"If I don't write to empty my mind, I go mad."
Lord Byron
Sunday, February 05, 2012
Saturday, February 04, 2012
Training to go Through the Keyhole
I am not usually a competitive person, at least not in respect to other people; although I do constantly compete within myself, striving to attain new goals and improve personal standards. However, my sense of isolated self-confidence took a thorough beating over the course of the New Year weekend. Indeed, ‘beating’ is probably not the correct word; I was, without an iota of doubt, comprehensively thrashed.
Finding myself in the position of ‘opponent’ for a game of glorified skittles, and then watching shamefaced as my challenger scored one ‘strike’ after another compared to my own one or two pins, was a humbling experience. The completion of my ignominious defeat was a round of golf, wherein I bounced from one bunker to another (when I wasn’t in the rough or hitting trees), whilst my competitor took hole after hole for a double-bogey (that’s two over par for the uninitiated). The problem was that I have never really mastered the art of ten-pin bowling or golf. Indeed, I have never previously played golf; the nearest I have been to a tee being a romp in the rough as a teenager (trying to find lost balls to turn into cash), and the occasional quick dash across a green as an adult, whilst negotiating an awkwardly placed public footpath.
There is worse to come, for I have more terrible confessions to make than the above. Not only was my opponent female (if you will allow me to be sexist in defeat), but she was considerably younger than my five decades. Indeed, she hadn’t quite reached her first decade. Oh, okay, I confess it; she was only four years old. There, I am totally chastened now; my morale has well and truly sunk below the horizon. I was decisively beaten by a debutante from a kindergarten.
By now you may well have guessed that all may not be what it seems. In truth, we were playing with games on a Nintendo Wii, with a television screen being the nearest we got to a bowling alley or the big outdoors. ‘Shame’, I hear you cry. However, before you castigate me for encouraging a child to waste valuable development time in front of a television screen, allow me to offer you the following for consideration.
In my daytime profession of medicine, the technical skills required in an operating theatre have changed beyond all recognition. Minimally invasive (keyhole) surgery has been one of the most radical changes since I qualified. No longer is there a need to operate through large open wounds for many procedures; including unblocking coronary arteries, repairing torn knee ligaments, removing gall-bladders, or taking a peek inside a bladder or the bowel. Instead, the surgeon often stares at a television screen whilst manipulating various gadgets, the ends of which have disappeared down small holes in the patient. Often life-saving miracles are seemingly performed by remote control.
The skills required to perform such procedures are feats of dexterity; dexterity which I clearly lacked whilst trying to salvage my ego from the skilful attack of a four-year old. The real problem for me is that I became an adult when such computerised games were in their infancy, and I have never made up for that short-coming. By comparison, today’s children are masters of such technology. Whilst I am the first to agree that children should regularly get outside in the fresh air for a spot of healthy exercise, I also have no doubt that they should be allowed to spend time in front of televisions and computer screens, playing entertaining computerised games. At such times, what they are really doing is learning valuable skills of dexterity and spatial awareness which may serve them very well in their professional adult lives. Achieving a balance between the two extremes is important, but I suggest that computer games are not necessarily the childhood evil they are often painted to be.
As for my four-year-old opponent, after the game of golf she went off to play with her toy doctor’s trolley. Who knows, perhaps I have just been witnessing a future brain-surgeon in the making.
(First published in the Scunthorpe Telegraph, Thursday, 12th January 2012)
Finding myself in the position of ‘opponent’ for a game of glorified skittles, and then watching shamefaced as my challenger scored one ‘strike’ after another compared to my own one or two pins, was a humbling experience. The completion of my ignominious defeat was a round of golf, wherein I bounced from one bunker to another (when I wasn’t in the rough or hitting trees), whilst my competitor took hole after hole for a double-bogey (that’s two over par for the uninitiated). The problem was that I have never really mastered the art of ten-pin bowling or golf. Indeed, I have never previously played golf; the nearest I have been to a tee being a romp in the rough as a teenager (trying to find lost balls to turn into cash), and the occasional quick dash across a green as an adult, whilst negotiating an awkwardly placed public footpath.
There is worse to come, for I have more terrible confessions to make than the above. Not only was my opponent female (if you will allow me to be sexist in defeat), but she was considerably younger than my five decades. Indeed, she hadn’t quite reached her first decade. Oh, okay, I confess it; she was only four years old. There, I am totally chastened now; my morale has well and truly sunk below the horizon. I was decisively beaten by a debutante from a kindergarten.
By now you may well have guessed that all may not be what it seems. In truth, we were playing with games on a Nintendo Wii, with a television screen being the nearest we got to a bowling alley or the big outdoors. ‘Shame’, I hear you cry. However, before you castigate me for encouraging a child to waste valuable development time in front of a television screen, allow me to offer you the following for consideration.
In my daytime profession of medicine, the technical skills required in an operating theatre have changed beyond all recognition. Minimally invasive (keyhole) surgery has been one of the most radical changes since I qualified. No longer is there a need to operate through large open wounds for many procedures; including unblocking coronary arteries, repairing torn knee ligaments, removing gall-bladders, or taking a peek inside a bladder or the bowel. Instead, the surgeon often stares at a television screen whilst manipulating various gadgets, the ends of which have disappeared down small holes in the patient. Often life-saving miracles are seemingly performed by remote control.
The skills required to perform such procedures are feats of dexterity; dexterity which I clearly lacked whilst trying to salvage my ego from the skilful attack of a four-year old. The real problem for me is that I became an adult when such computerised games were in their infancy, and I have never made up for that short-coming. By comparison, today’s children are masters of such technology. Whilst I am the first to agree that children should regularly get outside in the fresh air for a spot of healthy exercise, I also have no doubt that they should be allowed to spend time in front of televisions and computer screens, playing entertaining computerised games. At such times, what they are really doing is learning valuable skills of dexterity and spatial awareness which may serve them very well in their professional adult lives. Achieving a balance between the two extremes is important, but I suggest that computer games are not necessarily the childhood evil they are often painted to be.
As for my four-year-old opponent, after the game of golf she went off to play with her toy doctor’s trolley. Who knows, perhaps I have just been witnessing a future brain-surgeon in the making.
(First published in the Scunthorpe Telegraph, Thursday, 12th January 2012)
Men's Talk
Whilst the Christmas festivities are still in our minds, I thought we would start January with one of those cracker-style questions. What do the Book of Psalms, Sir David Frost, the European Commission, Loyd Grossman, the Irish Republic, the Chancellor of the Exchequer, and His Royal Highness the Duke of Edinburgh have in common?
The comedians amongst you will think of all sorts of answers. However, this particular quiz question has a serious message, especially if you are a man. (Ignore the female reader who just remarked that all men are jokes, and keep reading for the important bits).
As we have just had an important religious festivity (that might come as a surprise, but we’ll not go there today), I will start with the Book of Psalms from the Bible’s Old Testament. ‘But ye shall die like men’, reads verse 6 of Psalm 82. I doubt whether the writer of that particular psalm had the concept of 21st century public health in his mind. However, unknown to the author, it was a prescient statement with great modern-day significance.
But back to the quiz; have you got the answer yet? Perhaps Loyd Grossman can help. Grossman was the location presenter of the 1980’s TV game ‘Through the Keyhole’, hosted by Sir David Frost. One of his catch phrases, as viewers were about to be shown around a celebrity’s house, was ‘let’s go through the keyhole’. Ah, I can hear the penny dropping. Yes, you are quite right; the Duke of Edinburgh has recently undergone cardiac surgery; being the recipient of a minimally invasive technique, commonly called ‘key-hole surgery’. (Yes, I know the links are a bit corny, but I did liken this article to the standard found in Christmas crackers.)
