Forced down your throat

For once, this isn't about the Welsh language, which is the usual context for this expression - as in, "I've got nothing against the Welsh language so long as it is not forced down my throat" (which being interpreted means, roughly, "so long as nobody speaks it in public or makes me see it on signs). I have something more literal in mind here.

Once only during my long stay in hospital did I see an agency nurse load a large spoon with a lot of food (veg, gravy and meat) and try to cram it all into the mouth of an elderly patient who had tried to decline it. Some of my shock must have shown on my face, as the nurse said, "well, what am I supposed to do? She is losing weight!" Two things were bothering me (apart from the fact that I thought it unkind and undignified): if she had done it to me I might very well have choked; and, where did the memory of our school dining hall suddenly spring from? I genuinely can't recall anyone doing this to me there, but perhaps they did and I had suppressed the memory?

Looking back, the generation born in the 1920s and 1930s has quite a lot to answer for in terms of coercion around food. By the time I reached primary school in the mid 1960s food was fairly plentiful (but not always very nice). Rationing had long since finished. This was hard for those who had lived through the war to adjust to, for to them it was a recent event, while to us it was a distant story about a time before we were born. Didn't they love trying to make us all feel guilty, though! "We would have been very grateful for that", "That's a whole week's ration of meat for a family you've got there", and, in a desperate attempt to get more up to date perhaps, "starving children in Africa would be glad of that". Hardly surprising that the whole atmosphere around eating was a minefield. Enjoyment was never expected: just non-stop controlling behaviour and guilt trips. (I don't pretend to understand the issues behind eating disorders, which seemed to burst out in the 1980s, but I can't imagine that all this would have helped).

If we had been genuinely hungry we would, of course, have eaten the food. The area where my school was was not wealthy, and the pupils were from various backgrounds, but most were certainly not going without at home.

The food really was horrible. We were not allowed to bring sandwiches, or go home for lunch, or ask for smaller helpings. There was no choice. We were usually not allowed to leave anything. (One girl in my year had a number of food allergies and was allowed to bring her own food from home. How we envied her! But another girl I knew actually had to leave mainstream education and go to a special boarding school for the same reason, incredibly.) Everyone on a table had to have finished before they were allowed to go, so a child could be made unpopular with the others who were deprived of their time outside if they made a stand.

Many people record similar experiences of school dinners. Here's a brief list of the worst:

Cabbage boiled for a long time (my memory says all morning, but that can't be right, surely? anyway it was tasteless and smelly).
All the vegetables overdone.
Cheap meat full of large stringy veins.
Corned beef hash! Bleurgh
Toxic dark gravy poured over all of it.
Endless tasteless piles of mashed potato with everything.
The puddings!
Sago. Tapioca.
Lumpy pink blancmange. Pink custard.
Lurid thick yellow custard, with lots of skin and lumps, again poured all over everything.
The very worst, something they called caramel pudding, which bore no resemblance to the real thing but was like the blancmange, only greyish brown.

For the record, I liked liver, the fruit puddings, rice pudding, semolina (just about - this came with very sweet rose hip syrup) and some of the stodgier traditional ones, but this was rather dependent on whether I could manage to grab my plate and run before it was swamped with custard.

I didn't come from a family which went on demos and defied authority, but I did actually organise a protest march, with placards, round the playground, and learned that while plenty agreed with me and were willing to join in at first, they would melt away at the appearance of anyone in authority. It was a more authoritarian age.

My finest hour came when we were served the dreaded grey "caramel" pudding twice in one week. Nobody liked it. (We even discovered that the teachers, who got the same food but in a separate room, were also not eating it.) I refused to eat it, the whole table was kept in for the whole lunch hour (thus ensuring that I was the most unpopular child in the school). They were allowed to go when the bell rang for the end of the lunch hour, but I was not, and so began a grand stand-off with dinner ladies who no doubt were due to go home, an echoing empty dining room, and me not budging. Eventually one of them had what she thought was the killer argument : "If you won't eat it you must take it to the headmaster and explain why". "Oh, yes", I said, and off I went with my plate to seek him out. I was obviously impervious to teacher/dinner lady sarcasm and empty threats, as it never occurred to me that she didn't mean it. Everyone was supposed to be terrified of the headmaster, an "old school" teacher from the Valleys who was rumoured still to be using the cane.

