Heart Beat: "I am but mad north north west; when the wind is southerly I know a hawk from a handsaw." (William Shakespeare, Hamlet)
What has that got to do with a medical supplement? In all honesty very little. However, as part of my personal subconscious stress-management system, the above quotation came to mind this morning.
Looking across the sand with the river in the centre, I was struck by two things. First, there were a number of salmon jumping clear in the calm river. Second, eyeing them were our local cormorants, distinguished by myself from hawks and Shakespearean handsaws. This was the credit side.
On the debit stress calculator was the fact that the barometric pressure recorded on my weather system was falling, and the wind speed and direction modality had ceased to work.
Hence the birds, the wind direction and Shakespeare: if the unworthy thought takes root that all this portends a reluctance to return to the real world, this is, of course, true.
I know I can't hide away for ever, and despite my futile efforts to exclude them, the problems remain and get worse. This was brought starkly home to me last week by the latest so-called "plan" from our old friends in the HSE, and by the extraordinary criticism of his erstwhile colleagues by its extremely well-paid chief executive, Prof Brendan Drumm.
I'll give you my personal view of this. First, there has been almost no perceptible improvement in the service presided over by the Minister for Trolleys and the increasingly whitening elephant of her buffer HSE. This poses immediate problems.
There is an election coming - and this is for politicians as a wedding or major anniversary might be to the ordinary family. The house must be painted and the cracks papered over. All the little birds in their nests must agree things have never been better and the future seems even rosier. If this fails to convince the sceptics, other sinister elements must shoulder the blame. God forbid some crank or malcontent might wonder what you have all been doing these past 10 years!
Tweedledrumm and Tweedletrolley, singing from the same hymn or her sheet, had to do something about the A&E services. The trolleys and other problems had to be hidden from the public gaze at this most sensitive time. There is the usual waffle about admission lounges - simply beds by another name.
You understand, of course, that they simply can't admit that they were wrong and all the troops on the ground were right. The canard that the problems exist in only a small amount of hospitals is repeated shamelessly.
A recent example of this fallacy comes in the last week when the lamentable problems of the National Rehabilitation Service were highlighted. What about trying to get these unfortunate patients with their multiple problems dealt with through the National Treatment Purchase Fund, Minister, that most accountable of bodies? It, with its open policy, will let us all know what it costs.
There is a carrot-and-stick approach in the new plans. The stick consists of dealing with hospitals that cannot cope with their financial allocations and bed numbers by giving them less next time around. This is to reward efficiency!
The carrot, however, almost beggars belief. If the hospitals behave themselves, stop complaining, hide the trolleys and do not embarrass the Minister before the next election, they will be given up to seven new consultants! Now you understand, of course, that these will not be real consultants. They will be stuffed consultants. That really doesn't matter, as everybody knows consultants don't work anyway. The new ones can be wheeled on to ward rounds at any hour of the day or night, possibly by underemployed administrators who can also discharge the patients. They will make no protests and cause no problems.
Where will they come from? This is the really clever bit. The Minister for Trolleys and the good Prof Drumm both evince great enthusiasm for stuffing consultants. It appears to be their hobby. Indeed, it seems to be their policy.
If everything else fails, blame the consultants. Sure, they are a dreadful crowd, like the Garda, the teachers, the nurses and anybody else who questions the squandering of money over the last few years with but little to show.
And what is all this about the iSoft computer system? Have we another PPARS on our hands? There are other wondrous aspects to this plan and I will return to it next week.
Maurice Neligan is a cardiac surgeon.