"As a doctor, O’Mahony says, “there is little reward, professionally or emotionally, for doctors who tell patients the truth” about the end of a patient’s life and what to expect. “Nearly all families, and many patients, prefer the Lie.” Most of what he reads on the subject bears little resemblance to the reality. This is his corrective."O’Mahony is not a fan of assisted dying - in thirty years he claims never to have encountered a case where this would have been appropriate, and he is sceptical about advance directives - you just don't know what your wishes will be when the time comes.
...
"The worst kind of death you could have “without exception”, he says, is an acute death on a busy, understaffed general ward. Another cause of a “bad” death is family interference. O’Mahony describes the situation with an elderly woman with dementia and pneumonia who is brought to hospital by her family. He tries to persuade the family that at her age and in her condition, she should not be admitted to intensive care, where she will have to have highly invasive procedures: a breathing tube and mechanical ventilation.
"They aren’t convinced and so she is admitted. “Her death was farcical and undignified,” he says and he doesn’t try to veil his anger: “Although I had made it clear to the family that we would not attempt cardio-pulmonary resuscitation, when the poor woman finally died, two of the daughters attempted their own cack-handed version of cardiac massage and mouth-to-mouth resuscitation.”
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| Your author and his wife fronting Lytes Carey Manor |
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| Lytes Cary Manor |
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| An advanced case of topiary |
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| Nigel in the Bijou Garden |
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| Clare: "Enough already!" |
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| Daenerys Targaryen |
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| Tyrion Lannister |
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| Ned and Catelyn at the Keep |
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| Amazon link |
"Standing up with all the others as she entered, Bear felt an almost physical sense of the power she gave off. The graver this crisis became, the more assured became her leadership.Enough: put aside the hyper-stereotyped characters, the pedestrian plotting and the over-acronymed prose. We are not reading the new Tom Clancy; we want to know what's wrong with our defence posture.
"I know how lonely command in war can be, he thought. But, dammit, she’s just thriving on it. What was the saying? Cometh the hour, cometh the man? This time it was firmly cometh the woman ... and what a woman.
"With the President seated, MacWhite, the tall, lean former Special Forces general, who looked as if he’d be more at home riding the range somewhere out West than inside the Washington beltway, led the President through the agenda."
"But surely, even if we're outmatched conventionally, we've still got Trident?"This argument is exactly right, but contra the book, NATO is not going into a hot war with Russia over the latter's border accommodations. The trouble is, in the present state of disarray, NATO couldn't get into a hot war with any prepared state over anything; not a good place to be when negotiating with potential adversaries such as Russia and China.
"OK, Prime Minister,' sighed Kydd, let me take you through this from first principles. You ask what the Russians will do and I'll repeat. They'll do what they've done at the end of every snap exercise they've called recently. Launch an Iskander tactical nuke as what they call a de-escalatory measure to stop us dead in our tracks and stop us counter-attacking?"
"Hardly sounds to me like de-escalation. Surely them firing a nuke will lead to all-out nuclear war?" asked Little.
"That's precisely the point, Prime Minister. It's counter-intuitive . . . the President knows that there's no way you are going to risk the destruction of human life in the UK by launching a Trident at Russia in response to his tactical nuke when, by so doing, you can almost guarantee a retaliatory strike from an intercontinental ballistic missile in return."
"So, how should we respond? We just have to take it on the chin?"
"Sadly, with the state of our Armed Forces as they are today .. Yes. That would be my advice. Plenty of people told the last government that to be effective, deterrence needs to be matched at every level, conventional and nuclear. As I've just explained, you can't weaken conventional forces and expect Trident alone to protect you. Conversely, if we did have strong conventional forces, but no Trident, they could easily defeat us by threatening to nuke us and we would have no way of deterring them."
"The famous run is a 2.4km (1.5 mile) track in which you must complete the full distance within the given time. The time you have to complete the run will vary depending on the position within The Army that you have applied for.OK, so we're not going there.
"Before starting your timed run, you will warm up as a squad with the other people in the selection process. This consists of a slow jog and walk over a distance of 800 metres. You will then immediately begin your test.
