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Emergency Health Care – what do we really want?

There's yet another report today about emergency care, out of hours care, GP care... I've been sitting on my fingers resisting writing so long that my fingers are numb. So here goes.

I want to start with a little nostalgia for my childhood.

Back then there were 2 possibilities for accessing care directly: the GP and Casualty (and yes, it was Casualty, not A&E). But first you consulted Auntie. For some people Auntie might be replaced by Granny or Mrs Thing down the road. This was the person in the community who, having either years of experience (from having raised 9 or so children) or a little medical knowledge, provided what is now called Triage.

Casualty was for injuries. Your Mrs Thing would check some simple rules. Can you bend it? Then it's not broken (this isn't strictly true, but still provides a fair rule of triage as to whether you need medical care). Is the wound clean, free of foreign objects and not requiring stitches? Then clean it thoroughly with antiseptic and apply a dressing. A bump on the head? Did you lose consciousness or vomit? Is the patient alert and awake? Is there an external bump? Then a bit of careful monitoring (and don't sleep for a couple of hours) and you'll be fine (this was often accompanied by an application of butter, which I can only assume was a placebo as I can find no therapeutic value to it whatsoever!)

Every home had a first aid kit, containing antiseptic, wipes, dressings, an eye-bath, antihistamine cream (for bites and stings), burn cream, calamine lotion... you get the idea. For minor medical issues, we were self-sufficient.

For everything else, you saw your family doctor. Again applying some simple rules. Are you going to die before the surgery opens? Are you going to get significantly worse before the surgery opens? (The best way to establish this is to wait and see if you do start to get worse). If the answer to both is no, then you wait till the surgery opens. Of course, that assumed that you could count on seeing a doctor swiftly.

The doctor would make a house-call during surgery hours for rashes (though Mum, clutching her book on childhood illnesses had usually already diagnosed) and high fevers. Having the doctor call was a cause for great alarm (Mum always panicked about whether the house was clean enough for some reason). Fevers were treated with aspirin (seriously, for children!) and ice packs.

Out of hours visits were only if you were dying. I recall it happening exactly once in my entire life – the occasion I developed vaccination fever and did nearly die. I wasn't admitted to hospital even then, though. Treated with paracetemol and ice packs (which I recall eating, too).

So what has changed? Why is hour of hours/emergency care now so pressurised?

Several things.

The population has changed. More people live alone, offering less opportunity for short-term home nursing. We have a higher proportion of older people, who have greater health needs. This has placed a huge burden on GP services, resulting in pressure in some places for getting an appointment. People are turning up at A&E with non-urgent things that they know perfectly well they should have seen their GP for – but saying that “It would be a week before I can get an appointment” (I write this knowing I'm blessed with an excellent GP practice who will find me an appointment with a doctor or nurse prescriber at short notice, or booked to my convenience.) The very success of A&E wait time targets has aggravated this: when I was small, you avoided Casualty unless it was essential because it would mean a long wait time!

We have seen the demise of Mrs Thing. Whether because we no longer have 'granny's wisdom' in our society or because anyone with a little knowledge declines to give advice for fear of litigation, people are less willing/able to self triage and self care. Attempts have been made to replace this vital part of our community with the pharmacist, though she too is only available at certain times: if I have to travel to see an out of hours pharmacist I may as well go to hospital. The NHS helplines have had a different problem: the default response of NHS 24 is always “Go to A&E”. I can think of several occasions when I or others have been advised to go to hospital unnecessarily, but the risk of getting it wrong means someone at a distance diagnosing over the phone will always choose the less risky option if there is the slightest doubt. Not to mention the people who go to A&E despite being told by NHS 24 they don't need to. I see little evidence that the new phone lines will be any better.

People have come to expect routine care urgently. Our supermarkets are open 24/7. So are our pubs. So we have been encouraged (by walk-in centres and government rhetoric) to expect our routine healthcare to be available at our convenience. (Though not, strangely, our tax office, bank counter, road fund licence office, local council office...) Because some healthcare HAS to be available at all times, there's an expectation that ALL of it should. And then there's this concept of “At our convenience”. At whose convenience? When I was small, if you had a medical appointment, you were given time off work (or school). Now you're expected to fit that in 'out of hours'. Is that at my convenience or my employer's? The idea of waiting till the surgery is open has somehow dissolved into a notion of getting care when I think I need it. And that, I think more than anything, has caused the pressure build-up at A&E, which is the ultimate in 'walk-in' centres. People incur an injury, wait to see if it improves (all very good) then pop into A&E instead of seeing their doctor because … well, it's open.

