented research that there is racial bias in pain management for black people. [NIH: Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites]

Be forthright without fear

I lived with a diagnosed condition for more than 3 years that presented a co-morbidity, and each time I went for my biannual check-ups, it was noted but not dealt with. Everything with done around the periphery of it but not the essential action required. At one such consultation, I said to the consultant, I am very aware of my morbidity that you have observed and done nothing about for years, what do you intend to do about it as you all know it is getting worse.

I guess he was shocked by my forthrightness that within a month I was put on the latest medication and the condition was eradicated in less than 12 weeks. I have found I need to ask questions, seek satisfying answers, and deliberately go over a review of my test results to observe trends and mitigations to attain outcomes.

You cannot use the NHS from a stance of passive participation, you need to understand your condition fully, be knowledgeable and clued in on your medical notes as well as the medical personnel. There was one visit where my file was not available, when I finished, the doctor commended me for giving a detailed situation as good as a medical file. You need to read up and understand everything along with studying developments concerning your medical profile.

This might well help you

Anyone who needs access to the healthcare establishment, they should listen to the Reith Lectures delivered by Dr Atul Gawande on The Future of Medicine that covers topics like, Why Do Doctors Fail? and The Problem of Hubris, amongst others. I believe there are many tips and ideas you can gain about attaining the best outcomes in your engagements. [BBC: The Reith Lectures: Dr Atul Gawande - The Future of Medicine]

I started this blog to write about why I have not received some of the outcomes in service, attentiveness, or understanding of my requirements. Whilst some of that is covered in this blog, I feel I need to review how to write the second part of this topic.

Elizabeth II, The Queen

Change has come today

Many tributes shall be written about the woman born Elizabeth Alexandra Mary who became Queen Elizabeth II, Queen of the United Kingdom of Great Britain and Northern Ireland, and the other Commonwealth realms.

In a reign that spanned 7 decades and 7 months, many of us have known no other monarch, our anthem asked God to save the Queen, our coinage and postage stamps a side relief of her face through the times of her reign, our pound notes with her face beaming up at us, she represented constancy and stability that seemed would never end.

Records for the record

Her sense of duty continued to the very end even in her ever-increasing frailty, she did not flinch as other monarchs in continental Europe abdicated for their heirs in Spain, the Netherlands, and in Belgium. She represented an old-fashioned call to service and handling of responsibility that is rarely seen in leadership today.

It is with sadness that we mourn the passing of the longest-lived and longest reigning British monarch amongst other superlative records to list, the defining of the Second Elizabethan Age might well rival in consequence the First Elizabethan Age for how England changed and became a world power.

She becomes he

Maybe, there are times she should have intervened, but let history judge that, she lived above the fray of politics, asked 15 Prime Ministers to form a government and in her longevity gave perspective to the many who took office that their time was just a fraction in the consequential length of her reign.

Her death might well unite this divided nation in grief, but the machinations of her sometimes-calumnious governments has left the country in no greater shape than when she ascended the throne with the future looking quite bleak for citizenry and subjects, but things will turn, I believe.

As we usher in the reign of Charles III, we hope that it brings a new sense of hope and encouragement. The Queen has joined her ancestors and may she find eternal rest with the memory of her walk in life never fading.

Long Live the King. In an age where pronouns matter, she becomes he, her becomes his, and her becomes him, and the House of Windsor endures. May the reign of King Charles III and his Queen Consort, Camilla usher new prosperity in our nation. God Save the King.

The Platinum Jubilee in perspective

A platinum jubilee to all

The Queen, Elizabeth II represents an epoch-making example of duty, service, responsibility, and fortitude as we celebrate with her the platinum jubilee of her assession to the throne. Usually, we celebrate 70 years of age, maybe even 70 years of marriage to some, but 70 years in office is a uniquely different thing that it might never be experienced in many lifetimes and generations to come.

When His Royal Highness, The Prince Philip, The Duke of Edinburgh, the Queen’s consort passed on at 99 last April, one could only celebrate his public service and more particularly, his steadfast support of his wife for 73 years. They were only in their fourth year of marriage when she took on the role of monarch, at which point their devotion to each other was supplanted to their devotion to duty.

Blog: In the life of HRH, The Duke of Edinburgh

Longevity in our humanity

At 96, The Queen exudes the frailties of our humanity that comes with old age, much as she has promised to serve, she has had to hand over many tasks and duties to members of the royal family to represent her. This morning, she could not attend the national service in commemoration of her reign at St. Paul’s Cathedral, she was represented instead by the heir apparent, Charles, Prince of Wales accompanied by his spouse, Camilla, Duchess of Cornwall.

I appreciate monarchism especially in the United Kingdom as it gives us a kind of leadership that is essentially above the political fray, she has appointed 14 Prime Ministers during her reign, and whilst there could have been cases for republicanism that gives the leadership of a nation to popularly elected person, the kind of person that gets elected might not imbue the standards and qualities of leadership necessary for the role.