"The required times for the various regiments within The Army are as follows:
"Parachute Regiment - Run Time 09.40"
"Royal Signals, Army Air Corps, Royal Logistic Corps, Royal Electrical & Mechanical Engineers, Adjutant Generals Corps, Army Medical Services, Royal Army Veterinary Corps, Intelligence Corps, and Corps of Army Music – Run Time 14.00"In my school CCF I was in the Signals, so let's take 14 minutes as my target. If you run a km in five minutes (12 km/hour) you will run 2.4 km in 12 minutes. Way to go.
"Written by the recently retired Deputy Supreme Allied Commander Europe and endorsed by senior military figures, this book shows how war with Russia could erupt with the bloodiest and most appalling consequences if the necessary steps are not taken urgently.I see the Amazon comments are already being filled up with 'warmonger!' sentiments. And naturally one would like to discount books like this in advance, on grounds of special pleading and bureaucratic rent-seeking.
"President Putin said: 'We have all the reasons to believe that the policy of containment of Russia which was happening in the 18th, 19th and 20th century is still going on...' And 'If you press the spring, it will release at some point. Something you should remember.'
"Like any 'strongman', the Russian president's reputation for strength is everything. Lose momentum, fail to give the people what they want and he fails. The President has already demonstrated that he has no intention of failing. He has already started a lethal dynamic which, unless checked right now, could see him invade the Baltic states.
"Russia's invasion and seizure of Georgia in 2008 was our 'Rhineland moment'. We ignored the warning signs - as we did back in the 1930s - and we made it 'business as usual'.
"Crimea in 2014 was the President's 'Sudetenland moment' and again he got away with it. Since 2014 Russia has invaded Ukraine. The Baltics could be next.
"Our political leaders assume that nuclear deterrence will save us. General Sir Richard Shirreff shows us why this will not wash."
"Do you install fans?"The shop exists to sell components and that's the main profit-generating business. Installation (which undoubtedly also contributes to the bottom line) is a necessary add-on. An interesting example where vertical integration allows a market opportunity to be addressed.
"Yes, I'll get our electrician to give you a call."
"My absolute favourite anecdote about modern Russia comes from the British author, Edward Docx. At a dinner with the cream of Russian literary society, he happened to mention that the panel of the Man Booker Prize of 2011 was headed by Dame Stella Rimington, the former director-general of MI5.---
"Docx recalled: “They guffaw ‘Oh, the West! Oh, England! Oh, hypocrisy! You mean,’ they splutter, ‘that the winner of your most famous literary prize is judged by the security services?’ ” Startled, Docx protested that Dame Stella was retired now, and wrote thrillers herself. Sure, his hosts chortled. Like Vladimir Putin is retired from the KGB! And the more Docx blushed and stammered, the more they laughed and laughed."
"Korean Air Lines Flight 007 (also known as KAL007) was a scheduled Korean Air Lines flight from New York City to Seoul via Anchorage. On September 1, 1983, the airliner serving the flight was shot down by a Soviet Su-15 interceptor, near Moneron Island west of Sakhalin in the Sea of Japan.I was thirty two when this happened, and it was a big, scary deal. In the story which follows (comment #24 from here) you should recall that the SAC is the US Strategic Air Command, their nuclear bomber force.
"The interceptor's pilot was Major Gennadi Osipovich. All 269 passengers and crew aboard were killed, including Larry McDonald, a Representative from Georgia in the United States House of Representatives.
"The aircraft was en route from Anchorage, Alaska, to Seoul when it flew through Soviet prohibited airspace around the time of a U.S. aerial reconnaissance mission."
"I was in college when KAL 007 happened; we were all shocked but it was pretty clear it was a mistake. But a few weeks later, I was in my room listening to the college radio station (it was a really good station BTW) when the Emergency Broadcast System activated; I figured it was the standard test of the system, but when the alert tones stopped, instead of the typical “this is only a test” statement I heard “Attention: Please stand by for an official statement from Washington D.C.”…my pulse spiked and I immediately jumped to the window to look in the general direction of the SAC base about 30 miles away, then just as quickly tore my eyes away from the window and shut the curtain – after all, you really don’t want to be looking at the bomb when it goes off.
