Here's what the intellectually challenged bovine has to say in the Daily Mail today:

Sorry, but I blame Scarlett Keeling's mother
Fiona MacKeown, the mother of Scarlett Keeling, the 15-year-old girl who was raped and murdered in Goa, seems less like a grieving mother than an avenging tigress.

With her swishing curtain of grey hair, Fiona is taking on a corrupt local police force which initially denied that her cub had been the victim of foul play.

"If police had taken more interest in previous [suspicious] deaths, then Scarlett might not be dead now," growled Fiona.

Maybe so. But isn't there an even better chance that Scarlett would still be alive if her own mother had not abandoned her for several weeks after an argument and recklessly continued her own holiday?

Instead the blonde teenager, as tempting as a ripe peach, was left in the care of a 25-year-old tour guide - a local man she'd only recently met.

I don't know what they call that in globe-trotting hippy circles. Back here on Planet Parent it's known as dereliction of duty.

Mrs MacKeown is now to be questioned by Goan police for negligence - a tactic she claims is a "disgusting" attempt to "switch the focus" away from their own failings.

If anyone's trying to divert attention away from their own mistakes, I'd say it's Mrs MacKeown.

Scarlett was last seen at 4am in a bar surrounded by several men. Witnesses say she was totally off her head on ecstasy and cocaine.

That kind of behaviour would have made her vulnerable in her home town back in Devon, let alone in a culture where Western girls are all too readily viewed as sexually available.

Forgive me for being a boringly conventional bourgeois mum, but what the hell were Fiona MacKeown and her partner thinking of taking seven kids on a six-month "dream trip" to India - and then leaving one of them to fend for herself? Why wasn't Scarlett in school studying for her GCSEs?

Far be it from me to interrupt such an 'eloquent' rant, but I was under the impression that the children were homeschooled? But then, research isn't Pearson's strong point. Granted, I have yet to find what is.

The loss of any child must be a horror beyond imagining. But there is something about Fiona MacKeown that makes me want to scream at the TV.

Not an ounce of doubt or regret seems to weigh on this laid-back woman. She told reporters that she had counted every mark on Scarlett's body.

"There were almost 50 bruises and abrasions. She has clearly been battered and assaulted. I feel vindicated."

Vindicated? For crying out loud! Any normal person would be tearing out their own hair with grief and remorse.

Mrs MacKeown says her one consolation is that she's "got some photographs of [Scarlett] having a fabulous time".

She still doesn't get it, does she? Fiona MacKeown is an unrepentant member of the Me Generation, one of those people who would rather be a best mate than a parent.

It's more fun being a friend to your kids and, quite frankly, a lot less hassle.

You don't have to fight daily battles over bedtimes and body piercings. And if you have a row with your "mate" you can storm off, unlike an old-fashioned authority figure who has to weather the storm and stay put always and forever.

This week, John Dunford, head of the Association of Schools and College Leaders, warned that schools are the only moral framework in many children's lives.

With the erosion of traditional family life, parents are no longer giving their offspring basic social skills or a sense of right and wrong.

It's a bleak picture that brings to mind W.B. Yeats's great poem about a world where the natural order of things has catastrophically broken down: "Things fall apart; the centre cannot hold;/Mere anarchy is loosed, and everywhere/The ceremony of innocence is drowned."

For parents who are poor and ground down by work, or the lack of it, there may be some excuse. But articulate, middle-class people should know better.

Since Scarlett's brutal killing, Fiona MacKeown has fought for her daughter. Would that she had exercised half that dedication and sense of responsibility while Scarlett was still alive and in need of a mother's care.

Contrast this with the unwavering support she has shown for the McCanns. As an example, I have chosen thisarticle, again from the Daily Mail:

I refuse to believe the McCanns are guilty

[snip lots of guff about how Kate McCann's life is hell, far more so than any other mother who has lost a child]

As if that weren't bad enough, the police and social services have just held a meeting to discuss the future of your two-year-old twins in the light of allegations against you and your husband.

Sean and Amelie McCann taken into care?

My stomach actually churned at the thought that Kate might lose the babies who have given her a reason to get out of bed and generally pretend to go on living since she and Gerry lost Madeleine.

So leaving 18-month-old twins and a 4 year old child alone is fine (actually, I'd call it a 'dereliction of duty'), but trusting guardians with your 15 year old child isn't?

[snip more mindless crap]
Imagine how thrilled those literally clueless Portuguese cops were to be handed some inconclusive DNA evidence they could talk up to scapegoat the British visitors who had become such a pain in the backside.

So Portuguese police are capable of such a ploy, whereas Goan police aren't?

[snip more bollocks that reveals nothing more than Pearson's lack of knowledge of anything about Kafka other than his name]
Gerry is described as controlling and unemotional. As for Kate, she attracts suspicion for the sin of being nicely turned out. I actually heard one man complain that she wore a different, clean T- shirt every day and matching earrings.

In this post-Diana age, people want proof of grief. They don't want dignity or faith or an attempt to keep up appearances, even if you are collapsing inside.

'Not an ounce of doubt or regret seems to weigh on this laid-back woman.''Any normal person would be tearing out their own hair with grief and remorse.' Nuff said.

[snip how Pearson then hypocritically goes on to favourably judge the McCanns on their appearance]
Can anyone really believe that woman killed the child she went through two gruelling years of IVF to conceive?

That she then hid the small body and strolled down with her husband to enjoy dinner with friends?

That Gerry and Kate, devoted parents by all accounts, loaded Madeleine's decaying body into the boot of a hire car four weeks later while they were busy courting the international media to help find their child?

Can you credit it? Of course not. The allegation is not just revolting. It is surreal.

Whatever you may think about the error they made in leaving their children alone that night, these people are not Fred and Rose West.

So they made an 'error' in leaving their helpless children alone? Whereas Fiona MacKeown showed a 'dereliction of duty' in trying to allow her child to grow up. Similarly, Pearson has howled about how Shannon Matthews' mother didn't raise the alarm until 7pm when her 9 year old daughter failed to return from school.

I'm obviously at a disadvantage, since I'm not a 'boringly conventional bourgeois mum', but I can easily imagine how both of these parents ended up in the positions they were in. When I was a very naive 19 year old (far more naive than 15 year old Scarlett), I went around France on my own, getting into all sorts of scrapes. My mother let that happen - and it was good she did. She also let me go on school holidays to France at 11 and Germany at 14, in the care of teachers she barely knew. When I was 9, I walked home alone from school. Had I gone missing, I fully expect my mother would have checked around my friends' houses and gone looking for me herself before calling the Police. Being a parent is about gradually allowing your children more freedom, gradually letting them learn how to grow up.

What neither I nor my mother would ever in a million years have done is leave our tiny children alone, only being checked on every half hour (if they actually were). Not because of abduction fears, but because I would worry that for all I knew, my precious children could be crying for half an hour before I came to them. That thought obviously never bothered the McCanns.

Too late, they come over all concerned for their missing child, and are constantly in the news doing all they can to find her. The dullard Pearson's last comment on Ms MacKeown is far more applicable to the McCanns: 'Would that [they] had exercised half that dedication and sense of responsibility while [Madeleine] was still alive and in need of a [parent]'s care'

Couples by John Updike

I couldn’t get into this book at first, and I’m still not sure of the reason for the first section, except for introducing us to Piet Hanema, the horrible main character of this novel, a colourless and motiveless man. But I’m glad I stuck with it.

With the second section we get to know more about the other four Tarbox couples, who socialise and commit adultery in a seemingly endless round. The other characters are far more engaging than Piet, and the most interesting of all is Foxy, who has just moved to Tarbox with her husband Ken.

Whilst Piet would seem to be the character we are meant to sympathise with, Foxy is far more complex and becomes the prime mover in the novel. Where Piet is passive, she is proactive.

