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This Really Makes me Sick! (Health)
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Boreades


In: finity and beyond
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A fascinating family dispute is being aired in public via the Daily Telegraph's letters column.

Daddy (Russell Hopkins) sent his letter 12th Jan 2016

SIR – In 1998 I was elected a Fellow of the British Medical Association (BMA) in recognition of outstanding service. I had served on the central and subcommittees of the BMA in London and the Welsh equivalents for several years.

In those days, the BMA represented medical practitioners as a trade union, but with an acceptance of the needs of patient care and ethical practice. I do not recognise this today. The BMA has morphed into a militant, Left-wing political body seemingly interested in attacking the Government, while pressing the financial needs of the profession, giving little thought to patient care, ethical practice or the need for out-of-hours care.

Reasons that have led to today's strike include a lack of clinical training for undergraduates; the 48-hour week imposed by the European Working Time Directive, which reduces both clinical training and patient contact; the loss of clinical teams led by a named responsible consultant; the contract changes for GPs and consultants (introduced by Tony Blair); and a malevolent management unaware of ethical clinical practice, which has destroyed much of the goodwill that sealed many of the cracks.

The last few years of my life have been made difficult by the consequences of medical negligence. I despair at the prospect of the quality of care my children and grandchildren can look forward to as they age.

The public utterances of the present junior doctors’ leader and the chairman of the BMA Council convince me that this is not the same organisation which I was once proud to serve. Therefore I propose, with considerable regret, to return my certificate of Fellowship to the Wales office of the BMA.

Russell Hopkins Newport, Pembrokeshire


One of my medical colleagues politely described that as : the single worst example of what we might call a "in my day" article

Daughter (Claire Hopkins) replied 13 Jan 2016

SIR – I read the letter from my father, Russell Hopkins, with some dismay. He has been out of clinical practice for so long that he is disconnected from the problems facing the profession today.

Junior doctors chose to strike in order to take a stand against the destruction of the medical profession by a Government insistent on imposing an unfair contract that is ultimately driven by the desire to reduce pay and a promise to deliver non-emergency care at all hours.

I, too, worry for the future of the NHS, but for very different reasons. We need to continue to attract the brightest young people into medicine in order to maintain a high quality of service. With the proposed contract changes, plummeting morale and poor working conditions will mean that we will struggle to recruit anyone at all; school-leavers will simply choose other careers and those in training will continue to flee overseas.

My father and his generation enjoyed a career where they had respect and autonomy, were lavished with hospitality by drug companies, and then retired on final-salary NHS pensions. They would not recognise the job today.

As a consultant surgeon, I – along with most of my colleagues – support the junior doctors in their decision to strike.

Claire Hopkins Orpington, Kent


As the grumpy old-git father of a stroppy daughter, I'm tempted to side with Daddy, even if he is going ga-ga.
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Boreades


In: finity and beyond
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With impeccable timing, the Grauniad is today running an article on the Dr.Finlay-style "good old days" GP care you really can still get in the UK. House visits from your GP at 1am, etc.

Except you have to be on Shetland to get it.

http://www.theguardian.com/society/2016/jan/19/on-call-in-shetland-a-cliff-hanging-gp-at-the-nhs-northern-limits

No mention of the GP delivering whisky & baccy to patients though.
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Boreades


In: finity and beyond
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Are you drinking 42% more than you did in 1980?

Public Health England would have us think so. Earlier this month they released a report on alcohol consumption. They claimed that people in Britain are drinking twice as much as they did in the early 1980s. On the one hand, I thought this was good news, surely we should all be doing our bit to support a British industry?

But something didn't quite ring true. The report said:

Between 1980 and 2008, there was a 42% increase in the sale of alcohol


Huh? Why have they stopped there? What happened in 2008? Did they stop collecting data?

Time to check the references. Hmm, another whiff of something not-as-it-seems. The reference is to a BMJ article by a couple of minimum pricing campaigners (Nick Sheron and Ian Gilmore). The date range stopped in 2008, and nine years to date are missing. Hmm, is the data that hard to find?

