Showing posts with label Hospital. Show all posts
Showing posts with label Hospital. Show all posts

Saturday, 4 June 2022

Personal

 


Hospital in May

When you enter they only want to know your name and how to contact you again. There’s no time for small talk, some stories to break the ice, if you went to university. Their one interest is your complete well-being. They are dressed for it. They address you likewise with a direct speech touched by urgency. Their machines are designed with the same purpose, to find precisely what is your problem anyway. Animate and flickering inanimate exist because your well-being “is important to us.” Together they are there for your most personal need, now. All other needs occur in remote other nows. Apparently corridors are impersonal, swing doors and beds on wheels rolling through the swing doors. Yet every little electro-sticker is a personal badge. Clean needles read red blood for a personal result. Ear thermometer tells them the goldilocks plan, your personal heat. Unpronounceable tablets fast-track a personal normal. Paper thimbles of unpronounceables tip your own personal comeback. Zigzag monitors pulse ups and downs of very personal minutes. Down the corridor nurses converse about the progress of the latest patients, who refuses their medication, who cannot remember the date, or their own name, who is a priori a pain in the posterior, who’s a sweetheart. It gets very personal down there. They are concentrated on accurate measurements, timetables of check-ups, every step in the day that keeps the health fluctuations of dozens of patients under control, under benign surveillance, and at the very least moving along steadily. They are made for it, each with their own personal touch, and at present their main topic of converse is you. You are the name you gave at Emergency, but then you are the sum of all the personal details of care that are your unique situation. A common enough situation, granted, but for them and you the matter of the moment. Doctors arrive, clipboards, to speak frankly but thoughtfully about your famous condition in terms that are for now yours alone. The nature of cotton blankets keeps you warm, but not too warm. A bed curtain travels on hanging rails for your complete privacy. Wristbands leave no margin of error for your declared allergies. Surface pads of stethoscopes step onto undulant sites of turbulence below. Deltas of wires update recurrence. Down in the café visitors complain how impersonal these places are, sipping on their personalised coffees, taking small bites out of their hand-crafted pastries. Whereas there is no let-up on the other side of the swinging doors. Here staying personal is the essential transaction. Time moves from a matter of urgency to hours of window staring, the same pace you move towards the next adventure.

Teal


 

Hospital in May

Interdependence is the ground rule of hospital. Not one person I meet is out of place, doctors, surgeons, nurses, kitchen staff, cleaners, visitors, patients. I watch each person with a certain wonder as they go about their business, the business of ananke, or necessity. Independence, likewise, is made present to me in hospital. Although a patient must listen to every new development in a state of pure dependence, undivided attention, the sense of independent personhood is reinforced by all of those around me. I have hours in which my mind may wander and reflect, before the next blood pressure test. The curtains around my bed slide on a susurrus of aluminium railings, their soft fabric concertinaing from a standing position into a broad sky of the kind painted by Pierre Bonnard. Hooks hold up this sky that supports the occasional vertical column of shaded cloud and is entirely the colour of teal. It is a soothing sight as the mind tries not to think about diagnoses or procedures, or politics even. Many an email and text message tells me to rest and not worry about what’s happening now at work, or the tragic change in world events, or why the prime minister is a dropkick. Teal is the colour of the facemasks that must be worn by all visitors to the hospital; teal gives visitors the appearance of duckbills moving about with friendly intent. It is the colour of much of the signage in the wards, the bed numbers. The designer of the modern Austin Hospital had inlayed teal facings in lines all around the exterior of the buildings, a basic design feature that has been picked up and quoted ever since, right down to the bed curtains. Teal is immediately in the mind ducks, of course. I seem to recall a brand of Mildara sherry named for teal ducks: is it an oloroso, and do they still manufacture it? Teal feathers are the shining wing feathers that flash, an instant distinction. Kingfishers are good at that as well. Flights of teal thoughts divert before visitors arrive, Bridie and Carol with masks, New Yorkers, manga books, fresh clothes, and postal vote forms. Politics again, but then it’s the season, right? Bridie examines the Senate voting form, commenting that last election she noticed it’s twice the length of the cardboard voting booth. Now she can vote. We talk about how Kooyong could do a Mackellar in colour language. If Blue and Teal get about the same number of votes, then Red and Green send their preferences to Teal, Blue will lose its blue-ribbon seat. This is making for an interesting contest in many electorates, though not Jagajaga in Austin Hospital country, which has been Labor for generations. Teal might be a combination of Blue and Green, but that’s not the whole story in this case.

