Reflecting on the GMC hearing

Spent the day, exhausted, dozing on the settee and trying to make sense of the GMC tribunal*. The full determination can be read here. Having waited since August 7 when the tribunal began (and the dread leading up to that date) and limping over the past two weekends of part hearing, hearing that the panel found that Valerie Murphy’s fitness to practice was impaired was both a relief and beyond distressing. I’ve no coherent thoughts, just a set of (overlapping) questions and reflections. Hopefully the process of writing will help.

1. Is Murphy’s ‘medical practice’ common?
The damning determination (worth reading in full to get some idea of the medical ‘care’ learning disabled people can expect to receive) misses some points that made my stomach curdle during the August hearing. Is specialist learning disability health provision so impoverished that it’s OK to prescribe medication before meeting patients? What does this mean and suggest about the treatment of certain patients?

Can it ever be acceptable, knowing you’re going on a two week holiday at the weekend, to not see an 18 year old young man you’ve agreed to be admitted on the previous Tuesday evening? A young man brutally restrained and sectioned that first night [Howl].

Is it common for medical consultants to tout a travelling suitcase with patient records for a colleague to rummage through?

Have these points dropped off the determination because there are bigger issues to pursue or because they aren’t seen as unusual?

2. Was Partridge’s ‘defence’ appropriate? 
A pre-meeting with the GMC earlier this year to go through my evidence left me reeling. It wasn’t a patch on the cross-examination I was subjected to in August by Murphy’s barrister, Richard Partridge. The pre-meeting preparation suggests that the cross-examination I endured wasn’t unusual.

Partridge repeated similar lines to his colleague, Alan Jenkins, who represented Murphy at LB’s inquest. Both focused on my ‘failings’ and the ‘Dr Crapshite’ post. On what they both seemed to view as unacceptable, unreasonable and discrediting action by a feckless mother. Ignoring what that post (and so many others) revealed about the lack of available support. This focus says so much more about them. And/or their client.

3. Ted why? 
Twitter discussion has focused on Murphy still practicing in Cork. Earlier, a minor bombshell from Stuart who lives in/near Cork. Murphy’s appointment (which is still unclear) was heralded as a ‘turning point’ in CAMHS service provision. An expert from Britain, leaving her investigation cloud behind her.

Prof Ted Dinan, the Gut Man, was prepared to offer a character witness to a colleague he seemingly barely knew. What were you thinking Ted? Boldly pegging Murphy in the top 10% of Irish psychiatrists [shudder]. He told the travelling suitcase story without faltering. While twitter groaned and buckled with disbelief, a few sharp questions reduced his story to a handful of contact hours – “in an academic year she gave two lectures and approximately 14 hours of tutorials” – and help with 5 patients across two years.

He stated that he regarded Dr Murphy as “extremely competent” and marked her apart from other consultants he had worked with, particularly in respect of her willingness to come in and give her assistance.

In contrast to her apparent unwillingness to see LB for 19 days.

4. What price power and insight?
Power. On April 24 2014 Murphy received a letter from the Sloven Chief Medical Officer stating ‘it was not considered that any further action is required in this matter‘. A clean bill of medical health from the Sloven exec. The various CQC inspections, Verita report, inquest and Mazars review processes led to no further scrutiny of her medical practice. We made the GMC referral (with Charlotte Haworth Hird) in May 2014.

Without this referral Murphy would, I assume, be continuing her practice of ‘implicit risk assessments’ (in her head) and remote prescribing in Oxfordshire, Cork or somewhere else. How can this possibly be?

Insight. Reflexivity or reflectivity is a central task for sociologists. Constantly reflecting on stuff; who we are in terms of our identity and experiences, our assumptions, what we bring to our research, how we interact with research participants and the data generated, and our analysis. I’ve always thought of it as a sound task for life. Like I’ve long thought that ‘easy read’ texts should be the stuff of everyday life, not an added extra when funds or thought permit. Adjustments that make life better for everyone.

Murphy failed on insight. She failed over and over again. Her barrister arguably added to this with his own apparent lack of insight. 

We’ve been brutalised by this process. At the mercy of timescales decided by others, cross-examination, forced to revisit what happened, rehashing blame lines… our lives on hold. John Lish captured the experience of the tribunal perfectly in a tweet.

