This resentment ... had to do with feeling shut out. A library, I used to feel, was like a cocktail party with everybody standing with their back to me; I could not find a way in.
Alan Bennett on libraries of a lifetime
http://www.telegraph.co.uk/culture/books/8696077/Alan-Bennett-on-libraries-of-a-lifetime.html
Saturday, August 13, 2011
Friday, August 12, 2011
Thought for the Day
‘Poetry can save nations and people.’
Czesław Miłosz (1911 – 2004)
Polish Poet Laureate & winner of Nobel Prize for Literature
Czesław Miłosz (1911 – 2004)
Polish Poet Laureate & winner of Nobel Prize for Literature
Thursday, August 11, 2011
Quote of the Day (2)
Medicine stands in his way. He would have been a much finer writer if he hadn't been a doctor.
Count Leo Tolstoy
Count Leo Tolstoy
Quote of the Day
Medicine is my legal wife, literature my mistress. When I am bored with one I spend the night with the other. This is irregular but at least not monotonous and neither suffers from my infidelity. If I did not practice medicine, I could not devote my freedom of mind and my stray thoughts to literature.
Anton Chekov
Anton Chekov
Wednesday, August 10, 2011
Time Out
My wife and I have just returned from a week in the Kingdom of Heaven.
For the benefit of those who have their doubts about such a destination, we had a most enjoyable time and, once there, had no desire to make a hasty return. That said, the crossing from this land to that was rather turbulent at times; a process which took just under two hours and involved high winds and tempestuous waters. Nonetheless, it was worth the struggle, with sunshine, peace, tranquillity, and a high level of hospitality. I was also reminded of St Matthew’s gospel (it is easier for a camel to pass through the eye of a needle than for a rich man to enter the Kingdom of Heaven); providing an interesting reflection of the effects of our straightened national economy on those working within the National Health Service!
As one would expect, a dominant feature on the landscape in the Kingdom of Heaven is a church, which can be seen from some distance. However, contrary to expectation, there is also a very welcoming tavern, with lengthy licensing hours and a very good home-labelled draught bitter. Indeed, I confess that our time there was indulgent, with no work and hours free for idleness or leisurely pursuits. Sadly though, all good things must end and we were only able to spend one week in the Kingdom of Heaven before being forced to return; although the journey back was considerably easier, with calm water and a gentle breeze easing our passage. Back in this land, we are mentally and physically revived and looking forward to entering the Kingdom of Heaven again at our earliest opportunity.
Perhaps I should at this stage give a little explanation. In the Bristol Channel lies the magical island that is correctly called Lundy (http://www.lundyisland.co.uk). Over the centuries it has been owned by several wealthy families, including one whose surname was Heaven. Amongst the family was one Reverend Heaven, and it was he who was responsible for building the church; hence the sobriquet, ‘The Kingdom of Heaven’. Lundy is now owned by the National Trust, and the properties on the island are rented to holiday makers by the Landmark Trust. There are no cars on the island, and to get there, involves a two hour crossing by boat from one of two ports in Devonshire. The island is a wonderful nature reserve, with only one shop and a tavern. Once there, one has three miles of unspoilt and uncrowded rural beauty to relax in.
Having had one of your questions answered, you are possible now asking what relevance this has to someone reading this newspaper. My answer is that it has every relevance, especially in economically chastened times. Holidays are meant to provide the panacea to our daily toil. Sometimes, going somewhere close to home (by that, I mean staying within the British Isles) and doing something very simple which does not involve large daily expenditure, can be just as restful (if not more so) than travelling half-way round the world. You don’t even need to travel far from Northern Lincolnshire to achieve that, as we are blessed with some beautiful rural areas in Lincolnshire, Yorkshire and the adjacent counties. Simplicity is sometimes the answer to life’s daily stresses.
This article was first published in the Scunthorpe Telegraph, Wednesday 3rd August, 2011.