Alas, he was listening to a radio programme, and waved me away impatiently without hearing my grievances - but the dinner ladies had at last realised that they weren't going to win this one, and let me go. Around 20 years later my mother bumped into one of them in the town and heard the whole story again, still being talked about - "and we couldn't believe it, she went to the headmaster with her plate!"

So, while memories are one thing and might raise a smile when you're in need of distraction, please, please, don't make me actually relive eating some of this stuff when I am helpless in an institution and no longer have any control of the situation. For some strange reason this kind of food gets described these days as "comforting". It was unpleasant at the time, probably impossible to recreate now anyway, and the surrounding issues of guilt, bullying and control which went with it are anything but "comforting" to remember.

Chronic illness: unexpected extra hazards. 1, Voice recognition

"You can use voice recognition to access your account", they said. "No, that wouldn't work for me", I said, or rather croaked. "Oh, but it's more secure than remembering passwords and access codes and memorable information," they said. Me: "croak, whisper, cough". Them: "I'm sorry, could you repeat that?"

One of the most inconvenient aspects of the combination of chronic conditions I have is the unreliability of my voice. After having pneumonia last year I completely lost it for over a month, and that was very difficult. You can't respond to people who are calling to you from a different room, or walking away from you while asking you a question, or not looking at you when you nod or shake your head. Phone calls are not always possible.

My voice has returned, but it isn't great. It is non-existent first thing in the morning, it improves a bit during the day, it is not great in the evening. Sometimes it suddenly returns at full strength and it is then too loud and sounds aggressive. Sometimes what comes out is a weird bark like an angry duck. Because people can't understand me I am constantly being asked to repeat myself, and as talking can make it all worse I am learning not to initiate unnecessary conversations or make light-hearted throwaway remarks that were only mildly amusing in the first place and don't stand up to multiple repetition.

Voice recognition is one of the tech industry's new toys, however, and none of the institutions investing in it seems to want to hear about the downside. I would like to think that, happily, there are not many people living with this annoying and inconvenient condition, in which case I will be in a minority, shut out of accounts (apparently even HMRC are using it), and maybe the whole Internet one day.

Hospital food

Hospital food is, like most things in the NHS, free at the point of service. You will not be presented with an itemised bill at the end of your stay. It is plentiful (usually) and the feat which the staff accomplish with what must be a small budget, getting so many meals delivered throughout a large building, is amazing. Canteen quantities but without a canteen to do it in!

Having spent a long time in two NHS hospitals during 2019 (on 6 different wards altogether), I had plenty of opportunity to try out most of the menu, which runs over a fortnight and starts again (this does begin to pall if many weeks go by). There are variations in how it is presented (whether you get to choose in advance, for instance) even within the same hospital, and some things seem to be more available on some wards than others.

Roughly, what you can expect is breakfast which is not cooked, apart from porridge, except at weekends when there are a couple of cooked options; a supply of tea and coffee throughout the day (sometimes with cake and/or biscuits); full meals at lunchtime and teatime; possibly a later snack or a fruit trolley (depending on the ward!).

I have heard people comment that the food is "like school dinners". All this really tells me is that they are not former pupils of my school, Priory Road County Primary School, the memory of whose tapioca still has the power to make me heave. There is an element of truth in it which I think comes from more general British catering habits, which go back beyond school dinners ca. 1950-1980 to the wartime British Restaurants and perhaps to workplace canteens, now largely gone, but otherwise it is an unfair comparison.

Here's a very quick summary of the things I liked: pork casserole, the vegetables which accompany the many roast dinners (the meat was less appetising - lamb probably the best), omelettes, soup made on the premises, Friday fish and chips, ice cream, a pasta dish, fruit pies and crumbles. The sponge puddings and cakes were also good but about twice the size of anything I would usually eat as a dessert. While I was there they introduced Glamorgan sausage, which was splendid (especially considering that there is not a great choice for vegetarians). Unfortunately none of the staff or other patients seemed to have heard of Glamorgan sausage, so there were some disappointed would-be sausage-eaters. (This is where seeing the menu, with an explanation, would have been useful).

