The problem isn’t that their leader is old. It’s their ideas that are long past their sell-by date. They should have grown out of them years ago.

At two o’clock in the morning she lit up a cigarette in her bedroom, activated the smoke detector and set off the fire alarm. All the patients had to leave their rooms and go to the assembly point on the front lawn. The fire engines arrived and the fireman searched the building and found the tell-tale smoke detector.

In the morning the girl herself said she was too tired to go to the group therapy session. She made no apology to anyone.

Nicotine addiction is just as self-centred and inconsiderate as any other.

Sir Michael Rawlins, the chairman of the National Institute for Clinical Excellence (NICE), the body that tells doctors what they should prescribe or do, is upset that many charities have links with pharmaceutical companies that produce drugs relevant to the particular condition that they support (Aricept for Alzheimer’s disease, Herceptin for breast cancer). He’s got a nerve: the funding for NICE comes from the government.

“If it isn’t a novel or a biography, I\’m not interested.”

No chance there – but at least he was direct.

My late father-in-law always claimed to have beautiful feet. I cannot make that claim myself. When I was twenty (before the days of steel-capped boots) I was working on a building site to earn some holiday money when the fold-down side of a lorry fell off and smashed my left big toe. The nail has never grown right since that time and it becomes more of a horn. Periodically I have to have it cut out surgically or I spend a painful half hour or more tackling it myself.

Now Meg has found a home chiropody kit with a large drill which simply files the toenail away painlessly in a couple of minutes. The drill has its use. And, as if there was ever any doubt, so does Meg.

(Whoops, I think I could be in trouble for this one.)

I like the idea of starting afresh. I like it a lot. I want to get those punitive ideas right out of the place. I’ll take on the whole lot of them and stick to my own beliefs: tolerance, kindness, perseverance and support rather than arrogance, fear, punishment and rejection. The problem is that once those negative ideas come in they tend to take root. They don’t respond to reason or to giving examples of alternatives. They have to be pulled out. Fortunately, I am in a strong enough position to be able to do that and I’ve had plenty of experience, in one field or another, of starting again on my own. That’s the way I created my medical practice and the way I kept the Recovery Centre going in previous rebellious times.

Let me establish one thing for certain for once and for all: anyone who wants to challenge my ideas is welcome to do so – but equally I give myself the right to have my own.

She’s good, very, very good. It’s a real joy to have her on the staff. Actually, come to think of it, that applies to the vast majority of our staff. That’s the privilege of working in the private sector. People who aren’t any good don’t stay with us for very long. We see to that.

He is a massively strong man but some idiot has made him into a jibbering wreck by prescribing him large doses of tranquilisers for many years. I took him off them gradually but even then the withdrawal effects (presumably previously misdiagnosed as an indication for even more drugs rather than less) were difficult. We let him punch the bag in the gym but that was insufficient. He came to all the group therapy sessions and contributed as well as he could. He was no trouble to anyone. He missed his wife and young children but was prepared to do so if it meant that he could be free from the curse of the wretched drugs that took everything away from the colour of his emotional life and gave him nothing but grief when he tried to come off them.

I had no choice but to slow down the rate of withdrawal. He was very grateful to me. I think that was inappropriate. I have done nothing other than try to undo the damage caused by a whole clinical philosophy of disrespect for the integrity of the human brain that drugs it into submission rather than encourages and even loves it into health.

The sun doesn’t tan me: it burns me. Now I look moth-eaten. Meg has told me to be more careful in future. I don’t think she was referring to the risk of melanoma. She wants something less tatty to take out to supper.

I saw a starling. Just one. Where are all the others? I didn’t hear a cuckoo at all this year. I haven’t seen or heard a skylark yet. This dearth can’t all be due to the cats. Nor to changes in local farming methods because there haven’t been any. Nor to climate change because it hasn’t yet been all that drastic. Why?