Wednesday, 15 December 2021


 17 August 2021

"I do not fear covid 19 since the blood of Jesus that covers me stops every kind of disease or virus that tries to enter my spirit, soul and body."

Roger Dale Moon, pastor of revelation fire ministries, South Carolina.

19 October 2021

Covid 19 causes death of Roger Dale Moon.

This is by no means an isolated instance. The unvaccinated now account for 90% of all covid deaths. In the USA, where vaccination has become a matter of political and religious affiliation, Republicans (vaccination rate <50%) are outdying Democrats (vaccination rates <90%) by a rate of three to one, actively encouraged by their political and religious leaders.

Don't be like them. Get vaccinated

Friday, 5 November 2021

Bat shit insane

DZ has commented before about how extraordinary levels of stupidity do not seem to inhibit the ability of US citizens to attain high office.
Well it should come as no surprise that ordinary US people are capable of equal, if not greater depths of intellectual impairment.
The old, and superb, Disney film Snow White has a scene where the dwarf Grumpy is exhibiting a strong streak of misogyny, claiming that women are full of "wicked wiles". When one of the other dwarves asks him to explain what "wicked wiles" are he responds "I dunno. But I'm agin 'em". Well sometimes truth reflects fiction.

Lets be fair. It wouldn't take long to find similar levels of ignorance among the UK population. But I defy anyone to find anything as absolutely insane and deranged as this.

Ideocracy is here already!

Tuesday, 7 September 2021

Another appraisal fail

 I see another very dodgy doctor has been caught up with, having slipped through the tattered net that is appraisal and revalidation. I wonder how many more there are out there. We'll never know. As I've said before, the GMC couldn't find their own arse, with both hands, in broad daylight.

Wednesday, 21 July 2021

A cult of ignorance

In 1980 Isaac Asimov, the renowned science fiction writer published a book, “The cult of ignorance”. Asimov made many speculations during his life anticipating changes, not only on science and technology, but in the fields of education, politics and culture. Many of his predictions have been realised in fact and history. The book contains a famous quote.  “Anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that 'my ignorance is just as good as your knowledge.”

This prediction is to a certain extent realised in the UK. Precious few of our elected politicians have any scientific background at all, and we have not had a prime minister with a science degree since Margaret Thatcher. That this man was nominated as member of a science committee is perhaps an example of how little regard our politicians can have for science.

But if you want to see Asimov’s prediction realised probably far beyond what he might have anticipated, look no further than the USA, and in particular the Republican party, or GOP as it is also known. "The GOP has become the party that embraces ignorance, celebrates anti-intellectualism and dismisses scientific truths as mere inconveniences."

A good example would be the extent of denialism in the GOP over climate change. DZ has in the past had some doubts in this area, and is still sceptical of some of the more catastrophic predictions, but there can be little doubt now that it is happening. But acknowledging that would put at risk the huge political donations the GOP receives from the fossil fuel industry.

More specific examples include;

The promotion of injecting bleach to treat Covid made by the moron in chief of the GOP, Donald Trump, when squatting in the White House. The levels of delusion and lunacy now displayed by this man are at a level usually only seen in tertiary syphilis.

The suggestion that climate change could be tackled by somehow changing the orbit of the moon!

The passing of an actual law in Ohio requiring that ectopic pregnancies be transplanted into the Uterus!

A recent exchange between Anthony Fauci  and GOP's Rand Paul in which Fauci had to point out to Paul that he, Paul, "do not know what you are talking about".

And at it's very worst the incoherent deranged ramblings, bereft of of meaning and credibility exhibited by this individual.

And this one

The United States boasts some of the finest scientists, and scientific institutions in the world, and yet a sizeable proportion of their populace seems to be disinclined to take any notice of them, regarding them with doubt, suspicion and animosity. This article well represents their hostility to the educated.

It is no coincidence that the highest rates of scientific illiteracy and ignorance come from those states with the highest rates of religiosity, particularly evangelical christianity. When you start with the unshakeable belief that the world is only 6000 years old any attempt at education is simply pissing into the wind.

But perhaps Darwin may have the last laugh. Many GOP lawmakers and a huge proportion of the GOP base are highly skeptical of vaccinating against covid, or even that the pandemic exists. In the US 99% of covid deaths are in the unvaccinated and stories like this are becoming increasingly common.

I make no pretence that I have anything but contempt for these stupid fuckers. Their escalating numbers of deaths make the USA a better place, and diminishes the number of GOP voters.

No bad thing

Tuesday, 6 July 2021


 DZ has, in his geriatric naivety has only recently come across the concept of "incels". And gone down the rabbit hole of various misogynistic groups. Quite an education. A simple web search will turn up countless stories about how unpleasantly these guys can behave.

