Woman begs for a cup of tea....

[InsaneApache]

In a statement to William Armstrong, the coroner, Mrs West said her mother had begged her for something to eat and drink, or a cup of tea, but the request was refused by a nurse, on the doctor’s orders. Her last days were spent with her false teeth and hearing aid removed from her bedside, in a cold hospital room.

She was admitted on September 14, 2003, after a suspected stroke.After two weeks Dr Maisey allegedly told Mrs West that he was surprised her mother was still alive and said that if the family intervened, he would have them arrested.

link (http://www.timesonline.co.uk/article/0,,2-2283680,00.html)

I have no set opinion on euthanasia, I would take each case on it's merits and circumstances. However this does seem a cruel and barbaric way of assisting someones death. If I was part of her family, I would have told the doctor to get the police and do their worst. Shameful.

We need to get our act together and decide where we are going with the issue of euthanasia. This is not how it should be done, if done at all. Put it this way, if I'd acted in this manner to my dog I would expect to face the full majesty of the law. :shame:

[Banquo's Ghost]

I am almost speechless with horror. :shame:

I remember how emotionally unstable I was when my own mother was dying in hospital (where she received only the highest standard of care) and had she begged me to help her in such circumstances I doubt if I could have answered for my actions towards a doctor like Maisey. Yes, the police would have been needed.

To draw back from the horror of the situation reported and to examine the principle of euthanasia, I have to say I have long been in favour of it. I would go further - I have never seen why a rational adult cannot be allowed to procure the means to end their life easily and without censure.

As our population ages, and quality of life diminishes in many cases, there should be the option for the simple choice to let go, at a time one chooses, in a gentle manner. The comparison with vets is not an unequal one - we gift our pets the opportunity to go to sleep peacefully when their time is done, and people are frowned upon when they are too emotionally attached to let a suffering pet die. Why is this? Is it just because the religious have decided Tiddles has no soul?

There must of course be checks and balances for those not in a position to make decisions for themselves. To this end, every adult should be required to produce a living will detailing their preferences, so that families are spared the emotional trauma of having to make those decisions. In addition, full medical support should be given to the incapacitated if they choose to try to live. (There is a challenge inherent in that latter position, which is that modern medicine can keep alive a person who is to all intents and purposes, a mere breathing corpse, but nonetheless, choice means choice and we shoud be prepared to pay for treatment for someone who chooses life, however miserable).

I would like to end my life at a time of my choosing (should accidents not intervene) and gently, with dignity, with time to prepare any who should care about me. I have no fear of death or the oblivion it brings - and I enjoy life immensely, and would not bear to see those memories and experiences to come washed away by an inexorable tide of dribble and incontinence. I don't see why I should be shackled to the morality espoused by 'sanctity of life' advocates, invariably religious, when I don't share their views.

[AntiochusIII]

Wait, let me get this straight: the doctors refuse necessities to a patient capable of asking for them, and a family demanding for them for the patient?

WTF? :dizzy2:

[Husar]

I am almost speechless with horror. :shame:

I remember how emotionally unstable I was when my own mother was dying in hospital (where she received only the highest standard of care) and had she begged me to help her in such circumstances I doubt if I could have answered for my actions towards a doctor like Maisey. Yes, the police would have been needed.
You know, this Maisey may have needed the coroner earlier than my mom.~:rolleyes:

[Ja'chyra]

As this was done without the consent of the patient or family it sounds like murder to me.

[yesdachi]

if the family intervened, he would have them arrested.
Maybe after he picked his jaw up off the floor. KA-POW! :boxing:

[Shaun]

As this was done without the consent of the patient or family it sounds like murder to me.

Yes, technically it would be murder.

[Vladimir]

Wow, someone’s going to jail (I hope). So, the hospital refused to feed this woman despite a court order? It sounds like if anything, the police would have enforced the court order and not arrested the family. I thought Shiavo(?) was a mess here, I hope you guys have fun with *this* one. What a crazy doctor.

[Geoffrey S]

Disgusting. The article makes it quite clear that the hospital staff refused nutrition despite the requests of both a lucid patient and relatives, and a court decision.

[TB666]

I thought Shiavo(?) was a mess here
Well Shiavo(sp??) wasn't really a mess, her husband had the right and he decided. Fair and legal.
In this case however the ones that did have the right wanted treatment but was denied by the doctor.:dizzy2:
Really an awful story.
I don't think doctors should have such a right unless during extreme circumstances which this case doesn't seem to be.

