A personal blog transitioning into an exploration of the intersection of design, technology and ethics
This blog post has now been re-arranged with the manifesto at the top, and the reasoning that led up to it beneath. Because, after all, placing the important content six or seven hundred words in is hardly being pure, is it?
Content First. All articles, images, and graphics must be there to serve a purpose. Superficial or filler material is forbidden.
Being very old (or at least, that’s how I feel being in tech!) means that after coming up to nearly forty years in technology, I’ve seen some changes.
My first computer at home, that I owned, that I could truly call my own, was a Dragon 32. It was a small, 32KB computer using the rather lovely little 6809 processor. This CPU ran at 2MHz and the system as a whole allowed me to learn a heck of a lot about computer science as a geeky teenager who was busy ignoring sports.
Continue reading “The astonishing power of modern computing”
I came across this chart recently and it gave me pause for thought as someone whose life work is designed to improve productivity. It shows that from 2008, although we know technologies have been growing in power, productivity growth suddenly dropped away from the trendline following the global financial crisis. Why?
This is where I fall back on an old story as a developer trying to make things more efficient. I worked with my colleagues to bring a client company the equivalent of about ten hours a day of labour saving due to using a well structured database for better data integrity over their previous ‘loose’ system. As they expanded, each branch would save at least an hour of time, and they were no longer capacity bound at each branch where more customers would linearly increase administrative work in a difficult recruiting environment. This would provide a return on investment (ROI) of less than a year.
It worked exceptionally well and the person we’d worked with said their staff were even worried redundancies might be on the way! This was never going to be the case in a growing company, because there’s an infinite amount of work to do.
All was good.
Then for some reason, our contact’s role was diminished and they eventually left the company. And the knowledge of the improvement left as well. The board’s innate distrust of anyone and their perception of us as no more than a cost base resulted in a great difficulty for us to help them without dramatically increasing costs by gold-plating every spec and decision.
This left the client unable to gain for advantage by exploiting our skills. It was difficult for us to see, and we could do little for them other to look for cost savings when, in reality, they needed to implement cost savings by using us more. Instead they opted for a recruitment based strategy to feed their growth and we parted ways as they shifted the system to a maintenance partner.
In all my thirty years of development experience I’ve seen this again and again. Instead of sticking with a solid set of developers who have learned your business details, chop and change to save money. Treat developers as a cost base and you lose so much knowledge that you’ll fail to gain productivity nearly as quickly as you could treating it as a partnership.
I don’t feel this is unique. I see lots of projects following an arc of big development then a cost reduction period which ends up losing the momentum of ongoing improvement.
A strategy I now suggest when selling is to spend 60% of what you thought of on your project in year 1, then 40% in year two, 30% in year three, and then 20% a year throughout the product lifecycle. Software isn’t like building a bridge where things stabilise then stay them same for thirty years, sadly.
Fundamentally, I think corporate culture around custom software became both cautious and speculative following the global financial crash of 2008 and only invested in technology if it felt like it would create some impressive unicorn of an offering. We saw lots of developers tied up with venture capital chasing big things like blockchain and AI whilst ignoring the importance of daily incremental improvement that adds up to a huge return over time.
The answer then, is that if you have access to capital, you should stop chasing unicorns and start thinking about continuous pragmatic development aimed at dealing with all the little productivity blocks in your firm. Look to Kaizen style methodologies to help with structuring your processes around this.
What do you think? Feel free to comment!
Having a coronary artery bypass isn’t much fun and comes with challenges. Four years later I thought I’d describe some more of my experiences.
In my previous blog post, I described the adventure of having a heart attack and the five coronary artery bypass grafts that resulted. That procedure saved my life and actually restored my quality of life and fitness, within six months, to about the level of five years before. Today I’m as fit as I’ve ever been as an adult. So everything’s fine, right? Well, it’s a bit more complicated.
Let’s not mess about here, having a heart attack is a traumatic and terrifying experience. So is having a major operation with a risk factor measured in percentages. My risk of death was given as a bit under 2%. Which doesn’t sound too bad, but if you were told one in fifty planes crashed fatally, you’d perhaps be rather scared about flying, right?
With an event like this you come face to face with your mortality. The evening before the operation, Romana brought our chidren to see me. I hugged them hard before they left, but I also wanted them to know I was OK. No tears. But in a way I felt oddly calm. I knew my chances were better with the operation than without. But without the operation I was almost certain to be alive at the end of the next day. You have a fear horizon.
That’s… hard. For me I went into a different mental state. I always imagine it’s that mindset that a meditating Buddhist monk might go into. I was calm and collected. I thoroughly expected, when I was told about the need for a bypass, that I’d be a gibbering mess on the day. Yet most people I met facing this situation seemed to be the same. We know our choices are limited and this is our best chance. So off we go. But let’s not pretend that it also doesn’t scare and scar you. We may seem brave. We may be brave. But what choice do we have?
You can read about my waking up on that previous post, if you like. I’m mentioning it here because it marks the start of the new life. A life which is separated into the before, the after, and the now. The initial week you focus on moving, and managing the pain. There’s a lot of support available, the nurses are wonderful, people visit you. The odd one might nearly faint when they see nearly a metre of stitches.
You go home. My in-laws were staying and helped keep the house bustling during the day, which was honestly a help. We can’t communicate well as they don’t speak a lot of English, but they were always there with cups of tea and help with cooking – stuff that’s still difficult in the first few weeks home.
The operation then changes you. Different people react differently to these events, so I can only really talk about how I felt, and how I still feel at times. Please indulge me, or feel free to ignore me! I do this sort of writing because it’s good therapy for me. It gets those feelings out. Other people have other ways. I’ll try and break up the feelings into types, and describe how they pan out over the four years from the event. I’ve not sought out a diagnosis for any of the following, or treatment, so bear that in mind.
