Journalists!

 DZ has commented before on newspaper articles seem to be increasingly written by sloppy lazy journalists, and published by indifferent editors.

Here is another one.

To read the headline you'd think this was an event of clear negligence. As if the normal theatre procedures were not diligently followed, and the patient went on his way with everyone involved blissfully unaware of the problem. 

If you read the article it's obvious that, in fact that was not at all what happened. The end of surgery instrument check obviously did correctly identify that an instrument was missing, and the correct procedure for finding it was followed. While the patient was still anaesthetised. There was then a clinical decision made to leave it where it was and retrieve it at a subsequent procedure.

It's highly unlikely that the patient would come to any harm as a result of this, and in reality it's a complete non story. yet another case of some hack writer trying to generate copy out of nothing. 

Nurses

 So our nursing colleagues finally lost patience with the government over pay. What took them so long? 

This table shows starkly how poorly their pay has kept up with those who control the purse strings.

So nursing pay has risen only just over 11% over the last 12 years compared with almost 30% for MPs.  To put this in perspective inflation over the same period totals 34%, equating to a serious fall in real term earnings for Nurses. House price inflation over the same period exceeds 53%, so even more of their income has to go on simply providing a roof, eating further into their dwindling pay.

Only it seems a few months ago the nurses, and others were being lauded and applauded as "essential workers" putting their lives at risk to keep the NHS from total collapse. They know now that they have to make a stand to prevent this ongoing downward spiral. The various so called "independant" review bodies have totally failed in their function of ensuring fairness and adequate pay, having simply fallen into line as government puppets. 

And in those 12 years corporations continue to make record obscene profits and their CEOs take home seven figure salaries.

And don't even talk to me about fucking professional footballers, who can earn more for kicking a ball around for 90 minutes than a nurse for a year's work.

Oh dear, did you hurt yourself you fucking parasitic pansy!

Progress

 Last year's census for England and Wales has revealed some very interesting trends in the area of religious observance, as is covered very well in this article.

DZ sees the two main points as, first, a rapidly advancing move to a secular population, and second, within those who practice religion, an increasing diversity. Also, even those who describe themselves as "christian" are not all members of the church of England.-

Bearing these two points in mind is it not long overdue that the UK should disestablish itself from the Anglican church? That religion should be separated from the state, and that the bishops should be removed from the house of lords?  Not forgetting of course that the house of lords is itself an insult to the concept of democracy.

While the present government is unlikely to disturb the status quo, Mr Starmer is a more hopeful prospect, as is seen here and here.

Worth considering.

Why so coy?

 DZ has today come across this article in "the Independent" today. It talks about an increase in the incidence of oral cancer over the last 10 years, and particularly the increased incidence in young people. DZ actually knows what the increased incidence is due to, but the newspaper doesn't mention it explicitly. It mentions smoking, which has declined over the relevant time period, and alcohol, but the newer cause they skirt around. It's referred to as "lifestyle factors", which is not very helpful. Also they briefly mention Human Papilloma Virus, but don't elaborate.

They have completely failed in their duty to educate the public in a display of ridiculous prudishness, totally unbecoming a modern news outlet. Presumably they think that if they specify what exactly they're talking about there will be an epidemic of pearl clutching among their readers.

DZ is not so inhibited. What we are talking about here is (gasp) Oral Sex! There, I've said it! Clutch away.

Quote

 

00

Tolerance

DZ did not write this. It's reproduced here from a FB page, the Scottish Atheist's Group 

"Q: Why Can’t You Just Leave Religion Alone?

A: The answer is simple. Atheist activism exists because religion exists.

Religion permeates our culture, shows up on our doorsteps with literature, scriptures and threats of eternal damnation, influences our science books, contaminates our political systems, indoctrinates our children and postulates that its doctrine must be followed, lest we be destroyed in body, in soul, or both. Non-believers are simply responding to the avalanche of religious messages that bears down upon us daily.

If the religious lived in a bubble where no ripple effects negatively impacted others, there would be no problem. But religion does not exist in a bubble. It accosts us in our homes, in our places of work, in our personal and professional lives. Believers are charged with a lifelong mission to preach, teach, disciple, shout it from the mountaintops and to “go ye into all the world and preach the gospel to every creature.”And when the skeptic raises a hand of protest, he is dismissed as misguided, immoral, rudderless, angry or (wait for it) “religious about his atheism.”