The less said of the current Prime Minister on principles, integrity, service, or responsibility, the better for all, and probably that alone represents why we need a monarchy. My only concern is that the monarchy is appearing to be political neutral might well be politically negligent, for I still suggest that when the Her Majesty’s Government was found to have acted unlawfully and by inference had lied to the Queen on the matter of the prorogation of the Parliament in 2019, the government that could not be trusted to act with candour and honesty should have been asked to resign.

The Second Elizabethan Age

That might well be the only blemish on this amazingly distinguished and extraordinary reign of Elizabeth II. I have no arrangements to join in any revelry, there would probably be a service at the cathedral to celebrate and pray for the Queen. Even as we sing ‘long to reign over us’ as part of our national anthem, we know we are coming to the end of an era.

History would characterise this as the Second Elizabethan age that represented the second half of the twentieth century and probably the first quarter of the twenty-first century. That we are so different from the royal houses of mainland Europe is instructive as abdications are typically the norm there as has happened in, The Netherlands and Belgium in 2013, and Spain in 2014. The year of three kings of 1936 (this was the fourth occurrence of 3 kings in a year, the last being in 1553 [Wikipedia]) remains a recently sad and forgettable history for our monarchy, the pall of which hangs over this monarch as a childhood witness of that change.

I can only wish the Queen more strength, good health and the soundness of mind that allows her to continue in her role for as long as she can. My hearty congratulations to her and God save the Queen.

The utter misery of UK train travel

Choo-choo to all places

I used to consider train travel great fun, the pleasure of watching the English countryside from Brighton to Manchester over a 6-hour journey, even Manchester to Edinburgh, London to Glasgow, or Manchester to Torquay gave you a view of this amazing land. Yet, there are even more spectacular views by train on the British Isles.

In July 1999, I embarked on a train journey named the Imperial Tour from London Liverpool Street to Budapest and back. I was to complete the journey in 2 months stopping over wherever I wanted for as long as I needed to, it was first class for £483 and I plied my route through Amsterdam, Hannover, Berlin, Dresden, Bratislava, Prague to Budapest, my return leg through Vienna, Salzburg, Zurich, Basel, Brussels, and London. I would say, the Bratislava – Budapest leg and the Vienna – Zurich leg gave me the most spectacular views.

Ten years later at Easter, I was meeting up with my best friend in Geneva and I took the train from Amsterdam, the view from the window through places that you would neither see from the air nor from the road just gives you a different appreciation of the beauty, the culture, the nature, and the architecture of different places. That I vicariously watch train journey programmes to far-flung places is one of fascination and curiosity.

A travesty and atrocity

Yet, train travel in the UK has been anything but pleasurable, if the service is not sclerotic and substandard, it is the exorbitant cost of travel that puts you totally off, except that there are no good alternatives. Living in Manchester, for years, I enjoyed the Virgin Trains West Coast Main Line franchise, it was generally affordable, and the service was dependable, they ran the service from 1997 to December 2019.

Now that the franchise has fallen into the hands of Avanti West Coast, it has been misery piled on misery, what was once affordable is now outrageously expensive that you’ll guffaw at some eye-watering prices to travel on trains gilded with incompetence and lethargy. If you forked out over £300 for a Manchester – London Euston train journey and I never paid that much for a peak time return journey with Virgin Trains in first-class, beware because the train manager can unilaterally declassify the train and you are a mug even if you can claim compensation.

No words can describe

On my return from London on Sunday, it was prescient to consider an earlier journey back, though, on arrival at London Euston, I should have been presented with a timetable of trains departing every 20 minutes, but there wasn’t one for an hour and the one after it was already cancelled.

I boarded the train and took one of the Premium Economy seats, thinking I would be charged the extortionate £25 upgrade, but something said, the train would probably be a coal wagon, heaped high and trundled up the train line at speeds that would make walking seem a sprint.

Well, I was right, apparently the two scheduled trains before the one I boarded and the one after it was cancelled leaving the train carrying potentially all the passengers for 4 trains going a route that took 3h41 as opposed to the typical route we enjoyed with Virgin Trains that lasted just 2h10. Everyone having paid handsomely for this travesty of impunity, for this is not the first time that Avanti West Coast has merged trains.

It gets worse

All the aisles had standing passengers that the train manager had to implore some to get off and wait for another train that no one could with any certainty say would run. I endured, with my mask on to the end, only to find passengers in Manchester rushing to get on, why? A train had been cancelled and this was running late.

How Avanti West Coast got this franchise, I cannot tell, but the experience has been anything but pleasant or remotely good, it has been so deplorable that the only salvation would be to return to horse-drawn carriages. At least you can feed the horse carrots and hear it neigh all the way. They say it would be over 2026 come then, or come Lord Jesus.