Evil twin?

Poor Gordon - perhaps soon to be replaced by one or another Miliband. They’re twins. What happens if

Something of an eventful fortnight behind me. The weekend before last I had to pick up the Austrian State Prize for European Literature. This involved flying to Salzburg – cue much head twitching and feeble attempts at self-hypnosis in various bits of Gatwick. Eventually my imagination simply became so exhausted by picturing smiley things and projection screens and giving air gunners encouraging hugs that it could no longer picture my mangled remains dangling from a tree, ready to traumatise a passing rescue worker. At least not clearly enough to prevent me from boarding the plane and then carrying out every single obsessive-compulsive safety ritual I have – along with a few I invented as we bounced along. I’m sure I was a joy to all observers – tapping, nodding, shuddering and humming away like a shouldn’t-ever-be-out-patient.

Salzburg itself is lovely – delightful graveyard. The prize business involved wearing evening dress at most times of day, staring at canapés and being regularly assailed by classical music. All of which was so cultured, civilised and frankly unbelievable that it became pleasant, rather than nerve-wracking. The Austrian Minister for Culture is charming and actually cares about culture and the Austrian Prime Minister gave me cake – while I tried to assure him my own Prime Minister would have taken my cake and told me it would be given to the destitute and cake-needy before sneaking it into the cake trough of a cake-spattered man in a mink cake-eating suit. Poor Gordon, though - perhaps soon to be replaced by one or another Miliband. They’re twins, after all. What happens if we get the evil twin? I’ve watched more than enough Hammer horror films to know this is surely a risk.

Of course, the day after landing back from Salzburg (and being almost delighted enough by my continued existence to stay in the Ibis Euston without feeling nauseous – honestly, a sign in the foyer says it’s all about European values and “the breath of France” – France has serious internal problems if its breath smells of Ibis, that’s all I can say.. sorry that’s far too long a parenthesis and this is simply adding to it) I had to jump into my first preview performance for the Fringe.

And I’ve been running the show ever since – which is what I now choose to call a lovely holiday. I work one hour a day (unless I’m doing some other bit of funny stuff, which might bring that up to a whole hour and a half) and potter for the rest of the time, grinning like a Muppet. Thus far the ladies and gentlemen have been splendid, the venue has been only just hot enough to melt bronze and nothing apocalyptic has happened with any wiring.

I have now passed into that very special state of tiredness that only the Fringe produces – the sort where you can endlessly perform magic tricks on yourself. For example, approximately eight times a day I open my travel wallet with its central panel flipped left instead of right and then wonder pathetically where all my money and cards have gone. My show this year involves a mug of tea which I managed to put in my bag yesterday when I left The Stand. I then opened said bag on the train going home, noticed the tea – still, amazingly, in the mug – lifted it out of my bag and drank it. Which allowed fellow passengers to assume that a) I am unhinged b) I am a bad, beverage-related mime c) I am an unhinged and bad children’s entertainer. Things can only get odder and I can hardly wait.

You can see AL Kennedy at the Edinburgh Fringe

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A swimming pool and a bleeding toe put my medical competency in doubt

Doctors are used to contending with Google. Sometimes the search engine wins. 

The brutal heatwave affecting southern Europe this summer has become known among locals as “Lucifer”. Having just returned from Italy, I fully understand the nickname. An early excursion caused the beginnings of sunstroke, so we abandoned plans to explore the cultural heritage of the Amalfi region and strayed no further than five metres from the hotel pool for the rest of the week.

The children were delighted, particularly my 12-year-old stepdaughter, Gracie, who proceeded to spend hours at a time playing in the water. Towelling herself after one long session, she noticed something odd.

“What’s happened there?” she asked, holding her foot aloft in front of my face.

I inspected the proffered appendage: on the underside of her big toe was an oblong area of glistening red flesh that looked like a chunk of raw steak.

“Did you injure it?”

She shook her head. “It doesn’t hurt at all.”

I shrugged and said she must have grazed it. She wasn’t convinced, pointing out that she would remember if she had done that. She has great faith in plasters, though, and once it was dressed she forgot all about it. I dismissed it, too, assuming it was one of those things.

By the end of the next day, the pulp on the underside of all of her toes looked the same. As the doctor in the family, I felt under some pressure to come up with an explanation. I made up something about burns from the hot paving slabs around the pool. Gracie didn’t say as much, but her look suggested a dawning scepticism over my claims to hold a medical degree.

The next day, Gracie and her new-found holiday playmate, Eve, abruptly terminated a marathon piggy-in-the-middle session in the pool with Eve’s dad. “Our feet are bleeding,” they announced, somewhat incredulously. Sure enough, bright-red blood was flowing, apparently painlessly, from the bottoms of their big toes.

Doctors are used to contending with Google. Often, what patients discover on the internet causes them undue alarm, and our role is to provide context and reassurance. But not infrequently, people come across information that outstrips our knowledge. On my return from our room with fresh supplies of plasters, my wife looked up from her sun lounger with an air of quiet amusement.

“It’s called ‘pool toe’,” she said, handing me her iPhone. The page she had tracked down described the girls’ situation exactly: friction burns, most commonly seen in children, caused by repetitive hopping about on the abrasive floors of swimming pools. Doctors practising in hot countries must see it all the time. I doubt it presents often to British GPs.

I remained puzzled about the lack of pain. The injuries looked bad, but neither Gracie nor Eve was particularly bothered. Here the internet drew a blank, but I suspect it has to do with the “pruning” of our skin that we’re all familiar with after a soak in the bath. This only occurs over the pulps of our fingers and toes. It was once thought to be caused by water diffusing into skin cells, making them swell, but the truth is far more fascinating.

The wrinkling is an active process, triggered by immersion, in which the blood supply to the pulp regions is switched off, causing the skin there to shrink and pucker. This creates the biological equivalent of tyre treads on our fingers and toes and markedly improves our grip – of great evolutionary advantage when grasping slippery fish in a river, or if trying to maintain balance on slick wet rocks.

The flip side of this is much greater friction, leading to abrasion of the skin through repeated micro-trauma. And the lack of blood flow causes nerves to shut down, depriving us of the pain that would otherwise alert us to the ongoing tissue damage. An adaptation that helped our ancestors hunt in rivers proves considerably less use on a modern summer holiday.

I may not have seen much of the local heritage, but the trip to Italy taught me something new all the same. 

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear