Mystery object again

No guesses on this one. The instrument is called a probang. It was used for disimpacting the oesophagus when blocked with an over ambitious bolus of food, usually in cattle. You simply used the instrument to push the impacted food through into the stomach.

It reminds me of a patient I was involved with many years ago, when I was in training. Young male out on the town with his mates drinking heavily, and playing silly games. He bet his mates he could swallow a whole, intact chicken wing. He couldn’t, and it got stuck at the lower end of the oesophagus, and he needed surgery to move it.

For reasons I won’t go into, the rigid oesophagoscope was not available, and the fibre optic simply wasn’t up to the job. The surgeon, George, improvised. So what instrument did he use to retrieve the chicken wing? An old fashioned, steel & chrome, non disposable, used thousands of times rigid sigmoidoscope, like the one below. Good one George.

Mystery object-answer

Anonymous gets it right

"Looks like a burdizzo to me. we use them to castrate male calves"

It is in fact a veterinary instrument known as a “bloodless castrator” Nice.

Staying on the same theme this is another instrument used in veterinary practice, but also, historically, in humans. What is it? & what's it for?

To get an idea of scale, it would be one to two feet long

Mystery object

It's been some time since I posted a mystery object. This one, unlike my previous offerings is not an antique, and I think is quite easy. Any ideas what this is.

Anniversary

On this day, June 24, in 1916, the first British gun opened fire to start a week long artillery barrage, preceding the battle of the Somme. The first day of the assault, a,week later, generated 60 thousand British casualties. The RAMC of the day was totally overwhelmed.

RAMC stretcher bearers, 1916

Physios

Have had contact recently with the physiotherapy department in my hospital. Physios have a jargon all their own, treatments largely unevidenced, and to my mind mostly illogical and ineffective. They spout stuff that I don't recognise as science, and ponce around with a stethoscope around their neck.

I have had a nagging doubt for some time about the profession, which has now crystalized. I think they're the closest thing in the NHS to quacks. A total waste of money.

Losing battle

There is precious little in the media this morning about yesterday’s industrial action, and what there is is heavily biased against the doctors. It seems there was little support in the profession for the BMA action, and certainly my perception of my own location is that it was all very much business as usual. Can’t say I am surprised. 

No-one's all bad

I have been pretty scathing on this blog about the General Medical Council, and it’s chief executive, Niall Dickson, and I’ve highlighted cases where the GMC has behaved with vindictiveness, pettiness, inconsistency, and a total disregard for justice, or legal safeguards such as the Human Rights Act.

But it has to be acknowledged that sometimes individual doctors do cross the line and, as a group, we have the full range of villains just as people in other areas. I don’t assert we don’t need a regulatory body, we obviously do, but we need one as impartial, consistent, competent, and fair as possible, and it is here that the GMC often falls short.

But the GMC does get it right once in a while, as it did when it erased  Andrew Wakefield.

Mr Dickson too can’t be wrong all the time, and this story is one such, concerning a GP who introduced religion into a medical consultation. No-one wants to stop doctors talking enthusiastically about their religious beliefs if they have them, but at the best of times they have little place in this setting. And to use phrases like “the devil haunts those who do not turn to jesus” is simply inexcusable. Just plain wrong. 

The GMC have issued the GP in question a warning, and quite right too. So for once, when Mr Dickson said “This is not about religion. It is about respecting patients and making sure doctors do not use the incredibly privileged position they hold to push their own beliefs.” I have to say I agree with him.

Shag break

It has been pointed out to me that the goings on highlighted in that last post did not involve doctors, and that this might be because doctors have reserved car parking spaces in the hospital, making such activities impossible. I don't think that is the reason though. The giveaway is that the staff involved are engaging in these activities in their break. What the fuck is "a break"?
Still, the next time a nurse excuses her lack of knowledge of what is going on on her ward with the phrase "I've been on my break" I will look at her in a new light.

