The Circle of Life - and death

This post is inspired by a poem. As far as I can tell, it's not very well-known. Have a read of it first; its relevance will become apparent if you read what follows. At the end you can click a link and see it being read by a wonderful actor, to whom I am obliquely connected. Read on....

To a poet a thousand years hence

I who am dead a thousand years,

And wrote this sweet archaic song,

Send you my words for messengers

The way I shall not pass along.

I care not if you bridge the seas,

Or ride secure the cruel sky,

Or build consummate palaces

Of metal or of masonry.

But have you wine and music still,

And statues and bright-eyed love,

And foolish thoughts of good and ill,

And prayers to them who sit above?

How shall we conquer? Like a wind

That falls at eve our fancies blow,

And old Maeonides the blind

Said it three thousand years ago.

O friend unseen, unborn, unknown,

Student of our sweet English tongue,

Read out my words at night, alone:

I was a poet, I was young.

Since I can never see your face,

And never shake you by the hand,

I send my soul through time and space

To greet you. You will understand.

James Elroy Flecker (1884-1915)

Fourteen years ago today - 18th December 2006 - was the funeral of my father, who had died on the 9th at the age of 86, after a short period of ill-health. Only hindsight imposes patterns on what at the time can seem like chaotic and distressing periods of life: my father’s death came during an extraordinarily difficult month in what proved to be a prolonged and trying few years in the lives of my family and me.

And yet even at the time I had an intangible sense that all would be well in the grander scheme of things, and that we would all emerge stronger from our trials and tribulations. Fourteen years later I was caused to re-visit the day of farewell to my father in a manner which was positive and life-affirming.

I shall not dwell on the circumstances of December 2006 in this post: the full story is known to family and close friends, but suffice it to say that the death of my father was by no means the most traumatic event of that month, but that all was well in the end, and I look back on that month with gratitude rather than sadness. Had I been on social media at the time, sharing stuff as we now do, there would have been some interesting posts, to say the least.

My father’s death came at a time when my late mother was descending into the abyss of Alzheimer’s - a story I have already shared here. On the day of the funeral my brother and I arrived at her house with our respective families, dressed in black and ready to support her through a difficult day as she said farewell to her husband of 54 years. She answered the door with a cheery smile, dressed in casual clothes and said “Oh what a lovely surprise, how nice to see you all”. It soon became apparent that she had no idea why we were there, nor that he had died, despite our having been there a couple of days earlier with the minister preparing his funeral. My wife and sister-in-law took her to her room and helped her to dress appropriately (she had always been a stickler for dressing elegantly, formally and correctly) whilst gently reminding her of what had happened and what lay ahead that day.

During that minister’s visit two days earlier, despite appearing very confused as to who he was, who we were and why we were all there, she had startled us all with a moment of lucidity by announcing that she would like to read a poem of her choice at the service, reciting some of the words from memory, quoting the title and author in such a way as to enable us easily to identify it by an online search.

The poem concerned (see above) was previously unknown to me and to any other family members, and she was unable to give any clear reason for wanting to recite it (for example she said she didn’t know whether it was a favourite of our father’s or not), but she was particularly keen on a verse which she said summed up how she felt about being widowed.

But have you wine and music still,
And statues and bright-eyed love,
And foolish thoughts of good and ill,
And prayers to them who sit above?

The poem is called To a Poet a Thousand Years Hence by James Elroy Flecker (1884-1915), a relatively unknown English poet and novelist whose premature death at 30 is said by some critics to have been a major loss to literature and poetry. My own rudimentary research reveals no reason why my mother would have known or liked his work, with no obvious connection to her other than a shared birthplace. 

Come the day of his funeral, we were all nervous that mother might make a fool of herself, not least given her intermittent lack of awareness of his death, and her growing penchant at that time for speaking out of turn in an inappropriate manner. However, she stepped up to the lectern with grace and composure, and read it perfectly, with all the same expressiveness that she had shown in her pomp as a schoolteacher and choir mistress. Sadly, this proved to be a false dawn, as she rapidly descended into an unimaginably grotesque form of dementia, lasting over six more years with little quality of life, such that her death in 2013 was a merciful release for her and us.

Life moved on as it does, and I had put the funeral and that poem to the back of my mind, regarding it as a strangely enjoyable day on which my father’s life had been suitably celebrated, with our mother showing what proved to be one of the last manifestations of her true self.

But what goes around comes around in the Circle of Life, and so fourteen years later that poem suddenly returned to my mind a couple of weeks ago in another circumstance that was desperately sad, yet became strangely uplifting. I don't believe that "everything happens for a reason", because if it does there's some pretty perverse reasoning controlling our lives. However, I do believe in being aware of possible benefits even when at first they are hard to see, such that with hindsight, even the darkest clouds can have a silver lining. For me, many events and experiences in recent years have given me good reason to believe in the existence of silver linings.

My return to thoughts of December 2006 happened because of Lis Warren, a woman of similar age to me from Middlesex who has in recent years become a good friend thanks to our shared medical condition - Type One Diabetes. Lis and I got to know each other a few years ago thanks to the growth of an online peer support community of people living with diabetes: our paths have crossed several times at events both real-world and online, and we have many mutual friends. A silver lining indeed. She and I share much more than a medical condition, and in particular we are both lovers of the arts, in particular music; she, indeed, is a musician by profession, a graduate of the Royal Academy of Music and in her working life was an advisor on music education to the Department for Education. Lis and I were two of a small group of people with diabetes and healthcare professionals who set up and ran a project called ArT1st (follow that link to the website) during the Coronavirus Pandemic, which involved gathering and showcasing artistic work in the performing and visual arts produced by members of the Type One diabetes community: patients, carers and healthcare professionals. Working with this small group, some of them already good friends of mine, others new friends, has been the silverest of linings to this locked-down year.

Tragically, as we were preparing to stage a live end-of-year online event celebrating the success of the project, Lis’s husband John died in late November after a short illness, meaning that our close-knit group felt keenly the loss of one of its members’ loved ones. We wanted to add an element to our show as a gesture to Lis, who remained determined to take part in the show, even though it turned out to be on the very day of her husband’s funeral. It was, indeed, John who had thought up the idea of calling it ArT1st with the clever play on T1. Through the good offices of NHS Specialty Advisor for Diabetes Professor Partha Kar, who had set up the project, we were able to secure the services of an A-list member of the diabetes community, actor James Norton, very much a man of the moment thanks to several starring roles in TV and cinema in recent years. James had already proved himself to be a supportive and self-effacing member of the community, and we were therefore delighted when he agreed to read a poem for us. 

But what were we to choose?

At that point To a Poet a Thousand Years Hence came back into my mind. I looked it up, to remind myself of its words, and shared my suggestion with a couple of colleagues from the group. Both colleagues readily agreed that it was perfect. Flecker’s words are both a wonderful evocation of the lasting power and value of the arts and a painful reminder that our time on this earth is short and precious. Returning to them after over a decade I was struck again by how good a choice my mother had made, whatever the forever unknown reason for that choice. I remain surprised that it is not better-known.