There must be a better way.

*Am now off ‘sick’ for the week. Wary of the extreme spaces we now inhabit and what these mean. It’s only two weeks until the @HSE hearing to set the date for the HSE hearing…

The tribunal, two book launches and a dream

The five days between the General Medical Council tribunal weekend hearings have gone past quickly really. Filled with thoughts about a family operation (Tuesday/successful), new baby (due last Friday/born at 3am this morning… welcome to the world, Rory Joshua, you cheeky little cutesy), unexpected office move deliberations, the My Life My Choice AGM where the Queen’s Award was celebrated, and more.

Two book launches

Several people at work told me they’d been reading my book. Blimey. My book. I’d almost forgotten about it among the latest GMC hearing knocks, despite two extraordinary book launches last week. The Book Launch Extravaganza organised by Katherine Runswick Cole at Manchester Met on Oct 31. Six brilliant books, including ‘Don’t Cramp My Style’ by Simon Cramp and Kirsty Liddiard’s The Intimate Lives of Disabled People, a brilliant set of talks, discussion and nosh after.

On Nov 2, Helena Kennedy hosted and chaired a launch at Doughty Street Chambers with an all women panel; Caoilfhionn Gallagher, Deb Coles (INQUEST CEO), Helena and me.

It was another wondrous evening not least because of the open, welcoming and relaxed approach by the Doughty Street team who treated it as the celebration it was (a point I’d kind of forgotten en route on the Oxford Tube), and the sense spoken. The audience included family, friends, #JusticeforLB campaigners, journalists, human rights, mental health experts and some twitter legends. Michael Edwards, Dawn Wiltshire, Pam Bebbington and Paul Scarrott attended from My Life My Choice. The highlight of the evening was when Michael E encouraged Deb when she stumbled over the word ‘incredulous’ and then commented “I don’t use long words myself”.

A dream

I dreamed about LB this morning. Only the second time since he died. In the first dream, from what I can remember, I knew he was dead. It was more of an interactional/touching base/trying to prevent me from descending into madness type thing. He was wearing an unlikely bright red jumper.

This time we passed each other in a white corridor which kind of felt like home. I asked him how he was was. In his own style he said not brilliant. He wished he had a job. We sat down on a couple of chairs. Sitting close, leaning in together. Like we used to. I held his hand. There was that quiet intensity and comfort I’d forgotten about.

It took me a few minutes to remember he wasn’t alive when I woke up.

The GMC tribunal

The GMC tribunal continued today with the panel deliberating in private. They will be returning a decision on whether the charges against Valerie Murphy (LB’s responsible clinician) equal misconduct and, if yes, whether this misconduct amounts to a current impairment in her fitness to practice after 2pm tomorrow. Depending on the decision, two further dates may be arranged to decide on a sanction.

I hope she finds it in herself to turn up tomorrow. She was absent last weekend for undisclosed health reasons. I hope I’d turn up to face the music in such circumstances. As much for the family as for my own sense of self worth and integrity. Even if I felt utter shite. As I do.

 

The waiting game… again

We heard today the GMC tribunal panel will continue their deliberations in camera (privately) on Saturday and have ‘released all parties’ until 2pm on Sunday. The parties are the GMC legal representation, Valerie Murphy and her barrister, Partridge and, I assume, the public. The 2pm deadline doesn’t mean a determination will be given then as to Murphy’s impairment (or otherwise). It means it won’t be before then.

We’ve been warned the hearing may involve further dates yet to be set.

This hearing was originally scheduled for two weeks in the middle of August. Obliterating any summer thoughts or plans. It over ran and involved an inhumane and unnecessary cross examination which has, I suspect, left long lasting mental ill health shite. Harm caused in the process of trying to ‘objectively’ establish whether a person given a special key to count as a ‘medical professional’ is actually worthy of being a key holder. There is no apparent consideration for non key holders.

On Sunday we listened to a ‘defence’ which involved an absent ‘Murphy, a touting of patient records in a travelling suitcase (which sent alarm bells ringing among even the most resistant information governance ears) and a character witness worthy of a Tom and Jerry cartoon. Among copious tears, I felt an odd fondness remembering Butch. Life seemed so simple then.

