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Robert Jaggs-Fowler is an ordinand, physician and writer. His biography can be found at: www.robertjaggsfowler.com

Sunday, January 08, 2017

Sermon: 7th January 2017, Church of St Mary Magdalene, Lincoln

Saturday 7th January 2017
(Day prior to the 1st Sunday of the Epiphany)
Church of St Mary Magdalene, Bailgate, Lincoln

Congregation: Staff & Students of the Lincoln School of Theology,

Matthew 3.13-end
Let the words of my mouth, and the meditation of my heart, be acceptable in thy sight, O Lord, my strength, and my redeemer.

A very good morning to you all – and may I say how wonderful it is to be invited to preach within this beautiful and historic church of St Mary Magdalene.

My chosen text this morning is the Gospel according to St Matthew 3.13-end, which I shall first read.
(read text)

In 2006, I was in the habit of subscribing to a writer’s periodical called Writing Magazine. On one occasion, it carried a competition with the task to write a synopsis of Mozart’s opera, The Magic Flute, in no more than 50 words. It was indeed a significant challenge, but one that I rose to, though, I must admit, not sufficiently well enough to win the prize.

Judging by today’s Gospel text, I sense that St Matthew would have fared much better than me in respect to the challenge from the Writing Magazine, and would definitely have been in the shortlist of finalists, if not declared the outright winner. For, within 5 verses of text – essentially 6 short sentences - he manages to pack a veritable panoply of richness that defiantly challenges the sermon writer constrained to a 15-minute oration.

In the Gospel you have just heard, we joined Jesus’ cousin, John the Baptist, at the River Jordan. So, before I move on, let us just imagine that scene for a moment...

From the preceding verses to today’s reading, we know that John is probably standing in the water. On the bank is a small crowd clamouring and jostling to be next in line for John’s baptism for the repentance of their sins. To those he baptises, John issues a warning as to the coming of the Messiah, declaring that the Messiah will ‘baptise you with the Holy Spirit and fire’, and in the process, sort out the ‘wheat from the chaff’. In other words, there’ll be no messing about - the coming Messiah will sort the truly repentant from those who falsely repent.

Amidst this slightly chaotic scene appears Jesus, who has travelled a long way from Galilee with the specific intention of seeking John’s baptism. His arrival within the crowd of sinners is to John’s utter surprise and, at first, he tries to deter Jesus from partaking in the process of baptism because he perceives that he has no sin to repent. Jesus, however, insists and is thus baptised by John in the water of the River Jordan.

Then, as he surfaces from the water, there is this remarkable moment when the sky opens and the Spirit of God descends like a dove upon Jesus, accompanied by the voice of God, who declares that Jesus is his son, and that God is well pleased with him.

And that is it!

Within 6 short sentences, we have John baptising people in the Jordan, Jesus arriving and taking John by surprise, John baptising Jesus, following which the Heavens open, the Holy Spirit descends, and God speaks, declaring Jesus to be his son. The next verse in the gospel, unread today, simply flips the scene away to Jesus entering the wilderness to do battle with the devil…

Now, I don’t know how you feel, but this is blockbuster movie stuff. This is a good story… Just as one action-packed scene is over, and before we have a chance to draw breath and consider what we have just seen, we are off to the thrills and excitement of the next enthralling encounter...

But let us not go on for a moment. Instead, let us press the pause button, rewind and replay what we have just witnessed in almost a blink of an eye.

For, within this passage of just six sentences, are contained many of the raw constituent values of Christianity, including meekness, repentance, the sacrament of baptism, salvation, peace, and love, – to say nothing of leadership, preaching the gospel, the fulfilment of Old Testament prophecy, and the existence of the triune God.

To illustrate this, let us start with John the Baptist.

John is quite famous. He is well known as a preacher and has established a name for himself as something of a prophet. Many people - rich and poor - those with status and those without - all flock to him to hear what he has to say. He preaches the importance of repentance - of seeking God’s forgiveness, and starting life anew. This he demonstrates through the process of baptism – the use of water as a symbol of cleanliness and purification. And there is no doubt that he is good at it. Indeed, he is very good at it – and the scriptures show that he is most certainly a charismatic leader.

But despite all this fame and popularity, he is also humble. As we are told earlier in Matthew’s gospel, John dresses and lives frugally; but he is also very quick to diminish his own importance: ‘one who is more powerful than I is coming after me, I am not worthy to carry his sandals’, he says in Matthew 3.11. Despite being successful and famous, he has a firm grasp of his ego, his sense of self-esteem or self-importance, and is quick to recognise others who have greater value than himself.

So, there we have leadership, preaching, repentance, baptism and humbleness.

And then there is Jesus…

At this stage, Jesus, like many of us here today, is right at the start of his ministry, and if we set aside the magnificence of the nativity, he is yet to become well-known amongst the wider communities of Galilee and Samaria, let alone in Judea where he has arrived to meet John. That said, he is aware that he has a mission to fulfil on behalf of God: ‘Let it be so now, for it is proper for us in this way to fulfil all righteousness’, he says to John in respect to his request for baptism by John. But he makes this request not as someone who considers himself to be important, but by humbly taking his place amongst the throng of sinners on the bank of the Jordan. In this respect, he certainly takes John by surprise, for even if John does not know at that moment that Jesus is the Messiah John has been prophesying, he certainly recognises him as someone who is without sin, and makes his case for the baptism to be the other way around: ‘I need to be baptised by you, and do you come to me?’ he equally meekly exclaims.

Can you imagine what this moment must have felt like to John? 