Is that a fair assessment? When’s the last time an atheist rang your doorbell with brochures about the Good News of Humanism? How often do you find Richard Dawkins books in the dresser drawers of your hotel rooms? When was the last atheist temple erected in your neighborhood? Have you ever attended an atheist revival? Has atheism demanded 10% of your household income? How many dedicated atheist television channels broadcast through your satellite dish? How many atheist verses were you instructed to memorize as a child? When’s the last time someone thanked a farmer (or even the cook) at the dinner table instead of God?

On a more radical front, what’s the name of the last atheist who sawed the head off of an “infidel?”Or sentenced a shrouded woman to death for displeasing an oppressive husband? Or strapped explosives to his belt in order to kill hundreds in a public square? Or publicly hung a homosexual? No, atheist activism isn’t a religion. It’s a response. Religion is a pounding drum that has gone mostly unanswered for a long, long time, and legitimate challenge to its wild and often harmful claims is long overdue."

 To illustrate the point being made, here is a copy of an (anonymous naturally) letter sent to a brewer by one of these pious oppressive "christians"

Why indeed can't the religious just leave the rest of us alone?

 

Watch this space

 

Steve Barclay

So this is our new health secretary. There isn't much to go on in his wiki entry. He's been an army officer, for all of 5 months. He doesn't seem to be one of the rich privileged upper class Eton/Harrow Bullingdon twats we've become used to from this party. Does he have any previous experience in healthcare services provision? Well no. But on the plus side it's hard to imagine he could be as useless, idiotic and ignorant as the previous incumbent. Give him time. His main problem is going to be contending with the predatory impulse of that NHS nemesis Hunt. If he can stop Hunt from financially raping our health services then I'll be impressed. We shall see.

BUGGER!!. Missed it

 

Plus ca change

 Ten years ago DZ put up these two blog posts. (1) (2)

Since then things have not improved. In fact they are far worse. Every school in England now has children attending who are quite literally starving. In one of the richest countries in the world. DZ has always tried to stay clear of politics, but he has to point out that in those ten years we have had only one party in power. A party that has allowed the gap in wealth distribution to increase to breaking point. Giving us a country where so much wealth is now sequestered by the ultra wealthy that the economy can no longer function. And only recently their approach was to offer the wealthy even more tax cuts at the expense of everyone else. We are getting to a "let them eat cake" situation.

Scotland, and soon Wales show that free school meals for all primary school children is not unaffordable, unless you are preoccupied with using vast amounts of taxpayers money to, directly and indirectly, line the pockets of your cronies and financial supporters. 

This government's priorities are so far removed from attending to the well being of it's people that you can only conclude that they don't care as long they're OK. Even the last Labour PM of the UK came to power as a down at heel politician, and is now worth £45MILLION!!! What the absolute fuck?!

And they're now bickering about who should be in power, and even talking about bringing back that overprivileged upper class twat Boris. Fuck me!

They are courting disaster. Civil dissatisfaction is coming, inevitably to the boil as everything we had is being taken away. Decent pay, reasonable house prices, free education all the way to university, affordable utilities, and a decent health service. The list goes on & on.

In 1886 the people of France gifted to the USA the Statue of Liberty. Perhaps we should be asking them to gift us something too.

0

What?

 DZ is still working via agencies, so gets to see a fair few hospitals that are new to him. So he occasionally comes across stuff that makes his eyebrows go up. Like the hospital where the cleaners had put notices on the bins asking people not to shit in them. Or the hospital with a notice in the changing rooms informing staff that the CCTV cameras in the changing room had been removed!

Well today brought another surprise. At one time today I needed to use the staff toilet, and was surprised to see this on the wall in there.

The presence of the hole I'm sure  has a perfectly reasonable explanation. But what the hell is that message supposed to mean. I suspect I'd rather not know.

Royal quackery

 

So, we now have a new King. Before we get too carried away with enthusiasm let’s pause for a moment to remember some of the odd views he has in the medical field, a field he is not at all qualified to pontificate on. He has made it quite clear in the past that he is sympathetic to the use of complementary and alternative medicine (CAM) in the NHS. He has previously given his patronage to a pseudo college of pseudo medicine which eventually crashed and burned amid allegations of fraud and money laundering.

One of the excuses used by proponents of these pseudo medical disciplines is that they supposedly have no adverse effects. A shame that that’s not true.

Firstly all alternative modalities have the adverse effect that they have no beneficial effect. This, combined with the fact that many practitioners of CAM discourage their patients from resorting to normal medicine, thus allowing the patient’s condition to develop unchecked. The poor gullible patient is even encouraged to perceive doctors, or allopaths as they are referred to, as dangerous and in the pockets of “Big Pharma”

And specific practices can have specific adverse effects. Take this case for example. It would appear that the acupuncturist in this case was not aware that the lungs and pleura are right in the line of his fire, with inevitable consequences. Sticking needles in to the chest, without being familiar with what’s in there has also been reported to result in cardiac tamponade. Even anaesthetists, well familiar with the anatomy, approach intercostal block with some trepidation.