DZ thinks that the emergence of these people, who seem to have no social skills at all may have something to do with the way people socialise and communicate in today's world.

When DZ was a teenager, the only real ways to communicate were by letter, phone or face to face. But mostly face to face. And with face to face communication there is so much more than the spoken word. Facial expression, vocal intonation, and body language all conveyed information that transcended the simple spoken word. If we said something that the other person found uncomfortable or inappropriate, this non verbal feedback would be picked up, and cause the speaker to modify his behaviour, without any overt expression of discomfort. And in this way we learned social skills. Clearly some didn't but my recollection is that these people were less common than now. Even on the phone vocal intonation would provide some feedback, and writing a letter was such a slow process that it gave the writer time to think about what he was saying.

Today, such a lot of communication is by the unsupplemented  written word, written in haste and sent instantly. Without any non verbal feed back the speaker has no inkling of how his words are received and we sink into a world of unrestrained messages, eventually crossing the line into abuse. Social skills are not acquired, and incels are born. A generation, mostly of males, who feel towards women nothing but a sense of entitlement and rage when their expectations are not met.

Every possible grievance imaginable is directed towards women as a result of this justifiable rejection of these male misfits. 

But one in particular struck DZ funnybone. Paradoxically for men who are not getting sex, is their insistence that condoms are unacceptable in sex. And in their fantasy world one of the reasons is that they are so well blessed that no condom made can accommodate their prodigious manhood.

DZ remembers once, many years ago being at a party where there was a competition to see who could stretch a condom the most without breaking it. This young lady was the winner.

Thursday, 1 July 2021


It has recently come to DZ attention that many general practices are still denying patients actual physical consultations with patients. While their hospital colleagues have been conscientiously seeing, talking to, examining and treating people many GPs are simply hiding away, only doing telephone consultations, issuing prescriptions blind and making their less well paid employees continue the actual business of engaging with patients.
Practice nurses, pharmacists and reception staff are still in the surgery, talking face to face with patients, but the actual doctors are conspicuous by their absence.
Presumably they are fully vaccinated, if not why not. 
Far be it from me to suggest that they are now simply using the pandemic as an excuse to stay at home on their lazy arses, fobbing off patients by phone, or sending them straight to the hospital for their more dedicated colleagues to deal with, rather than actually doing their job.

To quote a military adage. "An officer leads from the front!"

Wednesday, 30 June 2021


 There can't be many out there who will be unaware of the fact that our esteemed NHS leader, Matt Hancock, has left office. Resigned or sacked, it doesn't really matter, the end result is the same. But I can't help feeling that he's not been treated fairly. Why? Because of the reason he's been forced out. Marital infidelity is hardly rare. Various studies indicate that, among married males something like 45% have at some time "played away". Among ladies it's lower, about 25%. Still a surprisingly high number. His own boss Boris has a far more interesting record than Matt. And on the continent the public have a far more tolerant and less judgemental, puritanical attitude towards such indiscretions in their politicians. We are all after all flawed human beings. As Henry Kissinger once said "Power is the greatest aphrodisiac".

Add to that the fact that some 5% of relationships in the uk are non monogamous. DZ finds it odd that, as a nation we have made great progress in increasingly accepting those of unconventional sexuality, yet swingers and polyamorists are still very much frowned upon, despite the mutual consent of all  those involved. 

And there is also a considerable number of people not in relationships at all who still have a very active sex life. 

That's not to say that DZ thinks Hancock should not have gone. There are plenty of reasons why he should have been sacked long ago. His predecessor Jeremy Hunt was guilty of much the same corruption and was also never brought to account for it

So DZ is a little concerned that he has been removed in the way that he has. It's clear that he has been pilloried for doing what his boss is renowned for, while his manifest corruption seems to be accepted as par for the course. The whole affair smacks of inconsistency and hypocrisy.

So welcome Mr Javid. Would it be too much to ask for a little integrity and competence during your tenure? Because if you can give us that I wouldn't give a shit about your private life.


Monday, 28 June 2021

Revitive scam

 Ads are appearing on TV and other places for a machine that supposedly improves peripheral circulation, specifically to the calves, and thereby alleviating a rather vague list of conditions said to be due to "poor circulation". Interestingly the only circulatory condition actually known to cause serious symptoms, peripheral vascular disease, is not mentioned in their promotional material. But they claim that it is highly effective for "tired legs", whatever that means.

So how does this device supposedly work. It's nothing more than an electrical muscle stimulator. The idea is that stimulating the muscles to ryhthmically contract , stimulating the muscle pump, and thereby increasing blood flow through the calf muscles. A similar effect is achieved during surgery using intermittent inflation of pneumatic boots. (Flowtron)

Revitive quote a number of research papers on their web site, but on inspection these papers are not good quality. None of the studies are blinded. Bearing in mind sham treatment is not felt, while actual treatment entails giving electric shocks it's difficult to see how it could be. Also most of the papers refer to it's use in varicose veins, which are asymptomatic in most patients. 

