Monday 23 June 2008

28.Last Night's Concert

After a very long interval, we went to a 'live' concert last night. For years, I have preferred records and CDs: Near-perfect quality, in the comfort of my home, at a convenient time. Still, these were cheap tickets through the U3A, and it was an attractive programme - the LSO at the Barbican.

We sat at the back of the balcony, but the acoustics are very good - and I had not forgotten to bring my hearing aid. Some people had brought binoculars, but they are not essential for an aural gratification [as Humphrey Lyttleton would have double entendred it].
Anre Previn had obvious difficulty walking and climbing the half dozen steps to the stage. He used no cane but he used the bannisters on both sides, and he sat on a high stool to conduct. From the programme we learnt that he is 79 [or 78]. Viewed from the long distance of our seats, my impression was not of Parkinsonism - unless it was well controlled by medication. He seemed to have weak leg muscles rather than arthritis - maybe due to trapped lumbar nerve roots: I know the feeling from my own experience. I felt sorry for him, particularly when the applause forced him to negotiate the steps to the stage for a second and a third time.

The music was excellent. During the 4 years of my private violin tuition as a boy, I was given a version of Mozart's 'Eine kleine Nachtmusik' adapted for solo violin. My performance was abysmal, but it made me familiar with this lovely piece of music. My gross technical inability, coupled with my reluctance to prectise, and the fact that I did not have perfect pitch, finally convinced me to give up. And I was able to convince our children to choose instruments that had a fixed pitch, rather than string instruments.

Next came a Mozart symphony - number 39. Beautifully played and very enjoyable. I'm not sure how much the concert notes add to my enjoyment. I'm not a musicologist but I do remember beautiful tunes.
After the interval the Brahms violin concerto was played brilliantly by Anne-Sophie Mutter, who is described as very well known. I discovered on the web that she was Previn's fifth [and most recent] wife - until 2006. They are obviously still good friends - he has just written music that they will perform together. She played superbly and did not use a score - but Previn did. Apparently she '...takes special pride in performing contemporary compositions for violin.' Well, include me out of those.

We travelled by tube, of course. On Sunday one can even park the car at the station forecourt. We had chosen to get off at Moorgate - equidistant with Barbican station. It proved to be a lucky choice, because as we waited on the platform to travel home it was announced that a signal failure had stopped the Metropolitan line there. Fortunately, the Northern line also connects at Moorgate, and we could join the Central Line at Bank. Had we chosen Barbican we would have had much more trouble - particularly as I had not brought my usual folder of bus and tube maps.

Compared with listening at home, the outing adds more than an extra hour at each end, and dislocates supper. But at least it didn't rain and it wasn't cold. We shall probably go again...

Monday 16 June 2008

27.Lucky Friday the 13th, and an enjoyable weekend

Friday the 13th was certainly not unlucky. I had forgotten all about it and did not stay in bed. Then we had some good news, and like the old Jew in the Catholic church, "I am telling everybody". (if you do not know this joke, and you are over 18, ask me).

First thing, Ruth had received the exam marks for the spring semester. Professor Langley-Evans congratulated her. He told her that, 'once again, it was an amazing performance'. Ruth was top of the Biosciences students for year one (by a country mile), as she had been in the autumn semester.
She emailed us saying that she was so pleased, that she might not be able to squeeze her oversized head out of the building. I consoled her by pointing out that as a result, her hat would now be big enough to contain the entire week's shopping.

Then we heard from Heather, who is losing her job due to 'downsizing' at Camden. Gordon Brown needs all their money, to repair his idiocy with the 10p tax rate. So he has to squeeze the local authorities. Her employers and colleagues at Camden had been extremely generous as a token of their appreciation of her work there. Very heartening. My own pride is tinged with sorrow concerning the loss of the occasional lunches at her nearby Caf, where they serve excellent falafel...

It was David's birthday. Rather than possibly wake him up, we had phoned him the previous evening. Later Heather told us, that she had in fact woken him up - so we need not have worried.

