David (see the posting on October 30) came up to me last night at our Cardiac Rehab. session and said that a week ago when he was in town, he suddenly realised that he was getting chest pains, so he parked his car and walked to our city centre NHS Walk-in . They took his condition very seriously and he was whisked off to hospital where he had a series of tests and was kept under their care overnight.

The report the next morning from a consultant said he had had a minor heart attack and would be put on new medication. Very confident about the care received over the years by his G.P.,David insisted that nothing should be prescribed and certainly nothing administered without reference to his local doctor, and this was agreed. Telling the story last night, he said ‘I’m living on borrowed time anyway’. Two reflections about this.

First, older people should take warning signs seriously and act accordingly. That’s better said than done. If you have spent much of your life as a natural unforced and highly skilled hypochondriac like me, identifying what may have flared up as a genuine medical problem isn’t easy.

(In my case fearing that something odd is happening to your health is complicated by having had so many false alarms in the past!) But at this end of our life-span one should take the risk of being mistaken. As David did. So there he was again last night, struggling to do as much of the exercising as he could manage, whereas if he hadn’t responded to that sudden chest pain, today he might be dead.

Second, those of us who are subject to the inconveniences of old age, need to speak up for ourselves sometimes, even – especially – when we come up against medical professionals. I like this idea of telling a hospital consultant that she/he should only make a prescription when he/she has first made contact with the general practitioner who knows all about you (or should do).

The medical profession in the U.K. – under-funded, always pressurised and under scrutiny by so many interests – is often unfairly criticised. It is serviced by human beings and therefore is not perfect.

But medics need to be reminded sometimes that the people they are dealing with are human beings too; often exceedingly vulnerable ones, who can so easily be bullied and patronised. And silenced. But not David.

B.R.