Flecker’s words remind us that we only tread this earth for a short time, yet what we do, what we say, what we leave behind us can indeed be eternal. Advancing years inevitably expose us to the loss of loved ones; if we are lucky, we do not experience real loss until later life, but experience it we all must. And as we age, we all start to wonder when and how our end will come, whether we will be left alone, or leave others alone, and what - if anything - lives on after our deaths.

The notion of life after death is a comforting one which sustains many and forms the basis of entire belief systems. We can never prove or refute it. However, of one thing I am more certain than ever: we absolutely do live on in what we leave to others, not in material terms, but in our deeds, our words, the personalities and values that we pass down the generations and, for a gifted few, the works of beauty that we create in art, poetry, sculpture, writings or music. A thousand years or more hence, especially now that mankind has devised such clever ways of preserving all that we produce, we will all live on. We can all now listen to music written and performed by artists long since dead, digitally preserved as fresh as the day they were recorded.

And every time I catch a look in a photo or a mirror and think “OMG, I’ve turned into my dad”, or every time I hear my own children utter words or express thoughts that I myself might have said, I realise that our earthly bodies are custodians not just of a set of genes, but more importantly of values, talents and ideas which can indeed be immortal.

“I send my soul through time and space

To greet you…You will understand”. 

Click here to watch James Norton reading this wonderful poem with the peerless expressiveness of the English gentleman that he is, dedicated to my friend Lis, her late husband John, and the diabetes community.

Note: This post was written with the knowledge and approval of Lis Warren, who has expressed her sincere and lasting gratitude for the love and support of the diabetes community during this difficult time

It's Getting Better: thoughts for World Diabetes Day 2020

November is Diabetes Awareness Month, and as happens every year in the first half of the month, leading up to World Diabetes Day on November 14th, there is a growing frenzy of activity and excitement in the online world of diabetes. This year, that online world is the only forum in which the diabetes community can interact to any extent, and so this frenzy and hyperactivity seem particularly intense. Moreover, we are approaching the centenary of the discovery of insulin therapy (January 11th 1922), so no doubt next year’s WDD celebrations will be even bigger and better, not least because we can all hope that celebrations will by then be back in the physical world, rather than the virtual one.

Amidst all the frenzy, it’s a good moment to ponder developments in the world of diabetes, in its treatment and care. In so doing it is impossible to avoid noting how much has changed in recent years, and difficult to avoid the conclusion that the pace of that change is accelerating.

My own thoughts at this time of the year are always shaped by the awareness that I am approaching another anniversary of my own diagnosis, my “diaversary”, which falls on December 19th, this year marking 23 years since I was joined for the second half of my journey through this world by my unwanted friend. Any reflections on what is going on in the diabetes world are necessarily shaped by thoughts on the passing of time, and the increasing longevity of my life with diabetes - I have lived around one third of my life, and more than half of my adult life, with diabetes.

So, in the words of the late, great David Bowie’s last big hit before his premature passing, Where are we now?

I find it very hard to resist being bullish in my response, not least given that healthcare in general is under unprecedented logistical and financial pressure from the global pandemic. In saying so, however, I must qualify it with the very significant caveat that my thoughts apply to those like me living in a prosperous country which provides free healthcare for all. I am painfully aware that any bullishness does not apply to much of the world, including parts of the world like the USA where the state’s prosperity should enable universal healthcare to be a reality. So the thoughts that follow are made in the full and somewhat guilt-ridden awareness of my own relative good fortune.

When I was diagnosed in 1997, diabetes care and therapy had already advanced significantly beyond what many of my friends who have lived with diabetes for far longer than me can remember. A good diabetes friend, of similar age to me but living with Type One since the age of 2, has lived from the days of testing by urine strips and injecting with large syringes, to nowadays using an insulin pump and a CGM. He keeps an impressive personal archive of some of the primitive-looking gadgetry that kept him alive in his early days.

My introduction to diabetes came when injection pens with pre-filled cartridges were fully established, and small electronic meters providing rapid and accurate figures on blood glucose level from a finger prick test had become the norm, albeit fairly recently. More importantly in some ways, I came in at a time when advances in insulin types were starting to give far greater flexibility by mirroring with increasing accuracy the workings of the pancreas. Within a year or two of my diagnosis, I had moved to the basal-bolus régime which is essentially the one that I follow to this day. So things were already pretty good for a Type One here in the UK, and I never at any time felt threatened by it; however, better days were to come!

I am in no doubt that the biggest technological advance in recent years has been the arrival of non-invasive blood glucose monitoring giving more than just a snapshot of levels, and giving it in such a way that it can be done unobtrusively, frequently and painlessly: I refer, of course, to low-cost continuous monitoring devices, and in particular to the FreeStyle Libre flash monitoring system. The advances in diabetes technology have been stunning, and are accelerating as they become cheaper in real terms: this mirrors the way that, in our everyday lives, we all now keep in our pockets a mini computer of infinitely greater power, capacity and capability than the lumbering desktop with its hefty CRT screen that sat on our desks back in 1997. 

Commercially available devices have in turn been the stimulus for creativity and amateur expertise which has enabled patients to drive progress towards closed loop systems, with the prospect of a widely available de-facto artificial pancreas now looking more achievable than the proverbial “ten years from now” cure.

Alongside medical technology, information and communication technology has also made an astounding difference to those of us living with diabetes. When I was diagnosed I felt very much “at the mercy” of diabetes, and therefore very reliant on the input of the doctors and nurses assigned to my care. 1997 was very much in the pre-internet age (I first went “online” in early 1998, and as such I was an early adopter of home computing at a time when the internet was seen by many as the province of nerds and teenagers). My knowledge of diabetes at diagnosis was minimal, and beyond what HCPs told me, my only source of information was the printed word in books and magazines. What a different world it is now, with our first port of call on a medical issue being, for better or worse, Dr Google. These days, a person newly diagnosed would be signposted to a vast amount of information, to websites, to YouTube videos, to blogs, to peer support groups and a whole lot more. The problem must be to decide which resource is good, which is bad and which is ugly.

However, I believe that an equally important change in recent years is not a matter of kit and technology, but rather a far less tangible change of attitude on the part of both those living with diabetes and those who care for them. The irony is that this, too, has been driven by technology. There are still some who decry the influence of the internet in general and social media in particular, but what strikes me in the context of diabetes is that people have used technology in a very human and personal way, and that it has built bridges and brought people together in a way that harnesses the best that technology has to offer with the best and simplest of human virtues: friendliness.

Back in 1997, I would never have believed how connected we were all destined to become. I would never have believed that I would be talking, during a global pandemic, to people all over the world in little boxes on my computer screen, or that I could be constantly conversing in real-time written messages with friends. These days, my best source of “breaking news” is my best diabuddy whom I only know because we both have diabetes and started talking about it on Twitter. When anything good or bad happens in the news, or in either of our lives, our first response is to message one another. Many other people with diabetes enjoy similar, relatively new, but close, friendships.

