iL Dottore

I don't think we should encourage him....

ION Sad news on the move to the new apartment, I have just been informed by Mrs iD that the move will require "half-sizing" (like "downsizing" but more radical: at least 50% of our "stuff" Must Go!). This means that ALL my 4mm rolling stock, kits, accessories, etc., Will Have To Go, as will the majority of my Railway Books (prototype and modelling). Plus I will need to find new homes for The Brunel Pub, The Georgian Terrace Houses and other buildings. This weekend I'll be cataloging what I actually have (PM me if you're interested in getting some "good sh*t" 😁). I think I can sell most of the 4mm stuff in one batch . It's mostly GWR stuff, so if you're looking for something specifically GWR PM me and I may be able to help! On the upside Mrs iD has to "half-size" her shoe and bric-a-brac collections. So, not ALL gloom and doom!

Not only that, it's the type and amount of training they. I read that the average amount of time a US cop spends in training is 833 hours, a hair-stylist in Austin Tx requires a minimum of 1000 hrs training and cosmetologist training varies between 4 and 5 years! At least you can be reassured that in Austin Tx your hair is safe!

Re. dirty & muddy dogs: both Schotty and Lucy love rolling around on the ground. With Schotty, his preference is for snow (preferably fresh powder snow); Lucy's preference is for cow poo! Fair enough, you might say, they're dogs enjoying being dogs - something we encourage (NOT the poo rolling though, however Lucy just ignores our instructions NOT to roll in cow pats) and a quick towel down (Schotty) or quick shower (Lucy) resolves things EXCEPT.... except Lucy takes great personal affront at being made to shower and makes her feelings very clear about it. She does aristocratic disdain like no other dog I"ve ever known. Dame Maggie Smith (Downton Abbey) in full Dowager Duchess mode has nothing on a post-shower Lucy!

She may just be being polite (y"know, keeping the Guv"nor happy). When she starts to insist her dinner is served in a LMS/GWR/SR/LNER/BR liveried dog bowl, you'll know you have trained her right.

Indeed. But reading through the BBC article it does seem that this was yet another one of the recurring and seemingly never ending NHS medical scandals. Tony's brief description of the situation his mother faced sounds a lot like a NHS scandal waiting to erupt. Nowadays, IRBs, regulatory agencies and the Pharma Companies themselves are incredibly strict - as today the consequences for malfeasance are significant involving loss of reputation and careers, significant legal penalties and significant financial damage. Apart from GCP (Good Clinical Practice) being the right thing to do (as everyone in clinical development will tell you), a reputable, ethical Pharma Company is not going to risk millions of pounds by overlooking investigator malfeasance

I did NOT say that, Tony and I resent you implying that I did. I only said "No clinical trial withholds essential treatment from a patient. To do so would be unethical, immoral and counterproductive (not to mention that the regulatory agencies would descend like a ton of bricks on any clever clogs trying to do so)". Whomever the physician was, what they were doing - if the situation was not misunderstood by your mother - would get them a nice cosy chat with their IRB, if not the BMA and the GMC. And the pharma company sponsoring that trial (if it wasn't an investigator sponsored trial - where standards are much looser) would soon ensure that he/she did no more clinical trials on their watch (and in serious situations, investigator malfeasance would be brought to the attention of the regulatory agencies - with severe penalties a very distinct possibility).

Poor lass. I hope she makes a full and uneventful recovery.