It was probably something akin to how I once felt as a GP when a consultant cardiologist appeared in my consulting room as a patient and asked me to treat his symptoms, which were quite clearly those of heart disease; and it is most certainly akin to preaching from a pulpit to a congregation of scholars from a local school of theology, and finding that amongst them is that eminent preacher, the Reverend Alex Whitehead!

… you can genuinely sense the palpable astonishment and even embarrassment of John when he realises who is next in the queue….  He knows Jesus as a good man, better than himself, and seriously thinks their roles are the wrong way around. He expresses this, telling Jesus ‘no, no, this is all wrong - I need to be baptised by you…’

Indeed, the scene is almost one of comedy in respect to who can be the humblest – ‘after you’ – ‘no, after you’ – ‘no, I really must insist, after you’…

But Jesus is making two important points here, apart from showing support for John’s ministry. First, he is showing solidarity with those who are known to be sinners; choosing to stand shoulder to shoulder with those whose lives have been blighted by misdemeanours of all sorts, and not electing for some form of preferential treatment. Secondly, by confessing sin on behalf of all people (just as Isaiah, Ezra and Nehemiah had done before him), he was commencing his ministry of teaching that salvation is available for all people, and that, after repentance, baptism is of central importance to attaining God’s salvation.

Meekness, repentance, baptism and salvation - they are all there, right at the start of Jesus’ ministry, such is their importance.  

And then we come to that remarkable moment that occurs as Jesus is coming out of the water.

Now, I want you to use your imagination again for a moment. I want you to bring to mind the last time you dived or jumped into an open air swimming pool – your hearing becomes muffled by the water; your vision is likewise affected – you see just blurry distorted images; and just as you cannot hold your breath any longer, you burst through the surface into the open air – the water runs off your face, the sunlight is dazzling in a vivid blue sky, and you take great lungful’s of air – you feel so alive, so joyful, so invigorated – you see so clearly the great splendour of the sky above you; a scene so vividly clear that the sky appears never ending, and you might even see a dove flying above you, and you rejoice at the splendour of it all…

And then imagine if, at that moment of exhilaration, you hear the voice of God saying ‘This is my Son, the Beloved, with whom I am well pleased’.

Words which echo the prophetic Old Testament reading for today, Isaiah 42.1: ‘Here is my servant, whom I uphold, my chosen, in whom my soul delights’; words that will not be heard again until the transfiguration of Jesus in Matthew 17.5.

This is my Son, the Beloved, with whom I am well pleased.’

In Biblical terms, this is a truly amazing moment. Not only is it the first occasion on which God publicly affirms Jesus as his son, but it is the first time when the triune God is present – God the father is speaking, God the son has just been baptised, and God the Holy Spirit has just descended like a dove – not as fire, or storm, or lightning, or a fierce wind – like a dove.

And there, contrary to the powerful and fearsome God portrayed in Psalm 29, we have God demonstrating his true nature as a peaceful, loving and tender God – showing absolute benevolence to his son as any parent might when the child’s action pleases the parent.

God is demonstrating love
So, there we have it. In a passage of just six sentences, the raw constituent values of Christianity – a demonstration of strong leadership, inspirational preaching, meekness, support to sinners, repentance, the sacrament of baptism, salvation, peace, the existence of the triune God, and a demonstration that God is love. (Indeed, the only significant bit that is really missing is the detail of the crucifixion and resurrection, as covered in today’s other New Testament reading from Acts 10.34-43).

And thus, regardless as to whether we are here now as ordained Priests, or potential Readers, Deacons or Priests of the future, we should remember that it is those same factors which are the core elements that we are required to possess and profess; the same elements that should form the basis of our ministry as Christians and the good news that we, as members of God’s Church proclaim to others.

And so, we pray that, as we leave here today, we might remember those six simple but powerful sentences of St Matthew’s gospel, and all that is contained therein; and we also pray that, by doing so - as we try to walk in the path of Jesus Christ - we might have our own eyes and ears opened to the glory of heaven, and the power of the Holy Spirit…

… and that one day we might give such good cause that, just like Jesus standing in the river Jordan, we will also hear God’s voice identify each one of us as someone…
with whom he is well pleased. 


Tuesday, March 08, 2016

New Website

My website has now been updated and refreshed and can be found at:


Sunday, September 27, 2015

Where is God in This?


As riot police moved in to stop migrants from entering the Channel Tunnel at Calais, a young Eritrean man said “God has seen me through the Sahara; he will not abandon me now”.

Where is God in this?

Clearly, the Eritrean understood God to have accompanied him thus far, and his faith was well supported in Scripture, for Psalm 107:4-8 says:

Some wondered in desert wastes, finding no way to a city to dwell in;
Hungry and thirsty, their soul fainted within them.
Then they cried to the Lord in their trouble, and he delivered them from their distress.
He led them by a straight way till they reached a city to dwell in.
Let them thank the Lord for his steadfast love.

However, the activity of the riot police may have indicated that the man’s faith at this last stage was misplaced; and I was certainly left wondering what the Christian response should be in England when we pray to the same God who saw that man safely through the desert.

Nonetheless, within one week, in the UK:

 - ½ million people signed a petition requiring the UK government to ‘Accept more asylum seekers and increase support for refugee migrants in the UK’ (when only 100,000 needed for a parliamentary debate); and c.f. only 71,000 signed a petition against more activity.

- the Government expanded the Syrian Vulnerable Persons Relocation Scheme from 1,000 people per year to 20,000 within this parliament.

- the Government pledged a further £100 million to the £900million in humanitarian aid

- the British public donated hundreds of thousands of pounds to charities aiding the migrants

- The Scottish government pledged £1m.