But it’s not just peer-to-peer: we in the UK are privileged to have an online diabetes community in which patients and healthcare professionals interact freely, safe in the knowledge that each has something equally important to bring to the relationship: lived experience on the part of the patient and clinical expertise on the part of the professional. I count myself blessed with the personal friendship of many HCPs whose initial connection to me was through the diabetes community.

The community has no leaders as such, but is led by many: I shall deliberately avoid mentioning names, but we all know that there are doctors, DSNs and pharmacists of national professional repute who freely share their expertise and time online, yet just as importantly they share their lives, their interests, their passions and much more from well beyond their professional lives. Likewise, we all know that there are people with diabetes - and parents of children with diabetes - who freely share the experience and know-how that comes from living with diabetes, yet also their own personalities, their lives, their passions and much more, again from well beyond their lives with diabetes. During the pandemic, we have seen individual initiatives, notably by the organisers of the weekly tweetchat, like Zoom quizzes and the Fantasy Football league, and also larger initiatives like the Art1st Project, run by a coalition of people with diabetes and healthcare professionals. What these have in common is that they are about the people, not the condition, and it is this generosity of spirit that has enabled the community to flourish despite the inevitable fragmentation that has resulted from its growth in numbers. Alongside the partnership between patients and HCPs, the diabetes charities, Diabetes UK, JDRF, and DRWF have also become part of the community, not least through the personal and personable engagement with patients by their staff and leaders.

The blend of timeless human virtues - kindness, sharing, listening - with technology has given us a world unrecognisable from that of only a decade or so ago. Spending so much time alone at home this year, as we have all been compelled to do, I have come quite close to feeling grateful to diabetes for giving me some of the best friends I have ever made. 

When we finally emerge into the post-Covid world - sooner rather than later, we hope - it will be in many ways different, but we can surely hope that the blend of technology-driven remote connectivity and the warm relationships that technology has help to foster will leave us with the best of both worlds.

I was going to entitle this post Where are we now, taken from that rather bleak but wonderful Bowie song referenced earlier, but given that the announcement of a breakthrough on a Covid-19 vaccine came after I had started writing it, but before I finished it, another song came into my head, and I prefer to leave that as my customary song title for this post: the uplifting 1969 classic by (Mama) Cass Elliot which speaks, I hope, of where we are heading in the pandemic, and in diabetes care: It’s Getting Better.

Happy World Diabetes Day, everyone! With thanks to all who are working so tirelessly to support people with diabetes.

People places and events from my world of Diabetes

When will I see you again? - Diabetes care and the Pandemic

Six months and counting..... 

As we popped our Prosecco corks with the clock striking midnight last New Year’s Eve, none of us had any idea what 2020 had in store for us. We have now lived for half a year in a period of unprecedented collective anxiety for all but the diminishing number who remember the severe privations and genuine suffering of the Second World War. Our world as summer turns to autumn looks and feels shockingly different to that of last winter. The list of new words and concepts with which we have become familiar is lengthy, and we have all become accustomed to routines, behaviours and attitudes which would have seemed utterly alien to us on New Year’s Day 2020. 

What would I have thought of this selfie back in January?

Tens of thousands have died in the UK alone, and many, many more have suffered, either from the effects of the Covid-19 Virus itself or from secondary consequences such as delayed diagnosis, postponed or cancelled treatments and indeed subtle longer term psycho-social difficulties yet to be fully recognised or understood. 

It’s not exactly been the jolliest year of our lives, and as we enter autumn here in the UK, with the Virus better understood and to an extent better controlled than it was earlier in the year, we are nevertheless facing questions, anxieties and uncertainties well into the future. A life of carefree interaction with our fellow human beings seem a distant memory and an even more distant future prospect. 

For those of us living with other medical conditions like diabetes, there have been well-publicised extra layers of uncertainty, and I for one have found myself more concerned about my own welfare, more careful about my own actions and choices than at any time since my diagnosis almost 23 years ago. In many ways, we who live with diabetes have been very well-served: there has been wonderful support from healthcare professionals in the online diabetes community, who have transferred their habitual enthusiasm and energy to online versions of their normal activities; the diabetes charities have been excellent sources of information and encouragement, despite suffering from significant loss of income and of course the patient community has displayed mutual supportiveness and information-sharing as always. I have been thankful for the online connectivity which we now take for granted, and contacts made through the world of diabetes have been a source of friendship throughout these difficult months, for which I am enormously grateful. 

Before we feel too sorry for ourselves, it is worth pondering what a lockdown of similar extent and severity would have been like in the pre-internet days of the not-too-distant past: no WhatsApp groups, no video calls, no instant online sharing of information, memes and funny videos, no working from home, no remote learning. Even twenty years ago, that would have been the reality of a similar scale pandemic and lockdown. 

If nothing else, surely one of the positives of the pandemic will be to convince even the most grumpy luddites that the information age is an overwhelmingly good thing, and that smartphones, tablets and laptops are a modern-day blessing, a miraculous tool for social interaction and information sharing, whose obvious faults and disadvantages are not the fault of the medium itself, but rather of the human imperfections or evils of those who use them. 

I have taken great delight during the pandemic in chatting over the garden fence with my octogenarian next-door neighbour about stuff he has found on the internet, or how much he appreciated an online video consultation with his doctor. He recently told me that he had bought a Bluetooth speaker and had googled the origins of the word Bluetooth (a 10th Century Scandinavian King in case you’re wondering). I was also delighted to receive a Facebook friend request from another octogenarian neighbour who had signed up and stumbled across me on a neighbourhood group. I really hope that the pandemic will hasten the demise of the “digital divide”, not just in terms of the older generation but also in terms of those afflicted by poverty and deprivation. 

So the pandemic has certainly taught us to value the internet. 

Now I am an irrepressible optimist. It annoys those close to me at times, but I often genuinely find doom and gloom about stuff a greater burden than the stuff itself. And this is definitely true of the pandemic. I have become far more annoyed and frustrated about the epidemic of opinion from self-appointed experts than with the disease itself. So doom and gloom is not for me, and I am already starting to look for the good that can come out of this pandemic. It’s not easy, but that shouldn’t stop us all trying: I was moved to write this post having filled in a survey for Diabetes UK about my experience of diabetes care during the pandemic. 

Here’s the link if you haven’t seen it – a short and easy survey:

https://t.co/0z17jYg22v 

I must say that filling it in made me somewhat frustrated, not least because a few weeks ago I had attempted to get some information from my hospital concerning their plans for re-scheduling clinic appointments (my last was in early December), and I received a rather vague reply indicating that I was on a list for a re-scheduled appointment “in due course”. A follow-up enquiry about the potential use of video or telephone consultation was deflected in the classic bureaucratic manner “We are also looking into the option of using video consultation within our service however plans have not yet been finalised”, whilst my suggestion that they might consider using LibreView to share my data was ignored in a manner which suggested that I was proposing something truly subversive and revolutionary. 