Let’s start with the big one and most common for survivors that I’ve dealt with. The fear. The feeling that every twinge is the start of the end, every bit of shortness of breath is the start of new heart trouble because maybe a graft is failing or new plaques are being deposited. Thing is, having had your sternum pulled apart hard, your pericardium sliced open, your arteries and veins harvested… well, it’s pretty natural you’re going to have all sorts of aches and pains and periods of struggle. You notice everything new. Can’t help it.
So we live in this state of increasingly intermittent rather than constant anxiety. It does get better too. I hold on to that. After a year the panicky moments are every couple of weeks. After four years, they’re every month or two. Still there though. I’d been doing some new exercises with weights. The next day my chest was aching and I had a moment where I thought it was a heart attack before I remembered I’d been working out my chest muscles.
Other things come in to play with anxiety also. I suffered a frozen shoulder following the operation, and that is painful and annoying. It eased off six months later, but you find yourself worrying that you’ll never have a pain free day again. And no, you can’t take ibuprofen if you’re on blood thinners despite it being the usual go-to drug for pain relief for things like this. Ah well.
And sometimes I’ll be puffed out because I have asthma, but I’m never sure… worsening asthma marked the decline of my heart health. Is this asthma or is it my heart? Take the inhalers and see if it improves and when it does you do feel this mental relief kicking in!
This is a very normal reaction to these events. Sometimes you can work through it, sometimes you can’t. I’m pretty certain I had a period of mild depression as a consequence. I still relapse and seem to have a bout of a week or two every now and again in this weird, empty space – I’m either too sensitive, or struggling to enjoy anything or do anything that is outside of routine. Then I’ll have a period where I’m super focussed and really get stuff done. When I’m in it I kind of resent hearing “let’s meet this week” or “there’s a birthday party for one of the boys’ friends this week and they’ve asked us to go along.” I always say yes. But I don’t want to. I want to be left alone. Half my current life I don’t want to talk to people, listen to them or do anything with them. But I do it, because it’s better for me than being alone, even if I prefer being alone. Mad eh?
I still sometimes like and need to be alone though. Last night it was relatively warm, Romana was studying a presentation she had to give, I’d done my chores, kids were in bed, and I curled up on the bench in the garden, with the cushions, and headphones on listening to some good music for an hour and not even glancing at my phone (which was now in do not disturb mode), and it was honestly one of the most enjoyable things I’ve done in a while.
I’ve put these two together here. There’s that “woe is me!” feeling which feels like the other side of the coin which is “you’re so f*cking happy and healthy and yet you drink and smoke and don’t exercise and do everything wrong! Feck off!”
These aren’t helpful emotions. But they exist and they’re real. And need acknowledging. And this tendency to anger means that when people get under your skin you have to decide whether they’re actually a positive impact on your life or not. I had a friend who was perfectly lovely and supportive in many ways, but the 2019 general election was coming up. She was very Momentum in politics even if it doesn’t quite chime with her middle class lifestyle, but that’s fine. The problem, the big moment, came when I’d posted something on Facebook about the Lib Dems who I support. She described Jo Swinson as “that vile woman.” And I flipped out. Had a go at her, blocked her, and that was that. She wasn’t the only person I did that to either.
I don’t miss these people I cut out, really. They had toxic personalities to me at that moment in time, and you know what you don’t need when you’re recovering from a major life event? People who are toxic. To you. They might be perfectly lovely people overall. People don’t get into Momentum or the Lib Dems or even the Conservatives, generally, in order to make the world worse. Sometimes they do, but that’s not usually the intention for most people. But those people can be terribly toxic to you. And I’m still recovering, so I don’t have the capacity to cope with that substantial difference of opinion.
Here’s an interesting one, and there’s probably a proper psychological term for it. But I just describe it as “I’ve got this! syndrome.”
A belief that I can deal with all of this. That all I have to do is eat perfectly, exercise perfectly, behave perfectly, care for myself perfectly, take the medication perfectly, be a perfect husband, be a perfect boss, be a perfect dad, a perfect patient, and everything will be fine.
Which is, quite frankly, delusional. There are no perfect people. Myself included.
This knowledge, sadly, doesn’t seem to stop me. I go through phases where I decide I’m going to run faster and further than ever before. Then I realise that in doing that, I’m skipping quality time with the kids, not doing laundry or jobs around the house… or I go camping with the kids and feel that I ate badly and didn’t do my run for the weekend… or I switch to alcohol free beer and then realise that actually it’s still full of simple carbs… or I think sod it, have the chocolate, but now I have to run extra hard, only to find that the extra hard running leaves me sore and exhausted the next day.
I guess this is that post-traumatic stress problem that people talk of.
So why don’t I get help?
Because I’m functioning, frankly. I’m not so depressed that I can’t get by. I’m not so anxious that nothing happens in my life. My kids are happy. I think my wife is happy. I think my colleagues are mostly happy. But each little setback, even if nothing to do with my health, sets me on a path of questioning and trying to work out how to be better, stronger, smarter, more organised, more caring, more focussed, better at caring for myself, better… better… better. Because that’s how I get over this and make the most of the 5-30 years I probably have left.
All things being well, there’s no real reason why someone who’s had a bypass like me, following a heart attack (myocardial infarction) with relatively little damage to the heart shouldn’t live another 30 years. Maybe more. An active and full life. I’ve come across people in amazing shape, aged nearly eighty, thirty years on. They look amazing.
But I also see some people pass away. Some of my grafts were from veins and they’re just not so tough and have a high chance of failing after ten years. I could get really unlucky and they could block and cause trouble in a bad way. Which could kill me.
Who knows, eh? I certainly don’t. Nobody does. I just keep taking the pills and hope for the best. Speaking of which:
So, xanthelasma are interesting. I had a couple of these. Here’s a before and after shot:
Excuse the ropey shots used – I never set out to document the disappearance of these things, but there you go. I had them, now I don’t.