- hundreds of people gathered at a ‘refugees welcome’ demonstration in Oxford.

- the Archbishop of Canterbury spoke out quoting Leviticus 19:34, saying we must…

Break down barriers, to welcome the stranger and love them as ourselves.

All of which suggested to me that the Holy Spirit was certainly at work and was indeed providing a Christian response to the crisis.

Hence, the answer to the question as to where is God in this? Is that I would suggest God is at work through us in providing aid to that man and his country-folk, in keeping with St Paul’s letter to the Philippians, where in chapter 2:13, he writes…

            For it is God who is at work in you…

Friday, October 31, 2014

Lamplight in the Shadows - new novel

My new novel is available for pre-ordering now. 
Click here and quote 'ARMSTRONG' for your personal discount.  

Lamplight in the Shadows

"How had it happened? How had his entire world been turned upside down; his every sense of right and wrong, of morals and religious duty, been so deftly swept aside to leave his mind in a tumult of emotions?"

Set in the early 1990s, Dr James Armstrong, a young, newly-qualified GP lives with his wife, Janice, in Barminster, where he is busy laying out plans for their future. However, his search for a medical partnership is complicated by a long-term and persistent sense of being called to ordination in the Church of England. 

Whilst exploring the possibility of a dual professional life as a doctor and priest, he accepts a position as a locum GP in a practice in the quiet market town of Bishopsworth. Once there, his world is thrown into chaos when he finds himself powerfully drawn to a beautiful young woman, whose own marriage is failing. The result is an emotional drama that brings into focus the underlying difficulties of his own bleak relationship. 

Torn between his loyalty to his wedding vows and the unexpected discovery of true love, James is left battling powerful emotions that make him question all that he has previously stood for. He needs to make some difficult decisions; decisions that will mean winners and losers. But what is he prepared to sacrifice and at what price? 

Lamplight in the Shadows explores the complex tensions between perceived duty and misplaced loyalties. With characters drawn from rural society and religious settings, the story will appeal to those who enjoy romantic fiction.

Published: 28/02/2015
ISBN: 9781784621582
eISBN: 9781784628208
Format: Paperback/eBook

Saturday, October 18, 2014

St Luke

The following is the text of my eulogy delivered at a Eucharist at the Parish Church of St Mary, Barton on Humber, on the Feast Day of St Luke, the 18th October 2014.

Today is the Feast Day of St Luke, and I consider it an honour and a privilege to have been asked to say a few words about the life and work of the man whose memory we now celebrate and for whose life we herewith give thanks.

That said, to some extent, Luke is, in historical terms, an enigma. We know relatively little about him as a person, and what we do know is gleaned from the writings of third parties or teased from the writings purported to be by Luke himself.

It is widely believed that he was born of Greek parents in the city of Antioch, Syria c.1 AD; Syria then being part of the Roman Empire.

·        It is understood that Luke was a physician, as evidenced by the writing of St Paul and, as such, can probably take the title of the first Christian doctor.

·        We know that he was most certainly a disciple of St Paul; accompanying him for large parts of his journeys and was with St Paul near to the time of Paul’s death in Rome.

·        And we understand from early church historians that Luke was unmarried, without children, and died at the age of 84yrs, c. 84 AD; possibly as a martyr.

But Luke was much more than that potted bibliography. Once again, it is early historians who give us the sense that he had an ‘exceptional degree of holiness’, and was revered as a saint within the first few centuries AD. What is more, whilst the original texts were written anonymously, there is considerable evidence to indicate that the third and longest of the major Gospels of the Bible was written by St Luke, and that he was also the author of the Acts of the Apostles. His desire for anonymity is therefore a remarkable indication of his modesty, bearing in mind that together, St Luke’s Gospel (telling us of the origins, birth, ministry, death, resurrection and ascension of Jesus Christ) and the Acts of the Apostles (giving us the early history of the Christian Church) compose almost 25% of the New Testament. It is because of these writings that Luke is known as one of the four Evangelists, whose work ‘proclaimed the good news – the gospel of Jesus’; and it is from St Luke’s Gospel, and only from his Gospel, that we receive some of our most loved stories, such as The Good Samaritan and The Prodigal Son.

And it doesn’t end there, for Luke was also:
·         An artist – who, it is claimed, painted some 600 icons as well as paintings of Mary with Jesus as a baby.
·         And he was a poet – for his work has led directly to such beautiful works as the Nunc dimittis.

So, what relevance does the life of St Luke have for us over two thousand years later? What message does he give to us that is as important in the 21st century as it was in earliest years of the Christian church?

Obviously, he tells us of the life of Christ and indeed about St Paul. However, there is much about the life and character of Luke himself that can still teach us a great deal in today’s world.

First, through the style of his writing, we know that Luke, as an educated man, did not look down on artisans, for his writing reminds us that those involved in manual work are equally worthy of our respect; prompting us to be mindful that all men and women are equal.

Secondly, St Luke, the evangelist, physician, writer, theologian, poet, artist, and historian – St Luke the polymath - should remind us that we all have multiple gifts bestowed upon us by God, and that, by using Luke as our exemplar, we should make use of all our individual gifts to further God’s work in the service of human kind and to assist in the spreading of the gospel of Jesus Christ.

Thirdly, he reminds us that to be whole persons, we must take care to heal both the body and the soul, and that such healing cannot come about through science and medicine alone, but in combination with the many arts, and not least of all, theology. One of his most famous lines is from Luke 19:10, where he writes ‘For the Son of Man came to seek out and to save the lost’.  From his life’s work, I suggest that the phrase could equally be applied to St. Luke himself, whom St Paul may well have called an Anam Cara, or Soul Friend; a doctor of the soul who, if he were alive today, would probably be known as a spiritual director.

