How To Survive Your Police Career: A Practical Guide To Health For The 24/7 Bobby And Bobbie (Updated 2022 Edition)

By Darren Moor

In this revised 2022 edition, recently retired Police Sergeant Darren Moor offers practical but humorous advice to Bobbies on how to maintain their health in such a bizarre job.

Written as a follow-on to his How To Survive Your Early Years In The Police Service for newer officers, Darren now turns his attention to the needs of the seasoned Bobby in this book crammed with useful information on how best to sleep, eat and exercise on 24/7 shifts, avoid infection and injury, how to maintain good mental health and relationships - especially after trauma, ethnic, female and good sexual health, fire and water safety, acid attacks, happiness, social media, eyesight and even teeth care.

Written in an irreverent, often mocking, style but combined with detailed medical information, and making use of help from experts in their field, this is the ideal book for the Bobby who wants to survive their career.

Also in this series. The precursor to this book …

How To Survive Your Early Years In The Police Service - Tips, Tactics and Humour For The Probationer And Beyond

And something for the partners of officers …

How To Survive Your Relationship With A Police Officer – A Practical Guide To Living With Your Bobby Or Bobbie

• Language: English
• Publisher: Troubador Publishing Ltd
• Release date: Feb 28, 2022
• ISBN: 9781803138282

Book preview

Contents

Why Good Sleep Is So Important

How a lack of decent sleep is likely to affect the quality and length of our lives. REM and N-REM; the mechanics of sleep and how different sleep benefits us in different ways.

Why Infections Love Us So Much, They Keep On Wanting To Visit

What exactly are infections and how can we avoid them? How our body tries to protect us against these critters but hasn’t been designed very well to do so. The differences between viruses and bacteria. Antibiotics and when to bug our doctor for them.

Exercise

The first section of a Q&A with police physiotherapist, Mark Heffernan, discussing posture and how we inflict long-term damage on ourselves through the oddest of activities … like sitting. The dangers of laptops and of joys of touch-typing, and why it’s a dangerous game to fall asleep in your patrol car on Nights even without your mate taking photographs of you …

Why Some Foods Really Are Better For Us Than Others

The deadly food diseases and how they can kill us if we’re not careful. Why adjusting our diet might put years on our life as opposed to stripping years from it.

‘Wadda You Mean – I’m Unprotected …!’

A sadly overdramatic title, I’m afraid, intended to highlight the important but not terribly exciting subject of vaccination and winter flu. ‘… But where’s my vaccination people! … I want my winter flu jab and I want it now …!’

Wired

Yeah, I know. I feel disloyal and a little dirty even doubting its wonderfulness …

Mental Health And Wellbeing For The Bobby

Wayne Goodwin, Police Inspector and our guru in all matters mental health and trauma, discusses how we can keep ourselves well in such a bizarre job. In this opening chapter he describes common mental health conditions and how they can affect us, and the simple things we can do to keep ourselves on track.

How We Can Get The Sleep We Need To Keep Ourselves Well Even When Working These Bizarre Shifts

You’ve had the theory, now here’s the practice. Tips and tactics for sleeping against the odds and the ‘Sleeping Mindset’.

More Infections Big And Small

The common cold. Glandular fever. ‘Strep’ and ‘staph’ infections, including MRSA. Meningitis. Norovirus.

‘I Think I’ve Got Food Poisoning …’

Oh hell, fetch me a bucket … E.coli, salmonella, campylobacter bacteria infections and what we can do when we get the raging poos …

And Back To The Gym

The second part of our Q&A with Mark the police physio discussing the importance of treatment and review following some drama. Why broken bones are easy while damaged tendons are scary. How you need to change your exercise regime at different stages in your life. Why yoga maybe isn’t as good as people make out … or running actually when you get to a certain age … and what you may wish to consider instead.

Super Foods Are Good But Super Diets Are Better …

Why certain foods give you energy for those long shifts but others drain you. Why certain combinations of food do the same. Why you should be thinking in terms of super diets as opposed to super foods. And just what is serotonin?

How We React To Trauma

Wayne, our mental health guru, explains why we react to trauma in the way we do and how we can help counter these effects. He also describes acute stress and adjustment disorders, explains how officers should be supported following their involvement in traumatic incidents – but sometimes aren’t – and tips his hat to the importance of Bob Hoskins in police officer mental health …

What To Do When That Sleep Don’t Come

Some simple tactics to deploy when your mind just won’t switch off at bedtime.

