A high school in County Durham has taken the unusual step of removing seats from its dining hall, apparently after a child ‘walked into a chair,’ thus prompting the pupils to claim it was done ‘as a health and safety’ measure. According to the staff it was done merely as a trial to create more space. Students wouldn’t stand for it, and so complained about vertical in-digestion, which I guess brought them one step closer to their parents who – if they are anything like me – are perpetually ‘noshing’ on the run. Naughty, often necessary, but true. I gather school benches will soon be restored.
Also it was reported over the past few weeks that Julian Fellowes, novelist, peer and writer of Downton Abbey, feels his opinions (in general) have been automatically discounted since he recently turned 70.
I think I’ll have to add that in my experience when a person reaches their late thirties or early forties they often find their opinions are considered worthless, Even worse if you’re female, and one’s radiant glow is on the wane. You may feel you have passed your zenith of youth, and your face may reflect not simply your age, but your journey of life! In my case my face has completed several marathons, and I’m less than half way to 120. So, oftentimes us ladies hit a double disadvantage, where men are frequently regarded as greying and distinguished, and we often look ‘lived in.’ By the time one reaches this age, young people are not really listening to you (especially if they’re YOUR young people) and folks may no longer acknowledge you, or hold doors open for you. But, when you hit 70 you risk becoming ‘invisible!’ Everybody is going to get old – unless like myself, you’re VERY unlucky – but they don’t often see it from where they’re sitting. They think they’ll be Forever Young.
Another fascinating piece of news this week is about the pianist Sir Andras Schiff, who I heard recently playing with the Orchestra of the Age of Enlightenment. He comments that audiences of today are rather ignorant as to what makes a ‘good’ performance. His view – slated by critics – is based on the fact that an audience which would have been around at the time the classical repertoire was written, would not just have been educated people, but they would likely have been able to play instruments – woodwind, piano, brass. They would have had family soirees, would probably have sung in harmony in church or in choirs, and therefore they would have some notion about what a good performance or a bad performance was. Today’s audience are largely musical ‘window shoppers’ (non players), blinded by wizardry, pyrotechnics or by speed, as opposed to tone, timbre, nuance. These subtleties are lost, I would agree, on 99.5% of an audience and many critics no doubt as well.
Schiff, who played Brahms 1st and 2nd piano concertos on consecutive evenings, has just made a recording of the 2nd Concerto with the AOE. Not the first time this musician has played it, of course, and by the way Schiff is 66, and there’s not a musician alive who would consider him past his sell-by date. He is vivacious, ferociously energetic and ranks amongst the best players in the world.
Now to something much more serious. Further to my comments some weeks back on coronavirus, where a member of the NHS staff told me that they were expecting to have to curtail outpatient services, more recent updates predicted that cutbacks will also significantly affect chemo and radiotherapy. The P. M. originally predicted that up to 20% of the workforce might stay at home and self isolate. This fallout of staff has already started in China and Italy. Now in terms of treatment, as cancer patients we have but three options: chemotherapy, radiotherapy and surgery, aside from a zero action philosophy (not really recommended). Chemotherapy, the first line of defence, perhaps requires the least specialist of staffing in that your drugs are administered by specialist nurses, rather than oncology doctors; radiotherapy perhaps requires some very expert radiographers to administer targeted therapy, and surgery obviously requires the expertise of a high-volume surgical centre with surgeons who have a reduced mortality rating on their CV. So, cancer patients need one of these three. One simply cannot do nothing and let cancer cells run amok – it’s inhumane.
Now for the gritty part. I’m going to say something which may be perceived as a bit controversial, and if I upset any readers, it is truly NOT my intention. I am championing for equality. You’ll see why if you read on….
They are talking about ‘prioritising’ the more curable cancers. Let me call them the ‘A’ group, and ‘B’ group.’ The A group would include leukemia, lymphoma, Hodgkins etc. Professor Karol Sikora (Rutherfield Cancer Centre) says those cancers that are not curable, but are slow growing – my B group – including lung cancers, pancreatic cancers etc, could be ‘treatment delayed’ by a month, and it wouldn’t make much difference to outcomes. Really?! Who is being cavalier about the ‘outcome?’ I have to take issue with the latter comment because for someone who finds themself diagnosed with stage 4 pancreatic cancer, which brings a dismal survival of perhaps only 8 – 14 weeks, delaying it by 4 weeks would be an absolute disgrace. This has nothing to do with me falling into that bracket, I just think it’s iniquitous.
Keep in mind that 14 week guess-timate when I remind you I had to wait 7 weeks to be given a biopsy, and a total of 9 weeks from diagnosis to begin chemo, because of an admin error in the NHS. We remind ourselves they are obligated to commence treatment for patients on the cancer pathway within 8 weeks, but with pancreatic, that’s really pushing your luck. I met patients who had a biopsy within a week, and a Whipple operation 10 days later. Someone like myself, currently clocking up 18 months, is well outside the norm. My GP is very tuned in to my case, because in his career he has lost only one person to pan-can, and they didn’t hang around for long. He doesn’t want to lose a second patient. If my response to this cancer is perceived as unusual, then for the more ‘usual’ stage 4 person, picked up after their symptoms force them to visit their doctor, they may meet their maker in 4-6 months, even with treatment. Ergo, a month of delay and allowing further spread of disease is absolutely unacceptable.
On the contrary, some might actually say that patients with the most survivable cancers should waive priority because they’re going to survive anyway, I don’t know.
My own mother, ז״ל, had bladder cancer, which was nominally treated, but the medics knew this wouldn’t bring about her denouement. It was a slow growing cancer, (apparently even s l o w e r in the elderly), and in fact it was her heart and advanced age which took her first. But had she had something like mesothelioma, a cancer brute on anabolic steroids, often picked up at a late stage and lethal, we would have pushed with every ounce of our being for aggressive treatment. Pancreatic may be slow growing, but when it finds you, it has already booked your one-way ticket to Bushey! No time then to shilly-shally.
Hypothetically then, those in the first group could present or be treated 6 weeks later and would still survive. The pancreatic/ lung patient who presents with metastatic disease (lungs, liver, peritoneum) has a probable survival window of 6 weeks, if untreated. Therefore, let’s at least TRY and help them extend their lives. We are not all old, debilitated or unworthy. Even if we were, SO WHAT!!! There is a duty of care, and a human right to fair and equal treatment. Their mentality might have been bang-on, if following Darwin’s theory of ‘survival of the fittest’: but we are cancer patients. This is the 21st century and we are fighting a virus, not ebola, or aids. Many of us in the B category are simply fighting to survive. I say, we should all get fair and equal treatment. It’s not like we are queuing up for cosmetic surgery, or something perceived as trivial. They will have to cut back on non essential surgeries or procedures instead. The NHS must NOT de-prioritise patients like myself!
Age and survival are surely relative terms, but most critically these are now – more than ever – in the eyes (or weigh scales) of the beholder.
Now, not wanting to be a complete harbinger of doom, but I’m obliged to remind you there’s not much time left until Passover. I’m sure Lord Fellowes might therefore encourage you to watch Downton Abbey, if only to glean some old fashioned cleaning tips. Unless, of course, you’ve finished your chometz blitzkrieg already.
Greetings to all
Jacqueline x





















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