Not necessarily, if a certain adverse event is seen in a large percentage of a patient population it doesn’t mean that you will experience that adverse event, just that you have a high probability of experiencing that AE. In one oncology study I worked on significant hypotension was a common AE seen immediately after treatment and although most patients experienced hypotension, a number did not. Depends upon the study design and the disease being treated. In life threatening disease, studies are designed so that patients get either <standard of care + new drug> or <standard of care + placebo>. Unfortunately, in some countries and/or some diseases <standard of care> means no treatment at all beyond managed decline. It is a sad commentary on the state of many health services across the world that sometimes the only way to access state of the art care is to sign up to a clinical trial. Nope, the physicians don’t get paid, the hospitals/clinics/institutions where the study is placed get paid per patient - but this is to pay for the blood work/scans/assessments/specialised pharmacy, nursing and study staff needed by a clinical trial (some institutions are notorious for charging eye gouging mark-ups on the otherwise routine tests required by a clinical trial). The average per-patient cost in an oncology trial (which excludes things like data management or production of study drug) is about £50,000 (and can go much higher). No clinical trial withholds essential treatment from a patient (see my earlier comment). To do so would be unethical, immoral and counterproductive (not to mention that the regulatory agencies would descend like a ton of bricks on any clever clogs trying to do so). This might have happened in the 50s and 60s, but not today. EVERY clinical study - both observational and interventional - has to be approved by the local IRB (institutional review board)/ethics committee before being allowed to proceed. Having had to - in person - justify to a German IRB why it was necessary to perform more CT scans than local standard of care, I can tell you they are NO pushover (definitely one of the toughest meetings I’ve ever been in. Even tougher than getting an extra $20 million out of senior management). As for the second highlighted point - just because to a layman they seem similar, doesn’t mean they are. Different patient populations, different regimens, different drug mode-of-actions - all relevant differences (and given the cost of a clinical trial no-one does one “just for the hell of it”). As for results being published: that doesn’t mean everything is “done and dusted”. Every single drug (or surgical intervention or other patient intervention) gets continuously studied and monitored during its effective lifespan - frequently leading to new therapeutic interventions and ALWAYS to new safety data.

I’m glad that you added that qualifier JJB. Although it is true that my knowledge of SE Asian food is not as extensive as I’d like it to be. I wonder what Shi En would makes of PB’s culinary world (standards, efforts, menus etc.). I wouldn’t worry too much about being “on the list”. The list being, I am reliably assured, scrawled in green crayon on lined paper. To be honest, I quite like “being on the list”, after all being on The List means that you have ANNOYED THE BEAR, which is a noble and fine endeavour. Unfortunately, moving will mean that I will have to trade my underground, “nuclear shelter” type shed for a “bastelraum” in the flat and TWO parking spaces (with associated storage) in the secure underground, garage. Still in return in addition to the usual rooms I’ll get a small loggia with a Japanese garden in it and a decent kitchen that can be, with some equipment changes, as professional a kitchen as you can get away with in a private dwelling.

Do you know the price of methylated spirits in Switzerland, if you can find it?(some sort of umweltschutz thingy). Now, whilst my circle of acquaintances is both broad and eclectic I have yet to encounter any toper who preferred tipple is meths (I do have a few acquaintances who drink lager, but you do need to make some allowances for your chums’ foibles). Obstwasser is cheaper and tastes better than meths (AND you can use Obstwasser to fire your live steam locos….)

Oh, I know the English alright, I was being diplomatic. And that’s a very English bit of understatement…. Not only wine, many in the UK think that paying more than £5 for anything comestible is extortionate…. Very sad. Napoleon had the right idea about Champagne: “in defeat you need it, in victory you deserve it”. Sparkling wine should be enjoyed at any time…. “Of almost any description” is - I suppose - a charitable way of describing the fizzy, alcoholic, lemonades that are the most sold (ahem) “beers” in the UK (according to Londonlovesbusiness.com) Thank goodness for microbreweries say I, otherwise you’d all be drinking the modern equivalent of Watney’s Red Barrell - were the brewing conglomerates to get their own way.

Regarding Champagne vs prosecco: it depends - I’ve drunk both Dom Perignon and Veuve Clicquot La Grande Dame, both were excellent (as you’d expect from a Champagne costing more that £170 a bottle); but most of the time “bog standard” Champagnes aren’t worth the price (although I find that the Heidsieck & C° Monopole Blue Top is a pretty decent “every day” Champagne). The Prosecco exported to the UK is pretty much undrinkable, as is most of the Prosecco exported from Italy (the Italians keeping the best stuff for themselves). Export Prosecco tends to be far too sweet, presumably to cater to local (UK, DACH) tastes (remember Blue Nun anyone?). Hunt around and you can get some really good Prosecco - but the price of the really, really good stuff is heading towards Champagne territory. Our current “go-to” fizzy is from Switzerland and is the Mauler Cuvée Tradition Rosé Brut (see https://www.mauler.ch/fr/catalogue-mauler-cuvees-classiques-cuvee-tradition-rose-75cl-c1-t2-p21.php) at SFr 25 or so a bottle (about £22) it’s worth every penny as it’s easily as good as any Rosé Champagne at three times the price.