The Horrendous World Of Hepatitis And HIV

The two ‘Big Hs’ – the dangerous stuff that we need to be aware of.

Police Constable Albert Alexander And His Part In The Development Of The Antibiotics That Help Look After Us Today

… and why we as Bobbies should all raise a toast with parade room tea to his memory.

Biscuit-Backs, Fitness Tests And Exercise Programmes

Mark the physio’s final instalment, covering bad backs and necks, the myth of the ‘crumbling spine’, how some medical specialists aren’t as good as others but are happy to take your money, fitness tests and a description of the ideal physical exercise regimes for different age groups within the policing family.

Hydration, Sensible Poos And Haemorrhoids

A triple-wammy of interesting subjects all gathered under one roof, whilst not forgetting of course the Battle of Waterloo. What’s to dislike?

How To Maintain Good Relationships With Your Partner And Children

In his final instalment of good officer mental health, Wayne turns to the subject of keeping things sweet on the home front.

More Sleep Issues

Oh, those ghastly shifts and how you can sleep around them..

Actually, Talking About Late Turns …

Why Bobbies and their partners need to make a special effort on this rotten shift.

Your Partner Deserves A Heads-up If It’s Gone A Bit Wrong At Work …

Because, otherwise, a bad day might get even worse.

More Infection Stuff

Bugs again. Sepsis and why we need to treat little wounds with appropriate respect – before they kill us. What to do if we’re spat upon by some idiot. Needle-stick injuries and how to avoid them. TB and Ebola.

So, Knowing What We Now Know About Food, What Is A Sensible Diet For The Shift-working Bobby?

How, taking advantage of what we’ve learnt about food, we can tailor particular foods to keep us going on different shifts.

Fasting During Ramadan When You’re A Shift-working Bobby

Because it’s never going to be easy!

Happiness. What’s Life All About Then?

A brief look at research into what actually does make us happy – takes ten minutes to read and might just change your life …

‘… I Thought I Felt Run Down Because Of The Shifts …’

How we might not notice that we have some serious condition with fatigue as a symptom because we’re always so knackered by shift-work anyway. Coeliac disease, type 1 and type 2 diabetes, obstructive sleep apnoea, lower urinary tract infections, chronic fatigue syndrome, iron deficiency anaemia, vitamin B12 or folate deficiency anaemia and underactive thyroid – an array of disasters waiting to clobber you.

What Exactly Is Cancer?

How it’s caused and treated? What we can do to lower our risk and what factors might make that risk higher.

Fire Safety

Jim Ledger, one of our friends from Trumpton, explains why the three fire phenomena of flashover, backdraft and fire gas explosion means that you don’t really want to go anywhere near that house-fire that the public are enthusiastically encouraging you to run inside and rescue people from – however brave you might be feeling – and why Fire Officers in white helmets like pointing at things while shouting a lot.

Do I Really Want To Search This Person?

Horrible skin conditions like staphylococcal, impetigo, cellulitis and even athlete’s foot – change those socks! Also head lice and bedbugs. Finishing with scabies, ringworm and Lyme Disease just to lighten the mood.

Making Food & Exercise Work Together

How combining what we eat and when we eat it can make a difference to the results of our exercise. Carbo-cycling. And how those protein shakes might just be as important as our tight tee-shirt wearing members of the team always make them out to be.

Specific Issues Relating To Female Health

A chapter provided by Debbie Wade, a police medical professional, aimed at the ladies but best read by the fellas as well if they want some chance of understanding their crewmate at three o’clock in the morning or indeed their partner when they get home. Hormones, PMT and how to reduce their effects. Endometriosis. A brief guide to ovarian cysts. Polycystic ovary syndrome. Toxic shock syndrome. Cystitis.

Additional Health Considerations For The Ethnic Minority Bobby

A title, I would like to think, that hopefully needs no further explanation …

Cancers Relating To The Police Officer Age Group

Breast cancer in women and men. Cervical cancer. Testicular cancer. Prostate cancer. Bowel cancer.

Booze!

How to enjoy booze without it affecting our health or getting us sacked or divorced.

