Archive for June, 2013

Being amused by small things

June 8, 2013 Leave a comment

Sometimes quite minor things can amuse me because of their strange and surreal qualities. One of these is TV subtitling, aka captioning, or closed captions.

You know the button on your TV that turns on subtitles for the hard of hearing? We have that on quite a lot, not because we’re hard of hearing but because it means we don’t need the sound on when we’re trying to be quiet, like enjoying the first coffee of the day. Usually at such times what we’re watching is a breakfast news programme.

Today I saw two news items that attracted my attention.

One was about giving blood. One of the people being interviewed, I think either an official of the NHS blood transfusion service or an award-winning donor, was talking about the process of giving blood and transcribed as saying: ‘It’s just like having an eagle peck in your arm, it’s painless.’ Oh yes?

The other was an item about the reduction in funding to museums and the possibility of  museum closures. One museum slated for possible closure was the ‘National Robbery Museum’ and another was the ‘Liverpool Chakra Museum’. I’ve never been to either, but it sounds like I should visit them both soon… I’d like to see a chakra museum; historical and curious chakras might be very interesting.

Of course the problem arises because of the way subtitling is done. Many dramas are professionally subtitled prior to transmission and what appears on screen is perfectly formed. Some live transmissions are transcribed in real time by someone sitting at a keyboard somewhere. I have a mental image of someone sitting in a darkened cubicle in the lower sub-basement of the TV station, wearing headphones the size of footballs and pounding the keys of a computer that was fresh and shiny in the late 1970s, but that’s just being fanciful. And sometimes the transliteration is done automatically by an audio-to-text programme that mostly gets things right, and maybe there’s someone who can add in corrections if they spot errors.

I have great respect for people who do these transcriptions because at many points in my research career, I’ve been involved in transcribing interview tapes, met court clerks who knock this stuff out at trials, and I know the kind of skill and speed that’s required to do this work in real time. So I think I can be forgiven for the occasional laugh-out-loud moments when either they, or the voice recognition software, gets it wrong.

As far as I know there isn’t a National Robbery Museum – the Met Police have a ‘black museum’ of implements used in famous murders, and the prison service has a museum of implements used in riots, escapes and so on. I’ve seen those (many years ago now), and indeed the Museum of Justice in Nottingham. And there isn’t a chakra museum either, though there is a witchcraft museum in Boscastle, Cornwall, which is interesting for a range of reasons including the social and folk history it reveals, and I’d recommend visiting it if you’re ever in the area.

Meanwhile, and wearing my fiction-writing hat for a moment, if you ever read a story of mine that has a robbery museum or a chakra museum in it, you’ll know where I got the idea from…


Random memory no. 137

June 6, 2013 Leave a comment

I was watching TV last night, a crime thriller, and there was some dialogue that reminded me of something that happened probably 25 years ago.

The plot involved someone visiting a prison and coming out saying ‘I’ve met my first murderer’. But 25 years ago I was occasionally involved in taking groups of students on prison visits. I can’t remember which prison we’d been to, but it held some lifers and we had a group discussion with some of them.

When we left after the session one of the students said exactly that to me: ‘So now I’ve met my first murderer.’

And my response was ‘How would you know that?’.

Because logically speaking, all she could say was that she’d met her first convicted and incarcerated murderer.

At some point I may use that as a detail in a story, when I get enough of my ‘day job’ writing done that I can get back into writing fiction.

Ambulance experience

June 1, 2013 Leave a comment

You’ll have seen stuff on the news recently (if you’re in the UK) about how the ambulance service, and indeed A&E medical services generally, are struggling to cope, missing targets and so on. Part of this also relates to how the NHS contracts GP services.

The debate about ambulance services (which are regionalised) is covered on the BBC website in relation to individual regions but in general they struggle with performance targets, often can’t recruit staff, experience budget trimming and so on. A&E is covered here on the BBC website; the ongoing debates about how local GP services are provided is also bound up with the introduction of the new ‘111’ service to replace the NHS Direct phone lines and so on.

But here’s a snapshot.

Someone who’s staying with us was in serious pain overnight – their head, face, neck. Paracetamol couldn’t shift it. They were literally screaming in pain. It could have been a bunch of things – an abcess, an infection, a migraine. They couldn’t tell us because they were in so much pain they could barely speak. Sob and scream, yes. Give answers to questions, no. But their face and neck were swollen and they were sweating, though there didn’t seem to be a temperature.

Had this happened 20 years ago I’d have phoned my doctor’s surgery (which is also their doctor’s surgery); spoken to a locum and arranged a home visit. The outcome would have been prescription painkillers.

This morning, with my friend having been in serious pain for about 5 hours at that point, I called the surgery – which is open on Saturday mornings but only for prebooked patients. The phone was answered by computer. No appointment is possible today but here’s an alternative number. The number turned out to be the county’s out-of-hours service. I spoke to a doctor there and explained the situation – and their response was to pass the call on to the ambulance service.

Give them credit: an ambulance was here in less than 10 minutes. The painkillers they carry are morphine-based, and used for treating serious injuries such as broken limbs. Not suitable in this case. Having decided the pain, face and neck swellings weren’t the result of a major infection, brain bleed or the like and were, if I can put it this way, painful but not an actual medical emergency, the only options they could offer were a trip to A&E, which doesn’t seem sensible because the problem isn’t a traumatic injury or anything requiring intensive treatment; leave me to arrange transport to an ‘urgent care centre’ (they used to be called walk-in centres); or just dose him up on the strongest over-the-counter painkillers we could lay our hands on, and book a doctor’s appointment on Monday. Since he didn’t want to be moved and there seemed no immediate reason to move him, he opted for the latter and I went with that.

So basically the difference 20 years makes is that I couldn’t get a doctor to see him on a Saturday and probably prescribe some good painkillers, which would have been the most effective option; but I could get a fully-equipped ambulance and crew for about an hour of their time, which didn’t seem to either me or the crew the best use of their resources and expertise or indeed the best use of the resources they could access – the local A&E department. And the outcome was a halfway solution that may keep the problem in check until Monday when he can get to the doctor’s surgery.

It’s no wonder that A&E is choked up with people who have minor ailments, because getting a doctor to make a home visit at the weekend and on short notice doesn’t seem to exist as an option any more. The ‘urgent care’ centres are, I used to think, a good solution to dealing with non-emergency cases that nonetheless need medical attention. But not in cases like this, because the ambulance couldn’t take him there to be looked at and having a screaming person in a taxi for a 12-mile journey isn’t going to be a sensible move. It’s no wonder ambulance crews are cynical about the amount of their time taken up on calls of this nature – and it wasn’t me that called the ambulance, remember, but the out of hours telephone service. And it’s no wonder A&E departments are stressed if they’re getting a large proportion of cases like this.

If that’s the way the medical service has gone, it clearly means more demand for ambulances and paramedics – because the doctors you can access out of hours are miles away on the end of a phone, rather than being locums answering calls rerouted from the local GP’s surgery and who are actually close enough to make a quick visit. And it would be helpful if the paramedics had the training and at least limited powers to issue prescriptions if they’re the key people dealing with stuff that in medical terms is relatively minor even if it’s painful, debilitating and scary for the person experiencing it. On the whole, this looks like a case where the quest for efficiency and budget control means that expensive resources – ambulances and potentially A&E departments – have ended up being overused and inappropriately used.

And the ‘crunch’ problem, or at least one of them, relates to cases that do need medical attention, where the solution is probably quick and simple, but also where the most effective treatments are only available on prescription.

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