For the benefit of those who have their doubts about such a destination, we had a most enjoyable time and, once there, had no desire to make a hasty return. That said, the crossing from this land to that was rather turbulent at times; a process which took just under two hours and involved high winds and tempestuous waters. Nonetheless, it was worth the struggle, with sunshine, peace, tranquillity, and a high level of hospitality. I was also reminded of St Matthew’s gospel (it is easier for a camel to pass through the eye of a needle than for a rich man to enter the Kingdom of Heaven); providing an interesting reflection of the effects of our straightened national economy on those working within the National Health Service!
As one would expect, a dominant feature on the landscape in the Kingdom of Heaven is a church, which can be seen from some distance. However, contrary to expectation, there is also a very welcoming tavern, with lengthy licensing hours and a very good home-labelled draught bitter. Indeed, I confess that our time there was indulgent, with no work and hours free for idleness or leisurely pursuits. Sadly though, all good things must end and we were only able to spend one week in the Kingdom of Heaven before being forced to return; although the journey back was considerably easier, with calm water and a gentle breeze easing our passage. Back in this land, we are mentally and physically revived and looking forward to entering the Kingdom of Heaven again at our earliest opportunity.
Perhaps I should at this stage give a little explanation. In the Bristol Channel lies the magical island that is correctly called Lundy (http://www.lundyisland.co.uk). Over the centuries it has been owned by several wealthy families, including one whose surname was Heaven. Amongst the family was one Reverend Heaven, and it was he who was responsible for building the church; hence the sobriquet, ‘The Kingdom of Heaven’. Lundy is now owned by the National Trust, and the properties on the island are rented to holiday makers by the Landmark Trust. There are no cars on the island, and to get there, involves a two hour crossing by boat from one of two ports in Devonshire. The island is a wonderful nature reserve, with only one shop and a tavern. Once there, one has three miles of unspoilt and uncrowded rural beauty to relax in.
Having had one of your questions answered, you are possible now asking what relevance this has to someone reading this newspaper. My answer is that it has every relevance, especially in economically chastened times. Holidays are meant to provide the panacea to our daily toil. Sometimes, going somewhere close to home (by that, I mean staying within the British Isles) and doing something very simple which does not involve large daily expenditure, can be just as restful (if not more so) than travelling half-way round the world. You don’t even need to travel far from Northern Lincolnshire to achieve that, as we are blessed with some beautiful rural areas in Lincolnshire, Yorkshire and the adjacent counties. Simplicity is sometimes the answer to life’s daily stresses.
This article was first published in the Scunthorpe Telegraph, Wednesday 3rd August, 2011.
Thursday, July 28, 2011
Between Art and Science Sits the Patient
‘Ars longa, vita brevis’.
The Latin inscription is above the entrance door to the Postgraduate Medical Centre at the Hull Royal Infirmary. It is a salutary reminder to the physicians and surgeons who gather there in the pursuit of furthering their medical knowledge. Translated into English, the phrase enjoins us to remember that ‘art is long, life is short’. The original quotation was not in Latin but in Ancient Greek, and can be found at the beginning of a medical text book written by that well-known ancient physician, Hippocrates. The rest of his quotation reminds us that ‘opportunity is fleeting, experiment dangerous, and judgement difficult’.
Although written sometime between 460 – 370 BC, Hippocrates’ aphorism is as pertinent now as it was 2,400 years ago. The ‘art’ he speaks of is not that which we would commonly think of as art today (paintings, sculptures, literature etc.). Hippocrates’ art is the art of medical practise, and in the early years of the 21st century medicine remains just that; an art. Today, however, the modern physician would extend the concept by saying that medicine is ‘an art based on science’. The word science is also of Latin origin, meaning ‘knowledge’. The phrase ‘evidence-based medicine’ is perhaps the commonest way modern physicians refer to the inter-relationship of art and science when applied to medical practise.
What this all means is that medicine is far from being able to offer a perfect solution to every single ailment that besets humankind. In the consulting room, the most a doctor can be expected to do is to diligently apply (the art) the most contemporary knowledge (the science) to a patient’s presented problem. Sometimes great cures are brought about; occasionally there is little that can be done; more often than not, the work of the doctor is to modify the symptoms suffered by the patient in order to make life more pleasurable. The latter is summed up in another (19th century) aphorism: ‘to cure sometimes, to relieve often, to comfort always’, which neatly returns our thoughts to Hippocrates and his idea that ‘judgement is difficult’.
