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Raising the Bar

Justin Wood, the Today programme’s Useful Idiot, was let out of his play-pen this morning to tackle a story with real numbers in it. He promptly crashed and burnt. So spectacular was the crash and burn that the erudite Prof McManus’ erudition flat-lined and later all but crashed and burnt too. At issue was the distinction between pass mark and pass rate for the Professional and Linguistic Assessments Board test used to assess clinical and English language skills in the - as the media would have it - foreign devils more formally known for the time being as International Medical Graduates. In Woodie’s upside down world, the great secret was to up the pass rate, the better to weed out those with forked tongues. In the real world, of course, upping the pass rate, rather than the pass mark, would have the effect of letting though not fewer but more IMGs.

The Blind Archer

Hell may have no fury greater than a woman scorned, but surely Heaven can have no joy greater than a woman reformed. In a remarkable development, scientists in North America have popped not a bun but a biodegradable scaffold layered with a patient’s vulval and other cells in the oven, and after the required time at the requisite temperature been rewarded with a fully formed vagina. Four women born without a vagina have had ready-vaginas made this way implanted, and have subsequently reported normal or even atomic levels of ‘desire, arousal, satisfaction and orgasm’. This extraordinary advance may in the short term pave the way for a gruesome commerce in designer vaginas – each scaffold is individually crafted - but in time it can only end one way: the day will dawn when we pop not buns but homunculi in the oven, to be rewarded nine months later with little incubi, all of whom will go on to report normal or even atomic levels of desire, arousal, satisfaction and orgasm. Truly, science knows no bounds.

Seven Seven

W1A (BBC Two) continues to amuse. Like totally. Following on from Twenty Twelve and WIA, the BBC must commission a third series, Seven Seven, being the slogan for like the new dietary advice to eat seven portions of fruit and veg seven days a week. With Lord Grantham tasked to deliver an alternative to the gruesome vision of a bloated ageing nation belching and farting its way to immortality, and the awesome perfect curves of Siobhan on hand to nail any loose puppies to the floor, Dr No SO gets it. Like totally. Give this pony some traction, guys, and we can be drinking from the fire-hose from the get go.

Over the Tarp

We are two peoples separated by a common language. Recalling on Radio 4 how his band had broken into the British market, an American moozish’n said it wasn’t until they had gartten on Tarp of the Parps that things reely took off. Travelling the other way, and now tarp of the parps in American health news, is our British NHS way of burning babies to heat our hospitals. Based on a horrific appeal to Holcaustian imagery from a Channel 4 documentary on the fate of terminated and miscarried foetuses, the anti-Obamacare American media wants its citizens clear on the dreadful consequences that await those who sup in the corridors of socialised medicine - and that’s without even beginning to mention what the Pro-Life lot had to say.

The Invisible Gorilla

Statins continue to generate more heat than light. On the Today programme this morning, the pro-statin academic Sir Rory Collins only just managed to get off at Edge Hill rather than go on to accuse BMJ editor Dr Fee of mass murder for publishing research suggesting statins for people at low risk of heart disease may do more harm than good. The bun-fight is interesting because in the heat we do in fact find some light shone on a blind sector in gold-standard drug research: we tend to see what we are looking for, which means we tend not to see what we are not looking for, an effect known as the Invisible Gorilla effect. A well known example is the sexual side effects of the SSRI anti-depressants. Because initial clinical trials were conducted on healthy volunteers (often stoodents) with male libidos the size of the Eiffel Tower, no one thought to look for sexual side effects. But once SSRIs got out into the wild, it became apparent that what had once been two foot long and hard as steel was now measured in inches and made of jelly. Once unwanted SSRI sexual side-effects are looked for, it turns out SSRIs are to your sex life what a water hose is to your bonfire.

Slit

Slit, the gash in the silk curtain BBC One legal procedural through which we get to see posh knobs with wigs on polishing each other off, is back. So too are the hormonally challenged. Leading QC Martha’s oxytocin levels are so high it can only be a matter of time before she starts lactating for her under-dog clients. Billy still plays the testosterone fuelled clerk ready to roger anything with a hole in it, despite a heartless medic telling him it’s bye bye Morning Glory hello tits for Billy, on account of his treatment for prostate cancer. In the last episode Martha’s oxytocin met Billy’s cancer head on, and the cuddle juice won. Billy coughed, and they cuddled.

Meanwhile, the show continues to tackle The Big Issues Of The Day. Increasingly these are medical. The first episode of the current series hinged on the fate of David, an undiagnosed schizophrenic charged with killing a police officer, while this week’s episode three took on maternal mercy killing. Neither, to this viewer, ended satisfactorily. The series formula – Martha gets you off – was rigorously applied, like a double mustard poultice. The schizophrenic walked free, the case against the self-confessed filicidal mother collapsed.

Staggering Catastrophes

As a doctor who has dabbled in epidemiology, Dr No is not unaware of the siren song of care.data. Greater minds, including epideiology’s Einstein, have frothed at the prospect of the data orgy to be had, only to have it dawn that theirs was a premature cigar. Yet even when left staggering at the catastrophes revealed, a hard core group still want care.data to happen, the idea being that if enough corks are inserted, then nothing will leak.

If only! Dr No remains persuaded that the call of care.data is indeed the song of a siren balanced on dangerous rocks. However alluring the song, the rocks remain; many rocks, but four stand out as especially dangerous.

Nice Try, But No Cigar

The front door, or rather back door, tactics of the shadowy Health and Social Care Information Centre have achieved a sort of slow-burn blowback over the last few weeks. Kicked off with a junk mail leaflet that aimed to be funky but turned out flakey – eye catching shape, double helix on the front, but the helix unravelling on the inside, and written by a Kafkaesque we who never said who we were, in opaque prose that bizarrely got a Crystal Mark for Clarity from the Plain English Campaign – the idea was to have patients default into allowing the NHS to hoover personally identifiable GP medical records into a vast data silo the size of Russia, generally for the purposes of improving care. But that was only part of it. Buried in the flyer, we also had plans to flog off your data, including sometimes personally identifiable so called red data, but only after the strictest approvals, you understand. Or at least we did. Whether the rest of us did was another matter.

Deflating Dr Dan

As part of a welcome recent trend, the Today programme this morning was presented by Monty and Mish, the twin set who occasionally manage to drop pearls. Devoid of the deadweight of burnt-out testosterone that burdens the older male presenters, Monty and Mish manage at times almost to sing, but since ’tis the season for mistletoe in the house and so guest editors on Today, the links were peppered with references to “the musician P J Harvey” and “P J Harvey the musician”, who, it was said somewhat defensively, was responsible as guest editor for doing ‘something unusual’ to the programme. As doing anything let alone something unusual to the Today programme is known to provoke a mailbag the size of a mammoth, Monty and Mish were right to sound anxious, but the bigger question was could anyone really do anything unusual to the Today programme? The answer, as it turned out, was an unexpected yes.

A Serpentine Spaghetti of Words

One of the more tiresome ways of our legislators is their habit of changing law through the use of amendment clauses. You know the sort of thing: instead of rewriting the clause from scratch, and presenting it in its entirety, we have ‘In section 650 of the National Health Service Act 2006 (Chapter 5A of Part 2: interpretation) (the existing text of which becomes subsection (1)) at the end, insert—’, the end result of which is a serpentine spaghetti of words so convoluted that the eyes glaze over and the temples throb. Never mind that the apparent zero after 65 is in fact the letter ‘O’, or that the said Act 2006 appears in fact to be said Act 2009; the fog generated while trying to cobble together the parts to make an intelligible whole is a masterpiece of Sir Humphreian obfuscation.