And vertebral artery tear, with subsequent stroke, as in this case, is now a well reported complication of chiropractic neck manipulation. Yet no chiropractor will warn patients of this complication and some even deny the problem.

Fortunately, in developed countries at least, CAM provision is heavily in decline and state provided health services are finally abandoning these absurd practices. Although in the USA osteopaths are considered to have the same status as medical doctors most western countries have now cut their ties with these quacks. The Homeopathic hospitals in the UK are now gone, and even in France, the home of Boiron, a water bottling company masquerading as a medicine producer, homeopathy is no longer funded by the state. Even in the USA things are looking up.

So let’s hope that Charles’ new position doesn’t result in him giving his uninformed opinion free reign. When it comes to stuff he knows nothing about he should follow his Mother’s example and keep his nonsense to himself.

Taking the piss

 It is now over three years since the fire that devastated Notre Dame cathedral in Paris. Almost immediately a fund was set up to rebuild, which has to date received almost one billion pounds in donations from all over the world. But the catholic church has stated that this is not enough, and they have gone, cap in hand, to obtain more millions from the French government.

What a bunch of fucking parasites!

More malice

 DZ has recently read an article about a Consultant Paediatrician who is being pursued by the GMC. There are two aspects to this case that I find disturbing.

Firstly the case at the centre of their action is 24 years old. If you check the GMC website you will see that they themselves have a "five year rule". They will not normally investigate cases older than 5 years. So they are acting contrary to their own guidelines.

Secondly, and far more disturbing. The doctor has decided to apply for voluntary erasure. This would terminate the action of the medical practitioners tribunal. Only back in June this year I posted on a similar case. In that case the GMC granted voluntary erasure, the MPT objected, and the case went to court where the legal precedent was set that a doctor can obtain voluntary erasure even if there was a tribunal in progress. On that occasion the GMC were actually the good guys. Which makes it all the more extraordinary that on this occasion the GMC are ignoring this precedent, and have rejected the application. So not only are they being malicious and vindictive, but grossly inconsistent too. One wonders what is their motivation here. 

Would it be too much to expect them to abide by their own rules, as well as the law, and be consistent?

Not secret

 DZ reads today the following in the news.

"Russian President Vladimir Putin escaped to his secret palatial complex near Lake Valdai, halfway between Moscow and St Petersburg,"

And they even provide a picture of the place.

Not fucking secret then is it?!

Sex equality

 Firstly, DZ is aware that in the UK we have a long way to go before we achieve equality of employment between the sexes. But there is no doubt that some progress has been made. Within medicine, half of all medical students are now women, and all hospital specialities now have women consultants, even including such bastions of male exclusivity as orthopaedic surgery.

Outside medicine similar progress is being made with more female engineers, barristers, soldiers etc. DZ was recently on a flight where both airline pilots were women, and it occurred to him that the use of the word "cockpit" to describe the flight deck is becoming inaccurate.

 His wandering mind wondered if the term "clitpit" would be more appropriate. Using this word would also prevent hijackings, since most hijackers are men, and the clitpit is not something they would be able to find.

Doomsday!

 

DZ has delayed slightly writing this post to ensure that it is no longer 24^th September anywhere in the world. Because apparently the mentally challenged loons who follow Q anon are convinced that there is going to be some major world event on that date. Unfortunately they can’t seem to agree on the nature of this event, though there are a number of suggestions. These ideas all seem to arise out of a slip of the tongue on the part of some German politician, and also a scenario in series 24, episode 9 of the Simpsons. Well it's now definitely 25^th September, and nothing particularly world shaking has happened. It won’t stop them making other predictions, probably centering on children being held in pizza restaurant basements being venesectioned to provide blood for the world elite reptiles to drink. Strewth!

But it wouldn’t really matter if some world shaking event had happened, because another prediction, for today, the 25^th, states that today is the day for the rapture, when all the righteous will be taken up to heaven prior to the end of the world. There is a theory that the use of lead in petrol, banned in the UK in 1999, is responsible for the mental derangement of large numbers of people, giving rise to the lunacy apparent in these ideas. But this would not explain the fact that people have been predicting dates for the end of the world for centuries. Invariably without success. DZ looks upon religious belief as a form of mental illness, and is by itself adequate explanation.

