1.      Wherever the wind takes I travel as a visotor 
2.      Annual Dinner 1998
3.      
There is no Town Like The Alice - John Murray
4.       The Powerlifting GP - Dick Herbert
5.       Chamonix - Rachel Ward
6.       Maudie Russell - OBITUARY
7.       Kenneth Forsythe - OBITUARY
8.       Success is a big Mistake - Theodore Dalrymple

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WHEREVER THE WIND TAKES ME
I TRAVEL AS A VISITOR


Having had a dream of sailing round the world for several years it seems almost unbelievable that we are now wondering how on earth we are going to get all the jobs done to be ready to leave the UK by the middle of September.


We have spent the last nine months attending briefing sessions one weekend a month run by the Blue Water Rally Officials which have been very interesting and informative as well as giving us the opportunity of meeting the skippers and crews of other boats. Two of the men on one of the boats happen to be brothers that my husband played rugby with many years ago in Manchester. We have spent time in Antigua and in England
sailing with the people we will be ending the next two years with and so far the biggest problem has been the fact that there are two Anthony and Jan's on our boat!


We are joining the Blue Water Rally which consists of about forty privately owned yachts which plan to take twenty months cruising round the world. We start from Gibraltar on October 24th which will be the furthest point north that the rally  will go. We spend Christmas in Antigua and then raft together to go through the Panama Canal to Ecuador and the Galapagos. We sail across the South Pacific to Cairns (the furthest point south) and to Phucket for the millennium, Sri Lanka, Maldives and through the Suez Canal back to Gibraltar. We have twenty official moorings with receptions planned with kings and cannibals and also will stop in many unscheduled places as well. The boat is an attractive fifty-foot Staysail Schooner with a clipper bow called 'CARO'. She is twelve years old and built by a fastidious Scotsman for his own use from iroko planks and covered with an epoxy cloth treatment She has been immaculately maintained and is a joy to sail.


There are some minor adjustments to be made to the internal structure, putting in more hatches - a must to increase Ventilation in the tropics - we also need a watermaker and a SSB radio. We have the job of provisioning and storage of supplies for the journey across the Atlantic and also collecting together the medical pack. There is also the job of clearing the house as one of my daughters and her husband will be here for the next two years. It is a very exciting, if exhausting time.

Jan Adams

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ANNUAL DINNER


The Kidderminster Medical Society Annual Dinner was held on the 20th June 1998 at Stourport Manor. Well over a hundred guests attended.
Th~ President, Dr Christopher Smith first made a few derogatory remarks about his predecessors sobriety (we were
informed that the previous President had no recollection of last year's dinner). Dr Smith also gave a vote of thanks to Dr Richard Taylor, former Physician at the hospital for his leadership of the 'Save Kidderminster Hospital' campaign. This vote of thanks was enthusiastically supported by all present.


The President then introduced the guest speaker, Mr Don McClean, formally of Crackerjack, and more recently host of the Sunday religious programme called 'Good Morning Sunday'. On this occasion Mr McClean played the role of a good, clean, upstanding comedian with an excellent line in patter, providing us with many good laughs, none of them smutty. He was superb entertainment and apart from being sometimes slightly 'politically incorrect', he was thoroughly enjoyed by all the guests. As always once the formal entertainment was over people continued enjoying themselves for quite a long time afterwards.

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There is no Town Like The Alice
Thoughts and Experiences from John Murray - Down Under!


My original idea was to spend a few weeks working in Frankston, Victoria followed by a two-week holiday. My friend, David Bannister, (Paeds Registrar 1978 at KGH) found that there was no place for British specialists in the better areas and suggested Alice Springs where they "Always need someone". So it proved, but I had to agree three months. One month later 1 came in on the 8.00 am plane from Darwin after 26 hrs travel. The tropical green of Darwin had given way to the red-brown earth covered with grey green spinifex and scored by the occasional straight dirt road and there was "The Alice" ringed by the McDonnell mountains, a green oasis with settling ponds on the western side. One of the anaesthetists, Dr Kumar, met me and drove me in his air-conditioned car (it was over 40 degrees C) to my small house in the hospital grounds. The Alice with its streets lined with trees, green gardens and low houses with verandas has the prosperous feel of an American suburb until one's eye settles on the Aborigines wandering aimlessly in small groups or slumped on the grass.