Strangely, not at all, thanks to the diligence of Her Majesty's Customs and Excise (HMRC), collecting revenue on every drop sold in the UK. HMRC figures show the amount of alcohol bought per adult. :

1986/87: 9.53 litres
1990/91: 10.01 litres
2000/01: 10.50 litres
2004/05: 11.73 litres
2007/08: 11.47 litres
2012/13: 9.65 litres

The conclusion is that the PHE story is more "false news". Why? The cherry-picking is necessary to support a campaign for minimum pricing (like the Sugar Tax) to protect us from ourselves. Despite the real evidence that we are (in general) actually reducing our alcohol consumption anyway.
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Mick Harper
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Reading the current issue of Luxury London at the doctor’s (I was taking a friend to have his ears syringed) I read an article about a Damien Hirst-designed hotel room that costs £100,000 a night to stay in. There could be some bitching – only modern abstract artists could afford to stay in it at those prices. Make the bed, Trace, there's a dear. My friend's ears AOK, in fact he can turn off the subtitles button on the telly now. Only Notting Hill NHS practices can afford subscriptions to Luxury London (seven pounds a pop) and only Notting Hill residents would find it therapeutic anyway. We call it ‘post code prescribing’. Look, I’ll shut up if the rest of you find this upsetting and patronising. You just have to say.
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Wile E. Coyote


In: Arizona
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I don't get why you read a mag you aint interested in, rather than use your E reader.

Really strange.

Still takes allsorts.
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Mick Harper
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It gets read automatically by EDF Energy. You want to start getting your own technology in order before taking potshots at me.
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Boreades


In: finity and beyond
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My medical colleagues keep sending me stuff. Some of it is friendly banter, like "Haven't you retired yet, you stupid old bastard?" Some it is useful clinical information, like new medical education resources, or updates on authorised prescription drugs. But sometimes it catches you completely by surprise. Like this morning's update on "recognised" medical conditions.

In 2013, an issue of the American Diagnostic and Statistical Manual of Mental Disorders (DSM) defined a new mental illness, called "Oppositional Defiant Disorder” or ODD. Defined as an “ongoing pattern of disobedient, hostile and defiant behavior,” symptoms include questioning authority, negativity, defiance, argumentativeness, and being easily annoyed.


Which sounds uncomfortably similar to the habits of AEL inmates.

New mental illnesses identified by the DSM-IV include arrogance, narcissism, above-average creativity, cynicism, and antisocial behavior. In the past, these were called “personality traits,” but now they’re diseases. And there are treatments available.


This is not new.

The Soviet Union used new “mental illnesses” for political repression. People who didn’t accept the beliefs of the Communist Party developed a new type of schizophrenia. They suffered from the delusion of believing communism was wrong. They were isolated, forcefully medicated, and put through repressive “therapy” to bring them back to sanity.


Surely it couldn't happen here?

Some states (In the USA) have laws that allow protective agencies to forcibly medicate, and even make it a punishable crime to withhold medication.


More here:
http://themindunleashed.org/2013/11/nonconformity-and-freethinking-now.html

Bing Bong : Paging patient Harpo, will patient Harpo please report to Nurse Ratched's Desk for your medication.
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Mick Harper
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The point surely is whether you can act antisocially in a controlled manner, not whether you are antisocial. It always struck me that you'd have to be mad to take on the Soviet state. In fact it was a clear signal that the Soviet state's days were numbered when people started doing it anyway. It's not difficult being just disruptive enough not to be excluded from school.

As someone who was in Ken Keyseyland at a time when going into the bin for the winter was a discussed hippy option, it is also clear that Jack Nicholson must have been mad to get himself nailed. You may be sure that Keysey wouldn't have made such a mistake. Hippy Rule No 1: you never go up against the man (alone).

However I would agree that Official American Nutter Checklists have been doing serial damage for decades, always tend to hoover up the marginal cases but still get taken up internationally because they're so damn convenient for the professional practitioners. But then again nobody seems able to deal with the situation any better any other way. Leastways in the absence of spending money that the sane always refuse to spend.
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Wile E. Coyote


In: Arizona
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ODD is a forgotten condition. Trepanning is the forgotten cure.
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Mick Harper
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Yes, I have not forgotten having my tonsils and adenoids out like everyone else born into the early NHS. The present sovereign cure is snipping a bit off your prostate gland. Well, not yours, you're a woman, but you know what I mean.
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Mick Harper
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Actually I did suffer from a mental illness -- I suffered from nightmares as a child. After being seen by someone it was recommended I be given an extra bottle of milk at school in the afternoon. We all got a third of a pint every morning in those pre-Snatcher days. I hated that so much the nightmares ceased. I like to think I'm a nightmare to the world now I'm all grown up but I'm being treated for that as well. It's good of the world to join in with the treatment.
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Boreades


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Harpo - have you been ghost-writing for the NHS? This smells like your style of writing (in an NHS England newsletter this very day):

Faced with ordinary problems that they cannot solve – lack of funds, staff shortages, rising demand, falling morale (you know the ones) – our leaders propose extraordinary solutions. By "extraordinary" we do not mean imaginative or clever, but bizarrely disconnected from reality or designed to avoid it altogether.

