Saving money the NHS way

I’ve been on the anti-cholesterol pills for yonks now, though it was only last summer that a combination finally brought the levels to where they ought to be. Not unconnected is that the goalposts change every year or so, getting ever narrower, so that it’s now much harder to actually score. And it doesn’t help that I’m allergic to the most potent statin.

Nonetheless, the combination of a statin and some other stuff whose name I can’t either pronounce or spell seems to have done the trick. So a couple of weeks ago, I rang the surgery for a repeat prescription, only to be told that the stuff with the name I can’t pronounce wasn’t going to be prescribed to me any more. It seems that the Stasi HQ has decreed that it ain’t cost effective, or possible even effective. And, as for the others, I could only have two months supply instead of three, and next time I wanted a repeat, I would only get one month’s supply.

This didn’t seem to make a lot of sense, but then having worked in the NHS for decades, I was quite at home with things not making sense.

So, I spoke to the top anti-cholesterol doctor; he said that there was no other combination that would be effective for me, and quoted the results from a study to me. Not that I would have understood much of it, but it was ammo for the meeting with the GP.

I understand the problems with primary prevention — taking pills to treat a problem when there have been no complications of the problem, such as heart attack or stroke. I haven’t had any of these, though blog readers might think otherwise.

There wasn’t any problem convincing the GP to return me to the drug with the unpronounceable name, nor any problem with having three months worths supply — and if the tests are still OK, I can have a year’s supply (as 4 x 3 months scripts).

But, he couldn’t arrange the blood tests for a month or so from today; the computer won’t allow this, yet the pills take several weeks to stabilise the cholesterol. So, I’ll have to ring up in a few weeks, and fight with the receptionist.

And, he told me, that Stasi HQ had decreed that some other pills were not to be prescribed generically; a supplier had been found whose pills were 10p cheaper, and patients were to be transferred to this.

Which might seem fine, except that the GP was rung up soon afterwards by a pharmacist who said that the supplier of these wonder cheapo pills had gone bust, and the pills couldn’t be given out. Back to square one.

How much money have we saved the NHS today?

PC or Mac?

Umberto Eco compared a Mac to being Catholic and a PC to being Protestant years ago. Briefly, being Catholic meant that it was all done for you, at least on Earth, you just had to follow the rules; whereas a Protestant was a free-thinker, and had to work it out for himself.

An ingenious argument, and one with more than the proverbial in it. Anyone who struggled with DOS, or even Windows 3.11 knows just how difficult it could be to get things working properly, and how often we had to refer to a thick manual (usually called a handbook) to work out what to do, or how to work around the problem.

A small confession: the first computer I used was an Acorn, twenty years or so ago. It had a simple, graphical interface, and a three button mouse. Yes, three buttons; the middle one was for ‘menu’. Acorns had a stable operating system, but used proprietary hardware and software which was more expensive than DOS stuff. I had to get a Windows laptop to be able to use email and chat with the Open University around 1996 — the Acorn didn’t support their software, or if they did, it was only through some sort of ‘emulation’. I then used PCs exclusively, and once I got onto Windows XP most of the problems were sorted. I have found Windows 7 and the latest versions of Word to be regressive; they may look simple, but in use I find them over-complicated.

They used to say that your choice of computer depended on what software you wanted to use. We wanted software for the kids, and the Acorn was by far the best choice at the time. Things change, and now the kids are divided between PCs and Macs.

A little while ago I thought I should try to be more serious about writing. I’d dabbled a bit over the years, but never produced anything very worthwhile. I did get a few scientific papers published, but I don’t count this as writing. A little research showed that Scrivener was the most favoured writing program. Or, perhaps, the most favoured drafting program — you still need something like Word or Nisus or Pages for the final editing tweaks. But, when I was looking, it was only available for the Mac. (It’s on Beta for PC now, though in the earlier generation.)

So I ended up buying a MacBookPro, the fancy carved-out-of-a-block-of-aluminium one. Same functionality as the carved-out-of-a-block-of-plastic MacBook, but the Pro has a SD card reader and a Firewire connection.

Well, if I thought that Macs were easy, I was mistaken. It took me a while to work out where things were; the keyboard differs from a PC laptop or netbook, and I couldn’t, for example, find where the # was. I had to get a book about changing from the PC to the Mac to help me out.

