I have to say. This is now my favourite pastime. I do very much enjoy creating denovo. But mending gives me immense pleasure. As well as repurposing and altering garments.

Sarabeth has a number of holes in this dress. I needed to put fabric behind some of them before carefully hand stitching them.

Helen asked me to repair a very worn out armpit using embroidery thread. Bobbin is very happy here!

This is a very old bag from Accessorize and there were a number of holes and worn out handles. I repaired the holes with multicoloured thread and replaced the handles completely.

Sarabeth had made this cardigan when younger but the neckline had gone so I crochet repaired it.

Sarabeth gave me some old fabric which she had inadvertently washed in the machine. I tried to repair it and turned it into some cushions for her.

Debby had an enormous T-shirt which she no longer wanted so I turned it into a cushion for her.

Am I the only one to get holes here in my trainers? I really do cut my toenails often! I used a wooden darning mushroom and made a feature using fuschia pink embroidery thread.

Nita had a new dress and she asked me to apply this large fabric image. Firstly I kept it in place using self-adhesive fabric tape and then sewed around the perimeter in purple.

When you have a done seven (favourite lower prime number) photographic books of your Barbies you need to do something with them. So I did. Thanks to everyone who took part! Aster la vista Barbie…..

The original Barbies – a first installation

Sarabeth was going to throw away these wooden trays. Debby suggested I might do something with them. I had already bought a Barbie sticker magazine and so I decorated the trays and the clock and put in the Barbies from my photographic project in the trays and one inside a deceased clock. They were the Barbies that went around Jaffa, Pez Barbie, Barbie in a furry coat and Goddess Barbie.

Barbies on a Barbie Pink Canvas

One of my neighbours left out an old broken canvas. Well three of them. One is not usable but the other two were. I painted the square one black and I made a giant dotty mandala painting (see ). The other I repaired and painted it “Barbie” pink. I used the 15 Barbies I had recently bought in England (Milton Keynes actually!) for a song. Everytime some came round they chose a Barbie and placed her in a unique pose on the board. I sewed them in with waxed cord for macrame.

Before the project started, I just placed them randmoly so I could see how many would fit. Although 15 is not a prime number is is the sum of three primes (3+5+7) and multiple of 2 primes (3×5).

Here are all the people involved in the project. They were allowed to refuse and Sigalit indeed did!

Imprisoned Barbies on a Cork Noticeboard

Debby found an old cork noticeboard. I had all these drawing pins – with small grey and white stones on the outside. So I decided, having decorated the corners and edges with textured fairy stickers, I would capture the four (3 pink and 1 purple) small Barbies with self striping sock yarn. These Barbies I bought on the Holloway Road, Archway, London.

My friends Christian and Maria gave me a load of Algerian sweets. I was already the third recipient. The sweets were incredibly sickly and all made of almond. We ate a few and then I gave most of them away. Christian suggested the Barbies would look better in this box rather than within the rather cheap aluminium frame. It took some doing to remove the frame without ruining the cork but I did it! Debby suggested rope as an internal frame. And Yasmeen suggested we call it “Trafficked Barbies” which really resonated with me. Thanks all! Christian since then said it is too narrow a title as it doesn’t allow the viewer independent thought. He suggested calling it Barbies tied up in an Algerian sweet box. Hmmmmmmmmmmmm

The Barbie photobooks

7 cloned barbies waltz around Jaffa

Barbie goes to Thessaloniki in a furry coat

Purple Mermaid Barbie goes to Limnisa

Pez Barbie (aka Princes Peach) goes to Sandbanks

Drinks Barbies interact with Medical Equipment

Busty, bindi Barbie hops around the outskirts of Jaipur

Goddess Barbie

Barbie in the Toilet

I found super cheap toilet brushes in my local tambour run by a lovely woman Shoshanna who keeps everything in small cardboard boxes. Each white plastic toilet brush and holder was 10 shekels (around £2). I covered mine in small Barbie stickers and varnished it.

I think this is enough “homage to Barbie” now!

