Fragile hope

A ceasefire was announced between Hamas and Israeli forces. In the few days between the announcement and the proposed start, Israel killed at least 103 people and injured over 260 in Palestine. Netanyahu didn’t even wait until the start of the ceasefire to threaten even greater killing and destruction, and has called the halt to the bombing ‘temporary’. The start of the ceasefire was delayed as Netanyahu demanded the names of the first 3 hostages that would be released. During the delay Israeli warplanes attacked the northern Gaza Strip and killed 8 people. Hamas has now released a list of 34 hostages who will be released in a phased approach over 6 weeks. They include Ariel Bibas, age 5, and Kfir Bibas, age 1. The trauma suffered by these children, and the children of Palestine is unimaginable.

I like to look at the Guardian’s photography feature, the week in pictures. This week shows both desperation and hope in Gaza. The ceasefire is welcome, but it is merely a pause, it is fragile, and it is just the start. I fear that the international community will continue to fail the people of Palestine and that we will not see justice in our lifetime. But we must continue to demand accountability and repercussions for the perpetrators of genocide; and peace, justice, safety and self-determination for the people of Palestine. I continue to support Osama and his family and hope they get the chance to rebuild their lives and pursue their dreams.

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This is why we can’t have nice things

We’re a week into the New Year and already things are quite terrible. Here are a few lowlights:

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New year, new hope

It’s a New Year! January the 1st is not only the start of the New Year in the Gregorian calendar, but also the Roman and Julian, so if you’re still following the Julian calendar like the Amazigh people, then we’re in synch. There are of course New Years all through the year in different countries and cultures, and some New Years which move. This feels destabilising. I like the predictability of seasons and festivals. This week I learned that January the 1st is a feast day in the calendar of Eastern Orthodox calenders because it is the Feast of the Circumcision of Christ. I’m not sure this knowlege has enhanced my life. And now you can reflect on whether it has enhanced yours.

I did not stay up until midnight. I was pretty exhausted from work so had the most luxurious evening eating a lovely dinner and retiring to bed. My favourite thing about getting older is that I feel less and less need to do what’s expected and instead I do whatever I like! P__ stayed up but he’s a definite night owl, wheras I’ve had to accept that I’m more of a morning lark.

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Yuletide cheer

I had a lovely Christmas week, full of family and friends, and food, and thoughtful gifts. We had Mushroom Wellington and Maple Glazed Seitan Ham for Christmas dinner. It was super.

I was working for the days around the Bank Holidays. We rotate who does Christmas Day and, having done last year, I get a break for a few years. Hospitals are strange places at Christmas, a mixture of intense sadness and heart warming joy. Maybe that’s always the case, but Christmas somehow magnifies the contrasts. The people who remain inpatients at Christmas are those who are too sick to care or notice, and those for whom hospital is their best option. We’re always under pressure to discharge people and make beds, but to be honest, in the few days before Christmas I don’t discharge anyone who wants to be there. If home does not have something better to offer than a hospital bed then who am I to inflict loneliness, fear or sadness on anyone.

There is flu and RSV everywhere. People with chronic medical conditions are very sick. Even those who are usually well are strugling to shake off the persistent cough and fatigue. Vaccination rates remain much lower than pre-COVID. It’s hard to see how we’ll ever improve the situation and convince people of the benefits when there is so much misinformation and fear around vaccines.

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Salt water

A non-exhaustive list of things that have made me cry this week:

Fast and slow

I seem to have lost a week in a blur of christmas parties, overflowing inboxes, overbooked clinics, carols and mince pies. And I am harbouring yet another Respiratory virus. They are persistent this year, with coughs lasting weeks. I was asked if colds last longer as you age. I can’t find any evidence this is the case. Illnesses last longer in those in poor health and at the very extremes of age but there’s no reason for differences in illness duration of 40 somethings vs 20 somethings.

Nutrition is of course a major determinant of health and immune funcion. A plant based diet is associated with a lower risk of hospitalisation in COVID-19. Plant-based diets provide micronutrients, including vitamins A, B6, B12, C, D, E, and folate; trace elements, including zinc, iron, selenium, magnesium, and copper; and the omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid, which play vital, often synergistic roles at every stage of the immune response. Plant-based diets are also anti-inflammatory, and support a healthy microbiome. There is little data on diet pattern and viral illnesses other then COVID-19, an area that needs further study. Despite having grumbling illnesses for weeks I’ve not had a single day off work. I’m convinced it’s the plants!

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Chaos and conflict

The world feels chaotic and unpredictable. Just this week Syrian rebel group Hayat Tahrir al-Sham have taken Alleppo and Assad has fled to Moscow; South Korea’s President Yoon Suk Yeol declared martial law, before having to backtrack in the face of parliamentary opposition and mass protests; and United Healthcare CEO Brian Thompson was shot dead on the street in Manhattan. The images coming out of Palestine and Lebanon are relentlessly horrifying. I read an article which asserted that indeed the world is getting more violent. One in 6 people live in an area of active conflict. This is not what I expected as I grew up, with the promise of increasing democratisation and peace.

Data from: https://acleddata.com/conflict-index/
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Granny’s Garden

I spent most of the week at the British Thoracic Society Winter Meeting. It was a great mix of catching up with colleagues, discussing projects, and learning from the latest research. It’s an exciting time in the world of COPD with real hope for new treatments and a transformation of care over the next few years.

Medical conferences are not always comfortable spaces. I wrote about my ups and downs in a thread. Thankfully 2024 was a definite up.

I wrote this 🧵on the other place in the run up to #BTSWinter2024. The conference starts today, so I’m copying it over here. On belonging, joy, fear, imposter syndrome & how to enjoy medical conferences. 💙 1/n

[image or embed]— DrLJ (@drlaurajane.bsky.social) November 27, 2024 at 6:58 AM

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A Tranquil Space

P__ and I went to Turn Up for Gaza at The Colour Factory. The venue is very cool. The line up was great, hosted by Jen Brister, and including JJ Bola, the repeat beat poet, Rozi Plain, Robyn Rocket and more. A highlight was Donna Thompson who made magic with her voice and a looper. And of course, my all time favourite Hollie McNish, who made me cry, as always. The event was in support of All Our Relations, supporting families displaced by conflict and violence, providing them with the financial, organizational, and emotional aid they need to rebuild their lives with dignity. I hope the event raised a lot of money. You can donate here or use the QR code.

There has been heavy rainfall in Khan Younis and other areas of Gaza. Osama tells me that conditions have deteriorated. There is no infrastructure. There is no shelter. Everything, everywhere is cold and wet. They worry that tents will be flooded and destroyed. I got paid, so I sent his family more money. Please help with whatever you can. I am matching all donations between now and Friday* so whatever you give will be worth double!

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Impatience

I was recently asked what my primary emotion is, and I answered, without hesitation: impatience. This is both a blessing and a curse. It drives me to work hard try to change the problems I see everywhere, every day, and makes me very productive. But it also makes me a bit of a nightmare to work and live with. I struggle to slow down and to accept the slow pace of change that is a common reality. I tell others to remember their sphere of influence and not to expend energy on things way outside it, as this way burnout lies. I often fail to take this advice myself. This week I have felt very impatient.

COP 29 is happening. At least 1,773 fossil fuel lobbyists have been granted access to the summit in Baku. In an open letter, a group of international experts have stated that the UN Climate talks are no longer fit for purpose, and called for reform. Global emissions continue to increase, carbon sinks are being degraded and we are headed for more than 2.9°C of warming by 2100. I respect those who continue to participate in COP but I would not have the patience or diplomacy required.

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