My creative journey on my sabbatical in India and beyond
With Debby and Luna
We saw work that I really liked by the following artists; Ziva Amir, Neora Washavasky, Yehudit Katz, Nora Frenkel, Shula Litan, Mirjam Bruck-Cohen, Sima Konson, Kathie Halfin, Ovadia Alkara, Yosl Bergner, Anna Tikko, Marcel Janco, Fatima Abu Roomi. A big thanks to Evi for arranging.
Mirit Weinstock is an Israeli artist and designer currently based in Japan. Her upcoming exhibition at MUZA, “MY Life in Flowers,” is her first museum exhibition in Israel, and will feature recent works created over the past five years.
Weinstock’s work is concerned with a quest for metaphors capturing humanity’s existential state, which changes as frequently as the surrounding natural world. She forges connections between the worlds of craft and contemporary art, while combining a range of mediums and materials – ceramics, paper, metal and natural vegetation.
The series of works featured in the exhibition will includes moments from her life, as sculpted with seasonal plants and flowers. Her works express the artist’s emotional and personal mood as it resonates in nature, and are concerned with the themes of time and duration. In this manner, Weinstock explores the dialogue between nature, time, space, the cyclical character of life, sculptural actions and drawing. The exhibition space serves as a vessel into which she introduces changing natural life cycles. Her works, which combine living plants that change and perish over time, present viewers to the exhibition with aesthetic realms in the process of withering.
Carly is super worried that this short story will turn into a rant. Not just any old rant. But an overwhelming, oversized, crushing, devastating tirade. That is how she feels about the term and the pandemic, with which it is synonymous. She has made it very clear, although there may have been some short term and unexpected benefits, Carly, as an extrovert who needs other people around to keep her mojo up, has told everyone, that come the next pandemic, she is checking out. Enough is enough, she assures anyone who will listen. She understands that all humans are different, and she may be on the extrovert extreme, but really. People actually enjoyed being kept indoors and told what to do? 24/7. For months. The messaging wasn’t even subliminal. It was out there. YOU WILL DO THIS. AND THAT. AND NOT THIS OR THAT. Carly is very much against capitals as they are shouty and reduce reading rate by up to 50%. But she needs to get her exasperatedness off her chest. Yes. There is now a wiggly red line under that last made-up word. But Carly sometimes needs license to invent things that can summarise how she feels.
So back to the term Social Distancing. Who decided to call it that name? It has to be the worst. It isn’t about distancing socially at all. It is clearly about physical distancing. How could the person who coined the phrase get it so totally wrong? Carly is flummoxed. She presumes it has to be a man. She has absolutely no evidence whatsoever for this, but it feels correct. Would a woman really not understand the huge error? The last thing we need in this pandemic is to be even more distanced from each other. Carly knows it is easy with hindsight to be clear about this. At the beginning we didn’t know if the virus spread on fomites or on other surfaces. But looking at the way most viruses spread, particularly coronaviruses, then we could predict that this wasn’t the case. Common things are common. Viruses spread from one person to another. So yes, in the beginning physical distancing did have a part. And then masks. More on that later. Carly, unsurprisingly, has a view on masks too! Carly is also clear that nomenclature is hugely important. It is absolutely tied to feelings and emotions. Like social distancing. Carly is pretty sure the reader/listener can feel this very obviously. It isn’t just a term with no resonance. Carly feels she has so far made her case very loud and clear.
And it was pretty bad at the beginning. All this not knowing and loads of people dying. But do pandemics come along for a reason? To reduce the population? We all know there are probably too many people in the world. But as always, the rich countries have the resources to keep their populations alive. We saw this with the uneven distribution of the vaccine. Carly shakes her head in dismay.