They


 

Hospital in May

Every second person attending asks for your name and date of birth. They are there through the uninformative hours waiting for your call. Their information of you could not be more direct, at the choice moment it is time to speak. They copy your latest personal statistics into endless diaries of full profile. They calm you down and don’t mince words. Their chit-chat is light on loiter. Every second person is about to up your dosage, down your dosage, take your sample, and report a result. They carry receptacles and implements purposefully designed for your ultimate survival. Their hands as quickly tear open a bag of squeaky gloves, a strip of sanitised handkerchief, a sachet of swabs. They observe every quaver of your body, your change of expression, your walk and your rest, your talk and your silence. You are the very best example of you that fits their condition description. They incise the healing wound then bandage you in advanced scientific materials. They provision the oral, fine-line the syringe, air-drop the drip. Their patient overload keeps the converse between flat-chat facts and reasoned comments. Their verbal highlights are diagnosis of fever, re-explanations of body reckonings, sightings of ooze. They tap the results into screens, stand still as sentinels at their tall desks on casters, a caravan of surgeon and his colleagues transit through, a doctor and his student doctor, their flying visit or in-depth analysis. They note and save, click and save, scroll and close. They mental tick the scree of tablets, the script of issues, the look in your eye. They have the details in their head and the medications at their fingertips. Their backup tubes and guards in cabinets and shelves line the corridors, deep banks of linen and towelling and cotton gowns, a dash they make for a fresh blister pack. They are here then not here, there where need presses, an emergency call to a hyper-event somewhere in the maze, a unit in at the reaction. Every third person hands you a two-day menu, cross the boxes and escape all fats. They ferry a squarish jug of water clinking 15 ice-cubes. Their trays of covered meals and zip punnets of fruit in juice slide into place before the eyes. Through the uninformative hours you may dine on best Australian produce, fresh and fulfilling as an autumn morning. They leave you to your bed, centre of their current attention, your current adventure. Their shifts turn morning into afternoon, afternoon to evening, the faces changing, the routines the same. They uproot the used cannula from the vein, tear bandages from skin with hair, test press the lunar-pocked arm for a fresh jab site, the bloodstream alive to the idea. They leave you to soft night, all your readings looking pretty good.

Oxygen


 

Hospital in May

Oxygen, we take for granted. Most of us don’t think about oxygen from one moment to the next. There it goes, feeding our thoughts every minute of the day, yet we don’t give it a second thought. Nurses think about oxygen regularly. In a flash they look up to check that the flow is going, the level is right, the air is breathing. They think about oxygen the way we think about time. By which I mean, what time is it now? We are likely to treat an oxygen tank as absurdist, at first. Isn’t the whole world an oxygen tank? The large letters of the word go the length of the tank in capital letters, but this is no cartoon, rather the air we intake, as the creatures will tell you and the trees are free to remind us, any old time. Once upon a time I went through a phase of reading a Canadian poet whose most famous poem is about beach glass. Another captivating poem of hers was a landscape with vast atmospheric sky. In order to affect airiness, all the words of her long poem were double-spaced apart both by line and sentence sequence. Punctuation was more or less dispensed with, freeing further the airy poetry, immensely enough oxygen to go around. Technically speaking this was a concrete poem, even though it celebrates the very opposite of concrete. Shape poem is a more helpful term, the spaces between the words illustrating with a naïve quick trick of illusion how oxygen runs the world. Charming as this landscape in words may be, the message is immediate. More difficult is to follow the same rules to write effectively about the airiness of a hospital ward. A comprehensive list of medical furniture, drug names, drips and drains, cannulas and monitors, spaced across several pages, may never get us to think about oxygen, or be thankful, even though life depends on it from a depending tube. The ward corridors of this hospital are well-spaced with paintings by the Heidelberg School. I tread carefully towards them on my frame as I do a lap of the ward. Each artist is fixed upon the colours of the Yarra floodplain in this part of town, the marvellous shapes of tree and mountain, and each has their own way of getting those factors right. Each is distinctively their own landscapist. And each is wanting to render atmosphere, that invisible source of life no matter how many clouds we gaze at, at the time. By which they mean, what time is it now? I spend some time deep-breathing, deep-breath-hold-breathe-away-cough, as I enjoy their oxygen of immense airiness, the way clouds are moving just so no rush, the way she-oaks are lungs alive along a crest of Eaglemont, the way magpies are flying between the trees in colours reminiscent of an absurdist oxygen tank, with wild warblings that are straight magpie.

