vastly enjoyable

Hay fever or a cold? I don't know. Perhaps medication-induced rebound nasal congestion - an ironic condition.

Repeat vaginal repair and unexpected enterocoele (vault hernia). That never happens with my repairs because Eddie Lillie taught me to plicate the Uterosacral Ligaments after the hysterectomy. They have a high rate of repair failure once they happen though. I suture it firmly to the sacrospinous ligament after closing the hernia sac then suture my posterior wall locking stitch with the remaining the end of thread at each throw, effectively running a double suture line down the wall to the introitus, then the usual levator plication (yes, I know some people think it is more painful, and unnecessary, but I disagree) and a subcuticular perineal closure. This is followed by an intravaginal TVT sling for proven urinary stress incontinence - as loose as possible to minimize post-op retention, always worse when there is co-existing urge incontinence. She is prepared for every eventuality including self- catheterization if necessary since all other treatments have failed. In my experience, in these circumstances the surgery always works perfectly just to make you feel stupid for not doing it a year earlier. I both love and fear surgery, so satisfying most of the time but so disappointing when there are complications. For that matter I also love and fear obstetrics......and my wife a little bit.....and getting older.
Actually, I love getting older, always have(and my wife of course). When I was younger it meant I was ever closer to the day I was in charge of my own life. Later it meant I would finish my training, then improve my skills and then gain respect for my wisdom. It is certainly no disadvantage to have grey hair in my profession though I have seen some eminent-looking doctors who had long passed their best. Later still, getting older means I will be able to retire and learn to speak French and play tennis properly at last.

Just finished another book, about a fat man who loses weight, meets different people, learns lessons and gets his life in order. In a critical mood I consider many of the books I have read recently. They usually come highly recommended and have an interesting premise; they are usually skillful at leading the reader on, maintaining the tension, leading to an inevitable revelation or climax, but they struggle to find a satisfactory conclusion that doesn't sound like a variation of they all lived happily ever after. We don't believe in fairy tales but don't want to learn that Cinderella got older and developed prolapse and urinary incontinence either. Perhaps the solution is to have a glorious death at the climactic end of the novel - exhilarating , and without the depressing gradual decline....although we generally do not prefer that in real life.

So, now I am off for the weekend. As always, I don't know what to do with myself. The children aren't here and I am bored with restaurants and shopping.  Furthermore, while I support them in principle, in reality I do not like live shows. Well, there are exceptions, but live shows ask for my commitment and I just want passive entertainment. Shameful, I know. When I think about it I find that even passive entertainment has lost its attraction. I rarely watch the television now. I don't even know how to use the device on which the children load all of their pirated films and TV shows from their laptop computers to play on television. I'm just not that interested. I don't drink much alcohol any more. Bottles of wine accumulate beneath the stairs. I decide to try one and watch a TV show with my wife.

She doesn't drink so that she doesn't get a migraine, but I open a bottle anyway. Pinot noir 2005. The show is all right, a fantasy series from 1989, but the wine does not induce any conversation and I feel tired. The show ends. My wife goes to bed. My bladder is full and I don't want to disturb her so I step out the back door, beneath the small iron-roofed porch. I discover that there is a constant warm gentle rain falling evocatively on the corrugated iron above, and the garden and courtyard all round. I stand at the edge of the falling raindrops, swaying from the effect of the wine, unzip my fly and make my own small contribution to the warm precipitation. That is as good an ending as any.