I’ve a largish photographic archive, around 40k images. I could set up Lightroom, my primary photographic program on the PC, on the Mac both in ‘native’ form and also in Windows under Parallels. But I’ve never found how to use it properly; Lightroom will say that the images (on an external hard disk) are on a network drive, or it will say it can’t write the file format (for the catalog). So that hasn’t been a success.

Scrivener is easy enough to use, at least the way I use it — like most programs, I probably only use about 10% of its capabilities, but it works for me. I find it very easy to drag web links, and links from programs such as MindManager, into it, so I can easily find them again.

Am I undergoing a religious conversion? I think of the Mac/PC divide more as being for the right and left brained. Left brainers — analytical, logical, independent loners and yes nerds and anoraks (and I guess empirical) — would be at home on the PC. Perhaps more at home in the previous versions of Windows, because modern versions actually seem to work more or less as they are supposed to do. Right brainers — creative, artistic, disorganised, needing support and hand-holding — would be at home with the Mac. It just does what it says on the tin, you don’t have to understand anything, and pretty well everything works the same way. 

Fictional index

Truman Capote introduced the term of the ‘non-fiction novel’ with his book In Cold Blood. In truth, the genre of ‘faction’ had been around for a long time beforehand.

The Suspicions of Mr Whicher by Kate Summerscale is a non-fiction novel. The author has researched the details of a Victorian murder — the written documents such as police records which are preserved in the Public Records Office at Kew. She has created a fictional reconstruction of the events around the ‘Road Murder’, and related this to contemporary events, both in real life and in fiction. She discusses the influences between the real detective, Mr Whicher, and the detectives in contemporaneous fiction, such as Sergeant Cuff in The Moonstone.

What is unusual about Mr Whicher, however, is the extensive list of references at the back; and there is a select bibliography and an index. Since when did a novel have an index? 

It was Martin Amis, I think, who said that Umberto Eco’s vast and dense novel Foucault’s Pendulum needed an index, and he did have a point. There is so much information in it that finding anything is next to impossible — and I’ve no idea how much is real and how much is invention (if any). Of course, you could say that Eco’s novels are more than works of fiction; he uses them to illuminate his semiotics and philosophy. The novel, again, as teaching resource?

Back to Mr Whicher; how many readers need the references, how many are going to check up, how many are going to go to Kew? The book is a novelisation, not a textbook or even a thesis — or is it? References are common in non-fiction books, and the lack of them and an index in them is adversely commented on.

But an index in a novel?

Readers' Guides

I heard The Coral Thief by Rebecca Stott as a Book at Bedtime (or was it The Late Book?) on BBC Radio 4. I later discovered that books broadcast in this way are reduced to 25% of the original — the books are (almost) rewritten for radio, and there are writers who specialise in this. So I thought I should read the whole. The ‘summary’ for want of a better description was well done, and I didn’t think I’d been cheated out of any of the main events.

I was disturbed though, when I’d finished the book, to find a section called ‘Reading Group Notes’ as an appendix. This includes a résumé of the story, and a list of topics ‘For Discussion’. There is also ‘Suggested Further Reading’ which, curiously, is printed twice.

I’m not so sure that I want a list of topics to be discussed at the end of a novel; I read novels for enjoyment, and I don’t expect to be tested on my understanding when I’ve finished. Perhaps it would help my greater appreciation if I did undertake these exercises, though as there are no ‘specimen’ answers, I don’t know how much benefit I’d get from it. The author’s positions include a Professorship in Creative Writing, and I was strongly tempted to think that the novel was an exercise, taking topics and constructing the fiction around them. And perhaps another reason for its creation was as use as a textbook. Maybe I’m just too cynical.

Wolf Hall, by Hilary Mantel, doesn’t have tests at the back, but there is an interview with the author, and her commentary on Thomas Cromwell (the hero of the book), and a list of key dates. Wolf Hall is set in the England of Henry VIII. Although I went to school in N Ireland, the history we learnt was English history. And it began, out of nowhere, in 1485 and ended equally abruptly in 1714. Mostly, it was a long series of dates which we had to memorise. There was little effort put into the ‘why’ of history; and looking back, the version we were taught was heavily expurgated. We didn’t learn about Henry’s marital problems, his over-riding need for a male heir, and absolutely nothing about his ‘natural’ son. So, although it’s a novel, Wolf Hall put a lot of what I remembered into context, and explained what was really going on. If only I’d known then.

