Posts tagged with Miscellaneous


The Chauffeur Must Decide

In Downton Abbey (ITV1), a good many scenettes – most are too brief to be scenes - are set up to climax with the wonderful Maggie Smith delivering a punch line. She has perfected the art of delivering these dénouementettes, which she does with a little shudder, as if a Tantric feather had tickled her G-spot. Last night she delivered a perfect corker: the decision lies with the chauffeur. In just six words, she encompassed a hundred years of medical and social history.

The dramatic tension at the heart of last night’s episode was the ancient clash between the GP and the specialist. It was as high concept as high stakes go: the life of a young mother was at stake. From the early moment a throwaway mention was made of swollen ankles, a pall-bearer of toxaemia, or pre-eclampsia, the obstetrician in Dr No knew it was going to end in tears. Fits would follow, and death was indisputably on the cards. The only question was how Julian Fellowes would deliver not the baby, but the eclampsia.

Deathiquette

One of the more noisome phrases in the air today is ‘one should not speak ill of the dead’. The sentiment, both spoken and unspoken, is everywhere, and the dead we should not speak ill of is of course Mrs Hacksaw, the Iron Lady who famously decreed and then ensured ‘there is no such thing as society’. But we shall not speak ill of the dead. Labour leaders stand as pupils before Miss Jean Brodie, the better not to speak ill of the dead. In the Today coven, Humph and Jimbo cackle away at each other, reminiscing about conviction politicians. No, we shall not speak ill of the dead, oh no. April is the cruellest month. Mistress Thatch – she dead! wail the hollow men, heads filled with deathiquette. De mortuis nihil nisi bonum. And yet, between the desire and the spasm, between the potency and the existence, between the essence and the descent, falls the shadow. But we shall not speak of the shadow, oh no: de mortuis nihil nisi bonum.

Word-Stir-Fry

Powering a juggernaut through a minefield of metaphors, Professor Sue Bailey last week achieved a spectacular pileup. Describing the dire state of mental health services, the outgoing Chief Pongo of the Royal College of Psychiatrists said, ‘It’s a car-crash that we are sleepwalking into’. Never mind the grammar being of the kind up with which we will not put, the utterance revealed what psychiatrists once called a word salad is now so old hat; instead, word-stir-fry is the new black. Bailey then took a punt at Health Secretary Hunt, but Punt was saving his powder for later in the week, when his chum Cammers was scheduled to get up in a crate, pop over the Brussels, and take a shufti. In the best English losing tradition, Punt reckoned that crashing and burning with only a Hungarian in tow was a swell show. Cammers himself appealed to an inverted – and so imploded - Pyrrhic logic, averring that sometimes one has to lose a battle to win the war. In the political fallout, only one thing was certain: Cinderella was still out in the cold.

Humph Flumphs Again

The Today programme’s resident grumpy old bull, John Humphrys, took a charge at Prime Minister David Cameron this morning, and ended up with his horns stuck in wood, and his tail between his legs. Cameron, in excellent patroniser-in-chief form, ordered Humph back to school. Humph, unable to extract his horns from the wood, acceded. “I will go back to school,” he said, adding petulantly as only Humph could, “and I will choose my teacher”.

Dr No has for some time been bemused by the media coverage of the Alternative Vote (AV) referendum, and, less bemusingly, by the public’s apparent lack of grasp of what is, all said and done, not a difficult a concept to grasp. Certainly, the jargon does nothing to help: ‘First Past the Post’ is nothing of the sort – there is no post, just a brutish my-pile-of-votes-is-bigger-than-yours battle, while the ‘Alternative Vote’ is a first past the post race – the post being 50% of cast votes; but the procedure, serial elimination of the candidate with the least votes, and allocation of those voters’ successive choices until one candidate passes the 50% post, is comprehensible. Or at least should be comprehensible – unless, that is, one is, as Cameron described Humph this morning, the BBC’s ‘lead broadcaster’, a remark which on paper gains the added thrill of plumbic insult.

Zombie Lawyers

Established readers of Bad Medicine will know that Dr No takes a dim view of m’learned friends, considering them to be a verminous infestation in the lives of normal folk. In Dr No’s ideal world, lawyers would be deported to burrows on the fringe of an unknown desert, where they could live out their wretched litigious lives fighting each other, while the rest of us get on with our lives, unimpeded by lawyerly interference. For the time being though, back in the real world, lawyers are still with us, an inconvenience to be lived with, like a pimple on the bum that won’t go away. The day before yesterday, the 18th, Dr No had occasion to email one such pimple, only to get back one of those pesky out-of-office auto-replies. The reply, of course also dated the 18th, stated “I am away from the office until Monday 16th June.” The pimple, it appeared, was a zombie pimple, stuck in a limbo the Devil knows where. Dr No was left with a worrying thought: if lawyers don’t even know where they are, how on earth can we be confident they know what they are talking about?

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.

Full Tank of Gas

Unbeknownst, presumably, to today’s Tory sound bite chefs, in Dr No’s youth to be full of gas had other meanings: to be full of wind, puff or bombast. These earlier meanings recurred in Dr No’s mind over the weekend, as the BBC’s news zombies trotted out Dave’s full tank of gas sound bite time and again. Presumably, like Camilla’s use of wicked, gas is meant to sound groovy. LOL! Where, Dr No wondered, was Little Nellie when you needed her? Dr No’s earlier scheme to pour sugar in Dave’s petrol rapidly gave way to an overwhelming wish to drop a match in the tank.

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.

A Short Life and A Sorry One

Stilton, the Chief Pongo at the General Medical Council, is pleased. In 2010, his Gestapo took on more cases, and spiked more doctors than ever before. His network of field spies, the Herr Medical Directors soon to be mantled Responsible Officers, are reporting ever greater numbers of medical dissidents to GMC-HQ. Only two years ago, a mass spiking event took place, with the introduction of medical licences to practice. But that mass spike will pale into trivial insignificance next year, when the greatest spike-fest of them all starts. Revalidation is, as they say in managerial and political circles, due to be rolled out, in 2012. Those doctors who manage to escape acute spiking will be rolled over repeatedly by the heavy steam-roller of revalidation. Doctors, once real life and 3D, will find themselves flattened two dimensional cartoon characters, with not even a shadow of their former selves left to relieve the barren new landscape of 360 degree multi-source blowback. Small wonder, then, that Stilton is so pleased.

The Doctor and Dr No

Sometimes Dr No has wacky ideas. One of his favourites is that all of time has already happened. Like a film in a can, it is all there, beginning to end; and, like a film, we see it sequentially, frame after frame, and that is what gives us the illusion of movement, and of the arrow of time. Sometimes he goes a little further; and, seeing the film strips lying in coils side by side on the reel, wonders whether we might, just might, if the conditions were right, be able to read the film not sequentially on the strip, but radially, on the axis of a spoke, and so be able to see, perhaps even move, backwards and forwards in time.