St Luke is symbolised by a winged ox or bull – figures of strength, sacrifice and service - and in recognition that St Luke sacrificed himself and his life in following Christ. Today we give thanks for his life and work; a life that should remind us that all Christians, even in the 21st Century, are called upon to do likewise, living and working our lives in the name of Christ; and for which, the emulation of St Luke is a good starting point. For, although we are not all called to be physicians, we can all be healers in a troubled world.


Monday, August 04, 2014

A Poem for the 100th Anniversary of the Outbreak of World War One

The Remembrance Day Parade

As he walked up to the rostrum,
silence round him fell;
and whilst he gazed upon the steadfast ranks,
emotive lines began to tell.
Too many lives were lost before today:
young men and women – yesterday's youth.
They were the cheques we drew to pay
for the blinded search for fallacious truth.
You are the inspired; the fortunate few
who have lived through to this day;
the ones who now must tell the world
to find a better way.
It is the charge of those who live
beyond vanquished dreams of many men,
to find the strength to forgive;
to learn and love as best you can.
And in so doing, let us ensure
a sense of remembrance, not of rage -
may this quietude beyond the war
turn pugnacious soldier to reflective sage.
Thus, he stood upon the rostrum as
the silence round him fell,
and gazed upon the steadfast ranks
of those returned from hell.
© Copyright Dr Robert M Jaggs-Fowler 2008

Saturday, March 01, 2014

Thought for the Day

'I think I am in my last days but it doesn't really matter because I have had such a beautiful life.

And life is beautiful, love is beautiful, nature and music are beautiful. Everything we experience is a gift, a present we should cherish and pass on to those we love.'

Alice Herz-Sommer (2014)
(Concert pianist and oldest Holocaust survivor, who died aged 110 years).

Friday, January 17, 2014

Thought for the Day

"You do not need to do anything; you do not need to leave your room. Remain sitting at your table and listen. You do not even need to listen; just wait. You do not even need to wait; just become still, quiet and solitary and the world will freely offer itself to you to be unmasked. It has no choice. It will roll in ecstasy at your feet." -- Franz Kafka

Sunday, November 17, 2013

Speaking of Honest Matters

An early seventeenth century proverb informs us that, for practical as well as moral reasons, honesty is the best policy. Oliver Cromwell, when writing to the High Sheriff of Suffolk, Sir William Spring, in 1643, remarked that ‘a few honest men are better than numbers’. In 1814, Jane Austen recognised the difficulties of positions of power when she was writing her novel, Mansfield Park, remarking that ‘we do not look in great cities for our best morality’. Yet only with the pursuit of honesty in public life as well as in private, can one hope to achieve the safe haven spoken of by the Roman Emperor Marcus Aurelius when he said ‘nowhere can a man find a quieter or more untroubled retreat than in his own soul’. Today, the Oxford English Dictionary informs us that ‘honesty’ is being ‘free of deceit; truthful and sincere; simple and unpretentious; genuine and straightforward’.

Why is it then, with over two thousand years wherein leaders in a variety of fields have recognised that being honest is an imperative of life, do we find ourselves confronted by newspaper headlines informing us that honesty appears to be the last moral value adhered to within the NHS? In the past few weeks we have seen a number of these, not least those proclaiming ‘Rotten NHS culture led to cover-ups’, followed by discussions of ‘institutional secrecy’, ‘NHS scandals’ and regulators ‘suppressing evidence of failures’. The Secretary of State for Health, the Rt Hon Jeremy Hunt MP, was even moved to make a speech in which he demanded a ‘new culture of openness, transparency and accountability’, whilst also recognising that ‘the best motivated people do make mistakes’.

That latter comment is important, for the pursuit of honesty is not the same, and should never be the same, as the pursuit of litigation for negligence. In an honest workplace, with every person sincerely striving for the common good, negligence should be a rare beast that raises its head. Honesty underpins the act of doing the right thing at the right time and then being clear about what it was that was done; even if, with the value of  hindsight, matters could have been done in a better way.

In the same speech as that mentioned above, Jeremy Hunt went on to state that the success of a new culture of openness and transparency ‘will depend on the right incentives and consequences’, citing the need for greater powers for the regulatory bodies such as the Care Quality Commission (CQC). However, regulation and regulators are not the answer; they have never been the answer. Regulators are merely ‘the dust-carts that follow the Lord Mayor's Show of life’ as the NHS commentator Roy Lilley recently put it. They tell us what went wrong in the past; they do not give us reassurance that all is well in the present.

No; it is not more regulation that we need. What we need is for those working in the NHS (and politics, and any other facet of public life) to be honest. For only on the solid bedrock of honesty, do we have the capability of building the necessary facets of a valued and enduring society.

First published in the Scunthorpe Telegraph, 4 July 2013
© Copyright Robert M Jaggs-Fowler 2013

Fancy Doing Something for Nothing?

The American Psychological Association’s Psychology and Ageing Journal may not be the preferred bedtime reading for many people in North Lincolnshire. However, this month it contains an article that we all ought to be aware of. According to researchers at the Carnegie Mellon University (I know, but we won’t let the name distract us), the process of volunteering is helpful in bringing about a reduction in blood pressure.  Now, when was the last time you volunteered to do something for nothing? The employed might retort that they work for nothing for the first five months of the year (Tax Freedom Day being somewhere around the middle of May in the UK), but I am assuming that doesn’t count, otherwise we wouldn’t have such a high demand for blood pressure pills in this country.

