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Brian R. Martin (London, UK)
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Complications: A Surgeon's Notes on an Imperfect Science
Complications: A Surgeon's Notes on an Imperfect Science
by Atul Gawande
Edition: Paperback
Price: £6.29

5.0 out of 5 stars Daily dilemmas of a junior surgeon, 18 Dec 2014
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This volume was originally published in 2002, when the author was a junior doctor undergoing surgical training in an America hospital. It was the first of a subsequent series of books that, together with giving the 2014 BBC Reith Lectures, have established him as a household name. It consists of a series of essays based on cases he worked on. They vary very widely, but all are linked by highlighting important question about the role of the doctor in medical treatment and the doctor-patient relationship, particularly in a hospital setting where decisions often have to be taken quickly against a background of imprecise information or knowledge.

A perfect example of this, although extreme, is the final case he discusses of an otherwise healthy young woman who presents with an inflamed red leg. Is this a severe case of cellulitis (probability approaching 100%) or is the leg infected with the bacteria necrotizing fasciitis (probability vanishingly small, but with potentially devastating consequences)? The author honestly admits that hunches, gut feelings and other unscientific considerations inevitably play a role in decisions about what actions to take, however much he wishes that they didn't. He is just as frank about other aspects of medical practice, such as the need for surgeons to hone their technique on real patients, with the inevitable consequences that the less advantaged in society become the `guinea pigs' and some operations will not be done well. But when his own child becomes dangerously ill he honestly confesses that he does not want an operation to be done by an inexperienced junior surgeon, as would any parent wanting the best for their child. How do we resolve this dilemma?

There are many other dilemmas of medical practice discussed in the book, such as: how should poorly performing surgeons be disciplined in a way that does not make the profession in general too conservative and hence hinder surgical progress; to what extent is a surgeon entitled to `steer' a patient into a course of action that they, the doctor, thinks is the right choice, even though the risks may be high; and should a doctor attempt to prolong life, even when the treatment will not prevent the inevitable outcome and may even produce more suffering?

This well-written book brings home to the reader not just the technical difficulties of being a surgeon, but also the ethical responsibilities it entails and the stark problems that surgeons have to face daily. It can usefully be read by both medical students and professionals, as well as by anyone who is liable to be a patient at some time, and that means all of us.


Being Mortal: Illness, Medicine and What Matters in the End
Being Mortal: Illness, Medicine and What Matters in the End
by Atul Gawande
Edition: Hardcover
Price: £11.19

5.0 out of 5 stars A moving plea for the medical profession to reconsider end-of-life issues, 15 Dec 2014
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Atul Gawande, an American general surgeon in a busy Boston hospital, is well known as the lead author of the `checklist' system, now used worldwide, which is designed to stop surgeons making errors before they even start an operation. In this book he turns his attention to `end-of-life' issues.

The spectacular advances in medical science in modern times have been matched by equivalent advances in practical medicine. Surgical procedures are now done that were previously thought impossibly dangerous, and new drugs can greatly prolong lives, so that living to be 100 is no longer a very rare event. But there is a price to pay. In all too many instances the extra years, and they can be substantial, are spent with a low quality of life, often in poorly managed and depressing care homes and the like. The end, when it inevitably comes, is a bad experience for everyone concerned, where all too often the emphasis on keeping the patient alive is frequently cruel and counterproductive. The author illustrates this by describing many cases he has personally been involved with, and by visiting care homes and similar facilities. They make difficult reading. He argues persuasively that by making such facilities the norm, medicine has failed its `clients'.

He also visits facilities where the emphasis is not just on safety and comfort, but focuses also on what the individual patient needs to achieve a good quality of life, and ultimately a good death. Hospices are just one example, but other very imaginative ones also exist, and examples are given that he has observed. In essence what he is saying is that there comes a time when the inevitability of death has to be accepted by the medical profession and at that stage the aim should be to achieve a painless and meaningful end. Remarkably, he quotes evidence that counseling and hospice care for dying persons has been shown to often result not only in a better death, but the dying person actually living longer than those under non-hospice medical care.

This a moving compassionate plea for a reappraisal of the way the medical profession views its role at the end of life and should be read by all medical practitioners. The author's previous books have been highly praised and have won prestigious awards and I am sure this one will too.