Xanthelasma are made of cholesterol, and are, in fact, an indicator of risk of cardiovascular problems. The fact they’ve gone is actually reassuring. I can see that my cholesterol levels in my blood, from blood tests, are about half what they used to be. This is potentially great news. I’m hoping it keeps me safe.
Turns out that it’s possible that strong statin therapy so dramatically reduces cholesterol in the body that these things can disappear.
With blood pressure, we all know that high blood pressure is bad for the arteries. It damages them, and is linked to stiffening as well.
In this case you can see that I’d started logging my blood pressure in the top part of this chart in early 2019, half a year before my heart attack. Then I kind of lost interest. It was a bit high-ish but not so high as to be of any real concern. I didn’t worry too much.
But the heart attack came! I started logging everything as soon as I came home, and you can see how I did it very regularly by the density of data points. Sometimes I was measuring two or three times a day.
You can track it along until March 2020, when I came off beta-blockers. You can see that the blood pressure readings became a little more varied, with more readings above 120/80 – my target is to keep below that. The trend didn’t really change, but over 2021 I’ve noticed that if I’m over 120/80 it’s by a very small amount. Most typically I see readings around 110/70 which is exactly where I want it to be. Ever since then it’s been much the same, but I’ve zoomed in to show how my desire to measure my blood pressure quite suddenly tailed off. Because I felt a lot better. You get the odd spike, but they often go with a bit of relaxation.
So now for a little list of the things I try to do to help myself. They don’t always work:
So that’s it. I just saw my word count and 2800+ words is far too many, really. If you’ve made it this far without merely scanning, then well done you! Take care 💖
Have you had a bypass operation? How did you recover? What tips do you have?
About a decade ago, I was at a conference and talking to a fellow developer (I still call myself one, even though I don’t code so much these days) when he giddily told me about the funding he’d got for building a new piece of software he was hoping would make it big. It was a two year project and he’d got £100k funding. I asked if it was just him… and no, he had a colleague. So £100k, for two people, for two years? £100k didn’t sound a lot… £25k/yr each, basically. Or what you can earn in a much simpler tech support role. I decided not to say anything and leave the poor guy in peace, although this sort of work seemed a lot like gambling to me.
Today, things are different although there’s still a sniff of gamble about it overall. If you’re a developer it’s relatively easy to find a highly capitalised employer that’s positively dripping with money who will pay you £60k-£90k a year. Potentially quite a bit more. This reminds me of the late nineties dotcom boom. In 1997 I myself quit my safe but somewhat dull job at a multinational to become a freelancer, doubling my income almost immediately, and quadrupling it another year later. The new work was, in some ways, more interesting. It was also a lot more stressful, bad for my health, and definitely wasn’t the most exciting coding work. But it paid. I honestly don’t blame developers who decide to do what I did 25 years ago. It set me up. I think it was also a large part of why I had a heart attack in 2019… living out of hotels for a decade wasn’t healthy, and cheese became far too much a food staple for me as a vegetarian. However, the money was very good and it helped set me up. When you’re poor, it’s very hard to catch up and a good income was necessary for a while.
I bring this up because today I’m not ‘just a developer’ but actually run a web development company that specialises in websites and custom software for clients. And things are happening today that are reminiscent of the dotcom boom on the late nineties. 25 years have passed, but people don’t really change nearly as much as you may think.
The late nineties were a period of post-recession growth and capital release. Banks had been deregulated, money was being created in the way it can be, and we were riding high on increasing productivity. Life felt good. And when money is created it can be invested.
There’s only one little problem in that. Sometimes, people get giddy and start splashing the money out too readily. The boom of the late nineties and early noughties, and the deregulation that encouraged it around the world, eventually led to the financial crisis of 2008. I’m a bit of a cautious soul, so even though I had plenty of income, I resisted borrowing too much to get a bigger house. In some ways I was foolish, because I could now be living mortgage free in the house I have now. But I figured that not having a big mortgage would afford me some other freedoms and I could use my money elsewhere. Mostly I just invested my money in solid companies. Friends, however, were telling me to invest in dotcoms. But I looked at the fundamentals. One example was a firm called Vocalis. They did, basically, telephone voice services software. Small team, and had some crazy valuation that was effectively equivalent of £20m per member of the staff. I rightly reckoned that was mad. My friend went ahead and pumped money in, and I mocked him. For a while I looked a fool. The value of the shares rose and rose.
Right now, there are loads of speculation bubbles. At the café at work I was trying to explain Bitcoin’s fundamental problems to our barista, when our receptionist came over excitedly wanting to know more. Both seemed interested in getting involved. That means the crash is likely imminent. They’re both lovely people, but in the economic chain, they’re nowhere near the top, which means that the speculation bubble is reaching it’s limits.
“If shoe shine boys are giving stock tips, then it’s time to get out of the market.” – Joe Kennedy, 1929 as the stock market was about to crash and lead to the Great Depression
So the dotcom boom and Millennium Bug led to a boom in demand for developers. New software was being created to replace supposedly outdated software that couldn’t be fixed (narrator: “It could”) and salaries were rocketing. I took advantage of that boom. I also knew it wouldn’t last. And it didn’t. My day rate as a PeopleSoft developer went from £200 a day in 1997 to £600 in 2002. It could have been higher. Cisco did an amazing job of raising funds in that era and I remember they kept offering me more and more to go to work for them in the Netherlands. But I didn’t really want to go to work there. I never really chased the money, so that’s about where I peaked. But I remember people with the right skills, experience and self confidence were on as much as £1k a day. That’s getting towards £2k a day at today’s prices. Some skills seen as super hard and rare could command double that. Most people didn’t, of course, make nearly that much, and some people preferred a job with reasonable hours and close to their families – a very valid and decent decision. But I was single with no ties.
There are a lot more developers around today – good incomes have brought many people into the trade. I meet people who called me a nerd in the eighties and now they’re working in IT. It’s a bit weird.