I’ve always liked Sherlock Holmes, even if many of the stories are nothing more than pot-boilers. They are littered with careless mistakes in chronology, in Watson’s first name, and the number of his wives. A large industry has grown up around Sherlock, with rivals, films and television series. As long as you don’t look too closely, these are enjoyable.

Irene Adler, the woman, appears in A Scandal in Bohemia, not one of the better stories, but the one in which Sherlock is defeated by the woman. And now there is a series of Irene novels, the first (Good Night, Mr Holmes) based on Irene’s side of Scandal. It’s amusing, even though it doesn’t quite recreate Victorian London in the way that the Literary Agent does.

But, at the end of the book there is a Reader’s Guide, and this includes a list of topics ‘For Discussion’, not just of the book, but of the other novels in the series. There are no answers. There is also the inevitable interview with the author (Carole Nelson Douglas).

I think my problem with books that have ’For Discussion’ is that they remind me of school textbooks. I’d like to think I’m beyond that now, I don’t read because I have to, I read for enjoyment. I don’t have to memorise large chunks, in case it’s asked about in the examinations. And I can often distinguish the themes from the story — of course, we weren’t taught about themes at school, well at least when we studied Eng Lit. I’ve a lot of ground to make up, but asking me questions isn’t the way to do it.

So why do authors and their publishers include ‘For Discussion’ at the end of novels? Is it a marketing exercise, to draw readers in, or something that ‘adds value’? And why, if this is necessary, can’t they simply refer to a web site about the novel? If I’m to be tested (and given specimen answers), why can’t this be done externally? There’s a big difference between reading for pleasure and enjoyment and reading a ‘set’ text on which one is going to be examined. So why not separate these two? By all means have a discussion on a web site — setting one up is so easy these days — with interaction from fellow readers, rather than leaving me to flounder alone.

I want to read a novel for enjoyment, for fantasy. I don’t want to have to dissect it immediately afterwards.

Mirror images

I read a blog the other day; it had a video at the end, used to illustrate some points in the text.  But, I thought it looked somehow odd. I looked more carefully — it had been reversed; it was a mirror image video, though the sub-titles were normal. There was no obvious reason for this, except perhaps to try to maintain a fiction that it was an American rather than a British video — there was a short scene with a car that made this clear.

It’s not that uncommon to find mirror-image pictures in magazines or newspapers. Usually, this is done so that the profile of the author or person being commented on ‘looks into’ the story, as if he/she was showing their interest and possibly their approval. And sometimes, when the sub-editors want to put distance between the piece and the photograph, the profile will look away, often looking beyond the limits of the magazine. Quite literally, they are looking out.

These are mostly subconscious impressions, designed to make and reinforce a point in the article. Or just possibly, a mistake. In the days of the wet photographic darkroom, it was easy enough to put the film into the enlarger the wrong way round — instead of ‘emulsion to emulsion’ and if it was a picture of someone you didn’t know, you wouldn’t necessarily recognise the error. Today, this isn’t possible in digital processing, unless you make a conscious choice to ‘flip’ the image.

It’s curious too, that we aren’t expected to see the deception. Many people think that their left and right profiles are similar, but they aren’t. Take a full face on portrait, divide it vertically down the middle, and separate the two halves. Now take the right half, copy it and ‘flip’ it, and then join up the two seamlessly. Do the same for the left side. You now have three pictures, yet all three will show different people. It’s surprising just how asymmetrical peoples’ faces really are. And of course, there are the changes in hairstyle and parting which can give the game away. And buttonholes on suits, and how the suit actually buttons up.

It used to be common in car manufacturers’ advertising material, with ‘continental’ models being passed off as British. There was generally a note in tiny print to the effect that some fittings were not available in the UK. This deceit seems to have stopped, there is no pretence at pretence now — but this mirror imaging has been replaced by crude Photoshopping to blur the wheels to give an impression of speed.

Mirror images don’t fool some of us any of the time. Just stop doing it.