So that leaves us with the European Commission, the Republic of Ireland and the Chancellor of the Exchequer to pull into the conundrum. Since you have done so well by reading up to this point, I will quickly quell your mounting sense of suspense. Towards the end of 2011, The European Commission published a report called ‘The State of Men’s Health in Europe’. Apparently, of all the European countries, the Republic of Ireland is the only member which has a national men’s health policy; all the rest treat men the same as women and children. Unfortunately, a ‘one size fits all’ approach doesn’t do men any favours, as working age men have significantly higher death rates than working age women (210% higher, in fact; not quite what the psalmist had in mind, but he was right, nonetheless).
Flawed life-styles are not the only reason for men’s greater mortality rates; although smoking, obesity, high-fat diets, excess alcohol and a lack of exercise are important causes of coronary heart disease. Road and workplace accidents are also significant issues. The fact that men do not make best use of health services and health-related programmes as much as women is also a contributory factor. (A good example is the fact that only 42% of patients participate in cardiac rehabilitation after a heart attack, bypass surgery or angioplasty; although I am afraid that Prince Philip’s example of attending a shooting-party lunch does not count as cardiac rehabilitation).
Finally, why should the Chancellor of the Exchequer be concerned about all of the above? Well, it is estimated that by 2060, there will be 24 million fewer working age men across Europe. That is a lot of lost tax revenue. There will also be 32 million more men (mainly not working) over the age of 65 years; a fact that should exercise both the Chancellor and the Secretary of State for Health. Perhaps we should be lobbying our MPs for a ‘men’s health policy’, rather than let the Government spend valuable resources on re-arranging the deckchairs on the Good Ship NHS. ‘Equality for Men!’ – now, there is a good slogan for 2012. As for me, I think I might pop over to the Irish Republic for a spot of masculine pampering.
(First published in the Scunthorpe Telegraph, Thursday, 5th January 2012)
The comedians amongst you will think of all sorts of answers. However, this particular quiz question has a serious message, especially if you are a man. (Ignore the female reader who just remarked that all men are jokes, and keep reading for the important bits).
As we have just had an important religious festivity (that might come as a surprise, but we’ll not go there today), I will start with the Book of Psalms from the Bible’s Old Testament. ‘But ye shall die like men’, reads verse 6 of Psalm 82. I doubt whether the writer of that particular psalm had the concept of 21st century public health in his mind. However, unknown to the author, it was a prescient statement with great modern-day significance.
But back to the quiz; have you got the answer yet? Perhaps Loyd Grossman can help. Grossman was the location presenter of the 1980’s TV game ‘Through the Keyhole’, hosted by Sir David Frost. One of his catch phrases, as viewers were about to be shown around a celebrity’s house, was ‘let’s go through the keyhole’. Ah, I can hear the penny dropping. Yes, you are quite right; the Duke of Edinburgh has recently undergone cardiac surgery; being the recipient of a minimally invasive technique, commonly called ‘key-hole surgery’. (Yes, I know the links are a bit corny, but I did liken this article to the standard found in Christmas crackers.)
So that leaves us with the European Commission, the Republic of Ireland and the Chancellor of the Exchequer to pull into the conundrum. Since you have done so well by reading up to this point, I will quickly quell your mounting sense of suspense. Towards the end of 2011, The European Commission published a report called ‘The State of Men’s Health in Europe’. Apparently, of all the European countries, the Republic of Ireland is the only member which has a national men’s health policy; all the rest treat men the same as women and children. Unfortunately, a ‘one size fits all’ approach doesn’t do men any favours, as working age men have significantly higher death rates than working age women (210% higher, in fact; not quite what the psalmist had in mind, but he was right, nonetheless).
Flawed life-styles are not the only reason for men’s greater mortality rates; although smoking, obesity, high-fat diets, excess alcohol and a lack of exercise are important causes of coronary heart disease. Road and workplace accidents are also significant issues. The fact that men do not make best use of health services and health-related programmes as much as women is also a contributory factor. (A good example is the fact that only 42% of patients participate in cardiac rehabilitation after a heart attack, bypass surgery or angioplasty; although I am afraid that Prince Philip’s example of attending a shooting-party lunch does not count as cardiac rehabilitation).
Finally, why should the Chancellor of the Exchequer be concerned about all of the above? Well, it is estimated that by 2060, there will be 24 million fewer working age men across Europe. That is a lot of lost tax revenue. There will also be 32 million more men (mainly not working) over the age of 65 years; a fact that should exercise both the Chancellor and the Secretary of State for Health. Perhaps we should be lobbying our MPs for a ‘men’s health policy’, rather than let the Government spend valuable resources on re-arranging the deckchairs on the Good Ship NHS. ‘Equality for Men!’ – now, there is a good slogan for 2012. As for me, I think I might pop over to the Irish Republic for a spot of masculine pampering.
(First published in the Scunthorpe Telegraph, Thursday, 5th January 2012)
Saturday, January 21, 2012
New Year Expectations
‘Be not inhospitable to strangers, lest they be angels in disguise.’
The latter was not written by W. B. Yeats (as is commonly quoted), but can be found in the book of Hebrews (13.2). It seems a good New Year resolution for us all to adopt, for wouldn’t the world be a greater place? However, a less sanguine approach will be taken by many, with the realisation that we have yet to resolve the financial difficulties that have recently beset us. A line genuinely by Yeats, from his poem Easter 1916, is more appropriate to the straitened times we continue to face: ‘All changed, changed utterly: A terrible beauty is born.’
I suggest that the beauty in this case could come with the growing need to increasingly draw on our own resources for food and entertainment, as money and jobs become scarcer. Growing your own fruit and vegetables is a remarkably healthy activity, with fresh air and exercise providing physical and mental well-being, combined with fresh food and a reduced grocery bill. Home-grown entertainment provides another mental boost, such as the company of friends around a table of home-cooked food, digging out those old board games, or re-discovering a good book that has languished untouched on a shelf for years. In the year of Charles Dickens’ 200th anniversary, perhaps re-reading one of his would be a good place to start for mental nourishment (for the New Year, what better than Great Expectations?).
You may have other New Year resolutions such as losing weight, exercising more, stopping smoking, drinking less alcohol, reducing cholesterol, and so on; all good worthy aims. However, why not add to those one or two other issues that you would like to see society confront as a whole? New Year should not be just about tackling personal issues. If society was made a better and healthier place, so too would be our own lives by default.
For example, just consider some of the problems society is currently facing. Eleven million people alive today will live to see their 100th birthday (almost 18% of the population), meaning that the pension crisis is only in its infancy. The concomitant reduction in the social care budget for elderly care only compounds the difficulties our elderly are already facing. At the other end of the spectrum, there is a global shortage of midwives (including in the UK), costing a million lives per year in infant and maternal deaths; whilst our own under-age pregnancy rate continues to rise, as does the rate of sexually transmitted disease amongst teenage girls. Of course, alcohol remains part of the problem; additionally causing injuries, relationship breakdowns and loss of working time.