Then we drove to Harlow for the Wansfell-2 weekend course on Symbolism in Art. It was an excellent series of slide talks and I learned much more than I had expected. Clare Ford-Willie knows her subject very well and spoke clearly and fluently, aided by abundant good slides. The fellow students were a nice bunch of people, including some former students from my own Wansfell courses. The good food included the customary treat of bacon at breakfast - not obtainable at home.

Tuesday 10 June 2008

26.Egypt and Canaan

Last night I attended a very good lecture at the monthly meeting of the West Essex Archaeology Group [WEAG] at Woodford County High school. I now only attend when the topic is of interest to me - and this certainly turned out to be most enjoyable. Using PowerPoint, Rachel Sparks from the Institute of Archaeology surveyed and illustrated the evolution of the links between Egypt and Canaan in the middle and late bronze ages [MBA & LBA], roughly the second millenium BC. She divided the period into three parts:

In the MBA I [= 2,000 - 1,800 BC] there were sporadic trade exchanges ['trading and raiding']. The route was overland along the 'way of Horus' and by sea - to the ports along the Levant coast. The Egyptians did not penetrate far inland. They still regarded Canaanite cities as potentially hostile, as evidenced by the execration texts: plaster effigies covered with the names of Canaanite cities, then cursed and smashed them. But bearded semitic men bearing merchandise were portrayed.

In the MBA II & III [= 1,800 - 1,200 BC], there was deeper Egyptian penetration inland, and an increase in trade and significant cultural exchange. At that time the Hyksos resided in the delta - foreigners probably from the Aegean. The delta site of Avaris was inhabited by Canaanites. Many storage jars of Canaanite origin were found there, whereas burials in Canaan contained many scarabs of Egyptian design - but often produced in Canaan. When skeletal remains could be analyzed, the male were often Asiatic/Canaanite and the females local Egyptians - there was intermarriage.

In the LBA [= 1,550 - 1,150 BC], the Egyptians actually conquered Canaan. The Egyptians mounted concentrated annual campaigns into Canaan, gradually extending their rule northward - despite a Canaanite revolt - the battle of Kadesh.
The loot was taken back to Egypt, where such Items can be recognized. The siege of Askelon illustrates the action. In the delta, the Hyksos were expelled and all traces of their culture were obliterated. Tribute was also extracted from the conquered Canaanite cities. Loyal rulers were appointed by the Egyptians, and their sons were usually taken to Egypt as hostages. When these princes later returned home, they spread the Egyptian culture that they had absorbed. There is a theory, that Joseph was such as hostage prince. [ Incidentally, the Romans employed a similar method ].

Local fortresses in Canaan were built by local labour. Burials included antropoid coffins, that contained shabtis in the Egyptian style - so these were probably Egyptian dead.
To remain in power, the Canaanite elite had to behave like Egyptians. Beit Shean was completely Egyptianized - they even imported Egyptian potters to work there. [ And I'm reminded of the Egyptian governors' style mansions at Dir es-Saidiyeh and Tel Afek - there must be others ].

The ethnicity of the inhabitants can be identified from various criteria: the images [beards, clothing, skin colour, tattoos], the texts and language, the names of individuals, and the style of their possessions.

The questions after the lecture confirmed my own views of the Biblical narrative. That part of the Old Testament was only written around the 5th century BC, or maybe later. The whole story, from the Patriarchs to Joshua's conquest, is a later 'spin'; the 'Apiru' that are mentioned in some extra-biblical texts refer to stateless vagabonds and terrorists, not to 'Hebrews'.
The topic of the Exodus was not mentioned at all in yesterday's non-Jewish forum. Its historical existence has now been convincingly rejected by contemporary scholars. Although Canaanites obviously resided in the delta at that time - during the LBA, they were not Israelite slaves. The Egyptians kept no slaves,
except for prisoners of war. Public works were performed by 'corvee' labour - Egyptians who served the king during the period of the Nile's inundation, while these farmers could not engage in agriculture.
During the period of the postulated Biblical exodus, Canaan
in the LBA was entirely under Egyptian rule: so where could Moses and the Israelites escape to?
The Old Testament is a very well constructed literary work. But I personally no longer celebrate Passover, its festival and its ceremony.
But then, I'm agnostic: I do look forward to encountering Tony Blair in Hell.