Job change

DZ sometimes feels like a change of scene, but where to go? The grass always looks greener but the reality rarely lives up to expectations. Still some places have perks that aren't available elsewhere. I wonder if there are any vacancies at Darent Valley Hospital.

Research & ethics

Today, June 15, is the anniversary of the first attempt to transfuse blood into a human being. Those who might think that blood transfusion is a relatively new idea might be surprised to learn that this was in 1667.

I have commented before on the total lack of regulation of medical research in history which meant that doctors could, and did, try literally anything on their patients, with impunity. No ethical committees then.

Unlike my previous example however these early attempts at transfusing animal blood into patients contributed nothing to benefit humanity. 

Anyone who thinks that ethical committees have today have eliminated this attitude to research should remember what Andrew Wakefield got away with, for a time at least.

Ethical committees, unsung heroes.

Thin end?

One recent story that doesn’t seem to have generated much interest is the recent recommendation by the Joint Committee on Vaccination & Immunisation that all children should be regularly vaccinated against flu. The rationale is that this would help prevent flu moving through the population as a whole.

Unsurprisingly this has caused a lot of the anti vaccine campaigners a fit of apoplexy. If you look up their various blogs & websites, which I’m not going to link to, you can find a level of rabid irrationality which is quite entertaining. I’m not going to spend time here dissembling their incoherent and ill informed rantings. Other bloggers out there do this far better than I could.

What is worrying is that, if you read the comments to the article, it is apparent that there are more than just a few people out there who have very odd and ignorant ideas about vaccination. As just one example one commenter seems to believe that tuberculosis is a disease of the past. If you want to spend a little time having your faith in human intelligence steadily eroded just have a good read of the comments.

But I do have one tiny reservation about these recommendations. Vaccinations against diseases other than flu are primarily promoted as being beneficial to the individual patient vaccinated. There is obviously a public health benefit too, but this is secondary. This is the very first time that I have heard of, of a vaccination programme being recommended primarily as a public health measure. Which means that the benefit to the individual patient has been placed as a secondary consideration. And that’s what bothers me just a little bit. 

Discovered

Aaaargh. The spammers have found me!

A bedtime story

From "The Medical Registrar" (facebook)

Once upon a time, there was an elderly care team of doctors who became very concerned that none of their demented patients were being fed at lunchtime.

So at the expense of their own lunchtime, the three junior doctors went round feeding and watering the patients as best they could.

This did not go down well with the "patient experience matron" especially when the local MP and the Chief Exec witnessed this and asked why the doctors were feeding the patients.

In response, the trust banned all medical staff between 12:30 and 2PM from the ward so such embarrassing scenes will not recur.

And that was how protected mealtime (at least at one hospital) was born. True story.

21st century humanity

I read this article with horror & disbelief. Let’s summarise;

A man and a woman are arrested in Sudan and charged with adultery. The male denies that adultery has taken place, his word is accepted and he is released. The woman has a confession beaten out of her, which is also accepted, and she is sentenced to death by stoning.

How is it possible to commit adultery by yourself? This is like something out of Monty Python, except that it’s not funny.

O24 Scam

It is getting difficult now to keep up with all the scam products appearing on the net at the moment. My post on the Nutrascience scam has now attracted over 10,000 visits and is still getting comments on a daily basis, but this is just one of the slimming products out there using the same modus operandi to swindle people out of their money. I say products, in fact it is usually the same product just renamed and put back out there, promising unfeasibly spectacular weight loss.

The latest scam product to catch my eye is a topically applied concoction of various random oils called O24, making unsubstantiated claims to relieve pain that I have no doubt breach Advertising Standards Authority rules, just as Finitro Forte did. Perusing the terms & conditions you find the phrase “authorising us to charge payments against your debit or credit card that you provided.”  That’s the phrase that gives the whole game away.

This variety of scam should be well known by now, but there are, I am sure, lots out there who will be lured in by the “special introductory offer” which will subsequently be very expensive for them. Don’t be one of them.