The Hospital was a three-storey building some ten years old surrounded by a steel security fence. It served an area more than twice that of the UK. There were about 300 beds, two principal operating theatres and a six bedded ICU which took cardiac and paediatric cases. 80% of the patients were aborigine although only 30% of the population. I was .one of three senior anaesthetists who were assisted by two juniors, one of them a registrar on rotation from Adelaide and the other a beginner in Anaesthesia. One senior anaesthetist covered the ICU and ward calls. These included epidurals in the labour ward, requests for subclavian cannulation in Renal failure (renal disease was very common.in Aborigines) and pre
and post operative management. Routine cases were seen at clinic before admission - { s.aw one lady who had come 350 Km from a cattle station. Despite these measures operating lists could 110t be trusted. Patients appeared without notice, ran away, or slipped down to the kiosk for forbidden food and drink. Sepsis, diabetes and assaults amongst Aborigines also produced a steady flow of emergencies, the grog being a frequent factor.

 Within a few days I found myself fully extended, coping with a heavy load of trauma and surgical cases. On one Saturday morning there was a cardiac arrest from pneumonia and septic shock in a 30 yr. old Aboriginal who had run away the previous day, an inexplicable onset of coma in a visiting American girl and a Brown -Sequard syndrome in an Aboriginal lady stabbed in the back by another woman plus a series of General Surgical patients for theatre. The ICU was well equipped and a high standard was set. Sepsis proceeding to septic shock being prevalent, anaesthetists were often fully occupied putting up arterial, central venous and dialysis lines, struggling to maintain output with catecholamine infusions and arranging for acute dialysis on a machine set up by nurses. I quickly had to learn femoral vein cannulation with a large Vas-cath, percutaneous tracheostomy and felt "professionally challenged for the first few weeks.


When the unit was overwhelmed or unable to cope with a problem, transfer to an Adelaide Teaching Hospital by a  Flying Doctor plane was arranged. The distance was approximately 1200 Km. Unfortunately the first on call anaesthetist frequently had to accompany the patient, often with five to six infusion pumps running plus a ventilator. Resuscitation of Cardiac arrest on route was unheard Of One English tourist survived the three hour trip with a ruptured aortic aneurysm but don't tell Dr McClusky.


Despite the hectic days the atmosphere was usually easy going. Everybody used first names and the Australian friendliness and lack of deference was a new and not unpleasant experience. Throughput in theatre was slower than I was used to because the anaesthetic rooms were not used and the routine preparation was thorough but complicated and repetitive. The rapid staff turnover -many people stay for less than a year - and the tendency to modify lists may have made this necessary. . I was able to fly 300 Km with a "Flying Doctor" and a nurse to an aboriginal settlement to help with a clinic. We were met at the dirt landing strip by an aboriginal health worker and taken to a collection of houses along about 100 metres of
tarmac. Children and dogs ran about on the dirt strewn with rubbish and paper scattered by the wind. One simple hut was the clinic and was moderately clean. There the Doctor attempted to apply first world medicine in a culture going back to the Stone Age. Hypertension, Diabetes, Donavaniasis (venereal) and ante-natal care were just some of the problems. I even performed a facet joint injection on a very well covered lady with a short needle on a less than spotless couch! As in every practice. There was a last minute rush when the plane returned. We left with three extra passengers for the Alice Springs hospital including a man who had broken his arm on a drilling rig in the bush. Time, off was spent visiting the many tourist sites in the "Red Centre" including Uluru ( Ayres Rock) and the other creeks and gaps in the mountains of this fascinating country. A second - hand mountain bike gave me a chance of going into the bush at dusk when the wallabies and kangaroos came out to graze. I was amazed to see three cattle on one occasion where they seemed to have no chance of survival. Alice Springs has museums art galleries and a cultural centre.


There are many restaurants and hotels where kangaroo, crocodile etc may be tried - I saw no Witchety grubs. My lasting memory will be the evening view from the hospital top corridor of a brilliant red sunset silhouetting a peak of the McDonnell Mountains --- There is no town like "The Alice". 

John Murray

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 The Powerlifting G P


My entry into the world of powerlifting came rather late in life at the ripe old age of 35. Kidderminster boasted in 1975 two members of the British Powerlifting team out of eleven which was pretty amazing. The training took place in the old church hut in Broadwaters now the Rose theatre. The
equipment was home made largely. For example, the squat stands were made out of oil drums with metals posts sunk into concrete!


