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March 2010

Witchcraft Down Under

Down below is a quaint euphemism for the nether regions, and this tale is tale of trouble down below, of troublesome menses, and by coincidence it happened down under, in Oz. A family court judge ordered the hysterectomy of a severely disabled 11-year-old girl, and in so doing unleashed a storm of protest from the right-on people-first brigade, who accused the judge of sexism, of forcing sterilisation on the disabled, and, in so doing, acting in a manner ‘incomprehensible in the 21st century’.

At first glance, Angela’s case appears clear-cut, and the ruling, though delicate, defensible, and the protesters more wrong than right-on. Angela (a pseudonym) was born with Rett syndrome, a rare genetic condition that causes a raft of disabilities that means she needs constant care for just about everything. Two years before the hearing...

Counting the Dead

Dr No is hopeless with numbers. Just being in the presence of statisticians causes a pressure of incomprehension to build up in his head. When they start to talk numbers, it is as if they are speaking in tongues; and when their chalk squeaks on the blackboard, all he sees is so many hieroglyphics.

But numbers are part of the fabric of medicine, and their understanding is necessary to the practice of medicine; and so Dr No has over the years developed a habit of translating the hieroglyphics into words, and the formulae into verbal instructions. Σx becomes the sum total of all the values of x; and μ = Σx/n becomes find the average value of x by adding them together, and dividing by the number in the sample. The dark impenetrable pool of numeracy is side-stepped on the well-worn plank of words.

The Royal College of Pharisees

That smuggest of colleges, the Royal College of Physicians of London, already infamous for its part in the MMC/MTAS disaster, has of late been cozying up ever more closely to the Department of Health, and its chief pongo, Sir Liar Liar Pants on Fire Donaldsong. Earlier this week it moved still closer, issuing an right-on report damning callous smokers who kipper their kids.

The report, featuring a cover photo of a prole caught in the hideous act of kippering a bairn, contains shocking figures and urgent recommendations in bountiful supply. Passive smoking, it estimated, caused children over 300,000 UK GP consultations and almost 10,000 hospital admissions every year, at a cost to the NHS of about £23.3 million. An alarming list of childhood illness caused by passive smoking includes old favourites such as asthma and wheeze (22,000 extra cases) and middle ear disease (120,000 extra cases), as well as the reliable media magnets meningitis (200 extra cases) and cot-death (40 extra deaths).


‘All social engineering is preceded by verbal engineering’

–William B. Smith, Verbal Engineering, 2002

Patricia Blewitt, the former Labour cabinet minister, now famous for more gaffs than a gap-toothed moose, has been spotted creeping around Westminster at a late hour by the ever vigilant Witch Doctor. Blewitt – who numbers amongst her affiliations patronage of the pro-terminator pressure-group Dignity in Dying – was busy urging her hon. Friends to gee-up and set about a Royal Commission on Assisted Dying; anything of a lesser stature simply would not do, she said. Her game – to sneak in a Royal Commission in the twilight hours of this Government, since she is due to stand down at the forthcoming election – was spotted by her hon. Pals and thrown out.

Tick Box Medicine

Dr No’s mother, a fit 80-something year old, recently attended an ophthalmology clinic, on the advice of her optician, and was told – out of the blue, by a nurse – she hadn’t even seen a doctor - that a bed had been arranged for her to come in two days later to have her cataract removed. The nurse was most put out when Dr No’s mother – who knows her mind very well – said she had no intention of coming in for an operation she neither knew about, nor did she need. Yes, she does wear reading glasses – but otherwise her eyesight is fine.

Revalido, ergo non sum

The one-time partly elected General Medical Council, now reincarnated as a State appointed Stasi, has started to rev up its revalidation machine.

Appraisal will change from an annual tea and biscuits affair into a game of Russian roulette. Multi-source 360 degree feedback will provide a Catherine Wheel display of our gaffs. Serious Untoward Incident reviews will expose out deepest faults. No amount of lists of dutifully conducted CPD will erase the stain of our failures. The Herr Obersturmführer Appraiser will click his heels and pronounce our conduct inadequate; and the Herr Oberscharführer Responsible Officer too will click his heels, and regret to inform us that he is unable to make zee rekommendation that we be revalidated. Our career will end, not with a bang, but with a click.

Ross Kemp on Gangs: The GMC

Medium shot of Kemp standing outside GMC Towers.

KEMP (to camera): I’m on my way to meet a gang that has been regularly mixed up in spurious allegations, career assassination, perjury and perverting the course of justice. A truly notorious gang who have been terrorising innocent doctors for more than 150 years, while at the same time always looking after their own. A gang so fearsome in its reputation that its victims refer to it only by its initials. It is the gang simply known as (dramatic pause) The GMC.

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.

Most Drugs Don’t Work

One of the most bizarre facts about modern medicine is that most of the time, for most people, most drugs don’t work. Naturally, this is something that Big Pharma is keen to keep hidden. Even most doctors are only dimly aware that most of the drugs they peddle might not always be what they are cracked up to be. At a time when drug companies and doctors are pushing ever more pills onto ever more patients, we should perhaps be a little more savvy about the pharmaceutical pact we enter into when we agree to pop pills.

For hundreds of years, doctors had few effective drugs at their disposal. Those that they did have were either herbal toxins used in small doses - opium, digitalis, quinine and the like, which most certainly did and do work - or so-called “tonics” – dubious placebos that nonetheless pleased the doctor and his patient.

Database State

We have seen in recent times how secure our national databases are. HM Revenue & Customs, the Ministry of Defence, the Department of Health, the Foreign and Commonwealth Office have all been reprimanded for serious ‘lapses’ that have put at risk the personal data of millions of UK subjects. On a wider scale, The Information Commissioner reported in January that there had been over 400 data breaches by government and the NHS in the past two years. Last month, the national children’s database, which records details of England’s 11 million under 18 year olds, was described as ‘not stable’ – official-speak for yet another security breach. Our national databases, it seems, are about as secure as a paper bag full of water.

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