A little explanation

The phrase goes that everyone has a novel in them and these words certainly echoed in my mind around the time I decided to give it a go. Strangely, the words of Karl Pilkington had a small part to play as well…

I decided that I wanted to write a novel around ten years ago while I was at university. I can remember quite vividly popping into the Cardiff branch of W.H. Smiths with a fresh face (or possibly a hangover) to buy some sort of fancy writing pad into which I could pour some of my ideas. If I’d known I would still not be quite finished almost a decade later, I’m not sure to this day how I would have proceeded. But thankfully, perhaps in part to the rather swish suede portfolio case I emerged with at the time, I now have a finished novel. It has been through six drafts so far and if I look back to the first one, the change and development is quite dramatic but I can honestly say it has been one of the most enjoyable and challenging things I have ever done.

The phrase goes that everyone has a novel in them and these words certainly echoed in my mind around the time I decided to give it a go. Strangely, the words of Karl Pilkington had a small part to play as well. For those not aware of him, he was the radio producer for Ricky Gervais and Stephen Merchant who gained fame himself in a series of podcasts the three of them put out and that I listened to avidly when I could. He was described regularly as ‘a little bald-headed buffoon’ quite often by Gervais, though deep within his ramblings I managed to find a spark of inspiration. Rather embarrassingly this involved the idea that people’s minds could be transferred from body to body, thereby involving incredibly long life. Thankfully this aspect is completely absent from my story – it is not a science fiction novel – but it did help shape my own ideas and themes in the development of things to come.

As a side note, Karl missed a trick as his idea about transferring minds into new bodies has been used since in at least one TV series that I can think of. There are probably more.

So there I was with a seed of an idea. The trouble was, I had a degree to finish and the small obstacle of the wider world beyond this. I started work immediately and throughout, I had my sites now firmly fixed upon writing this novel at some point or another. Two years later, the time came for me to take a year out of work and this is where I put most of it down on paper (or actually on a hard drive). By this time, I had accumulated a lot of notes and ideas about the story; how it would end and the themes I was trying to convey. The fact it was on the back burner for such a long time may have been a blessing in disguise as all the little notes and musings I would jot down helped give the story a depth that it may not have done if I had gone straight into it.

Fast forward a year and I can remember the day I sat back having typed the last words of the first draft and feeling an immense sense of achievement. Writing a novel is a solitary task, and I was sat amongst strangers in a quiet pub at the time so couldn’t really jump up and down in celebration. As it happened I didn’t really want to. Rather than make a scene, I was content to sit back with a new found sense of calm and reflected on the time and thought that had gone into what I had just written. I also ordered myself a pint of beer.

Little did I know then that it would be another 4 years or so before I would be at a stage where I was happy to share it with a wider circle. And sharing something like that is actually far more nerve wracking than I had anticipated it to be. A novel is quite a personal thing and I confess I felt quite exposed when I first let other people read any of it. Was it actually any good? Would people think I was mad?etc…

Thankfully I received some vital and much appreciated feedback from certain individuals who know who they are and it is because of this that the project has survived to this point. The subsequent drafts were done in a more disjointed fashion, fitted around work when I could and there have been at least 2 occasions where I have declared to all that it is done and finished. It’s the sort of thing one could work on forever, constantly tweaking and altering so it is just right in my mind. The danger here is that, in altering it too much, one loses the essence of the novel itself. Something that was initially quite readable could potentially become unreadable in the blink of an eye and this is something I am wary of.

Now on its sixth draft, I have cautiously begun to send it to a select group  for the first time, to see what happens and to discover whether it has legs in its current form. Yes there are aspects that I could and definitely will improve and now that this process is up and running, I thought it would be interesting to share my experience along the way. Having recently popped along to the London Book Fair, I discovered how many aspiring writers there are out there, and moreover the friendly atmosphere that this community seems to generate.

It dawned on me that perhaps opening myself up into this community might, in the first instance, help me find new insights into all the different avenues of writing and perhaps even make some new friends along the way!

 

 

The Problem with Antibiotics

Our honeymoon period with antibiotics and their undeniable benefits ended long ago, but since their inception we have created a deep seated culture of dependence.

Many thanks for your responses to my article last time around – keep those suggestions for topics coming. Shortly after I had finished the article about the common cold, I developed a cold of my own, so I have decided to postpone indefinitely my planned article on smallpox.

Our topic this week is antibiotics – a subject which is garnering more and more attention in the media. Since 2015, there has even been an annual ‘world antibiotic awareness week’ which, appropriately, was last week.