The relationships between all the couples are complex, and the story is captivating once you are fully in it. Updike likes his descriptions, of weather, scenery, houses, interiors even. The scenic and weather descriptions are effective, they draw you in further, but I found myself becoming annoyed to read yet more about someone else’s wallpaper and sofa when I want to know who’s going to flirt with who, and who’s going to find out. But on the whole a really worthwhile read, and this is a writer who at least credits his readers with being able to see what he’s getting at without spelling it out.
(81/100)

The Memory Keeper's Daughter by Kim Edwards

Kim Edwards would seem to be the wordier sister of Sue Monk Kidd, and that’s saying something. It’s an interesting story of an panicky decision taken by a doctor that affects him and his family for the rest of his life. But it’s ruined by unsympathetic characterisation, over explanation and being dragged out too long. It’s also annoying when phrases that are initially strikingly beautiful are repeated throughout the novel until the become cliché; for instance ‘the silverfish’ of vision when someone is feeling faint.
(68/100)

The Risk of Darkness by Susan Hill

I’d read ‘Air and Angels’ by Susan Hill many years ago, and remembered it as being a thought provoking, well-written novel. I picked this up in the ‘crime’ section of the library whilst checking for some Ian Rankin, and wondered if it was the same author. According to the list at the front of the book, it was. You’d never guess from the writing.

It is written in the style of a workmanlike crime thriller. But the crime is incidental, and the thrills are pretty few and far between. Apparently (according to Susan Hill’s fans), this isn’t meant to be a crime thriller at all, but some kind of family saga, centring around Simon Serrailler, who happens to be a detective. Yet the characters are made of cardboard, and though the family is the only link between the two main strands of the book, I didn’t care enough about any of them for it to make a difference. So in effect, the storylines were disparate and not interesting enough in themselves to make reading the book worthwhile.

There was one interesting and surprising twist, but where we could have had an interesting insight into the mind of a serial killer, or the policeman in charge of the case, or the effect on the families and friends of any of these, or even some kind of examination into the nature of death, we just have a pointless meandering pair of tales, haphazardly dragging in multiple poorly-delineated characters.

I never did find out the relevance of the woman who died of CJD, her husband, and the whole of that storyline, except to give Hill something to do with Simon’s tediously virtuous sister.

The serial killer is found due to chance and the bodies needed for a successful prosecution are discovered by (cliché alert) a dog. Simon Serrailler might as well not have bothered to go to work for the whole of the book. I really wish I hadn’t bothered reading it.
(35/100)

Foundation by Isaac Asimov

More philosophy than sci-fi in a way, especially as the technology is pretty 50s-inspired. Although it’s set way in the future, in a time when the origins of the human race are forgotten, it’s actually an examination of the nature of empires, and what happens when they decay. It introduces the concept of psychohistory, and looks at how one man used this to shape the future. We witness, over the span of almost a thousand years, several crises of the Foundation he creates, and how these are resolved. On the way, the book examines the role of religion, trade, heredity, science and politics on shaping society. Each section takes the form of a short story, interlinked with the others. Really interesting, even if you’re not into sci-fi usually.
(79/100)

We'll all have heard the news this morning that Selective Serotonin Reuptake Inhibitors (SSRIs) are only as effective as placebo in the treatment of depression, so I'll not choose any particular news article to comment on, although the research paper is available online at the PLoS Medicine website.

What has been really interesting to me is the reaction this metanalysis has received from the 'scientific' and mental health world.

For many of us, this is old news: many published papers which claimed to find a treatment effect for Prozac in particular actually did nothing of the sort when you read them properly. Of course, most doctors don't have time to read the research, so they just read the blurb from the drug companies.

Yet now here we have a decent metanalysis (I'm taking it at face value as I haven't had time to scrutinise it properly myself!) which is saying the same thing many of us have been saying for years, and all the medical folk on the news this morning were defending the drugs in the face of the evidence. How very different to their attitudes when research on homoeopathy is published: pro- evidence is summarily discounted and anti-evidence is quoted as gospel, whatever the methodological flaws: and let's not forget there's a paucity of research done on alternative/complemenary therapies, because there's no money in it for the big research funders - drug companies.