Surely, diabetes care is a prime case for the rapid adoption of new ways of communicating and sharing that we have all taken on over the past six months. For a diabetes patient such as me, fortunate at the moment to be living well with Type One, a six monthly face-to-face at the hospital as well as an annual review with my GP is an unnecessary burden on the system, and arguably upon me. A five minute appointment with a phlebotomist at my GP could yield my HbA1c result, and, together with a look at my LibreView data, would form the basis of a discussion which could surely be just as effective remotely as it is in a hospital ten miles from my home. 

Now of course, there are multiple caveats. My own condition is, for now, good, but might not always be so, and there are aspects that cannot happen remotely. Nobody can check my feet, my injection sites, my eyes, and in many ways most importantly, my emotional welfare, over the phone or through a shadowy face on a screen. Some sort of triage could surely be applied to people with diabetes, such that those in most need would be seen face to face, whilst others would be seen remotely. And I am not proposing online only consultations: if we are seen six monthly, then surely an annual face-to-face, with an interim online in between, makes perfect sense. 

Above all, we must NEVER, in healthcare or elsewhere, allow on-screen interactions to replace face-to-face ones. Zoom, Facetime, Skype, WhatsApp or whatever are wonderful, but nothing can get near to replicating the multiple subtleties of human interaction: badly-lit faces in front of a bookshelf cannot convey body language, subtly raised eyebrows, non-verbal reactions, fear, anxiety, reluctant agreement, embarrassment. We are beautifully subtle creatures who thrive on our interactions with each other, and the human physiognomy is a truly wonderful and subtle thing. I for one am longing for a world in which I can once again see people in the real world, out from behind their masks and visors, or out from behind their webcams. I am very glad that I am retired from teaching, as I would have hated to teach from behind a mask, or to teach young people whose faces, whose reactions and responses are hidden by a piece of cloth. 

So please let’s try to take the best of what we have had to get used to during the pandemic, but also be sure to discard the worst as soon as it is safe to do so. I’ve had more than enough of zoom calls already. 

A Zoom Meeting of Diabuddies from across Europe and beyond

My enduring emotion is that of the Three Degrees song which forms the title of this post, and is a plea which applies to my healthcare team, just as much as to the many friends and acquaintances whom I am missing so much: When will I see you again?

"He ain't heavy, he's my brother" - who cares for the carers?

Photo Collage by my friend Lis Warren

It is self-evident to say that we are living through strange and troubling times: you need to be over 80 to have any significant recollection of the Second World War, so for most of us, the COVID-19 pandemic and its associated lockdown is by some distance the most significant, disruptive and worrying collective experience of our lives. We must, of course, be careful not to overstate its impact upon us or our own level of suffering and deprivation: those of us fortunate enough to have unaffected income, a home with outdoor space and the company of others, together with the means and ability to connect with others through the online world should not be tempted too much into the realms of self-pity.  The privations and worries of our grandparents in wartime were infinitely greater.

If we and our loved ones have not (yet) succumbed to the illness, all that has really happened to us is that we have stayed at home, saved a lot of discretionary expenditure on leisure activities and tended our homes and gardens to within an inch of their lives. My own extensive garden has never been so well tended, many of the boxes which were dumped in the loft or the garage when we moved house three years ago have been tidied and sorted, and many a neglected DIY task has been sorted. So despite occasionally feeling sorry for myself, reflecting on missed outings and holidays, friends and family not seen, I have (so far) little to complain about.

Yet for many, it is not so. In the UK alone, a horrendous death toll means that there are tens of thousands mourning the premature loss of a loved one, and tens of thousands more are still struggling to overcome the lingering and in some cases life-changing consequences of COVID-19.

And whilst I, and many others, have had to do no more than just stay at home and forego some discretionary pleasures, many others have seen their workload increase, their working conditions and practices changed beyond recognition and the level of stress and strain hugely increased.

There has been, quite rightly, much said and done to recognise the efforts of our so-called “key workers”, most obviously in the health and social care sectors, but also those who provide our essential needs - the shop workers, the delivery drivers, the teachers, the IT people who have kept the internet running seamlessly, the refuse collectors, those in the media who have kept us informed and entertained - the list is endless. The very least that the rest of us could do was to stand on our doorsteps every Thursday and applaud, however much that at times felt like a rather empty “look at me” gesture, akin to the way in which some feel compelled to modify their social media profile picture in response to some cause or other.

It is, of course, far too early for anyone to write the history of the pandemic, not least as it hasn’t even reached its peak globally, and remains a significant threat locally here in the UK. However, I hope that when we are able to look back on 2020 - let’s hope it is only 2020 - we may at least be able to see it as the start of a more caring society compared to that which appeared to have been evolving in the “take back control” and “America first” world of the past decade or so. Surely, if we have learned anything from the pandemic, it is that there absolutely IS such a thing as society, whatever the late Mrs T meant by her notorious “no such thing” line. We have seen a relatively young Prime Minister, the Heir to the Throne, the Health Secretary and the Chief Medical Officer all laid low by the infection in a manner which reminded us that in the face of a virulent disease, we are all in equal need of the expertise of doctors but equally the care and dedication of all who work in healthcare, from the consultant to the ward cleaner.

We are all links in a very long and fragile chain. Advanced human society is built upon each and every one of us performing a particular and specialised role, and therefore depending on others who perform another equally specialised role, and those upon whom we depend are often those whose role is most easily overlooked - until they are unable to do it.

I remember once hearing - on an “Understanding Industry” course - that in any organisation, the person whose absence is most immediately noticed is not the person at the top, but rather those supposedly at the bottom. In a school, the Caretaker’s absence would be immediately noticed, as it’s he or she who opens the building at the crack of dawn. A Headteacher could be absent for several days without any pupil noticing. In a hospital, the consultant surgeon cannot do her or his job if the laundry people haven’t provided clean scrubs. One could make similar points about every workplace or organisation.

Of course, we must not from this conclude that those at the top - the leaders, the experts, the bosses - don’t matter as much as the rank and file. Of course they do, and surely another thing that we have learned from the pandemic is that we have not, as some tried to argue at the time of the EU Referendum, “had enough of experts”. We need our experts and wise leadership more than ever.

But what we do all need is to CARE for and about each other.

There’s a commonly used Latin expression Quis custodiet…, abbreviated from Quis custodiet ipsos custodes which rightly asks “who keeps an eye on the guards?”, reminding us that even those who supposedly act in our interest should themselves be held to account.

Well equally importantly at all times, and especially of late, is “who cares for the carers?” It’s a very pertinent question: my son once put it very well by saying “Who gives Father Christmas a Christmas present?”