Eyesight And How To Look After It

What we can do to reduce fatigue from those damn computer screens. The importance of breaks and blinking. Why sunglasses and wide-brimmed hats are more than a fashion statement. The dangers of UVA, UVB and various eye conditions which we don’t want to affect us. Why ‘surfer eye’ is not as glamourous as it might sound. Steps we can take to keep our eyes healthy. How, if we wear contact lenses, we need to be careful about following the instructions provided by the optician that supplied them. What to do if we get something in our eye, and the fastness of flies compared with the slowness of turtles …

Dog Bites & Human Ones

Dangerous dogs and what to do when we’re chomped on by some hound or human ‘… aaaarrrrrhhhhhhh …!’

Things We Can Do And Kit We Can Carry To Help Protect Us From Infection

Why a knife tube crammed with wet-ones actually makes good logical sense when you think about it …

The Dangers Of Open Water

How open water can kill us as police rescuers. How cold water immersion works against the instincts of our body and turns us from rescuers into someone else who needs rescuing. Practical things we can do to help people without entering the water. The danger of strong currents, rip-tides … oh, and coconuts …

What Bobbies Actually Should Be Doing At Building Fires …

Advice from our friendly fireman Jim on practical things you can do to help save life without recklessly risking yours.

Shift Patterns And Sleep – A Generational Perspective And How We Can Make Things Better

Everything You Ever Wanted To Know About Sexually Transmitted Infections But Were Too Afraid To Ask

And, gosh, as it turns out, there’s an awful lot to know, starting with the basics of STIs and a description of some of the popular favourites.

Acid Attacks

Some detailed suggested actions for if the worst happens.

Female Health Part Two

Part Two of Debbie’s advice aimed at female officers but of use to the chaps as well. Covering pregnancy within the service. The menopause. Why routine health checks are so important, as is checking your boobs. And the various benefits, including erotic, of regularly exercising your pelvic floor muscles ...

More Cancers Relating To The Police Officer Age Group

Nothing funny to say really. Skin cancer. Leukaemia. Ovarian cancer. Brain cancer. Hodgkin lymphoma & non-Hodgkin lymphoma. Thyroid cancer.

Those Damn Fags

A chapter which, quite rightly, soon descends into a never-ending rant about the dangers of smoking.

Cancer. A Couple Of Final Points

Because some things are worth reiterating.

STIs Part Two

Some more STIs that it’s worth knowing about along with some suggestions about how to avoid them.

‘I Wish I Had Looked After My Teeth …’

Because when you don’t – let’s be honest - they cost you a fortune … a brief section covering care of the old choppers.

The Joys, But Mostly Dangers, Of All Things Social Media

Those damn complaints ... how what we commit ourselves to in social media can not only end our careers but also expose us and our families to danger from terrorists and organised crime groups. And, before we finish, just what is your partner putting on-line …?

The Moor Quick Guide For Sleeping After Nights

As we’re getting towards the end of the book, a recap on this important subject in one handy package.

A Final Consideration In Respect To Food, Especially For Those Of Us Who Are Getting A Bit Older

A hopefully, fairly obvious(ish) point …?

Road Traffic Collisions And The Danger Of Explosion

But, for a change, let’s look at this subject from a Fire & Rescue perspective and, in particular, what are the dangers of explosion? Jim explains all.

The Mr. & Mrs. Moor Weekly Health Index

It’s great - try it!

And, Finally, Something Cheerful To Finish

Because if anyone needs cheering up these days then it’s probably Bobbies …

A Big Thanks To …

Oh, I Knew There Was Something Else …The Medical Disclaimer Bit

A Quick Point About Material

Why Good Sleep

Is So Important

And so, let’s begin.

Ever found yourself slapping your bare arms while driving home after Nights in an attempt to stay awake? Ever woken up in a bus stop having pulled over because you were too knackered to carry on an hour before … the bus driver tooting at you to get out the way, passengers alighting all around you looking rather dischuffed and bending back your car mirrors as punishment? Or ever scared the life out of some other motorist by actually dropping off to sleep in slow-moving traffic, drifting over into the opposing carriageway and coming to a stop a foot short of their front-end as they blast away at you with their horn? Or – here’s a good one – decided that it made sense to wipe spittle onto your eyebrows before cracking open all the car windows as your mate had assured you that it was so irritating that you couldn’t possibly sleep-drive having done so?