Elsewhere, a lack of donor organs for transplantation sees precious (often young) lives needlessly lost; whilst the medico-legal world struggles with the issues of voluntary euthanasia and the use of organs harvested as a result. In Britain alone, tens of thousands of children wait for families to adopt them, as their formative years disappear, often amidst peripatetic lives of one foster home after another. Meanwhile, the bedrock of our caring society, the National Health Service, is under very real threat, as is our traditional approach to General Practice as the centre of that service. And if that is not sufficient, the very core values that often drive individuals within caring professions are being demonised and extruded from the workplace; I speak of those values deeply rooted in a person’s faith, be it Christianity, Islam, Judaism, Buddhism or any other where the fundamental teaching and beliefs, when appropriately harnessed, can be a powerful aid to all in our society.
New Year is about resolutions, change and fresh starts. Exercise more and stop smoking by all means (in fact, please do). However, what about making 2012 the year when you resolve to make a small contribution to at least one of the many other challenges facing our worldwide society? After all, major successes all start with small steps.
A happy, healthy and thoughtful New Year to you all.
(First published in the Scunthorpe Telegraph, Thursday, 29th December 2012.)
The latter was not written by W. B. Yeats (as is commonly quoted), but can be found in the book of Hebrews (13.2). It seems a good New Year resolution for us all to adopt, for wouldn’t the world be a greater place? However, a less sanguine approach will be taken by many, with the realisation that we have yet to resolve the financial difficulties that have recently beset us. A line genuinely by Yeats, from his poem Easter 1916, is more appropriate to the straitened times we continue to face: ‘All changed, changed utterly: A terrible beauty is born.’
I suggest that the beauty in this case could come with the growing need to increasingly draw on our own resources for food and entertainment, as money and jobs become scarcer. Growing your own fruit and vegetables is a remarkably healthy activity, with fresh air and exercise providing physical and mental well-being, combined with fresh food and a reduced grocery bill. Home-grown entertainment provides another mental boost, such as the company of friends around a table of home-cooked food, digging out those old board games, or re-discovering a good book that has languished untouched on a shelf for years. In the year of Charles Dickens’ 200th anniversary, perhaps re-reading one of his would be a good place to start for mental nourishment (for the New Year, what better than Great Expectations?).
You may have other New Year resolutions such as losing weight, exercising more, stopping smoking, drinking less alcohol, reducing cholesterol, and so on; all good worthy aims. However, why not add to those one or two other issues that you would like to see society confront as a whole? New Year should not be just about tackling personal issues. If society was made a better and healthier place, so too would be our own lives by default.
For example, just consider some of the problems society is currently facing. Eleven million people alive today will live to see their 100th birthday (almost 18% of the population), meaning that the pension crisis is only in its infancy. The concomitant reduction in the social care budget for elderly care only compounds the difficulties our elderly are already facing. At the other end of the spectrum, there is a global shortage of midwives (including in the UK), costing a million lives per year in infant and maternal deaths; whilst our own under-age pregnancy rate continues to rise, as does the rate of sexually transmitted disease amongst teenage girls. Of course, alcohol remains part of the problem; additionally causing injuries, relationship breakdowns and loss of working time.
Elsewhere, a lack of donor organs for transplantation sees precious (often young) lives needlessly lost; whilst the medico-legal world struggles with the issues of voluntary euthanasia and the use of organs harvested as a result. In Britain alone, tens of thousands of children wait for families to adopt them, as their formative years disappear, often amidst peripatetic lives of one foster home after another. Meanwhile, the bedrock of our caring society, the National Health Service, is under very real threat, as is our traditional approach to General Practice as the centre of that service. And if that is not sufficient, the very core values that often drive individuals within caring professions are being demonised and extruded from the workplace; I speak of those values deeply rooted in a person’s faith, be it Christianity, Islam, Judaism, Buddhism or any other where the fundamental teaching and beliefs, when appropriately harnessed, can be a powerful aid to all in our society.
New Year is about resolutions, change and fresh starts. Exercise more and stop smoking by all means (in fact, please do). However, what about making 2012 the year when you resolve to make a small contribution to at least one of the many other challenges facing our worldwide society? After all, major successes all start with small steps.
A happy, healthy and thoughtful New Year to you all.
(First published in the Scunthorpe Telegraph, Thursday, 29th December 2012.)
Monday, January 09, 2012
Power of Positive Thinking
‘I am very well, thank you. If I was any better, I wouldn’t be able to cope.’
There cannot be many doctors who have been greeted by such an enthusiastic response when enquiring of a patient’s state of health. However, it was a delight to hear, and said much for the frame of mind of the patient. I imagine he generally has an optimistic outlook on life, requiring some considerable misfortune before his solid sense of well-being is shaken.
There is no doubt that psychologically having a glass that is half-full rather than half-empty is beneficial on the way our bodies cope with the stresses of life. Numerous accounts have demonstrated over time how some individuals have survived extremely unpleasant situations, which would prove to be the ultimate test of courage for most people. Terry Waite’s experience of being a hostage in Iran in the 1980s is an example that figures prominently in my own memory; and there have been many other similar stories since. One can add to that many wartime heroes, as well as those who have been tested to their physical limits by personal accidents (think of the Chilean coal miners, for example).
Positive thinking has the power to drive you to health (boosts immunity), happiness (banishes depression and anxiety) and success (motivates and empowers); whatever the odds against you may be. It has the ability to change your life for the better. It is a mental attitude that expects nothing but good to come of any situation, however difficult or dire the experience may be. It is almost a case of ‘believe in it, and it will happen’.
For example, how often does someone greet you by complaining about the weather? Last week, I had several people gloomily comment about how cold it has become. No surprises there; after all it is winter. However, looking on the bright side, the temperature was still in double figures in early December and it was sunny; a considerable improvement on the same time last year when we were struggling with ice and snow. I would say that is a good reason to be glad and rejoice.
Even ill-health and impending death can be fought with courage and a positive outlook. I have previously commented on an old friend who, weeks before he died, replied to my enquiry as to how he was by saying ‘I’m alive; it’s all that matters’. Last week I had the need to attend two funerals; one of a young cousin, and the second of a well-known local farmer. Both men showed courage in the face of adversity. At a time when he could not walk unaided, the farmer refused to give in to his increasing frailty by insisting that his grandson hoist him on a fork-lift so that he could change a light bulb in a barn. My cousin fortified himself for his death by stating that he was ‘looking forward to seeing Heaven’. Both men were dignified and positive in their response to an otherwise very negative situation in life.
A few weeks ago I had great pleasure in presenting an award for Outstanding Achievement in Acting to a member of the Duck Egg Theatre Company. The successful actress confesses on her Twitter site that she is ‘over-enthusiastic’. On the contrary, young lady; it is your enthusiasm that has helped to make you what you are; a rising star. What we need is a bit more enthusiasm from everyone, not less of it.
(First published in the Scunthorpe Telegraph, Thursday 15th December 2011)
There cannot be many doctors who have been greeted by such an enthusiastic response when enquiring of a patient’s state of health. However, it was a delight to hear, and said much for the frame of mind of the patient. I imagine he generally has an optimistic outlook on life, requiring some considerable misfortune before his solid sense of well-being is shaken.
There is no doubt that psychologically having a glass that is half-full rather than half-empty is beneficial on the way our bodies cope with the stresses of life. Numerous accounts have demonstrated over time how some individuals have survived extremely unpleasant situations, which would prove to be the ultimate test of courage for most people. Terry Waite’s experience of being a hostage in Iran in the 1980s is an example that figures prominently in my own memory; and there have been many other similar stories since. One can add to that many wartime heroes, as well as those who have been tested to their physical limits by personal accidents (think of the Chilean coal miners, for example).
