Day 28 – Dampierre-sur-Salon to Gy

A good name is to be chosen, rather than great riches… Proverbs 22:1

Saturday 28/4/2018

Distance 30.3km Total Distance from Canterbury 708.3km

So today, a simple question. How would you pronounce Gy, the place I was aiming for today? It’s only two letters. There are not unlimited possibilities. But still, you could be right or you could be wrong.  You could be conventional or you could be creatively individual – though you need French people to understand where you are referring to. Commit yourself now and I will tell you later.

I didn’t tell you yesterday what happened when I arrived at Dampierre-sur-Salon. If you have been following you won’t need me to explain here that the Salon is a river. I made my way, as advised yesterday, to the tourist office, only to find that it was closed. Finding things closed is rather the default position in France. It is not worth getting excited about. Why ever should the tourist office be open in a tourist area on a Friday afternoon to welcome people who have come for le weekend?

So when in doubt in France, always try the Mairie. A rather unusual mairie here in Dampierre-sur-Salon, with a built-in laundry area. These are called lavoirs and they are in every village in this area.

They are the old communal washing areas, generally on a river. If they could talk, they would know a lot. They must have been great places for chatter. A very helpful lady in the mairie fixed me up and told me to collect some food in the supermarket opposite. So I headed a few kilometres to Croq’Loisirs.

I can’t really translate this. Croque can have literal meanings like crunch, crackle and also to munch. Loisirs is leisure, or hobbies or spare time or recreation. I think it means ‘enjoy your recreation’. And I did. It is a large purpose-built activity centre for primary children. It is non-residential, with both indoor and outdoor pursuits including fitness and sports, art and ecology. It was a bright and cheerful place. The staff could not have been nicer and gave me a great welcome, making up a bed and showing me the facilities. They were just finishing for the weekend so left me with the whole building to myself. Use anything they said. A washing machine, a large kitchen, toilets and showers, super fast WiFi and, for that matter, a large trampoline. The cost? €5. I was just to leave the key in the mailbox in the morning. I felt like Goldilocks in the wrong house! The furniture was very very small.

I would have like to stay for the weekend. But pilgrims keep moving. After breakfast I was on my way to Gy. Keep thinking how you will pronounce it.

Pronunciation is difficult in French, but it is difficult in English too. How would you teach someone to pronounce -ough? Enough, trough, though, through, bough….. It is easy for us, but can you explain it? Some languages are very easy to pronounce, such as Italian, Spanish, Swahili though you may need to learn the odd new sound. But they are pronounced as they are written. Not so French and not so English.

I enjoy asking French people to explain pronunciation, but they can’t make much sense of it either. An egg, un oeuf, is ahn erf. For the plural you add an s, which you don’t pronounce and you also now don’t pronounce the f. Two eggs is deux oeufs, derze err. Bout is pronounced boo, but but is pronounced boot. And I don’t think French people are the least bit unkind but they do tend to look a bit uncomprehending when you pronounce something wrong.

George Bernard Shaw was a man of many opinions and also grumpy. And he was an advocate of spelling reform in English. There is a well known suggestion that ‘fish’ in English could be spelt ghoti. The ‘gh’ as in enough, the ‘o’ as in women and the ‘ti’ as in nation. This is often attributed to Shaw, but in fact it was in circulation before his time. It is silly, but it illustrates the divergence between English spelling and pronunciation.

I worked once in a hospital near Liverpool called Fazakerley. That is itself a strange word. Put the stress on the second syllable. It used to be an isolation hospital, out in the country, built first in about 1900. It dealt with smallpox and TB which were scourges at the time. It is now called Aintree University Hospital and is right next to Aintree racecourse, famous for the Grand National. I think there are only three race meetings a year, but there is also a car racing track which in the past staged the British Grand Prix. On a Sunday morning you could hear cars on the track.

I was looking after newborn babies in the maternity wing, a new building with delivery rooms on the ground floor and Special Care Baby Unit (SCBU) on the fifth floor. Paediatricians attend any delivery in which complications may be expected. So I was there one day as a rather young mum delivered her child. I was there mainly because of the young age of the mother. The delivery was happily without complications. Or at least without medical complications. We were just moving towards health and safety in those days. New babies used to be called ‘Baby’ but now there was a move to insist they should get a name immediately, and this went on two name bands, one on an arm and one on a leg. I don’t think it was always enforced yet, and of course was not at that stage in any way binding. ‘What do you want to call your baby?’ asked the midwife. ‘Gooey’ said the mum. ‘Gooey?’ said the midwife. ‘Yes Gooey’ said the mum. A nursing mother, like any other nursing mammal, is not to be tangled with. And she was adamant and becoming a bit cross. ‘But’, said the midwife hesitantly, ‘that’s not really a name is it?’ ‘What do you mean?’ said the mum. ‘It’s me favourite name!  Gee – You -Why! Gooey!’ Well that sorted that one out.