Monday 9 June 2008

25.A New Book


For over 50 years, Zvi Alexander has built up a most significant collection of Holy Land postal history - that is not just stamps but postmarks and entire letters and postcards. It is probably THE most important and comprehensive such collection in existence.
For the last 24 years Zvi has exhibited various parts of his collection internationally, and has been awarded Grand Prix and numerous large gold medals - the highest philatelic accolades.

Rather than selling his unique items, he has generously donated the entire collection to the Eretz Israel Museum in Tel Aviv on a 50 year loan. The museum's philatelic pavilion has been named after him and he has endowed it for onward displays and education.

To mark its opening earlier this year, the Museum produced a sumptuous glossy hardback catalogue. In some 200 pages it illustrates and briefly describes (in Hebrew and English) a selected fraction of these postal history items, beginning in the 15th century, through the Turkish post, the European postal agencies of Austria, Germany, Italy and Russia, to the British Mandate, and finally the war of independence in 1948. The postal items are linked by selected historical photographs and thus form a marvelous overview of the history of the country and its postal services.

Even for a lay person, the material provides a fascinating and vivid survey. But if you know the
philatelic background, the wealth and quality of these items (not to mention their market value) are astonishing. Quite a number are described as unique - 'the only recorded item'. My personal friendship with Zvi has given me additional exciting insights into his hard work in locating, researching and acquiring these rare gems.

As Amazon would say, five stars plus!
It is sold at the Museum for 150 sheqel - about £23.

Thursday 5 June 2008

24.The General Medical Council (GMC)

To practise medicine, doctors have to pay the GMC an annual fee, to remain on the Register. Only doctors who have no income from any source worldwide, including from pensions and investments, are exempt. But until now, no more payments were required after the age of 65, whether or not one engaged in gainful medical work. The GMC now claims, that the 2006 law against age discrimination prohibits them from exempting the over-65s.

So for the time being, the cunning lawyers and the greedy GMC councilors have actually been provided with a golden opportunity to rake in a great deal of extra money from elderly doctors.

In my opinion, the spirit of this law is intended to prevent older persons from being more disadvantaged, and not the reverse. To prove this and clarify the law would require very high and expensive legal authorities. I wonder: what about my old-age advantage of travelling free on London transport? And my exemption from prescription charges, and concessions on entrance tickets? Will all this be abolished now to avoid discrimination against the young?

The GMC should have changed their regulations in a different way to comply with the 2006 law - as interpreted by their lawyers. Instead of the exemption by age, which is now allegedly illegal, they could have introduced an exemption for those who do not engage in any gainful medical work, irrespective of age, and irrespective of non-medical income. But that would have demanded logical, intelligent and compassionate thinking by a body that is notorious for its archaic habits. Rumour has it, that they still use quill pens and are not particularly computer literate.

After I reached 65 and no longer had to pay my GMC fee, I did no gainful medical work of any kind. The only use that I made of my ongoing GMC registration was for private prescriptions for a short course of antibiotics for relatives of friends who visited from abroad. On several occasions I provided emergency help on airplanes or during meetings. Presumably all this will have to stop. When needed, my GP or a former colleague would write me a private prescription. To resume paying the annual GMC fee - currently £390 - just to allow me to perform these trivial actions is naturally out of the question.

I have my own personal bad experiences with the GMC.

When newspapers print a report that the GMC have 'struck off ' a delinquent doctor, their full personal particulars are always reported. But when these episodes are later reported in the GMC newsletter, they are left anonymous. No medical reader would be able to recognize such a culprit, if they were to seek work despite their ban and endanger more patients - it has happened. The GMC newsletter invites readers' comments - but my letters were totally ignored twice.
The GMC logo used to include the term 'protecting patients'. No more. They changed the motto to: 'Regulating doctors, ensuring good medical practice'. They should add 'ignoring doctors, endangering patients'.