Still, the 25^th isn’t over yet!

Surprise!

 DZ has not planned on commenting on the death of the Queen. It's hardly a tragedy or a surprise when someone of her age dies. And while DZ had a degree of respect for her as an individual, he sees the monarchy itself as one of three bastions of anachronistic privilege that stands in the way of true progress in the UK, towards egalitarianism and fairness.

There is one aspect however of the timetable for the next week that seems not to have been considered. Our new PM has generously decided that the day of the funeral will be a bank holiday. Now the NHS closes down for bank holidays routinely, when only emergency care is provided. But we know when these dates are well in advance, so disruption is minimal. We don't even know yet, as I write, what the date is, though 19 September seems likely. 

What this means is that, once the date is announced, the NHS will have maybe a week to inform 18,000 patients that their surgical procedure is cancelled. And 360,000 patients that their out patient appointments are cancelled. All so we can bury a deceased old lady. DZ republican tendencies mean that he will not be watching the TV, and if asked, will gladly go to work if normal. 

Dirty mind

 DZ has bought himself one of those machines for shredding garden waste. Mrs DZ has, as usual, expressed some apprehension about whether it will cause lost digits, but I've pointed out that the entrance slot will not admit a hand. However the entrance slot has caused me some amusement. This is it.

Thinking perhaps it's just my dirty mind at work I showed it to her, and a few other people. Everyone thought the same as I did. However my dirty mind was further titilated by this advice in the instruction booklet;

"Never insert anything into the exit hole".  Snark snark, nudge , wink!

Going backwards

 

Scientific achievements in DZ lifetime.

1950s  Cardiac pacemaker invented.

1960s First man on the moon.

1970s Personal computers and floppy discs.

1980s DNA fingerprinting

1990s Hubble space telescope put into orbit.

2000s Gene editing.

2010s Effective HIV treatment.

2022. FOR FUCK’s SAKE. THE EARTH IS ROUND!

And if that weren’t enough we have people opposing vaccination at the height of a lethal pandemic. And every day we have news headlines like this one.

If there are really aliens coming to Earth to observe, they must think we are dumb as fuck.

It's true!!!

 DZ took this picture a few days ago. The chemtrail conspiracy theorists will love it.

If any of them are looking, it's just ice crystals boys, and a question of relative humidity.

Yet more ignorance

 DZ has recently put up a couple of posts featuring the insane  burblings of American fundamentalist christians. It's a rich vein of material. Particularly when the subject matter is of a sexual nature, where the ignorance displayed is often so profound that you have to wonder how they manage to procreate so prolifically. Here is another one. What depths of educational inadequacy could be responsible for the idea expressed here. There are sciencey words in here but the end result is word salad.

If they really worry about this then why not wear a condom. that would solve the problem. Oh wait.

Free Speech

 

Here's hoping that this gentleman makes a speedy and complete recovery.

Animosity

 DZ, like I suspect most doctors, has met colleagues he did not get on with. And I'm dead certain that some of my colleagues have not liked me very much either. Such is human nature. I have had one colleague threaten me with violence, and I've called one a "fucking idiot". I've even wished death upon one or two. But that's as far is it goes. 

Unlike this guy, who tried to burn his colleagues house down with him in it, and when discovered by his intended victim, stabbed him. 

I bet he doesn't put that in his appraisal form, though I suppose that's moot. I can't see him keeping his GMC registration for long. The GMC takes a dim view of doctors who try to murder their colleagues.

What surprises me the most is the vehicle on which he went to his victim's house, and on which I presume he intended to escape.

A "getaway" bicycle

More ignorance

 DZ has commented before about some of the bizarre ideas some men have about female anatomy, and sexual and reproductive physiology. These ideas always seem to originate from the same source. Ultra right wing fundamentalist religious Americans. People who think you can re-implant an ectopic pregnancy, or who don't seem to have the slightest idea about how sex happens.

Here is yet another. An actual politician, someone actually in office, has criticised his opponents for, among other things, advocating late abortions. Very late. Very late indeed. In fact the gestational age at which he is suggesting the abortion happens is such that the kid would be three months post partum!

Giving birth to that would make your eyes water!

Colleagues

 DZ has often written about appraisal and revalidation and how it affects medical practitioners, but of course our nursing and other colleagues also have to endure this process. And there is no evidence that the system works any better in catching naughty boys and girls for them than it does for us.