We are all enormously indebted to carers in the broadest sense at present, be they experts working on the longed-for vaccine, scientists and politicians trying to figure out what it is safe and prudent to do when, van drivers bringing our online orders, nurses and doctors tending the sick, pharmacists keeping us supplied with our life-preserving medication, charity employees and volunteers keeping their vital work going in the face of devastating loss of income, but equally importantly the millions doing their ordinary jobs: people like my son and younger daughter working in their schools or my elder daughter helping to keep a major university's life and vibrancy going in the post-corona world, or volunteers like my wife sewing scrubs and masks for the NHS, or a friend of mine who lives with Stage 4 cancer and is using her online voice to campaign for the resumption of full diagnosis and cancer care for others. Then there are also all those whom I have seen and heard just quietly doing their bit, maybe by helping those being shielded, sharing fun stuff online or generally just being kind. These, in the broadest sense, are the carers.

So we must all remember to care for the carers. They are not heroes, and they have no superpowers. They are just human beings, with the same frailty, doubt, guilt, imposter syndrome and anxiousness that we all feel at times. I was moved to write this post after seeing evidence of such things in the much-maligned but essential world of social media. I have in recent times spoken with friends who are on the proverbial frontline and I have seen from their social media posts, public and private, first-hand evidence of the stresses and strains of their lives and work. I have also seen honest online expressions of self-doubt from an eminent NHS consultant and from a friend who is a tireless and enthusiastic advocate for others living with diabetes, who suddenly found herself creaking under the strain. Equally importantly I have seen evidence of supportive acts of kindness towards these people: I have seen those who give care being cared for, and it is surely very important that we all remember that they too have their needs.

So this post is for the carers. It has been my pleasure and privilege in recent years to become friends with many who work in the NHS as doctors and nurses, thanks to my small involvement in the diabetes community, and I have watched in awe as these people - if you are reading this you know who you are - not just do their jobs, but go way beyond the call of duty to ensure that the rest of us are cared for.

My Latin teacher wife thinks that Quis curabit ipsos curatores just about works as a Latin motto for “who cares for the carers?” so there’s a good title, but being me, I also need a song title for this post. How about the Hollies’ 1969 classic He ain’t heavy, he’s my brother. It immediately came to my mind when I saw that much-shared picture of a black man carrying an injured white counter-demonstrator at the "Black Lives Matter" demonstration a few weeks ago. 

It’s a wonderful song, an entire sermon in 4 ½ minutes, all about sharing the burdens of others. 

He ain't heavy - He's my brother

“A Little bit More” - it's all about the Bolus

It’s been a while since I posted anything about diabetes; there’s been a veritable pandemic of words and opinions throughout the Coronavirus emergency, and I have many times in recent months turned off the TV, closed or muted a person or a conversation on Twitter or just cut short a real life conversation because I am so exasperated by a surfeit of half-baked opinion.  I am, therefore, cautious to write and post anything, let alone anything medical, but if you’ll bear with me on this one, it will get to diabetes and has no direct relevance to COVID-19. 

The train of thought leading to this post started with one of the many really bad flare-ups of hay fever which I have experienced this year. Apparently, like nearly everything, the exceptionally bad hay fever experienced by many of us in 2020 can be traced back to COVID-19, in that the (very welcome) lowering of pollution, caused by the lack of road traffic, caused by the lockdown, caused by the COVID-19 pandemic, has allowed the pollen to run riot in the less polluted atmosphere. Such is the chaos theory in practice that we have all experienced this year.

Sodium Cromoglicate eye drops

I tweeted something about bad hay fever a couple of weeks ago, and was grateful to receive much sympathy and helpful advice from friends and strangers alike. Among the suggestions was that I should try antihistamine eye drops containing Sodium Cromoglicate, a mast cell stabiliser; I had previously used standard eye drops, which provide only symptomatic relief for itchy eyes. I bought some drops of the suggested type, started using them and found that not only did they relieve the itchy eyes which are such a distressing part of hay fever, but that they also suppressed other hay fever symptoms, in particular sneezing.

This made me take to Dr Google: do eye drops enter the bloodstream and therefore act on symptoms other than the eyes themselves? I was aware, from all the COVID-19 “don’t touch your face” talk, that the eyes are a potential entry route for infections, so perhaps I shouldn’t have been surprised to find, quite readily, that the eyes are indeed a route into the bloodstream:

“When you put drops in your eye, the drops can become “pumped” into the tear system if you blink. Once in contact with the vascular nasal mucosa, relatively rapid absorption of drugs into the bloodstream can occur. The drops can act as a systemic “bolus” - an infusion of the drug into the bloodstream.”[1]

There you are - I said I’d get to diabetes! The word “bolus” jumped out of that sentence from a medical website, and - perhaps like many not medically qualified people - I was surprised to see it, apparently in a new context. “Bolus” is a word all too familiar to those of us whose lives are sustained by insulin, so familiar that I had never really thought much about any wider use of the word. However, look up the word and you’ll find a definition such as this:

“a single, relatively large, quantity of a substance, usually one intended for therapeutic use, such as a bolus dose of a drug injected intravenously.”

So it’s not just we people with diabetes who bolus! I hope that other non-HCP readers will react in the same way, otherwise this blog post is an embarrassing confession of ignorance.

Being a linguist by trade, my reaction to having a word brought to my attention is to think about and research its etymology. So again, I turned to the internet to discover that the word bolus is, as expected, of Greek via Latin origin and originally meant a clod or lump of earth. Some sources suggest a connection to the English word ball, but that is far from clear.

So there you have it: that familiar word bolus is so called because we are injecting or pumping a “lump” of insulin into our bodies. It gets even better if you know the etymology of the word “dose”, because that word actually comes from the Greek word for “gift”. I love the idea - especially as it was gifted, not monetised, by Banting et al - that we inject a gifted clod of insulin!

So what about bolusing? Well for me, it is one of the arts of diabetes management at which I have become increasingly skilled, but at which I am still a long way from being proficient, and never will be. I, along with the vast majority of people with Type One diabetes, rely on injection pens for the administration of insulin (I am miles away from fulfilling any criteria for a pump), so bolusing remains for me a relatively unsophisticated - dare I say hit and miss - process of trying to whack the mole, ideally before the mole pops up. (...now where did that “whack-a-mole" analogy come from??)

I make no claim to being an expert in diabetes; quite the reverse, in fact, compared to many whom I have come to know through the online diabetes community, but I have certainly become more confident in the art of effective bolusing in recent years.

For me, two aspects of bolusing stand out.

Firstly, the timing of bolus injections of fast-acting insulin prior to eating: I was taught at diagnosis, nearly 23 years ago, that the injection of fast-acting should be just before eating (“wait until the food is on the table”) and for years I feared some kind of humiliating loss of sense and dignity if my food was delayed for more than a few minutes. However, in recent years, I have realised that for me, a bolus dose is most effective if taken well in advance - sometimes up to an hour, especially at breakfast time.