Why the fuss? Well I am sure most people by now have heard all sorts of stories in the news about antibiotic resistance and the emergence of ominously entitled ‘superbugs’. This is all for good reason as I will expand upon.

To begin with, let’s focus on antibiotics and what they actually are. Prior to their discovery and development in the early half of the twentieth century, we had no really effective ways of treating bacterial infections. Historically, all manner of approaches were used, from the rather dramatic process of blood-letting (thought to stabilise the balance of the perceived four humours: blood, phlegm, yellow bile and black bile), to the use of things like willow bark by the ancient Greeks for curing fevers and pains. (Willow bark actually contains salicin, which is chemically related to modern day aspirin).

Things all changed when the Scottish botanist Alexander Fleming returned to his laboratory in 1928 after a family holiday and noticed that mould had grown in his petri dishes of staphylococci bacteria. The mould in question (penicillium) had killed off the surrounding areas of the bacteria prompting Fleming’s famous response – ‘That’s funny’.

The rest, as they say, is history and since then many different families of antibiotics have been developed to fight off bacterial infections that had once been, at best, troublesome and, at worst, fatal. As we approach a century of antibiotic use, we can look back upon a vast improvement in our ability to treat infections such as pneumonia, syphilis, tuberculosis, meningitis and many more. This has no doubt had a vast social and economic impact. However, now we come to the problem.

Antibiotic resistance is a process that has been developing from the very beginning. In broad terms, let us consider a group of bacteria exposed to an antibiotic. In any reproducing population, there will always be random mutations that occur in the genes of certain individual bacterial cells. Sometimes these mutations happen to protect the bacteria from the effects of an antibiotic. Bacteria without that protection die, leaving the resistant bacteria free to multiply without competition. Over time, these populations spread from person to person, meaning that, when the same antibiotic is used repeatedly, it becomes less and less effective in controlling these bacteria. That’s it in a nutshell.

We are now at a stage in which no new class of antibiotic has been found since 1987 and there are thought to be around 12,000 deaths each year in the UK as a result of bacteria resistant to antibacterial treatment. If this trend continues without further action, the World Health Organisation (WHO) state that the global mortality from such infections could be as much as 10 million people a year by 2050. Advancements and achievements in modern medicine such as chemotherapy, organ transplants and routine operations like caesarean sections and hip replacements – all of which rely heavily on the availability of effective antibiotics – are now potentially at risk.

Development of resistance is and always was a natural and unavoidable process but our use of them has unequivocally made things worse than they could have been. In 2015, it is thought that around 25% of antibiotics were taken unnecessarily in the UK. When you factor in un-regulated use of antibiotics in farming and the availability of antibiotics over the counter in some countries, one begins to see how much of a global issue this is.

On a personal note, I have certainly seen strikingly inappropriate use of strong antibiotics prescribed in other countries for even the most trivial of ailments. There is most definitely a responsibility amongst us as healthcare professionals to monitor what we are prescribing. Having said that, there have been surveys suggesting that up to 90% of GPs have experienced pressure from patients to prescribe antibiotics even when this was not appropriate and would serve no purpose. While this obviously differs from area to area (and to be fair you’re a pretty good bunch), we all share a certain responsibility in tackling this issue.

I don’t want to sound too gloomy, and thankfully there has been some international recognition of the issue. The WHO endorsed a global action plan in 2015 (though lamentably it will certainly now have to make do without the help of Robert Mugabe) and since then 193 countries have given further political endorsements via the UN to install tighter regulation and encourage further research into new antibiotic classes.

As often is the case with such gradual phenomena, the effects of such crises are not always immediately apparent. However, in this case, the signs have been there for a long time and Fleming himself warned about the potential for resistance. Now those signs are becoming ever more obvious and we must face up to the inconvenient truth. We stand to lose a lot if we refuse to do so.

Hygiene both in the community and in hospitals is vital to prevent the spread of bacteria. Responsible and restrained prescribing from doctors both here and all over the world is also required. Research into new antimicrobial agents is ongoing but slow, and techniques to bolster our existing agents is important for our short term management of the more serious infections. Crucially, educating people as to why it is often inappropriate to prescribe an antibiotic is just as important – after all we’re all in this together.

Our honeymoon period with antibiotics and their undeniable benefits ended long ago, but since their inception we have created a deep seated culture of dependence. This will be difficult to withdraw from, especially considering the advances we have built around it. Over the coming years, we must now consider whether or not an even more dramatic shift in our utilisation of such medicines is required before nature takes the matter out of our hands.