It's to be expected that Marjorie Wallace, the chief executive of MIND, would say, : "If these results were upheld in further studies, they would be very disturbing. If validated, this research would mean that psychological therapies would be the only available treatments for the majority of people, but these do not work for everyone, particularly those with severe clinical depression.These results are focused on clinical effectiveness rather than health risks." It's the sort of fudge you'd expect from someone who has never been what you'd describe as a boat-rocker. What is more disturbing is when she says, "It is important that people should not stop taking the anti-depressants immediately, as doing so could lead to severe rebound depression." What further evidence is needed that she is in the pocket of the drug companies than her description of a withdrawal symptom as being a 'rebound depression'. Call it what it is, woman!

Drugs have always been the easy option in mental health, and because of the placebo effect they often work: especially since the placebo effect is greatest in those drugs that have the most and worst side-effects. Many of the drugs used in mental health (not SSRIs) also have the effect of tranquilising the user, so that they are far less hassle to their families, neighbours and carers (hence, I suspect, Marjorie Wallace's fandom).

More interestingly, in the face of this evidence, what do the drug companies say? A spokesman for SmithKlineGlaxo, makers of Seroxat, says the results are, "at odds with what has been seen in actual clinical practice". These were almost exactly the words of Dr Hillary Jones on GMTV too.

Yet according to the 'scientific' skeptics (dictionary definition: person with a mind closed to anything it is too small to comprehend), the evidence of clinical practice is meaningless and pointless, and to be disregarded in the face of pure research.

So for a laugh, I went over to Quackwatch this morning. Surprisingly it has nothing to say about these medicines, even though they cause severe side-effects (such as suicide) in some patients, and have withdrawal effects. Of course, Stephen Barrett is far too busy exposing the scammery of something like craniosacral therapy, which has no side-effects at all (aside perhaps from lightening your wallet if you don't get it on the NHS), to be bothering with a huge quack like the drugs industry.

Luckily I've never worked with anyone so small-minded, and even the most sceptical of psychiatrists (that would be Dr Moffoot) would refer patients to me for craniosacral therapy when all else failed, because they saw the results for themselves. I have no objection to being called a quack, so long as the definition is fair, and applies to anyone using a method of questionable efficacy, not just those that certain self-appointed 'quackbusters' don't understand.

After all, it was the quackbusters of the time who drove Semmelweis to madness and delayed the implementation of hand-washing in medical care. Whatever way you look at it, a stubborn refusal to even consider the possible efficacy of something purely because the explanation for its mode of action isn't immediately apparent is anything but scientific.

Black Swan Green by David Mitchell>

I enjoyed Cloud Atlas, and this was just as good, in a totally different way. It's quite reminiscent and influenced by The Catcher in The Rye, but this book is set in the Malverns, in the 1980s. Anyone who grew up during the 80s will recognise the references (actually, you get the impression that some are put in because Mitchell's done the research, so he's gonna use it: but nowhere near as intrusively as Maria McCann and her ilk), and anyone who's read Cloud Atlas has a little treat in store (I'll say no more, don't wanna spoil the surprise).

It's an easy read, a page-turner, that has you hooked, and Mitchell's real skill is that the story is so thoroughly told from Jason's point of view that you don't see the end coming, because he doesn't. The indications are there from the start, but you are so caught up in Jason's life and problems (his stammer, his struggles to be cool, his family concerns etc) that you forget them as you go along. So for once I was surprised at the 'twist' that really isn't a twist, the total reverse of my usual situation (I truly didn't notice there was a twist in Sixth Sense!)
(90/100)

The Other Side of You by Sally Vickers

This is another author I'd previously enjoyed, having read Mr Golightly's Holiday, which was my second-favourite fiction book of 1996. This book surpasses that one to become one of my favourite books of all time. I would have loved to read it again straight away, there were so many little strands going on. A psychiatrist becomes involved with one of his patients, who herself had an affair which ultimately resulted in her attempted suicide.