[BDC]

On the other hand if she had chocked to death on a piece of food would that be murder too?

[spmetla]

No but at least it beats starving to death over the course of several days. :furious3:

[InsaneApache]

Not having a drink must have been like being tortured. Poor, poor woman.

[A.Saturnus]

Not having a drink must have been like being tortured. Poor, poor woman.

Under narcotics not necessarily.
I have to say, I find the article pretty unclear. Among other things, the chronology of events is a bit hard to follow.


The order was made by Mr Justice Forbes in the High Court on October 6, 2003, after an application by Mrs Knockels’ grandson, Christopher West. Four days earlier all food and fluid had been withdrawn. The next day, however, the order was varied by the judge when David Maisey, a consultant, telephoned him. In the amended order, of October 7, nutrition and hydration were to be reinstated only “so far as is medically possible”.

This was one day before her death. However, feeding her was already tried earlier:


When Mrs Knockels was admitted, she was given intravenous fluids but, ten days later, nurses found they could not gain access to a vein so it was decided fluids would be given by subcutaneous infusion. But, the inquest was told, on October 2, medical staff found fluid leaking and the removal of the equipment was ordered. Two attempts were said to have been made to insert a naso-gastric tube, but without success.

So as it seems to me, when the amended order came on Oct 7, she was already as good as dead because a naso-gastric tube didn't work and feeding her manually would have cause asphyxiation.
So it seems to me the doctor had two choices: letting her starve in combination with narcotics, which is the usual way of assisted dying or letting her choke to death. This might be a wrong interpretation of the events (as I feel it's hard for a layperson to interpret them) but in my view, the doctor was the one to make the decision, not the daughter.

[InsaneApache]

Thanks Saturnus for that insight. :bow:

Then increase the diamorphine levels to precipitate a speedy death, sadly the law, at least in the UK, does not allow for such an action.

So my statement at the start of this thread is still valid.

[orangat]

........
So as it seems to me, when the amended order came on Oct 7, she was already as good as dead because a naso-gastric tube didn't work and feeding her manually would have cause asphyxiation.
So it seems to me the doctor had two choices: letting her starve in combination with narcotics, which is the usual way of assisted dying or letting her choke to death. This might be a wrong interpretation of the events (as I feel it's hard for a layperson to interpret them) but in my view, the doctor was the one to make the decision, not the daughter.

Why did the hospital not repair the machine that was rehydrating Olive subcutaneously after it was found to be 'leaking'?

And why did the doctor speak in such a manner about putting patients down like animals?
"In a statement, Christopher West said: “I told Dr Maisey: ‘I wouldn’t treat my dog like that’, and he said it was easier for vets because they . . . can put animals to sleep.”"

It does not change the fact that slow codes and witholding liquids are informal methods to bump off patients who doctors feel are beyond help.

[Avicenna]

This is the first time in my life that I really wish for someone to go to hell.

[Don Corleone]

This might be a wrong interpretation of the events (as I feel it's hard for a layperson to interpret them) but in my view, the doctor was the one to make the decision, not the daughter.

I thank you for your rational and helpful insight on this Saturnus. But this last line, I'm afraid I have to take issue here.... I appreciate your point, that the doctor is the only one qualified to make the medical judgement that the patient would in all likelihood struggle with feeding tubes. But call me old fashioned, I simply do not want the medical establishment to be making arbitrary decisions about who lives and who dies. Allowing this decision to pass uncontested is one more step. The next, which is already being hinted at by medical ethicists, is doctors deciding who is worthy of treatment and who is not. It's stories like this that are the reason why I personally DO NOT go to physicians, no matter what is wrong. I know I'm a touch paranoid, but doctors terrify me.

[Fragony]

What was she dying from? Eating or drinking something could have done more harm then good, causing her to puke or cause stomachaches, who knows.

I have no set opinion on euthanasia, I would take each case on it's merits and circumstances.

Euthanesia is not like ordering a beer at the bar, you have to be in insufferable pain, and there should be no medical cure.