Upcycling Clothes from the Street

I found all these clothes for free on the street. After washing them, I decided to apply the same design to all of them. Not that I can wear them all. Some are far too big and others are far too small!

Baby Vests

I love to make baby vests – especially not in white. Two Jaffa babies. To Lia from netball – a boy Gal Noah and to Noam a pilates teacher who lives in my road and once came for a sewing lesson – a girl Rom.

Fabric bowls

I made some fabric bowls using strips of purple fabric and Modge Podge glue. They hold tea lights.

A wedding present

My first wedding as an Israeli – friends I have met here. For their engagement I made them a bespoke challah cover with pink bougainvillea flowers (they still are pink 6 months on) and for their wedding I bought them a gift they could make together. The fabric vase for the lego flowers is from hand block printed fabric from the Anokhi museum in Amber Fort outside Jaipur covering a large plastic water bottle using modge podge glue. I made the card from spare fabric and an earring that had lost its mate that Sarabeth gave me.

Shadows of me and my dog – early morning

1st December 2024

Sunsets/Sunrises – various!

Who can ever beat a sunset. Even amazing on a plane!

In Jaffa one evening

Clouds in Jaffa

Whilst getting ready for paddle boarding I found some breast pads in the top I was going to borrow. I asked if I could remove them. Lindy Lu was happy for me to do this. I decided I would make nice bouncy kippot for her boys.

I was on my way one morning to give these kippot to Lindy Lu. And it felt just right to engage these 2 repurposed bra cup kippot into a fun photographic project around Jaffa. Enjoy!

I went to India – well just Jaipur, Bagru and Pushkar with Tanya. This was her first trip her but my 9th! I wanted to do another photography project and Tanya suggested bringing her childhood snoopy who had a load of different outfits. He had a lot of fun!

I have an interesting relationship with Karvol. It is no longer produced in the UK but I found some old capsules in my medicine cupboard. So, of course, I decided to imprison them. Using embroidery thread ranging from oranges and reds to browns and beiges. Following the project see my story (Carly has an ambiguous relationship with Karvol) to see how it all began.

Once framed

I brought some amazing box frames back with me from the UK. I used spray mount to attach the khadi paper I had used to the frame back. I also “imprisoned” the frame itself with the same coloured embroidery thread as I used for the implements used to open the Karvol capsules.

Carly has an ambiguous relationship with Karvol

Carly has an ambiguous relationship with all sorts of things and all manner of people. That is the nature of someone who is contrary at times. She is reminded of Mary, who might have really been called Mary-Mary, who sat on something in the garden and is not to be confused with Little Miss Muppet. As a paediatrician, Carly has had to prescribe a lot of medication for children over the years. This isn’t really an ambiguous relationship (Carly and prescribing). It is just what she and all her colleagues do. If she was a surgeon she could perform operations, and if she was a radiologist, she could take various images of patients. But she is a physician and really there isn’t much in the way of treatment that she can administer. There is talking and there are drugs. When she was a medical student, she would practise saying complicated drug names in front of a mirror. Even now she finds it difficult to remember the name of the new drug she wrote a guideline for in the last year (dextropropoxyphene). She has become a teensy bit lazy with learning this sort of name. It is so long and unwieldy. But it does work. The drug that is. Not the learning of the name. She tries hard not to overly prescribe medication. Most children’s ailments get better all by themselves. And it is important to heed guidelines about not prescribing antibiotics unnecessarily. This is because they are often used to treat viral infections and so, by definition, don’t work. But also, the bacteria get resistant to the drug and so when they are needed for a bacterial infection, they don’t actually work anymore. Unsurprisingly, there is pressure to resist prescribing unnecessary antibiotics and for some utterly bizarre reason this has been termed “antibiotic stewardship”. Who on earth coined this phrase was on a mission to mask understanding and make things unseemingly complicated. But Carly has taken advantage of this by getting involved in a virtual reality scenario to see which sorts of GPs are able to resist prescribing antibiotics for an elderly woman by her very demanding daughter. It had certainly been a fun project. And the results. More senior doctors were better than junior ones!

