Friday, April 24, 2009


Witnessing wilful self-destruction is never easy. Watching someone plumb the depths of alcoholism, or push the oxygen supply aside to light up with hands made uncontrollably trembly by the drugs needed to keep breathing because of the damage that same act has inflicted down decades is a living hell for those charged with care of loved ones so afflicted, and a kick in the teeth to those that try to treat them.

It’s often hard to take a step back and reserve judgement. But we are not them, we’ve not seen what they’ve seen, or done what they’ve done. We all have our vices, (Hob Nobs might spring to mind perchance) and we all sometimes take a road we know we ought not, just "to see what it’s like". Fortunately for many of us, we get turned around before a wrong turn gets us hopelessly lost, and that can give us some empathy for those less fortunate.

The thing I’m finding more difficult right now is finding that same empathy for those that opt to take a wrong turn on purpose. This winter Blighty has seen a Mumps outbreak. Most of the victims are young adults who were born a year or two too early to be caught in the initial MMR campaign of the late 80s. Some have been children held back from immunization because of a false fear placed in their parents minds by a tub thumping campaign based on widely discredited science about a supposed danger form the combined MMR vaccine.

The fall out from this was hopelessly bungled by the same politicians that told us BSE could never affect humans and by a scientific and medical establishment that failed to articulate clearly enough the counter argument. In the first flush of controversy it is easy to understand why some parents opted to hold back, but we are still finding MMR uptake rates lower than they need to be after all this time, and whilst I’m usually the first to champion the rights of the individual, I’m a little less keen on the right of the individual to remain wilfully and dangerously uninformed. Especially when it is not they, but their children who will bear the brunt of their decision.

In my time in Ambridge I’ve also witnessed patients cut off from family and community for an act so seemingly trivial as accepting a life saving blood transfusion, on the grounds of religious dogma, and others choosing to die, or being condemned by relatives to, for want of the same. I’ve also witnessed patients with curable, or at least remittable malignancies place their faith in crystals and carrot juice rather than hospitals and medicine, and have to endure unnecessary agonies and speedier exits as a result, all through some blinkered perspective that classed all allopathic medicine as bad because they had a bad experience once with Dr X or Hospital Y.

Mankind truly is everywhere born free, but some make pretty odd choices for their chains, and their blinkers.

Wednesday, April 15, 2009


As I traversed the Ambridge Gyratory System* the other morning I was struck by the contents of the large estate car in front. Two gormless lop eared Labradors gazed benignly out at me, until the car hung a left and disappeared down the ramp to the Councillor Dan Archer Park and Play Area.

Walkies, it seems, have become "bit of a drivies". Man's best friend no longer has to turn out attached to a leash and walk to the park before getting to zoom about like a lunatic chasing a tennis ball. Now Fido can expect to be chauffeur driven there and back again, and spend ten or fifteen minutes wheezing about after some fuzzy, squeeky monstrosity from the pet shop that looks like a failed genomics experiment and has none of the roll or bounce potential of the good old b-a-l-l (sorry felt the need to spell it out just in case any dogs were listening).

I worry slightly that as soon as they develop a playstation controler adapted to the canine paw, instead of a drive to the park, poor pooch will be parked in front of the doggy version of Doom or Quake, and left to get on with it. It's no wonder our pets, like their owners and their owners kids, are facing an obesity crisis.

There's just one word for it really.


* The ring road hemi circumnavigating our fair town, not the 1970's Jazz Fusion Combo of the same name.

Tuesday, April 07, 2009

Clock watching

You might wonder why, should you ever have cause to see a personal medical attendant, you spend ages sitting in a waiting room , browsing decade old National Geographics and the like. Perhaps a quick snapshot of this afternoon’s surgery will help explain.

15.00 Enter first patient. Young adult male. Suicidally depressed and in crisis. After a bit of a chat, we manage to tease out the principal cause, agree a management, with antidepressants and the safety net of a ring back any time offer, and fix a two week follow up appointment.

15.30 Enter second patient (appointment 15.10). He’s been drinking a lot lately—just fluids, not alcohol, after all he is only 14—and he has to get up a few times a night to pee. No he hasn’t brought.. but yes he can do a specimen. We find a pot. He pees. The stick shows he’s passing glucose syrup. We find a glucometer and prick his finger. His glucose is 24, or roughly four times normal. We agree he should go to the hospital and get started on insulin. This needs a phone call to arrange.

15.55 Enter third patient (appointment 15.20). She’s worried. She had a car accident a few days ago. Thing is she can’t remember it. She can’t remember if she ought to remember it. She plainly hasn’t had a significant head injury. She’s not had seizures in the past. We’ve no reason to think she has had one this time. Bur we’ve no convincing reason to think she hasn’t. She’d quite like to know, so we agree she needs a brain scan and a referral to a gerontologist for more clever tests. In the meantime I have to advise her not to drive anymore—not a problem right now, since her car has been written off, but still she needs to be advised.

16.20 Enter fourth patient (appointment 15.30). She needs to renew her annual repeat prescription for high blood pressure. So far her BP control has been o.k. Then this week she was told she might loose her job soon. And so might her husband. And her BP control has gone a bit wonky….

16.45 Enter fifth patient (appointment 15.40). “You’re running a bit late today—did you nod off for a bit?”

18.33 Enter DS Carter and WPC Watmough. Seems grabbing a punter by the neck and squeezing hard amounts to assault.

Hard to believe I know. Still at least Broadmoor might be a bit quieter.