Reichian

 


Hospital in May

A little night music strums the inner ear courtesy of composer Steve Reich and his rich rare friends, magical notes every one through the Spotify tube. I hear curious resonances from the days in care, things that go bump in the night. Music for Nine White Tablets in a Paper Thimble, for example, rattles their condition signifiers, loud clicks that pop inside the very brain methinks. Ambient rush of iced water, one mouthful, sends the music down the throat for hours of almost Mozartian pain relief. This music, for which we may send out a small ovation of thanks. Melbourne water, only the best. Don’t say it, spray it. Music for Corridor of Beeping Monitors, the permanent Reichian 4/4 beep at one pace and tone for the entire sequence sets a sort of dripfeed drone as other monitors beep in and out of tempo to the main drive, at least one beep set to draw in thin air the Fibonacci Sequence. Fandom will discern something more than the random. Music for Name, Date of Birth, and Allergies. This repetition masterpiece goes for several days, each performance the length of one patient’s hospital stay. The best way to appreciate the work is to do it yourself. Nurses and doctors at any moment, from admission through to discharge, ask you for your name, date of birth and allergies. Seems simplicity itself. Reich said the same in a recent interview. Reviewers are divided as to whether the effects fall into the category of euphoria or delirium. Music for Deep Breath and Oxygen Tube, in which deep breaths in and out again, in and out again, in and out again restore the collapsed lung, all the while interspersed with cheerful little bubbles of oxygen regularly spurting into nostrils. For further information, listeners are directed to Reich’s seminal lecture ‘The Flow is Going, the Level is Right, the Air is Breathing : Thinking about Oxygen is the Way We Think about Time.’ Music For Blood Pressure Cuff, Thermometer, and Stethoscope utilises these classical instruments of the repertoire into a surging rising and falling heartbeat rhythm, transforming the regular hourly check-up into a percussive anthem that you don’t want to stop. Music for Disposable Medical Gloves. This gem from the Reich back catalogue enjoys a well-deserved revival. Purple gloves, and blue, are thwacked into shape, blown open for palm and fingers, stretched with those stretchy latex sounds, smoothed like the sea, readjusted squeakily, for each new procedure of the visit. Each procedure is subtly different from every other procedure, their repetitions different in every case. Job done, the team of glovers strip their instruments from their hands, rummage them into gaia balls, pop in a bin. Asked about the meaning of this work, Reich replied with his trademark laidback good humour, “It’s simplicity itself.”

Healing




Hospital in May

The blood blister on my righthand snuff box, caused by a blood test needle pre-op, blackened like a moon’s dark side, lifted into scab and has now dropped off. Pockmarks from similar needles, several a day in intensive, fade as circles inside green bruises, and mauve. I may joke that my arms are lunar landscapes. They are replenished thoroughly by more water than can be found in the Sea of Tranquillity. Rips from round bandaids have pinkified across freckled skin, a jab at a time. Nine days out from the operation, the heart is more in order now than it must have been for some time. Late at night the beat increases, with no fear now that increase will turn into chest pain. Homer’s graphic moments of spearhead cutting bone and live sinew flow in the mind. An invasion can maim or kill, the poet leaving us hanging at the point of the deed. Nothing so dramatic or deadly occurred in the theatre, yet it is necessary to imagine the knife weaving between the chest muscles, tending ever so gently around precious organs, drawing a fine line down the breastbone. It is that rupture to the norm will take the longest time to heal, as bone melds again into bone to hold the ribcage firm. Lungs learn anew how to breathe easy. On the ninth day after the operation it hurts to laugh, whatever the standard of the humour. Finely stitched with thinnest steel, the sternum keeps on doing what it was designed to do, not letting anything out, keeping it all in. A darkening crimson band , part-billabong, now heals from clavicle to navel. The doctors are happy, the surgeon explains how flesh rejoins as it’s designed to do, nurses hover for the latest reading or a cup of pills. Their expressions say everything is healing, swimmingly, without saying a word. Masks cannot hide their friendly eyes. Shock of catheters is in the past. Miracle cannulas have left the bloodstream to resume its banks. Rainbows of wires have gone from the scene. Only a few silk sutures stay in place beneath a strip for time of removal, as hair returns little by little to the shaven chest. Healing is the blood-rich line of the left forearm and healing is the blood-rich line along the right calf. Straight streams firm, billabongs and all. An arm bandage secures the incision that now folds back in on itself, the lost vein reinventing itself as well, as the body will. How this reinvention takes place is ultimately beyond modern medicine, explicable perhaps when sun helped form flesh in a time no machine can tabulate, beeping the odd hours, keeping arteries mobile. The Achilles tendon escaped the blade, thanks be to the perception and skill of the surgeon, the calf soon rebandaged for recovery, with only small winces when pressure is applied upon a slight wrong angle when standing.

