(written 15th January, added later because I am away)

In Poland, at Opole University, in the south, my visiting professorship again. It is exam time, so there is the air of anxiety and tension characteristic of any university when the pressure is on and the nights are noticeably less rowdy. I sign lots of record books of students, some of whom I recognise, who claim to have come to my talks in the autumn.

To the PhD students, I do a talk on assisted dying; this sparks a spirited debate. One candidate (as PhD students are known) works in a hospital that cares for children with learning and other major disabilities, and feels strongly that as medicine moves on many things become possible. My aim here is to get a differentiated view about what many people see as euthanasia; for example the medical decision to give pain relief that is adequate even though, being strong enough, it might shorten life. There is appreciation of one of the cases of a young man with extreme disability who nevertheless expressed great pleasure in the things he is able to do, living until the moment he dies. Another candidate talks about not being able to say goodbye to her grandfather as a child, because he was in too much distressing pain, and there is discussion about the importance of good pain relief. The area has home palliative care services and has a hospice half-built, which has run out of money. I emphasise how much can be done with home care.

It’s always possible to wonder whether St Christopher’s would have been an in-patient unit when it was built in the 1960s if home care had been more accepted at the time. I think it would; it’s easier to demonstrate a new idea in a place rather than in a diffuse service, and home care followed on immediately afterwards. I think also that some beds a vital as a fallback, particularly where St Christopher’s is, with all the single person households and small apartments, where it’s very hard to provide adequately for people with major disabilities or at risk of, for example, heavy bleeding.

I follow up with the PhD students with a discussion of bringing older and younger people together using the DVD about the St Christopher’s school and youth project (see post 12/12/08), emphasising how careful the planning has to be to get community projects like this to produce useful outcomes.

Pics of the St Christopher’s building works, in solidarity with colleagues who are working in difficult conditions, so that things can be better in the future. Final tarmacing, showing the beginnings of change to the entrance.