Take for example this story about a mental health nurse who was a major drugs dealer, while at the same time being employed by an NHS Trust. Being employed, by definition, means he was getting through appraisal and revalidation, and has only recently been struck off by the Nursing and Midwifery Council, as a result of his criminal conviction. To get an idea of how big he was in his job on the side, this is how much Class A and B he had at the time of his arrest!

So why do you suppose he wasn't picked up by the appraisal system? I expect that when it came to the relevant section it must have slipped his mind to write. "I am heavily involved in supplying illicit drugs to large numbers of addicts" A simple accidental omission I'm sure. It could happen to any of us.

Pareidolia

 DZ has written a few blog posts in the past about pareidolia, the "the tendency to perceive a specific, often meaningful image in a random or ambiguous visual pattern." Seeing an image of mohammed in a blob of Marmite, Or that of jesus in a dog's arse.

This is how some people are so easily fooled into believing in various myths like the Loch Ness monster, Chukachabra, Bigfoot, or the various sightings of "big cats" in the English countryside. Invariably any pictures supporting these beliefs are taken from some distance, blurry, poorly lit and could often be anything. But we live in a world where millions of people thought it was a good idea to elect an elderly, psychotic, semiliterate, incoherent dement to the position of President of the United States. And to some people, the less credible something is, the more likely they are to believe it.

Take this pic for example.

I like to think people who look at my blog are bright enough to realise exactly what it is. But I have no doubt that there are sites on the web where, suitably embellished with a little made up narrative, I could put this and convince people that it is of some serpent like creature. It looks vaguely like a snake with it's mouth open, or maybe even a real dragon, and distant enough and blurry enough to convince the gullible. In fact I took this pic this morning while walking my dogs. This is what it looks like close up and better lit.

It's tempting to post it on one of the conspiracy type sites as a joke, but I don't think I will. There is no limit to human stupidity, and I don't want anything like this to happen.

I have it!

 

DZ has had a “Eureka” moment. It has come to him like a blinding flash what is at the top of the massive list of things that is wrong with appraisal. It’s so simple!

Imagine for a moment that in the recruitment process it was acceptable for candidates to write their own reference. I think most people can see what would be wrong with that.

So why is it considered OK that we fill in our own appraisal form? Just maybe there might be a little bias and exaggeration involved, and a little filtering possibly?

When it comes to colleague feedback might we just ask people we get on with, or have a little dirt on, and exclude that vascular surgeon you called a cunt.

And patient feedback. Might we just ask those we know like us? And exclude that guy whose young wife we comforted while he was in hospital?

And when it comes to the appraisal form itself do you suppose it’s possible that that too is bordering on a work of fiction? Is it possible that those patients you misdiagnosed, screwed up, swindled, fucked or killed don’t get a mention?

Surely not! Surely an organisation such as the GMC must have thought of that?

GMC appraisal dept.

Apprentice doctors?

DZ went to medical school in the 1970s, having been born in the 1950s. Had he been born twenty or more years earlier it is unlikely that he would have even contemplated applying to study medicine. Being the son of immigrants, and from a working class background the cost would have been prohibitive.

But the Education Act 1962 made it a legal requirement for local education authorities to provide funding for university tuition, and a maintenance grant, for any young person in their area who obtained a place at a British university.

This meant that anyone, regardless of gender, social class, parental income or ethnic background could aspire to a university education. DZ remembers well that his peers at medical school were indeed a very diverse bunch, from a wide range of backgrounds. For 36 years British youngsters lived in a window of opportunity where anyone could afford a university education.  This situation continued until 1998 when Tony Blair brought in student tuition fees, and loans. And all that ended. We now live in a time when higher education is considered a commodity. Students graduate with such huge loans that many can never hope to pay off, and many youngsters are put off going to university by the costs. The clock has been turned back, and again only the sons of the wealthy can aspire to a career in medicine. This at a time when we are thousands of doctors short, and there are plans to massively increase training places for doctors.

This has been noticed and the view has been expressed that it would be desirable to “widen access and participation in undergraduate medical education and attract students from varying backgrounds that better mirror communities, or may have struggled to pursue a traditional medical degree education”

So they have thought of a new route to a medical degree, as described here. It is assured that this will not be a second class version of an ordinary medical degree, and that those enrolled will earn a wage! It sounds a lot like a back door way of admitting the old grant system was better, and bringing it back, (but only for medicine) whilst calling it something new and avoiding all the embarrassment of admitting that you fucked it up in the first place.

It's due to start as early as next year.

0

Strike??