So what to do? Well, here's my few suggestions for the DoH.

Increase the number of GPs and make more appointments available during normal surgery hours. Then the people turning up at A&E because it's easier than trying to get to see their own doctor will go where they can best be helped.

Provide proper governance for out of hours GP services. I live in an area where people have very little confidence in the out of hours GP provision, so prefer to go to A&E if they possibly can. I'm not advocating a return to local GP surgeries taking back the responsibility (for an excellent account of GP out of hours care and the changes to contracts, see here) though contracts awarded to large companies rather than GP collectives seem to inspire less confidence. (Understatement)

Teach first aid and basic medical awareness in schools. Not just CPR (though that's useful too) but how to wash a cut, bathe an eye and determine whether or not you need a doctor. Train up the next generation of Mrs Things who can make less risk-averse assessments of need for professional intervention.

Back pedal on the rhetoric of 24/7 medical availability. Start helping people to see that it's ok to be ill overnight and wait to see the doctor in the morning. By all means, encourage the truly urgent to get the care they need critically – but persuade the less urgent not to clog up the works (and make things harder for those with critical needs). Make 'time off for medical appointments' a basic workers' right. Do we really want sick people forced to work and only see a doctor when it doesn't get in the way of them 'being productive'?

Of course, I doubt the politicians will do any of these things. It's much easier to blame the GPs for everything, rant about how much they're spending on A&E and pretend things are getting better.

Papacy: No country for old men

First off, if you came here looking for a eulogy for Pope Benedict, you found the wrong page. I didn't know much about the man, was wary of his life-story, and what little of his theology I encountered I disagreed with.

But that doesn't stop me being deeply saddened by his decision announced yesterday to retire on the grounds that he's no longer fit for the job.

Because it raises in my mind the question of what sort of 'job' being Pope is. Or even whether it's a 'job' at all. I didn't think it was.

I'm the generation who can call up in my memory (for as long as it works) images of a lively, vibrant Pope jetting around the world, rushing down plane steps and kneeling to kiss the ground in far flung parts of the world. And I can equally recall images of a frail old man, draped in red, ermine and gold thread propped up in a chair trying not to nod off. And both seem to me to be valid incarnations of 'Pope'.

I'm really not sure I'm comfortable with the apparent transition of the concept of 'Pope' from something someone is to what they do. It seemed to me that Papacy, like priesthood generally, remained one of the last bastions of recognition of the value of who someone is beyond what they can do.

It turns the church into a giant business (which we all knew it is, but wanted to believe otherwise) where the CEO is stood down because he failed his appraisal and occupational health assessment. It stops it being a family, where Grandpa is still Grandpa even when he's become old and frail and only ever talks about the past. If the Pope is only valued for his output, what hope the rest of us?

Maybe I shouldn't be surprised: I said I didn't like Benedict's backstory. He spent a chunk of his youth absorbing an ideology that decried the weak, disabled, learning disabled and elderly because of their lack of economic value. I suppose I'd hoped he'd moved on from that.

The Church has spent centuries creating a notion of priesthood and papacy as being ontological – about one's very being (Does Benedict suddenly stop being infallible on 1st March?) Now it seems happy to throw all that away in favour of a business model that we need a younger, fitter CEO.

I'm a bit of a conspiracy theorist: enough to least wonder if throwing away such a central theological tenet is in fact being done for some deeper reason, some secret that might have come out of Benedict had stayed. And not since the Borgias has a Pope been able to claim he wanted to spend more time with his family, so did some reason for his discrete removal have to be given? We'll never know. We're left with the official story that Being Pope has ceased to be a lifetime committment.

And I have to hold up my hands as a member of a denomination which changes its leader annually (To ensure he or she can't actually do any damage) but respects the Office. (At synod yesterday we were invited to 'Stand for the office of the president' when he didn't have so much as a filofax about him.)