Carly has often been involved with prescribing projects. She helped launch an online teaching tool to encourage safer prescribing of medicines for children. This group was headed up by a colleague at a tertiary hospital. He was lovely and kind, but Carly always felt he was about to drop dead by self-explosion, as he looked like he was always about to blow a gasket. He seemed very highly strung which meant Carly had to really reign herself in when they were working on this project. She didn’t want to be responsible for him self-detonating because of her exuberant nature. 

Carly felt that the Medicines-for-Children’s website was really helpful and when she found out there was a restricted number of parent information leaflets on commonly used medicines, she set about resolving that. She involved a whole team of doctors in training. This was the easy part. The bureaucracy was the hard part! It always was when dealing with large organisations. In the end, many years later, this website covers far more drugs. Carly feels she has had to learn from her prescribing mistakes. Over the years she has made a number. Luckily no one came to any harm. Phew, muses Carly. And she has put her energies from feeling guilty about these prescribing misdemeanours to use. 

Early on in her career, a toddler came into the Emergency Department in extremis. The family only spoke French, so it was difficult to elicit a history. Essentially, the child had a blocked nose and the family had squirted Karvol up his nostrils causing him to struggle even more with his breathing. Things calmed down but Carly couldn’t really understand why they had done this. Then she looked at the packaging and realised that the photos showing how you were supposed to apply this decongestant liquid to the pillow could be misinterpreted. The pillow or handkerchief looked quite like a nose. And the fact they couldn’t understand the written information meant Carly now really did understand. So, she took it upon herself to contact the manufacturers. But they seemed very uninterested. Carly was rather bemused, but as one who is serendipitous by nature, instead she wrote it up as a journal article. Being very junior in her team, she sought help from a more experienced colleague. Let’s call her Kathleen Bumble. The initials (KB) are the same. Clearly there was going to be an issue, as she would normally just use the real ones!

In the end they wrote the case up as a letter for the Lancet. This is a very prestigious journal and Carly was so excited. The very start of her academic career. But when the letter was published it only had KB’s name on it. Carly was bemused and contacted the journal. They said that KB was unsure of how to spell Carly’s surname and so left it off. Normally they would contact all the authors but only in the States where this journal is published. Now Carly was actually furious. Totally, hopping mad. It was her work and her case, and she had merely asked for some help. After lots of phone calls and letters, as the internet and emails were only in their infancy then, eventually, Carly managed to sort this out. But it was a very important lesson. One she has NEVER, EVER forgotten. It must be really significant, as Carly so very rarely uses SHOUTY CAPITALS.

Since then, Carly has written many peer review papers and published abstracts. Right from the get-go, even if the project may fold and get nowhere, Carly ensures that the author list and order is clearly laid out. As her senior mentor and colleague, Ben Lloyd (of course this is his real name as this is complementary) said “the goal is always clarity”. Carly did a number of presentations on this Karvol case – she called it the Karvol Kid – and images of a child with a Stetson riding around in the Wild West, on a horse with packets of Karvol in his pockets would pop up in her head and she would smile quietly. She even made slides of her then niece Harriet who was a toddler taking the Karvol and putting it up her nose. Carly and Harriet’s mother had to keep warning her this was just for the camera, and she must never do it in real life. She never did and also became a doctor. Maybe this early, formative experience influenced her career choice.

Karvol was something Carly used often for her children when they were blocked up with colds. Of course, she put it on their pillows. Or on handkerchiefs. By this stage the packaging has miraculously changed, so it was clear you didn’t squirt it up your child’s nostrils. In fact, she still has some, mostly as a memento. The company no longer makes Karvol, as it folded in 2013. Carly dares not look at the expiry date on the packaging. She believes anyway that medicines probably just get a bit weaker over time. Actually, she couldn’t resist. She took a look at the packaging. It is now October 2023. The expiry date was March 2010. What’s 13 years between friends?