I remember once, utterly ball-bagged at the end of a first Night Duty, handing over to the on-coming skipper, equally zonked as it was her third or fourth Early Turn, and needing to show her something on the CAD. The thing was that, rather annoyingly, my mouse decided not to work. After a few moments of listening to me cursing about the general rubbishness of our IT she pointed out that manipulating a desk stapler with my hand instead of the mouse was probably unlikely to help navigate the curser around the screen, however much I swore at it. And incidents like this weren’t unusual; another morning at briefing I found myself answering the radio by picking up my coffee cup and talking into the handle … luckily, most of the troops were so knackered they didn’t notice.

Oh dear, good sleep is just so fundamental a principle and yet how many Bobbies do we know claim that they get enough? Forgetting about funny incidents for a moment, think about how corrosive that lack of sleep is to us and our families. We all know how ratty we can get through lack of sleep, the way we end up saying things in front of our loved ones or acting in that unreasonable way which we regret later. But then think if we were actually a lot worse than we imagined? – because that’s how we are. Having now retired, my wife – who’s technically a saint I hasten to add – has been quite open about how horrible I used to be to live with on Nights and even Lates … snappy, unapproachable, forgetful … even snappier when she tried skirting around the merest possibility that I had forgotten something … that obviously I had, like our wedding anniversary. Most people who know me would, I suggest, consider me a nice chap but, apparently, I use to be a right grotbag … no wonder the kids used to hide behind the sofa. Oh grief; I sit here while writing thinking how I have decades of making up to do.

All things considered – and I don’t say this lightly – I have come to the conclusion that inadequate sleep and the behaviour it causes over a long enough period of time destroys as many police officer marriages as those usual culprits of stress and trauma. We also know how our mates on the team tend to progressively lose their tempers with each other, and the public, the further into that set of Nights or Earlies we go. BUT this rattiness, unfortunate and uncomfortable though it is, is only the tip of the iceberg – it’s the underlining lack of sleep that’s positively dangerous to our health and could well take years off our lives, and the quality of it, if we don’t take steps to positively address the problem.

As will be – you might come to notice – traditional in this book, let’s first cheer ourselves up by considering an array of horrible health conditions associated with whatever the chapter is entitled and see where things go from there. Inadequate sleep can lead to …

*Obesity in that it can result over time in the body altering levels of the hormones ghrelin and leptin which are linked to a feeling of continuous hunger and subsequent overeating; failure to get an average seven hours sleep in twenty-four is associated with weight-gain (and there you are, that Circle Of Bobby Health starts turning already …).

*Diabetes. Research suggests that while getting less than five hours on average increases the risk of diabetes generally, missing out on deep sleep changes the way our body processes glucose and so particularly increases our risk of developing type 2. Lovely …

*Heart disease. Long-term sleep deprivation is associated with inflammation which stresses the heart and increases the heart rate … which increases blood pressure and so leads onto …

*Hypertension – which in turn can lead on to the heart attack that kills you.

*Shift-work Sleep Disorder. Rotten. If you want to have even more sleepless nights then look this beauty up on the internet. The sufferer, having a working pattern which results in them sleeping at non-standard times, constantly feels tired but then finds it hard to sleep even when they do have the opportunity. They feel the need constantly to doze, often drop-off without meaning to, demonstrate reduced mental dexterity than they would normally, are more likely to suffer accidents and are pretty irritable … HEY! THAT WAS ME! – for years … decades! Their symptoms coincide, strangely enough, with working rotating shifts.

And, oh yeah, you are also at increased risk of:

*Problems with your immune system, which in turn make you more susceptible to infections – even more fun in this age of Covid-19.

*Anxiety and depression.

*Issues with fertility … and general lower libidos – ‘… I’m tired …!’

If we say that an a verage Late Turn these days finishes at 1.00pm and an Early Turn starts at 7.00am then, disregarding Annual Leave for a moment, nearly six out of ten of your sleeps as a 24/7 Bobby are disturbed as a result of the shift pattern you work. That’s why you feel tired; that’s why you should tune in to all these news reports about the dangers to health of not getting enough sleep; and that’s why you would do well to take some positive steps to actively monitor – and then almost certainly increase – the amount of sleep you get.

WAKE UP! GET SOME PROPER SLEEP!

Okay, I’m Convinced, But What Is ‘Proper Sleep’?

Ideally, an adult needs somewhere in the region of eight hours of sleep in every twenty-four hour period. I know that there’s at least one Bobby on every section who seems to thrive on not much more than three or four and always says how they don’t bother at all with sleeping after their last Night Duty but the reality is that surviving on insufficient sleep is exactly that – surviving; it will catch up with you. It’s also interesting to speculate just what the memory / reasoning ability of your sleep surviving mate will be as they grow older.