High blood pressure is a major risk factor in heart disease, strokes and kidney disease, so it is worth taking seriously. The American research suggests that positive lifestyle factors such as volunteering can have a major impact on blood pressure through the chemical processes that bring about the ‘feel good factor’. To benefit, a person has to perform voluntary work for at least 200 hours per year.

Of course, one’s blood pressure isn’t the only thing to benefit from volunteering. Volunteering also helps to build a caring society, reduces social exclusion, makes an economic impact (adding £4.8 billion to the UK’s finances), opens up social networks, brings interesting and exciting new experiences, improves personal skills, enhances personal development, and improves employment and career prospects. From a medical perspective, stress levels are also often reduced, which may be part of the way in which volunteering reduces blood pressure. So, all in all, it is a good thing to do.

Meanwhile, in other areas of this week’s medical press, we learn that the Department of Health has decided that there is no evidence to support the concept that GPs are not capable of working in General Practice until their 68th birthday. Ironically, the same report acknowledges that the same GPs may not be motivated to work that long. Motivation is a multifaceted beast, but it has a lot to do with job satisfaction, manageable workloads, and not feeling exhausted before getting to lunchtime (in itself a vague concept these days). Even more ironically, on the same day the above report was published, other reports highlighted (as though it wasn’t already clear) that General Practice is at breaking point and cannot be looked to in order to solve the country’s A&E crisis.

Nonetheless, that didn’t stop NHS England suggesting that GPs should provide 24/7 ‘decision support’ (whatever that means) to tackle the out of hours problems. Neither did a national lack of GPs stop the Care Quality Commission announcing that it would close GP practices that didn’t stay open long enough to satisfy patient demand. I may be losing the plot here, but will someone please explain to me how that solves the problem? Even as I write, I can feel my blood pressure rising. Perhaps a quick spot of voluntary work will help? Now, I wonder whether emptying the dishwasher and putting the rubbish out, before Mrs J-F tells me to do it, will count towards my 200 hours per year target?

First published in the Scunthorpe Telegraph, 27 June 2013
© Copyright Robert M Jaggs-Fowler 2013 

What do you want?

I recently had a go a cutting my throat. Needless to say, it wasn’t a clean sweep, otherwise I would not now be writing this column. Either that or I would be making a small post-mortem fortune in describing the true goings on from the ‘other side’. My wife immediately suspected that I had been listening to Mahler’s 5th Symphony; for me, a wonderful work with an unfathomable depth of emotion to it. For my wife, it represents a morose person about to commit suicide. It is interesting how music affects people in different ways. However, the truth is that I was not listening to Mahler.

Neither was I contemplating whether to interview the young doctor who put in his curriculum vitae that his hobby was listening to ‘vintage rock’. It was the word ‘vintage’ that stopped me in my tracks (sorry; for those who still have LPs stored in the loft, I couldn’t resist that pun); as he then went on to explain that the term ‘vintage’ meant music from the 60s. As I was born in 1960, it was a new experience to be considered by implication as ‘vintage’.

No, the truth of the matter was that my razor head fell apart; giving the blade a new found freedom that heretofore it had only dreamt of. The result was a one inch gash a little too close to my left carotid artery for comfort. Fortunately, I survived the auto-mutilation and can now devote some time to contemplating how I wish to continue keeping well and live an independent life in North Lincolnshire. Which is all a very long-winded way of bringing me to the point of this week’s subject.

North Lincolnshire’s Clinical Commissioning Group (CCG) is, since April 2013, the organisation responsible for buying health services. The CCG is now keen to know your views; views that will help to inform how services are developed within our county. The question being asked is ‘what needs to happen so that you and yours feel confident about keeping well and living an independent life to the full?’ The CCG is keen for people of all ages to contribute to this learning process. What would make a difference for you and your family? How do we need to develop health and social services to help and support your aims and needs?

There are two ways in which you can become involved with this important survey. The first is to simply go on-line and complete a survey heregiving us the opportunity to see how you see life. The second is to attend a public meeting on Thursday 27 June 2013 between 9.30 – 14.30 at the Wortley House Hotel, Rowland Road, Scunthorpe, North Lincolnshire DN16 1SU. The organisers say that the event will be ‘fun, inspiring and you will learn a lot’.

Finally, if you want to learn more about public health inequalities and what people die of in your area, enter your postcode into the Longer Lives website and see how we compare to other areas: http://longerlives.phe.org.uk/. Fortunately, self-beheadings do not seem to feature for my street, so I may be okay for a while longer.

First published in the Scunthorpe Telegraph, 20 June 2013
© Copyright Robert M Jaggs-Fowler 2013       

Gallantry and the Ungallant

My faith in human nature has been partially restored this past fortnight by the myriad of telephone calls by worried patients wishing to express their concern that we live in such an uncaring world that a GP could be left stranded by the roadside whilst half his local community simply drove past without bothering to enquire as to his well-being. Many have gone to great lengths to reassure me that they did not pass me by on that fateful day; and furthermore, to emphasise that, if they had seen me, they would most certainly have stopped to give assistance. Such an outpouring of goodwill is gratefully received; so much so that, contrary to data protection laws, I have made a note of your contact details and will ensure that you all receive a daily printout of my future travel plans.

Not that I am likely to need you, thanks to an enterprising local business couple who have devised the ultimate emergency aid for doctors. Kindly presenting me with the prototype at the start of a recent consultation, the aid consists of a protective cardboard storage tube in which is housed a rolled-up warning sign. On green paper (green for medical and no doubt also fluorescent in headlights – clever people these entrepreneurs), the sign boldly proclaims ‘STOP! THE DOCTOR’S CAR IS NOT WELL!’ Thank you. I shall most certainly display it next time I breakdown; if only to assist my aforementioned telephone rescue brigade in finding me.

