Dr No's Editor's Choice

A selection of Dr No's posts, ordered by number of page views. Older posts tend to have more weight because they have been around longer, and so have more time to gain page views.

Re-order by date (latest first), number of comments (desc), no particular order (random) or return to order by page views.



The Ultimate Quack Remedy

Top Prize in the recent busting homeopathy stakes undoubtedly goes to Simon Singh for his wonderfully effective puncturing and deflating of the pompous David Tredinnick MP on the Today programme. Tredders was wind-bagging on about how they do homeopathy better in France, but he hadn’t bargained on Singh doing his homework. The best selling homeopathic remedy in France, said Singh, is a ’flu remedy made from the mashed up entrails of a single Muscovy duck that generates a staggering $15 million of revenue. It was, said Singh brilliantly, ‘the ultimate quack remedy’. Tredders had more than his wings clipped: he was permanently grounded; while Humph was reduced to muttering something about getting his hands on ‘that duck’.

Carry On Commissioning

Dramatis Personæ

King Field, out-going Chief Pongo.
JD, a Jobbing Doctor.
The Darzi of Dagenham, a Stooge.
Sir Sidney Ruff-Grumble , a Hospital Doctor.
Queen Enchilada, Chief Pongo elect.

ACT I

Scene I—The Tudor splendour of Richmond House, a GP commissioning group hide-away deep in the heart of the Essex countryside.

Enter King Field, in a silly red and yellow hat.

Field. Infamy, infamy! They've all got it in for me!

The XX Factor

Were it not for the genuinely sad nature of the case, the last few hours of Lynn Gilderdale’s life could almost have about it the air of a grotesque Benny Hill sketch. In a surreal speeded up video, complete with that memorable theme tune, one might see Kay Gilderdale rushing around their home, searching out pills and potions, furious grinding in pestle and mortar, frantic googling, over-size syringes full of air…

…and all in very bad taste, Dr No fully agrees. But sometimes he wonders whether it isn’t necessary to look a little harder at the current wave of mother-love hysteria that has risen on the back of the Inglis and Gilderdale trials for murder and attempted murder of their respective children.

The Oxygen of Morality

Kerrie Wooltorton is dead. But she isn’t going to go away. Her sad suicide, and the aiding and abetting of that suicide by her doctors, have opened a door to a cesspit of legal incompetence and medical Eichmannship.

For those who have been frying fish for the last few days, KW was a woman with both depression and emotionally unstable personality disorder who wanted to kill herself. That’s what she said, anyway.

Unnatural Selection

By way of a reply to WD and Dr Boots' latest comments on Dr No's last post.

In Dr No's medical student days, most medical students were WASP males. There was a lot of rugger, and high jinks, à la Daily Hail, only in those days, having studied Latin and so Roman habits, we knew how to throw up properly.

About fifteen years later, about ten years ago from now, Dr No had already noticed a shift away from WASP medical students towards more BME and more female students. He even remarked on it during a tea and biscuits break on a ward round - and a health service fattie, a psychologist of all things, all but exploded, but thankfully didn't, because all the tea and biscuits inside her would have made a terrible mess.

Alma Mater

Today is Mothering Sunday, the day when we thank and honour the mother who has nurtured us. Dr No has been doing his filial duty - when it comes to Mothering Sunday even Dr No says 'Yes' - but thinking of nurturing set him thinking of the other nurturances and influences that have shaped the way he is. There are a number, but without doubt many cluster round his years as a medical student, when a young, volatile, opinionated, yet still malleable teenager was transformed at the anvil of apprenticeship into a brash and brittle junior Dr No, who walked the wards burning bright from the heat of the forge.

Drive-By Surgery

David ‘Ozymandias’ Cameron’s five NHS pledges – worthy of only the briefest flash in the news-pan yesterday – are already showing all the substance of five brown ballerinas. Even as he made his speech, the smart finger was on the money. PCTs have been running rings round the fixed national tariff for months, allowing private providers to compete on price.

The Bureau of Investigative Journalism has spotted a loophole, a loophole, we might add, that is as wide, open and inviting as a barn door, that allows – forgive the jargon – community services provided under the any willing provider procurement process to escape the national tariff. Since this is the kind of terminology that gives the rest of us a migraine, we may translate this to mean stuff done outside hospital, excluding normal general practice, that is not subject to fixed prices.

Lest We Forget: A Poppy for the NHS

Dr No observes Remembrance. Last Friday, the day before yesterday, at the eleventh hour on the eleventh day of the eleventh month, and this time as it happens of the eleventh year of the century, he fell silent and still for two minutes, and remembered those who have given their lives for the freedom we enjoy today. It is a moment of solemn awe for the sacrifice made, and of great humility in the face of such selflessness.

Remembrance was made that bit more poignant this year by the breaking news that Circle Health had signed the long foretold contract to run Hinchingbrooke Hospital. This contract is a clear challenge to the authority, competence and perhaps most of all to the values of the NHS; a challenge which, if not seen off, will in short order threaten the very life of the NHS.

Ain’t Turning No Machine Off

“I ain’t turning no machine off” said Kelly, as if she was a teenager talking about shutting down her Playstation. In fact, she was a mother talking about turning off the life support for her very premature baby.

And so it was that last night's BBC2 documentary 23 Week Babies: the Price of Life exposed one of the central dilemmas at the heart of the medical and ethical minefield that is whether to resuscitate very premature babies. Kelly was clearly up for not turning no machines off. Whether she was up for understanding, let alone navigating, the medico-moral minefield was another matter altogether. She hadn’t even in fact been asked to turn no machine off, only what her views were on aggressive resuscitation should her baby take a turn for the worst. The program’s presenter, Adam Wishart – a thoughtful cove whose brief onscreen appearances featured averted eyes, even if the eyes of his cameras probed mercilessly – asked: is it right to place such a burden of responsibility on the parents?

Most Drugs Don’t Work

Just over three years ago, when few had heard of him, Dr No wrote a post called The Collapse of the Probability Function. At its heart lies the troublesome paradox that, while we might know how a group of patients might fare, we have no way of knowing how individual patients will fare. We might know that of a hundred patients, five will die in the next ten years from a heart attack. What we don’t know is who of the hundred will be the five; and the flip side of that is, when as doctors we choose to intervene, as increasingly we do, there are ninety five souls now tangled in our medical web, with all that that entails, be it tests, treatments and general apprehension, who were never going to have a heart attack anyway, let alone die from one in the next ten years. That’s a whole lot of medical intervention without any benefit whatsoever – but what the heck – overall, we might save a handful of lives - or so the hopeful reasoning goes.