Connor died in 2013. Murphy denied any wrong doing until the GMC case was well established in 2016. She spent three years denying and deflecting blame. This weekend we heard, via her barrister, about her recent ‘brain child’, her ‘contribution to the profession’; a speedily produced poster published (unusually with her husband) about a yellow card system. 

I think (hope) we ain’t beyond the realm of reasonable in the justice shed. If Murphy had behaved differently at any point in the last 4.5 years, I hope we’d have found it in ourselves to give her ‘a go’. And if we couldn’t, I hope a close mate, relative or colleague would have nudged us to do so. During the train journey to Manchester in August to attend the tribunal, Rich and I reflected at length on the apology we thought I’d been called as a witness to receive from Murphy.

There was no apology. Just a no show. Like she didn’t turn up for her second day of giving evidence at Connor’s inquest, instead appearing by video link and expressing disgruntlement at having to return after a lunch break.

George Julian live tweeted the tribunal parts that were public this weekend. She felt it went too fast to catch the comprehensiveness of the GMC case presented. She wasn’t able to convey how the overarching objective of the GMC was failed individually and cumulatively.

There are no words to describe, explain, capture what this slow drip drip feed of the ‘processes’ around the preventable death of your beautiful and beyond loved child by a combination of something described as ‘health and social care’ is like to experience.

The GMC have kept us consistently kept us informed which is good. Dunno what else to say really. Other than what a pile of shitfuckerywankmarbles.

Prof Ted the Gut Man and the travelling suitcase

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Exhausted. A terrible, terrible day following George Julian’s live tweeting of the General Medical Council (GMC) tribunal examining the conduct of LB’s ‘responsible’ clinician, Valerie Murphy. A tribunal that began back in August and is now spread across the next weekend or so.

Todays offering included a tangential figure – Prof Ted (a gut expert) on the phone to provide a character reference for Murphy – and an account of a travelling suitcase full of patient records. Murphy apparently asked Prof Ted to pluck records out of her suitcase, like drawing raffle numbers, to comment on her record writing skills. These are apparently top notch now. She’s learned not to keep them in her head.

Twitter commentators went into free fall. Eh? Audit? What records? With patient consent? Were they redacted? What price ethics?  Murphy was unable to attend for undisclosed health reasons. She seemed to be following the @JusticeforLBgmc twitter feed as, late afternoon when her barrister phoned to ask how this ‘audit’ was conducted, she tried to re-shape the suitcase story into something slightly more robust. Apparently she selected the first fourteen patient records (whose?) alphabetically and stuffed them in her travelling suitcase. Prof Ted randomly selected eight records from these 14.

He unwittingly generated criteria for what to look for when choosing a character witness who doesn’t really know you. Not a big demand for such a role possibly but useful to a few maybe:

  • Choose someone who barely knows you but is prepared to stick their hand into a dodgy travelling suitcase of patient records and describe this process under oath.
  • Make sure they are so tangential in your life that you spend around 14 hours a year in situations in which your paths could cross.
  • Make sure they are prepared to make outlandish statements about how good you are. For example, that you’re in the top 10% of consultants they’ve ever come across.
  • And when pushed on this claim, they’re willing to state rubbish like having a PhD and ‘being helpful and willing to offer an opinion’ is evidence of being brilliant at your job.

Around late morning the GMC presented their submission. We were suddenly thrown into a space of rare sense. Suitcases and gut stuff ditched. The GMC arguments can be read on the @JusticeforLBgmc twitter feed. The statements that made me weep were around how it was not unreasonable for us to expect LB would be looked after in the unit. Chloe Fairley, the GMC barrister, made the point that Partridge’s cross-examination of me in August was an example of Murphy’s more general blame-casting which included nurses and support workers.

Rich and I broke off to eat our weight in takeaway nosh. Returning to twitter an hour later Partridge was presenting his submission. Right back to Gut Man and the suitcase. And Murphy’s ‘brainchild’ the ‘yellow card’.  A shameless rip off of a well known government scheme on a pilot scale. The ‘yellow card’ was presented as Murphy’s contribution ‘to the profession’ to make sure no one ever died again.

Her entry back…

The fakery, sham and offensiveness of this redemption narrative, generated once the  tribunal process was put in motion and not as an outcome of LB’s death, was difficult to sit through. The dripping of ‘madam’, ‘in my respectful submission’ and ‘very painful for her’ statements by Partridge were grotesque.