Memoir of a Thinking Radish: An Autobiography (Oxford Letters & Memoirs)
Memoir of a Thinking Radish: An Autobiography (Oxford Letters & Memoirs)
by P.B. Medawar
Edition: Paperback

4.0 out of 5 stars Memoir of a brilliant medical scientist, 28 Nov 2014
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Sir Peter Medawar was a superb medical scientist working in the field of immunology, who is best known for his pioneering work on graft rejection and the co-discoverer of acquired immune tolerance, which was fundamental to the future success of tissue and organ transplants. He has been described as the `father of transplantation'. Born in Brazil in 1915 of an English mother and Brazilian father of Lebanese descent, he came to England at an early age and quickly showed his brilliance as an experimental scientist, but also someone with wide interests, from opera to cricket, and possessing a sharp whit. By midlife he had been showered with awards including many honorary doctorates (all meticulously recorded) and shared the Nobel Prize in Medicine in 1960. He held many prestigious posts, the most important of which was the Director of the MRC's Medical Research Centre at Mill Hill in London. Tragically, his career was seriously curtailed when in 1969 he suffered a major stroke, which left him unable to do the lab work that he loved. Doubtless his life style, frequent worldwide travel to give lectures and attend conferences, accepting multiple administrative commitments, plus a lifetime of heavy smoking, did not help. At times he railed against his medical treatment when this was poor, but never asked the `why me' question and was dismissive of religious explanations.

This book is not a conventional autobiography, but as the title says, is a memoir, with a mixture of accounts of his scientific work, some quite technical, with more personal memories. He is remarkably frank, and often scathing, about institutions that he has found wanting, and the same is true of people. Haldane is described as "the most brilliant man I have known and also the most stupid". Many others are written off, perhaps somewhat cruelly, without redeeming features. At times there is more than a hint of intellectual arrogance. When he became Director of the Medical Research Centre and made the customary visit to all the groups he summarized the staff as mostly "journeymen scientists", with some outstanding individuals. He sometimes comes across as someone who is so focused as to be unaware of much else. This is true of his family life, where he freely admits that he was hugely dependent on his wife, and devotion to his research meant that he was a very poor father to his four children. Three of the latter we are told made bad first marriages, but he makes no connection between this and their upbringing.

This is an interesting book that is certainly worth reading. If nothing else, it confirms once again that great men have their failings and that health is no respecter of status.


BT8500 Advanced Call Blocker Cordless Home Phone (Quad Handset Pack)
BT8500 Advanced Call Blocker Cordless Home Phone (Quad Handset Pack)
Price: £94.99

1 of 2 people found the following review helpful
4.0 out of 5 stars Very good call blocking phone with answerphone - a few minor niggles, 13 Nov 2014
Verified Purchase(What is this?)
I bought a quad set to operate with a Virgin phone line and I have no serious regrets. The hardware is well made and fits nicely in the hand with the buttons slightly recessed to avoid mistakes when keying in. The screen is clear, a reasonable size, and its colour during calls can be set by the user. Brightness and loudness are two other features than be changed. There are also a wide range of volume-adjustable ring tones that can be chosen for different purposes. The call screening/blocking software (Call Guardian) has an extensive number of options that seem to cover most eventualities, and works well provided you have some form of Caller Display enabled (for which providers usually charge). If you don't want to block a class of `suspicious' calls, for example Withheld Number, or International, then they can be diverting automatically to the answer phone. This is very useful because you then can examine them at your leisure. Alternatively you can initially accept all calls and by the press of a button block those you don't want to accept in future, thus building up a directory of permanently blocked nuisance calls. The useful one-button Rapid Call, or its equivalent, is also enabled if your provider has this option. Setting up a directory of Contacts who bypass Call Guardian is, as usual, tedious, although once done on the base set they are automatically copied to all phones. Some way of inputting the data from another phone would have saved a lot of time.

I found two unsatisfactory features. One is that although the sound quality when making calls is good, the quality of the sound from Call Guardian when announcing a caller is very poor and I have several times been unable to decipher it and so had no option but to accept the call. The other criticism is the documentation supplied. This is a 70-page booklet, but no Index, just a useless Menu, but without page numbers. The equivalent documentation for the BT6500 and the BT7600 both have comprehensive indices. Why not this one? Fortunately, setting up the various features is fairly intuitive and there is a `wizard' to get you started, but it would have been made easier with a better manual.