Later on in her training, Carly went to work at Guy’s Poisons Unit. This was a rather sideways move. She wanted to take a regular 9-5 job with no nights or weekends as she thought it might help her fertility treatment to work. Oh, and it did! She was there, on the phone lines, dealing with all sorts of queries. Both accidental and deliberate poisonings. And strangely it was also for pets. One man was upset that a mouse was getting into Fluffy, his rabbit’s hutch. So, he put down warfarin as poison for the mouse, not realising the deleterious effect it would have on Fluffy. Carly was flabbergasted that people really could be that dense! This job culminated in Carly presenting a series of paediatric accidental methadone overdoses at a national conference. And being pregnant. Double whammy!

When she was pregnant, Carly did yoga at the Active Birth Centre in North London. She was keen to have as natural a birth as possible and felt yoga might help her on that quest. They had one weekend for couples to explore birth with other pregnant women and their partners. Ades, her then husband, was excited to come along. The first exercise was to crawl around the floor, like a toddler, and collect an article from a newspaper or a magazine from the floor that seemed to be of interest. He chose one about having no sleep. He suggested to the group that he thought paracetamol would help and he would be keen to give this to his baby. Whenever he himself cannot sleep, this is what he takes. Carly tries to explain about the placebo effect, but he shrugs and says he doesn’t want to know as it works. Okey dokey, says Carly. That’s ok. But doling out Calpol to a baby who won’t sleep, didn’t really go down too well with this rather politically correct and baby-front-and-centred group. Carly and Ades decided this was a last resort strategy. Their kids are now adults. They usually had medicines when they needed them and seemed healthy and not currently addicted to any drugs. Phew! Job well done feels Carly as a mother.

Carly gives a number of talks about medicines at this stage in her career. She has several on her Dr Carly YouTube channel. One of her big bugbears is to promote shutting bathroom doors and keeping medicines in locked cabinets. Carly is perturbed by how many of her paediatric colleagues with young children don’t abide by these simple guidelines. But Carly cannot be too smug. When Boo was two, she went for a sleepover with her friend Johnny. One of them had a sore finger and so they went off exploring to find some analgesia. They found paracetamol tablets in the bathroom and popped them out of the packet. They told Carly that they had posted them down the bath plug hole but it wasn’t easy to see if this was true. Off they went to the Emergency Department to have levels checked. She should have believed them as these levels were indeed negative. But the treatment is simple, and the consequence of liver damage is severe. 

So, for all Carly’s expert knowledge about drugs and poisons, one must always be vigilant…..

October 2023

Prescribing – a Personal and Professional Journey (for the Annual European Conference on Assessment in Education in Holland 2017)

I like to teach about journeys – usually patient journeys (1). They are a good source of how to teach about professionalism. And this is my personal journey. My prescribing journey. I realise it defines who I am and how I practise. I prescribed Valproate for constipation (instead of Docusate) – whoops picked up by pharmacy – we are fallible. My first publication was about Karvol. It appeared in The Lancet without my name initially as the senior colleague helping ‘forget’ how to spell Fertleman (2).

I am hyper-vigilant about author recognition and order because of this experience. I was involved with a number of studies about medications. One to speed-up pain relief in sickle cell disease (3) and another about paediatric methadone toxicity (4). These were simple studies for a jobbing clinician. Then, as a lecturer, I led undergraduate
prescribing assessments (UCL) where they produced a drug poster. But it didn’t really teach them about therapeutics or prescribing. Rather how to make posters! So I led an award-winning multidisciplinary team that produced an innovative prescribing teaching programme using drug charts and a summative OSCE. This developed further into integrated teaching combining medical and pharmacy students who held preconceived views of each other. This joint teaching dispelled such myths (5). This led to provision of training materials nationally to enhance paediatric prescribing skills and assessment (6). As prescribing became electronic we delivered bespoke sessions to students before they qualified (7). Recently I delivered a quality improvement project to substantially increase the number of drugs listed (medicinesforchildren) (8). For the paediatric exit assessment I have co-written most of the extremely complicated and realistic prescribing scenarios. This formative assessment compels candidates to remediate against poor outcomes before completing training. As candidates perform the prescribing station poorly, I have decommissioned a live question with concomitant explanations to incentivise future trainees to improve their prescribing.