And How Much Sleep Am I Actually Getting?

It’s probably not as much as you imagine. If you go onto the website you will see our sleep diary record sheet; why not fill it in for a month and scare yourself. Alternatively, use an activity tracker to assess your sleep patterns and scare yourself electronically (get one that monitors your blood pressure and you can scare yourself twice-over). My non-shift working wife, who seems to sleep so deeply and contently that I doubt she would notice even if I was carrying her downstairs over my shoulder because the house was on fire, only manages an average of seven hours a night over a month according to her tracker … and she’s always asleep.

And How Do We Sleep?

The mechanics of sleep have been pretty well researched and documented over the years. The conclusions of this research are that we tend to do so in cycles of between 90 and 120 minutes, each beginning with shallow sleep which descends into deeper unconsciousness. It’s unclear why we sleep in cycles in this way but one theory is that the body has discovered that this is the most efficient method of recuperating mind and bodily systems while defragging our memory and making sense of what it has experienced before sleep – clever thing the body.

These cycles can be broken down into non-rapid eye movement sleep or NREM – where you slip, by various degrees, deeper and deeper into unconsciousness – and rapid eye movement sleep or REM where your brain seems to take on a data processing role and becomes very active under the surface. Good NREM and REM are each thought to benefit the mind and body in different ways; let’s look at NREM first.

Our NREM Sleep can be broken down into three stages of descent into deep unconsciousness. The first stage can be characterised by you losing awareness of the world around you, your body relaxing, but also that occasional ‘falling down the hole’ sensation where you suddenly wake up with a jerk, known sometimes as a ‘sleep start’ or ‘myoclonic jerk’. Some people – think elderly uncle after Christmas lunch (or that Bobby sat outside the cell doing the constant supervision … or me, thinking about it, at that civil hearing where the judge seemed particularly unimpressed) – will wake up from this early stage NREM and not even believe that they have been asleep. During the second stage your body and mind descend even further into unconsciousness and, thankfully, becomes even less aware of the world around you and the disturbances likely to keep you awake; this second stage accounts for about half of your total sleep. The third stage, unsurprisingly, is your deepest sleep and is the period which does you the most good; the more NREM3 you get the more refreshed you will feel the following day. Just for fun it’s also the period when you are must likely to sleep-walk, swamp the bed or amuse your partner by talking rubbish to yourself; if you’re going to have a nightmare it will probably be during NREM3.

After around ninety minutes of NREM your body will drift into REM mode. The brain becomes very active at this stage and you are likely to experience your oddest, most vivid dreams; fortunately, that active brain of yours, rather cleverly, protects you by paralysing your arms and legs so that you don’t act out any of these adventures. Chaps might notice one organ it doesn’t paralyse, however, when they wake up woozily to discover an erection almost Olympic in proportion, but at a time, more often than not, when their partner is so enjoying their deepest NREM that they won’t appreciate it. The ‘rapid eye movement’ reference comes from the way in which your eyes dart from side to side under the eyelids during this period (do you ever get that sensation that you’re flipping through a series of images just before waking?). Sleep boffins speculate that REM might be the time when the brain is actively assessing information and processing memories stored up during the day, before filing them for the long-term; perhaps that’s why ‘sleeping on a problem’ sometimes reveals the answer? Some people wake up or experience light sleeping immediately after REM Sleep before drifting back off into early stage NREM. New-born babies, incidentally, for those parents amongst you, also go through REM and NREM cycles so try to avoid that first-time parent thing of anxiously picking them up when they become twitchy, start breathing heavily and muttering to themselves; it’s all perfectly normal at the REM stage and by removing them from their warm, cosy cot for a cuddle, all you’re doing is waking them up from their slumbers so that you have a grumpy baby on your hands.

These cycles of NREM and REM continue through our sleep until we wake, ideally at the end of a last bit of REM but probably instead when the alarm wakes us up for Early Turn during that deepest of NREM3. The more cycles of sleep we get in one session the longer and deeper those REM periods tend to be but the shorter the NREM3.