"After a few seconds, my rational mind began to assert itself, thinking “this has got to be a mistake.” And after another few seconds, the message on the radio cut off, the DJ said, “Woops, I’m probably in big trouble now,” and the standard “this is only a test” recording came on. I decided that escaping near-certain nuclear annihilation was worthy of a shot of whiskey, even at 10am; fortunately my first class that day was after lunch.
"The DJ was right; I never heard him on the station again."
"With notable exceptions, Britain’s universities are still not doing enough to attract poor students. English 18-year-olds from the most advantaged 20 per cent of backgrounds are still more than six times more likely to attend a top university than those from the least advantaged 20 per cent.In fact he is quite wrong.
"Jo Johnson, the universities’ minister, calls this unacceptable and he is right."
- Given a population with average IQ of 117, you would expect 42% to be eligible to meet the 120 cut-off.That's a ratio of 42/0.8 = 52.5 - far worse than the lamentable six to one quoted by The Times.
- Given a population with an average IQ of 84, you would expect 0.8% to be smart enough to meet the IQ 120 cut-off for the Russell Group.
"First, the essence of eugenics was compulsion: it was the state deciding who should be allowed to breed, or to survive, for the supposed good of the race. As long as we prevent coercion, we will not have eugenics. Our politics would have to change far more drastically than our science."His second point is more dubious - reassuring cant, some might call it. Artificial insemination with the eggs or sperm of strangers is not what most couples want - they made their own eugenic selection when they chose their partner.
"The second reason we need not fear a return of eugenics is that we now know from 40 years of experience that without coercion there is little or no demand for genetic enhancement. People generally don’t want paragon babies; they want healthy ones that are like them. At the time test-tube babies were first conceived in the 1970s, many people feared in-vitro fertilisation would lead to people buying sperm and eggs off celebrities, geniuses, models and athletes. In fact, the demand for such things is negligible; people wanted to use the new technology to cure infertility — to have their own babies, not other people’s. It is a persistent misconception shared among clever people to assume that everybody wants clever children."But what if their own child-to-be could be tweaked a little? Or there could be a little bit of selection amongst all their possible children? This is already pretty popular for genetic disease screening; and rightly so.
"The more recent discovery that traits such as intelligence are caused by the complicated interaction of multiple genes of small effect means that it is anyway going to be virtually impossible to decide what genetic recipe to recommend to somebody who wants a clever child, or a good-looking one, or an athletic one. By contrast, the genetic changes that cause terrible afflictions such as Huntingdon’s disease or cystic fibrosis are singular and obvious. Selecting embryos that lack such traits, or editing the genes of people so that they are born without carrying such traits, will always be much easier than selecting genetic combinations that might, in the right circumstances and with the right upbringing, lead to slightly higher IQ. Cure will always be easier than enhancement."We know that embryo selection on as few as ten fertilised eggs could span an IQ gap of ~11 IQ points. That would boost Caucasian populations to the level of the Ashkenazim in one generation. And not a CRISPR in sight.
"How many American tanks are permanently stationed in Europe? At a time when Vladimir Putin has invaded Ukraine and grabbed 10,000 square miles of his neighbour’s territory, you might be surprised to learn that the answer is none.Mark Urban paints a disturbing portrait of a "hollowed out" Western military. After the end of the Cold War, investment in classic state-on-state military systems was throttled right back. We have ageing ships and aircraft, and if they were destroyed in combat, the factories which could replace them have long since ceased production.
"With impeccable timing, the last American main battle tank left Europe shortly before the onset of Ukraine’s crisis in 2014. During the Cold War, the United States Army kept 5,000 tanks in Europe to defend its Nato allies; today, not a single one remains.
"Surely the world’s only superpower could rustle up some heavy armour pretty quickly in the event of an emergency? Don’t be so sure. General Sir Richard Shirreff, formerly Nato’s deputy supreme allied commander, thinks that America would need between six and 12 months to deploy one armoured division in Europe.