I started training in a small way and then news travelled around the Powerlifting world that a doctor was involved in the sport. I was immediately appointed M.O. to the British team and travelled with them for several years to European and World competitions. These events took me to Scandinavia, Canada and other European cities particularly in Germany and Holland. The British= team in those days was always in the first three in the world. The team would always have weight problems arriving two days before the event several kilos overweight. Diuretics were legal until - ten years ago and so the lighter members who had the most difficulty losing weight were as dryas a chip. There was usually an hour and a half between the weigh-in and the start of lifting and therefore intravenous fluid replacement was quite common, as there was insufficient time to replace fluid orally even with metoclopramide.


During these trips, I had to deal with every common ailment which a party of twenty would suffer from ranging from sore throats to piles. I spent many an hour in the drug testing room trying to encourage a dehydrated lifter to pass urine. It is extraordinary how long it can take for the kidneys to wake up after such. My own career in the sport took off after the introduction of veteran classes when I became quite competitive in my early forties. Towards the end of the decade, I could not compete with the younger just forty year olds but in my fiftieth year I managed to win the British championship in the 75kg class narrowly beating a good friend of mine who was the national team coach but 8 years older than me. This led on to my selection to represent Great Britain the over fifty geriatric team in Frankfurt at the European Championships This was a disaster for several reasons. Lifting at 9 o'clock in the morning was not my sa~ne and a facet joint injection from Peter Thorpe the day before departure did sap my confidence a bit. The real reason why I did not do well was that all the others were a lot stronger!


I have given up the sport to concentrate on my weekly counselling session with Paul Brothwell, the hospital chaplain, on Cleobury golf course with loud support from John Murray, John Reddy and Reg Johnstone.

Dick Herbert

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Chamonix


Walking past patients in a crowded waiting room one day, waiting patiently for my ski-pass the next; what a joy it was to put
everyday medicine in cold storage for a week and head for the snow and ice of Chamonix.


The French Alps provided a perfect backdrop for my PGEA outing last January and who minds a week of evening lectures
when a full day's skiing comes first? The London-based firm Conference Plus organised my trip with commendable efficiency and they handled everything from flights and coach transport to the excellent hotel and optional ski-school classes. As any skier knows, Chamonix is a world class resort with a wide variety of slopes and breathtaking Alpine scenery. It is not, however, the ideal venue for beginners. There is very little in the way of door-to-door skiing and most journeys to and from the slopes are by bus. The skiing, naturally, was exhilarating and the highlight of our week was tackling the famous Vallee Blanche run on Mont Blanc - a memorable and uplifting experience.


Staying awake for the lectures was a major challenge in itself after an arduous day's skiing, but the guest speakers were so stimulating, entertaining and informative that nobody contrived to nod off. Most of the lecturers were skiers themselves and their only regret, like ours, was that the tight schedule allowed no time for a traditional glass of gluwein after leaving the mountain. Some of our group brought their spouses, others brought their partners and some brought ... well, that's enough about the off-piste activities! But quite a few us came alone and for me, this was my first break from our two young children since three-year-old Olivia was born in December 1994. My husband Mike was left holding the babes and the fort for a week and I did the same for him when he went out to Zimbabwe for his parents' 50th Wedding celebrations in May - and our next skiing trip will be as a family in a year or so.


The Chamonix venture was not exactly cheap at 650 (coffee and wine included) but nobody doubted that Conference Plus gave us value for money in return. Not to mention a welcome respite from surgery.

Rachel Ward

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Maudie Russell
OBITUARY

We are very sad to report the death of Maudie Russell whose funeral was at Abberley Church on Friday 17th April. Maudie and john, her late husband, were very regular attenders at Medical Society functions and very well known throughout the Wyre Forest Area especially in the 60s and 70s. After John's death, Maudie was still seen at Society functions and she did in fact present the cricket cup - the John Russell Cup, to the society shortly after his death. Sadly, shortly after John died, their only daughter Jenny also died leaving 2 daughters. Although considerably disabled after an accident in the late 80s, she still managed, until fairly recentle, to be out and about. Our deepest condolences to Phil, Maria and the girls.