Had enough of sleep for a bit? Or dropped off? In the next sleep chapter later in the book we shall discuss some tips and tactics for clawing back this sleep whilst working shifts. But, for now, let’s spin the Circle Of Bobby Health around onto the subject of infection … which, of course, we’re more vulnerable to if we don’t get that sleep …

Why Infections Love Us So Much, They Keep On Wanting To Visit

Hell, what a voyage of discovery this subject turned out to be. You hear stories about first year medical students who become convinced that they have all the symptoms of every ghastly new disease they learn about and – yeah – I can understand why. And how lucky I’ve been with my health now I realise the dangers! But then, how careless as well? – why would I think it made sense to hold a pen in my mouth which was used earlier by a drug-plugging prisoner to sign for his property …

We’re going to begin this little chapter of loveliness with an unashamed egg-sucking session for everyone on the general causes of infection. Hopefully you’re going to know this stuff already from your school biology or all those Covid-19 government briefings, but we are going to rattle through it anyway as there seems little point in describing techniques of avoiding infections if we aren’t aware of how they develop in the first place. Sorry if some of it appears a little basic but hang in there; as Bobbies you’re probably used to, or if new to the service will have to get used to, the job telling you stuff that appears pretty obvious (and, conversely, members of the public always assuming that you know everything about them, their family, their ex-friends and their myriad of ghastly problems).

Let’s start by reminding ourselves then that we live a life surrounded by naturally occurring but potentially harmful germ organisms – they’re everywhere. They moon around happily in that germ-like way and congregate on all natural things but, if given the choice, would rather seek out new warm, cosy environments to relocate and multiply in – perhaps like inside or on the body of the nearest rozzer. We as individuals only suffer an infection when they actually succeed in embedding themselves somewhere upon our bodies or manage to smuggle themselves inside.

Now, having created germs harmful to us as humans, nature – with some irony and being that horrendous passive-aggressive monster that she clearly is – also equips us to defend ourselves against them with an elaborate array of mechanisms designed either to keep the pesky fellows out of our bodies when they do come nosing around or indeed fight them internally should they make it inside. It could be argued, therefore, that ‘Mother’ Nature is a little odd in the way that she goes about things; she is, apparently, the type of mother who, having two children, might gleefully provide the aggressive idiot of the pair with a large stick while kitting out the calmer, more thoughtful sibling with a protective suit and crash helmet. It also becomes apparent when you look into this stuff that some of the defence mechanisms devised by nature – those protective suits and crash helmets – aren’t quite as good as they might be.

Nature’s first line of defence for us humans is a tough, waterproof skin designed to keep harmful germs from breaking through into our bodies (or, indeed, fluids seeping out of our bodies, which would prove even more of a design fault). Of course, as defence strategies go, this only works if we can keep that tough waterproof skin intact; if a hole occurs, perhaps because we scrap off the top layers of the skin while fighting with someone, then germs have the opportunity to slip inside us via these open wounds and reap their havoc. That’s why we should always cover open cuts and grazes with waterproof dressings until they are suitably healed and not, despite what our nan might have told us as small children, ‘… let the air get to it …’ because what we are actually doing is allowing air–borne germs to invade our body and potentially cause that infection.

In the absence of any raggedy, recently created and unprotected holes in our skin, those cunning germs might instead opt for the less obvious forms of entry into our bodies such as the eyes or ears, or more likely, that blatantly obvious, and almost always open, super highway into our respiratory system – the mouth and nose – and gain entry that way (and, yep, we will discuss the other ‘holes’ where germs can enter our body later on during the chapters on sexual health). Luckily again, having at first made us rather vulnerable to germ attack through designing us with a gaping cake-hole and twin-barrelled conk in our face, nature, almost grudgingly, and probably as an afterthought, attempts to compensate by lining our trachea and nasal cavities with tiny hairs and mucus to catch those germs as they come in, while also teaching us a cough or sneeze reaction designed to expel the little blighters before they have a chance to make themselves at home. Not wishing to be left out, eyes employ a similar system in the form of tears, while ears create wax and vaginas create acids to protect against harmful bacteria … did you realise that?