A good summary of the evidential basis for this device can be found here.

The only condition where the pathophysiology is one of reduced circulation is peripheral vascular disease. The use of a revitive device would increase oxygen usage within the calves, without increasing blood flow, and make symptoms considerably worse. For this reason peripheral vascular disease is considered a contraindication to the use of Flowtron in surgery.

And if you don't have peripheral vascular disease increasing blood flow through you calves is going to have bugger all benefit. You could achieve just the same effect by periodically rocking on your feet, or even just flexing and extending your feet without even leaving your bed.

The Revitive device is a complete scam. An ineffective waste of money. There is a way that you can increase the circulation through your calves for free, and also improve your cardiovascular health, and your general well being.

Go for a nice walk. Every day. Preferably with a dog.

Wednesday, 12 May 2021

Appraisal fails once more

 A little over a year ago DZ wrote about a surgeon who had successfully negotiated yearly appraisals  and periodic revalidation despite causing harm to hundreds of patients over many years. 

Well here is another. The emerging pattern is one of appraisal being no barrier to poor performance.

And yet DZ has seen instances where poor performance has not only been picked up, but also acted on. Not by the GMC, but, surprisingly, by private health insurance companies. On more than one occasion he has encountered practitioners who have been informed by insurance companies that they would no longer be reimbursed by those companies for certain specific procedures. Presumably the insurers audit practitioners and flag up instances where either a higher than expected proportion of patients receive a certain procedure, or there is a disproportionate incidence of complications

In those cases DZ has seen, no restrictions were placed on the doctor by their NHS employer.

So credit where it's due. The private sector has a system of identifying poorly performing doctors that actually works. Without making anyone go through the joke that is appraisal. The NHS & GMC don't. 

Well no shit Sherlock!

Friday, 5 February 2021

Abuse in the name of god

DZ has posted in the past about the physical abuse inflicted on children in the name of religious observance. Female genital mutilation comes top of the list, an utterly barbaric practice that kills an unguessed at number of girls each year, and severely affects the physical and mental health of those who undergo it. Male circumcision is less drastic, but more common, and circumcision without medical indication is highly prevalent even in the USA where there is usually no religious imperative.

But it seems even baptism can be a form of torture and murder, as is illustrated by this case, where the unfortunate victim was immersed until he drowned. What sort of people subject babies to this vile abuse. To add insult to injury there seems no regret or commitment to change from the church hierarchy.

And the mental abuse suffered by millions of children of devout (ie fanatical) devotees of multiple religions in the name of their particular superstitious delusion can not be quantified.

All over the world supposedly civilised liberal societies persist in tolerating these practices in the name of “religious freedom” What a bunch of disgusting cowards we all are. By failing to stand up for the rights and welfare of these children we are as guilty as those who wield the knife.

As Christopher Hitchens said “religion poisons everything”

Thursday, 4 February 2021


 I thought I'd reassure any regulars who follow me that I'm still here. Still working, now some years past retirement age, and desperately longing for the current situation to come to an end.

And yet DZ has precious little to complain about. He works in a covid free environment, in a job he loves, with fabulous staff, and is well paid. His professional commitments and social contact makes him rarely privileged and keeps him on an even keel. He has incentive, and purpose. And little cause for fear. Especially since he has now been vaccinated.

I keep in touch with many friends and colleagues at the very sharp end. People who have now borne the brunt of professional and psychological demand for almost a year. I can not begin to imagine the strain they are under. Many are building up psychological problems that will only surface when they allow themselves to stand down. Their experience, and trauma they will carry with them for the rest of their lives and I have no doubt that many will retire early, utterly burned out and exhausted.

While most of the general population appreciates their conduct, there is a minority in the population who have an incomprehensible, to me, desire to vilify and denigrate these people. A vociferous minority of people who have the deluded belief that the pandemic is a hoax, and those doctors who express their experiences are liars and party to some bizarre conspiracy. Anti maskers, antivaxers and covid denialists who, in their narcissism believe they alone possess knowledge denied the rest of us. 

These are people who believe that the covid vaccine contains a chip that allows Bill Gates to monitor their every move. Fuck me, who do these people think they are that Bill Gates is interested in when they go to Tescos. 

No pic, or video on this post. Too sombre.  I hope you all stay healthy and come through this. There is now light at the end of the tunnel. But even when this is over, it will take years for the NHS to catch up on the backlog of work building up. And it's staff will be depleted and exhausted. 

The late hero of the orthopaedic world, Sir John Charnley worked at Wrightington Hospital right up to his death at the age of 72. The NHS may well be asking others to do the same.