Hmmmmmmmmmmmmmmmmmmm. Carly remains upset, even angry. That is no great revelation. Carly does spend a lot of time bouncing between these two primal emotions. Carly was also very relieved that her sabbatical finished only a few weeks before lockdown in the UK was announced. Carly remembers a dream she had on her sabbatical. She had it interpreted by a holy man in India who explained that all her colleagues didn’t really value her, and she should stay in India for longer. She realised that for every five completed years in the NHS you were allowed a three-month career break. And although she told everyone she was on a sabbatical that wasn’t technically true. Sabbaticals are paid for. And this one wasn’t! Anyway. Career break or sabbatical. It is only semantics. Carly had a most marvellous time. It was only for four months. She did the mathematics. 15 years of no break of slaving away for the NHS. She was entitled to a total of nine months. Another five to take. So, she wrote in all seriousness, to her colleagues about her dream, the guru and informed them she was staying for another five months. She did apologise that she was indeed mucking up the Easter rota. But c’est la vie. However, it was all a complete fib. Interestingly, they all believed her apart from her colleague Neeta. She knew it was all a load of tosh! And in the end, they were all around for Easter as the world had shut down. Everyone was off to destination nowhere. So much for sadhus and gurus and dreams. But it did make everyone giggle. Could they really believe she would play a stunt like that? And anyway, there was the slight issue of the money. India is cheap but not free. And Carly likes to live at a certain level. Not sleeping in a hostel and eating once a day. No Carly has standards and her money had actually almost run out!
Back to social distancing and the pandemic. By nature, Carly is sceptical. At the very beginning of lockdown, she really couldn’t see what all the fuss was about. Then she met with one of her geriatrician colleagues who was miserable and overwhelmed. Finally, the penny dropped, and she did understand. This was way back at the beginning. Hospitals didn’t really know what they were doing, how to triage patients, manage them or their relatives, as well as running out of oxygen. They had so many deaths it felt surreal to Carly. She is a paediatrician and wasn’t really sure how to help. Not at the beginning. She just stood there dumbfounded. And this, for Carly, is a very unusual state of being. Carly almost invariably has a plan. And if that plan doesn’t work out, she is flexible enough to think outside of the box and moderate or completely change her strategy. In the meantime, Carly thinks about the noise. Or rather lack of noise. Perhaps that could help with a new direction for her.
A lot has been said about the birds. That at the beginning there was so little traffic you could hear them. For Carly, having few cars on the road meant she could zoom out on her bike almost without looking for any other vehicles to run her over. This felt very good indeed. Her brother once said that if we banned all private cars, that would go some way towards people getting fitter and losing weight. Surely this was a good thing? And Carly loved the fact that she owned the roads. It was her and her trusty bike. Oh, and the birds. Carly isn’t really a maven about birds. She can recognise the hammering of the woodpecker, the cooing of pigeons and then the rest just falls into the general tweeting category. But she is off. To go to work. To do what? Well, be at work. It gave her a purpose when the rest of the world seemed to have fallen off its perch. It was rather tricky though as very few independent coffee establishments were open. And when she got to work, there wasn’t much to do. She couldn’t make oxygen. Maybe once upon a time she could theoretically work out how to make oxygen. But this wasn’t a real starter for the moment. She did go to the adult wards to help patients contact their families. And she was able to break bad news. One of the serious advantages of having grey hair. People took you seriously on the one hand. But being grey meant it could take up dye much more readily. So, would you take a grey-haired paediatrician with smatterings purple/pink/red seriously? They seemed to, thought Carly, who was glad to be of service. Most of the general public think she works with feet and not children anyway.
Back to the title though. Of course, Carly has an opinion on the term social distancing. The wrong term and so what is not at all needed in a pandemic. Then she thinks of those totally annoying stickers blaring it out all the time. And go this way. Not that way. Pick you right nostril only. Sneeze into a red handkerchief only. It almost made 1984 (the book by George Orwell, not the actual year when Carly was 19 – oh yes second favourite prime number – yippee!) seem gentle and forgiving. This pandemic really played into the hands of those with control issues. The rule makers and followers. One-way systems. Grrrrrrr. The worst was in a restaurant trying to find a toilet. You might have to go around several times before getting the right turn off. In the meantime, accidents could have happened.
She is so very much over this. We need to hug everyone, as much as possible. And no masks. Really. How can we be ourselves if we cannot see what people are saying? You only smile a bit with your eyes. It is mostly with your face! Carly smiles to herself. It is an inward smile. No eye involvement and no face contortions. Maybe they will give you all over cloth visors for the next pandemic?