[GoreBag]

Whoa, feed her and have her choke, or let her starve? Those were the options? I'm actually laughing at the absurdity behind my monitor, here. Could not the doctor or hospital provided a quicker means? A lethal injection, or even a quick neck-break? She must have been a feeble one. This might sound obscene or insincere, but I would take a quick death over a drawn out (and not to mention ignoble) one.

[A.Saturnus]

Then increase the diamorphine levels to precipitate a speedy death, sadly the law, at least in the UK, does not allow for such an action.


Yes indeed. Let's face it: decisions about whether treatment should be given are part of everyday life in hospitals all around the world. Resistence against legalization of euthanasia do not prevent doctors from making decisions about who has to die and who is been tried to save, rather it keeps it in a grey area and prevents it from being regulated properly.


Why did the hospital not repair the machine that was rehydrating Olive subcutaneously after it was found to be 'leaking'?

I'm no doctor, but it may not be that easy.



It does not change the fact that slow codes and witholding liquids are informal methods to bump off patients who doctors feel are beyond help.

They are also informal methods to help people die who would die anyway, only slower. Helping people to die is as much a doctor's duty as saving lives.


But call me old fashioned, I simply do not want the medical establishment to be making arbitrary decisions about who lives and who dies.

They already do that, Don. So much to further your concern, but it is not just about living and dying. In my view, the doctors have to do what is best for the patient and that is not always keeping him or her alive. I for one find the idea of being kept alive against my will to be one of the most horrible scenarios that could realistically happen.
Whether the doctors in question acted correctly, I don't know. In fact, I think none of us here has enough information to judge that.

[Vladimir]

They are also informal methods to help people die who would die anyway, only slower. Helping people to die is as much a doctor's duty as saving lives.

They already do that, Don. So much to further your concern, but it is not just about living and dying. In my view, the doctors have to do what is best for the patient and that is not always keeping him or her alive. I for one find the idea of being kept alive against my will to be one of the most horrible scenarios that could realistically happen.


I'm not sure what oath your doctors take but I'm pretty sure ours involves the words "do no harm" and not "we can kill you if you want us to". Your statement sounds like a Hypocritical oath instead of a Hippocratic oath.

[Ser Clegane]

I for one find the idea of being kept alive against my will to be one of the most horrible scenarios that could realistically happen.
The "against your will" is important here.
According to the article the woman was still able to communicate, and if she asked for tea it could certainly interpreted in a way that keeping her alive would not be against her will


I'm pretty sure ours involves the words "do no harm" and not "we can kill you if you want us to".
If somebody kept me alive against my expressed will I would consider this as "doing harm"

[Ser Clegane]

I for one find the idea of being kept alive against my will to be one of the most horrible scenarios that could realistically happen.
The "against your will" is important here.
According to the article the woman was still able to communicate, and if she asked for tea it could certainly interpreted in a way that keeping her alive would not be against her will


I'm pretty sure ours involves the words "do no harm" and not "we can kill you if you want us to".
If somebody kept me alive against my expressed will I would consider this as "doing harm"

[InsaneApache]

What was she dying from? Eating or drinking something could have done more harm then good, causing her to puke or cause stomachaches, who knows.

I have no set opinion on euthanasia, I would take each case on it's merits and circumstances.

Euthanesia is not like ordering a beer at the bar, you have to be in insufferable pain, and there should be no medical cure.

I actually do. I just thought it prudent to engage a debate, not to post it.

My view is this.

If you wish to die, provided that you are 'compos mentis', then who is there to tell you that you are wrong.

If you are terminally ill, then you should, if you so desire, have a way out from that anguish.

A living will would be desirable, however it should be voluntary.

Criminals serving life sentences excluded. Let the swine rot in gaol.

At the moment the doctors are in a bind.

Just my thoughts.

[Big King Sanctaphrax]

But call me old fashioned, I simply do not want the medical establishment to be making arbitrary decisions about who lives and who dies.

I think in this instance I'd be glad that the Doctor made the decision rather than me. The idea of having to choose between feeding my mother, and having her choke, and letting her starve to death is so awful that I doubt I'd be able to make any kind of decision at all, let alone an objective one.

I don't imagine the doctor enjoyed doing it, either.

[orangat]

........
I'm no doctor, but it may not be that easy.

They are also informal methods to help people die who would die anyway, only slower. Helping people to die is as much a doctor's duty as saving lives.
..........

