The end

If ever you are feeling in a really wicked mood try this. You will need mobile internet.

Get yourself onto some form of public transport, try to look furtive. Select a victim and sit next to him. Open your laptop so that your victim can see the screen.

Log on to the internet. Then click onto this site.

http://www.myit-media.de/the_end.htmlhttp://www.myit-media.de/the_end.html

Jellyfish

Jobbing Doctor, in his latest post, expresses scepticism that Dave Cameron will U turn on the NHS reforms. I am not so sure, as he has done it before.

In my last post I mentioned that the regulations on purity and safety of herbal medicines quietly became law in April. This is something of a surprise, because just a few weeks before, the government were stating that they were going to defy the EU and block this law in the UK.

Now I do not actually think that for a government to change it’s mind is a sign of weakness or poor government. If Dave were to stand up and say that, on reflection, he had changed his mind, I would regard that as a sign of open mindedness and maturity, deserving of respect. As Cromwell once said, “Think it possible you may be mistaken”

But he hasn’t. With the herbal medicine law he has said the law would not happen, and then gone quiet as it went onto the statute books by stealth. I actually think it is a very good law, but that is not the point. The point is that Dave has been devious, weak and spineless by hoping no-one would notice his little U turn.

So it seems to me that Cameron is capable of U turning when he thinks it expedient, and his only real concern is in how to carry it off without losing face. The government, as a coalition, is insecure, and having Dave the invertebrate at the helm makes it even more so. 

Zorro would not mind betting that this parliament will not run the full term, and that the next general election will come sooner than we think.

Branching out

I have commented before on the use of herbal medicine, and how the public have this view that because the products are “natural”, they are innocuous and safe. This view is reinforced if you visit any herbalist shop or website where a very one sided view is presented, without any mention of the potential risks.

The herb itself can however be potentially toxic and two particular examples are ephedra and aristolochia. Add to this the fact that contamination with pesticides and heavy metals is not uncommon. Also some herbal products have been found to contain modern pharmaceuticals, presumably added deliberately. Drugs found have included NSAIDs, steroids and amphetamines. If that is not enough there may also be biological contamination. These problems seem to be more prevalent in Chinese Herbalism.

These significant and serious safety concerns resulted in the EU law requiring herbal products to be tested for safety and purity, which came into force in April in the UK despite initial reluctance from the British government.

This law has been misrepresented as a ban by the herbalists but it is nothing of the sort. Herbalists can see that being forced by law to provide safe pure products is going to be difficult and one enterprising chinese herbalist has decided to branch out into other areas of business. It seems to me though that this is yet another area where contamination might be a problem for customers.

The best and the worst

Fuddled Medic, in his latest post, demonstrates how astute he (she?) is by his realisation that he is about to “join a profession that includes a whole lot of bastards”, something that Zorro did not fully realise for many years after he had qualified. It is a sad fact that the profession seems to have it’s share of misogynists, racists and egocentric bullies.

But, with nearly a quarter of a million registered medical practitioners in Britain it would be absurd to assume all of our colleagues are saints. Temperament, like any other human variable will always follow a distribution curve, and there will always be those at either end beyond two standard deviations.

We all know colleagues who we regard highly and trust absolutely, just as we all know those we would not turn our back on. Doctors are no different from any other group of people and will include the full spectrum.

As an illustration, this has set me thinking about who I would nominate as the best and the worst of our profession. This is bound to be a personal and arbitrary choice, based on how I would define merit, but, sod it, it’s my blog and so here goes.

The very best.

Since January 1856 the Victoria Cross has been awarded to 1353 recipients. Only three recipients have ever been awarded a VC twice, and two of these were doctors. The selflessness, devotion, and courage displayed by these two men  can not be exaggerated, and I would nominate them as the very best of our profession.

                                               Noel Godfrey Chavasse

                                  Arthur Martin-Leake

So what about the very worst. I have no doubt we all would have our own nominations, but I have decided to stick with my theme of double achievement here. I have decided not to name them, though it is easy enough to find them on a google search. Astoundingly I have found two doctors who have been struck off by the GMC, twice. They were both struck off, later reinstated, and subsequently struck off again. Quite an achievement.

So yes FM we do have some real bastards in the profession, but don’t let it make you too cynical because we have some stars as well.

Another miracle

Extract from a consultation letter.

"Thank you for referring this little girl who attended today with her mother. The mother is concerned about spina bifida, which occurred in her sister’s child, and is worried about the child’s back. On examination the child was perfectly well. She does however have a sacred dimple."

From the mouths of children

I was talking to a youngster today, and he explained to me that your choice of religion should be based on how various deities have delivered on their promises, rather like politicians.

Now Jesus promised to bring peace to the world. He has now had 2000 years to deliver on his promise and manifestly failed.

Thor however promised (and I suspect this information comes more from an X box game than from genuine mythology) to rid the world of Ice Trolls.

Now, when did you last see one of those?

Witches and witchcraft

Anyone well familiar with this blog will be aware that I do not have much time for complementary and alternative medicine. I have also in the past been quite scathing about midwives, so an article featuring both betes noir is bound to get my attention.

The Journal of Advanced Nursing has accepted a paper from an organisation called NORPHCAM suggesting that quackery should be offered by midwives to their patients, and included in the nurse and midwifery training. The apparent reasoning is that these techniques are “popular”.

Where do you start. 

Firstly nowhere in the paper does it actually state what these techniques are supposed to achieve, and no evidence is presented that any clinical objective is attained. In fact there is no evidence that any of the CAM practices are of any benefit in pregnancy and some may even be harmful. For example herbal medicine. What are they doing encouraging pregnant women to take herbal substances without any evidence that they are safe to mother and foetus. This article indicates also that these substances may be contaminated. One can imagine the exchange between a suitably “educated” midwife and her patient. “Good morning Mrs Gullible-Loon, and how would you like your agricultural pesticides this morning, with or without heavy metals?”

That a journal should accept a paper of such appalling quality from a CAM promotion organisation, which is what NORPHCAM is, indicates perhaps that it is not a very discerning journal. 

And why is a nursing journal pontificating on Midwifery. As the midwives tell us forcefully, they are NOT nurses. In fact a very good way to get a spectacularly aggressive reaction from a midwife is to call her a nurse.

To get a good idea of what happens when you persuade midwives that CAM is a legitimate therapy for pregnant women have a look at this.