Now you see it........

Dr Rant's latest post, which was found here, has vanished. Where has it gone? And why?

PS. To Dr Rant. If there is some reason why you no longer wish to show that excellent little film please let me have it, or a link to where it can be found, and I will post it.

Mystery object

Well done to Claire who correctly suggested that the mystery object was a haemorrhoid clamp, in this case with ivory jaws. Although anaesthesia was invented by 1860 it was not widespread and the likelihood is that most people would have had this applied to their piles without anything to alleviate the discomfort.

Mystery Object

This one is from 1860.

Any guesses?

Legal right to offend

the Racial and Religious Hatred Act 2006 contains wide exemptions for freedom of speech, specifically saying that nothing in the Act shall prohibit or restrict 'discussion, criticism or expressions of antipathy, dislike, ridicule, insult or abuse of particular religions'.

Crown Prosecution Service

Open season then!

Wrong diagnosis

The National Institute for Clinical Excellence is very much a curate’s egg. Their latest guidelines on the management of hypertension is one of their better publications. It points out that 25% of those diagnosed with primary hypertension, may in fact be normotensive most of the time and have erroneously high readings due to the anxiety of having their blood pressure taken. These people are being treated inappropriately.

There is something of a parallel here in hospital practice. I have noticed over the last few years that anaesthetists now religiously take the patients’ blood pressure in the anaesthetic room, just before surgery. I may be wrong but I am sure that they did not do this in the past. 

Now if patients get anxious just by having the GP take their BP, how anxious are they going to be immediately prior to anaesthesia & surgery. This anxiety is then compounded by the anaesthetist expressing concern about how high their BP is.

Could I suggest to my anaesthetic colleagues that the BP reading you get from someone in your anaesthetic room is meaningless, inaccurate, and counter productive. Why don’t you stop doing it?

The evils of drink

More scare mongering, this time on the evils of drink from that well known bon viveur Sir Ian Gilmore, and backed up by Prof John Rhodes and Sir Richard Thompson. The article predictably is full of words such as “could”, “predicted”,”up to”,”if”. In other words lots of speculation padded out by phrases such as “wider harm”, and including the usual “how many have to die” from Thompson. (All of us actually, idiot) I think there should be a rule that anyone using that phrase should automatically lose the argument.

The usual stupid statistics are rolled out. Alcohol related liver disease now kills 1 in 10,000 of us, yes 1 in 10,000. I’ll drink to those odds.

In the league of alcohol consumption Britain ranks 16th from the top. Now I know that there is a tendency in reporting major sporting events to portray 16th as nearly at the top, but it isn’t really is it.

I met one of the three named above once. I quickly gained the impression that he was the sort who would burn heretics at the stake if it was still legal. The three of them have really lost site of reality with phrases such as “The regulation of population-level alcohol consumption is a duty of responsible Government.” Jawohl.

This is not to say I condone heavy habitual drinking. When I come across people who frequently drink for the sole purpose of getting drunk I think of the line from Blazing Saddles, “Why you do that to yourself”. But these people are mostly adults and while we have a duty to educate people, the urging of Gilmore et al to impose legal controls on what people legally consume should be resisted.

After all, if it were not for drink some of us would never get laid.

Slippery slope

DZ engages in one or two sports. In one of them today he found himself competing against his own son. DZ has been engaged in this sport since before dear son was born, but nonetheless today DZ got his arse kicked.

A very odd feeling, a mixture of pride and despair.

Fun with statistics

While we are on the subject of daft research & recommendations cast an eye over this article. At first glance it might seem to be quite worrying for those who practice oral sex. An increased in risk of 250% seems quite significant until you think about what that actually means in absolute terms. But bear in mind that the risk of throat cancer is normally 1 in 50,000. Having had more than five oral sex partners in your life would increase that risk to 2.5 in 50,000, or 1 in 20,000, which is still pretty long odds.

And yet they still feel justified in making lifestyle recommendations on the basis of their slim statistics. And what is the recommendation? Always wear a condom for oral sex. I wouldn’t mind betting that the investigators were all men as they seem to equate oral sex solely with fellatio. It does not occur to them that wearing a condom is a bit illogical for those engaging in cunnilingus.

Still if ever your partner expresses concern over the risk of cancer from oral sex you can reassure them that this is yet more pointless research of virtually no benefit. Remembering of course it is rude to speak with your mouth full.

And as for spit tests, I don't think I will go there.