 

There is no doubt that over almost 20 years doctors’ pay has declined significantly, by a process of slow erosion. The same is true of other NHS staff, but I’m going to confine myself to talking about the medical profession. The BMA estimates the drop in real earnings to be 30% since 2006, a figure I can well believe. Coincidentally that also corresponds to the time period when doctors have been burdened with the extra workload of appraisal and mandatory training in most cases without any reduction in clinical workload.

The BMA are thumping their chests and demanding a pay rise of 30% in real terms over the next five years. And a national strike is threatened if they don’t get it.

Those of DZ age will know that, no matter how justified this might be, this is just not going to happen for a number of reasons.

Firstly a third of all doctors are not actually BMA members. They will not be balloted on strike action, and are unlikely to support it. The government know this

The BMA are “all mouth and no trousers”. They don’t have it in them to pursue their aims against a hostile and intransigent government. Nor will they support individual doctors who become targeted by employers and the GMC. The government know this.

Next, doctors have never felt easy with industrial action, for the simple reason that action which hurts their patients goes against the grain. Total support for strike action is unlikely, and support will fall if the action drags on. Both the BMA, and the government know this.

The GMC have in past disputes made veiled threats towards doctors who engage in such action.

Government will use the same tactics to screw us that have always worked before. Dig in their heels and wait. The BMA will not be able to sustain a prolonged campaign. Both the BMA and the government know this.

DZ addressed this the last time doctors engaged in industrial action and lost. He even made a suggestion that never occurred to the BMA, or perhaps it did and they decided it was too likely to shake up the government and the GMC, that the gongs that many BMA high ups aspire to might be at risk.

A form of industrial action that would be popular, sustainable indefinitely and not adversely affect a single patient.

Boycott all non clinical work.  Refuse en masse to engage in appraisal, revalidation, CME, audit, mandatory training, teaching etc. We could keep that up for years if necessary. And there’s fuck all they could do about it if we all stuck to it.

Preverts

 

The recent and ongoing battle in the USA over reproductive rights has induced disbelief and horror in most other advanced western countries. What many outside the USA do not appreciate though, is that, for the fundamentalist Christians in the USA, the overturning of Roe v Wade is just the beginning. The decision of the US supreme court made their decision on the basis of the argument that individual states should be the ones to decide on abortion policy. And yet before the ink was dry the victorious religious loons announced their aim to impose a ban throughout the USA, riding roughshod over the very idea of states’ rights that they were happy to use only days before.

And there’s more. Emboldened they have also made it clear that they have contraception, and same sex relationships in their sights too. And at least one of the supreme court judges has already expressed his sympathy with this aim. This is no surprise. With these fanatics misogyny and homophobia have always gone hand in hand.

Nothing gets them more frothing at the mouth than contemplating, obsessively and at length about what other consenting adults get up to in private. Like Grumpy in “Snow White”, they don’t actually know what “wicked whiles” are going on, but nonetheless they’re “agin em”.

This is nothing more than a frantic, and fanatical attempt at control, particularly of women, and more particularly of female sexuality. The whole concept of female sexuality terrifies them. And this is reflected in some of the frankly bizarre mythology that some of them cultivate

So I’d like to present just a few examples of the more eye popping and absurd ideas displayed by some of them.

Like this guy.

Jessie Lee Peterson

A man who manages to combine misogyny, and homophobia with a breathtaking hypocricy as detailed here. One thing in particular that seems to have him incensed is the notion that women can have orgasms. How dare they?

And how about this for some really bizarre notions?

You don't have to be a gynaecologist to understand that you can't actually insert anything into a clitoris, and any attempt to do so is definitely not going to induce an orgasm. The rest of his rant just makes DZ head spin. One gets the impression that the reverend has never actually seen a lady's bits up close at all. I've certainly never seen any that looked like that.

The same guy also wrote this!!!

So he wouldn't like this then.

If, and I don't advise it, you have a look at this deranged lunatic's facebook page, to which I'm not providing a link, you will find a whole world of mind exploding ideas that you'd probably regret reading. Fortunately much of it is in Spanish

Whenever DZ comes across people like this he comes to the view that their utter obsession with other peoples' sex lives is far more unhealthy than any of the practices that offend them. They remind him of this clip.

What?

 DZ tends to click on medical articles in the media. They're often characterised by a total lack of research on the part of the journalist, as here.

So it's difficult to say if the statement in this article originated with something the patient actually said, or was misinterpreted by a lazy journalist.

Apparently a lady having nerve blocks administered for migraines by a pain doctor had an anaphylaxis. They administered adrenaline by what looks like the intramuscular route without benefit. The day was saved by the arrival of another doctor who administered adrenaline intravenously.

There is so much about this that sounds weird.