Positive thinking has the power to drive you to health (boosts immunity), happiness (banishes depression and anxiety) and success (motivates and empowers); whatever the odds against you may be. It has the ability to change your life for the better. It is a mental attitude that expects nothing but good to come of any situation, however difficult or dire the experience may be. It is almost a case of ‘believe in it, and it will happen’.
For example, how often does someone greet you by complaining about the weather? Last week, I had several people gloomily comment about how cold it has become. No surprises there; after all it is winter. However, looking on the bright side, the temperature was still in double figures in early December and it was sunny; a considerable improvement on the same time last year when we were struggling with ice and snow. I would say that is a good reason to be glad and rejoice.
Even ill-health and impending death can be fought with courage and a positive outlook. I have previously commented on an old friend who, weeks before he died, replied to my enquiry as to how he was by saying ‘I’m alive; it’s all that matters’. Last week I had the need to attend two funerals; one of a young cousin, and the second of a well-known local farmer. Both men showed courage in the face of adversity. At a time when he could not walk unaided, the farmer refused to give in to his increasing frailty by insisting that his grandson hoist him on a fork-lift so that he could change a light bulb in a barn. My cousin fortified himself for his death by stating that he was ‘looking forward to seeing Heaven’. Both men were dignified and positive in their response to an otherwise very negative situation in life.
A few weeks ago I had great pleasure in presenting an award for Outstanding Achievement in Acting to a member of the Duck Egg Theatre Company. The successful actress confesses on her Twitter site that she is ‘over-enthusiastic’. On the contrary, young lady; it is your enthusiasm that has helped to make you what you are; a rising star. What we need is a bit more enthusiasm from everyone, not less of it.
(First published in the Scunthorpe Telegraph, Thursday 15th December 2011)
Friday, December 30, 2011
Repetition, Repetition, Repetition
Repetition, repetition, repetition…
It was a mantra drummed into me by one music master after another. Although whilst at school I found the process of making music to be pleasurable, the requirement for constant practice was not quite so enthralling. With the impetuosity of youth, I was keen to move to the next bar, the next page, the next piece of music, even the next instrument.
Forty years later, my attitude has changed. Now, the drive to capture every nuance of sentiment from each musical phrase is a powerful force; an irresistible compulsion; an absolute obsession. Yes, playing musical instruments feeds my obsessive-compulsive disorder to a level of sheer gluttony.
However, there is a downside to the above. Whilst the end product is often worthy of an audience, the process of rehearsal frequently drives my wife mad as she is subjected to the same phrase of music over and over again. It wouldn’t be so bad for her if I was confined to the piano; but when the saxophones follow on, and then perhaps some classical guitar, and maybe a quick blow on the clarinet for an encore, well it is sometimes a wonder that I am still alive, let alone married.
The plus side is that playing music keeps me healthy and fit. Research has demonstrated that playing a musical instrument increases the ability to memorise new information, improves the ability to reason and problem-solve, enhances time-management and organisational skills, fosters a team-spirit, develops mathematical skills, acts as physical exercise (good exercise for arthritic joints), develops lung capacity (wind instruments are good for asthmatics), cultivates self-expression, discipline, pride, concentration, communication skills, and acts as a relaxant and an anti-depressant.
Music has lasting health benefits for all ages. Even just listening to music can, in addition to some of the above, reduce blood pressure and the severity of pain, reduce the effects of loneliness and depression, and help prevent or ease the effects of dementia. Recently, it was demonstrated that listening to classical music whilst driving can decrease the chance of an accident.
For readers in their later years who didn’t have a musical education, do not despair; it is never too late. You may never become a virtuoso, but your brain will benefit nonetheless. Even an older brain has the ability to change in a positive way, developing new connections, new circuitry and new levels of neurotransmitters.
The downside is that you might get to the stage where you drive yourself mad with the enthusiastic repetition of it all. The theme tune to Downton Abbey was recently my nemesis. There was a day last week when, after a weekend of piano practice, I just could not shake the tune out of my mind. Every time I set foot in a corridor, ventured up the street, or turned the car onto a road, the mesmerizing, repetitive beat of the music flooded my brain and set the rhythm of my movement. At one stage, it got so bad that I was imagining a yellow Labrador walking by my side. The ultimate cure was to sit down and start on another piece of music (the Labrador has gone, but Nellie the Elephant is proving harder to displace).
Of course, having an enthusiasm to learn means that selecting presents for me is easy; just think of an instrument I haven’t got and I will be delighted. That said, my wife wasn’t quite so pleased when she saw the letter I sent to Lapland…’Dear Santa, all I want for Christmas is a drum kit…’
(First published in the Scunthorpe Telegraph, Thursday, 8th December 2011)
It was a mantra drummed into me by one music master after another. Although whilst at school I found the process of making music to be pleasurable, the requirement for constant practice was not quite so enthralling. With the impetuosity of youth, I was keen to move to the next bar, the next page, the next piece of music, even the next instrument.
Forty years later, my attitude has changed. Now, the drive to capture every nuance of sentiment from each musical phrase is a powerful force; an irresistible compulsion; an absolute obsession. Yes, playing musical instruments feeds my obsessive-compulsive disorder to a level of sheer gluttony.
However, there is a downside to the above. Whilst the end product is often worthy of an audience, the process of rehearsal frequently drives my wife mad as she is subjected to the same phrase of music over and over again. It wouldn’t be so bad for her if I was confined to the piano; but when the saxophones follow on, and then perhaps some classical guitar, and maybe a quick blow on the clarinet for an encore, well it is sometimes a wonder that I am still alive, let alone married.
The plus side is that playing music keeps me healthy and fit. Research has demonstrated that playing a musical instrument increases the ability to memorise new information, improves the ability to reason and problem-solve, enhances time-management and organisational skills, fosters a team-spirit, develops mathematical skills, acts as physical exercise (good exercise for arthritic joints), develops lung capacity (wind instruments are good for asthmatics), cultivates self-expression, discipline, pride, concentration, communication skills, and acts as a relaxant and an anti-depressant.
Music has lasting health benefits for all ages. Even just listening to music can, in addition to some of the above, reduce blood pressure and the severity of pain, reduce the effects of loneliness and depression, and help prevent or ease the effects of dementia. Recently, it was demonstrated that listening to classical music whilst driving can decrease the chance of an accident.
For readers in their later years who didn’t have a musical education, do not despair; it is never too late. You may never become a virtuoso, but your brain will benefit nonetheless. Even an older brain has the ability to change in a positive way, developing new connections, new circuitry and new levels of neurotransmitters.
The downside is that you might get to the stage where you drive yourself mad with the enthusiastic repetition of it all. The theme tune to Downton Abbey was recently my nemesis. There was a day last week when, after a weekend of piano practice, I just could not shake the tune out of my mind. Every time I set foot in a corridor, ventured up the street, or turned the car onto a road, the mesmerizing, repetitive beat of the music flooded my brain and set the rhythm of my movement. At one stage, it got so bad that I was imagining a yellow Labrador walking by my side. The ultimate cure was to sit down and start on another piece of music (the Labrador has gone, but Nellie the Elephant is proving harder to displace).