Now it’s a bit weird. Rates still aren’t at the dotcom level, once adjusted for inflation, but they’re close. You can do very well in tech. But in my little firm we pay typically around £40k for a developer, plus various benefits, kit, resources etc, meaning you’d need to make around £70k as a freelancer to equal it. At least the way I calculate things and always did. I nearly swapped my £600 a day for £60k a year and kind of regret not doing that.
But why have the rates risen? Well, there are a few hot areas, and they can be summarised as AI, analytics, mass market apps, and blockchain. I’ll discuss each briefly:
This is a hot one – the idea we can replace rooms full of people doing dull and not very high value work (from the perspective of the company) such as service desks with AI bots is very attractive. It won’t work though. Most “supposedly AI” bots are just following decision trees and the only bit of AI is in parsing the meaning out of a sentence in a very tightly defined context. AI is useful today for categorisation problems – e.g. looking at a picture and deciding “this is a cat” or “this is a threatening comment”. It’s not brilliant at the job, but I like that an AI can work out which pictures are of my Mum, for example, even if it misses about a third of them… it still makes my life easier. A bit. But what an AI can’t do is right a decent blog post. Sorry, it can’t. They’re awful at it. There’s loads of AI generated content out there and it feels obviously fake. The main job of these AI generated blog posts is to trick other AIs (Google, Bing etc) into categorising a website as useful. And because AI’s make toddlers look worldly wise, they can be easily fooled… and that means you can’t trust them with anything of real importance. Like your business decisions.
But, it’s a hot keyword, and naive venture capitalists like the idea. So in comes the money.
Tracking and stalking customers across the internet is very attractive for advertisers believing that doing so makes them seem more interesting to consumers. I’m not convinced. People often find it creepy. They feel like they’re constantly stalked. They visit the website of, say, a printer supplier and they receive ads for a month for printers… but not only for that supplier, but for other printers because the tracking provider is cheerfully using your data as a supplier against you and selling that information to your rivals! I think advertisers are starting to cotton on, but are unsure of what to do… but I know there’s a lot more direct selling of adverts between publishers and advertisers than there used to be.
But, the siren call of analytics is strong, and people love a nice chart on which to justify a decision, so the more nice charts your system can create, the more people will pay to use it and try to gain an advantage over competitors. And advertising is huge, so in pumps the money. For now.
Can you build the next Facebook, Instagram, or Slack? What’s the potential for an app that lets people read books from any publisher for a fixed monthly fee? How about an app that revolutionises food delivery? Interestingly, some apps are about replacing old and inefficient intermediaries and putting new ones in place. Uber is a nice way of hiring a minicab with flexible pricing that rewards drivers for being available at the right time. They don’t disintermediate, however. The customer is both the driver and the passenger. The new intermediary takes their share.
If you can replace old intermediaries you can make a lot of money. Imagine taking 0.5% of every single financial transaction, like Visa do? That’s a lot of money. Then you have intermediaries between the card firms, providers, and networks, such as Stripe… and then there are those replacing old ones, like Wise, for money transfers across borders.
What other things can be improved? Well, literally anything.
But most attempts to build these apps and the supporting infrastructure are doomed to never turn a profit.
Blockchain is a really interesting concept for a public ledger, using an interesting concept called proof of work to make it hard for any one person to try to dominate the network and win the consensus mechanism on new transactions. There are theoretical ideas out there to improve on this, but at the moment they remain just that and haven’t been proven.
And it’s a scam. Pure and simple. But it’s a hot topic. Bitcoin, Ethereum, Dogecoin and many others are actively speculated upon, as well as being used for the exchange of value – often in a hope to evade regulators. It appeals to the natural rebels amongst us because it’s outside of government control… and given that governments aren’t always a force for good, I get that.
Problem is, Blockchain breaks the rules of good software development… if you look at the big O notation for software, it has to follow certain rules or it will fail at some point and need to be re-engineered. Big O matters. I don’t have academic access to papers, and the internet is full of vested interests pretending that Blockchain scales just fine. I used to see the same in WordPress land, where people said the software scaled fine… but it doesn’t. In WordPress we get scale by putting a layer between WordPress and the internet to balance things out – the work the software itself does goes up in line with the number of people talking to WordPress. We can define that as O(n) so long as you know what you’re doing – that’s OK. We can live with that. But the consensus mechanism required for multi node agreement of transactions as required to track transactions will, by its nature, follow a curve that is likely to be somewhat greater than O(n^2) (each node does O(n) work in a linear fashion but the total work done on the network as each node is added therefore grows as O(n^2) plus a bit for network latency and overheads. Yet bitcoin transaction cost isn’t following that curve in spite of huge interest because, I reckon, most Bitcoin trades aren’t real.
Yes, that’s right. And what does that mean? It’s because wideboys, crooks and the overly-optimistic are involved. Given it is, by design, a pyramid scheme, it will have to fail at some point. But people are motivated to hide that, so there are Bitcoin tracker schemes, rather like gold purchase schemes, that never hold the asset in question. They will pump and pump values as hard as you like. And as long as there are new people coming in, like our receptionists wishes to, all is good.
And there are enormous amounts of money to be made. As in a goldrush, the people making real money are the shovel makers and traders. And they need developers. So for as long as there’s money to be made, coked up wide boys will be gurning their way through stressful meetings, fidgeting and anxious to cash in before it crashes out. You can earn a lot there. For a while.
Well, it means developers are really expensive right now. Small firms that do actual useful work and aren’t highly capitalised (like mine) can’t grow because we can’t suddenly charge our customers double for the work so that we can compete against these booms. It’s as if a very rich person has moved into your town and hired all the builders possible to create a huge mansion. They even approached builders working for firms and offered them double to come build that mansion. Soon builders are all swanning around town in Teslas and feeling pleased with themselves for being so cunning as to be in the building industry.