Doctors make judgements all the time; judgements are the end results of their application of art and science to patients’ problems. Judgements are not perfect and, ipso facto, neither are doctors or medicine; which is one reason why I believe that it is the duty of responsible newspapers not to be over-dramatic about small gains in medical science. Often a small scientific gain presents doctors with just another tiny piece of knowledge in the vast jigsaw of medicine, based on which judgements are made. It is rare that significant life-changing discoveries are made which will greatly influence the treatment of today’s patients.
A good example is the recent national press coverage of how the effects of certain drugs in combination can (by something called their anticholinergic effect on the nervous system) increase the risk of cognitive impairment (confusion and dementia-like symptoms) and death in people over the age of 65 years. No doubt my colleagues across the country had patients arriving in surgery clutching those newspaper cuttings, anxiously querying the effect of their drugs. The fact is the survey was based on drugs commonly used in the early 1990s. Twenty years later, many of those drugs are no longer used, or are rarely used in the combinations stated. Science has moved on and thus, too, has our art.
When I was a cub scout in the 1960s, we would salute our Arkela with the words ‘Arkela...we’ll do our best’. As far as doctors are concerned, the words of Hippocrates are more erudite than the ‘grand howl’ of the cubs. Nonetheless, the meaning is the same. Patients...we’ll do our best; but please remember we practise an art based on science; a science which is not, and never can be, perfect.
First published in the Scunthorpe Telegraph, Tuesday 12th July 2011.
The Latin inscription is above the entrance door to the Postgraduate Medical Centre at the Hull Royal Infirmary. It is a salutary reminder to the physicians and surgeons who gather there in the pursuit of furthering their medical knowledge. Translated into English, the phrase enjoins us to remember that ‘art is long, life is short’. The original quotation was not in Latin but in Ancient Greek, and can be found at the beginning of a medical text book written by that well-known ancient physician, Hippocrates. The rest of his quotation reminds us that ‘opportunity is fleeting, experiment dangerous, and judgement difficult’.
Although written sometime between 460 – 370 BC, Hippocrates’ aphorism is as pertinent now as it was 2,400 years ago. The ‘art’ he speaks of is not that which we would commonly think of as art today (paintings, sculptures, literature etc.). Hippocrates’ art is the art of medical practise, and in the early years of the 21st century medicine remains just that; an art. Today, however, the modern physician would extend the concept by saying that medicine is ‘an art based on science’. The word science is also of Latin origin, meaning ‘knowledge’. The phrase ‘evidence-based medicine’ is perhaps the commonest way modern physicians refer to the inter-relationship of art and science when applied to medical practise.
What this all means is that medicine is far from being able to offer a perfect solution to every single ailment that besets humankind. In the consulting room, the most a doctor can be expected to do is to diligently apply (the art) the most contemporary knowledge (the science) to a patient’s presented problem. Sometimes great cures are brought about; occasionally there is little that can be done; more often than not, the work of the doctor is to modify the symptoms suffered by the patient in order to make life more pleasurable. The latter is summed up in another (19th century) aphorism: ‘to cure sometimes, to relieve often, to comfort always’, which neatly returns our thoughts to Hippocrates and his idea that ‘judgement is difficult’.
Doctors make judgements all the time; judgements are the end results of their application of art and science to patients’ problems. Judgements are not perfect and, ipso facto, neither are doctors or medicine; which is one reason why I believe that it is the duty of responsible newspapers not to be over-dramatic about small gains in medical science. Often a small scientific gain presents doctors with just another tiny piece of knowledge in the vast jigsaw of medicine, based on which judgements are made. It is rare that significant life-changing discoveries are made which will greatly influence the treatment of today’s patients.