Now, I would suggest that at some stage of evolutionary development, nature realised that this idea that she had come up with of ‘catching and then blowing out germs’ from the respiratory system wasn’t that good if she was honest, not that efficient, especially if the person’s ability to cough wasn’t up to much, perhaps because they were getting on in years or were weak or injured. I suspect that this realisation led on to some kind of review, perhaps a project group chaired by someone being fast-tracked for promotion – and played a good game of golf – which concluded that the whole ‘blowing out of germs’ thing and barrier systems (acid in the vagina? … wax in the ears? – what if they got it mixed up?) hadn’t turned out to be as good as first expected. Of course, they didn’t want to upset the person who had originally rolled out the project because that character was now high and mighty within the organisation – very influential in terms of other people’s promotions (and not averse to bearing a grudge if their past work was rubbished. Oh, and also played golf …), so why not instead have a system that instead of replacing the original project … well, supported it … a second line of defence for dealing with those harmful germs that had made it inside the body? – breached the castle walls as it were? Being such a sensible idea, they ran with the plan – in fact they got rather enthusiastic and came up with two parallel systems designed to operate within the body at the same time and we shall look at these systems now.

The first system employs happy, harmless bacteria that wait in the body ready to confront the bad germs as and when they arrive (sound familiar? Probably because you’ve seen those adverts from yogurt companies that flog their wares on the basis that it tops up your ‘good bacteria’ and therefore makes you less susceptible to infection). Under normal circumstances this harmless bacteria system, your resident flora, works in balance with natural yeasts, stomach acids, bile and other heroes within your body and all’s good with the world, BUT we need to be aware that this balance can be disturbed by some outside influence, perhaps your consumption of strong meds whilst ill and, in particular, and as we shall discover, antibiotics.

The harmless bacteria guys work in conjunction with their sister-protectors, your body’s immune system, which itself is broken down into two separate elements – white blood cells and antibodies. White blood cells (and there’s a name not dreamt up by someone involved in equality and inclusion), save us through eating up or neutralising the effects of the bad germs that invade. Sometimes, this may result in the infected area becoming inflamed and swollen as white blood cells contain and then attack the invading microorganisms, and perhaps causing us to feel feverish or cold, or have aches and pains in the affected muscles as our nerves are aggravated. The immune system also produces antibodies which identify and target particular germs before dealing with them. We are all passed on some forms of passive antibodies from our mothers when we are first born, but others – active ones – are only created by our immune system in response to exposure to particular germs invading our body. This means that, in the same way that a probationer only learns properly how to deal with a pub-fight by being exposed to a pub fight, our body only learns how to deal with some kinds of infections once it has seen them up close and personal … can you see the potential problem here or am I going too fast for the non-ex ‘A’ Level Biology students amongst you? Yep, correct, if your body has never encountered a particularly nasty and invasive germ before then it might not be able to cope with it and, before you can say Black Death in England killed a third of the population between the years 1348 and 1350, or damn you Covid-19 turning the whole bloody world upside-down, your poor, unprotected body might be fit only for the undertaker.

Luckily, after thousands of years of people dropping dead from rampant and pretty common diseases, scientists perfected the process of vaccination as pioneered by Dr.Jenner in 1796, when he took it upon himself to slit open the skin of an eight year old boy from his local village and scrap into the wound some live smallpox(!) to test his theory that the lad was immune from the disease as a result of the cowpox that the good doctor had scraped into his skin beforehand (‘… can someone get Social Services on the phone … we need to discuss a police protection order …’). Fortunately, it did … as opposed to tragically killing him, which was handy. Incidentally, the cow from which the cowpox originated, Blossom – I kid you not – became quite a celebrity in her own right and now has her hide hanging on the wall of St.George’s Medical School in London, while the word vaccine comes from vaca, the Latin for cow … but I digress … in simple terms, when vaccinated, our body is exposed to a small and harmless quantity of a ghastly microorganism, through those jabs or something tasting horrible on a lump of sugar or lolly that you used to line up for at school, and then the immune system does the clever thing of using this mild exposure to work out how to deal properly with the unpleasantness should it return, all guns blazing, next time. Thank heavens for that. Now, for the first time in history, we can protect ourselves from common diseases that, until quite recently, ravaged the world and killed squillions of people every year. Of course, this has meant that we are now left instead with out-of-control population growth, vast numbers of people who traditionally would have died now desperately using up the planet’s dwindling resources, but, hey-ho, let’s keep things light and worry about things that we do have some control over.

Incidentally, a curious fact for those of you old enough to remember having your polio vaccination on a lump of sugar; that particular generation vaccine ended up being withdrawn as the ‘weakened’ strain of polio it contained turned out not to be as weak as was intended, so resulting in some people contracting the disease as opposed to becoming immune from it … let’s not always expect these scientists to get it right the first time!