Same in software. Locally there’s a Tesla with a crypto referencing private number plate and a young, bearded and muscular techbro driving it. Fine, I’m not going to judge. He’s happy and making good money.
But if builders are all hired by the rich, the rest of us get priced out. Same in software. Small firms are going to find they can’t afford websites unless they just use some cheap web builder platform – it’ll give a less good solution, but it’ll do the job. Ish. And the firms that can afford will do that bit better. And better. And the gap will grow.
At my firm I’ve had to raise salaries, but we still struggle to clear a profit with the raised salaries. I’m fiscally conservative, so we’ve always had decent cash reserves. This lets us ride out the storm. From 1997 to 2002 dev rates went crazy. By 2005 they were back to normal again. We as a firm can’t handle eight years of this. But it’s not quite the same as back then – you can now hire developers globally and have them work remotely, if you really wish to, which can save some money and also help those countries out with extra foreign revenue. I, however, really like quality and good communications and I find that a geographically tight team works the best. It also makes it easier to hire new people into the trade. So, for now, I’m sitting tight. I won’t seek venture capital, or borrow. And if the worst comes to the worst, we’ll add AI to something that does basic statistical analysis, and blockchain to something with two computers in the network and hope someone out there fancies throwing us some money so we join the party. In the meantime, however, there’s still a healthy living to be made as a business doing useful things and avoiding the hot trends. I never set out to be rich, merely secure – I’ll ignore the rich mansions and do my own thing, creating good code for good people.
n.b. about the above – the above isn’t a paper. It’s a set of opinions designed to inform and illuminate about what’s happened. It relies on anecdotes. Don’t take it too seriously and don’t use it as the basis for what you want to do with software and investing in software. Or crypto. Do your own thing with the information you gather from multiple sources. Also remember that a lot of people say misleading things because it’s in their interests to do so, and that you shouldn’t trust a random blog or news source on the internet. Mine included.
A year ago, I was sitting, shorn of all body hair and waiting to go in for a five or six hour operation. I knew the next two weeks would be hell.
It’s hard to explain the odd calm that came over me as I sat there, waiting for the biggest operation of my life. I didn’t feel happy. I didn’t feel miserable. It wasn’t as if I’d been feeling terrible. I’d just had one bad morning two and a half weeks earlier where I felt rough, then more rough, then really really rough, then fine again.
It’s weird. You see heart attacks on TV and you get this idea of a mad bad event where you keel over, clutching your heart in agony. But it doesn’t really work like that. The night before I’d felt tired. In fact, for a few years I’d been feeling like hard exercise was a challenge. It took me an age to warm up for a sport, and then I’d be fine. But the first half hour was a chore. And if I’d eaten I was basically useless for an hour or so.
I put it down to age and asthma.
I wish I hadn’t. But thankfully, I got lucky, in a way.
So driving along to work I felt this tightness in my chest, a tiredness, and a general malaise. So I decided, as was sensible, to pick up some vitamin tablets on the way to work. That’s what you do when you’re tired. Take vitamins, and get plenty of sleep. That was my plan. But by the time I got to the counter, I felt even worse and decided to mention the chest tightness to the chemist. She very clearly said I should go to the walk-in centre and get checked out. Instead, of course, I decided I’d get it checked out at some more convenient moment. But by the time I got back to the car I realised I was very out of breath just walking slowly.
I was having a heart attack. I didn’t know it yet. I looked at my Fitbit on my wrist and it said my heart was doing a nice old 70 bpm. Normal enough for me. So why was I puffed out? Must be an asthma thing. But I decided that I would go to the walk-in centre after all. I drove, feeling increasingly out of sorts, parked quite badly, and shuffled in to reception.
A few hours later, I was hugging my wife in A&E at the Royal Liverpool Hospital. I was worried, but not terrified. The doctor dealing with me said “I’m concerned but not worried.” That was a relief. The diagnosis was swinging between heart attack and pericarditis. I was atypical. Relatively young, slim, non-smoker, evidently in reasonable health, and moderately active for someone desk-bound at work.
But they couldn’t satisfy themselves. The A&E cardiologist said I had to go in for observation. They observed me.
I was sent up to a cardiac observation ward where there were a range of folk from really quite ill and very elderly to me. By then I was feeling fine, quite chirpy, and generally comfortable. My biggest complaint was that the ward was a bit noisy, with an elderly chap who was rather confused causing the most noise. But hey, I was alive, the food was tolerable, I had my Kindle and my phone. I started to obsessively read about the heart, interpreting ECGs and so on. It’s all quite fascinating. And complex. I won’t pretend a lot of it stuck. But now I knew the possibilities.
The rather wonderful Mr Fisher, my cardiologist at the hospital there, did a series of echocardiograms. He felt that I was 95% likely to have pericarditis, in which case a few tablets and I’d be right as rain within a couple of weeks. However, there was a 5% chance of something else, so he’d scheduled me for an angiogram at the Liverpool Heart and Chest Hospital. If they found something, they would be able to stent me there and then and I’d be on the path to recovery.
95% chance of some tablets and everything was fine? OK, I cried a little and started looking forward to the family holiday we had planned.
An angiogram is where a fine catheter is inserted up to the heart, then a substance that can be detected using x-rays is released into the heart. This allows the surgeon to get a visualisation of the heart. It’s really interesting. And a little unpleasant, but definitely not much more unpleasant than a longer dental visit. It is surgery of a sort, and done carelessly it can do damage, so they always have someone on standby ready to whiz your chest open and do some emergency surgery.
Thankfully it’s usually very safe. It just feels odd, sitting there with this big machine whizzing around you imaging your heart, a massive TV screen to your left, and a very precise talking and unambiguous surgeon on your right instructing his team. I was anxious. He noticed that, and he said “just give him the valium. Now”. At least I think it was valium. In some ways my memory is a bit fuzzy.