Sadly, the same gushing sentiments cannot be written about my declining faith in the medico-political world. If the incessant public bashing of doctors in particular and healthcare professionals in general was not sufficient, a Conservative health minister has now got to the nub of the problem. The difficulties of the NHS have nothing to do with decades of political interference and mismanagement, underfunding, inadequately resourced training, mindless bureaucratic targets, and burnt-out GPs. No, the problem has been staring us in the face all the time. It is the fault of women; or to be more precise, female GPs. At least it is according to Ms Anna Soubry MP. Why? Because women want to mix a working life with caring for their families, and thus wish to work part-time; thereby putting a strain on the NHS. Her outdated and derogatory comments understandably caused outrage amongst the medical profession and feminist movements alike, and did nothing to bolster the failing reputation of politicians. With women making up over 55% of today’s medical students, the future of general practice is as a female profession. In itself, that is not necessarily a bad thing; after all, are we not told by anthropologists that women are biologically geared to be more caring in nature than men? If that is the case, I know which sex I would wish to be sorting out my multiple pathologies of old age. No, Ms Soubry, the problem is not the women, but the failure of Westminster to recognise the changing face of the world’s working patterns, and to ensure that more doctors are trained in order to facilitate part-time working, flexible-working, and job-sharing. Paraphrasing the words of Henry II, who will rid me of these turbulent politicians? Perhaps my new-found band of ‘community vigilantes’ could help?

First published in the Scunthorpe Telegraph, 13 June 2013
© Copyright Robert M Jaggs-Fowler 2013

A Pilgrimage on Life's Odyssey

If life is the greatest journey of all, then last week I went on one small pilgrimage within my life’s odyssey. Of course, a pilgrimage is usually thought of as a religious undertaking; the process of travelling for religious reasons to somewhere held to be sacred. My pilgrimage was not truly a religious one, but more spiritual in nature; meaning the seeking of something or somewhere that elevates my sense of well-being.

There are several such places I can rely on for spiritual sustenance. One of these is nearer to home; being the entire North Yorkshire Dales. I have often joked that, during the week, my body can be found working in North Lincolnshire whilst my soul is freely roaming around the Yorkshire Dales. When time allows, I don walking boots and a back pack and stride into the dales where, with a sigh of pleasure and a great sense of freedom, my soul re-joins my body and I am once again as one with the world around me.

If that seems a trifle odd, you may then find it hard to believe that a small portion of my soul also lives in the remote and deserted mountain village of Vouni in Cyprus. With a chequered history that includes being a centre for EOKA (the National Organisation of Cypriot Fighters, who fought a campaign for the end of British rule of Cyprus) the village was down to a population of about 136 in 2001. Most of the old stone houses are now empty, abandoned and crumbling; with the cobbled streets echoing to little more than the occasional footsteps of the inquisitive traveller.

However, despite its past, there is one stone house that held my attention when I first stumbled across it a few years ago. Tucked away in a narrow side street, it stands as a detached sentinel, waiting. Lizards have been its only inhabitants for some years; the paint on its shutters is peeling, and the doors are held fast by rusty bolts. A balcony adorns the first floor at the front, appearing to stay in place more by an act of levitation than any means of construction; whilst a rambling bougainvillea entwines the whole in its rose-red petals. It is a potential haven just waiting for a writer or artist; its empty rooms echoing to the sound of chatter and untold stories amidst filtered beams of sunlight. I was smitten at first sight; so much so that a small portion of my soul was left there, recumbent in the shade of its courtyard.

We all need places of retreat, where we can recharge our batteries. However, we do not need to own them to experience their life-enhancing power. Neither do we always need to travel far; it may be somewhere very close to home that works for you. For the sake of physical and mental health, it is important to find that place, or those places in your life, and to tap into their revitalising power from time to time.

First published in the Scunthorpe Telegraph, 30 May 2013
© Copyright Robert M Jaggs-Fowler 2013

Who is my Neighbour?

Last week I related the experience of having dropped my Smart car into a pothole, only to find that, when it re-emerged, it didn’t work anymore. I likened the process of contacting the RAC and the subsequent service received, along with the aftercare by the local council, to that of a patient seeking medical assistance. What I didn’t describe was the distinct lack of Good Samaritans on the B1218 at 1pm on a sunny Tuesday afternoon.

For those who are not regular readers, my moribund car had drifted to a halt on the Barton to Brigg road, just before the B1206 turn-off for Barrow and the A15 intersection. It is a fast road and not the sort of place a sane person would normally park. However, over the course of three hours, despite the fact that over one hundred assorted cars, vans, lorries and tractors passed by, not one person paused to find out if I was okay, or offer assistance.

Now, it is true that many did look in my direction, and several had to stop behind me before being able to pass by, so it is not the case that they didn’t see me. It is also true to say that many will have recognised me; I certainly recognised them as local people. No doubt they all had their reasons for not stopping (perhaps some used it as retribution for not being able to get an appointment at the surgery). However, one thing is for certain, they couldn’t have concluded that seeing a local GP sitting on a crash-barrier in the middle of nowhere, with his car at a strange angle and partially obstructing the road, was a normal activity in the early afternoon, midweek. Unless they thought I was merely taking the opportunity of the sunshine and topping up my vitamin D level; though I can think of safer ways.