Of course, having an enthusiasm to learn means that selecting presents for me is easy; just think of an instrument I haven’t got and I will be delighted. That said, my wife wasn’t quite so pleased when she saw the letter I sent to Lapland…’Dear Santa, all I want for Christmas is a drum kit…’
(First published in the Scunthorpe Telegraph, Thursday, 8th December 2011)
Friday, December 23, 2011
A Medical Miscellany
Christmas: a strange occasion when time seems to slow whilst people enjoy a few days of enforced relaxation and normal routines are put on hold. For some (including myself) it can induce a mild anxiety. Being used to a life-style that is frenetic, I greet the Christmas break with trepidation. The unease comes from the sudden indecision as to what to do with days free from packed surgeries, medical meetings and deadlines. It seems an opportunity too good to waste on relaxation. With all those hours to fill with something of personal interest, letting them seep through my fingers with nothing to remember but too much food, drink, television, party games and company…well, yes ok I admit it, bah humbug!
Nonetheless, I usually manage to rescue myself from the horrors of compulsory socialisation by diving into the calming pages of a good book. With any luck, Father Christmas will have squeezed the odd tome or two down the chimney, and I can pretend to be entering the Christmas spirit by playing with my favourite presents. As books are my favourite presents (closely followed by malt whisky, in case anyone is interested), such a ploy means escaping into a different world altogether (clever, eh?).
So what might a doctor read at Christmas? We all vary of course. However, one section of my library reads like a collection of the medical ghosts of Christmas Past, with each book reminiscent of a different year. Dr Zhivago by Boris Pasternak is one of my all-time favourites; a heady mix of dashing doctor and anguished poet, with a lashing of passion thrown in. Does that remind you of anyone? Well, one can dream.
Another firm favourite is The Story of San Michele by Axel Munthe; the classic and absorbing memoir of a 19th century Swedish doctor who, via the high society of Paris, built a villa on the island of Anacapri. A.J. Cronin’s The Citadel is another classical ‘must’; whilst Ask Sir James by Michaela Reid is a fascinating tale of Queen Victoria’s physician. Will Pickles of Wensleydale, by John Pemberton, returns us to the ordinary with the story of a GP from North Yorkshire whose research helped in understanding the spread of infectious disease, and who was a founder of the Royal College of General Practitioners.
Patrick Devlin adds some intrigue in Easing the Passing, as he relates his account of being the judge at the 1957 trial of Dr John Bodkin Adams, a forerunner of Dr Shipman. Alternatively, John Berger’s A Fortunate Man is another classic story of a country doctor; or there is always A Ring at the Door, providing the personal experiences of George Sava, a Harley Street surgeon of the 1930s.
Reminiscent of one of my recent columns is a 1953 book entitled A Doctor Heals by Faith, by Christopher Woodward; not that I could let the General Medical Council know that I have been reading that one. The Doctor by Isabel Cameron is in a similar league, albeit fictitious, and featuring a Doctor of Divinity rather than medicine. The book, a Scottish classic in the early 1900s, sold 240,000 copies.
For those with a military interest, The Red and Green Life Machine by Rick Jolly is a Royal Navy surgeon’s absorbing account of the bravery of medical personnel in a field hospital during the Falklands War. Finally, and to balance the last, no reading list should be without some humour, and Richard Gordon provides just that with his Doctor in the House series of uproariously funny tales from the wards.
I could go on (as indeed does my collection of medical literary miscellanea). However, I am sure you have mistletoe to hang and presents to wrap. Speaking of which, I can see a least one book-shaped parcel with my name on, alongside something that could easily be a bottle of malt whisky. I think I’ll just position them next to this armchair in preparation. With that, a very happy and healthy Christmas to you all.
(First published in the Scunthorpe Telegraph, Thursday, 22nd December 2011)
Nonetheless, I usually manage to rescue myself from the horrors of compulsory socialisation by diving into the calming pages of a good book. With any luck, Father Christmas will have squeezed the odd tome or two down the chimney, and I can pretend to be entering the Christmas spirit by playing with my favourite presents. As books are my favourite presents (closely followed by malt whisky, in case anyone is interested), such a ploy means escaping into a different world altogether (clever, eh?).
So what might a doctor read at Christmas? We all vary of course. However, one section of my library reads like a collection of the medical ghosts of Christmas Past, with each book reminiscent of a different year. Dr Zhivago by Boris Pasternak is one of my all-time favourites; a heady mix of dashing doctor and anguished poet, with a lashing of passion thrown in. Does that remind you of anyone? Well, one can dream.
Another firm favourite is The Story of San Michele by Axel Munthe; the classic and absorbing memoir of a 19th century Swedish doctor who, via the high society of Paris, built a villa on the island of Anacapri. A.J. Cronin’s The Citadel is another classical ‘must’; whilst Ask Sir James by Michaela Reid is a fascinating tale of Queen Victoria’s physician. Will Pickles of Wensleydale, by John Pemberton, returns us to the ordinary with the story of a GP from North Yorkshire whose research helped in understanding the spread of infectious disease, and who was a founder of the Royal College of General Practitioners.
Patrick Devlin adds some intrigue in Easing the Passing, as he relates his account of being the judge at the 1957 trial of Dr John Bodkin Adams, a forerunner of Dr Shipman. Alternatively, John Berger’s A Fortunate Man is another classic story of a country doctor; or there is always A Ring at the Door, providing the personal experiences of George Sava, a Harley Street surgeon of the 1930s.
Reminiscent of one of my recent columns is a 1953 book entitled A Doctor Heals by Faith, by Christopher Woodward; not that I could let the General Medical Council know that I have been reading that one. The Doctor by Isabel Cameron is in a similar league, albeit fictitious, and featuring a Doctor of Divinity rather than medicine. The book, a Scottish classic in the early 1900s, sold 240,000 copies.
For those with a military interest, The Red and Green Life Machine by Rick Jolly is a Royal Navy surgeon’s absorbing account of the bravery of medical personnel in a field hospital during the Falklands War. Finally, and to balance the last, no reading list should be without some humour, and Richard Gordon provides just that with his Doctor in the House series of uproariously funny tales from the wards.
I could go on (as indeed does my collection of medical literary miscellanea). However, I am sure you have mistletoe to hang and presents to wrap. Speaking of which, I can see a least one book-shaped parcel with my name on, alongside something that could easily be a bottle of malt whisky. I think I’ll just position them next to this armchair in preparation. With that, a very happy and healthy Christmas to you all.
(First published in the Scunthorpe Telegraph, Thursday, 22nd December 2011)
Tuesday, December 20, 2011
In Praise of Eccentricity
‘Where have all the flowers gone?’
It was a question posed to a crowded lecture hall of final year medical students twenty-six years ago by a much respected consultant physician and lecturer at the Charing Cross Hospital Medical School, London. His name was Dr P B S Fowler, although I think that is where any tenuous personal connection ended. As we were about to set forth into the world of medicine as fully fledged doctors, Bruce Fowler was about to retire from the NHS. A huge man, who always wore an academic’s black gown when addressing the students, he was an entertaining lecturer and could fill an auditorium to over-capacity regardless of the subject of his lecture. On this particular occasion he took as his theme the demise of doctors with individual characters, lamenting the modern trend for medical schools to manipulate new undergraduates into identical clones. Those who initially showed promising signs of individuality were systematically humiliated by the teaching methods of the day, until they succumbed to a life constrained by the need to conform to the rules of professional conduct.
Of course, Britain has always been a country of eccentrics; possibly containing far more per head of population than many larger countries. The history books are full of them. Relating to behaviour considered to be unusual or odd, eccentricity is often found in the company of the artistically creative and the intellectual, and frequently invokes the concepts of genius and madness; as Mr Pickwick remarked in Charles Dickens’ Pickwick Papers, ‘Eccentricities of Genius, Sam’. This failure to conform to society’s norm is one often loved and admired from a distance, but can be quite disturbing to close members of the family. A former patient of mine was a man of great character, quite unconcerned by the community’s occasional disapproval of his behaviour to the point of being a local eccentric. I praised his individuality to his son one day, whose reply was illuminating: ‘Characters are wonderful people, as long as you don’t have to live with them’. Having an eccentric in my own family, I found myself warming to his words.