I have been making beaded jewellery for many years. Here are pieces I have made.
I ran a workshop for Abby (19) and her mother Natalie (mid 50s) who had inspired me to get a second piercing for my ears. I thought it would be fun to make chains that connected the 2 earrings. Abby used hoops and Natalie studs. Mine didn’t work as looped chains as one of the chains (the braided one) didn’t hang correctly. No matter – I just made a simple hanging stud earrings (spot the difference!)
Actually I really don’t like fiddling around with studs so I changed them to hoops!
I wanted to make some rainbow earrings for the most accepting of LGBT cities – Tel Aviv. I measured 7 equal lengths of small pink, red, orange, yellow, green, blue and purple chains and had the fiddly task of popping them into the ends – a type of ball crimp. Then I had to thread them onto a single ring and onto the earrings. At one end the purple was long and the pink short and vice versa for the other earring. Hey presto!
Tracey was keen to make a necklace and she came over and chose beads from my collection. She used a strong black polyester thread that I tied into 6 alternating direction half-hitch knots at the end. It was large enough to fit over her head and wonderful hair. She chose only pearls and turquoise beads.
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!
And then she found a jumper with a hole in it. Perfect colour match already in stash!
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.
This coat from Winnie Magee is so very old and keeps getting holes. I have mended it several times. There are a mixture of patches, coarse embroidery and blanket stitch.
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…..
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.
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!
Yasmeen gave me an old stretchy rainbow top and I made a dress for Barbie with a train that she could catch up in her hand. Meanwhile Galina gave me two metal cages that could be used for an old-fashioned Victoria Barbie. I spray-painted one gold as well as beads and disco balls and a green cat. I used some steam punk discs and put her in pink trainers. She has monochrome bells on her right hand and a rainbow assortment on her left hand. For her hair I used lots of hair ties from Good Pharm. Lev gave her the name Disco Barbie.
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
I went to a painting evening at The Tel Aviv Art Studio at 42 Frug. I sat next to some lovely young people who were from France and Germany and to include me changed to speak English. Then Kylie came and sat next to me and painted a really beautiful red flower. For relaxation she paints bottles at home and lives between Haifa and Acre. The wine was flowing and the food amazing (cheese, crackers, roasted veggies, loads of fresh fruit and brownies.
We had a 30 cm x 40 cm canvas and were copying a Yayoi Kusama hummingbird with a red flower. To overcome her childhood trauma Yayoi paints with lots of dots.
I like spirals so included them in my painting. As we used gauche paints (liquidy and quick drying) I experimented by put lots of paint on top of other colours and ended up with 5 marbled circles (on top of spirals).
My hummingbird was not great so when I returned home with my canvas I applied real feathers and puff paint for his crown. I embellished her beak with a snappy and sharp and scary hair-clip beak. I didn’t have any spare Barbies to use for this piece so suggested Barbie’s exit from the clutches of the hummingbird’s beak with a pair of pink Barbie shoes.
This time I made the saree for Barbie having followed a YouTube video. She has an orange Ganesh (who went round Dubai airport at the time of the Hindu festival of Diwali) and four instrument playing Ganeshs at her feet. I painted the background using stencils with felt tip pens and watercolours.
I went on a course to learn how to do punch needle work. It appears I do not have the patience for this and in fact do not really like the end product. The teacher was wonderful and the rest of the women there loved what they were doing but I went off piste. Firstly I used my own yarn (alpaca as opposed to the provided acrylic which was better in fact!), secondly I “imprisoned” some fleece to variable degrees of sucess and thirdly I thought I would use this new technique on Barbie. I had brought with me a canvas painted Barbie pink and a Barbie. I had fun “imprisoning” her using the punch needle. I redid it at home with firstly dressing her in a velvet back shift, using black yarn for her boots, rainbow fleece with pink needle punched yarn and a rainbow rubber band necklace.