The episode raised an interesting question for me in respect to how we see each other in the 21st century. The Catechism in the Book of Common Prayer reminds me that ‘My duty towards my Neighbour is to love him as myself, and do to all men, as I would they should do unto me.’ It is a direct reflection of both the Bible’s Old Testament (Leviticus 19:18) and the New Testament (St Matthew 22:38). My question is, if we cannot extend such exhortations to those within our own community, what chance is there for our neighbours in today’s so called ‘global village’? The Good Samaritan helped a stranger because he saw his need. If we cannot help someone who is not a stranger but well known to us, how can we counter the vast needs we see in other parts of our country and the wider world?

Maybe those who passed me by perceived the truth that I was essentially okay. However, I suspect that many were too busy, too distracted, or just too indifferent to even think about asking. What, then, does my breakdown tell us about our true ability to meaningfully respond to our neighbours in the wider world?

First published in the Scunthorpe Telegraph, 23 May 2013
© Copyright Robert M Jaggs-Fowler 2013

Feeling the Bumps

I had to call upon one of the emergency services last week to assist me. They were very helpful and, within an hour, I had professional assistance by my side. He made sure the situation was safe before greeting me politely and taking a quick history. He then proceeded to examine the problem, made a preliminary diagnosis, and tried treating the condition. Sadly, relapse occurred after a short distance of mobility and, despite two more attempts at treatment, we finally agreed to call a halt. There was nothing for it but to call for transport and whisk me off to hospital. Well, at least my Smart car was whisked off to a car hospital. I had an afternoon’s work to do.

I have to say that the RAC provided a first class service. They answered the telephone quickly, were caring in their approach, had assistance to me as quickly as possible and, before that, kept me informed throughout by regular telephone updates. The patrolman was incredibly attentive and went out of his way to be of help, with a ‘nothing is too much trouble’ attitude (even to the point of running me home to collect another car whilst we waited for the transporter to arrive.)  The driver of the car ‘ambulance’ from Gallows Wood Services was equally caring and soon had my car delivered to the garage, where it has since been operated on.

As a postscript, the aftercare has also been good. Even the local council sprang to life with the rapid mobilisation of community care in the guise of the Mayor of Barton upon Humber, Councillor Paul Vickers. Within 24 hours, he ensured that his office staff had been informed of the whereabouts of the offending pothole and, the last I knew, he was seen striding up the B1218 armed with a can of yellow spray paint.

Likewise, Smart cars are usually wonderful things; small, nippy, easy to park and very economical. At least that is how they are until one hits a pothole or two in the road. Once that happens life has the propensity to come to an abrupt halt, with the prospect of helplessly sitting staring at a ploughed field, or the equivalent, for several hours. At least it was a sunny day and the birds were singing.

However, the analogy between my car hitting a pothole and the subsequent care received from those coming to my assistance, made me think about our journeys through life and how unexpected events have the ability to bring us to an abrupt halt. I also recognised an analogy between the services provided to me by the RAC and Gallows Wood Services with that experienced by patients in the NHS. Our hopes and expectations would be very similar: swift, expert and compassionate care interlaced throughout with good communication; followed through with focused community support after the event. It is what we all want at times of crisis, and I don’t think it is too much to ask for, is it?  

First published in the Scunthorpe Telegraph, 16 May 2013
© Copyright Robert M Jaggs-Fowler 2013

Putting Lie to the Myth

I recently had the audacity (according to some patients) to take ten days off and go on holiday with my wife. Astonishingly, when I arrived back in the UK, I found that my aeroplane had become a time machine. I had not simply switched time zones, but was greeted by newspaper headlines proclaiming that GPs were to be tasked with providing 24-hour care, and that the concept of the ‘family doctor’ was going to be revived. I had gone back not just ten years or so, but a few generations, for there was even mention of Dr Finlay.

For the youngest of my readers, Dr Finlay was the leading character in a BBC television series from the 1960s. The stories were based on A J Cronin’s novella called Country Doctor; itself based on fictitious tales of medical practice in a small Scottish town in the 1920s. So, Dr Finlay was a mythological character, and one whose style of practice is a century out of date. A myth is, of course, a traditional story concerning a widely held false belief, a fictitious person or thing. The poet, W B Yeats, wrote of the folly of believing in such stories in his poem ‘A Coat’: ‘I made my song a coat/Covered with embroideries/Out of old mythologies/From heel to throat;/But the fools caught it/Wore it in the world’s eye/As though they’d wrought it./Song, let them take it,/For there’s more enterprise/In walking naked.’

Well, the present Secretary of State for Health, Mr Jeremy Hunt, appears to have a new coat. It may look fine in many people’s eyes, but I predict it will leave him looking foolish when the truth is realised and reality is seen for what it is. Somebody needs to tell Mr Hunt that Dr Finlay is not only dead, his real-life counterparts practised medicine at a time of home visits on horse-back, when medicines were tinctures of coloured water, and the sun shone from May to September.

Now, I am sure that I speak on behalf of all my colleagues when I say that we strongly believe that everyone deserves good out-of-hours medical care. Nobody wishes to deny anyone that service, and it is what we need to strive for. However, it cannot be provided by a GP who has already worked a 12-hour day; therein lays danger for everyone. So the first myth to go is that of the ‘family doctor’. Even if GPs were to provide the care, it would still be a miracle if you saw your ‘own’ doctor.

Training more doctors to become GPs is a good start, and that must be supported by increased funding to allow them to be sensibly employed within a 24-hour service. Sadly, such an influx will be many years off. So, Mr Hunt, let us start talking sensibly about the problem; which means dropping the myth-speak, and not simply dumping the problem onto General Practice without giving us the tools to do the job properly. Our patients, your constituents, deserve more than fables and buck-passing.