Because then, as he finished everything up, he explained that a stent wouldn’t be possible and I would need what is called a coronary artery bypass graft. Four, maybe five. I… didn’t like that news. I felt shocked, scared, and unhappy. I’d gone from probably just an annoying health scare to looking towards having my chest sliced open and my heart operated on.
How do you even operate on a heart? It’s not supposed to stop. Right? Stopped heart = dead. No?
So then you just wait. And wait. They wouldn’t let me leave the hospital. I was at risk of another heart attack, the blockage was so bad, and they needed my system to flush out the drugs I’d been given when I was suspected of a heart attack. Risks, apparently. It took two and a half weeks from admission to operation. Long enough to think about my mortality, prepare some things, and do weird things like have a company meeting in the middle of the ward to ensure everyone knew what to do, and how.
It was an interesting time. People came and went. I got to know some, and would chat to them as they faced their fears. Most people were older, most were as surprised as I was. What really surprised me is that the image most of us have of people waiting for a bypass wasn’t really fulfilled. Sure, you had the smokers and the fatties. But loads of us were relatively active, relatively slim people. Not that athletic, mostly, but in a line-up of people most likely to need a bypass, you wouldn’t have picked most of us.
Sometimes I’d chat with people facing the operation the next morning and they were, usually, very anxious and worried. Some said things like “well, if I die… I won’t know it. It’s my family I worry for.” Others joked about having their last cup of tea. There’s some morbid humour, but it felt like a release too. A way of expressing anxiety with a laugh.
But the fact so many of us weren’t people who’d neglected ourselves felt terribly unfair. I struggled to deal with that.
One chap, about ninety years old and looking in remarkable health, was in for a new valve. He said without it he’d likely not survive the year. With it he had a good chance of another five years. Yes, there was a risk, but as he said “I’ve had a good life.” I guess by the time you reach your nineties you come to a realisation that you can’t really have that long left, no matter what you do.
I talked about my own misgivings. I’d been a bit plump in my twenties, and I enjoyed partying and chocolates. I’d also been a hard working type with little time to do lots of exercise. He smiled and said something like “Life’s full of could’ves and should’ves, but they really don’t matter. You have to deal with the present and make things as best you can for the future. The past has gone. Leave it be.”
He was so right.
As the date loomed I thought I’d get increasingly anxious, but it just stopped. I wasn’t aware of being pumped with chill-pills. I’d seen more frail people go off to operation, and I’d chatted with them as they recovered. It was clearly hard going for them, but they lived and they seemed in good spirits. It’s a very hard operation to go through, I knew that, but now it felt tangible. I also had visits from colleagues, friends and family, so each day I had something to look forward to.
I did do some morbid things. I wrote a note to my family, should I die. I have no skeletons in the closet, but wanted to ensure they knew where to find financial stuff. I knew that they knew that I loved them. I kept the schmaltzy stuff to a minimum. Just crack on. What needs to happen has to happen.
Now, this is where it gets more interesting, really. First thing you have to do is shave off all body hair below the neck. You’re handed a quality hair trimmer, with a sterile trimming blade, and pointed to the bathroom. Bzzzzzz! It takes for ever! And those things bite! Once on the balls. I wasn’t really sure where to stop, and I couldn’t really do my back on my own, so I left that, assuming they knew that too.
My operation, schedule for the afternoon, meant no food or drink. I read a bit, chatted with Romana, and refused to say goodbye. I was coming back. I knew it. I was confident. I’d already met the surgeon, and he seemed confident, precise, and concise. I like that in a person. We talked a little about technicalities and how the procedure would be done one me, what arteries they were harvesting and from where. I’d also spoken to another surgeon who I assumed assisted. He poked me and checked how various bits of me worked. I had a breath test. I had a lot of tests. But the day of the operation itself was quiet, really.
So I knew the operation was going to be a beating heart one, without using a heart-lung bypass machine. The attachment of the grafts would be done using some weird sucker machine (maybe called an Octopus) that would stabilise my slowed down heart, but at no point would it be stopped. Amazing. Each stitch carried out between the beats of my heart on arteries just 1.5mm wide.
And then it comes. The porters arrive, you give everyone else on the ward a wave, they say good luck, and you go. All the stuff you have is bagged up and taken away. You don’t need it the next day, and if there are emergencies stuff can get lost, so it’s better if a friend or partner handles it.
Then you wait in a pre-operation room with clouds painted on the ceiling. It made me think of going to heaven, but it was better than white tiles, I guess. That was when I chatted with Romana, ensured she knew I loved her, again, and waited. And then they come for you. You say goodbye, and off you go to theatre.
There, the anaesthetist I’d met before, hooked me up to a skullcap for monitoring my brain, and started preparing me with those injection thingies. A theatre nurse chatted and joked with me. Clearly there to keep my mind off things and keep me calm. And the moment comes. The anaesthetic is injected and you’re switched off.
It really is like that. You don’t have any awareness.
Actually, I remember a vague moment of having something pulled out of my throat, being conscious, and then out of it again. According to Romana when I first woke I became agitated, so they sedated me again for a while. When I next woke I had a nurse talking to me, giving a button to press with instructions about how it delivered morphine and would ease my pain. I couldn’t overdose with it apparently.
I tried.
I clicked that button again and again! Not to deliberately kill myself or anything, but because it was so nice! However, it’s rate limited. Keep pressing and it just beeps. When it kicks in you feel this warmth, and the pain goes. It’s a very nice drug and I’m not surprised people get addicted.
Romana came in. I was… not really in the best place. I was in pain. I felt like I’d been hit by a truck. I don’t even know if I have the order of events right.
Click. Oh, that lovely morphine button.
We chatted a little, but I remember very little. I had an oxygen mask, I was uncomfortable. I realised I had a urinary catheter in place, so I could stay still. She left, and I think I slept.
One thing I never realised from films, is that intensive care really is just that. It’s actually, in this case, Post-Operative Critical Care. A nurse is stationed at the end of your bed and watches you constantly in the first night. At one point I remember being woken.