So what makes someone an eccentric? In a 1995 study of ‘sanity and strangeness’, Dr David Weeks and Jamie James concluded that the principal characteristics an eccentric possesses are: non-conformity, creativity, being motivated by curiosity, idealism, an obsession with one or more hobbyhorses, an awareness from early childhood of being different, higher than average intelligence, a tendency to be opinionated and outspoken, a love of solitude, and a mischievous sense of humour. Do you know anybody like that? I suspect that younger readers are more likely to say yes, as eccentrics are nearly always older than ourselves, and of course we never recognise eccentricity in our own behaviour; after all, for an eccentric it is the rest of society who has got it all wrong.
I was reminded of Bruce Fowler’s lecture recently by a wonderful coincidence of timing. Sadly, in August this year he died, albeit at the age of 90. His obituary appeared in the BMJ on the 29th October. It just so happened that the Ancient Order of Eccentrics was reformed on the very same day, with eccentric guests travelling from all over the British Isles to attend a banquet in Lincoln. First founded over two centuries ago, the Eccentric Club exists to celebrate ‘Great British eccentrics and original thinking, flying in the face of the bland modern world’. I am sure that Dr P B S Fowler would be overjoyed to know that the flowers he once lamented are in fact alive and blooming in the 21st century. If only I was an eccentric, I would be tempted to become a member.
(First published in the Scunthorpe Telegraph, Thursday 24th November 2011.)
It was a question posed to a crowded lecture hall of final year medical students twenty-six years ago by a much respected consultant physician and lecturer at the Charing Cross Hospital Medical School, London. His name was Dr P B S Fowler, although I think that is where any tenuous personal connection ended. As we were about to set forth into the world of medicine as fully fledged doctors, Bruce Fowler was about to retire from the NHS. A huge man, who always wore an academic’s black gown when addressing the students, he was an entertaining lecturer and could fill an auditorium to over-capacity regardless of the subject of his lecture. On this particular occasion he took as his theme the demise of doctors with individual characters, lamenting the modern trend for medical schools to manipulate new undergraduates into identical clones. Those who initially showed promising signs of individuality were systematically humiliated by the teaching methods of the day, until they succumbed to a life constrained by the need to conform to the rules of professional conduct.
Of course, Britain has always been a country of eccentrics; possibly containing far more per head of population than many larger countries. The history books are full of them. Relating to behaviour considered to be unusual or odd, eccentricity is often found in the company of the artistically creative and the intellectual, and frequently invokes the concepts of genius and madness; as Mr Pickwick remarked in Charles Dickens’ Pickwick Papers, ‘Eccentricities of Genius, Sam’. This failure to conform to society’s norm is one often loved and admired from a distance, but can be quite disturbing to close members of the family. A former patient of mine was a man of great character, quite unconcerned by the community’s occasional disapproval of his behaviour to the point of being a local eccentric. I praised his individuality to his son one day, whose reply was illuminating: ‘Characters are wonderful people, as long as you don’t have to live with them’. Having an eccentric in my own family, I found myself warming to his words.
So what makes someone an eccentric? In a 1995 study of ‘sanity and strangeness’, Dr David Weeks and Jamie James concluded that the principal characteristics an eccentric possesses are: non-conformity, creativity, being motivated by curiosity, idealism, an obsession with one or more hobbyhorses, an awareness from early childhood of being different, higher than average intelligence, a tendency to be opinionated and outspoken, a love of solitude, and a mischievous sense of humour. Do you know anybody like that? I suspect that younger readers are more likely to say yes, as eccentrics are nearly always older than ourselves, and of course we never recognise eccentricity in our own behaviour; after all, for an eccentric it is the rest of society who has got it all wrong.
I was reminded of Bruce Fowler’s lecture recently by a wonderful coincidence of timing. Sadly, in August this year he died, albeit at the age of 90. His obituary appeared in the BMJ on the 29th October. It just so happened that the Ancient Order of Eccentrics was reformed on the very same day, with eccentric guests travelling from all over the British Isles to attend a banquet in Lincoln. First founded over two centuries ago, the Eccentric Club exists to celebrate ‘Great British eccentrics and original thinking, flying in the face of the bland modern world’. I am sure that Dr P B S Fowler would be overjoyed to know that the flowers he once lamented are in fact alive and blooming in the 21st century. If only I was an eccentric, I would be tempted to become a member.
(First published in the Scunthorpe Telegraph, Thursday 24th November 2011.)
Saturday, December 10, 2011
Fiction Today, Reality Tomorrow?
How many readers remember the television programme ‘Tomorrow’s World’? The presenters’ mantra on this forward looking weekly survey of the cutting edge of scientific development could almost have been ‘today’s science fiction is tomorrow’s reality’. In many cases that has indeed been the case, especially if you consider the modern technology behind mobile telephones, computers, satellite navigation, the ability to carry around hundreds of books on a Kindle, MP3 players that can store an entire music collection, cloning Dolly the sheep, the space shuttle, micro-surgery, and so.
Such thoughts recently took my mind back to a book I read when I was fifteen years old. It was called ‘Colossus’ by D.F. Jones. Published in 1966, the book was hailed as a ‘horrifying instalment of the man versus machine competition’ by the New York Times, and ‘hellishly plausible’ by the Sun. Colossus was about man creating the ultimate machine; a computer (as we would now call it) about the size of a large room, which took on its own personality and assumed responsibility for the defence of the free world. It was captivating stuff for a teenager in a pre-computer era; so much so that I still have the aged paperback in my library.
I was recently reminded about Colossus when two separate headlines caught my attention and connected my thoughts to a column I wrote last year, when I invited you all to my 120th birthday party in 2080 (Scunthorpe Telegraph, 20 Oct 10). The first headline was ‘Breakthrough brings human cloning a step closer’ (The Daily Telegraph, 6 Oct 11); the second was ‘by 2040 you will be able to upload your brain…’ (The Independent, 7 Oct 11). Ah! I can almost hear the penny dropping with your realisation as to where this preamble is taking us…
Suspend your disbelief (and possibly your cerebral discomfort) for a moment and consider this: scientists have developed a technique called somatic cell nuclear transfer, whereby they take the nucleus from a cell of a piece of human skin and transfer it to an egg cell. A wave of a magic pipette later and you have an embryo; and in theory, just like acorns and oak trees, from little embryos big people could grow. Now, needless to say, various international ethical committees are not about to allow some mad scientist to grow a real-life soft-tissue version of Frankenstein’s monster; nonetheless, the whiff of the possibility of replicating your own body is there on the borders between today’s scientific fiction and tomorrow’s reality.
However, what use is a personalised clone if it doesn’t really think like you? Well, a scientist called Ray Kurzwell may have the solution. He believes that by the end of the 1930s we will have the ability to upload the entire contents of the human brain to a computer; thereby salvaging, in Kurzwell’s words, ‘a person’s entire personality, memory, skills and history’. Kurzwell is internationally respected by senior scientific figures and his work is taken very seriously. Whether that uploaded personalised database is then installed into a mechanical android or a real-life soft-tissue clone, the fact is the end result is as near to immortality as our present mortal frames will ever get.
