Cold water blues

Middle-aged marathon men aren’t faring too well on road runs, racing bikes or in icy water, writes Maurice Gueret, who says it’s not much better down the sewers

Triathlon man

Ironman isn’t really me. Half a marathon in the Phoenix Park as a medical student — with a few well-timed cigarette breaks before the hilly bits — was more than enough. I’m weed-free for many years now, and triathlonfree as well. Men, being men, will often push themselves farther than common sense. A new study of endurance addicts was published in September. Since 1985, there have been 135 deaths in American triathlon races. Fifteen deaths were trauma related — all in the bicycle section. Of the other 120 cardiac arrests, a dozen were successfully resuscitated. When corpses were counted, 85pc were men and the average age was 47 years. And 80pc of the deaths happened in the swimming section. The authors want organisers to pay more attention to the temperature of the water and want middle-aged athletes to pay more attention to their tickers. The more sensible triathlete has 18 holes of golf, followed by a frame of snooker and a brisk walk home.

Hillbilly phlegm

I had heard a lot about a new book on small-town America. But the name eluded me on bookshop visits, and I didn’t have the courage to ask for a book with no name. I finally found it north of the Border, for a tenner. They had fewer lightweight books on display, and a bigger array of serious stuff. It’s called Hillbilly Elegy: A Memoir of a Family and Culture

in Crisis. The blurb says you won’t read a more important book about America. Not quite true, but if you want to read about how your Scots-Irish cousins up in the redneck Appalachians have fared since the 18th Century, this memoir is a good primer. Author of this searing family saga is JD Vance, and the big characters are his grandparents, Mamaw and Papaw. They raised JD and raised hell in their home town. The book has one of the best descriptions of smokingrelated chronic bronchitis I have ever read. Of his Papaw, Vance writes that “a lifetime of smoking had blessed him with an unlimited supply of phlegm, and he had no problem sharing that phlegm with everyone, no matter the time or occasion”. You can learn much about life from books. But for that innate wisdom you cannot find on printed pages, you’ll get it from the Hillbillies.

Poo, pee and paper

Fatbergs — a congealed lump of fat, sanitary napkins, wet wipes, condoms, nappies and similar items, which do not break down like toilet paper — are everywhere, and its not a nice time to be a sewage inspector. In East London recently, it took a team of eight men with axes and power hoses over 20 days to break up a sewer fatberg that was 250 metres long. New York and London are fast becoming the fatberg capitals of the world and more cities are now following. Belfast had its own fatberg earlier this summer

— it was known as the Dublin Road fatberg, and wastewater officials let it be known at the time that, in the past, they had to remove sofas, Christmas trees, and teddy bears from sewers. Doctors who look after the underground health of sewer workers are fastidious about vaccinations. Hepatitis A is a constant worry if your daily life brings you in touch with excrement. Luckily, there is an effective jab to prevent it. New York christened their most recent blockage the Baltimore-berg and public health officials offered simple preventative advice to all lavatory users in the city. Only three things should go down the bowl and they all begin with p — poo, pee and paper. It’s no for nappies, don’t for diapers, sinful for sanitary items, criminal for condoms, woeful for wet wipes and terrible for teddies.

President Fatberg

The American writer Naomi Klein recently claimed that President Donald Trump was the political equivalent of a fatberg. She called him a merger of everything that is noxious being glommed together in a self-adhesive mass that’s very hard to dislodge. Fat people have to deal with such abuse all the time, and I suppose chubby Presidents are no different. But I have been wondering when Donald Trump is going to have his first medical examination as President made public. He has kept on White House physician Ronny Jackson, who was appointed to the job four years ago by Barack Obama. Trump was the oldest first-time President in history, and his former doctor made a Trump-like claim that he would be the healthiest President ever elected to the White House. We know that the Donald takes a daily aspirin with his cholesterol-lowering medication, and that his weight hovers around 17 stone. But it’s time we had an update from Donald’s couch. Dr Maurice Gueret is editor of the ‘Irish Medical Directory’ imd.ie