The things I didn't like do, mostly, come back to those school dinner days: ubiquitous mashed potato (which, I know, most people do like, but I think a little goes a long way); sometimes you might get a strange mixture (omelette with gravy, mashed potato and Brussels sprouts, for instance); rather tasteless macaroni cheese; above all, that terrible British habit of drowning the pudding in custard and the meat and veg in gravy. I loathed school custard, but came round to custard eventually. Again, a little is enough for me, and I don't see the point of concealing the pudding so you have to go fishing for it. I never did come round to gravy, which people tip all over your food (not just in hospital) and in my view spoil it all, Asking for "just a little" custard doesn't work, though - you perhaps get it not quite up to the brim of the bowl but still too much. The actual custard and gravy in hospital are vastly superior to anything served at my school, but the memory lingers on.

The debate about funding all this has been raised as another area in which something at present free could be salami-sliced off in an attempt to reduce costs. Elderly people, who grew up before the NHS was born, are often afraid of the potential cost of their hospital stay, and difficult to reassure on the subject. I saw one lady constantly reject food (and be told off about it, as she was losing weight) - and when she had finally understood that there was to be no bill for it, seize the dish with both hands and eat the whole lot very quickly, obviously hungry. If you feel you should be paying for it, there's nothing to stop you making an appropriate quiet donation, surely, without making everyone else afraid by introducing charges.

On the whole, then, a big and grateful thumbs up to NHS hospital food. There are always going to be some things people don't like. The menus are a little old-fashioned (average age of an in-patient is 84, or so a poster on one of the wards told us - that age group certainly seemed quite enthusiastic about the traditional dishes), and occasionally you could see where little corners had been cut (rice pudding and jam on the online example of the menu, but no jam ever in evidence). It is a reasonably healthy balanced diet. All cheerfully served by kind and patient staff. Diolch!

On having a chronic cough (2: the kindness, or not, of strangers)

I have already noted the anxiety which a cough produces among its witnesses. There is the often - well, mostly - unspoken thought that anyone with a cough is infectious and unthinkingly about to share the germs with everybody else. This really stems from lack of knowledge of chronic conditions and some of their unattractive symptoms. Everyone has had a cough at some point, and unless you are among the unlucky ones with one of those horrible (but NOT contagious) diseases your cough progressed through some disgusting stages and then got better. Therefore, you know all there is to be known about coughs.

People's kindness can be nearly as stressful as the hostility. I have lost count of the cough sweets pressed on me and the glasses of water thrust into my hand, "to soothe your throat". It would be in vain to explain that I haven't got a sore throat. Cough = sore throat, doesn't it? So I usually thank people nicely, but then I feel as if I'm under obligation to stop coughing, which can be difficult to do (without going into too much detail, a coughing fit means my airways need to be cleared, a process which is delayed but not improved by stopping to scoff cough sweets). People mean well, I know, but the end result is that I am hesitant to go anywhere.

The other thing I really can't do is talk much, or at all, from the start of a coughing fit until after the, er, "clearing of the airways". Trying to talk makes the effort worse and delays the process. I do understand that people are trying to check whether I am choking, but I am more likely to do so if I start talking at the operative moment, so better to wait with your questions until the moment passes.

Here is a gentle suggestion of what might constitute a list of Top Things Not To Say To A Complete Stranger With A Cough:

-   That's a nasty cough you've got.

-   Have you seen a doctor about that cough?

-   You should take [X] for that cough [or any other unsolicited advice].

-   Have you seen the posters about how if you've had a cough for more than three weeks it means you've got lung cancer? [this one only comes once you've got far enough into the cough discussion to have established that it's not the sort which comes, is cured, and goes away. Anyway, suppose the cougher does have lung cancer? Are you actually prepared for that answer, before you jump in?]

-   You ought to be in bed.

And finally, but most of all, please don't recite this jolly little rhyme, as several people have done to me. It's not that I lack a sense of humour, but - really? Tactless, or what?

-   It's not the coughing that carries you off, it's the coffin they carry you off in.