A good example is the recent national press coverage of how the effects of certain drugs in combination can (by something called their anticholinergic effect on the nervous system) increase the risk of cognitive impairment (confusion and dementia-like symptoms) and death in people over the age of 65 years. No doubt my colleagues across the country had patients arriving in surgery clutching those newspaper cuttings, anxiously querying the effect of their drugs. The fact is the survey was based on drugs commonly used in the early 1990s. Twenty years later, many of those drugs are no longer used, or are rarely used in the combinations stated. Science has moved on and thus, too, has our art.
When I was a cub scout in the 1960s, we would salute our Arkela with the words ‘Arkela...we’ll do our best’. As far as doctors are concerned, the words of Hippocrates are more erudite than the ‘grand howl’ of the cubs. Nonetheless, the meaning is the same. Patients...we’ll do our best; but please remember we practise an art based on science; a science which is not, and never can be, perfect.
First published in the Scunthorpe Telegraph, Tuesday 12th July 2011.
Friday, July 08, 2011
Being Human
Have you ever wondered what is it that makes us human? What are the particular aspects that make you and me different; not only from other animals, but from every other one of the seven billion people alive today on this planet? The permutations are enormous. However, it is the small variations in physical and personal attributes which allow us to identify one person from the next.
Yet, amidst this pot pourri of the world’s humanity there are emotional traits which allow us to empathise with our next door neighbour, sympathise with struggling tribes in Africa, go to war with other countries, or fall in love with someone far removed from our own community. These are the complex peculiarities which bind us all together in that group called human-kind or humanity.
Stemming from the same Latin origin as the word ‘human’ is the term ‘humanities’; the academic disciplines that involve the study of that which we term the ‘human condition’. Included within this group are literature, art, music, languages, law, history, philosophy and ethics. By increasing our knowledge of these topics we can begin to really understand what it is to be human.
However, here lies a conundrum. We often turn to the doctor, and most specifically the GP, for help at times of both physical and emotional difficulty with the expectation that he or she will understand what it is that we are experiencing. After all, that is what doctors are trained to do, isn’t it? Paradoxically, the reality is that this is one area where doctors have the least training, and the problem starts early on when we are choosing A Level subjects. Traditionally, budding medical students are encouraged to study biology, chemistry and physics; three sciences that assist us to understand the physical nature of the body, and enable us to diagnose and repair it when something has gone wrong. We are academically forced, at a formative stage, to abandon those subjects which are equally important to achieve a rounded education and produce experts in understanding human-kind.
This omission is what has led some universities to now include a humanities module within their training programme for medical undergraduates. In addition, it is now possible to study for a Master of Arts degree in medicine and literature; investigating the interaction between the two disciplines. After all, some of the world’s greatest authors knew a thing or two about what being human really entails. Think, for example, of the works of Emily Brontë (Wuthering Heights), Shakespeare (A Midsummer Night’s Dream), Tolstoy (Anna Karenina), James Joyce (Ulysses), Thomas Hardy (The Woodlanders), Charles Dickens (Bleak House), Charlotte Brontë (Jane Eyre), D H Lawrence ( Women in Love), E M Foster (A Passage to India), and Evelyn Waugh (Decline and Fall). The list is endless. All these authors explored the emotional depths of humanity; that is why their works have found a lasting place in our collective souls; their characters are reflections of what it is to be human; to be you and me in all our times of trial and happiness.
So next time you wonder whether your GP is up to date, don’t ask which medical journals he or she is reading; ask whether your GP has recently read a classical novel. If the answer is ‘yes’, you may have found a doctor who really understands what being human is all about.
First published in the Scunthorpe Telegraph, Wednesday 15th June 2011
Yet, amidst this pot pourri of the world’s humanity there are emotional traits which allow us to empathise with our next door neighbour, sympathise with struggling tribes in Africa, go to war with other countries, or fall in love with someone far removed from our own community. These are the complex peculiarities which bind us all together in that group called human-kind or humanity.
Stemming from the same Latin origin as the word ‘human’ is the term ‘humanities’; the academic disciplines that involve the study of that which we term the ‘human condition’. Included within this group are literature, art, music, languages, law, history, philosophy and ethics. By increasing our knowledge of these topics we can begin to really understand what it is to be human.