Secondly, correction doses: I used to be very cautious about injecting between meals, but these days, I willingly inject in response to a rising level, or ahead of a snack-attack. The result of this is that I almost always have more than the theoretical three doses of fast-acting a day.

I will add two very important caveats to this. Firstly that freedom to bolus with such relative recklessness is dependent on always wearing some form of CGM, which for me is the NHS funded Freestyle Libre. I have said it many times, but the ability to know more than just a snapshot BG value, but rather a clear indication of direction of travel, is life-changing. Secondly, that I am fortunate enough to be retired and therefore more in control of my time and activities than someone in a busy working life. When I was working, there wasn’t time to pre-bolus or correct, nor was the timing or nature of my midday meal in any way predictable.

I am well aware that my mastery of bolusing will never be perfect, and indeed that it could be far better with the help of an insulin pump and associated looping technology, but I am nevertheless grateful to the incremental improvement of knowledge gained through the online diabetes community, a better-late-than-never DAFNE course and of course the advice of  HCPs.

And having discovered the etymology of bolus, I am most grateful that I am able to indulge in bit of constructive mud-slinging – throwing a little bit more insulin into my body. There’s the customary song title for my post, a memory for those old enough to remember it, from that long, hot summer of 1976.

DISCLAIMER: Injecting insulin is a responsibility placed upon everyone who lives with Type One diabetes, and requires knowledge and caution. Nobody should modify dosage and timing without careful consideration of all the multiple factors affecting blood sugar levels and any changes to the timing and dosage should only be made with professional advice and guidance.

---

[1] https://www.glaucoma.org/gleams/eyedrop-techniques-from-dr-andrew-iwach.php#:~:text=When%20you%20put%20drops%20in,the%20drug%20into%20the%20bloodstream.

My Song is Love Unknown - is there anything good about Good Friday?

This is an update of a piece I originally wrote in 2015 and have edited and re-posted once already. I make no apologies for doing so again, not least because the bizarre and unforeseen circumstances in which we find ourselves for Holy Week and Easter 2020 have given more people the time to sit and read.

More importantly, we are all being forced to confront the painful reality that our world is one in which suffering, pain and loss are an inevitable part of our existence, and that if we naively believe that "all will be well", we will inevitably be disappointed. It's a cruel world, and to turn in anger on "God" and say "if there is a God, why does he let bad things happen?" is futile. My concept of God is of an abstract force for good, not some sort of guardian against bad stuff, and for me, Good Friday gives a powerful reminder of that reality.

The combination of a national and international lockdown with the week in which we remember the death of Jesus gives good cause to ponder the meaning of it all, and to question whether religion has any useful part to play in our lives. If you object to religion, it's perhaps best to stop reading now. However, if you can bear with me, you might just come to see that being religious doesn’t mean you’re opinionated, self-righteous, and in-your-face, or that you necessarily have to believe in implausible miracles. 

Today is known as Good Friday, and we would all be forgiven for hollow sarcastic laughter at that thought - not much good about this particular Friday, is there? Good Friday commemorates what was surely one of the most significant events in human history, and a notably horrific event, yet its meaning and significance are increasingly forgotten, at least in our increasingly secular country.

For me as a unitarian Christian, the whole business of Jesus’s death and resurrection is complicated. Many people now pay little attention to the traditional meaning of Good Friday and Easter, yet nobody can deny that the events of what we call Holy Week are as significant as any in the history of mankind. The fact that we are eating hot cross buns today and chocolate eggs on Sunday is a direct consequence of our commemoration of those events 2000 years ago.

If you are a follower of Jesus Christ, the events of Holy Week and Easter are pretty hard to deal with. The day on which the hero of our belief system was cruelly and violently put to death by a tyrannical occupying power is called, in English at least, “Good”. As if that’s not bad enough, Christians are then taught to believe that he did it “for their sake” and that he then rose from the dead, thereby defying the one certainty in life: death. According to many, that’s what’s “good” about Good Friday – the idea that Jesus “died to make us good”, to quote C F Alexander’s wonderful hymn, “There is a Green Hill far Away”. My own brand of Christianity really struggles with the idea that someone else had to suffer and die for my sake, and much as I love that hymn, I find the words very hard to identify with, and any notion of Good Friday being a good thing because of an act of self-sacrifice doesn't work for me.

Actually, calling it “Good” is a largely English-speaking oddity. Most other languages have a different term, most commonly some variant on the word “Holy” – in French, for example, it is “Vendredi Saint”. Of the major European languages, only Dutch – which is the living language closest to English in many ways – uses the term “good”: “Goede Vrijdag”. I actually think the German term is pretty apt in terms of telling us what happened: Karfreitag – which means Sorrowful or Suffering Friday.

Whatever you call it, it wasn’t a very good day for Jesus and his followers. They would have taken some convincing, at the end of that terrible day, that what he went through was in any way good. I too struggle to see what’s good about the cruel and horrible death of a patently good man.

As a Unitarian, I certainly don’t accept the idea that we are all inherently sinful and need someone to suffer and die in order to save us. I believe that we human beings are all capable of the most terrible sins, but that’s not the same thing as being sinful, and I certainly believe that our salvation lies in our own hands, not those of an innocent man. So in that sense, there is nothing good about Good Friday for me.

However, I have an aversion to well-meaning attempts to manipulate language to make it match literal truths. After all, Easter is a term derived from the name of a pagan goddess of Spring and fertility, so at one level I’m happy to accept Good Friday as “just a name” for an important day.

Yet the idea that today is a good day because it recognises the good thing that Jesus did for us is not necessarily the correct explanation for the name of the day. Another very plausible explanation comes from the fact that the words “good” and “God” are often interchangeable in the English language. We need look no further than the word “goodbye”, which means “God with you” (God-by-ye) for proof of that. So if we accept this explanation for the term, “God Friday” is perhaps a little easier to accept.

I certainly prefer this explanation: to call it God’s day is much easier for me to accept, in that my own interpretation of God is that it simply means “good”. My concept of God is not as an omnipotent father-figure and creator who ordains all that is, was and shall be, but rather that “God” means all that is good in the world. After all, it is commonly observed that there is only one letter of difference between God and good, and also only one letter of difference between devil and evil. Etymologists rightly point out that this is probably just a neat coincidence, but it certainly suits me to believe that “God” can simply mean all that is good in the world, while “devil” can simply mean all that is bad in the world.

Jesus’s death, and especially the manner in which he was condemned by a fickle and baying mob, was surely the work of the devil – of evil. No different from many other acts of betrayal and violence throughout history. But it is my view that wherever there is evil, good is never far away, and good always has the last word. Time and again, when something dreadful happens in our world, we are left to despair of humankind’s capacity for evil. Yet invariably, and especially if we look for it, there is a response which is good, although you often have to look harder for it, because the media prefer bad news to good news. There are so many examples, but one that always sticks in my mind is the way in which the family of 12-year-old Tim Parry, the boy killed by an IRA bomb in Warrington in 1993, used his death and that of 3-year-old Johnathan Ball in the same incident as a catalyst to set up a peace foundation, contributing in no small measure to the eventual end of the IRA bombing campaign and the start of the Ulster peace process. I could quote numerous other stories from throughout history to make the same point. Good – or God – had the last word.