Vickers' descriptions of unhappy relationships ring utterly true, as do her descriptions of psychotherapy and psychiatric patients, which has to be a first in my experience. The book is beautifully written, moving, but not sentimental. If anyone is ever tempted to read chick-lit, don't bother and read this instead. It's just as easy to read, far more enthralling, and a hundred times more worthy of your time and money.
(96/100)

The Mermaid Chair by Sue Monk Kidd

This doesn't quite live up to The Secret Life of Bees, but it's worth a read anyway. Jessie Sullivan has an affair with a monk when she has to return to an isolated island to care for her mother, who is acting a bit weird. Eventually we find out why, and it's no big surprise. I really liked the central storyline of Jessie and the monk, I loved the little insight from her psychiatrist husband half way through, but the book feels over-written, and unsatisfying at the end. And what is it with US women writers that they are only satified if they've introduced some sort of 'ethnic' feel? I also don't like the way she hits me over the head with how clever she is: 'oooh look, you probably missed what I was alluding to there, so I'd better tell you in black and white, thicko'. I hate that!!
(86/100)

Falling by Olivia Liberty

An interesting first novel. Excellent in the beginning, one third too long. Once you realise why Toby Doubt's girlfriend has left, it really feels like we need to speed to the conclusion, as the driving force of the novel is lost. The characters, previously comic, at times touching, become caricatures. What was an interesting look at a disturbed mind becomes cruel farce. And there is some really weird punctuation and phrasing going on, which I initially thought was meant to somehow be indicative of Toby's state of mind, until I came to a really tortuous attempt at avoiding the so-called split infinitive that made me realise what was really needed here was a decent editor. I'll read her next book though
(70/100)

From BBC News

Lords rule on Lotto rapist victim

A victim of millionaire rapist Iorworth Hoare is due to find out whether she has won her 20-year fight for compensation from her attacker.

Previously lawyers for the woman, known as Mrs A, said they were optimistic the House of Lords would make a landmark ruling in favour of her appeal.

Hoare, 53, was jailed for life in May 1989 for the attempted rape of Mrs A in Roundhay Park, Leeds.

That's the first thing that's not fair: people who are jailed for life should stay in jail until they are dead. For some crimes (such as murder, repeated rape offences etc) rehabilitation and release are not appropriate. It shouldn't matter whether a person is later judged to be no longer a danger to society, because the crimes they have committed in the past are so bad that they require ongoing punishment (lack of liberty) as a deterrent to others and as a reassurance to the rest of society that life and personal safety are of value. If life meant life, the capital punishment lobby would be deprived of one of its arguments. Of course, the crappy government might have to build more prisons...

He won £7m when he bought a lottery ticket while on day release from jail.

Hoare was also jailed several times for a string of sex attacks, including rape, two attempted rapes and three indecent assaults, during the 1970s and 1980s.

He now lives in a £700,000 mansion in Ponteland, Northumberland.

Historic claims

In 2005, a High Court judge ruled that a compensation claim by Mrs A was outside the legal six-year limit. The Appeal Court upheld that decision.

The Law Lords have been examining whether it is fair to preclude claims six years after an attack, or, in child abuse cases, more than six years after the victim reaches 18.

A ruling in favour of Mrs A could pave the way for thousands of actions by victims of sex abuse to make historic claims against their attackers, some dating back many years.

Mrs A was awarded £5,000 from the Criminal Injuries Compensation Board after she was attacked by Hoare in 1988.

She was ordered to pay his legal fees after unsuccessful attempts to bring a case for compensation in the High Court and Court of Appeal.

This doesn't sound very fair either. This case is of importance to the whole legal system and our democracy, so it's pretty rough on her that she's supposed to then give money to her millionaire near-rapist.

However, the whole idea of being able to claim at any time isn't a good one, I think. Again, if life meant life, maybe Mrs A wouldn't be looking for compensation, since she says in The Times:

“I decided to take this claim forward in order to fight for justice for myself but, far more importantly, for others who will also face similar injustice in the face of an unfair and out-of-date legal statute.”

