Hospital tribulations

 This post is a departure from my usual style of blog entries because it is a personal record of a series of unfortunate events about my passage through the New Zealand public health system during my treatment for prostate cancer.

The story started with the surgery to remove my prostrate in January 2018 at the Dunedin hospital. When sewing me back together the surgeon stitched the tube that drains the wound into me so securely that it required a further operation under general anaesthetic to remove the drain. Well, these things sometimes happen and I would have thought no more about it if only the surgeon had had the grace offer his apologies for a clear error.

I seemed to recover well until, in late 2020, my PSA readings began to rise and a consultation was scheduled with my urologist in November 2020. This was a different person to the one who had conducted the surgery and I will suppress their names so as not to embarrass them. The consultation was by telephone and lasted about 10 minutes. In principle I have no objection to consultations by telephone but they have the unfortunate effect of not leaving the patient to make notes conveniently. I have since learnt that a transcript is prepared by the consultant which contains useful information for the patient. It is a matter of policy not to use email to forward it to the patient and I did not receive a letter by regular mail. Instead a letter is sent to the patient's GP.

The main conclusion from this consultation was that I should go to Christchurch for a PET scan and the surgeon undertook to notify Christchurch Pacific Radiology for them to schedule an appointment. PET scans, by the way, are not funded by the public health system and I was fortunate to have some private insurance for the $3000 fee. I was told that I should hear something soon.

Nothing then happened for several weeks and in the second week of January I phoned the Urology department at Dunedin hospital. It was clear from the reaction that the consultant had not notified the radiologists and he had now gone on leave. A flurry of activity by a very competent administrator resulted in a PET scan appointment for me on 21 January.

Since the appointment was at 11.00am my wife and I rose at 4.15am that day to drive to Christchurch. It was a smooth journey until we reached Timaru some 250kms from Dunedin. Then we received a telephone call from Pacific Radiology to cancel the appointment as the radio-active pellet required had not been loaded onto the plane. This was a somewhat low psychological moment and we had to return to Dunedin with another appointment arranged for the following week.

The PET scan happened on 28 January. I was told that the results would be sent to my consultant and GP within a day or two, and I asked for a copy for myself.

Two weeks then passed and I heard nothing so made another phone call to the Urology department. They had received the results but would not give me any details. I was aware of a level of embarrassment when I said I had heard nothing from them - and they told me I would see the consultant on 8 March, and they would write to confirm (email confirmation again being impossible but, mirabile dictu, my GP would receive a letter).

A further week passed and still no letter so I made another phone call. More embarrassment and I was told the letter would be sent immediately.

The very next day I received a phone call to say that the consultant would actually be on leave on 8 March but they could offer me a phone consultation on 24 February. I agreed to this with some misgivings and after receiving assurances that all would be confirmed by letter. Possibly I was being alarmist but I had absolutely no idea about the seriousness of my condition and I was uneasy about having to react over the phone to some possibly challenging news.

The next day I received the confirmation that my 8 March consultation was arranged (the one that had been cancelled the previous day) but I recognised that this had most likely been sent before the cancellation.

I write this on 21 February and will update the saga as it continues to develop.

24 February: I waited patiently by the phone from 30 minutes before the appointment time of 1.40pm. No call. After an hour I called the Urology department to ask what was going on - and received the message that this was outside their business hours (mid-afternoon). Then I texted the Urology department, received no reply, and one hour and twenty minutes after the appointment time, still not having heard, had to leave. At 5.40pm the consultant called. The PET scan had been inconclusive and he recommended to just monitor the PSA levels and that he would write to my GP about the next PSA test.

Early memories of Peter Neumann

My friend and mentor Peter M. Neumann died on 18 December 2020. There have already been many tributes to him and fond memories recalled. Some of these are reported through the Queen's college memorial page to him. Here I recall some personal early memories that are maybe not so widely known.

I went up to Queen’s in October 1964 at the age of 18 and immediately met the 23 year old Peter Neumann. He became my mathematical mentor first as undergraduate tutor and then doctoral supervisor, and was easily the biggest influence on my development as a mathematician.

In the acknowledgements in my D. Phil. thesis (1970) I wrote “My chief debt is to my supervisor Dr. P. M. Neumann, whose interest and encouragement were unfailing. It is a pleasure to thank him for all his advice and to record my appreciation of his friendship.” I was to know this warm, courteous, witty and clever man for a further 50 years and we had many personal and mathematical interactions. Here I’d like to mention some earlier memories as his student which, looking back, were particularly formative for me..

It was common in the 1950’s and 1960’s for boys to be called by their surname so I was taken aback when Peter immediately addressed me as ‘Mike’ and invited me to call him ‘Peter’. It was also a surprise that he always greeted me (and my fellow tutees) warmly when we met going about Queen’s. But for all this familiarity he had high expectations of his students and spared no effort in his encouragement.

In my first long vacation he got all of us to write an essay on a topic chosen from a list of mathematical topics well beyond the standard curriculum. I remember one of these was ‘The art of M. C. Escher’ but the one I chose was on Hilbert’s problems. Peter gave me the background. David Hilbert, in a famous address to the 1900 International Congress of Mathematicians, had proposed 24 problems that, in his opinion, were the greatest mathematical challenges of the day. Some of these had been solved, some had faded into oblivion, and some were open. My essay was supposed to summarise the present status of these problems. Peter appreciated  that my mathematical knowledge would be inadequate to even understand some of these problems and offered help on request. I did indeed require help and the Oxford-Leeds correspondence that ensued gave me my first insights into the research mathematical literature and such tools as Mathematical Reviews. It also impressed on me how widely knowledgable Peter was.

I became increasingly aware of the formative role that Peter’s parents, Bernhard and Hanna, had played in Peter’s early life. He once told me, as a very young child, he had watched Bernhard prepare breakfast for the family, counting out the slices of toast in the mysterious sequence 1, 4, 9, 16, 25, …. He realised eventually that the rule must be that the differences increased as 3, 5, 7, 9, …. and was delighted when Bernhard revealed the sequence of squares rule.

While his parents were obviously key influences in Peter’s early mathematical life he became an independent mathematical thinker well before I met him, publishing his first single-authored paper while still an undergraduate. However he never forgot his debt to his parents and always spoke fondly of them. In 1969 he dedicated his splendid paper on BFC groups ‘to my father on his 60th birthday, with love’.

By the time I became his graduate student Peter had become the most versatile of a generation of young Oxford researchers in algebra. But he never talked down to his students or his colleagues and was willing to engage with them almost on demand. I remember in about 1969, when I had learnt the rudiments of the theory of group characters, hyperbolically proclaiming to him that this must be the neatest little topic in the whole of mathematics. I had some reason to hope that he might agree with this proposition since I had heard him lecture on William Burnside, one of the originators of character theory. It would have been easy for Peter to prick this pompous little bubble but, after some some careful thought, he offered an alternative opinion that the theory of complex variables was even neater. Since this theory is not even part of algebra it made me realise that taking an interest in areas outside my own would be a good habit to cultivate and that has stood me in good stead ever since.

I knew Peter in another role too. He and I were both members of the University folk-dancing society. Peter’s contribution to the dancing was in providing music on his violin. I do not know very much about Peter’s other musical activities but he was a superb asset to our folk-dancing many times being the only accompanist and (so it seemed) effortlessly sight-reading whatever we asked of him. Dancing and directing dancing has been an occasional activity of mine throughout my life and, on those occasions, I always think of Peter. His face would display a mixture of concentration and enjoyment, a combination which accompanied also so many of his mathematical activities.