Tears and more tears.

The day ended around 5pm. It starts again tomorrow at 9.30am with a private hearing.

Writing about an ongoing tribunal (or inquest) process is something we’ve thought about. We concluded today the process is so flawed and stacked in favour of the ‘professionals’ it can’t matter.

The deep sadness I feel. For LB. For the callous and continued disregard of his life (and so many other lives) – presented today as a ‘single patient episode in 2013’ – is matched by the obscene acceptance of the clearly wrong by tribunal panels. By senior NHS officials, by Jeremy Hunt and so many others.

We’ll keep writing justice. As simple as. And not be bullied by the processes seem to be designed to silence. That’s all we can do.

[Thanks to @RoseAnnieFlo for the title of this post.]

‘It was found that…’ A reflection on grief spaces

The General Medical Council (GMC) tribunal examining Valerie Murphy’s fitness to practice starts again tomorrow. Monday. And next weekend. Next Saturday and Sunday. And two more days possibly still to schedule. The findings so far are summarised here:

During the August hearing I was cross-examined by Murphy’s barrister. He said the way I described her in my witness statement upset her. We aren’t allowed to read her statement. We’ve no idea what she’s said. About LB. About what happened. About anything.

I was unwell after that hearing. Having just about managed to duck and dive the  traumatic, unexpected and preventable death cloak over four years, the calculated and deliberate questioning/non-questioning (and giant arch lever file action) by the barrister floored me.

Anxiety, panic attacks. Distraction, agitation, worry and more anxiety.

I worked today. I often work weekends but this was in anticipation of possibly becoming unwell again. And the late realisation it will be impossible to work on Monday (possibly Tuesday, Wednesday, Thursday…)

I was talking to someone recently about how NHS investigatory processes interfere with or even obliterate grief spaces. Spaces people have a right to inhabit after the death of a loved one. About how the ‘National Health Service’ generates further harm with little apparent thought. Even glee. [The slightly hysterical briefing to the then CEO of NHS England about how #JusticeforLB campaigners were hacking into Sloven staff Twitter accounts springs to mind…]

I thought about these spaces during my recent trip to Canada and the US when I experienced unexpected and breathtaking waves of intense and deep sadness. I don’t know if the lengthy bus and train journeys were a mechanism to re-enable grief thoughts. Or the space itself.

The determination of facts can be read here. George Julian will be live-tweeting tomorrow and Monday. A remarkable open justice service you can follow here.

Here’s to ‘finding’ sense. And space.

The Percy Problem?

Oh my. A piece in the Mail on Sunday* today about Katrina Percy, former Sloven CEO, touting leadership expertise on LinkedIn.  During twitter exchanges across the day I was bounced back to exchanges around our referral of Percy to the Care Quality Commission (CQC) for investigation under the Fit and Proper Person Regulation (FPPR) back in the day.

A right old dogs dinner that spanned more than 18 months. Littered with a remarkable number of non-responses. Demonstration of the disregard and disrespect bereaved families can expect from the NHS and wider bodies. Brutal non-responses…

2015
17 March 15 We refer Katrina Percy for investigation.
[No response.] Please reply even if only to say you’ve received the email. Families are in a terrible, brutalised position. To ignore is to simply add a size 10 Doc Marten kick in the gut to the experience.
27 May 15 I tweet about this non-response. Andrea Sutcliffe steps in to mediate. Good for Andrea but it shouldn’t take a tweet and the potential for reputational damage to generate action.
29 May 15 An apology from Mike Richards, then Head of Inspection, for the delay in response.
1 June 15 A letter from Richards with the panel decision:
Richards bollox

No words.

2016
3 Jan 16 After publication of the Mazars review we ask the CQC to reconsider their decision.
[No response.] As above. I tweet and Andrea Sutcliffe again steps in to mediate This flags up some communication type issues that really need addressing.
1 Mar 16 Email from Mike Richards’ executive PA to say our referral is tabled for the FPPR management review meeting on 11 Mar 16 and we’ll hear after that.
‘Thank you’ I reply. The differential in power laid starkly by the ‘thank you’ emails.
31 Mar 16  Hello, I email… Again.  Is there any news? As above.
1 Apr 16  Email from Paul Lelliot (Deputy Chief Inspector for Mental Health) to say the Chair, PA and Mike Richards are on annual leave. We should hear soon. A holding email takes about 1 minute to write and send. There is no excuse to piss off on leave and not reply. 
4 Apr 16 The Chair replies:

The panel concluded that any further action should be considered once CQC had concluded our most recent review and have an understanding of the position of NHS Improvement in relation to the trust.