Although it seems odd that Mrs A only decided to seek compensation when she heard of his lottery win. The Times goes on to say:

Mrs A still suffers nightmares. Now in her late 70s, Mrs A has said that the brutality of the attack destroyed her confidence and left her with lasting psychiatric injury.

A time limit on compensation claims is good for the victim as well as the perpetrator. I don't see how money can bring closure to anyone. Yes, it must be gutting for Mrs A to see the scum who attacked her luxuriating in his mansion, but how will any amount of money change what happened to her? How can money make her feel better?

It's like we tell children: life isn't fair. Holding on to the past is no way to have a happy future. Money isn't the be-all and end-all, and it's certainly no substitute for real justice: which would be Hoare in jail until he's dead, and Mrs A moving on with her life and not letting him affect it any longer.

So finally the 'scientific' community is admitting what we knew all along - from Medscape

Study Identifies Bias in Favor of Publishing Positive Antidepressant Trials
Marlene Busko

January 17, 2008
A study of Food and Drug Administration (FDA)–registered clinical trials of 12 antidepressants found a bias toward publication of positive results. Almost all studies viewed by the FDA as positive were published. The clinical trials that the FDA deemed negative or questionable were largely not published or, in some cases, were published as positive outcomes.

For each of the 12 drugs, at least 1 study was not published or was reported in the literature as positive despite a conflicting judgment by the FDA.

The overall effect size of the antidepressants (vs placebo) that was reported in the published literature was nearly one-third larger than the effect size for these agents that was derived from FDA data.

"Selective reporting of clinical-trial results may have adverse consequences for researchers, study participants, healthcare professionals, and patients," they conclude.

These findings are published in the January 17 issue of the New England Journal of Medicine.[snip]

'Evidence Based Medicine' is currently the be-all and end-all of clinical practice. This is problematical anyway in that whilst it is fine to accept that spending money on unproven treatments, it isn't accpetable to throw the baby out with the bathwater by refusing to fund treatments which are poorly or un- researched. Something like physiotherapy intervention is especially difficult to research, because so much of it is down to choosing the right treatment for the right patient, which is something that comes with practice. Evidence based medicine doesn't allow for any status to be given to treatments which are based on clinical experience.

As an example we can look at the application of heat treatment in low back pain. This is something that physiotherapists and others often do, yet there is very little evidence that it works (or doesn't work), according to the Cochrane Collaboration. Looking at the papers they have used to conclude this, we find that they are deemed poor quality because they are not all the 'gold standard' of randomised (patients randomly assigned to the intervention or control group) controlled (treatment group versus placebo) trials. Yet in clinical practice, my experience has been that it is pointless using heat therapy in anyone other than frail elderly ladies with a history of previous back pain and previous successful heat therapy, in which case it is more effective than anything else. But who will fund a randomised controlled trial of heat therapy on such people? How long would it take to find a suitable amount of patients to make a meaningful sample? Who would care about the results?

This is why treatment efficacy is usually decided on mass samples of lots of different people, thus hiding any efficacy for particular groups of people, or indeed for individuals. As physiotherapists, we are always urged to treat people holistically, to consider them as whole people. In practice this doesn't happen in the NHS, where taking a 'social history' usually means asking if the patient has stairs. Could it be that evidence based practice is making professionals even less likely to treat patients as individuals by leading them to disregard their own clinical experience?

I'm all for evidence based practice (strangely in psychiatry the evidence base is ignored when it comes to choosing between drugs or other treatments): but the evidence base has to be unbiased (which the above would seem to suggest isn't the case), and clinical experience shouldn't be discounted as evidence too.

The Nightwatch by Sarah Waters

This book is set in 1940s London and follows the entwining stories of Kay, Julia and Helen, Viv and Reggie, and Viv's brother Duncan. Their stories are told in the three chunks of the book, which work backwards in time, so that we learn how the characters reached the positions they are in at the beginning of the book, in 1947.