First published in the Scunthorpe Telegraph, 12 June 2013
© Copyright Robert M Jaggs-Fowler 2013

A Collective Accolade

A few weeks ago, I received an e-mail via this newspaper’s office. It came from a local resident who knew me from many years ago when we were both serving Queen and Country. (Well, ok, I admit that much of that was whilst also enjoying a weekend or two under green canvas out in the English countryside, or suffering the rigours of postings to far-flung places like Gibraltar. Nonetheless, our spirit was in it.)

Anyway, this old acquaintance of mine had taken the kindly trouble to write with his own reflections regarding the National Health Service and the selfless dedication of those who enter the caring professions; this being sparked by his own knowledge of a young person set upon entering the medical profession. As someone whose retirement is sitting on the horizon, it is reassuring to me to know that enthusiastic young people are likely to be qualifying as doctors just at the time when I might need them in my dotage. However, in true Ronnie-Corbett-style, I digress. The point is that the e-mail ended with the following comment: ‘I'd be grateful if you could give a firm and well-deserved pat on the back to all serving "medics" in your excellent column’. Humbly forgoing the reference to my column, I therefore hereby thank you for your gracious words, kind Sir, on behalf of all my Northern Lincolnshire medical and nursing colleagues.

The reason I have chosen to include my reader-correspondent’s comment this week is that it times well with the publication of the findings of a review by the Commonwealth Fund International Surveys, called ‘How Does the UK Perform? Improving the Quality of Primary Care: An International Perspective’. This presents a very different picture of Primary Care (General Practice) to that constantly being put about by politicians hell-bent on undermining the morale of health professionals in general, and GPs in particular. The findings make for interesting reading and should offer some reassurance to our community that we (the doctors and nurses) really are trying our best on your behalf.

Whilst noting that the NHS is not particularly good when it comes to easy communication across the various sites of the NHS, or in respect to the time available to spend with patients, it did have the following positive comments:

Compared to other countries, the NHS has the second lowest health spending per capita; the lowest ‘cost related access problems’ to primary care; the joint best same or next day access to general practitioners; the least difficulty in accessing out of hours care without needing to attend A&E; the best access to out of hours care (with noticeable improvement in recent years); the highest access to online repeats and appointments; the least hassle in getting patients needed medications or treatment; the highest scores for management of chronic diseases; is joint second in use of information technology; and is highest in reviewing patient data and outcomes. The review concluded in stating that the UK stands out and performs at the top (or near the top) of the range for many of the above aspects of care.

So, ‘serving medics’, there is your public pat on the back as requested from my correspondent. Well done. Now get off your laurels and go back to work…

First published in the Scunthorpe Telegraph, 9 May 2013
© Copyright Robert M Jaggs-Fowler 2013

A Cauldron of Emotions

As someone who was very content with a portable black and white television until I was thirty-two (well, the news is the same in any colour), I never thought that I would someday find myself reviewing a television programme. However, one recent series had me captured for all eight of its weekly episodes; not just because it was a slow burning ‘whodunit’ type of mystery story, but even more so because of the magnifying glass it held over the emotions of a small community deeply affected by the death of one of its children. I refer, of course, to Broadchurch.

The writer of Broadchurch, Chris Chibnall (who has also written several episodes of Dr Who), has stated that he never intended it to be a murder-mystery suspense story, but had wanted to look closely at how the murder of a child has the capacity to stir up the whole spectrum of human emotions within a close-knit community. Well, my own take on the situation is that he managed the feat of pulling off both aspects with considerable acclaim.

Repeating the plot here is superfluous for anyone who saw the series, and I have no intention of spoiling it for anyone who did not and may wish to find out what they have been missing by other means. What I will comment on is how the story started with the anguish of a child’s death, and went on to evoke scenes of grief, numbness, shock, bewilderment, panic, anxiety, suspicion, envy, passion, anger, depression, doubt, compassion, betrayal, resentment, hatred, ambivalence, confusion, indecision, trust, mistrust, rage, bitterness, pity and forgiveness. The whole gamut of human emotions was entwined throughout the plot, as they weaved their way from character to character like the threads of an invisible spider, until everyone was captured within its sticky web of sentiment and sensation. The 19th century English novelist Thomas Hardy would have been proud. Set against the backdrop of his native Dorset, Broadchurch was a 21st century mix of all the human passions stirred up by Hardy’s books such as Jude the Obscure and the Woodlanders.

However, for all of that, the one emotion standing out from all of the others was, for me, the ability for anguish to turn to forgiveness. We saw several examples when individual characters, once thrown upon the helter-skelter of distress, spun for a while in uncontrolled frenzy, only to be rescued by the soft landing of an overwhelming sense of forgiveness. Even the anger of the dead boy’s father turned to pity when finally confronted with the confused, emotional wreck that was the person responsible for the death of his son.

Forgiveness is a layered reaction and is given in degrees. In essence, ‘to forgive’ is to stop feeling angry or resentful towards someone for an offence or mistake. It is not synonymous with a state of unconditional love and trust; such feelings are entirely different. Forgiveness is more a state of neutrality and acceptance. As the 20th century psychiatrist, Thomas Szasz wrote, ‘The stupid neither forgive nor forget; the na├»ve forgive and forget; the wise forgive but do not forget’. Broadchurch held a mirror up to us all, and in so doing, reminded us that it is best to be wise.

First published in the Scunthorpe Telegraph, 2 May 2013
© Copyright Robert M Jaggs-Fowler 2013