Goodbye

 

Over the past few months DZ has made an effort to put more posts on this blog, after a long period of neglect. But looking back over my more recent posts they all look a bit repetitive, and stale. I’ve simply run out of things to say.

This coincides with the fact that I have finally taken my retirement, and my interest in medicine is changing in perspective, from provider to recipient.

And of course blogging, as a form of communication is becoming distinctly passe.

And so this will be my last post, although I will leave the blog here for a while yet.

So as I ride off into the sunset, inevitably, I look back on my 40 plus years in NHS hospitals. I’ve been lucky in enjoying my work immensely, and the company of many of my colleagues has been a joy. I’ve worked with many people I have respected, admired, and even loved. But of course I’ve also experienced occasions when I have been disappointed with some of the people also involved with the NHS who I’ve encountered, and the vast majority of these occasions, on reflection have been concentrated in one group whose ability to dismay and demoralise has never failed to surprise and disappointment.

Surprisingly it’s not our political masters in government. Their repeated attempts to “reorganise” has been a constant source of disorientation, and their obsession with trying to wring every last ounce of “economy” has been a disservice to the people who vote for them. And their concerted attack on NHS pay, by year on year pay increases below the rate of inflation, effectively a pay cut, while reprehensible is not surprising. We expect them to behave like malicious arseholes, and they don’t disappoint.

Nor is it the nursing, and other NHS staff we deal with on a daily basis. Obviously once in a while you come up against someone who rubs you up the wrong way, but DZ has always found the vast majority to be good colleagues and good company.

It’s not even the GMC. Although they are without a doubt vindictive, unfair, malicious and incompetent, and with a bizarre attitude that the laws of the land don’t apply to them, most doctors have very little contact with them in their whole career other than paying the fees, and 5 yearly revalidation. Again we don’t have high expectations of them, and they don’t disappoint.

It's not management either. Their attitude seems to be mostly one of indifference born of ignorance. They don’t seem to have a clue as to what’s going on, and they’re easily manipulated by the real villains in the hospital.

So who are the real villains. The group that almost exclusively is responsible for those occasions when my life has been made difficult, unpleasant, unenjoyable, and, ultimately, makes me glad to finally leave.

It’s hospital senior doctors of course, my own colleagues, the medical profession. While many of my medical colleagues have been fantastic people, and lifelong friends, my perception is that as a group we have within our ranks an exceptionally high proportion of those that are cynical, selfish, backstabbing, avaricious, two faced, greedy, mendacious, dishonest, deceitful, rude, arrogant, aggressive, egocentric, scheming, venal, unethical, overbearing, vindictive, malicious and just plain mean.

And I’m not talking about the trainees. I’ve always found them polite idealistic and selfless. So how do they turn into the villains I describe? In the same way that children, abused by their parents, often become themselves abusive parents, constant exposure to their bosses turns many of them too into monsters. And things are not getting any better. Within the last month I’ve seen consultants abusing and humiliating their trainees, and having temper tantrums, throwing instruments across the room.

I’m not going into details of the appalling behaviour I’ve seen amongst my consultant colleagues on an almost weekly basis. I’d be here all day. They are the ones who have disappointed me the most in my career.

So. So long, it’s been good to know ya! Some of you anyway.

The Hague

Wow, does someone from the international court read DZ blog???!!!

"International Criminal Court issues arrest warrant for Russian President Putin" on YouTube"

Thin air scam

 

DZ is going to continue his little thread on Oxygen, and combine it with two of his other favourite themes, scams and lazy journalism.

They’re all together in this little article I came across today about a pseudo medical therapy called “thinAir adaptive oxygen therapy”, described in the article as “groundbreaking”. So what is it? The article doesn’t enlighten. The journalist, Kelsey Maxwell doesn’t seem to have asked that rather important question, or anything else for that matter. Despite describing herself as a “chief  reporter” all she has done is given the providers of the therapy free rein to simply promote it without question.

I’ve had little success in getting this information on the web either, but it seems to involve getting the gullible mark to breathe air which can alternate in Oxygen levels between hyperoxic and hypoxic levels. So what is it supposed to achieve. Everything apparently. Here is a list that I’ve copied.

What are the benefits of thin air?

Restoring health for everybody

• Assists with reducing inflammation in the brain and body.
• Uses all of your oxygen more efficiently.
• Repairs damage to the body (physical and mental wellbeing)
• Regenerates the body on a cellular level.
• Slows the ageing process on a cellular level.
• 100% safe and zero risk to health.