After the comment about putting patients down like animals to the woman's own son and threatening to have the family arrested, I wonder if the doctor was really concerned about the patients wellbeing. Maybe the machine wasn't even broken.

And no, they are unethical and in the case of dehydration - cruel methods to end patients lives.

What seems to be the problem is doctors ending lives against the wishes of their patients. The elderly in the Netherlands are afraid of their doctors snuffing them out after euthanasia was legalised.

[Vladimir]

Holy cow, an admin double posted! ~:eek:

Has this story been verified? It sure has prompted a strong reaction.

[Banquo's Ghost]

Has this story been verified? It sure has prompted a strong reaction.

Well, it was a report from a coroner's court, so I guess it's bona fide. The accusations and statements made however, are by witnesses and therefore may or may not be corroborated as to detail and provenance.

[Vladimir]

Interesting. For a story that seems to have attracted such interest I was hoping that a follow-up or supplementary article would be soon to follow.

[Don Corleone]

A. Saturnus, perhaps I misinterpreted the article, but I received the impression that the family and the individual were looking for treatment. The doctor decided to starve/dehydrate the woman and was threatening legal action against any family member that disagreed with his decision. As others have said, his reference to putting down dogs certainly shows his mindset was not foremost on the welfare of the patient.

Let's face it, in today's society, doctors view patients as objects. There is no respect for humanity. We are test subjects, we are cash generating enterprises, we are burdens, we are many things, but we most certainly are NOT human beings in their eyes. We are their toys. When they've had enough of us, they'll throw us in the trash, and that's precisely what this 'good doctor' did to this poor old lady.

Yet one more step in the march towards the engineered species, with doctors taking for themselves the decision-making capability regarding selectively culling.

Go back and read the worst of the worst that Nazi physicians performed (as it was testified to in Nuremburg). Then ask yourself what they did that's not acceptable practice today.

Personally, I'd rather just have my heart attack/stroke and stay the hell away from whatever devious experiments they decide I need.

[Big King Sanctaphrax]

Let's face it, in today's society, doctors view patients as objects. There is no respect for humanity. We are test subjects, we are cash generating enterprises, we are burdens, we are many things, but we most certainly are NOT human beings in their eyes. We are their toys. When they've had enough of us, they'll throw us in the trash, and that's precisely what this 'good doctor' did to this poor old lady.

I think you're being a bit unfair to a group of people who do a very difficult job for comparitively low pay, and who save a very large number of lives.

Did you have a bad experience with Doctors, or something?

[Don Corleone]

Relatively low pay? This must be a reigonal thing. In the US, doctors are the highest paid professionals out there.

I have had bad experiences with doctors, yes, but that would only be anecdotal evidence. My concerns go far beyond my own experiences. When you look at this case, several other cases where doctors have made the decision NOT to save the patient in oppossition to the wishes of the family and/or patient, the rationing of health care, the Dutch situation where doctors now decide which infants will be euthanized, regardless of the wishes of the parents... in short when you look at the big picture of where medical ethics currently stands, and I'm terrified. We're their guinea pigs and meal tickets. Nothing more.

[Banquo's Ghost]

Let's face it, in today's society, doctors view patients as objects. There is no respect for humanity. We are test subjects, we are cash generating enterprises, we are burdens, we are many things, but we most certainly are NOT human beings in their eyes. We are their toys. When they've had enough of us, they'll throw us in the trash, and that's precisely what this 'good doctor' did to this poor old lady.

I loathe having to go anywhere near a doctor too, but I think you're being very harsh.

Some doctors may think or act the way you describe, many others don't.

As I noted in my first reply, the care given to my dying mother over an extended period in hospital was utterly excellent. Kindness, listening to our views, helping make her comfortable, and at the end, asking if we understood the effects of increasing painkillers to ease her suffering, and administering such relief when we asked.

Both nurses and doctors were wonderful. :bow:

But I've met the odd stinker too. :furious3:

[orangat]

I think you're being a bit unfair to a group of people who do a very difficult job for comparitively low pay, and who save a very large number of lives.

Did you have a bad experience with Doctors, or something?

Does it excuse the fact that they might have deliberately murdered an old woman? If they stand cannot stand the low and pay and long hours, then they should try another line of occupation.

And why do you assume that the work they do is life-saving? The medical system is the leading cause of death in the US. 20,000 extra cases of breast cancers are estimated to have been produced by the now deprecated estrogen therapy by the elderly in UK alone.