When I arrived in Britain in 1962 my qualification, MD (Jerusalem), was registered by the GMC on my Temporary Registration. But as the medical school in Jerusalem was not interested in foreign accreditation and did not apply for it, my degree was not recognized by the GMC for full registration. I had to re-qualify. After making enquiries I chose to get the simplest 'recognized' qualification - from the Apothecaries' Hall in Dublin. The procedure was a farce - maybe I'll describe it in another blog - so I was not surprised to learn a few years later that the GMC had withdrawn its accreditation from
the Apothecaries' Hall in Dublin. Nevertheless, my licence of LAH remained a 'kosher' degree. I ignored it when I provided my personal details: it was secondary to my original MD.

Imagine my surprise in 1996, when I was notified by the GMC that after 36 years they had decided to re-designate my qualifications. Henceforth I was no longer registered 'MD', only 'LAH'. I tried to reason and to protest, but the dinosaur refused to budge.
Later I passed the membership exam of the Royal college of physicians and was subsequently elected a fellow.

So as of this morning, sod the GMC registration:
I am still MD, FRCP.

Sunday 1 June 2008

23.Anatomy

Last week Daphne, Jane and I Visited the Wellcome exhibition 'Medicine Man', with its model of a lesson in anatomy. It reminded me of my study of this subject in Jerusalem.

In the early 1950s, before I began my studies, students had to go abroad for their pre-clinical studies - and for anatomy in particular. Similar to the 18th - 19th centuries in Europe, corpses were scarce in Israel. There were no executed criminals, or abandoned vagabonds; and the orthodox Jewish institutions insisted on the Biblical commandment of burial before sunset, and of the complete body - to ensure its resurrection intact, when the Messiah comes.
If the law demanded a coroner's autopsy, a trained rabbinical expert had to be present, to ensure that every organ was replaced in the body, possibly excepting some tiny fragments for essential microscopy.

After Israel's independence in 1948 a new source of corpses became available: Arab terrorists who had been killed
by the army in ambushes. In the 1950s they were still called infiltrators. Their existence was denied by the Arabs who had sent them; and their bodies were not reclaimed. So now anatomy could be studied at the medical school in Jerusalem. The city was divided, of course, without access to the university departments on mount Scopus. We were scattered in various buildings around western Jerusalem, and the anatomy department was in an old Arab house behind the municipal 'garden' - an oval area with flowers and trees, not far from the demarcation wall with the Old City beyond.

On the first day we all assembled in the large room, sitting silently around the dissecting tables. The bodies were covered with red rubber tarpaulins. There was a strong smell of formaldehyde. Professor Itzkovitch and Dr Gershon Gitlin introduced us to the subject - I remember it very well. First and foremost, they emphasized, these were human beings. They were dead, but they had to be treated with respect. No smoking was allowed in the room, and no eating. Second, we were reminded that there was some opposition to human dissection among the population. We were forbidden to talk about the activity there. No photographs, or visitors, were allowed.

It took me a while to realize, that there was another reason for the secrecy. All the bodies were middle aged men, with a swarthy appearance, and all were circumcised. Some had puncture wounds, or evidence of internal bleeding. Clearly, only more or less intact Arab bodies were chosen, and all bullets had been carefully removed. The delivery of bodies, and their embalming with formaldehyde, obviously took place at night. Soon, we had named out corpse Ahmed.

The course was intensive - we spent very many hours dissecting, for a whole term. Our textbook was Cunningham's manual and we followed its instructions to the letter. Each table of 5 or 6 student worked on one body. We began by laboriously teasing out the nerve strands under the skin of the scalp and face. Then we removed and dissected the brain. Then we turned to the chest, the abdomen and the limbs. We also received lectures about osteology, as well as embryology - it was Dr Gitlin's favorite research subject. The female reproductive organs were brought in on separate trays - presumably they were from patients who had undergone the relevant surgical removal, or perhaps 'unofficial' post-mortem dissections of non-orthodox women. We never asked.

With hindsight, anatomy was grossly overrated and over-taught in 1954. This imbalance was later recognized, and the topic of anatomy in the curriculum was gradually modified and shortened. Different specialists obviously required different aspects of anatomy - and psychiatrists needed none. So why burden their limited brain capacity?