But it leaves me sad. Sad that even my Roman Catholic friends are being pushed down the road of valuing people for their output, for what they can do, what they can produce. Pushed away from a sense of human value being in who we are, regardless of health, fitness and capacity, value based in the belief that each unique human being is made in the image of God and therefore precious.

So goodbye, Benedict. I'm afraid I won't miss you personally. But I'm really sorry you decided to give up 'doing poping' rather than remain and be Pope to the end.

None of my business but...
Somehow it hurts.

I remember back in 2002 when we were debating the proposed Anglican-Methodist Covenant, I was the awkward bugger who stood up in our local District Synod and voiced the question "If this were about entering into Covenant with a denomination in which black men were forbidden to become Bishops, would we be having the debate at all?"

After a suitable pause for the very audible gasp, and time for one or two to recover from the vapours, I stepped down: point made. Two things followed in the debate. One was that in entering this covenant it was recognised that we were asking our Methodist women to make some sacrifice. The other was a loud reassurance that our brothers and sisters in the Church of England were on a journey, and we should walk with them rather than stand aloof. On that basis, our synod duly voted in the Covenant.

Today we have seen that enough of those brothers and sisters have no intention of travelling anywhere to cause the journey for all of them to come to a standstill.

A small (Methodist) part of me wants to say "Ok, can we cancel the Covenant now until they get their act together?".

But the greater, more caring part of me weeps for the pain this decision has caused and will continue to cause those wonderful women - and men - who have been called by God and who faithfully serve Him in the church every day. Those no-voters probably don't even realise that in refusing certain areas of service to women they are denigrating the service of all those faithful women, ordained and lay, by indicating that in the Official Opinion of the church they are somehow 'lesser'.

There will be a lot of pain and a fair few tears in the Church of England tonight. But tomorrow those hurt priests and their congregations will be back doing what they do best, trying to serve God in the communities in which they're set. It is all those faithful brothers and sisters that we're in Covenant with. And those brothers and sisters we sit with tonight as they come to terms with a vote that brings a long process to an end, at least for now. Maybe the subject can be raised again in a few years, but tonight we, your Covenant partners will sit down beside you, hold your hands, share your pain and wait. And we will pray with you and for you.

A very quiet 'Yay!'
Not often I actually write a blog post about me, but I suppose this is the place it happens when it happens. So this post is about me. And is a rather subdued celebration.

I'm going to talk about weight. As a young child I had major health issues and was always dangerously underweight. Then the hospital sorted my problem, and I blossomed. My mother, who was anorexic, had a problem with this, and put me on a diet which I have been on more or less ever since. I finally accepted that my weight belonged in a certain range, and kept it there for about 15 years. Then I relaxed, stopped worrying and it rose a little and plateaued. It settled, and I could maintain that without any real effort. Ten years ago, it rose... I dieted and brought it back down. It plateaued again (at the same point).

Which brings me to last summer, when it started rising again. Possibly in part because I no longer have a dog. Either way, it was creeping up. I took my usual approach of "I'll do something about it when it starts to worry me". It didn't... instead I became depressed and lost my appetite. As a result, when I went on my October holiday, I was back to my 'plateau' weight. I came home with a virus I collected on the plane, so carried on gently losing a little. I was under plateau when I went to Morroco in the spring.

While in Morocco I realised how important it is to me to exercise. I became aware how much I was missing the dog walks. And dancing. So I got back on the exercise bike which was lying around, and invested in some dance-exercise videos. The weight started to drop. And I signed up for some Serious Cosmetic Dentistry - something I've wanted for years, in a effort to feel good about myself. (Yes, I have looked in the mirror at my teeth and thought "Well, no-one is ever going to want to kiss that!") He looked into my mouth and went "Oh!". So first up was a lot of work restoring and stabilising teeth that were falling apart, fillings long overdue replacement etc. Then we got to the 'cosmetic' stuff fairly recently.

Which brings me to the small celebration. A few weeks ago I achieved my first weight target. Last week, the major item of dentistry was completed. (Yes, my mouth is extremely sore and bruised, resulting in some very crude remarks about what I can't do at the moment, but it will heal). And I can now actually boast that my weight has reached one of the serious targets: I have a BMI in the 'normal' range (just!)