However, here lies a conundrum. We often turn to the doctor, and most specifically the GP, for help at times of both physical and emotional difficulty with the expectation that he or she will understand what it is that we are experiencing. After all, that is what doctors are trained to do, isn’t it? Paradoxically, the reality is that this is one area where doctors have the least training, and the problem starts early on when we are choosing A Level subjects. Traditionally, budding medical students are encouraged to study biology, chemistry and physics; three sciences that assist us to understand the physical nature of the body, and enable us to diagnose and repair it when something has gone wrong. We are academically forced, at a formative stage, to abandon those subjects which are equally important to achieve a rounded education and produce experts in understanding human-kind.
This omission is what has led some universities to now include a humanities module within their training programme for medical undergraduates. In addition, it is now possible to study for a Master of Arts degree in medicine and literature; investigating the interaction between the two disciplines. After all, some of the world’s greatest authors knew a thing or two about what being human really entails. Think, for example, of the works of Emily Brontë (Wuthering Heights), Shakespeare (A Midsummer Night’s Dream), Tolstoy (Anna Karenina), James Joyce (Ulysses), Thomas Hardy (The Woodlanders), Charles Dickens (Bleak House), Charlotte Brontë (Jane Eyre), D H Lawrence ( Women in Love), E M Foster (A Passage to India), and Evelyn Waugh (Decline and Fall). The list is endless. All these authors explored the emotional depths of humanity; that is why their works have found a lasting place in our collective souls; their characters are reflections of what it is to be human; to be you and me in all our times of trial and happiness.
So next time you wonder whether your GP is up to date, don’t ask which medical journals he or she is reading; ask whether your GP has recently read a classical novel. If the answer is ‘yes’, you may have found a doctor who really understands what being human is all about.
First published in the Scunthorpe Telegraph, Wednesday 15th June 2011
Friday, July 01, 2011
How Useful is the Establishment of a Duty of Care for our Armed Forces?
Much has been written in recent months regarding the ‘duty of care’ this country has to its armed forces. Such a duty does not have to be enshrined in statute law and the establishment of such a duty is often left to the common law to determine in respect to individual cases. However, it is a welcomed fact that the duty is being enshrined within the Armed Forces Bill currently moving its way through parliament.
That said, whilst many people were, through the media of press and television, publically rejoicing at the Government’s decision, I was led to consider what such inclusion might mean in reality, and whether it was just a statement of the existing situation rather than a positive move towards establishing that which most people really want; that is, practical care of our serving forces personnel and their families, along with appropriate after-care when they leave the forces (and especially so if they are injured). The best way I can describe my concerns is to consider the duty of care which exists in respect to the role of healthcare personnel to our patients.
The Oxford Dictionary of Law defines ‘duty of care as ‘The legal obligation to take reasonable care to avoid causing damage’. Clearly, that is an understandable duty in respect to the actions of a doctor, for example. However, the same concept does not translate very well to a soldier serving in the front line of a war zone. In medicine, it is a duty which has been established in common law and is enshrined within the General Medical Council’s Code of Practice for doctors. From a patient’s perspective, the purpose of establishing a duty of care is to ensure that the patient is treated well. The flip side is, of course, that a patient might seek legal remedy should there be the perception that something has gone wrong in the process of that duty being performed. Therein often resides the difficulty, for establishing negligence (and thus being eligible for compensation) is a tortuous path to tread.
To establish negligence a patient must first show that there existed a duty of care; that done, the next step is to prove that there was a failure on the part of the doctor to fulfil that duty. Finally, it has to be shown that the failure directly led to the injury for which the patient seeks compensation. If there is no injury sustained, or the causal link between the three factors cannot be proven, then there is no remedy in law as negligence has not been established.
In medicine, the whole process is often confounded at the second hurdle, as what constitutes good or appropriate care is not always clear-cut within a profession that is only partially based on science. The Bolam test is often quoted, being a judgement stemming from a 1957 court case (Bolam v. Friern Hospital Management Committee), when it was established that ‘a doctor is not guilty of negligence if he has acted in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art’. So, if it is as difficult as that within the realm of healthcare, what hope does the family of an injured soldier have, where the boundaries are even less clear? I fear that the current inclusion may be a good start, but the victory may still prove to be very hollow in a practical sense.
