Observations EASL day 2: Milan is warm There are a lot of very clever people here- and have to say- women are rocking hepatology! There is a pharmacological arms race to treat fatty liver when I’m sure there are cheaper, more population based options…

Day 3 EASL reflections I think I’m getting fatty liver Christophe Bureau is the rock-star of the TIPS world Vascular liver disease is an interesting and a clinical problem. VALDIG is a publication machine I’m trying to work a certain dried potato substitute into a MASH talk!

Prepping clinic for next week. Electronic GP referral letter. 46 pages. Actual relevant bit page 26. We talk about the digitisation of the nhs improving efficiency- another classic example where that is clearly not the case. Very fixable- have raised this before-but not fixed

David Patch Often over 100pages! A summary front page has been on a wait list for approval from NCL for nearly 2yrs!

Amazing double standards in public life- 2 MPs accused of illegal betting. One “apologises”. Policeman accused of the same- is ARRESTED, suspended and charged.

In my neighbourhood it appears that the louder you shout at the TV, the greater the patriot you are.

David Cameron has the backbone of an amoeba. Anything gets a bit tricky- off he slithers

Mass shooting in US= major intervention of “ thoughts and prayers” Perhaps any chance now of serious control of guns? I’m guessing unlikely

Trump will be seen as “strong”, “bulletproof” and “ chosen by God”. Biden seen as “old”, “mentally frail”, “tired”. Looks like we are going to be heading towards another nightmare whereby a recently convicted felon is the President of the most powerful country in the world….

Five years in prison. Five years for blocking the M25 for Just Stop Oil protester- but a motorist can mow down a cyclist and get penalty points, or a fine, or an imprisonment- but never 5 years. No wonder prison’s are full. I do not think that is proportionate justice

Just extraordinary lack of nuanced discussion about NICE not approving a drug. Why is no one coming out and explaining that we are not funding some of the most basic elements of public health and that the back door of hospitals is effectively closed

Are the Paralympics a reflection of a country’s health service?

FBI comment on the BBC regarding the capture of a potential DT assassin : "We had this place surrounded with helicopters and dogged within minutes," he said. I wonder if they have seen the Peter Kay video…

🎉 Lucky number 7! 🎉 Two exciting updates: Derriford Hospital University Hospitals Plymouth NHS Trust our 7th site to open! Huge thanks to Dr. Cramp and the team for all their hard work! Welcome😀 Royal Free Hospital has just recruited their 7th patient, bringing our total participants in the trial to 12!👍