When out and about recently I found some coloured glue gun glue. Plain and glittered. I thought it might be a good idea to see if I could drape a small Barbie on a piece of A4 Indian Khadi paper with rainbow colours. This meant chopping up 1cm pieces of glue, arranging them in rainbow order and feeding them into the glue gun. I didn’t see much yellow and the pink was plentiful so I gave her pink sleeves and shoes. She is now sitting pretty in The Magic Tea Box that Jean gave me decades ago. She needs a friend on the other side. Probably using the glittery glue sticks.
One of many Barbies found by Jennifer had a “Femme and Fierce” dress. I painted a piece of wood I found a pale pink and sawed off the small wooden dowels and put on a chain to hang it up. With some whisks, horses also provided by Jennifer on her travels to collect Barbies for me as well as a ribbon I found, unknotted, washed and ironed, as well as 16 tubes of rainbow coloured beads I made a slalom run.
Then I realised she would be rather cold so I knitted her leggins, wristies and a headband. I gave her some pink sticks to help ski properly.
I wanted to represent Barbie as Mayor of London instead of Dick. I work at the Whittington Hospital where Dick turned around in Archway to return to London. He had his red gingham bundle on a stick and his black cat. I made this Barbie with a lacey white cotton top, trousers from an old sock, stockings from a black hair tie and white laces. Her velvet black hat had a black feather too. She is worn out and sitting down. I made a street scene by covering a piece of foam I found ont he street with a stiff grey fabric and poured loads of stones and concrete lumps over it and sealed it with PVA glue.
I have to admit it. I just totally love “Love is Blind” and having been watching the American version since the beginning. All 8 seasons. And the one UK one. So, I know the score. Here is the blurb modified from Wikipedia.
The series follows an equal number of men and women hoping to find love. For 10 days, the men and women date each other in purpose-built “pods”, small rooms where they can talk to each other by speaker but not see each other, except through a blue translucent barrier that allows no visual detail. The cast members are initially paired in a speed-dating format but later can choose to have longer dates. The daters may extend a marriage proposal whenever they feel ready. A couple meets face-to-face only after a marriage proposal is accepted. The engaged couples then head to a couples’ retreat at a resort for one week. During this trip, they spend time getting to know each other and have their first opportunity to be physically intimate. They also meet the other couples participating in the experiment. During this period, they are not connected to anyone in the outside world. After the couples’ retreat, the engaged couples move to an apartment complex in the city where they live for the final three weeks of the experiment. They are reunited with their devices as well as family and friends. At the apartments, they meet their partners’ friends and families and learn more about their partners’ lives, exploring issues such as finances, recreation, personal habits, and their ultimate primary residence. They also plan weddings to be held at the end of four weeks. During this wedding planning period, the women go wedding dress shopping and the men go suit shopping together, bringing a few friends or family members along. They have joint hen and stag nights and at the altar, each participant decides whether to say, “I do” and get legally married. Mostly one of the couples (often the women) say no!
When I made a Barbie what I thought would be a fairy dress, it looked more like a wedding gown. And I had a Ken. I used organza for a puffy skirt to fit over a tight fitting shift dress made from a stretchy white top with separate sleeves. And an organza veil. Ken had big stomping boots, a vest top and cropped trousers made out of lone sock. Both sported a Magen David necklace. I made the chuppah out of a shoe box base, cut up a bamboo cane into 4 pieces with my small jig-saw and covered them with pretty paper tape from Podgorica. I glued them in place with my glue gun. I put the Ken and Barbie on top of a pretty pink yo-yo but they kept wobbling about. What better than to put them in glasses reminiscent of breaking the glass – a hugely iconic part of a jewish wedding. I used a sheet and painted stripes to make a tallit for them to get married under. I used 8 cords in each corner and three small colourful elastic bands in lieu of knots.
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 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!
I ran a private workshop for Vanessa and she printed two tops and added on puff paint.
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.
I made some fabric bowls using strips of purple fabric and Modge Podge glue. They hold tea lights.
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.
December 2024
Who can ever beat a sunset. Even amazing on a plane!
In Jaffa one evening
Sunrise by Sde Dov.
Another windy and wet day at the end of 2024.
Grass in Park Midron – so very variable!
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.
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 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
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.
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