6 Apr 16 A warning notice (and no action) from the CQC is announced.
7 Apr 16 I email to ask what the CQC are going to do about Katrina Percy.
14 May 16 I chase up my email.
15 May 16 Apologies for not updating I’m told. We will provide an update shortly.
29 July 16 I email for an update. [Note we’re leaving gaps of 5/6 weeks before recontacting. The spectre of the vexatious family/mother ever present. This consideration is not even a whiff among CQC business. Kind of reminding me of a paper we wrote about the ringside seat autistic people can have to mainstream life with little or no reciprocated thought from mainstream society.]
29 July 16 An email response: they are waiting for Tim Smart’s review of board capability and governance.
22 Aug 16 I email to ask if there is any decision about FPPR.

No reply. They didn’t bother to reply. As above. With bells on.

Katrina Percy ‘stepped down’ at the end of September 2016.

2017

There are three criminal prosecutions against the Trust in 2017. All cover Percy’s period of ‘leadership’. The Health Service Journal awarded her a ‘CEO of the Year Award’ back in the day which features on her LinkedIn profile. This was, according to a HSJ journalist, awarded by an independent (non-HSJ) panel, nothing to do with the HSJ and ‘before the issues were known‘.

We all know the issues now. Many of us recognised them before weighty (bloated, worn out and toxic seeped and steeped) senior NHS (Improvement/England/CQC/Dept of Health figures) eventually stopped slumbering. We all now know.

There is no more pretence. No more shonky little (and big) practices covering up, denying, bullying, bouncing and battering blame onto bereaved families.

The questions that whizzle around our brains/discussion relentlessly (raised by all sorts of people we meet, bump into or who even pull over to talk to us on the street)… Questions any sensible, non-NHS befuddled (at best) person asks and continues to ask remain unanswered. Not least how the hell could any of this happen? 

I don’t know if I want to ever know the answer/s to this. I just hope that those senior bods who were, and continue to be implicated, take a long hard look at themselves. That they start to polish their murky and corrupt stained goggles. Set aside the lure of the rewards for not seeing, not listening and denying and breath in some fresh air.

You’ve been arsewipes of fuckwhattery proportions. There’s no doubt about this. There is also time to change.

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*Our experience of sensitive and thoughtful exchanges with journalists continued with Jonathan Bucks. Thank you.

When Pittsburgh turned yellow…

L1031481Last day in the US. Teaching on a short course for researchers within the Veterans Administration at the Grand Wyndham Hotel in Downtown Pittsburgh. In a conference room cut off from the outside world with air-con set to ‘artic’.

Lunch break was 1 hour 15 mins. I step out of the hotel into a beautiful sunny, beyond baking hot day. Slightly disorientating. Everywhere I look people are wearing yellow and black. Walking across the park in front of the hotel. It’s Sunday. The Steelers are playing. I walk in the same direction. Across the yellow bridge. Towards the stadium.

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L1031507I’m told/observe a few things.

American football is a family event. People head over to the stadium hours before the game for the atmosphere, pre-drinking and eating. Very, very few people do not wear the kit in some shape or form. You can take alcohol into the stadium but no bags (other than clear/plastic bags).

I saw one policeman on a bike. Looking totally out of place. As if he was passing by on his lunch hour.

A retired player posed for photos with fans. The queue was enormous.

 

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“Get your phones out and ready” people were told. No charge. A snap or two. A ‘terrible towel’.  More cheer.

I wandered back towards the yellow bridge. To the beige hotel (in the photo below) for the final sessions in this marathon trip.

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What a backdrop. What a city. What an extraordinary journey…

I cannot wait to be home.

Pittsburgh and the speakeasy

L1031307 (1)Pittsburgh. A city where everything seems big.

After meandering my way here overland via Montreal with some freedom, I’ve been full on working.