It's an easy book to read, and kept me engaged thorughout, although the final, 1940, chunk came as a slight let-down compared to the drama of the 1944 section. And somehow Duncan's story never feels part of the rest of the book.

The characters are alive, although Helen and Duncan are the weakest. 1940s London is vividly described, but unobtrusively so: there is no description for the sake of it, none of the 'I've done my research and I'm gonna use it' feel that ruins so many other period books (Maria McCann and the execrable 'As Meat For Salt' for instance).

This was my first Waters book, and I'll definitely be reading more.
(84/100)

The Virago Book of Ghost Stories by Richard Dalby (ed)

This is a really good book for Christmas reading. The tales are spooky and atmospheric rather than scary, but if you like ghost stories, particularly MR James or EF Banson, you'll enjoy these.
(73/100)

So this means that according to my scoring my book of 2007 was The Confessions of Max Tivoli by Andrew Sean Greer, although in retrospect the book I think I liked the best and am most likely to read again is Muriel Spark's The Prime of Miss Jean Brodie.

At last, the last catch-up of books from this year:

The Confessions of Max Tivoli by Andrew Sean Greer
I really can't recommend this one highly enough. It is engaging, emotional and strangely believable, given the subject matter. For Max Tivoli lives his life backwards: or rather, he is born an old man, and becomes physically younger as he chronologically ages. It's also a moving love story, and it got to me the same way as The Great Gatsby does, because of that longing the author portrays so vividly.

Although it's a clever book, it's never self-conciously so. The narrator is so very human, it feels like a very personal book, and for that reason it pips The Dream of Scipio to be my favourite book of the year. It also contains a quote that has stayed with me all year, 'we are each the love of someone's life.'
(94.5/100)

Plain Truth by Jodi Picoult

Another Picoult novel, another annoying heroine, another courtroom drama, another good idea imperfectly executed. This one involves the Amish. I think she's slowly working her way through each and every US minority population.
(50/100)

As Meat Loves Salt by Maria McCann

I couldn't be bothered to read this book properly. It's a door-stop in hardback, and no wonder. McCann has done her research, and so she's gonna use it! Hence lengthy descriptions of everything from housing to a bloody marriage feast that had me asleep twice before I finished it (without a word of a lie). The protagonist, Jacob, seems to be an interesting character: a murderer so desperately in love with his wife of an hour that he beats and rapes her. But not interesting enough for me to wade through the turgid prose. So I skim read it, and was glad I hadn't wasted my time. This character is motiveless, from what I can see, just randomly acts out violence against those he supposedly loves (and those he doesn't), yet narrates as though he's Michael Palin (though who knows what darkness may lurk under THAT genial exterior!).

If you want to read about a violent, sexually-ambiguous maniac, American Psycho is at least well-written. If you want to sleep with irritatingly irrelevent details of the Civil War whizzing around your brain, you might want to try this.
(5/100)

More book catching up:

Fangland by John Marks

I read three books this month and this was the weakest, but it is still absolutely cracking. It's the story of how a vampire tries to take over the world through the medium of television. Which sounds as bizarre as it is, but the engaging central character means there is always a personal element tying the reader into the story. There's a nd to Bram Stoker in the way that the story is told from differing viewpoints and in different forms (diary, e-mail etc). The suspense is maintained throughout the story, and the ending is no disappointment.
(84/100)

The Interpretation of Murder by Jed Rubenfeld
Another excellent book. Psychotherapy meets thriller as Freud visits the USA. There's a murder, a near-murder, and a love story. The wekness of the novel is its denoument, because it was pretty obvious all the way through. I'd have liked more of a twist. I'd also have liked a more realistic depiction of Jung, who is particularly monstrous in this book. Freud, in contrast, is a genial old chap, and I somehow think the reverse would be nearer the truth.
(86/100)

The Testament of Gideon Mack by James Robertson
This was the best book of the month, and the questions it raised don't go away. Did the minister really meet the devil? If he did, is the devil as bad as he appears? Is God as good? Or was Gideon Mack merely insane?
(89/100)

From the Daily Mail:

Chief medical officer wants hospitals 'fined if they harm patients'

Hospitals should be fined if they harm patients, the Government's chief medical officer said yesterday.