BMI is an absolute pain for short people. I'm sure I have the same sized internal organs as everyone else, and I certainly have the same sized boobs. Not to mention that courtesy of the exercise, most of what's left of me is now muscle. So achieving a normal BMI is something I'm mildly proud of. And I've lost over 12% of my body weight since this time last year.

Hence the quiet 'Yay!'

It's a quiet one because the mood levels are still seriously crap, so I lack the impetus to do the happy dance. And because there's more to do: a few more visits to the dentist to swop amalgam fillings for white ones, and a few more pounds off the backside. And then I have a nice posh bottle of perfume I'm going to open for me, to feel a bit girlie. Meanwhile, I'm having to look at my wardrobe as many things no longer fit (I had my knickers fall down in the supermarket last week - thank heavens I was in trousers to catch them!)

Now all I need is to find someone who might *want* to kiss me!

R.I.P. Mo – so what next
I've been thinking about a new phone for a few weeks, having realised that my n900 was having charging issues. They came to a head on Friday night when he was unable to charge. I removed the cable, and the usb socket came away with it. So that's that for Mo. I cried a little: I know he was only a piece of technology, but Mo introduced me to so many wonderful people and took me to places I would never have been without him. Besides, I need to find a way to get the data off him with a dead battery!

Which leaves me needing to rather rush my decision about a new phone.

I narrowed it down to a couple of choices, and asked my friends on twitter: Galaxy s2 or Nokia n9?Unsurprisingly given the people I interact with, they came down in favour of the n9. But I still haven't quite decided, as I have a few niggling doubts. So I thought I'd blog about them – partly as a way of getting my thoughts clear, and partly so people who know better than I can address the doubts and see if they're meaningful.

So: In favour of the S2:

Terrific specification – probably still the best phone spec on the market. Though some of that is because Android needs a fast chipset. Except...

Future proof: S2 is expecting to get ICS in the next few months. And ICS runs on a slower chip in the nexus, so presumably will run like lightening on the S2's chip.

Software: android market is huge, with stuff that's both practical and fun. I can probably make it do everything I want – and it will include DRM stuff like kindle and kobo books. I have both on the HTC flyer and it would be nice to have the same book on the phone so I can read at work.

Novelty items like locking (face unlock with ICS)

Against the S2:

Reputed to be plasticky build quality

Android operating system is a bit clunky in places. Though I do ok with it on the Flyer (actually, preferred Gingerbread to Honeycomb, to be honest)

Big phone for small teddy paws.

In favour of the N9:

Spec is pretty good. It has most of the features I would want to use, including that Carl Zeiss camera lens.

Harmattan is reputed to be the perfect operating system, running like silk with amazing integration.

Reported to have solid build quality – though the n900 is not a good recommendation given the problems those have had. Lovely shape, too.

Against the N9:

End of the line operating system – no future proofing

Do I want a phone I can't access the battery? No slot for an SD card, either.

Will have to switch to a micro-sim card so extra hassle

Less apps etc, though it has most of the things I'd look for apart from kobo/kindle app.

So that's where my thinking has got me. On the irrational side, I think I feel more excited technologically about the idea of an S2. But the n9 would bring me back into networking with the people who've been such great friends with the n900. Which is why I'm still sitting here undecided. I hoped one would drop in price today as the sales start and that would help me decide. But sadly not.

If anyone has comments I'd be really glad of them (Unless you're selling UGG boots – I've deleted a lot of those comments already!)

The Invisible Dog-collar
You know, I'd almost forgotten I wear it. I so seldom wear a real clerical collar, and working in the NHS, far fewer people see me through the lens of “clergyperson” so I'd got used to being seen as 'Me'.

This week, I was brought down to the pulpit with a bump.

It started with an email. From a gentleman. From a very nice gentleman. It said:

“There is due to be a charity ball on 1st October at the Eden Project. I shall be attending. Would there be any chance you could come as well?”