Now, returning to my stated intention of living to 120, I will be eighty in 2040; just about the right time to take on a youthful transformation for my second innings, therefore I shall be making contact with Kurzwell in the near future to book my place at the front of the queue. So, to all those of you who diligently saved my column from the Scunthorpe Telegraph of the 20 October 2010 as proof of your invitation to my 120th birthday party (and I know for a fact that some of you have done so), well done and I will see you in January 2080. As for the rest of you cynics, I am sure the editor may have a few back copies he will let you have…at a price, of course. Immortality doesn’t come cheaply.
(First published in the Scunthorpe Telegraph, Thursday, 17th November 2011)
Such thoughts recently took my mind back to a book I read when I was fifteen years old. It was called ‘Colossus’ by D.F. Jones. Published in 1966, the book was hailed as a ‘horrifying instalment of the man versus machine competition’ by the New York Times, and ‘hellishly plausible’ by the Sun. Colossus was about man creating the ultimate machine; a computer (as we would now call it) about the size of a large room, which took on its own personality and assumed responsibility for the defence of the free world. It was captivating stuff for a teenager in a pre-computer era; so much so that I still have the aged paperback in my library.
I was recently reminded about Colossus when two separate headlines caught my attention and connected my thoughts to a column I wrote last year, when I invited you all to my 120th birthday party in 2080 (Scunthorpe Telegraph, 20 Oct 10). The first headline was ‘Breakthrough brings human cloning a step closer’ (The Daily Telegraph, 6 Oct 11); the second was ‘by 2040 you will be able to upload your brain…’ (The Independent, 7 Oct 11). Ah! I can almost hear the penny dropping with your realisation as to where this preamble is taking us…
Suspend your disbelief (and possibly your cerebral discomfort) for a moment and consider this: scientists have developed a technique called somatic cell nuclear transfer, whereby they take the nucleus from a cell of a piece of human skin and transfer it to an egg cell. A wave of a magic pipette later and you have an embryo; and in theory, just like acorns and oak trees, from little embryos big people could grow. Now, needless to say, various international ethical committees are not about to allow some mad scientist to grow a real-life soft-tissue version of Frankenstein’s monster; nonetheless, the whiff of the possibility of replicating your own body is there on the borders between today’s scientific fiction and tomorrow’s reality.
However, what use is a personalised clone if it doesn’t really think like you? Well, a scientist called Ray Kurzwell may have the solution. He believes that by the end of the 1930s we will have the ability to upload the entire contents of the human brain to a computer; thereby salvaging, in Kurzwell’s words, ‘a person’s entire personality, memory, skills and history’. Kurzwell is internationally respected by senior scientific figures and his work is taken very seriously. Whether that uploaded personalised database is then installed into a mechanical android or a real-life soft-tissue clone, the fact is the end result is as near to immortality as our present mortal frames will ever get.
Now, returning to my stated intention of living to 120, I will be eighty in 2040; just about the right time to take on a youthful transformation for my second innings, therefore I shall be making contact with Kurzwell in the near future to book my place at the front of the queue. So, to all those of you who diligently saved my column from the Scunthorpe Telegraph of the 20 October 2010 as proof of your invitation to my 120th birthday party (and I know for a fact that some of you have done so), well done and I will see you in January 2080. As for the rest of you cynics, I am sure the editor may have a few back copies he will let you have…at a price, of course. Immortality doesn’t come cheaply.
(First published in the Scunthorpe Telegraph, Thursday, 17th November 2011)
Wednesday, November 30, 2011
Pessimism or Realism?
Amongst family and friends I am well-renowned for being an early riser, with a willingness to extol the virtues of making use of the time between 5am and 7am to an effect more rewarding than sleeping. However, this morning my newspaper colleague, the Honourable Columnist for ‘Strictly Speaking’, kept me in bed for an extra hour. Such is the stuff of rumour and gossip. However, before the editor makes room on the front page for a lurid exposé, let me explain that I simply awoke thinking about something my fellow correspondent recently wrote about the NHS. In his article on Thursday 27th October, Hugh Rogers expounded on why he felt confident about the future of the NHS, stating that in this respect ‘pessimism has no place’.
Whilst I am a person of strongly held views, I am always willing to consider the possibility that I have got something wrong. With this is mind, I lay awake pondering my recent proclamations within this column in respect to the current changes the NHS is being subjected to in the form of the Health and Social Care Bill 2011, asking myself whether I have been too pessimistic.
The answer can perhaps be drawn from a trawl of recent news articles regarding GPs (bearing in mind that the majority of medical care in the UK is carried out in general practice and not in hospital). According to a BMA survey, the majority of GPs believe the relationship of trust between them and their patients will be damaged by the NHS reforms. Commissioning will also bring a greater workload to GPs, who are already disenchanted trying to deal with an excessive workload and an administrative nightmare. Additionally, new work makes it harder to fit everything into a ten minute consultation slot, especially as a great deal of the work GPs now do used to be done in hospitals. One answer is to recruit more GPs. However, the evidence suggests that fewer young doctors are being attracted into general practice (this August there was an 11% fall in doctors accepted onto GP training courses compared to 2009); on top of which it takes ten years to train a GP from scratch, so increasing medical student training may help in a decade’s time, but doesn’t answer today’s problem. Then we have the suggestion that the government wants to do away with practice boundaries, so patients can see a doctor anywhere they wish. This may be handy for minor acute illnesses, but would be difficult and potentially dangerous for complex issues, apart from making it hard to predict demand for some popular practices.
What about the patients’ perspective? Well, I think everyone knows how hard it is to get an appointment with a GP at present. I am sorry to tell you that the forecast shows that it is going to get worse; a large percentage of GPs over the age of 50 years are actively looking at taking early retirement or going part-time. The reason is low morale, four years of seeing GP pay decrease year on year, government threats to the NHS pension, and a totally skewed work-life balance. Personal health budgets should also raise patients’ concerns. 50,000 people will get personal budgets over the next three years, with a view to rolling it out to more thereafter. These budgets will initially apply to patients with complex medical problems. So what happens when your personal budget runs out? After all, the changes are not just to make the NHS a more efficient service for patients; they are also to reduce the overall cost to the nation. This is further evidenced by the ‘care crisis’ induced by the one fifth cut (£1.3 billion) in government funding for nursing homes at a time when the elderly population is expanding.
I agree with Hugh Rogers that as a nation we tend to triumph at times of adversity. However, I don’t think I am being pessimistic in my expressed views. The evidence is out there and we are unwise to ignore it. Honesty and truth does not equate to pessimism; it is called being realistic.
(First published in the Scunthorpe Telegraph, Thursday, 4th November 2011)
Whilst I am a person of strongly held views, I am always willing to consider the possibility that I have got something wrong. With this is mind, I lay awake pondering my recent proclamations within this column in respect to the current changes the NHS is being subjected to in the form of the Health and Social Care Bill 2011, asking myself whether I have been too pessimistic.