The Faber Book of Reportage
The Faber Book of Reportage
by John Carey
Edition: Paperback
Price: £14.39

1 of 1 people found the following review helpful
5.0 out of 5 stars History from those who were there., 12 Nov 2014
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This is collection of short descriptive pieces, some no more than a page and seldom more than half a dozen, mostly written by eyewitnesses to the events described. They range in time from 430 BC to 1986 AD.

The dominant theme is conflict and its accompanying horrors, with atrocity stories to the fore. Examples are: the massacre of prisoners by Richard I after Richard I after taking Acre in 1191; the murders of English women and children by Indians at Cawnpore in 1857; the horrors of the German concentration camps in WW2, with their sadistic medical `experiments'; and many, many others. There are also grim descriptions from civilian life, such as: the Black Death of 1348; the burning of Archbishop Cramer at the stake in 1556; and the barbaric behaviour meted out to slaves in the West Indies. Horrific as these accounts are, they are often also very moving, such as the description of the death of Nelson at the battle of Trafalgar in 1805, and Fanny Burney's account of her mastectomy without anesthetics in 1811. There are also lighter, more cheerful, pieces such as Marconi's account of sending the first radio signal across the Atlantic in 1901, and Jan Morris' account of the first ascent of Everest in 1953.

These examples give some account of the impressively wide range of topics in the book, which are the result of much reading by the editor and, as he admits, much badgering of friends and acquaintances for suggestions. The result is a superb volume. Open it at any page and one can find an engrossing account of some event that almost invariably gives one a new insight, even if the subject described is well known. However, because of the unremitting horror of much that is reported, it is best sampled in small doses.


The Faber Book of Science
The Faber Book of Science
by John Carey
Edition: Paperback
Price: £12.79

1 of 1 people found the following review helpful
4.0 out of 5 stars A fine selection of scientific writing, 30 Oct 2014
This is a collection of scientific writings spanning several hundred years from the Renaissance to modern times. John Carey has obviously read very widely to compile the entries, which range over many topics in the physical and biological sciences, and, as befitting a professor of English, he has made his choice not only on the importance of the topic, but also on the quality of the writing. The contributions vary from a single page to several pages; some have extensive commentaries from the editor, others just a note on the source reference. They also vary in style. There are classic pieces of writing about seminal discoveries such as radioactivity, X-rays, and the atomic nucleus, by the discoverers themselves; commentaries by eyewitnesses or later interpreters and biographers; and personal accounts by eminent scientists about how their ideas evolved with time. One of the longest entries of the latter type is Darwin on evolution. There are also occasional lighter pieces, such as the story of how Bird's Custard Powder came to be invented, and even a few contributions, including poems, from well-known literary names who were also amateur observers of nature. I enjoyed reading this collection. It is of course a personal selection and one can think of many other possible entries, but most are well written and informative and their length means that one can dip into the book and read some of them when one has a few minutes to spare.


Rapesco 2200 Punch Heavy-duty 2-Hole Capacity 150x 80gsm Black Ref PF220AP1
Rapesco 2200 Punch Heavy-duty 2-Hole Capacity 150x 80gsm Black Ref PF220AP1
Price: £73.58

5.0 out of 5 stars Excellent heavy-duty paper punch, 25 Oct 2014
Customer review from the Amazon Vine Programme (What's this?)
If you have ever had to compile collections of paper files of some sort, the obvious thing is to store them in a ring binder, which usually means punching a few sheets at a time, which is tedious, and the final result is often a rather untidy badly aligned bundle. Not if you use this machine. It is a very sturdy, well-made device that effortlessly punches neat holes through a large stack of up to 150 sheets of 80gsm paper. There is no spring mechanism; the smooth action is due to its long handle and the quality of the steel cutters. It has an excellent paper guide and can be set up for 2-hole and 4-hole operation (the latter in two stages). It is supplied with one set of cutters and cutting boards (small discs which the cutters hit after punching the holes) and it is recommended that the latter are rotated regularly by a small interval (a trivial task) and replaced when they have been rotated a full turn. Spares are available on Amazon, from example, at £5 for a pack of four and the machine has a storage area where they can be kept. Cutters are more expensive, but should last much longer. Given the price and the desk space it requires, you would have to use it regularly to justify buying one for home use, but for a small office, siting one for general use, near a copier perhaps, would improve efficiency for all users. Finally, although its use is mostly self-explanatory, it has a small but well illustrated manual.