I wasn't sure what to make of that, so I showed it to a few trusted friends. Two said “That's asking you for a date”. The third said “Ooo err!” because she was the only person to whom I showed the name of the sender, and she, like me, knows that he has a long term partner. So no, I knew it wasn't a date.

But I was left very, very unsure what I WAS being asked. My best guess was that I was wanted as escort: the gentleman's partner had a very nasty accident earlier this year, and is recovering, so it was possible he needed someone to take to the event.

Rather than risk putting my foot in it, I emailed back discretely asking what I was being invited to.

And it turns out that the Trust Chair is organising a party to attend this Ball, and deputed the gentleman to find people to make up a table. And I got the impression from his reply that he was rather alarmed at the realisation that I might have misunderstood his email.

I momentarily toyed with the idea that I had been deliberately made to look foolish. But The gent is actually too nice for that. (I think!)

Which leaves me facing the sad reality that it never occurred to him to look carefully at how he worded his invitation. It didn't occur to him that as a woman I might just misread his intentions. He wasn't sending it to a woman. Because, after all, I'm not a woman. I'm the chaplain. A member of that mysterious asexual group known as clergy. Many years ago, I found a cartoon (sadly not online) showing the doors for three public loos: left, the door with the symbol for the gents, right, the door for the ladies, and in between, a door with a little stylised figure in cassock and clerical collar. Neither male nor female...

And I just didn't need that reminder right now.

Because they can
Many people have commented and speculated on the recent events in the UK, which are being referred to as riots, criminal action, feral youth rampaging.. call it what you will.

For those readers not in the UK, this started as a peaceful protest at a police shooting (which was possibly a mistake but investigation takes ages) and the rather poor treatment of the family of the victim. In the UK, most of our police don't carry guns, so this is a rare and troubling event. The local community spontaneously protested. And someone decided this was a good setting for a riot.

But pretty quickly it became evident that this was not really anything to do with that. This is about young people taking the opportunity of a temporary breakdown in peace-keeping to have some destructive fun (smashing and burning things) and to get some stuff – it's no accident that the targets are phone, electronics and high-end sports and fashion shops. That's apart from the woman photographed looting armfuls of haribo – kids and grown-ups love it so!

Are these kids natural criminals? I don't think so. I think they're opportunists. Him Up North has written a lovely creative piece (I assume it's creative, as I have reason to believe Him Up North is not a teenager living at home ) expressing the sense of 'getting caught up' of what's going on.

So why? I'd like to make a simple suggestion: because no-one has given these kids any reason not to do stuff like that. And if our leaders really want to prevent this sort of thing happening again, that's what they need to do.

Historically, lots of things have been used to prevent criminal or amoral behaviour. Will any of them work here?

The fear of God.
Time was when God or religious belief was motivation enough to behave appropriately. People literally had the hell scared out of them. They were taught from an early age that stealing a sweetie or talking back at teacher was liable to end you in eternal torment. Unfortunately, most people these days don't actually believe in God. And those of us who do are highly uncomfortable with his/her being used to promote social control because of the dangers inherent in that: what happens when the state does need opposing? Besides, who wants to believe in a divine creator who loves people so much s/he send them to infinite torment for extremely finite crimes?

Because it's wrong
With God out of the picture, he has been replaced with a humanist morality. Some things are just 'wrong' because they obviously are. Or are they? Our collective social morality has become increasingly relativistic, to the point where 'right' has become equal to 'you can get away with it'. These young people have seen plenty of people – leaders of industry and politics among them – make off with huge wealth that wasn't theirs. And get away with it. So the notion that some things are just 'wrong' no longer has much currency. And when you're stealing from large corporations (like big chain stores) it feels vaguely victimless. So if you can get away with it, it's ok, right?

Fear of the law
It's no accident that this started at a peaceful protest into the police mis-handling something. Because that ensured that they were on the wrong foot. Did the police try the 'softy softly' approach a little too long out of fears of headlines about brutality? Realistically, how many of these young people will be brought to court? And if they are, what can/will the courts do? Our prisons are already overflowing. We lock up more of our population than anyone else in Western Europe. A fine? A few hours community service? Our law isn't scary any more

Fear of public disapproval
Really? Most of those kids will have had their peer group around them. When I was a kid the idea that a policeman came to a house in our street would set the neighbours talking for a week. If you had a social worker, it was something to be ashamed of. But “What will people think” is no longer a reason not to do something. People don't actually care any more. Besides, you can always take out an injunction to stop anyone making news out of it.