So instead of despairing when something dreadful happens in our world, and bemoaning the absence of God at such times, perhaps we should look for the good – the God – which is always there to respond, to comfort and to heal. And in that respect, Good Friday is aptly named, in that however hard it must have been to believe it at the time, God (or good) was not far away. Good Friday comes just two days before we remember that even if the physical Jesus was put to death, his spirit, his values and his example of how to live a good life continued to shine in an at times dark and evil world, and still do so to this day.

So Good Friday is indeed good in a strange way, if only as a reminder that however evil our world may seem, good is never very far away and always has the last word. And my chosen title, My Song is Love Unknown, sums up all that the life and death of Jesus means in our sad world: “Love to the loveless shown that they might lovely be” seems a pretty good summary of what he was trying to achieve, and to attempt in our own small way to do likewise is the least we can do to honour his memory.

Urged and inspired us, cheered us on our way: Kirkham Grammar School Founders' Day

Kirkham Grammar School Founders’ Day

Today, Wednesday April 1st 2020, at 2:30pm Kirkham Grammar School would have been holding its annual Founders’ Day Commemoration Service at St Michael’s Parish Church.

Founders’ Day is an occasion on which the school community reflects on and gives thanks for its long and distinguished history, whilst remembering in particular those who over the years have been supporters and benefactors of the School.

Holding the service in St Michael’s Church gives an appropriate reminder of the School’s earliest origins and its continuing links with the church: KGS was founded in the Sixteenth Century as a chantry school in the church grounds, in all probability before the stated founding date of 1549. For the next four hundred years, the School was situated next to the Church and the lives and work of the two institutions were firmly intertwined. The School moved to its present buildings in 1910 but has retained close links with the St Michael’s.

The Founders’ Day Service is actually a relatively recent tradition: it was instituted after the Second World War as an end-of-term event perhaps comparable to a modern Open Day, in that it was an opportunity for the School to display to the public something of its life and work and to celebrate all that it stands for. The day used to feature an inspection of the Cadet Force followed by a public parade of cadets to the Church, and the service was followed in the afternoon by a School against Old Boys cricket match.

The first recorded occurrence was on Saturday 26th July 1947, when the then newly appointed Headmaster Mr Dennis Norwood instituted the event as an end-of-term celebration of the School’s heritage. This extract from the newly-formed General School Committee in May 1947 shows the new Headmaster’s plans for the day.

In modern times, Founders’ Day has become a service of thanksgiving, normally held on the last Wednesday of the Spring Term, at which the school community gathers for a short act of worship, with music led by its choir, an address by a guest preacher and an act of thanksgiving for the School’s benefactors read by the Headmaster:

The names of those benefactors whose names are read out are somehow evocative of the school’s long and distinguished history: Thomas Clifton, Isabel Birly, Cuthbert Clifton, Thomas Westby, John Parker, Thomas Langtree, Thomas Hesketh, Arthur Greenacres, Henry Colborne, James Barker and William Grimbaldeston.

These names all have a role in the history of the school which is recorded by history, most notably Henry Colborne, whose bequest left in trust with the Drapers’ Company of the City of London in the seventeenth century led to the longstanding and still flourishing connection with the Drapers. Perhaps the most colourful story relates to Isabell Birly, daughter of a Kirkham alehouse keeper who apparently saved the school from falling into disrepair in the year 1621 with a donation of £30 (then a substantial gift) which she brought to the school authorities in her apron. 

Like so much else in our lives, today's Founders’ Day has fallen victim to the Coronavirus pandemic, along with the whole routine and rhythm of school life: like all schools in the UK and across much of the world, KGS is closed for normal teaching and learning for the immediate future, with pupils and teachers adapting to distance learning, and the school campus deserted other than for a handful of children of key workers. Public examinations have been cancelled leaving the GCSE and A-Level cohorts uncertain of their fate, and deprived of the bittersweet rituals of the end of their school days, with celebrations such as the Fifth Year Party and the Sixth Form Ball postponed to an as yet unplanned future date.

Founders’ Day is a perfect opportunity for all in the present and past school community - pupils, parents, teaching and non-teaching staff - to pause, reflect and give thanks for being part of an ancient, loved and resilient community. In its 470+ year existence, the School has been through difficult times and always emerged in the long term even stronger and wiser, and will do so again.

Let’s all take a moment today to pray for our well-loved school, to give thanks for the leadership and energy being demonstrated by the Headmaster Dan Berry and his staff, as well as the guidance and support of the Governing Body.

I have also always thought that on Founders’ Day, every pupil past and present should perhaps take a moment to give thanks for the financial and other sacrifices made by their own families to give them such a special education. We too easily take our schooling for granted, and I think many Old Kirkhamians will echo the thought that we appreciate and love the School even more as the years go by.

Since 1999, the Founders' Day Service has concluded with the School’s adopted hymn, the much-loved Lord for the Years. We're not singing it today, but here it is on YouTube - watch, enjoy and reflect on those words.

And in case you haven't seen it before, here is a link to a blog post I wrote a few years ago about Lord for the Years.

Everything I Own - an updated tribute to my father, 100 years on from his birth.

March 10^th, 2020, marks the centenary of the birth of my late father Arthur John Long. He died at the age of 86 in December 2006, so sadly didn’t live to see his 100^th birthday. I am re-editing and re-posting this tribute on what would have been the eve of that birthday - a landmark worthy of some reflection.

My father in 1983, at about the age I am now

To the wider world, Arthur was a much loved and respected elder statesman of the Unitarian movement, and a leading expert on the history of liberal Christian theology, but to me and my brother Chris, he was Dad. To my wife Sue and Chris’s wife Michelle, he was a caring father-in-law Arthur and to his four grandchildren, Felicity, Nick, Rosie and Natalie he was just Grandpa. However, what struck me at the time of his death, when I read and heard public tributes to him, is that unlike many people with a public persona,  the public and the private man were no different. And as the years roll on, I am increasingly aware of the extent to which I inherited from  him far more than a striking physical resemblance.

Born in 1920, Arthur was one of four children of the Revd. Walter Long - my grandpa -  himself an eminent Unitarian minister in London, who was President of the General Assembly of Unitarian and Free Christian Churches in 1963. Walter was a teetotal, firebrand socialist nonconformist of the old school, and having recently uncovered some hitherto forgotten documents and archives relating to his life and work, I am even more struck by his work and achievements. Walter was in effect a social worker in a dog collar, whose work for the people, especially the children, who attended Bell Street Mission in Marylebone, reflected his values and ideals. Chris and I knew him as a cheery, benign old man, like a cliché grandad from a Ladybird book - he looked about 90 when he was around 50 - but a glance at the press cuttings from his life reveal a man of deep commitment to improving the lot of the poor through putting Christian principles into action. Accounts of the holidays he and his wife Amy ran for deprived London children at Bruce Cottage in Bognor Regis are a joy to read.