Nanny knows best

Not a week goes by without something like this from yet another government which wants to interfere with every aspect of life. Last week it was alcohol and dysrythmias. And often the recommendations contradict those of not so long ago. I am sure I am not the only one who thinks that, when it comes to this petty attempt to possibly reduce a risk of one particular condition by one or two percent the government and it's scientists can just fuck off.

Previous form.

One of the strange aspects of human psychology is how individuals react in disasters. The “it can’t happen to me” mentality, whereby people carry on behaving as if nothing was amiss in the midst of chaos, until it is too late. This is well illustrated by the King’s Cross fire where it was reported that commuters were still entering the station despite the smoke billowing out.

There is an element of this mentality in how we react to the treatment of the NHS by successive governments. Although we believe full well that they can screw it up totally by repeated and ill thought out reorganisations, none of us believes, deep down, that the governments really want to destroy it completely. That is something that we are unable to contemplate.

But they have form.

In the early 1980s the British armed forces maintained eight military hospitals in the UK (as well as a similar number abroad). Up until that time it was inconceivable to all that these hospitals were under any threat. The military medical services had provided free medical care to soldiers, in peace as well as war since long before the NHS. Even in peacetime they had a valuable function. Soldiers with, what would in the NHS be seen as low priority conditions, such as torn meniscus, would be seen, operated on, rehabilitated and back on duty in weeks, as opposed to months or years in the NHS.

And then, almost overnight, they were gone.

Princess of Wales Hospital Ely Cambridgeshire, closed 1992

Princess Alexandra Hospital Wroughton, closed 1995.

Royal Naval Hospital Stonehouse Plymouth closed 1995

Cambridge Military Hospital Aldershot, closed 1996.

Queen Elizabeth Military Hospital Woolwich, closed 1996.

St Mary’s RAF Hospital, Halton, Bucks closed 1996

Duchess of Kent Hospital Catterick, closed 1999.

Royal Haslar Hospital Portsmouth, closed 2009.

Soldiers were no longer treated rapidly, and returned to duty, and today are treated as a disposable commodity, being medically discharged at the drop of a hat. The Government had promised that soldiers would be prioritised and fast tracked within the NHS but this promise proved worthless.

So they have closed down entirely a complete health service without a qualm. Why should we believe therefore that the NHS is safe in their hands.

DOH!

Over the years a great many laws, rules and regulations have been imposed upon us from the EU. Most of these have simply been accepted and implemented by various governments without question, and regardless of how the British electorate feels on the issue. 

So why is it that this government chooses to defy Brussels on one of the few good laws they have made?

Further link

Love

It is not just fundamentalist moslems who object to Valentines day. The response of other religious loons to what is a pretty harmless idea also demonstrates an antipathy to human sexuality that makes you wonder what on earth they are so afraid of.

Here is another repressive tirade against sexuality in general but premarital sex and homosexuality in particular, this time from the christian side. 

The hatred and malice expressed by the ultra religious of all persuasions against gays is well over the line into insanity. (1) (2) (3)

As for sex & marriage, it’s a bit like buying a car innit. You would not make such a momentous choice without taking the thing for a test drive now would you. You might find that under the sleek paint and alluring bodywork lurks the engine of a Reliant Robin. And if you don’t find out until you are committed you find that trading it in for a faster model is bloody expensive.

Privacy

An anonymous commenter has criticised my previous comment on Valentines day restrictions in Malaysia. He assures me that moslems don’t do premarital sex, and that I “should not intrude on their business”. Well the Malaysian authorities seem to have a far more realistic view of whether human beings like sex or not, having arrested at least 80 moslems for doing just that.

The authorities did not catch these people in public. They caught them by raiding hotels and bursting into the privacy of guests’ rooms. 

Now who exactly is intruding into other peoples business?

A woman with her head up her arse.

If you don't know who this is, and why she is a complete fuckwit, then you have been away on Mars for the last week or so.

H2O

Here in the UK inflation is gathering pace and many essentials such as food and fuel are increasing in price much faster than inflation. One commodity that is increasing out of proportion but is an easy economy is bottled water, a triumph of promotion over substance. What sort of an idiot buys bottled water anyway, when what comes out of the tap is essentially free. In my local Asda you can get lemonade cheaper than water. Come to that what sort of an idiot drinks water at all. Things made with water, yes. Tea, beer......er thats it really, but not water. As W C Fields said "Water? never touch the stuff. Fish fuck in it."

Happy Valentines Day

For those of you enjoying Valentines day spare a thought for Malaysians. I think it true to say that most in the UK think Valentines is so harmless that even our adolescent youngsters send each other cards without causing any concern. In Malaysia however this is considered by the government to be “a trap” to ensnare the young in a life of vice, and immorality.