Tonight a free evening and some wandering.  I stumble across an extraordinary old building positioned in what looks like a stage set in the shadow of sun soaking tower blocks. Beckert Seed and Bulb Co. A Disney film in the wings.

L1031416Nate happened to be sorting the rubbish. He ran with my fascination with this ‘out of/more than in’ place building.

“There’s the old speakeasy down there… You know. The illegal liquor sales… The door to the speakeasy is still there.”

The speakeasy.

L1031422We went and looked at the door down the alley way.

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“So long ago now…” said Nate. Shaking his head. He went back to work.

L1031424I went back to my big hotel.

 

Finally, New York to Pittsburgh

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L1031190 (1)So I’m inviting the nerdier among you to join me on my last long distance journey on this mammoth North American trip. New York to Pittsburgh on an Amtrak train. Leaving New York Penn Station at 10.52am. Get some nosh in advance I’ve been advised. The train fare can be a bit limited.

Tim is the ticket inspector. With more than a hint of banter and humour.

“You think this is the first time my picture has been taken by someone from England?!” he asks, posing for a few pics like an old pro as the train bounces around the track a bit and he keeps blurring.

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The train is well worn, comfy, spacious with a range of around the seat gadgets. A distant table, a foot rest attached to the seat in front moved with a foot pedal. Under each seat is a pull out chair extension so you can recline your chair and almost lay down with your legs stretched out. A shiny round black knob on the arm of the chair pings the extension back under the seat.

There’s plenty of room.

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A dining car and free (speedy and largely consistent) wifi.

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And wonderful views.
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From the edges of New York city through villages of colourful wooden houses dotted around tree filled Pennsylvanian hills, the 400 or so mile journey takes nine hours. Its a relaxed pace, slow to middling. Allowing time to soak up the changing scenery. Read, work. Think.

A bit of excitement mid afternoon. Tim’s replacement, a similarly comedic, big voiced, kindly woman, marches into our nearly empty carriage.

Now listen up everyone. I have an announcement to make! Are you listening? I have something important to say!”

Crumbs. What’s happened? The six or seven of us left after the mass exodus at Philadelphia station a few hours earlier poke our heads out from our by now, personalised spaces. Footrests up or at ease. Seats reclined. Full body sleepage on the go.

“A couple of people have reported the smell of smoke in this carriage. Yes. Smoke. Now if I catch anyone smoking I will toss them off the train at the next station. Got it?”

We nod. Feeling guilty. She marches out of the carriage with a flourish and a cheeky smirk.

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Early evening, more excitement. An unexpected announcement over the tannoy. We’re about to approach the ‘world famous horseshoe curve’. Time to look out of the left hand side of the train. Wow. One for the serious train buff maybe but it’s pretty cool. It takes me back to the days of wooden toy train track building with the obligatory figure of eight curves. We never had enough pieces for a horseshoe.L1031276

We settle back in our various spaces. The sun slowly sets and by Johnstown it’s dark. The industrial approach to Pittsburgh reduced to chaotic lights in blackness.

Time for a cheeky bottle of the local brew, Yeungling, from the dining car. And to reflect on the humanity both generated by and captured on public transport.

Walk on the High Line

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I entered New York three times for the first time over the last four days. Train from Boston Friday, car on Saturday evening, Coach USA today. Arrival into Penn Station, via the George Washington Bridge and the Lincoln tunnel.

Friday involved an in and out, without stepping out, of stations. Cloaked in a humid, frantic and harsh Friday evening space. New York a promise of familiar names, signs and lifelong memories.

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Saturday evening I walked a chunk of Manhattan Island with the friend/colleague I was staying with in Nyack. Promise more than realised as we grazed Central Park, Times Square, 5th Avenue and the Empire State Building.

Today I caught the bus from Nyack and checked into the New York Yotel. Mid afternoon, I went to walk the High Line. The park that almost wasn’t.

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Built on a historic, elevated freight line destined for demolition… run by the non-profit conservancy Friends of the High Line which relies on individual donations.

A disused elevated freight line made into a park. An extraordinary, joyful space with original tracks, plants, walkways, seating, artwork and views.

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And then I came across the choir.

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L1031150Truly wondrous.

Eh? Sorry, what was that? A park on a bridge across the River Thames?