Sleep

 



Hospital in May

Sleep, the subject, comes around regularly as night follows day. How pleasant to think about that over which we have no control, more pleasant anyway than death and taxes. Today the newspaper has a fresh article on the ancient habit, if we may call sleep a habit. The eight-hour day honours eight-hours sleep, those hours spent not working and not being recreational. Sacrosanct is the time our body spends each day asleep. It is a sign of good health. After the news of the heart-attack I began reflecting on sleep patterns in the past year, going to bed early, power naps surpassing 45 minutes into REM extravaganzas, snoozy snatches on the couch. The heart wasn’t dealing with disease, my body craved more than eight hours every day. Exercise was not as attractive as shut-eye. My body craved a normative pattern. The newspaper says sleep time patterns vary and sleep shortens as we age. We ponder whether aging grows with memory, if our world makes more sense at later stages, now there’s a way to judge what’s worth thinking about, what is not, and how good sleep is dreamt up from such awareness. We cannot break the habit of a lifetime, we would have sleep that goes unbroken. Or do we? The newspaper recommends reading or listening to ambient when we wake in the night. I don’t see how this is any different from playing with our apps or browsing our email details in dead of night: the energy levels are going to increase, distraction will keep us awake. The reason we wake in the middle of the night, it’s called biphasic, varies so personally anything might be going on. Our One Brain has a trail of trials that won’t instantly be resolved listening to the music of Brian Eno. My sleep is biphasic, divided in two by the simple need to have a widdle. Such is the regularity of this break from dream transmission, I am soon enough returned uninterrupted to my prior stream of consciousness. Hospital has turned my sleep temporarily polyphasic, hour after hour of blood tests, stomach needles, drug stops, flying doctors, numberless nurses. In hospital, anaesthetic releases us from all such thoughts, into a sleep of immeasurable peace. Morphine keeps the dull body ache at bay for hours. Adjustable beds glide or tilt or elevate me into restful reclines previously unimagined, all in the name of sleep. Though uninterrupted blissful sleep may also be induced by the simplest, inartificial of means. On election night (21st May 2022) in the hospital, the following statement from ageless psephologist Antony Green, sometime after 9 pm, helped me drift off happily into the sleep of the just: “On the figures I’m looking at here, I cannot see the Coalition holding on to more than sixty seats.” Two Panadol also helped.

Royal

 


Hospital in May

Sunday. After two weeks, dear Diary, we experience unusual moments when we believe this is how monarchs pass the time. Persons arrive at the bedside, say what they have to say, then retreat again into the labyrinth of the institution. Then more of them. Doctors, for example, and we are sure you have experienced this at some time (journals being timeless much of the time), land post-haste at our right hand to deliver news from the interior. Revolts of the system, or against the system, revolts anyway are now under control, though it was a close thing and good they got onto it straight away. Surgeons are cool subjects to have around and we thank them for this blessed extension to our earthly mortality. We are left feeling very important as they dash off in their flowing gowns. Very important indeed. Monday. Nurses are helpful with all the science, science being the object of our continuous gratitude, and the nurses. We find however that nurses are good practice for our schooling in advanced diplomacy. We find that five nurses means five opinions, not always consistent, indeed of variable verity. Monarchs must be grateful for all expert advice while apprising the situation, but a measure of common sense is necessary in any reading of flat contradictions. We thank them one and all, but keep our own counsel. Tuesday. Transfer from hospital to rehabilitation today. Pleased to note the task being allocated to Royal Flying Doctors. We are elevated into the vehicle and fixed into place, from which elevation we may wave modestly to everyone as we travel the high road to our preordained destination. Not everyone returns the wave, yet our spirit is free, released with a new inner life. Wednesday. Courtiers come and go with practical flurry. Doctors again, a mine of figures, the figures all mine. Menu Lady, copying our requests in precise detail into her food map. Cleaners, pleasantries exchanged. Nurses, more needles and medications and figure-finding and opinions, to which we nod in agreement. Physiotherapists, we don’t have enough. Occupational therapists, tell us to limit our engagements. Thursday. Family visits. These people are outstandingly excellent. They speak our language. They fill the room with humour, nor do they depart after five minutes. Finest raiment is bestowed, carefully chosen for our very needs and taste. They observe our mood, tell us to stay on our throne, don’t stress and other sage suggestions. Our heartfelt acquiescence is true, after all there is only one me. They festoon the ledges with cards. Talk news from the provinces. Friday. Morning: newspapers and despatches. Prime ministers! Cannot live with them, cannot live without them. That Orstralian fellow said he was a bulldozer. Hard to disagree. Afternoon: pedicure.