The answer can perhaps be drawn from a trawl of recent news articles regarding GPs (bearing in mind that the majority of medical care in the UK is carried out in general practice and not in hospital). According to a BMA survey, the majority of GPs believe the relationship of trust between them and their patients will be damaged by the NHS reforms. Commissioning will also bring a greater workload to GPs, who are already disenchanted trying to deal with an excessive workload and an administrative nightmare. Additionally, new work makes it harder to fit everything into a ten minute consultation slot, especially as a great deal of the work GPs now do used to be done in hospitals. One answer is to recruit more GPs. However, the evidence suggests that fewer young doctors are being attracted into general practice (this August there was an 11% fall in doctors accepted onto GP training courses compared to 2009); on top of which it takes ten years to train a GP from scratch, so increasing medical student training may help in a decade’s time, but doesn’t answer today’s problem. Then we have the suggestion that the government wants to do away with practice boundaries, so patients can see a doctor anywhere they wish. This may be handy for minor acute illnesses, but would be difficult and potentially dangerous for complex issues, apart from making it hard to predict demand for some popular practices.
What about the patients’ perspective? Well, I think everyone knows how hard it is to get an appointment with a GP at present. I am sorry to tell you that the forecast shows that it is going to get worse; a large percentage of GPs over the age of 50 years are actively looking at taking early retirement or going part-time. The reason is low morale, four years of seeing GP pay decrease year on year, government threats to the NHS pension, and a totally skewed work-life balance. Personal health budgets should also raise patients’ concerns. 50,000 people will get personal budgets over the next three years, with a view to rolling it out to more thereafter. These budgets will initially apply to patients with complex medical problems. So what happens when your personal budget runs out? After all, the changes are not just to make the NHS a more efficient service for patients; they are also to reduce the overall cost to the nation. This is further evidenced by the ‘care crisis’ induced by the one fifth cut (£1.3 billion) in government funding for nursing homes at a time when the elderly population is expanding.
I agree with Hugh Rogers that as a nation we tend to triumph at times of adversity. However, I don’t think I am being pessimistic in my expressed views. The evidence is out there and we are unwise to ignore it. Honesty and truth does not equate to pessimism; it is called being realistic.
(First published in the Scunthorpe Telegraph, Thursday, 4th November 2011)
Monday, November 21, 2011
First Amongst Equals - A Tribute to a Former Colleague
I like to think that it is a rare individual who cannot name one person who has influenced their life. Most of us can probably name a parent or teacher. However, just occasionally somebody comes along who is more than just influential; someone who is inspirational and whose memory lives on as a person against whom we measure our actions.
I have several such mentors; most of whom are oblivious to their role in shaping my personality and actions. The first in medical terms was a doctor who was my immediate senior when I was a houseman in a Devon hospital. His unfailing courtesy, diligence and attention to detail made him stand out from all other doctors I had come across during my training. His name was Dr Assad Al-Doori, and he was an Iraqi. Over subsequent years, I have often thought of Assad and hope that I have incorporated some small measure of him within my own practise of medicine.
Until recently, there have been few doctors who have measured up to Assad’s standards. Then I had the fortune to meet a doctor some twenty years my junior, who subsequently became an associate within my practice. Such was his dedication to his patients that one year ago we offered him a partnership, recognising that he would be a tremendous asset to our community. He embodied the very attributes I had recognised in Assad: unfailingly kind, gentle, polite, thoughtful, and dedicated to the art of medicine, the care of his patients and the teaching of young doctors. He was an untiringly hard worker who thought of himself last of all.
His name was Dr Imran Arfeen. He was from Pakistan and he was a devout Muslim. It was his Islamic faith which strongly guided his principles and actions and, alone in his consulting room, he would snatch moments of his busy day to incorporate his ritual of prayer. To observe Ramadan, he worked non-stop throughout the day in order to overcome his hunger. Imran was inspirational and influential; holding long conversations with me regarding the comparative values of Islam and Christianity, the Koran and the Bible. I discovered from Imran far more about how the two religions overlap than I had previously discovered. Imran also quietly and gently reminded me on numerous occasions of the reason why we practise medicine – to serve the poor and sick. My colleagues now tell me that I was not alone in benefitting from his wisdom and humility.
I write of Imran in the past tense as, shortly after being offered a partnership, he was diagnosed with a terminal illness. He died two week ago. Throughout his illness, his courage and fortitude remained inspirational. Taking strength from his faith, he never lost hope and fought an heroic battle. Insisting that work was best for him, few of his patients knew that he was receiving chemotherapy, and was in effect more gravely ill than many of those he was treating.
Ironically, on the day he died, the practice received a letter addressed to Imran from a patient who is a retired Church of England priest. The letter is an outstanding testimonial to Imran’s attitude, beliefs and character; extolling his work as a doctor. It was meant as a private letter, but sadly not one Imran was to read. If he had, I am sure that we would never have known about it; such was his self-effacement.
No parent should ever suffer the grief of losing a child. It is equally true that no doctor should see a younger colleague succumb to a fatal illness. However, Imran was a devout Muslim amongst Christians, the most Christian of Muslims, and medically the first amongst equals. He taught us all something of value and his humanitarian legacy will live on as we endeavour to serve our masters the poor and sick.
(First published in the Scunthorpe Telegraph, Thursday, 3rd November 2011)
I have several such mentors; most of whom are oblivious to their role in shaping my personality and actions. The first in medical terms was a doctor who was my immediate senior when I was a houseman in a Devon hospital. His unfailing courtesy, diligence and attention to detail made him stand out from all other doctors I had come across during my training. His name was Dr Assad Al-Doori, and he was an Iraqi. Over subsequent years, I have often thought of Assad and hope that I have incorporated some small measure of him within my own practise of medicine.
Until recently, there have been few doctors who have measured up to Assad’s standards. Then I had the fortune to meet a doctor some twenty years my junior, who subsequently became an associate within my practice. Such was his dedication to his patients that one year ago we offered him a partnership, recognising that he would be a tremendous asset to our community. He embodied the very attributes I had recognised in Assad: unfailingly kind, gentle, polite, thoughtful, and dedicated to the art of medicine, the care of his patients and the teaching of young doctors. He was an untiringly hard worker who thought of himself last of all.
His name was Dr Imran Arfeen. He was from Pakistan and he was a devout Muslim. It was his Islamic faith which strongly guided his principles and actions and, alone in his consulting room, he would snatch moments of his busy day to incorporate his ritual of prayer. To observe Ramadan, he worked non-stop throughout the day in order to overcome his hunger. Imran was inspirational and influential; holding long conversations with me regarding the comparative values of Islam and Christianity, the Koran and the Bible. I discovered from Imran far more about how the two religions overlap than I had previously discovered. Imran also quietly and gently reminded me on numerous occasions of the reason why we practise medicine – to serve the poor and sick. My colleagues now tell me that I was not alone in benefitting from his wisdom and humility.
I write of Imran in the past tense as, shortly after being offered a partnership, he was diagnosed with a terminal illness. He died two week ago. Throughout his illness, his courage and fortitude remained inspirational. Taking strength from his faith, he never lost hope and fought an heroic battle. Insisting that work was best for him, few of his patients knew that he was receiving chemotherapy, and was in effect more gravely ill than many of those he was treating.
Ironically, on the day he died, the practice received a letter addressed to Imran from a patient who is a retired Church of England priest. The letter is an outstanding testimonial to Imran’s attitude, beliefs and character; extolling his work as a doctor. It was meant as a private letter, but sadly not one Imran was to read. If he had, I am sure that we would never have known about it; such was his self-effacement.
No parent should ever suffer the grief of losing a child. It is equally true that no doctor should see a younger colleague succumb to a fatal illness. However, Imran was a devout Muslim amongst Christians, the most Christian of Muslims, and medically the first amongst equals. He taught us all something of value and his humanitarian legacy will live on as we endeavour to serve our masters the poor and sick.
(First published in the Scunthorpe Telegraph, Thursday, 3rd November 2011)
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