First Published in the Scunthorpe Telegraph, Monday 30th May 2011
That said, whilst many people were, through the media of press and television, publically rejoicing at the Government’s decision, I was led to consider what such inclusion might mean in reality, and whether it was just a statement of the existing situation rather than a positive move towards establishing that which most people really want; that is, practical care of our serving forces personnel and their families, along with appropriate after-care when they leave the forces (and especially so if they are injured). The best way I can describe my concerns is to consider the duty of care which exists in respect to the role of healthcare personnel to our patients.
The Oxford Dictionary of Law defines ‘duty of care as ‘The legal obligation to take reasonable care to avoid causing damage’. Clearly, that is an understandable duty in respect to the actions of a doctor, for example. However, the same concept does not translate very well to a soldier serving in the front line of a war zone. In medicine, it is a duty which has been established in common law and is enshrined within the General Medical Council’s Code of Practice for doctors. From a patient’s perspective, the purpose of establishing a duty of care is to ensure that the patient is treated well. The flip side is, of course, that a patient might seek legal remedy should there be the perception that something has gone wrong in the process of that duty being performed. Therein often resides the difficulty, for establishing negligence (and thus being eligible for compensation) is a tortuous path to tread.
To establish negligence a patient must first show that there existed a duty of care; that done, the next step is to prove that there was a failure on the part of the doctor to fulfil that duty. Finally, it has to be shown that the failure directly led to the injury for which the patient seeks compensation. If there is no injury sustained, or the causal link between the three factors cannot be proven, then there is no remedy in law as negligence has not been established.
In medicine, the whole process is often confounded at the second hurdle, as what constitutes good or appropriate care is not always clear-cut within a profession that is only partially based on science. The Bolam test is often quoted, being a judgement stemming from a 1957 court case (Bolam v. Friern Hospital Management Committee), when it was established that ‘a doctor is not guilty of negligence if he has acted in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art’. So, if it is as difficult as that within the realm of healthcare, what hope does the family of an injured soldier have, where the boundaries are even less clear? I fear that the current inclusion may be a good start, but the victory may still prove to be very hollow in a practical sense.
First Published in the Scunthorpe Telegraph, Monday 30th May 2011
Friday, June 17, 2011
To be or not to be (a doctor)
'If you had your time again, would you still have become a doctor?'
The latter was a question to me a few weeks ago, not long after my article regarding the current NHS political changes. It was an interesting question, and one I have asked myself over many years. Careful consideration always produces the same honest, emphatically positive response. It is true that I can think of other paths I would have liked to travel; other subjects I would have enjoyed reading at university; other areas of the country (or even the world) where I would have enjoyed living. Then again, which of us (regardless of the nature of our upbringing, social status, occupation or interests) hasn't had similar thoughts? Is that not simply a case of 'the other man's grass is always greener'? Ultimately, we have to settle for something which will provide the backbone to our lives. Thirty one years after I first walked into a London medical school, I have no hesitation in saying that I would still chose to become a doctor.
Of course, 'becoming a doctor' is not quite the same thing as receiving a Bachelor's degree in medicine. There are many years following the five or six spent as a medical student before a doctor can feel that he or she has arrived at the long-sought destination, during which time a junior doctor jumps the various postgraduate hurdles of training posts and postgraduate examinations. Even then, there is the need for life-long dedication to continuing professional development.
So you may ask why I would do it all again; why, when the training is arduously prolonged, the workload overwhelming, and the political interference with the NHS so frustrating? The answer is because a medical degree can be one of life's most valuable passports. I am sure other professionals would claim similar attributes for their own qualifications. Nonetheless, the intimate involvement in people's lives that the practise of medicine requires can be both spiritually rewarding and tremendously humbling; bringing with it a tremendous sense of worth and satisfaction that few other occupations can easily trump. There is also the chance of a decent standard of living; although not necessarily a fortune to be made. However, the qualification is far more valuable than that. With imagination and determination, a medical degree can open so many opportunities in life that it is difficult to say where the boundaries are. In my view, those opportunities are far more valuable experiences than the acquisition of wealth.