“David… can you breathe please?”
I took a gasp.
“You’re worrying me with your apnea,” she said.
I took a few breaths. I felt as OK as I could manage.
I could only see one other person on the ward, and he would wave at me and give me thumbs up. He couldn’t take his mask off. We waved and smiled at each other. I never saw him on the cardiac recovery ward, but he could have had different conditions – they do other kinds of surgery there beyond hearts.
The next day was a bit less painful. You get x-rayed in your bed, poked, prodded and checked. My blood pressure tended towards the low side, but you could see that at the 24hr point I was getting a lot less attention, all the pipes in my chest were out, stitches put in, and I was being made to sit for a while now and again. The second night I was definitely left to my own devices for a bit.
After a few checks the next morning, it was off to recovery.
Each day you feel better. You need less and less supplemental oxygen. You start eating normally again.
I’d also heard that after a major operation, you get constipation. Had I known this I’d have been tempted to stop eating two days beforehand!
Because after a few days, you realise you have to poo. Thankfully this comes once you’re mobile again. But even walking fifteen metres to the bathroom is still tiring on the third day. The poo won’t wait. Nor should it. Because the longer it takes, the worse it’ll be.
Man, you’re giving birth.
Seriously. I sat in the bathroom. It started to come. Very very slowly. It. Was. Huge.
And a huge poo is going to be unpleasant, no matter how much time you give it. I feel for heroin addicts dealing with that. Their piles must be quite something.
I strained, but only a little as I’d been warned not to. So I had to tolerate this thing… half in, half out. Slowly but surely, little by little, it came. But it seemed to never end. I swear, I spent an hour in that bathroom, swearing, cursing, and wishing I’d never been born. And if I pushed too hard my heart rewarded me with a palpitation or to and I’d feel breathless.
The thought occurred to me… what if I died right now? A poo, half the way out of my arse and me, on the floor? That would be the last thing the world saw of me. Ew.
Deep breath.
Carry on. Wait. Be patient.
Eventually, it was over. I hobbled back to the bed, grabbed my oxygen mask, and had a nap. I’d deserved it.
Six days after being open and lying surrounded by dedicated specialists, I was going home. They test you to see if you’re capable of being trusted. You have to walk a certain distance, unaided, and climbing and descend a flight of stairs. A group of you go together for this test. We all did it. There was some sort of air of celebration around us. We were survivors! This thing wasn’t going to defeat us after all! Each day we were stronger!
Getting to leave the hospital is a joy. I’d been taking walks and stepping outside anyway. I was very keen to be moving. I felt frail and slow, but it allowed me to feel like life was going to improve.
But in spite of that, on discharge, you’re given your bag of drugs and wheeled to the door. Once you’re off in your car, you’re no longer their problem. Until then though, they have a process to follow and they’ll stick to it!
As you can see, I had the weird hospital socklets and stockings on. The compression stockings help reduce the chance of a blood clot forming in your legs, and reduce swelling. You can see from this photo that my left leg, from which a vein had been harvested, was definitely bigger than my right
And that’s it. The next phase is about getting back to full fitness, work and leading a full life. I surprised myself, and I’ll share more soon. I’m planning to discuss stress, work-life balance, family and a few more things. And this blog may even come back to life a little bit. I’m bored of helping Facebook and friends to keep their platforms populated with content that is then lost in a silo. Longer writing definitely has a place. Please feel free to join me here.
Hello – here’s the refreshed blog. I’ve decided to revert to a more typical blog format, after many months of soul searching on the issue. I previously had a layout based on a framework we used at interconnect/it for a couple of clients
But not only have I opted to switch to a blog layout, I’ve decided to use an off-the-shelf theme. I’m now using Khoi Vinh‘s Basic Maths WordPress theme.
Well, it’s a lovely theme, for starters. The typography is pretty good. The archives page is brilliant (check it out) and should be the standard bearer for all themes archive pages.
But the real question for many, I suspect, is why I’m not using an interconnect/it designed theme. Well, for starters, interconnect/it hasn’t produced an off-the-shelf theme in years. It’s just not our business. So rather than use a product of ours, we’d have to spend good and valuable time on creating a new theme. And, well, why would we want to do that?
Lots of reasons, actually. I could have a theme coded at the office that really shows off what we can do. But the problem with that is that there’s not much need. My blog is not an important one. It isn’t about WordPress (most WP related content will be on our company site, not my personal one) and it just doesn’t get much traffic.
I run a business. Its purpose is to make money, employ five people, and, with a bit of luck, turn a reasonable profit. Its job is not to service my ego or make me look good. A really good theme costs the equivalent of around £10k-£20k of chargeable time to design, code, test and implement.
Given that we’re turning work away, I thought “why bother?” And decided to go shopping for something.
It’s actually quite weird using somebody else’s theme. I actually tried a few out and here are the things I learned that will hold us in good stead.
No really, they don’t. One of interconnect/it’s biggest challenges is making sure that WP is as easy to use for clients as possible. This means following standards, but it also means using some little tricks that help out – for example, registering and setting plenty of different image sizes, and setting/over-ruling whatever the media settings say.
There’s a fundamental flaw with the default WP export/import. If you have inline images, although the importer has the ability to download and attach the image in your new site it won’t change the links. And if you do a search and replace, and your image sizes have changes, your lost. Totally – the img tag will point to a file that doesn’t exist.
So what do you do? Well, usually if I’m moving a site from one server to another, even switching domains, it’s a non-issue. I have my tools. But if you’re starting from fresh and working like an end-user would then you have to go through every single damn post in order to fix the images. Every post with an image in it. That’ll take a while.
If you’re really geeky, you’ll sort it, but it takes time. Way too much time. This kind of stuff needs to be sorted and it’s something we may look into as a contribution to the WP project.