But, returning to the brilliance of science as opposed to its failings, if there’s something – along with general infection awareness – that Covid-19 can be credited with then it’s how it has helped to push along the development of vaccination in quite remarkable fashion. The new Covid-19 vaccines are – as any vaccination geek will gleefully tell you – spectacular. They make use of RNA research advances which, if they continue on their present trajectory, could be a game-changer in terms of all kinds of medical research. In the future, for example, should you be diagnosed with cancer, it may be possible for you to be given a personalised vaccine designed to attack and kill your individual cancerous cells – this is fantastic stuff and could save countless lives. To put it in some kind of perspective, at the time of writing around 120,000 people in the UK are reported to have died within 28 days of a positive Covid-19 test – a horrendous number – but then, on average, and as we will discover in the cancer chapters later in the book, 165,000 would be expected to die each year of cancer but now could be potentially saved … gotta love the boffins, in fact I really love the boffins. Sure, this pandemic has been awful but it has at least reminded us how marvellous our scientists and public health officials are … and how ropey the media can be, but that’s another story!

Autoimmune Conditions – The Dark Side

Of the Immune System …

Although our immune system is clever, in some people it can get rather overprotective and decide that something harmless entering our body poses a serious threat which needs to be fought against with a bizarre, over-the-top response. With coeliac disease, for example, the immune system mistakenly decides that gluten in food is a danger and so decides to attack it as it enters your digestion system. This inflames the insides of your small intestine and means that you are unable to properly absorb nutrients into your body – well, thanks very much … how silly of me eating that bread roll. We shall talk more about autoimmune diseases later when we discuss conditions where fatigue is a factor but not noticed by the Bobby because they’re always so knackered by the shifts anyway.

For the moment, though …

What’s The Difference Between A Virus And Bacteria?

I suspect the only reason why anyone other than a medico would want to know this information would be through some vague recollection that one type of infection could be treated by bugging your doctor for antibiotics while the other can’t, so let’s provide a quick explanation.

Bacteria are pretty basic, single-celled and mostly inoffensive little fellas of which only one strain out of a hundred will do you any harm. In fact, some, like the ‘resident flora’ that we spoke of earlier, actually do us good through breaking down the food that we scoff and fighting the bad germs that make it inside our digestion system. Sure, there are some nasty bacterial infections like meningitis or syphilis … cholera … Legionnaires’ Disease … that can spoil your day, but most bacteria are harmless – remember that when you see an advert for a cleaning product that boasts how it ‘… kills 99% of all known germs …’.

Viruses, on the other hand, are just horrible little fascists. They’re tiny – even smaller than the weeniest bacteria – and can’t survive or achieve their evil aim of reproducing and spreading mayhem except by invading and then taking over cells, perhaps those within your body, which they then re-educate into other virus-creators in their own image. Some viruses target particularly important parts of your body like the liver or the respiratory system. In the worst-case scenario, they transform good cells into rampaging monsters that spread cancer and other ghastly conditions all throughout the body. They’re like that horrible child in the playground, damaged by whatever ghastly events have occurred in their upbringing and so psychotically driven to have everything their own way, while also being far too clever and manipulative for their own good. Well, you did ask …

So, where-as, for the most part, bacteria aren’t a bad thing (sorry, did I mention leprosy …?), viruses are; in fact they’re pretty horrible as it goes, as perfectly demonstrated by that worldwide tragedy that has been Covid-19.

Antibiotics – What Are They Good For?

In some cases, antibiotics can help with infections caused by bacteria; they don’t, however, work with those caused by viruses. If you’re anything like me you won’t remember this essential difference unless you have a memory-prompt so here’s an easy one supplied by Natasha, my pharmacist friend and general fact checker on all things infection …

The letter ‘B’ is contained in both Bacteria and Antibiotic, whilst there’s no ‘B’ in Virus.

See – all those years of study!

Antibiotics – The Ticking Time Bomb

Having grown up in a world where these wonder drugs have always been around to deal with our infection problems, it is rather disconcerting to realise in recent years that bacteria has decided that it’s not going to be pushed around so much by those hard-assed antibiotics.

Rather in the same way that your body learns how to create antibodies when exposed to a dangerous microbe, bacteria seems to be learning how to overcome antibiotics because they are exposed to so many of them. To a certain extent we, as a society, have brought this upon ourselves through the over-prescription of antibiotics for quite minor complaints that would have cleared up anyway. There’s also the problem of antibiotics wrongly being prescribed – we catch some rotten virus and go to our doctor where we moan and groan about it;