Cross Country Skiing

Lots of people go on skiing holidays at this time of year, and the vast majority are purely downhill or alpine skiing, where you queue up at the bottom of a ski lift, get pulled up a mountain side and then ride down it, only to repeat the whole thing over and over. A bit like riding a rollercoaster I suppose.

Cross country skiing is different. Firstly, you have to ski up hills as well as down them. Secondly the skis are longer and have different bindings - you're only fixed at the toe which apparently makes them harder to control but safer in terms of not breaking your leg or tearing your cruciate ligament.

We stay in a cabin about 900m above sea level in the Numedal region of Norway, just outside the town of Veggli. It's pretty basic, with no mains electricity, bottled gas for cooking, a wood burning stove for heat, water from a well and a composting toilet.


The cars are parked about 400m away down the hill, and on arrival you have to do several trips up on your skis with rucksacks full of clothes/food/booze. Virtually impossible to walk up as the snow is about 4ft deep and you just sink up to your thigh.


Kids had a great time. The big two are pretty good on their skis now, and even Sophie at almost 4 years of age had a go. We built an igloo that stood for all of 5 minutes before collapsing for no apparent reason (wrong sort of snow probably), and several snow men/cats/chickens!

Piano Lessons

Had another piano lesson yesterday - I seem to be making good progress.

When I started these lessons I was worried the teacher would try and take me back to basics and have me playing really simple stuff but not so - she's asked me to have a go at a Rachmaninov prelude which I think is more difficult than anything I've tried so far, but she thinks I'll be able to do it. I'll post a video when I can.

UK NHS

Whenever I travel across to England to teach on a course, or attend a conference, I inevitably hear all about the problems in the NHS over there. We're lucky on the Isle of Man that we don't have the same level of political or management interference as they do over there.

Here's an example. The 18 week rule was brought in to ensure everyone gets quick treatment. However, what they don't advertise is that if someone 'breaches', then a miss is as good as a mile. A patient was recently listed for a hip replacement at a large Mersey region hospital. A manager there found he was after the 18 week limit, and promptly cancelled his admission so that another patient could be done in his place who hadn't breached. As far as the rules are concerned once he's waited 18 weeks and a day, he may as well wait for 3 years - the figures look equally bad once collated as required by the government. I find it unbelievable that clinical priorities and fairness can be distorted in this way.

There are many other examples involving the 'choose and book' system, or the 'pre-appointment physio triage' system. I'm glad we don't have these set-ups here.

More Golf

Played 11 holes today at Douglas with William. Had my best round ever, starting with a genuine birdie at the 1st (genuine as in no 'practice shots', and no mulligans), and a handful of bogeys. No disasters - worst was an 8 on the usually uncomplicated 5th, all down to my poor bunker technique taking 3 shots to get it out of the sand. If my performance over the 11 holes is extrapolated to a full round I'd justify a 22 handicap or thereabouts. Definitely felt like I'd made some progress today.


William did OK. Like every single golfer in the world he can get frustrated if shots don't go well, but his drive on the 10th made up for it all - about 150yds straight down the fairway. I was envious after I hit mine about 160yds, into the rough on the left.


Photo is looking back down the 5th fairway. Beautiful day today for golf. Spring, hopefully, has finally sprung.

Sunny Golf

Today has been a gorgeous day weather wise, quite unusual for February on the Isle of Man. I took the opportunity to play a round of golf with one of my radiology colleagues. He's been playing longer than me and is much more consistent. At my stage virtually everyone I play with is much better than me which I find quite nice. It means that I'm not under any pressure to do well, and if I halve or even win the odd hole it's an achievement.


I started well today, with a 4 for par on the 1st and 4 for a bogey on the 2nd. Rest of the round went OK, with only a couple of disaster holes, a few decent drives and a noticeable improvement in my putting. Had to play at Peel today - photo is of the 12th green - as they had a 'shotgun' competition at Douglas which meant the course was full. I've played Peel a couple of times before, and this was by far my best round there.

18 handicap by the end of the year is my aim, and I think it's at least possible.

Piano videos

Got round to recording a couple of videos of me playing the piano and posted them on YouTube. First one is my attempt at a famous Chopin Nocturne. A couple of dodgy notes in there but not bad overall.



Second one is a medley of old Queen tunes - Bohemian Rhapsody, You Take My Breath Away, Melancholy Blues and back to Bo. Rap at the end. Apparently Freddie Mercury played a Bechstein Grand on 'A Night at the Opera', so it's not a coincidence that my little Bechstein sounds quite close to the tone at the start of Bohemian Rhapsody - at least it does when you hear it live, rather than having been recorded through a mobile phone.

Waiting lists

When it comes to health service politics and management one of the biggest issues is the length of time patients have to wait for treatment, and I understand why this is the case. The problem is that the issue is far more complex than managers and particularly politicians seem to understand.

For a long time in the UK waiting lists for appointments and surgery were far too long. It was a running joke in the NHS that you waited a year for an appointment, followed by 18 months for a scan and then a year or so for your operation. By spending huge amounts of money, which a number of my UK colleagues have spent on Lamborghinis and the like, the Labour government has brought waiting times for treatment down significantly. At least that's what we're told.

Short waiting times aren't necessarily a good thing. They can lead to overtreatment. A number of conditions will resolve or improve spontaneously with time. If I saw and operated on everyone with a slipped disc on day 1 I'd be doing 90% of the operations unnecessarily. They also lead to inefficiency. If patients know they don't have to wait long for treatment there is a tendency to cancel appointments at short notice for seemingly frivolous reasons. Thirdly, a short wait for a specialist appointment means the GP's threshold for referral decreases giving a reduced conversion rate in clinic and a loss of balance between inpatient and outpatient work.

There has to be a happy medium. The UK's 18 week limit from referral to operation is in my opinion too short and inflexible. If I made the rules they would be to aim to see patients about 3 months from referral, and to aim to operate on them within 3 months from the decision to do so.