Don’t blame the Wing Commander. He was - as they say - following medical advice. Having recently had surgery, our <boy in blue> is still recuperating, both physically and psychologically (any major surgery has a degree of psychological impact*). Therefore I advised him that the sight of pachydermal and ursine freeloaders wallowing in, and stuffing themselves with, CAKE would set his recovery back a couple of weeks. Being a sensible chap, he heeded my advice and thus had an enjoyable and stress free birthday. * this is actually true.

It depends upon the cake. The cheap ones from the supermarket not only use the cheapest ingredients (e.g. synthetic vanilla flavour vs real vanilla extract) but are also full of all kinds of interesting (ahem) “stuff” to facilitate transportation and extend shelf-life*. Furthermore, far too many are (unnecessarily) sickly sweet. These are definitely Not Good For You. At the other end of the scale are those cakes (homemade or from a patisserie) that are made from best quality ingredients and are sweet but not sickly so. These tend to have a very short shelf-life - in terms of edibility as well as availability (as in they get scoffed quickly). These aren’t terribly good for you, although a slice or two as part of a balanced diet will not go amiss. I can’t remember the last time I ate a shop bought “industrial quality“ cake. The last slice of cake I had was from a variation on a boiled fruitcake that I made last weekend, where – instead of boiling the fruit– the raisins were left to soak overnight in an Irish whiskey liqueur. The result was more than scrumptious (as was the rhubarb crumble cake I made the weekend before that). * an interesting bit of trivia: Mrs iD loves “sliced white” for her toast (we all have our little foibles), so one week I bought a loaf of “sliced white” for her and made my usual wholewheat loaf (just flour, water, salt, fresh yeast [and a little bit of sugar to keep the yeast happy]), as Mrs iD only ever eats a slice or two of toast, the “sliced white” hung around for a bit. By the end of the week the homemade bread had gone hard as a rock (but still edible and used for croutons) whilst the commercially made bread - full of preservatives - had gone mouldy!

Is that a secret RAF code for naughty indoor shenanigans? Like ‘Allo, ‘Allo’s “flying helmet and stick of celery”?

You have to be careful about analgesic cocktails as liver, kidneys and gut are all affected by such drugs and any existing known (or hitherto unknown) vulnerabilities in these organs could be amplified or affected. Perhaps a better approach to pain management could be changing the doses of each of the individual drugs in the existing cocktail of analgesics rather than adding yet another on top of the existing mixture. As an example of some the side effects of analgesics: now, opiates are very useful drugs indeed - but amongst the side effects of opiate use can be severe constipation. I when I say severe, I mean severe to the point that faeces have to be disimpacted (manually removed) before something like an enema or a stool softener can do its job. Changing the administration timings of the individual drugs may also provide better pain relief.

Good Morning All, A belated HB to our tame Air Commodore @Dave Hunt. I hope the usual fighter-jock “wild and crazy” birthday bash shenanigans were a bit tamer this year - allowing our boy in blue to continue to recover from his surgery (he has a sick note and all). Thanks to @jjb1970 for mentioning Eva Air - I remember them, are they still going? Anyway, before I book my flights I have to get a new passport as my current passport will expire right in the middle of my trip and airlines get MOST unhappy about changes in documentation (even when completely legit). Off to view the penthouse flat this morning - with a long list of things to note/measure/photograph. We also need to make a list of the changes we will make before we move in (the place is currently empty). New curtains are a must, as well as upgrading kitchen equipment and shower installations. I also reckon I need to get an embroidered dressing gown and silk pyjamas (and a buxom mistress) for that whole Bob Guccione/Penthouse Pet/retro 70s man-about-town penthouse dweller vibe 🤣😁 Then back to work. The “bright young thing” (who is moving on to “other things”) has not been either meticulous or thorough. To be fair, this youngster doesn’t have the decades of experience that I have, but even when I was a “bright young thing” (back at the dawn of time) I was never less than meticulous. Although - professionally - it irks me that this BYT was so lax, financially the tidying up and moving forward will be a fiscal boon (and we all need a good boon now and then). Off to do Lucy’s breakfast (stir fried chicken and rice - lucky girl) Ciao for Now iD