Why do you ignore the fact that the machine that was feeding the patient not repaired as a life-saving measure? Why did the doctor mention putting patients down like animals? Why did he threaten the family with arrest?

And more disturbingly, why was the woman lucid and begging for fluids? Shouldn't PALLITATIVE care instead of ABANDONMENT/euthanasia be more appropriate?

[Lehesu]

Anybody that believes doctors take their college exam and then suddenly morph into numb, uncaring, and inhumane people should examine the way he looks at the world.

[orangat]

Anybody that believes doctors take their college exam and then suddenly morph into numb, uncaring, and inhumane people should examine the way he looks at the world.

Anyone who believe exams can induce and enforce good moral behaviour needs to get a reality check.

If you think slow codes and dehydration isn't rampant, then why do you think large scale investigations happened in the late nineties and started the push for the 'backdoor euthanasia' bill which was tabled in 2004 defines food and water as treatment?

"THERE are 60 alleged cases of involuntary euthanasia or maltreatment of elderly patients currently under investigation in Britain - 40 of which are in Derby, where alleged victims were said to have died slowly from dehydration and starvation."

"A six-week undercover investigation of two London hospitals, conducted by the Sunday London Times, concluded, "Shocking inhumanity, negligence and criminality are everyday features of the National Health Service."

http://www.telegraph.co.uk/htmlContent.jhtml?html=/archive/1999/12/06/neld106.html
http://news.bbc.co.uk/2/hi/health/552326.stm
http://www.internationaltaskforce.org/iua20.htm
http://www.timesonline.co.uk/article/0,,2-1403803,00.html

[Big King Sanctaphrax]

Does it excuse the fact that they might have deliberately murdered an old woman? If they stand cannot stand the low and pay and long hours, then they should try another line of occupation.

'The fact they might have deliberately murdered an old woman'? Is it just me or does that sentence not quite sound right? Aside from the fact the you're assuming that they did kill the old woman in your response, you were attacking a strawman-at no point did I say that poor pay and long hours would excuse murder. I was merely objecting to people characterising the entire medical profession as slobbering psychopaths who get their jollies from killing old ladies.


And why do you assume that the work they do is life-saving? The medical system is the leading cause of death in the US. 20,000 extra cases of breast cancers are estimated to have been produced by the now deprecated estrogen therapy by the elderly in UK alone.

Yeah, that's right, scientific medicine isn't of net benefit. Hell, we're better off without it.

As an aside, I'd love to see some statistics backing up those assertions.


Why do you ignore the fact that the machine that was feeding the patient not repaired as a life-saving measure? Why did the doctor mention putting patients down like animals? Why did he threaten the family with arrest?

The article didn't have enough information on the first point, so I can't comment. As for the threatening with arrest-I'd hazard a guess that it might have been because feeding her would cause her to choke, but, again, I don't have access to his actual reason. I'm pretty sure it wasn't 'because I love killing the elderly', though.


And more disturbingly, why was the woman lucid and begging for fluids? Shouldn't PALLITATIVE care instead of ABANDONMENT/euthanasia be more appropriate?

I belive it's mentioned in the article that she was unable to take food or drink orally, and other methods were not working. I'm not sure what palliative care they could have undertaken. Drugged her out of her gourd?

[orangat]

'The fact they might have deliberately murdered an old woman'? Is it just me or does that sentence not quite sound right? Aside from the fact the you're assuming that they did kill the old woman in your response, you were attacking a strawman-at no point did I say that poor pay and long hours would excuse murder. I was merely objecting to people characterising the entire medical profession as slobbering psychopaths who get their jollies from killing old ladies.

Yeah, that's right, scientific medicine isn't of net benefit. Hell, we're better off without it.

We'd all be better off treating the medical profession like we do any other occupation. They should be accountable for their own mistakes.



As an aside, I'd love to see some statistics backing up those assertions.

I stated a fact. Google is a useful tool.



The article didn't have enough information on the first point, so I can't comment. As for the threatening with arrest-I'd hazard a guess that it might have been because feeding her would cause her to choke, but, again, I don't have access to his actual reason. I'm pretty sure it wasn't 'because I love killing the elderly', though.