Because it will screw up your own future
This might work. If these folks had anything to lose.

And that's the point, isn't it? These are folk who cannot see that they have anything to lose. They have no reason not to opportunistically grab a wii, a pair of trainers or a bag of haribo. Most of them will get away with it. Our politicians will rant that there's no justification for this sort or behaviour – but was there justification for the bankers getting huge bonuses? for MPs (and fraud investigators, and council leaders...) claiming expenses that certainly don't look like they're job related? for sports-people and entertainers to earn the sorts of wealth most of us can't even imagine while ordinary people like nurses and firemen lose their jobs? If we want moral behaviour from the populace, we have to start by demonstrating moral behaviour from the leaders.

Otherwise, sooner or later this will happen. People have learned that they can get away with something for nothing. And they have no reason not to.

Flying Tonight
For the last two or three weeks, I've been battling the Black Dog. Those who know me well know that I suffer from chronic depression with acute patches. Those who meet me fleetingly find this hard to credit, since I do a damned good job of hiding it and acting like a happy bear.

But anyway, the last few weeks have been tough on the old emotional front. And one of the the things I do when I'm low is treat myself to things – partly on the “I'm worth it” principle, and partly because it's a pretty nifty distraction.

So a fortnight ago I eschewed morning service in favour of worshipping in the lingerie department at Matalan. I came away with all the knickers I might possibly need for my holiday in October. And since it wasn't yet lunchtime, I wandered into Comet next door.

A few months back I looked at the market in Tablets (that's digital ones, not large quantities of paracetemol). I didn't want an ipad – I've never had an apple product and don't plan on starting now – but the growing collection of android devices quietly seeping onto the market were interesting. And Comet had a few on display. To my utter astonishment, I found I could actually use the capacitive screen for typing on.

It proved a useful distraction: for the next few days I amused myself browsing in the stores and online, seeing what was available and what was nice to use. I also gave a great deal of thought to what I might actually use one for, and therefore which features and hardware would be of value.

And I fell in love. Not, as you might think, with the highest spec, biggest, newest thing on the market. I fell in love with the htc Flyer. It's a 7 inch tablet, with 3g as well as wifi, 32gb memory plus micro-sd expansion slot, running android 2.2 rather than the tablet-specific android 3, but with htc's 'sense' overlay.

The only downside was the price. By the end of the week, I'd convinced myself it was overpriced, being at the very top of the price range. I persuaded myself that the best thing would be to wait till either something better came out or the price dropped.

Great plan. Except that on Friday evening, Amazon launched a one off weekend-only offer reducing the price by £120. I decided the universe was trying to tell me something, and with relatives holding my paw on Saturday last I placed the order. (I still have to actually pay the credit bill, but the money is in my account!)

The Flyer arrived on Monday, and I've spent the last week playing with it, setting it up, filling it with things I will find Useful, removing things that turn out not to be Useful, and generally having fun.

So... impressions. I am surprised at how easy the capacitive screen is to work with. This bodes well for when (if?) Nokia release the N9 in the UK. Indeed, it's faintly alarming: I keep the haptic feedback turned on, and often find that I don't actually touch the screen – the heat from my finger is enough to trigger the response (I have very hot hands!) It feels almost alive as a result.

The htc sense UI is lovely to use. Most of its gestures seem to be some form of swipe – though I know Nokia has now claimed that (and I think Apple are trying to patent it!) I have 8 homescreens, now all suitably stuffed with, well, with stuff. It reads email, collects my friends stream from twitter, keeps me logged in to google-talk (Still looking for a google+ invite!) The screen is bright and clear – amazing for viewing video on, and I have an account now for the bookstore associated with the reader software, and even one for htc Watch film store. The 'live wallpaper' burns battery, but some of them are beautiful. In my usual style I shall collect a few and change them with the seasons. And I determined that the Flyer is not for work, so he doesn't have my work diary. Friends and fun only, please, as he'll be my companion in my leisure time and holidays.