Firstly migraines are not treated by nerve block. In this area Botox has been used, which is a licensed indication. But nerve blocks? No.

Secondly chronic pain is an anaesthetic subspeciality, and nerve blocks are done by anaesthetists, so the pain doctor would have been an anaesthetist. Who would have been well able to obtain IV access and give adrenaline.

Thirdly I would assume that the guy who saved the day was also an anaesthetist. But apparently not. To quote the newspaper article; 

"I think they gave me three shots of adrenaline but it wasn't working, so they needed to gave me intravenous adrenaline when the antitheist came. I think that saved my life."

So what qualifications do you need to be a NHS antitheist? DZ might apply for that.

Appraisal causes disaster.

 

I’ve written repeatedly here about appraisal and revalidation, and vowed to myself on a number of occasions that I’ve now exhausted the subject, and I’ll put it to rest.

And then along comes another horror story.

This one concerns a doctor who started working in an NHS post in 1991 as a haematologist, who carried on working into his mid 80’s by simply informing his employers that he had made a mistake with his date of birth, and “updating”. He did this more than once until it was noticed that his latest update would have made him just 8 years old when he qualified from medical school.

He duly appeared in front of the GMC, was found guilty of dishonesty and his registration was suspended for twelve months, after which he was restored to the register.

Prior to his suspension he had accumulated a number of adverse incidents relating to his work, no doubt related in part to his advanced age. You would have thought that the Trust involved would have taken steps to ensure his retirement but no. Unbelievably they gave him his job back and he returned to work.

So let’s just summarise

He had a string of adverse incidents

He had a GMC conviction for dishonesty

He was 85 years old

And his Trust gave him his fucking job back!!! With the full acceptance of the GMC!!!

So what happened next should not surprise anyone.

A patient of this doctor required bone marrow sampling and he chose to obtain it by sternal puncture using the device featured in my recent mystery object post. This is a simple procedure and very safe if properly done. DZ himself performed it a number of times as a houseman in the 1970s. It requires some physical force to penetrate the front of the sternum and it is absolutely crucial that the adjustable collar on the needle is securely set at the correct distance from the tip to prevent the operator from “following through” and coming out of the back of the sternum. The correct distance is usually just a few millimetres.

Reading between the lines either, the collar was removed, the collar was not set at the correct distance, or it was not properly tightened. The result was that the doctor went through the sternum and penetrated the heart causing rapid death from haemopericardium and cardiac tamponade. The patient was in her 40s, and was accompanied by her husband, who witnessed the entire debacle.

Naturally the police were involved and the doctor found guilty of criminal negligence. He has been sentenced to three years in jail.

The GMC, and the Trust involved undoubtedly failed in their duty of care to the patient. But they also have a duty of care to the doctor. In restoring his registration, and reemploying him they clearly failed in that duty too. He should have been quietly and gently informed by both that he was being retired, not just for the benefit of his patients, but also his own. As a result of their abject failure a woman died, and the doctor will spend what is almost certainly the rest of his life in prison.

So where does appraisal and revalidation come in here. Well obviously he has successfully navigated these since 1991. Had he not he could not have been revalidated and reemployed. So this is not just yet another case of the process not working in weeding out an unfit doctor. It is far worse. This is a case in which the appraisal and revalidation process actually facilitated the return to work of someone unfit.

Nice one boys.

Mystery object, answer

 An anonymous reader has correctly identified this as being for the aspiration of bone marrow. It's used specifically for obtaining this by sternal puncture. The important part is the adjustable collar on the needle which limits the depth to which the needle can penetrate. The idea is to get into the marrow cavity, but not perforate the posterior wall of the sternum, and the large pulsating organ behind it!

 This instrument, and the collar on it, will be featuring in my next post.

Mystery object

 DZ has found a better pic of that last mystery object. maybe we can get some suggestions as to what it is.

Mystery object

It's a very long time since DZ published a mystery object. Not a very good quality image I'm afraid, but if you know it you'll recognise it. DZ is old enough to have used one of these in the dim & distant past. So, any guesses?

 

Hypoxia!

 DZ has always been careful to ensure he does not identify himself on this blog, but on this occasion has decided to post a pic of himself. Here I am.

Yes, DZ has acquired a dinosaur suit as a present, and very pleased he is with it too. It's a wearable plastic inflatable. It's kept inflated by an electric fan which also supplies the wearer with an air supply, very important when wearing a large plastic bag. Like most men DZ finds the idea of reading instructions a bit demeaning. After all I can figure out something as basic as this without having to resort to patronising instructions. And so it was that I installed the fan the wrong way round. I put it on, zipped up and turned on the fan. Which promptly sucked all the air out of the costume, causing some consternation as the resultant suffocation started. Unlike some strange souls I am not someone who finds this a pleasant experience. Fortunately I was able to find the zip fairly quickly and open up. 