Today was a busy and thus profitable day at work, but I still managed to get in some airline flight searches so that I could organise my own travel for my late autumn trip to Japan. Now, @jjb1970 had mentioned how insanely expensive Singapore airlines is on their routings to Europe, however, I found that flying out of Zürich, depending on the date and time of travel, they were not insanely expensive (but certainly at the higher end). Both Air China (PRC) and China Airlines (Taiwan) were incredibly competitive, even though it means a two stop journey (basically popping over to Munich, before heading towards either Taipei or Shanghai, and then onwards to Tokyo). Even British Airways had a fairly reasonably priced offering in business class and their new business class product on the airbus A350 they use on their flights to. Japan looks incredibly good. Unfortunately, both the British Airways food & drink and the British Airways customer service still remains in the toilet (when it has been for quite a few years, unfortunately. BA used to be very, very good). In addition to the questionable food and drink offerings (no roast beef! No sausage and mash! No jam roly-poly, or spotted dick! And they are supposed to be a British airline), you also have to negotiate that living hell which is London Heathrow. Like a good Swiss, I also looked at what SWISS was offering. (they have a direct Zürich to Narita flight), and (@polybear better sit down for this) they wanted SFr 9000 (about £7880) for a return ticket! Of the European airlines I looked at the ones with the highest prices out of Zürich to Japan were SWISS, Lufthansa, Austrian Airways, Air France and Iberia. Of these, only Air France makes it into the World’s Airline Top 10 (although SWISS, Iberia and BA made it into the top 20). No matter which airline you are travelling with, Business and First Class are much more expensive than they should be because First Class and Business Class passengers are subsidising the very cheap economy class fares (the wife of friend was an airline hostess and she informed me that they [cabin and cockpit crews] were told that once business class had been filled [and the airline’s costs met, then every bum-on-seat in economy was pure profit).

A very salient point, Andy. I sometimes wonder if the UK would be better off building Euro-style (and quality) apartments instead of trying to cram smaller and smaller houses into poorly thought out and designed “developments” in Britain’s remaining green space. I would have thought that the government would have made the (re-) development of brown-field sites a priority - providing tax breaks and - if necessary - subsidies for cleaning up such sites. Having an open plan arrangement in a tiny house does have solid logic behind it. But I notice, from programmes like Grand Designs, even those with both the space and the money to do otherwise go for open plan layouts (OPL). in fact, I would go as far as to argue that OPL has become an architect’s cliché. Along with: Flat roofs Square and boxy buildings Overabundant, nay, excessive use of concrete, glass and steel floor to ceiling windows no curtains and no blinds polished concrete floors glossy, shiny, kitchen cupboards and furniture* A lot of these builds, appear - at least to my eyes - to be of the “look at how much money I can throw at an on-trend architect to build me a house” types. The great Terry Pratchett made a comment or two about modern architecture, one of which was along the lines of “it was a newly built house by a famous architect. You could tell that it was new as the windows hadn’t yet fallen out or the flat roof started leaking” There is a reason traditional architecture looks the way it does…. * do you know how hard it is to keep high gloss finished cabinets clean and finger print free? You’re constantly wiping down and polishing the surfaces (as a friend found out to his cost when his missus got such a kitchen)

Morning! Unfortunately today I had another 3am “emergency poo run” with Lucy, poor mite. Fortunately, a vet visit for Schotty is scheduled for early next week (for his physiotherapy) so we’ll take Lucy as well. Thanks for your comments, it does look like that we will be going for the penthouse flat rather than the garden flat (it got the seal of approval from GP Friend and Mrs GP Friend - which has helped nudge Mrs iD towards the [ahem] “right” decision). I’ve never understood this craze for open plan living. OK, I get the point that you may want to be sociable, but do you really need to turn your flat/house into an approximation of an aircraft hangar or warehouse to be so? I think that there’s a lot to be said in favour of dedicated rooms (so library/smoking room, home office, m**** r****** room and so on). Another consideration is that with dedicated rooms you can avoid the “whole house smells of XXXX” scenario (plus, separate rooms means that I can have my wicked way with the young scullery maid in the library and not disturb Mrs iD having Earl Grey Tea and buttered crumpets with her friends in the withdrawing room). To answer PB’s question we would have access to a communal garden, though “garden” may be stretching tye definition a bit - flower beds in the front and a narrow lawn at the back. Moving house: Oh What Fun…..