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Kenneth Forsythe
OBITUARY

It is with deep regret that the editor records the death of Mr Kenneth Forsythe, aged 89, who used to be consultant Ophthalmologist at Kidderminster from the late 40s until August 1975. Mr Forsythe was instrumental in setting up the department on his arrival her and worked single handed with the assistance of clinical assistants only ( including in the early days Mr John Pearce who proceeded to devise the intra occular lens implant)  until the arrival of Mr Tallents in 1974. As well as a very full health service workload he also worked at the local eye centre and had a large and successful private practice. On a personal note the editor, who was his clinical assistant for many years, very much appreciated Mr Forsythe's support and assistance in learning the rudiments of opthalmology and his friendship for many years thereafter.  He leaves 3 children, John - a solicitor in Kidderminster, David a GP in Oxford and Jane, an orthoptist living in Edinburgh. The editor and the society send their sincere condolences to Mary and his family.

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From Medical Monitor, 15'" April 1998
(A bit late in the Newsletter, but worth reading)
SUCCESS IS A BIG MISTAKE


If an NHS job is worth doing, it's worth doing badly - notes Theodore Dalrymple. After all, the only way for an NHS planner to stay in work is to keep messing it up. A well-wisher recently informed me about the situation in Worcestershire, where the health authority has produced a plan to rationalise its hospital services - it will virtually close one of its three main hospitals, Kidderminster General. To sell its unpopular proposals to a deeply sceptical population, the health authority has produced a glossy brochure entitled: Investing in Excellence. One would never have guessed from the brochure's contents that the principal move behind the proposals was to make good a 9 million budgetary deficit: on the contrary, using a technique borrowed from US TV evangelism the brochure pretends that this is a golden opportunity available for earthly salvation. I attended a public meeting in Kidderminster, held by the Community Health council in which an audience of 1 ,300 townspeople confronted the health authority's Chief Executive and the county's Director of Public Health. It was clear from the beginning that these bureaucrats would not he able to smooth feelings over by a few ill-chosen, vague and gimcrack mission statements: the audience was hostile and well- informed.


The bureaucrats had one or two good points to. make which, however, were uncontentious. No-one disputed that certain specialised services had to be centralised in the county (at a yet-to-be-built new hospital in Worcester) to make them viable and of high quality: but that argument did not apply to the great majority of clinical services. Over and over again the members of the audience asked questions that made the plan elaborated by bureaucrats appear bumbling, amateurish and incompetent. For example, the virtual closure of Kidderminster hospital would save 1.2 million a year, they said. A man in the audience, who should have been a barrister, laid a trap for them: he asked how many losses there would be as a result of the plan. The man knew, of course, that it would have been impolitic for the bureaucrats to admit to any specific number. And they duly said that they could not tell how many there would be, for the plan was an outline only. Then how well can you know that the plan will save 1.2 million?' asked the man who I said should have been a barrister, Of course he was right. Wage costs are by far the largest item of NHS expenditure and to save money you have either to make staff redundant or disproportionately reduce services. Accustomed to speaking - and probably thinking - in jargon and circumlocutions, the bureaucrats could answer him nothing. Either they would have been caught out, or they would have been revealed as
hopelessly incompetent. Either way the audience could not be expected to have much
confidence in them thereafter.


On my way to the meeting, I noticed that Kidderminster General Hospital had a large new modem wing which, 1 was told, was very well - and expensively - appointed inside. It was opened in 1995, less than three years ago. At the meeting the bureaucrats made much of the need to plan ahead: medicine was fast changing, they said. Indeed it is, but has it really changed so much in the past two and a half years that a hospital wing that was deemed necessary in 1995 was completely redundant in 1998? What faith could people possibly have in a planning bureaucracy that opens expensive hospital wings in one year, and closes them practically the next? Would it not be more advisable to get rid of the bureaucracy than
the Hospital wing?


One can already foresee what will happen next. The plan will be implemented in the teeth of local opposition and advice. Then, when the hospital has closed and is decayed beyond repair, or has been turned into a leisure centre, and when the new services fail to work adequately, a bright and brilliant planner will come up with the solution; why not a hospital in Kidderminster? One begins to see why it should be so expensive to maintain services at levels below those of preceding years, and why so many planning meetings are necessary. Planners need chaos like fish need water and incompetence is in their best interests.


Theodore Dalrymple

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