"Russia, meanwhile, has no fewer than 2,300 tanks, most of them already positioned in the European theatre.
"In The Edge, Mark Urban sounds the alarm over the scale and pace of the West’s disarmament since the collapse of the Soviet Union. Back in 1979, Urban, now the diplomatic and defence editor of Newsnight, was “for a short heady time” the “commander of one of the British Army’s 900 Chieftain tanks”.
"The era when Britain could field hundreds of the heaviest machines of war now seems impossibly distant. By way of comparison, the Army was down to 36 operational tanks for much of last summer.
"The picture at sea or in the air is little better. Year after year, every country in Nato – including America – has been paying off warships and decommissioning fighter squadrons.
"Even the forces that remain have been hollowed out by a shortage of spare parts and trained personnel. On paper, the Spanish Air Force has 39 Typhoon fighters, but only six are actually ready for combat. Of Germany’s 109 Typhoons, only 42 are in any condition to defend the country’s airspace.
"In clear and concise prose, Urban lays out the way in which an entire continent has chosen the path of wholesale disarmament. It is impossible to read this authoritative book without feeling a deep sense of alarm, indeed of wonder, that our leaders have chosen to take such breathtaking risks.
"The assumption behind the shredding of Nato’s defences is that warfare between European countries is no longer conceivable. In military jargon, “state-on-state” conflict is now irrelevant; the sole purpose of the tattered remnants of our armed forces is to fight “non-state actors” like terrorists and insurgents.
"Russia, however, was never so foolish as to make such an assumption. After the Cold War, the Kremlin was at first compelled to disarm for the simple reason that Russia’s economy had collapsed. For the last decade, however, Russia has been rearming on a huge scale – and its generals take the ruthless business of “state-on-state” conflict very seriously indeed. In Georgia in 2008 and now in Ukraine, those are precisely the kind of wars that Putin has chosen to fight."
"I have a mattress blocking my hall. I'd like you to remove it as you contracted to."
"The team’s technique looks for changes not in alleles themselves, but in the DNA that surrounds those alleles.---
"If a particular allele is more beneficial than other variants of a gene, it will tend, as lactose tolerance did, to spread through the population. As it does so, it will carry with it neighbouring DNA which is not strictly part of the gene and does not affect its function. This DNA can thus mutate without damaging the allele. And it is the amount of mutation this peripheral DNA has undergone which is the giveaway.
"DNA neighbouring an allele that has recently spread quickly will have had less time to accumulate mutations than that near one which evolution has been ignoring. By looking for evidence of mutations around particular alleles, Dr Pritchard and his team can reconstruct their history.
"Apply the method to lots of people, and it is possible to discern what evolution has been up to."
"Is there something about the genomics of Europeans/Asians which enables them in principle to run successful democracies?"If they wish, they can have the null hypothesis that the answer is no.
- a democracy replaces kin- and tribe-based interest-mongering with an atomised population delegating conflict resolution to a formal and non-violent eliteNone of these things seems the kind of thing social animals usually get selected for.
- in a democracy, leaders who wield power are expected to hand it over in the event they lose an election, regardless of the idiots who won it
- if your sectional group has a problem, you are expected to wait for an election until it gets resolved; and then suck it up if your group does not succeed in winning power.
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| Clare with her new new summer dress and book |
"The second law of thermodynamics implies that the energy inside a closed system will always tend towards the lowest level possible. ..."This is meant to be a metaphor for the complacency of the present Conservative government.
"The first law of thermodynamics is a version of the law of conservation of energy, adapted for thermodynamic systems. The law of conservation of energy states that the total energy of an isolated system is constant; energy can be transformed from one form to another, but cannot be created or destroyed."So it seems that in a closed system, the energy is unlikely to always tend to the lowest level possible (which would presumably be zero, ignoring quantum fluctuations).
"The second law of thermodynamics states that in every real process the sum of the entropies of all participating bodies is increased."So got that? In a closed system the entropy (not energy) will increase (not decrease).