I belive it's mentioned in the article that she was unable to take food or drink orally, and other methods were not working. I'm not sure what palliative care they could have undertaken. Drugged her out of her gourd?
It sounds fishy that the doctor expressed surprised that she was 'still alive', talked about putting Olive down like an animal and threatened the family with arrest.
For someone who said that doctors had a duty to help patients do die, you don't sound very encouraging about giving Knockels a sedative.

[Lehesu]

Anyone who believe exams can induce and enforce good moral behaviour needs to get a reality check.



Not what I said. If you Brits have issues with your doctors, that is out of my ken. My experience is only in America. It's sad, because I believe in nationalized health care, but so many bad examples of it are around that makes our cutthroat free-market system look appealing. No one in the states will gleefully start killing people without consent in such a competetive and litigious environment such as the U.S. If that is not the case in the UK...

[orangat]

Not what I said. If you Brits have issues with your doctors, that is out of my ken. My experience is only in America. It's sad, because I believe in nationalized health care, but so many bad examples of it are around that makes our cutthroat free-market system look appealing. No one in the states will gleefully start killing people without consent in such a competetive and litigious environment such as the U.S. If that is not the case in the UK...

I'm not a Brit and I'm currently living in the US.
I never once said or implied in my posts that the doctor was gleefully killing his patients. The doctor's authoritarian demenour stems from the paternalistic mindset of the medical profession.

And threat of litigation didn't stop a doctor and 2 nurses in New Orleans from carrying out involuntary euthanasia on their patients during Katrina. They were arrested and charged with homicide.

[Lehesu]

There is always an exception to the rule. And variance to every statistic.

[Don Corleone]

I know there are some fine, noble, upstanding doctors out there who practice medicine for the virtuous goal of improving the human condition.

I personally believe they are in a distinct minority.

My sister has Systemic Lupus (look it up). She's actually been a patient at Yale New Haven Hospital (again, fancy program, look it up) because she became subject at age 12, almost unheard of.

At age 27, she went to see her regular practitioner, because she had had a bad cough. The first two organs Lupus attacks are your lungs & kidneys. The yaboh she went to see told her her coughs didn't 'sound bad enough', and asked her if she wasn't just milking it to get out of work. Mind you, this is over the span of 6 visits and 5 months. By the time my sister got to a rheumatoligist who had his head screwed on (Lupus is within their specialized field and the above dickhead was a rheumatologist as well), she was diagnosed as being in a severe flare-up and and had lost 66% of her lung capacticy (her lungs are now mostly scar tissue).

When I went to the doctor after having fallen off of a 4 story roof, I went in complaining of dizziness, nausea and moments of dimensia. You'd think I'd be a prime candidate for a concussion cat-scan. Nope. My joker decided to admit me, spend three days performing alzheimers tests (I was 23 at the time), ran up a 30K bill, then dismissed me, under orders no anti-inflammatories were to be given to me. I went home, but had to be readmitted later that night when I woke up with a nosebleed because my cranial lobes were being crushed against my skull.

I've had experiences with women (friends) going in for breast cancer were told if they wouldn't commit to the reconstructive plastic surgery, the doctor wouldn't perform the mastectomy. I had a friend be dismissed from a hospital with level 4 ovarian cancer, because she tested out of a study her doctor wanted to get into. She died, age 24. I had a grandmother on blue cross, blue shield (not medicaid, but doesn't pay as much) and the doctor AT HER ELDERY CARE FACILITY, wouldn't treat her after she fell and broke her hip.

You can tell me it's all anecdotal and that there are good doctors out there. I can't seem to find them, and I'm not a stupid man.

[InsaneApache]

It seems the same doctor has a record for doing this sort of thing.....


A CORONER investigating the death of a woman allegedly starved and deprived of fluids in hospital has been asked to hold an inquest into the death of a patient on the same ward.

Relatives of Harold Speed believe that he died of dehydration, not pneumonia as his death certificate says. The 84-year-old former music teacher had been examined by the same doctor who treated Olive Nockels, who died after her drips were removed.

Dr. Giggles (http://www.timesonline.co.uk/article/0,,2-2301896,00.html)

If you fall ill, make sure you get the hell out of East-Anglia.


Mr Speed and Mrs Nockels were patients on Kimberley ward at Norfolk and Norwich University Hospital.

It will be interesting to follow this and see where it leads....