Küche is kitchen. I certainly don't want to talk to my guests when I'm cooking. Mrs iD does the "gracious hostess" bit, whilst I cook up a storm in the kitchen. Besides, you won't believe how long the cheesy pong from a Fondue hangs around....

Well, "zimmer" just means "room" - so they can fulfill any function wish. The number of bedrooms that will be needed will depend upon the <nocturnal snoring situation> - currently a topic of much debate 🤣😁 The garden apartment has been designed with an open-plan kitchen/dining/room space, something I utterly LOATHE*, but as we are still at the architect's plans stage, these can be amended. * I'm afraid I'm very old fashioned and prefer dedicated rooms to open plan living.

Re. older dogs: My two (Schotty and Lucy) are definitely aging (Schotty is about 12 - 13 and Lucy about 14 - 15) but are doing well. Both are rather stiff in the morning and Schotty - like iD - has arthritis. I take diclofenac on a PRN basis, whilst Schotty gets a dose of a Cox2 inhibitor plus gabapentin (half a dose in the morning, a full dose in the evening). He also gets regular physiotherapy. Lucy is now almost completely deaf - (although I sometimes wonder how much of Lucy's deafness is like Mrs iD's [ahem] "hearing limitations": i.e. selectively turned on and off!) and she still has intermittent GI problems and could stand to gain a kilo or two, but otherwise both she and Schotty are happy and pain free (the aches of aging excepting). At this rate we could see both Schotty and Lucy getting to 16 or so. ION In the ongoing saga of leaving Schloss i.D. for pastures new, we now have two candidates in mind: one, an existing penthouse (which covers the entire top floor of the building) and the other a yet-to-be-built state-of-the-art eco garden apartment. Both have positives and negatives. Here are the two apartment footprints. I'm slightly more in favour of the penthouse, Mrs iD the garden apartment. The penthouse apartment is slightly larger at 170m2 Thoughts? ION-2 I'm getting seriously cheesed off at the travel agent who arranged my trip to Japan last year. I decided to use them again this year and I tasked them to (amongst other things) find me an advantageous Business Class fare to Japan using Asian airlines and novel routings (as our chum @jjb1970 has often spoken about) - so what do they do? They offer me two routings out of LHR at astronomical prices - the sort of price I would be quoted (as a non travel industry person) by booking on the airlines' own websites. I thought that travel agents could use their purchasing muscle and insider knowledge and status to get very advantageous fares (in this case, obviously not). I had a go myself, and without much effort found a routing through Shanghai for 1/2 of the price of the cheapest flight offered by the travel agent! Unless they up their game, they may find themselves loosing a customer....

Which is why properly qualified handwerker and craftsmen are thin on the ground in the UK. Brits tend to be very snobbish about skilled craftsmen and tradesmen and frequently don't want to pay them a fair fee for what they do. Being a neurosurgeon and being a qualified and certified electrician are different jobs - but both can have fatal outcomes if the responsible individual doesn't do his/her job properly. Both jobs require academic and practical credentials, not to mention lengthy training and lots of supervised work whilst in training. You wouldn't want to get a neurosurgeon "on the cheap", so why get an electrician or plumber "on the cheap"? Maybe it's an "it's an easy DIY job*" mentality or perhaps it was the skilled Eastern European workers being paid poorly by UK standards (but making a lot of money by their own - home - standards) that has lead to this "they have to be cheap" mentality. I would argue that it's this refusal in the UK - pretty much across the board - to pay decent prices, salaries and fees** that has led to much of the UK's infrastructure (public and private) not being properly maintained. * I've read a book or two about neurosurgery and thus I'm supremely confident that I could do some DIY brain operations on friends if they wanted to save some money. ** as mentioned before, the UK is a low wage/high tax economy