The android market is mature and full of stuff. I have eschewed fart apps, but found plenty of utilities and even a few games to keep me amused: I'm an Angry Birds addict (want one of those cuddly toys!) I found a way to print stuff directly to my printer, and am currently struggling with the settings to access my network drive over the wifi. I have a Bible, daily reader, daily prayer cycle, and other personal stuff. The Tumblr app will let me post direct to my tumblr account where-ever I go, and I found something which will resize images so I don't have to post them full-size over 3g.

The location services work pretty well: my back garden recorded as being in the Chinese takeaway – which was off by about 10 yards. Inside the house it doesn't work so well, but then the house is made of granite.

The Flyer's “Killer feature” is the capacitive pen. This enables you to scribble notes and draw things. Well, in my case to doodle. There's a selection of pens from highlighter to calligraphy, taking in paintbrushes, pencils etc. It can be used in the note-taking application, the reader (for notes in the margins) and on photos (for putting Hitler-style moustaches on your friends). If you want to use it on anything else, it automatically takes a screenshot of what you're looking at, and saves it as an image for you to write on. And it links what you've scribbled to your calendar – so you can find stuff by “I wrote that last Thursday” if you get so many notes you can't sort them. I'm not sure how much use it will have in the long term, but it's certainly fun. And will be good for photos when I'm on holiday. (I've also downloaded the touchnote app for turning your photos into hard postcards.)

If I get really bored, I will get some screenshots and upload them for you. This was my first attempt with the 'notepad'.

I continue to play. I can't say the Flyer has cured this particular bout of depression, though he has kept me occupied and amused enough to be less aware of it. And if I want to find a cliff, the 'car panel sat nav' will get me there safely!

The N9 is Announced
So Nokia have finally announced the shiny new N9, the next in their Open Source line of devices, and maybe the last. Allowing for a fairly normal lead time, it should hit markets about two years after its predecessor, the N900. (Though Nokia is not famous for getting devices out for due dates, something their new Powers That Be claim to have fixed.)

What's it like?

Well, most industry bloggers tripped over their feet in rushing to put finger to keyboard to extol its virtues. Even Engadget liked it! The BBC, notorious Apple fans, managed to say it was quite a good device, then pour negativity over its future.

The community seems pretty divided. Those who are willing to embrace something new can see its potential. But many people who came on board with the N900 are disappointed at the very different feature set. If you chose your device for the feature set, I can understand disappointment with the change of feature direction.

So what do I think?

Mostly, I think I like it. And more importantly, I think Nokia have made the right moves with this device. Unlike any of the maemo offerings, the N9 is first and foremost a consumer device. It follows current consumer fashions, and puts Nokia's own spin on them. Which means doing what everyone else is doing, only better.

What makes N9 a consumer device?

* Nokia have streamlined hardware and concentrated on form factor. The N9 is a fashionable keyboardless 'monoblock' device with a capacitive touch screen. Whereas the n900 was stuffed full of every piece of hardware you could think of, some of which shipped without software - left to the community to create, the N9 has more or less only those hardware features which are tried and tested in the market: it does what most people expect a phone to do, but there's no FM radio (receiver or transmitter) and no IrDA. But the items that are there are are high quality and polished. The camera may only be 8mp, but it's got quality software, and of course that Carl Zeiss lens that keeps some of us coming back to Nokia devices. The new idea in the block (rather than on the block!) is “Near Field Communication” - how useful that will prove will depend on whether other devices have it too. Great for pairing with your Nokia headset, but what I really want is to pair with a friend's Sony Ericsson so I can swap photos.

* The second thing that Nokia appear to have got right is the performance. Judging by the videos, this baby has enough juice in terms of processor and memory to comfortably multi-task a large number of apps while still being able to play those animated transitions. You slide off a video, and the half screen continues playing. It's paused in the background when you go to the 'open apps' screen, ready to pick up where you left off.