The Unexpected Professor: An Oxford Life in Books
The Unexpected Professor: An Oxford Life in Books
by John Carey
Edition: Hardcover
Price: £12.91

1 of 2 people found the following review helpful
3.0 out of 5 stars An Oxford English professor remembers, 25 Oct 2014
John Carey is a respected writer and literary critic and some of the books he has edited (for example, on reportage and science) are a joy to read, but this one I found disappointing. It's a mixture of autobiography, literary criticism and a description of life as an Oxford academic in an earlier time before the harsh winds of reality swept through that university. For me, this mix doesn't work. The description of his early family life at the beginning of the book, with lists of uninteresting relatives who played little part in forming Carey's character, is dull. The bulk of the book is a series of commentaries on the writers, particularly poets that he has studied and admires. These are often far too detailed, technical and rather tedious; they out of place for a relatively short book such as this. They also add little to understanding Carey himself. The most revealing sections are the descriptions of his academic life at Oxford. They are not very flattering. All too often he boasts about his achievements: in being the driver for modernising the English Faculty, in getting excellent reviews for his books and articles, and some minor discovery in the arcane world of English scholarship. Although he likes to portray himself as left-wing and on the side of the common man, he also likes to drop the names of the great and the good, and let the reader know they are in his circle of friend. I suspect he always felt a bit of an outsider at Oxford and still harbours resentment to those who held their positions almost `by right'. Carey's life has the material for a good biography, but it needs to be presented more objectively, not as an autobiography.


Kid Galaxy Morphibians Terrapin
Kid Galaxy Morphibians Terrapin
Price: £10.56

4.0 out of 5 stars Sturdy, great fun toy, 23 Oct 2014
= Durability:5.0 out of 5 stars  = Fun:5.0 out of 5 stars  = Educational:3.0 out of 5 stars 
Customer review from the Amazon Vine Programme (What's this?)
This was a great hit with my 5 year-old grandson and his 3 year-old sister. It is a robust machine made of strong rigid plastic, with large deep-tread tyres that grip very well on rough surfaces such as carpets and grass, but not so well on woodern floors, where they tend to spin. It also works well in still water, but is less successful at climbing ramps. It needs three AA batteries for the machine and one 9V (neither supplied) for its wireless controller. I suspect they may well need to be replaced regularly because the performance of the machine, speed etc, is very impressive. The boy greatly enjoyed getting the knack of steering it (not so easy because of its rapid acceleration) and operating the two-lever joystick controller (a useful skill in today's world!). The latter is light, compact and well-suited to small hands. The only (minor) criticism it that the two aerials would have been better made of flexible plastic rod, rather than the flimsy wires that have been used, and which look as if they could break easily.


Tacwise Z3 Stapler 4-in-1 Nailer Kit
Tacwise Z3 Stapler 4-in-1 Nailer Kit
Price: £21.16

1 of 3 people found the following review helpful
2.0 out of 5 stars Looks good, but ...., 23 Oct 2014
Customer review from the Amazon Vine Programme (What's this?)
Multi-purpose tools all too often fail to live up to expectations, and so I was interested to see if this device, from a well-known manufacturer, would be any different. It comes in a useful box which can be used to store the tool, and is supplied with a range of small nails, staples and cable clips. It also appears to be sturdily made. But whether it 'does the jobs' is difficult to say.

The only instructions, such as they are, are two miniscule pictures on the side of the tool, but even these are almost useless because to load the tacker you have to invert it, and of course then the 'instructions' are upside down - poor design. The 'instructions' only address loading the device, and this inadequately. There is a lever on it that is not even mentioned. Although I have quite a lot of DIY experience, I have never used a tacker, and given that this one is clearly aimed at the DIY market, it is inexcusable to supply it without any instruction leafet. (The manufacturers have responded to this criticism by hastily posting some 'instructions' on the web, but they are merely enlarged prints of the 'instructions' on the side of the tool.) I did eventually work out how to load it with nails, but its performance was diasappointing: they failed to penetrate more than a few millimetres into softwood, and the device misfired several times (appeared to be trying to fire more than one nail). The spring lever is also understandably quite strong and I couldn't see myself using it for extensive jobs.

Overall, this is a disappointing tool. Perhaps I was loading it incorrectly, but why should I have to waste my time trying to find how to use what is a potentially dangerous tool, just because the manufacturers can't be bothered to supply it with instructions?
Comment Comments (2) | Permalink | Most recent comment: Oct 24, 2014 4:02 PM BST


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