Lucky I didn't end up like this.

Expert quack

 

DZ opinion on medical and science journalists is not very high. Their formula for writing an article seems to be.

Scour the journals for any random article.

Sensationalise it to induce outrage/ discontent/dissatisfaction in the reader. This may require some considerable distortion of the original article, but no matter. Misrepresent results, conclusions and implications at will. Misrepresent entirely the writer of the original article one way or another.

Under no circumstances should the journalist take any steps to learn about the subject of the article. Do not verify statistics. If in doubt make it up.

Ignore the corrections offered by true experts.

A prime example is this guy, editor of, among other things, this article. One of the most sloppy, lazy, inaccurate misleading articles DZ has seen in a long time. I’ve sought to find out Mr Bagot’s background and qualifications. From what I’d read I doubt very much he has a medical qualification. Or a science degree. Or O level. I was right. He has a degree in English studies.

So let’s look at the newspaper article in question. The headline reads.”Experts call for the NHS to stop prescribing pills that do more harm than good” The gist of the article is that NHS drug prescribing is massively higher than it used to be and implies that most of these drugs are unnecessary. Apparently drug prescriptions per patient doubled from 5 to 10 items over the ten years from 1996 to 2016. That may be true, and I have no doubt that some unnecessary prescribing does happen. But not, in my perception, to the extent claimed. Also they fail to mention the two main reasons for this.

Firstly, life expectancy in UK men increased over the period quoted from 77, to 79, partly due to modern therapeutics. Since the elderly require medication more than the young this in itself will have an effect.

But far more significant are the advances made over that period in terms of medical and pharmacological progress. I remember for example when anyone having significant gastric  ulcer disease would end up with a horrific operation, the vagotomy and pyloroplasty. The advent of proton pump inhibitors effective, safe drugs, has consigned this procedure to the historical dustbin. Similarly far fewer men now have surgical prostatectomy due to the development of safe medical treatments. And when I qualified there simply were no effective treatments for acute myocardial infarct or stroke, leaving those who were lucky enough to survive these with significant, and often severe disabilities. Prophylactic and therapeutic pharmacological options for these have reduced both mortality and disability enormously.

So who are these “experts” who are promoting the beyond pills campaign. Well despite claiming that the campaign is supported by “doctors and senior politicans” only two politicians are actually named. One is Heidi Alexander, shadow health secretary for a whole year in 2015. A real expert then. Not. The other is Stephen Dorrell, who was briefly Health Secretary over 25 years ago! Another has been who knows fuck all about it.

And which medical big gun has backed this campaign. The Chief Medical Officer perhaps, or some eminent respected physician, or maybe a Professor of pharmacology. No. None of those. It’s this quack, who I’ve written about before. He chairs a pseudo college called The college of medicine and integrated health. This rose from the ashes of the Princes (Charles) Foundation for integrated health which went under amid allegations of fraud and money laundering. Dr Dixon is not an expert in anything whatsoever. I don’t know how many doctors are members of this so called college, but I bet that, if they had a conference they wouldn’t need a big venue.

There are one or two, shall we say, distortions in the newspaper article.

Firstly the article quotes the “national overprescribing review”, a real and reputable document as saying “10% of prescribed drugs are unnecessary and may cause harm” It doesn’t say that. What it actually says is that 10% of drugs prescribed in General Practice are overprescribed, which has an entirely different meaning.

They then quote the review as saying that “Adverse drug reactions now account for up to a fifth of all hospital in patient admissions”. It doesn’t say that either. The sentence quoted does not refer to “all” hospital admissions, but those of patients over 65. As a proportion of all patients the report states 6.5% as the actual figure. Still high, but definitely not one in five, and I’m even dubious about that. This government response cites  the number of patients hospitalised in 2020 as a result of adverse drug reaction as 7270. This report quotes the total number of admissions to English hospitals at 17.2 million. You do the maths.

So between them Mr Bagot and Dr Dixon have produced an article, published in a national newspaper that is misleading, inaccurate, dishonest and allows a known quack to publicise a dubious college. Nice one.

Overprescribing is a genuine issue. This article obscures, not reveals the true state of affairs. The National overprescribing review is well worth a read and sets out goals to reduce the problem and reduce the number of unnecessary drug prescriptions. Perhaps they could start with statins?