References

1. Chloe Macaulay, Polly Hirons, Caroline Fertleman. Learning from Paediatric Patient Journeys:
   What Children and Their Families Can Tell Us. CRC press (2016).
2. Blake, K. D., Fertleman, C. R., & Meates, M. A. (1993). Dangers of common cold treatments in children.
   Lancet, 341(8845), 640.
3. Fertleman, C. R., Gallagher, A., & Rossiter, M. A. (1997). Evaluation of fast track admission policy for children with sickle cell crises: questionnaire survey of parents’ preferences. BMJ, 315(7109), 650.
4. Fertleman, C. R., Eastwood, J. A., & Dawling, S. (1999). Methadone poisoning in children. Proceedings of the Royal College of Paediatrics & Child Health Spring Meeting. In Archives of Disease in Childhood Vol. 80 S1 (pp. A6).
5. Birley, K. J., Moreiras, J., Fertleman, C. R., & Bates, I. (2014). Integrated pharmacy and medical student practical prescribing teaching. Medical Education, 48(5), 530-531.
6. www.rcpch.ac.uk/training-examinations-professional-development/quality-training/paediatric-prescribing-tool/paediatr
7. www.researchgate.net/profile/David_Gamble4/publication/303518448_Teaching_prescribing_to_MBBS_medical_students_using_an_electronic_prescribing_computer_system/links/5745d01808aea45ee8560dbf.pdf?origin=publication_list
8. www.medicinesforchildren.org.uk

This has been the inspiration behind three recent projects. Cosmetic imprisonment, Karvol imprisonment and imprisoned ceramic Israels. I started this when I was on my sabbatical in India just before the Covid-19 pandemic. Here is a short summary with one or two images from each of my earlier imprisonment projects.

1 Goan Sewn Postcards

There was a supermarket near where Betsy (my daughter who came to visit) and I were staying in Mandrem, North Goa. We bought a few bits and bobs there and really liked some large postcards. They were modern painted versions of Hindu gods and other Indian icons – cows and tuk tuks. Betsy kept some but I don’t think she ever sent them. They are nice just to pin up on the wall.

I cut most of mine up and sewed them onto nice thick white card. I sat in a comfy sofa looking over the river where we could kayak in Olaulim Backyards taking a break from fighting with the manual sewing machine that I was using to make my three fabric books. I liked the idea of sewing on the cards using some interesting yarns like Tencel from my stash I had stocked up from the Finsbury Park iconic Handweavers Studio and brought out with me to India. I also enjoy cutting things out and I could edge the five of these montages with tapes going in different directions.

2 Large Andeshe Plant Montages

Every morning in Andeshe after my yoga (ok very short – 10 minutes using the Yoga Studio App) I ran with Johnny the adolescent dog there. We ran up and down the road and returned in time for my breakfast of an oat, date and banana dairy smoothie. Collecting interesting seed pods on the way is important as a way of not having to run (!) and also to incarcerate/imprison within some Tencel yarn I have brought with me in a variety of purple hues. I was inspired to “catch” things on paper by sewing them on when I did my postcard series in Goa by the encouragement given to me by a fellow guest Lynne Lawton. I love the juxtaposition of a natural plant in India, encased in a criss cross of purple thread with an exquisite piece of lace at the bottom signifying all the loudness, richness and colour that is truly India.

3 Imprisoned Purple Cars with an Escape Route.

I made a series of imprisoned/encased purple cars with escape routes. I imprisoned all the cars and they each had a different escape route with different threads/yarns and thread for making candles burn. I still have four of them with me on my wall in my bedroom in Jaffa, Israel today.