This column is not a place for me to blow my personal trumpet. It is suffice to say that, suitably armed in educational terms, I have ventured into numerous occupational realms that, as a child, I never dreamt I would access. I have also had the pleasure of travelling the world, participating in grand society events and meeting people from all walks of life. For me, a medical degree has been the passport to life's sweet shop, enabling me to fulfil Rudyard Kipling's maxim of filling 'the unforgiving minute' in a kaleidoscope of ways.
So, the answer to the original question is an emphatic 'yes'; I would still become a doctor and, placing medical politics aside, I would encourage others to do so. More importantly, to any young person considering reading medicine, I would exhort you not to consider your degree as the 'be all and end all' of your aspirations. There is a whole world out there; with effort, determination, and imagination it is all yours to sample.
First published in the Scunthorpe Telegraph, Wednesday 11th May 2011
Monday, June 13, 2011
The Encouraged Optimist
Sign seen on the bar of a pub ('The Dog') in Whalley, Lancashire:
'I'm going to live forever.
So far, so good.'
Saturday, June 04, 2011
Extra, Extra, Read all about it!
Blessed with such wonderful weather, the Easter weekend was a great opportunity to clock up some time exercising in the great British outdoors; which is precisely what I had the fortune to be doing in that land known as God's own country, the Yorkshire Dales. However, with a few days away from the turmoil of the surgery, it was also an excellent time to catch up on some serious reading of an ever-growing backlog of medical journals.
Keeping up to date with medical developments is a task that doctors endeavour to perform on a regular and life-long basis. It is almost an impossible task, and we can only try to do some justice to the postbags of journals and medical newspapers that fall through our letterboxes on a weekly basis. However, most of us will select and concentrate on a few favourites and then scan the remainder for particularly eye-catching articles which the others may not have covered. For me, the British Medical Journal and the Journal of the
Royal College of General Practitioners are the main players, topped up with a couple of medical news magazines called GP and Pulse.
This particular weekend was of considerable interest, and I was able to update my knowledge of how vitamins pills may be bad for you by increasing the desire for fast foods (reported in the journal Psychological Science). I also took notice of various public health articles on the smog alert affecting Britain; found that the Archives of Disease in Childhood contained research linking excessively crying babies with the later development of behavioural problems; learned that the journal Arteriosclerosis, Thrombosis and Vascular Biology was reporting on the link between the time children watch television and the development of heart disease and high blood pressure; discovered that the General Medical Council is considering holding misconduct hearings for GPs behind closed doors; and that peat moss was once used for dressings for battle wounds during the First World War. Further reading included an article on euthanasia, and how elderly people in Holland are now carrying cards to ensure that doctors do not over-enthusiastically end their lives. There were also papers with evidence that playing a musical instrument may help protect against Alzheimer's Disease (reported in the journal Neuropsychology); reports on how air pollution raises the risk of breast cancer (reported by the American Association for Cancer Research), and finally, that the Boston University Medical School had discovered that the 'older' types of contraceptive pill may be safer than newer versions.
All of the above made for fascinating reading. However, the truth is, none of the articles were actually from the journals I earlier reported reading on a regular basis. In fact, they were all to be found in the nation's daily newspapers. I cannot imagine for one moment that any GP actually receives half of the journals mentioned above, let alone gets to read them. So, despite our best of efforts, we cannot possibly keep on top of every single development in medical science; I am not even certain that retirement would allow sufficient time to do achieve such a herculean task.
One often hears the phrase 'if in doubt, consult your GP'. However, a gentle plea on behalf of all my GP colleagues: whilst we do our best to keep our knowledge fresh, the next time you come to the surgery to discuss an article in this week's news, please bear in mind that journalists will often trawl through esoteric science journals to find eye-catching headlines which the jobbing GP will never read at first hand. If we sit their nodding wisely and saying nothing, it is probably because we are totally bemused and wishing we had paid more attention to the weekend's newspapers.
First Published in the Scunthorpe Telegraph, Monday 2nd May 2011
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