Last year, it was a huge pleasure and privilege to organise a family reunion to celebrate the centenary of Walter and Amy’s marriage, at which we gathered virtually all their surviving descendants and their families, including their surviving son, Peter. I wrote an account of it here:

https://adrianlong3.blogspot.com/2019/04/never-forget-where-youve-come-here-from.html

Arthur added to these qualities and values which he inherited from his father the scholarly mind and conciliatory instincts which made him a lifelong ecumenist, who strove throughout his long and distinguished career to bridge the gap between Unitarianism’s more radical tendencies and the mainstream Christian churches. The Unitarian Christian Association is very much part of his legacy.

Here, briefly, are the factual details of his life: Arthur was born in Loughborough, while his father was Minister to that congregation, but he grew up in Wembley, living much of his childhood in the shadow of the old Empire Stadium. I remember seeing those towering white walls over the railway line which ran past the end of their garden. He was the first of four children, with two younger brothers, Ronald and Peter, and a younger sister, Joyce.

Arthur was educated at Wembley County School and won a place at Exeter College, Oxford in the days when county grammar school boys were still a rarity at Oxford Colleges. Although he himself always admitted to having felt somewhat out of place at Oxford, he in fact blazed a trail at Exeter College which was followed by his younger brother, and then by his son (myself), granddaughter and two nephews. Few families can claim such broad and prolonged association with a single college.

He trained for the Ministry at Manchester (now Harris-Manchester) College, and took up a Hibbert Scholarship at New College, Edinburgh, then served long and effective ministries in London and Lancashire. His lengthy ministry at Unity Church, Bolton coincided with a period of great social and economic upheaval and hardship in the Lancashire cotton towns, but he kept the church there in its traditional place at the heart of the community. In those days in industrial Lancashire, the local church of whatever denomination was in effect the parish church to those who lived in its shadow and that of the Lowryesque cotton mills. We lived our childhood in a real-life Lowry painting.

The locals just thought of him as “the Vicar”, and Chris and I were known as “the Vicar’s boys”, especially if we did anything naughty - heinous crimes like riding a go-kart down the street in a reckless manner.

He may not have been the Vicar as such, but our childhood was awash with vicars, priests and nuns. Always an enthusiast for ecumenism (an “ecumaniac”, to use a term coined at his funeral by one of his protégés Revd. Jeff Gould), Arthur was for thirteen years Secretary of the Bolton Council of Churches, in which role he enjoyed warm and active relationships with all shades of the Christian community in Bolton. Our childhood memories are of incessantly answering the door or the telephone to clergy of all shades of Christianity, and it was only in later life that I came to realise how unusual and precious such inter-denominational cooperation was.

Whilst ministering among the people of a working class Lancashire community, presiding over a church which was very much a social centre as well as a place of worship, he was like his father a social worker in a very poor part of the town. He wrote and produced an annual pantomime, starring members of the congregation - very much a highlight of the social calendar, and loved organising social events. He once organised a complete “mock wedding”, at which members of the congregation took all the parts of a traditional wedding, took vows in church, then enjoyed a reception and party in the Church Hall. He took the congregation away for a fun weekend at Hucklow, and in every way cared deeply about their welfare. More than once, he interrupted family holidays to return home to conduct a funeral of a loyal member of the congregation.

Yet he was also an awesomely erudite thinker and writer. Arthur developed a career in theological academia alongside his day job in Bolton, firstly as a tutor, then as Principal of Unitarian College, Manchester, a training college for the Unitarian Ministry. In this role, which he took up in 1975, his ecumenical instincts again came to the fore when he brought the College into the inter-denominational Northern Federation for Training in Ministry in 1984. Through his broad outlook, he brought a Unitarian perspective into the wider theological community, and was appointed as an Honorary Lecturer in the Department of Religions and Theology at Manchester University.

He enjoyed the academic phase of his career every bit as much as he has enjoyed ministering to working class folk in Bolton. He was honoured with the Presidency of the General Assembly of Unitarian and Free Christian Churches in 1983, twenty years after his father had held the same post, and in 1995, he was awarded a Doctor of Theology degree by the United Protestant Theological Institute at Kolozsvar (Cluj) in Romania.

His warm relations with the flourishing Unitarian communities of Eastern Europe predated the fall of Communism, and were another manifestation of his outward-looking and tolerant approach: he drove, would you believe, to Romania in his little Vauxhall Chevette in 1979 for a conference and preaching engagement. Lord knows what those surly border guards must have thought of the Englishman in a dog collar driving through the then very real Iron Curtain.

Arthur loved writing and public speaking. In this respect I have followed in his footsteps. He was a prolific writer of sermons and articles, whose style always mixed scholarly erudition with down-to-earth wit. He was founding Editor of the Unitarian Christian Herald and a regular contributor to The Inquirer and Faith and Freedom. He continued to preach well into his eighties, and conducted services until shortly before his death. As late as 2004, he appeared twice in ITV’s now sadly defunct “My Favourite Hymns”, and took great delight in the venue for filming being the magnificent St Walburga’s Roman Catholic Church in Preston.

But what was he like as a private person, as a family man? Well, as I said earlier, really no different! He was absolutely dedicated to his family, and doted on his wife, our mother Margaret, whom he met when she acted as temporary organist at Stamford Street Chapel, where he was Minister. The story goes that she reluctantly agreed to stand in for her then boyfriend, who was organist there, when he went on holiday. The said boyfriend must have regretted that request!

Arthur was a real softie, a true romantic - a quality I have singularly failed to inherit! He would write acrostic love poems to his wife for every wedding anniversary and birthday. Margaret was rather more cynical and hard-headed, and I never saw any reciprocal poetry! He illustrated Christmas cakes with poetry and words from Scripture written in icing, and his tastes in music, theatre and literature were as catholic as his theology. Indeed, I always feel he was somewhat constrained by his wife’s refined and narrow tastes in the arts, especially music. She abhorred popular music in any form, which must have been difficult as that art form blossomed in the swinging sixties. He secretly rather liked it, and I remember her horror when he preached a sermon extolling the lyrics and music of Elvis Presley’s The Wonder of You when it topped the singles chart in 1970. I remember him furtively asking me and Chris to take a recording of it off the radio onto the reel-to-reel tape recorder that he had bought for use in church.

So perhaps it is fitting that I conclude with some words not from the Scriptures, not from one of Shakespeare’s sonnets, but from David Gates, of the 70s soft-rock band Bread. His song Everything I Own is a lament for his father, who died young, but it has always spoken to me about Arthur’s paternal love which was so closely aligned to his love and concern for those to whom he ministered:

You taught me how to love

What it's of, what it's of

You never said too much

But still you showed the way

And I knew from watching you.

God bless him.