 

Murmuration


 

Hospital in May

Day 3 of hospitalisation was my birthday, the seventh of May. That’s the day when my cardiologist said “we are looking at 30 years here. We’ll talk again soon.” Bridie gave me new Derwent pastel pencils in a tin box, a packet of Smiggle twin tips, and two drawing books. Carol’s present was another kind of book, ‘Hungry Heart Roaming : an Odyssey of Sorts’ by the Cambridge Shakespeare scholar Charles Moseley. We had been enthusing about this book before any of the heart business started, so the title was apposite, not some secret message. It’s a memoir based entirely on travels he has made through his long life. Site-seeing is almost redundant, Moseley’s interest being in the meaning places gave him at different ages, personal connections rather than a pack of wow moments. The first hundred pages, for example, recount his honeymoon in Greece, sometime in the early sixties, interest being in personal encounters and the handmade past of word and construction, speaking to the present. Early on, he says that he had for a while considered an alternative title for his book, ‘Murmurations’. One description goes: “Then: across the level vastness of the Fen, against that bright sky, sudden, first one black speck, then another, then a whole cloud, like crowding thoughts, swirls and swoops, swift, now dense black … billowing as thundercloud … thousands upon thousands of starlings.” Day 25 of hospitalisation finds me in Rehabilitation on a picturesque hilltop of eastern Melbourne. At least two nurses have said I have the best room in the hospital, secluded and with vistas across large back gardens towards Kinglake. Both picture windows afford views all day, much to my surprise and delight, of smaller and larger murmurations, parading across housetops and treetops. I am not going to try and draw any of these murmurations, as their large curving shapes change so quickly in the air it is impossible to capture even an outline before the birds have glided into a new formation. Smiggles might make a nice abstract out of dot points, maybe, while the phone cannot get closer than the windowpane to catch the scale and movement of dozens of birds together in group flight. Instead, I prop my phone against the glass in hope of getting at least one fuzzy, nay thin, representation. More fun is playing what’s that bird. My Melbourne hilltop affords a sight of shape-shifting flocks of black wings, same as anywhere in the world. Cockatoos? Galahs? Pressing myself close to the window, I occasionally get lucky with identification. Moseley says: “The single starling never sees the dance of the murmuration. Just so, I, like a starling, know there is a dance out there but can only know the steps I myself take. So let me tell my story, my memory …”

Physiotherapy

 