* And while we're mentioning the animated transitions, please can we give a huge cheer for the UI guys this time. I was chatting to a client yesterday about Open Source and his comment was “My problem with Open Source is that they tweak stuff and make it very hard to use”. I replied “It's not that they make it hard to use – most Open stuff is written by enthusiasts who don't worry too much about polishing the interface. On the other hand, go look at the N9!” Because if the N9 has done anything right, it's that nifty, user-friendly attractive interface that makes even die-hard resistive screen fans like me want to try it out. It may not be easy for us furry fingered types to get our paws round the capacitive typing, but that UI makes me determined to try!

* Did I mention the marketing? I confess I wondered what Nokia was about launching so far from home in Singapore. Though of course, they have huge markets over there – a fact often forgotten by the journalists and bloggers who think that Europe and N America is the centre of all things mobile. The launch went smoothly, the excellent website was ready to go live – and it didn't crash! The Excitement was all over the web within 5 hours of the announcement. The ads are smooth, the information enough without being overloaded – it looks like it's all been aimed at the consumer who was just waiting for the next big thing.

* And then there's the N950. Just when you wanted to bitch that Nokia has sold out their MeeGo project to the consumer and forgotten their loyal developers and community, there's the n950. A device just for the developer. There won't be many around, and it's not designed with glossiness in mind – but it has that all-important hardware keyboard for on-device programming. Actually getting your hands on one may not be terribly easy. If you think you could justify being awarded one for some project or idea you have, now is the time to sign up to the community devices programme.

Anyway, those are my first reflections on the new N9. Ideally, I'd like to check I can type on that screen. But this bear of very little brain is counting her pennies (and waiting for a release date) as I think I'd rather like one of those. In pink.

Seven Reasons why I believe Jesus WOULD have mocked the “Rapture” prediction.
There's some talk online about whether those of us poking gentle fun at the whole “Rapture” business today are being unkind and unChristian. Jesus, they say, wouldn't mock the Rapture. Well, actually, I think that, had he a twitter account, Jesus would. And here's seven reasons why.

1) Gentle Jesus, not so meek and mild. The Victorians may have wanted to believe that Jesus was Tewwibly Nice, but we need to remember that this is the man who attacked the money changers in the temple with a whip of cords (John 2:15). A quick reread of his words in Matthew 23 might help to remind people of this rather less than meek aspect of his divine nature. Jesus didn't like self-righteous religious leaders who claimed to know the mind of God.

2) Jesus specifically said we wouldn't know the hour nor the day (Matthew 25:13). Don't you think he'd be a bit miffed at some pastor in the USA claiming to know the mind of God better than he did? (Disclaimer, Jesus didn't have modern computers on which to do his calculations: maybe he'd have been able to give us a date if he'd had more fingers and toes?)

3) Dateline God: according to the prediction, the “Rapture” will role around the world based on a time set by human clocks and human calculations. Err... since when was God (that's God Almighty, Creator, Lord of heaven and earth) bound by the international dateline? What does he do about daylight savings time zones? What happens to people who live too close to a time zone change?

4) Noah. Revd Camping has calculated his date as 7000 years since Noah's flood. Which is set as exactly when? I can't find Noah's Online Blog to give me an exact date for the start of the flood. Besides, is the exact moment when the rain started? When the ark first floated, probably several hours after the first raindrops? When the whole earth was covered? When the flood ended? (which was exactly when?) Seems a bit too uncertain a date to max out your credit cards on.

5) Noah (part 2). What's it got to do with Noah anyway? The end of the Noah story is the delightful assurance by God that he won't repeat the flood. While the earth remaineth and all that. So whatever happens at the end of the world (whenever it happens) it won't be a repeat of the flood. Sorry Revd Camping: unlike the BBC, God doesn't do repeats. (Genesis 8:21-22)

6) Waste of resource: Looking at all the millions suffering and dying in our world from unnecessary wars, curable diseases, lack of basics like clean water and enough to eat, I somehow feel Jesus would be a tad uncomfortable with the huge waste of resources which has been put into promoting this upcoming “Rapture”. Revd Camping's radio station is valued at $86 million. How much nearer could he make the Kingdom of God by using that to relieve suffering – and encouraging his followers to do the same? (Matthew 25:31-46)

7) The final reason I believe Jesus would mock the “Rapture” is this. I know I'm going out on a limb here, and probably setting myself against the whole of the world church. But I can't help believing that Jesus has a sense of humour.

Peace. ;-)