4 Large Dyed Yarn Enclosed Montages

I dyed cotton threads from my yoga mat made from water hyacinth plant fibre and imprisoned them on a piece of A3 card. I did a further four more including some from dyed candle wicks, some furry fluffy yarn which was lilac and I dyed purple. This ended up being spiky and not at all soft and furry! Finally, I incarcerated some balloons from my pool project which all burst pretty early on in the process. One morning, when on a run with Johnny I found a bit of balloon on the roadside at the end of my run. I could tell you it had blown for miles but I do short runs – in fact just like I do short yoga sessions of either 10 or 15 minutes.

The bottom edge lace is from Samrat Craft Megastore which is a treasure trove of all sorts of wonderful haberdashery and other items. And with the usual huge number of staff members. Hilarious to go in there and be served by about 20 young men. So delightful.

5 Hampi Montages Large

I had some new A3 thick white watercolour paper and I had found a formula of sewing on objects that I found satisfying to undertake whilst listening to podcasts. I was enjoying some by Stephen Fry who is witty and clear. A joy to listen to!

The seven plastic flowers are for an aquarium and were actually quite difficult to sew on as they were 3D and wouldn’t really behave all that well! I loved imprisoning the feather/s and sewing in the pretty corsage flowers I had previously dyed purple and mauve. The caterpillar was fun too! The series should fit my rules. And be a prime number but I had six ideas and six pieces of card. And what are rules if not to be broken!

I finished them off with the lovely spiral stamps using stamp ink which stains everything! But does stamp nicely. Here I used spiral trails too.

This blog is a look at all my imprisoning from my sabbatical in India. Many of these pieces I still have today.

Lucy told me about a 10 shekel (£2)workshop over Succoth (harvest festival in October) in one of the container houses in the Jaffa port area. It was held in an indoor sukkah next to my very favourite cafe (Cafe Blue). I think it was for children but never mind. You use 3 D printed plastic peel cutters, thread through smaller pieces and join larger pieces a bit like a jigsaw. I loved the recycling nature and once home made one from a lime, one from a lemon and then another 11 from oranges. To the point that I had to juice them to enable me to have enough peel to play with! I bought one 3 D printed plastic cutter and then found small ones in my fimo bead making box and bought some more larger ones at Tiger in the Dizengoff centre. You can dry them under books but now the weather is cooler that takes an age, so I put them under a load of heavy plates and dried them in the oven set at a low temperature. Talulah found this stick on which I hung alternating brass and chrome hooks.

My flight returning from Limoges landed in Leeds/Bradford international and so I used the opportunity to head up to stay with Sandra in Berwick-upon-Tweed. Actually she technically lives in Tweedmouth – but it is still England! It happened to be the 400th anniversary of Berwick Bridge and there all sorts of celebrations. Including a brass band (English) and a highland band (Scottish) as Berwick has changed hands numerous times.

I signed up first for a drawing workshop using brick dust. My efforts aren’t even valiant. They are just plain rubbish! But I went onto a paper making workshop and I loved this. I have used various buttons from a yarn shop on Bridge Street (very nearby the paper shop) to decorate the paper. I have given them to Ollie, Breenies, Harry, Toby, Betsy, Lucy, Tracy, Lev, Michael, Sarah & Lizzy, and Catherine.

Paper making in Jaffa

I had an afternoon in Jaffa paper making with Galina. I had SUCH fun.

Next I am going to explore imprinting paw prints and baby foot prints. Actually I did try and it didn’t work

The process to make handmade paper and the finished, still wet, hand made papers

Before the varnish. The green lime peel didn’t work at all for me so it was cannibalised to strengthen the large piece with bougainvillea flowers.

This time I put in lots of natural products including popcorn, orange peel, rice, sesame seeds, leaves and flowers. I think helped seal some of these papers with Modge Podge clear varnish – gloss. This has made the papers quite heavy.

I had four hours to kill in Dubai airport. And for me this is a great opportunity. I had decided I would take an small orange Ganesh I had brought from a toy shop in Pushkar and place him in as many places inside the airport as possible. Just like LHR stands for London Heathrow, DBX is Dubai’s airport acronym. I was in Dubai just before Diwali and 20% of the population is from India, and most of them are Hindu.