Imagine a medieval scene in which the castle gates are soon to be breached and the besieged army has run out of arrows and boiling oil. Any sensible leader might resort to dropping lumps of stone from the ramparts, kitchen utensils, effluent from the latrine or the bodies of serfs on the enemy.

If this were an NHS England production, the commander would instead declare: "Fetch my spacecraft – you know, the one with the photon torpedoes!"

"But sire, we have no such device."

"Then fashion me one, sirrah, in yon innovation greenhouse."

"You what, my liege?"

At this point in the medieval siege drama, the players would acknowledge that the king had lost his last marble, before lowering the drawbridge and throwing themselves on the mercy of the invading army.

But this is an NHS management production, so the plot just keeps getting sillier. And in case you're not quite following this one, it was revealed this week by the soothsayers of the NHS England press office, who foretold a marvellous plan to build, yes, an "innovation greenhouse", the precise nature of which we shall come to shortly.

First the dubious science.

In impossible situations, human beings often resort to the improbable.

Once upon a time it would have been a goat tethered to a tree or the ritual sacrifice of a virgin to placate the angry gods. But we no longer believe in gods and even if we did it's unlikely that any serious placating would occur in the face of opposition from animal rights groups and militant virgins.

The only credible god for a rational age is technology and the new worship is called innovation. This is not to be confused with actual innovation, which proceeds quietly and results in things of benefit to humanity, such as penicillin, as well as things that probably weren't an unqualified good idea, such as nuclear weapons.

Innovation in the NHS England sense of the word is a rite, an incantation, a whiff of incense here, a solemn vow by a very senior manager there; a mystery that is not meant to be comprehended but to be believed unquestioningly, like transubstantiation or Richard and Judy.

Innovation hovers just out of reach, promising relief from our earthly problems – crappy IT systems, dilapidated buildings, unfeasible staff rosters – and ultimately salvation.

It is an act of faith made necessary by the realisation that healthcare does not cure the sick but creates them. Just as building bigger roads gives people more reasons to travel, bigger hospitals encourage people to embrace ill-health. (Think about this carefully next time you feel the urge to complain about shortages of doctors and nurses. Could they be the problem?)

Healthy living may be a step in the right direction, but it is dull and takes a long time to work.

Some might say, if the widespread availability of cheap (or zero-apparent cost) healthcare is encouraging people to be officially "sick", or invent new diseases, one conclusion is the quickest way to get people healthier would be to close some hospitals.

This isn't an issue that affects me, as I do not have permission from M'Lady Boreades to ever be sick or take a day off work because of whatever.
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Mick Harper
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I am offended but not surprised you would think me capable of writing such tosh. How do I know without necessarily thinking about it all that much. The following

1. We were never told what the McGuffin was
2. We are given a silly illustration about photon torpedoes in Arthurian times, even given the general tenor
3. I agree with the central proposition that is being denounced
4. We are given a single good example (penicillin)and a single bad example (nuclear weapons) both dating from seventy-five years ago
5. We are told people believe unquestioningly in two things that nobody believes in unquestioningly, transubstantiation and Richard & Judy
6. I did though, like you, agree with the penultimate paragraph.
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Boreades


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1. We were never told what the McGuffin was

McGuffin? What McGuffin?

2. We are given a silly illustration about proton torpedoes in Arthurian times, even given the general tenor

I think that's a typo. It's meant to be the photon torpedoes (in Arthurian times).

3. I agree with the central proposition that is being denounced

What's the central proposition?

4. We are given a single good example (penicillin)and a single bad example (nuclear weapons) both dating from seventy-five years ago

I can fix that for you.

This is not to be confused with actual innovation, which proceeds quietly and results in things of benefit to humanity, such as the internet, as well as things that probably weren't an unqualified good idea, such as the internet.


5. We are told people believe unquestioningly in two things that nobody believes in unquestioningly, transubstantiation and Richard & Judy.

I'm sure you can suggest better things that people believed unquestioningly.

6. I did though, like you, agree with the penultimate paragraph.

Agreeing with me ? I'm shocked, shocked! What about the ultimate paragraph?
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Mick Harper
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Modern Medicine

Mr Harper?
Yes.
Michael John Harper?
Yes.
Doctor's surgery here.
Yes.
Your blood tests are back.
That was quick.
Your serum lipids are abnormal.
Can you spell that?
Your ferritin level is abnormal.
My what?
And your blood count.
Yes?
Abnormal.
I had a chest X-ray as well.
Did you? Oh yes, I see you did.
What does it say?
Abnormal.
I'll get my coat.
No need to visit the surgery, the doctor can phone you. Would the end of next week suit?
Ye-e-s.
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