They will even be raiding hotels and presumably knocking down doors to catch people at it who in their view shouldn’t be. A case of coitus very interruptus I should imagine.

Now who are the ones really obsessed with sex here?

Colleagues - Opthalmology

An exchange between a patient and an opthalmologist.

Patient; "I'd like you to have a look at this doctor", producing an Aldi carrier bag. The opthalmologist looks into the bag. It contains a turd. But not just any old turd. This one is fully 18 inches long, and 2 inches thick.

Opth;  "Hmmmm. Yes. Why exactly do you feel that this is something you should be bringing to my attention as an opthalmologist?"

Patient; " Well Doctor, every time I pass one of these it makes my eyes water"

Colleagues - ENT

CEA fibs

In a previous post I questioned the argument that CEAs should be retained in order to encourage doctors not to emigrate to more financially rewarding countries. The examples cited in this article were Australia and the USA. 

I was remiss in not providing evidence for contradicting the article, but have now found evidence which not only backs up my argument, but also surprised even me.

This article in the New York Times confirms two things. First, if you exclude the USA, British doctors are up there at the top when it comes to pay compared with anywhere else in the world, and certainly we earn significantly more than our Australian counterparts.

Secondly, although it is true that US doctors earn more, the differential is nothing like as large as I (and I suspect most of you) would have imagined. If you then factor in the eye watering premiums for malpractice insurance Americans pay compared with our crown indemnity, then most of this differential is gone. Add in our pension scheme and it is amazing there is not a mass exodus of doctors to the UK from the USA.

So those advocating the retention of CEAs can not honestly use this argument, and I suspect they know it full well.

Over to you CEA apologists.

boom boom

Here is a joke I heard at work today which I suspect not everyone will find funny. If you are one who is offended then remember this quote by Sarah Jeanette Duncan; "One loses many laughs by not laughing at oneself"

Q. What is nine inches long and dangles in front of an arsehole.
A. A stethoscope.

Call my bluff

I am not a gambling man, but I do know that to execute a successful bluff, you have to be convincing. Your opponent has to believe that you have a strong hand. 

In it’s latest statements on the NHS reforms the BMA seem not to understand this simple fact. Their entire approach indicates some sort of delusion in which they have authority and standing, and where people give a shit what they think. 

To start with they have “set out a series of demands (my italics) to ministers they say must be met.” Ooooooh get them. I expect Cameron & Lansley are quaking in their boots having been presented with the BMA’s demands. 

Now I am as dubious as any about the NHS reforms, but this sort of empty posturing by the BMA is, I think, unlikely to generate anything in government but raucous amusement. 

As for the threat of strike action by the BMA, this is the most transparent bluff. The medical profession will not strike on this issue and the government knows it. Raising this as a threat just makes the BMA look foolish and I imagine disinclines the government to involve them at all. They know full well, as do we all, that the BMA could not organise a poke in a brothel with a fist full of cash.

If they want to be taken seriously perhaps they should stop threatening to scream and scream and scream until they’re sick.

Job offer

It is nice to see that there are employment opportunities for the members of the Welsh rugby team.

Refund

According to government statistics the number of people in the UK who pay income tax is 30,700,000. A proportion of tax collected goes to the Department of International Development, essentially a department to dish out overseas aid. In effect this is enforced charitable donation, but very few people take issue with this as, despite our current impoverished status, we are as a nation vastly wealthier than many, and overseas aid is usually money well spent.

Usually.

It now transpires that it was this department that footed the bill for the visit of the pope to the UK. A bill of £1.85 million. Correct me if I am wrong but the Vatican is not exactly impoverished now is it.

Well I want my sixpence back.

Technically this is an old 6d, now equivalent to a little over 2p. Sixpence today, in old money would be 1s/2d. (For you youngsters that's pronounced one an'tuppence)

More Defiance

Another of the famous mohammed cartoons that has resulted in death threats is this one by Kurt Westergaard.

Mr Westergaard was attacked on new years day 2010, in his own home by an axe wielding Somali, who was shot in the leg by Danish police. The attacker has been found guilty of terrorism and sentenced to 9 years, followed by immediate deportation. Nice to see the Danes taking freedom of speech seriously.
The attacker should consider himself lucky that the Danish police shot him once only and in the leg. Can you imagine his fate had he been confronted by British anti terror police.

Uncanny

When I wrote my last post I did not think anyone would take my suggestion seriously, or so quickly.