Hospital in May

It is one step at a time in the physiotherapy room. Many of the patients arrive in wheelchairs. Others are already at work on elbow circles and shoulder shrugs, mentally counting out their two lots of twelve, their bid at improvement. This is the world of the next ten minutes. Life is walking on the spot, or as likely a square of blue foam rubber, balancing the bilateral. It is sit to stand and stand to sit. “How was that?” asks the sprightly physio of Frank, who returns an effort of smile in a cloud of exhaustion. Broken ribs have not dimmed self-composure nor his desire to finish the exercise, a gentle sashay along the parallel bars, barely perceptible movements, breathing okay. Followed by marching on the spot, thirty seconds. Our bodies have known grander days pre-operation, that strain today and sag far behind our minds. Our active minds would sprint to the closest coffee shop, while our bodies remain in their chairs for the next ten minutes, learning limits. The Rehabilitation Hospital has fifty physios all told, half a dozen working the room at any one time, matching the patient’s surgery with their capability, the damage with the goals, the pain with a minimised effort. Achievements in miniscule notations the physio enters into each personal logbook. Noel is tall and slightly bent, would have been a ruckman in the school team, who today squats, three lots of ten, both hands firmly holding the bar. Heyday was a tap to the rover for a snap goal, that post-operation completes bicep curls, three sets of 12, a one kilo dumbbell in each hand. “That’s all for today.” The falls enter the physiotherapy room with little steps. There is John, a veteran of striding, before the fall. That wasn’t meant to happen, or, That doesn’t happen, or, What happened there. Collateral damage keeps John at a steadying pace behind his frame, easing his way uneasily along the bars. “Just in your own time.” Then there’s Maeve and Joan, falls, who have both passed 100 and laugh because Joan was born in July and is therefore older than Maeve. They raise their arms above their heads, or lever them up and down in front of their bodies, two lots of twelve, like saluting the sun in the sitting position, then they rest. “I’ll need a nap after all of this.” Crutches lean against mirror walls, ready to raise Michelle to her full height. Her stoic gaze could fill a book. Ian was designing computers before there were computers. The oxygen peg on his middle finger reads the particulars while he recovers breath from resisted chest presses, three sets of twelve. The new wounds join the old wounds in the exercise yard. The brisk physio is all friendly commands and rote questions. “How would you rate all of that? Easy? Moderate? Hard? Very hard?”

 

 

Bedside

 


Hospital in May

Bedside Glossary. Blanket: a two-dimensional intricate layer designed to accommodate the patient’s every three-dimensional stretch, curl, turnover, turnback, layout, quasi-shiver, cuddle, hang-loose, breathing in, breathing out, deep dream warmly and effectively for forgotten durations. Card: a colourful gate that opens towards the patient like a handwave or a blessing with get well soon, thoughtful, lined along the sill to join a street of gates, the patient’s caring neighbourhood watch. Flower: a paradox of petal and stem saying get well soon, its own life drastically shortened in so doing; saying, thinking of you; its other thoughts similar to the patient, here comes the sun; typically arrives in groups of paradoxes, with handwave gate, beribboned. Jug: a glass round-tower reflecting red light switches, orange apparatus indicators, nightlight white stripes, blinking fixtures, its ice blocks melting to cool midnight dry throat and here comes daybreak Panadol revival. Log: a scrupulous compendium of blood pressures and temperatures and medications and the patient’s midday confessions about where it hurts; huddled over by doctors, their bedtime reading, coming along swimmingly. Phone: an oblong black universe held in the hand, once pressed offers the known world in bright-lit slides that flip the news, snap happenstance apps, private message get well soon, go ogle whatever. Remote: a spaceship-shaped hand device devised to delve every corner of the patient’s personal universe, the room wherein hours become years and years eons, switching on a nightlight, beaming up the television mooning in the ceiling, alerting nurse during an imagined relapse. Spectacles: a device that, propped on the nose, makes larger than life the steadying words of the occupational therapist, in essence never spend more than ten minutes on any task; otherwise a coagulation of scripts. Stitch: an invisible mending further repaired by flesh, holds ribs secure; a bind that breathing makes home. Tablet: typically a white pebble that, once consumed, stops things, or starts things, increases things, decreases things, thickens things, or thins them, speeds up things, slows them down, for a while, before another white pebble must be consumed, and so on, and so forth, ever your most humble servant. Tray: a magic platform gliding into place from the invisible kitchen, loaded with breakfasts, lunches, dinners, thereafter perforce a pile of empty cartons, crumpled napkins, cutlery awry, thence away to the invisible washing-up. Window: a transparent device, like spectacles, to remind the patient of the past and future world beyond the precious confines of operations and recoveries; to offer promise of life beyond get well soon and just taking your temperature.

 

Friday, 9 December 2016

Hospital (December)



December repeats the pattern of sunshine and shower. Sun glows through falling water on glistening trees. Roads adopt the darkness of rainwater and cars gleam like an advertisement. Hillside windows become gold facets when showers end. Overdecorated Christmas trees on shop roofs sparkle as normal. Up on Heidelberg the hospitals keep a brave face. Their windows gaze out on the potentiality of wellness. Houses dry in the sun and birds return, more lively than ever. It’s coats and umbrellas in the streets. Efficiency finds its way to work, whatever the mood. Blue sky now but big cold grey feels imminent.