Field Marshall Mannerheim of Finland is one of the giant, if relatively under fêted, figures of European history. Called out of retirement at the age of 72 to lead tiny Finland against the might of the Soviet Union in the Second World War, his achievements were not only to win two wars, but also to know when and how to sue for peace. It is this latter aspect which is almost certainly the most significant reflection of the wisdom of ageing and experience. more…

In an era when didactic teaching in medical education is frowned upon and where workshops and problem based learning rule supreme, it is refreshing to be reminded of the powerful impact of a high quality lecture.

A superb overview of how good lectures tap into expectation, ritual and theatre posits that lectures are particularly effective because they exploit the spontaneous human aptitude for learning from spoken (rather than written) information. [1] more…

Washington in spring is a visual treat, the spectacular arrays of cherry trees in bloom adding a frothy filigree to the sober magnificence of the iconic National Mall. Throw in blue skies and crisp spring weather, and it is not surprising that crowds flock to its Cherry Blossom Festival at weekends in March and April.

This vernal efflorescence provided a refreshing backdrop to the annual conference of the American Medical Directors Association (AMDA), the main organization for doctors working in nursing homes in the USA. The provision of formal guidance and continuing professional development to doctors in nursing homes is relatively underdeveloped in Europe , and the main organization for European geriatricians, the European Union Geriatric Medicine Society (EUGMS), has developed a special interest group to engage with the issue. more…

It is perhaps stating the obvious that the best mode for exercising human rights is while still alive: as the Vikings stated rather bluntly in their eddaic saga Hávamál, “there is nothing the dead can do” (1). So it was with some sadness that I read, and re-read, the submission of the Irish Commission of Human Rights to the Irish Supreme Court in an appeal seeking protection from prosecution in assisted suicide.

The case relates to a woman with advanced multiple sclerosis and her husband, who were the subject of a documentary screened on Irish television earlier this year. Their story is very moving, their relationship clearly firm and loving, and the ongoing deterioration of her neurological status clearly very challenging.   more…

The last time I heard Keith Jarrett was just over thirty years ago, a distraction from the tensions of final med with some fellow medical students. Even the choir balcony tickets were eye wateringly expensive, the compact and elegant National Concert Hall in Dublin barely half full on a damp November night, and the experience was unforgettable.

I had first come across his music when staying in a Militante Frauenwohngemeinschaft (militant women’s living collective, a long story for another day) while on my electives in Hamburg. His Köln Concert (the largest selling solo piano album in history) was firmly embedded in the cultural landscape, his persona as Serious Artist at one with earnestness of German culture and the single-mindedness of my flatmates. It even pierced my Irish cultural fecklessness in a way that surprised me. more…

One of the most striking theatre productions I have ever witnessed was a riotous Polish play called Birthrate, the highlight of the 1981 Dublin Theatre Festival. Starting with a stage set resembling a train compartment, all was sweetness and light as the first few passengers entered, ceding place politely to a mother and baby. However, as more and more passengers piled in, tempers began to fray and civility eroded, to the point where the baby and the mother became the first to be ejected through the window. more…

Transport is the invisible glue that holds our lives together, an under recognised contributor to economic, social, and personal wellbeing. Unfortunately, in public health terms, our profession has allowed itself to focus almost exclusively on the downsides of transport. The chapter on transport in Marmot and Wilkinson’s otherwise excellent Social Determinants of Health makes for grim reading—accidents, pollution, and the impact of cars on exercise, and no mention on how lack of access to transport is associated with impaired health and social inclusion, an emerging research issue. more…

When visiting a city for the first time, graveyards rarely feature high on my agenda. So, little did I suspect that a very beautiful graveyard would be one of the aesthetic highlights of a recent short stay in Portland, Maine, a compact and attractive port city with interesting French influences. My host, the founder of the most innovative alternative transportation system for older people, ITNAmerica, had also been a prime force in saving and restoring Evergreen cemetery, one of a handful of landscaped garden cemeteries in the world. more…

Visiting Kennebunkport, Maine, in winter is a surreal experience, almost akin to playing an extra in the Truman Show. Neat clapper board houses and snow encrusted churches cluster around a serpiginous and sylvan sea inlet. In the grocery cum café store locals cluster over coffee and cinnamon buns amid the general supplies in an ambience with a comforting feel of the 1950’s. more…

Limiting access adds savour to most sensory experiences, a sentiment captured by Patrick Kavanagh in his poem Advent: “through a chink too wide comes in no wonder.” A narrow aperture to one such wonder is provided every January by the National Galleries of Ireland and Scotland, one that also has interesting linkages to both medicine and ageing. more…