At first glance this looks like a load of steaming, pseudo scientific bullshit, but let’s not be too judgemental. What’s the evidence? Well there isn’t any. At all. A number of sites promoting and selling the therapy have a fair few testimonials from satisfied patients, but, as we all know, these anecdotes don’t constitute evidence, even if they’re genuine. To give a flavour of these testimonials one male claims that the therapy enables him to continue playing football in his forties. Hardly an achievement. Many sports, including quite vigorous sports, have active veterans including people in their 80s. And the thin air practitioners use a lot of sciency words to impress the gullible. So my first impression is correct. It is, in fact, a load of steaming, pseudo scientific bullshit.

In particular I’m sceptical of the claim that the therapy is “100% safe and zero risk to health.” There are, scattered on the slopes of Mount Everest some 200 unretrieved frozen corpses of climbers whose deaths were caused by a combination of hypothermia and hypoxia

 And ask any anaesthetist how they would feel about giving their patient less than 21% Oxygen, even if their very expensive machine would permit them to do such a thing.

To summarise. Human respiratory and cardiovascular physiology is very good at optimising the body’s Oxygen level and delivery, having evolved systems that are sensitive, responsive, robust and, when studied, actually quite beautiful. Those selling this product are totally ignorant of these systems. Or of the potential harmful effects of thin air therapy.

ThinAir adaptive oxygen therapy is undoubtedly a blatant scam, and it’s only a matter of time before someone with a genuine medical condition comes to harm as a result of it. Avoid.

War criminal

 DZ read this article today. How on Earth can it be that Putin is allowed to leave Russia and walk freely in other countries? He's a war criminal, with the blood of thousands on his tyrannical KGB hands. He should be arrested the instant he steps off the plane.

Coincidence?

DZ today came across this article, saying almost exactly the same thing about high Oxygen levels as he wrote in his most recent article. Compare these statements;

"You can kill anything with enough Oxygen"  DZ 7 March

"At high levels, oxygen is toxic to every form of life"  Phys org, 9 March

I'm not saying I've been plagiarised. I am fully aware that the work that went into the article has been months at least in preparation, but it's a coincidence nonetheless.

It seems that hyperoxia is more harmful than moderate levels of hypoxia. DZ is always amused when he observes the degree of panic induced in his anaesthetic colleagues when the patient's saturation drops below 90% despite the fact that everyone in Mexico city walks around on a daily basis with saturations hovering around 80%. And those who make it to the summit of Everest without using bottled oxygen will have saturations as low as 40%, the sort of level that would induce apoplexy in an anaesthetist.

Perhaps Oxygen is over rated!

Hyperbaric Oxygen

If the only hope for the ending of the Russian invasion of Ukraine is dependent on the death of Vladimir Putin, then there is hope that Putin himself may be expediting this with his own stupidity.

This article appears to indicate that Putin is using a hyperbaric oxygen chamber to rejuvenate himself. Oh dear. As Paracelsus pointed out 500 years ago "All things are poison. It is in the dose that they become poisonous". And Oxygen is no exception. Oxygen is nasty toxic stuff, and living organisms live in an uneasy truce with this substance, having evolved mechanisms over the aeons to protect themselves from it's toxicity. You can kill anything with enough Oxygen. This is why Hydrogen Peroxide is an effective bactericidal. 

Ask any intensivist how comfortable they feel when patients require high levels of Oxygen, even at just atmospheric pressure. As far as DZ is aware there are only two therapeutic indications for hyperbaric oxygen therapy, gas gangrene and carbon monoxide poisoning. Other than this the only effect on lifespan with this practice is to likely shorten it. The lethal dose for humans is not well documented, but 3 atmospheres of 100% O2 is probably a very bad idea, potentially causing convulsions and death. Despite this there are however various sites on the internet extolling the virtues of this therapy, which they offer commercially to a gullible public seeking "wellness"

And the consequences of generating a spark in a hyperbaric Oxygen chamber don't bear thinking about.

Excuses

 As a follow up to my last post, the (not a) doctor in question has now been sentenced to 7 years in prison.

As comment I'd like to quote from the article;

“That the degree certificate and supporting letter were accepted by the GMC represents an abject failure of scrutiny." (of the GMC)

“such clearly false documents” and why it took a journalist rather than a professional governing body (the GMC) to uncover the truth.

The GMC claimed in court that documents in the 1990s were not subject to the “rigorous scrutiny” now in place."

That does not fill me with confidence. The incompetence involved is staggering, and DZ sees no evidence to suggest that scrutiny is now more rigorous. Unless of course they are referring to the appraisal and revalidation process. A process that the lady in question successfully negotiated for years.

The GMC are ingrained with incompetence, ignorance, complacency, amateurism, rank stupidity and pomposity. They are utterly unfit for purpose, root and branch.

If our Health minister really wants to do something about the massive and manifest failings of the GMC it would not be enough to reform or tinker. Step one is to terminate it totally and start from scratch with a proper regulatory body, staffed by properly qualified people, rather than a bunch of aimless retirees wanting a hobby. And not one current employee of this failed organisation should have any involvement with the replacement.