The reason for a reboot was that I felt that my site’s DB had been filled up with all sorts of crud. Lots of plugins create tables, leave options, and so on. Surplus tables have little impact, but they clutter the place up. But options, lots and lots of them, do have a minor performance hit, and they add up.
Other plugins leave hooks, don’t deactivate properly and so on. And over the years, I’d been through an awful lot of plugins. The site hadn’t been redone since WP 2.0 had been set up on it. I felt it was getting sluggish.
So… there are beautiful and amazing themes out there, and WP is wonderful, but there are little things that could make life just that bit better. Better migration tools, a better system of managing images within content and their migration, and a better system for activating themes so that image sizes are better handled.
Is it a lot to ask? Well, we’ll see what we can do about that!
Had my father’s headstone delivered and installed yesterday.
It was a fairly sombre moment, and my last goodbye to him. I won’t go back soon.
Unfortunately the computer I’m trying to upload my photos to won’t play ball, so no pictures for the moment. Sorry. Maybe tomorrow when I get to San Pedro de Atacama.
Edit – 08/07/2011: Finally added the picture, nearly a year later. Some kind of mental block for me when it comes to gravestones. Here it is. I’ve also added a gallery with images from the cemetery in general.
I’m staying put while I wait for the headstone to be finished and fitted, and consequently got to see an Arican weekend.
There’s not a lot for me to do in many ways, so yesterday I spent some time going through all of my father’s papers and notebooks. I found evidence of one email address he’d used from five years ago, but it no longer existed. So I returned from the computer and continued… until I found painstakingly detailed notes on how to use Yahoo mail. Including a password.
Bingo!
I felt that if he had e-mail perhaps he’d been in touch with people and I could work out more of his life. I ran down to the computers they have here in the hotel, logged in and… he’d only ever emailed one place – the Department of Work and Pensions. It was all about his pension, along with a couple of emails explaining that they had his address wrong (and which they never seemed to correct!) and that was it. Nothing else, nothing in the sent folder to anyone else. It was a dead end.
Ah well. So I went back to the notes and worked out a fair few things. I’ll note what I’ve learned in full at the bottom of this post, as the whole day taught me things.
One of my disappointments was to find no detail of any personal life, anywhere. But I did bring with me all the letters he sent me from 1988 to 1991. These covered his crisis period. I decided to get them in order, photograph each one, for posterity, and then read them one after another.
Ouch. This caused another period of getting down, because I realised some things. I remembered how, in the letters, were statements which were essentially threats to commit suicide. The incredible emotional blackmail. His feeling of injustice over what he thought was some kind of inheritence. In part that my memory hadn’t formed a perfect impression of the order of events (although I wasn’t too far out) and that his crisis had clearly been real enough, but largely because towards the end of the letters he stopped being so demanding and so hard on me. In fact, the very last letter was more about caring for me than himself. He was almost upbeat and looking to the future.
That was the moment. He’d realised what he’d done and he was trying to repair it. Problem is, he was too late. I was still upset at him, and I’d now rejected him completely. At the time I couldn’t forgive him for what he’d done. The letter is in quite a sorry state as I’d crumpled it up ready for the bin, but interestingly it looks like I changed my mind, flattened it out and put it with the rest.
And so I found myself wondering. Should I have forgiven him sooner? I’d certainly have stood far more of a chance of finding him, and maybe he’d learned. But at the same time I do believe I was still scared of him. I never told him I’d moved, and I never checked again with the neighbour who’d been taking my post in.
I think, to me (and maybe to others) that this is a valuable lesson in the dangers of losing the trust of those closest to you. If you want to get it back a letter isn’t enough. You have to earn it. Really work at it. He could have forged the connections once more, the stupid bugger, but he couldn’t stop me walking away. My own instability at the time meant he had no chance of finding out where I lived…certainly not from South America.
It’s also taught me that communication is everything. Sometimes those around you know little about what you do and what you think. For example, he didn’t really understand the repossession of my grandmother’s house or the intense solitude I felt at the time.
Maybe if I’d simply told him? But I needed to protect myself as well.
I did originally plan to place the letters online in their entirety, but that will have to wait. I saw some things there that could cause real issues for some people and which need to be cleared first. Maybe in the future. But it’s a thin maybe.
At 9pm, after the terror pizza, I headed to the pool hall to meet more of my father’s friends and acquaintances. There was Oliver (or Oscar, my notes aren’t clear on this and I need to check tomorrow) who met him over ten years ago on the La Paz-Arica train. Or Pablo, who’d known him since 1991… from the time of that last letter.
Obviously I had questions. I asked if he’d mentioned family and they only had one mention… a daughter, in Quito, Ecuador, who died in a road traffic accident at the age of about 13. But I couldn’t find any more detail than that. No names, no known addresses, and there’d been nothing in the notes. Back home we suspect he may have been using this as a way of blocking conversation about family, but who can be sure? He gave the story consistently, everyone reported it as the same, but something occurs to me… it’s an old story. If he was reporting this 19 years or so ago, then the age wouldn’t be possible as I’m not aware of him having been to South America prior to around 1983.
So, after all this, and without the help of an interpreter, I only had vague echos of the man. Nothing so firm other than that he was, it seems, generous with friends, selective about his company, and a creature of habit. I sat where he sat, chatted with his friends, enjoyed a beer, and learned to spell ‘jote’, the red wine and Coke mix, correctly.
This all cheered me up. Apart from the odd mentalist (my father did hang around with a diverse group) I found that these friends he had were pleasant, intelligent people with things to share. We drank to my father, I tried to explain the story in as sensitive way as possible, and we laughed and joked.
Oh seriously, sometimes, when you travel the food is amazing. Sometimes, it looks like it might be a danger to your health…
No, I ordered a veggie pizza, not some sort of mentalist giant cheese flan.
Argh! It’s vomiting salad at me!
Father’s health was seriously affected by malnourishment. Maybe he was just scared of the food here?
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