Does it help you with Gy?

I’ll tell you another story about a name at Fazakerley, but a bit of background first. When you begin medical practice, you start at the very bottom of the hierarchy, as a pre-registration house officer. I was a house surgeon a long time ago. We admitted a very very old and very ill lady late one night with a blockage in her bowel. She had become very weak at home before allowing her son and daughter to arrange for the doctor to come. He sent her to the hospital. She was admitted by me, and taken to theatre for surgery. It would have been major surgery for anybody, but was even more so for a women in her enfeebled condition. Because of her age and frailty she was transferred after the operation from theatre to the ICU (Intensive Care Unit) in the early hours of the morning. While she was in ICU an attempt was made to correct an abnormality in her blood chemistry, The value was not really very unusual for a woman of her age and condition, but in ICU I think they like things to be right. In simple terms this was done (not by me I hasten to add) in a way which hastened her death. She died before the morning. The following day, I was dispatched by my hierarchy to speak to the family, not because of any personal expertise (although I had an Honours degree in Medicine with a Distinction in Surgery) but because there was no one less important than me to be given this job. So I went to see the son and daughter. I had to explain to them that as their mother had died immediately after surgery, she would need to have a post mortem examination. I also told them, in words I felt they could understand, not only that their mother was extremely ill, before and after the operation, but also that the care she had received at the hospital had probably hastened her death.

Later in the day, I met the hierarchy who checked that I had done my job. What had I told them? ‘I told them what happened’, I said. I can still picture the look of consternation on their faces. This was not evidently what they would have done. We heard nothing more from the family, except for a letter thanking us for our kindness and care for their mother. I believe, and will not be shaken from my belief, that telling the truth is always the best thing to do. There may be different ways of doing it, but telling lies is not one of them.

This I think is illustrated by the Truth and Reconciliation Commission in South Africa, for instance. This was far from perfect, but illustrated that people generally wanted to know the truth about what happened, more than they needed revenge even thought the granting of amnesty to those who gave evidence was in some cases very controversial. The broader concept of restorative justice, dealing with criminal issues, and the rehabilitation of both offenders and victims, is related.

Restorative Justice has been defined by Dr Carolyn Boyes-Watson of the  Centre for Restorative Justice of Suffolk university as

…a growing social movement to institutionalize peaceful approaches to harm, problem-solving and violations of legal and human rights. These range from international peacemaking tribunals such as the South Africa Truth and Reconciliation Commission to innovations within the criminal and juvenile justice systems, schools, social services and communities. Rather than privileging the law, professionals and the state, restorative resolutions engage those who are harmed, wrongdoers and their affected communities in search of solutions that promote repair, reconciliation and the rebuilding of relationships. Restorative justice seeks to build partnerships to re-establish mutual responsibility for constructive responses to wrongdoing within our communities. Restorative approaches seek a balanced approach to the needs of the victim, wrongdoer and community through processes that preserve the safety and dignity of all.

I think in a slightly different context this applies to medicine too. People can understand that an honest mistake, or a deviation from best practice can be made. They may be unhappy about this, but I think they are even more unhappy if they are not told the truth.

To return to Fazakerley. I told you that a paediatrician is in attendance at any delivery which has been identified as having high risk, for whatever reason. When this happens, the paediatrician will be there towards the end of labour and will have had time to read the mother’s notes, and speak to the parents to prepare them for any procedures that might be necessary.

A different scenario is when an unforeseen emergency arises during delivery. A ‘flat baby’ is a baby who doesn’t breathe after delivery, despite normal stimulation. He or she may have a weak or absent heartbeat too. It is not particularly uncommon and is usually very easily treatable by routine resuscitative measures. These are not as glamorous or as noisy as a cardiac arrest on Casualty or Holby City, but are probably a hundred times more successful. In a busy maternity unit you might be called to see a ‘flat baby’ almost daily.