"According to the second law of thermodynamics, [...] there is a general natural tendency to achieve a minimum of the Gibbs free energy."Perhaps Times readers are more familiar with the pioneering work of Willard Gibbs.
- two or more states experience differences which cannot be resolved peacefully;In the United States, a well-honed system of federal conflict resolution + economic unification tends to dampen inter-state conflicts of interest. If that were ever to break down, the US (federal) military would demolish any individual state's armed forces. They did it before.
- each state must be militarily capable with a belief in the possibility of winning.*
'...the father’s generation fights bitterly, their sons seek to avoid the mistakes that led to violence, but the underlying pressures still exist, so their grandsons repeat the pattern as memories of the causes and consequence of civil strife fade.'If the interests of states within the current EU were to diverge sufficiently, then war is perfectly possible - the legally-enshrined authority of the central institutions of the EU would be brushed aside as effortlessly as during the continuing refugee/immigration crisis and the events in Greece.
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| KALs' cartoon from The Economist this week |
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| Lowest energy orbital for the hydrogen molecule ion |
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| Success! |
"HMS Erebus and HMS Terror .. left port in June 1845 from the British Isles under the command of Sir John Franklin in search of a Northwest Passage that could energize trade by connecting western Europe to East Asia. They were outfitted with two field tested ice-breaker vessels equipped with state-of-the-art steam engines, retractable screw propellers, and detachable rudders. They also had five years of provisions and were prepared to deal with the harsh winter in the Arctic Ocean. And yet, even with all of these things going for them, the crew was forced to abandon ship in their second year and move onto King Williams Island—where they became fragmented into small groups and forced to the point of cannibalism before all dying eventually.Henrich has many similar anecdotes about the adaptations which enabled humans - uniquely amongst primates - to develop, share and propagate a collective culture, something we understand in business when we say that 'good processes get excellent performance from average people'.
"The crew was in an area where Inuits had lived for thousands of years, some of whom came into contact with the shipwrecked crew during the time they were stranded there. It was a harsh environment where the locals had amassed a repertoire of knowledge about how to build kayaks and igloos, hunt sea animals for food, and scavenge for plants during the brief warm spells of summer. Unfortunately for the British explorers, this body of cultural knowledge was not available to them and they suffered the consequences."
- on TV, you get to appreciate team strategies;Here are some pictures.
- roadside, the lycra blur communicates supreme athleticism .. and stoicism.
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| Yes, we were on TV (ITV4). On the left Clare, Alex and Adrian spectating & green-anoraked myself above with camera. We're just up from Hutton-le-Hole. |
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| Alex at Nunnington Hall (NT) |
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| Clare and Adrian at the TdY finish in Scarborough |
"Dear PGP-UK ParticipantI have this morning spent ten minutes spitting into a test tube and the sample has been posted off to the Wellcome Trust Sanger Institute to be sequenced: whole genome sequencing. Scary thought: I can now be cloned.
Following your completion of the PGP-UK geographic survey, we would like to invite you to participate in PGP-UK.
As outlined previously this involves the collection of a saliva sample from you, from which DNA will be extracted and whole-genome sequenced at the Wellcome Trust Sanger Institute."
"Fine-scale genetic variation between human populations is interesting as a signature of historical demographic events and because of its potential for confounding disease studies. We use haplotype-based statistical methods to analyse genome-wide single nucleotide polymorphism (SNP) data from a carefully chosen geographically diverse sample of 2,039 individuals from the United Kingdom.More later.
"This reveals a rich and detailed pattern of genetic differentiation with remarkable concordance between genetic clusters and geography. The regional genetic differentiation and differing patterns of shared ancestry with 6,209 individuals from across Europe carry clear signals of historical demographic events.
"We estimate the genetic contribution to southeastern England from Anglo-Saxon migrations to be under half, and identify the regions not carrying genetic material from these migrations. We suggest significant pre-Roman but post-Mesolithic movement into southeastern England from continental Europe, and show that in non-Saxon parts of the United Kingdom, there exist genetically differentiated subgroups rather than a general ‘Celtic’ population."