Sir Liam Donaldson also suggested that hospitals where patients contracted superbugs could have to pay for any extra treatment.

At the launch of a report by the National Patient Safety Agency, he said: "Why should the Health Service, funded by the taxpayer, pay for the care of a patient that's had bad care?

"In any other walk of life if you receive very bad service then you don't pay for it, you get a refund, and I don't think it should be any different in the Health Service.

He's obviously never heard of Ryanair. Or Local Government. Or New Labour. I've received terrible service from this government, which has lost my personal details, including everything needed for someone to steal my identity and my child's. It has also reneged on promises to improve educational standards, and has gone 90% of the way to privatising the NHS when it promised it wouldn't. Where's my refund, Sir Liam?

The NHS, like government, is NOT a business, and it wastes money to run it as such. It is a public service. Like the railways, privatising it will create greater expense for the service users, with more safety and service problems.

"If somebody develops MRSA and has to stay in hospital longer to be treated, why should it be funded?"

He said that in the U.S., some states require hospitals by law to report medical errors.

Last month, Rhode Island Hospital was fined 50,000 dollars for performing "wrong site" surgery on a patient for the third time this year.

Sir Liam said similar systems should be brought in here which would act as an "incentive" for hospitals to provide better care.

When I began working in the NHS in the mid-80s, we often had visits from US healthcare managers who wanted to see how the NHS achieved so much on so little funding. They didn't take on much, because as businesses it wouldn't work. Everyone just mucked in, we were poorly funded, but basically we were left to get on with the job as we saw fit. There was a feeling that everyone was in it together: our hospital managers were well-known faces who were often on the wards and understood the difficulties faced by staff. We knew they'd help if they could, but were cash-strapped.

This isn't suitable for a business model, which is what the US healthcare system is. Fundholding managers want to feel in control because they have to report back to shareholders and make profit. Yet they are way distanced from their staff. Those making the financial decisions may never have seen a ward, they are relying on reports and statistics. So endless time is taken collecting data and meeting targets that are clinically pointless.

Primary care trusts could withhold some of the funding due to the hospital for the care of the individual affected, Sir Liam said.

So a hospital that is obviously already struggling will be made to struggle more. It doesn't take a brain surgeon to realise that this will only make infection rates and other tragedies resulting from malfunding even worse.

Malfunding is probably the best word to use, even if it might be a made up one. The NHS is now gobbling up resources, but the money is disappearing into the gaping maw of financial mismanagement, funding givernment targets and staff demoralisation: there's no feeling of wanting to muck in any more (eg by working routine unpaid overtime, not taking holiday, and working outside of job description) because for staff it is now them against the managers, who are seen as the agents of Government.

He would be recommending the idea to Lord Darzi, who is carrying out a review of the NHS.

Data from the NPSA revealed there were more than 700,000 "patient safety incidents" in the NHS in 2006/07.

In total, 6,558 incidents resulted in severe harm and another 40,665 caused moderate harm to patients. There were 2,929 deaths.

Last night the Department of Health insisted that it would not be taking forward Sir Liam's proposal to fine hospitals for poor quality care.

I suppose we should be thankful for small mercies.

But it added that under the NHS "operating framework" unveiled yesterday, PCTs would be able to charge hospital trusts if they failed to stick to locally-defined targets to reduce C.diff rates.

Charges would also apply to trusts which breached an 18-week waiting time target, due to be implemented by the end of next year.

Because it is so very important that one shouldn't wait more than 18 weeks to have one's ongrowing toenail removed. And an 18-week wait for a breast cancer operation really isn't anything to complain about.

Why the fuck don't the government piss off meddling in the NHS and go and do something useful, like looking for those missing computer discs, or even better, trying to find their long-discarded socialist principles?