So some days after meeting Gooey for the first time I was ‘crash bleeped’ after midnight to go to the labour ward. The SCBU was on the top floor and the labour ward on the ground floor. You could conceivably be in bed, in a bedroom on the ward, although this was rare enough. The stairs are quicker than the lift and down I went, hurtling down into the labour ward and attended to the baby, already of course being expertly managed by the midwives. It was a full-term baby boy, of a good size, and I was told the pregnancy and labour, up to the point of delivery, had been uneventful. With standard treatment, the baby was soon pink and crying noisily and was handed to the proud parents. I explained to them that I could find nothing wrong with the child, but that in the circumstances we would admit the child to the Special Care Baby Unit for observation overnight, where they would be welcome to visit at any time. They were happy.

Finally I came to write up the notes, and for the first time picked up the mother’s folder. In very large red letters on the front were the words ‘Parents are Jehovah’s Witnesses. No blood products to be used.’ This was not terribly uncommon and it would be the job of the obstetricians to discuss with the mother her treatment choices. Adults can make their own treatment choices. So a mother can specify, for instance, that if she needs a Caesarean Section, or has a haemorrhage during delivery that she should not be given blood.

In my ‘standard treatment’ of the baby boy I had given some human plasma, a blood product. This is entirely normal in the circumstances. Conceivably something else could have been used, if I had known the wishes of the parents (although in practice, probably not). In writing my notes I had options. I could have written ‘standard resuscitative procedures applied, with volume expansion’ which would have been true. But I always wrote very detailed notes and I spelled out in the notes exactly what I had done.

Some time later, by now well into the small hours, the father came up to see his son in the SCBU. I explained to him again that all seemed well with his son. I also said that I needed to explain something to him, and told him that in the emergency situation I had used a blood product to help my resuscitation of the boy. I said I knew that he and his wife had specified that blood products were not to be used for her. I said I could understand that this might be upsetting for him, but I wanted him to at least know and to understand I had acted in good faith, using best medical practice. He said little, but did not seem disturbed. I asked him if he would like me to explain this to his wife and he said, no, that he would speak to her first. (The fact of the matter is that, in law, I could not be faulted for giving a blood product to a child who needed it, in spite, I am sad to say, of the parents’ objections. But that is not the point here. And antagonising parents of sick children is never a good idea.)

The long night in SCBU wore one. In those days the long night in SCBU was preceded and followed by a normal working day, so we are talking about a shift of 32 hours.  Later again in the morning, as dawn was breaking, the mother was wheeled up to SCBU to see her son, accompanied by her husband. While the Sister served us all a cup of tea, I again explained, now to Mum and Dad, that I had given a blood product to their son. And again, I didn’t apologise for my action, but told them I was sorry if they found this difficult or upsetting. ‘What is your name?’, said the mother. I always introduced myself by name, and said once again my name was Dr Redmond, and wrote it down for them, genuinely enough in case they wanted to make a complaint. ‘No’ she said, ‘what is your Christian name?’ ‘Tim’, I said. ‘Well’ she said, ‘we will call the boy Tim’. And that was the end of that, although it is fair to say that i was very touched.

‘A good name is to be chosen rather than great riches.’ Indeed.

As I write this, I am in Italy and always find it amusing to see my name all over the place here. TIM is a mobile telephone operator here: Telecom Italia Mobile. It makes me feel a bit like Richard Branson. When I ring up a hostel or albergue to make a booking here, and they ask my name I always say ‘Tim – come il telefono’ – ‘Tim, like the telephone.’

Redmond I did not expect to see. If you go to Washington State in USA  there is a city called Redmond and it is the corporate home of Microsoft. However, here in Italy as I write, I saw this place name the other day. It was not a very exciting place, but I was excited!

But then something unexpected happened. On Sunday last (as I write) I undertook an epic trip to a Decathlon store outside the city of Pavia. This was to buy new walking shoes, having worn my first pair out, despite the fact that they were new when I set out. Decathlon is a wonderful shop if you like that kind of thing. Having overcome great adversity to get to it, I spent a long time trying on different walking shoes and eventually made my choice.  Columbia brand. Only when I picked up a pair to bring to the checkout did I pay attention to the label. Here it is.

Here they are. Names are important.

So finally, Gy.

It is pronounced ……. Well I can’t easily write it for you, because I don’t think we have a way of showing the beginning of a word with the correct sound in English. It is like half of the girl’s name ‘Gigi’. Maybe ‘Zhi’.  Like the sound of ‘s’ in ‘treasure’, or ‘measure’ or ‘pleasure’ or the ‘z’ in azure, or the ‘s’ in ‘Asia’. I was calling it Ghee all day, until I got there. You cannot tell for sure  by looking at the letters I am sorry to say.

Both Gooey and Tim must be about 32 years old now and I hope life has turned out well for them.