rodkersh1948

Psychoneuroimmunology and all that

We are the finite of our bodies and we are the infinite of our minds.

We are a walking anachronism.

Long distance relationships

It was a toughie. It took me an hour to unravel what was what, which medicines were which, what had been stopped, started, changed, what he could and couldn’t do, what he understood, what the family understood, the plans for further tests and follow-up.

Doctoring, fast and slow.

Originally posted on Dr Rod’s Odd Blog (almondemotion):
In my experience I have found three types of doctors; Those who work very fast, very slow or somewhere in the middle. This is obvious and logical as human behaviour is divided on the basis of a normal distribution, with most being average. In life, there…

My blood pressure is too high and when I get out of bed in the morning, I almost collapse. What should I do?

Thanks to Nigel for inspiring this blog. If follows-on from yesterday’s about postural hypotension. I don’t think, in fact, I am almost certain, no patient has ever asked me this specific question, although it is a thing. It is a condition that is tricky to manage and I suspect, one which is becoming moreContinue reading “My blood pressure is too high and when I get out of bed in the morning, I almost collapse. What should I do?”

Every time I stand up I fall over.

Originally posted on Dr Rod’s Odd Blog (almondemotion):
This is potentially a tricky one as it will blend medicine with an overall philosophical interpretation of what is wrong with some aspects of doctoring. Where to begin? I’ll start with the straightforward – a lesson in physiology. I will not go into the details as…

the woods

They are a nightmare.

The poop you walk past, Navalny and others on standards in society

It is more a chaotic butterfly of cause an effect, a stochastic randomness that nudges the world in a certain direction.

Free Speech, Twitter, Elon & Biko

Some people, let’s call them extraverts tend to let everything spill-out. I am not one of those.

This blog is a form of cognitive expiation.

This is Dying Matters Week.

Freud suggested that we can’t imagine our own death.

I’ve tried and I can although it isn’t a comfortable or pleasant.

Oxygen masks, paranoid androids and helping others

Not so much, ‘When in doubt, act,’ more, ‘When in doubt, care.’

The Brazil nuts from Brazil

As a consequence of not scoffing sweet-salty popcorn or Sports Mixtures I have been consuming more nuts.

Civility, Incivility and being nice

Incivility from me to you is as bad as my stabbing you with a knife, just less bloody.

Florence Nightingale, Florence Synagogue, Dali and palpitations

‘Diagnosis – Florence Syndrome’

‘Treatment – avoid visiting Florence and/or trips to art galleries. Watch more TV’

What have I learned, what have I seen?

We don’t really move or go anywhere.

In space and time, we stand still.

Hospital at home, virtual wards and turning care in the community on its head

The doctor calling the ambulance rationalises their actions, ‘I don’t know what will happen to their chest (NB not ‘Albert’, but his chest – a lapse into pathology and medical-speak

Analogy

To me it means ‘oy vey’ and ‘there you go’.

The Waterboys, Gene Kelly & Worm Moon 2022.

I thought of the residents of my care home,

Was it disturbing their mental continence?

Would it influence me?

Human, all too human.

This is the transparency I encounter when I visit patients at home, in their poorliness or vulnerability, on their death-beds, in their terminal loneliness.

Black-belt medicine

For me, the difference between the two belts and their equivalents in medicine can be described as transactional and transformational care.

Holidays

I am famously last-minute. If you know Myers-Briggs, you could guess the last letter of my type. Despite this propensity, I almost always get things done on time. The argument to myself and those around me who wonder why I am not doing anything when I should be preparing is that I am thinking (worrying)Continue reading “Holidays”

My mum – for International Women’s Day 8 March 2022

My mum Would pass thread through the eye of a tiny needle and perform what she called invisible stitches. It was what all the ladies wanted. The middle-aged women would call-in at our house Requesting alterations to aid their spread, their girth expansion from the time in-between diets. Mum would sit at her Singer sewingContinue reading “My mum – for International Women’s Day 8 March 2022”

Drowning in data, in war.

We fear crazy men who remain in power for too long, who climb to the top ensuring multiple mutually assured mechanisms of destruction for anyone who might threaten them.

The cost of loneliness (Roubles, dollars or robots?)

One patient recently attempted to resuscitate her (toy) baby when the batteries ran-out.

Ukraine and Ubuntu

I guess if he is great, Trump is great and, great is not so great.

Confusion Screen

In today’s blog Rod tried to explain what he meant when he wanted to say something was to complicated to be summarised by the word ‘screen’

Safety netting – to net or not?

Sure, some readers will think, ‘Honestly, this isn’t nannyworld, people have some responsibility, they should use their common sense.’

The week that was and was not!

Still recovering from IDLES my daughter tested positive for Covid.

A ramble through dodgy phone calls via IDLEs and back again.

You can ghost, delay, emoji respond.

Have I adapted to text or have texts adapted to me?

I was an ageist arse

Makes my think of my grandfather and his dilute Dettol baths or his pronunciation of Argos

Desperately seeking Sheffield’s spirit

Poor old Sheffield.

Lots of students but a shrinking soul.

Greek letters, a return to Leonardo, The Code, and my face

Rod talks numbers, art and the imperfection of his face.

Innovation, oranges and the impossibility of happiness (Monday imaginings)

…the shape of hills, the movement of water, muscles and the eye, the mechanism of the woodpecker’s tongue, the development of the foetus, creation, innovation, perspective and momentum.

Where did you come from, where did you go?

You are both more distant and more closely related to your next-door neighbour than you think.

Should I or he or she or they stay at home or go into care?

Locked in a room, when you are 90 and if you have dementia and significant physical and cognitive impairment is horrible. It is cruel and harmful. It is what our older folk have to do, whilst we, the rest are out and about, living it up.

Have I got dementia?

“whistle”… Rover, where are you? Oh, he must be upstairs on the bed, that old dog.

2022

The guest that over-stayed its welcome.

The Waltzer that doesn’t stop.

Nu, what about the news?

I spend too long with the news. On my phone. On the laptop. When I have an excess of spare time, I even watch it on the TV, although only Channel 4. That is, if the downtime is between seven to eight during the week. It is hard to avoid listening to updates on theContinue reading “Nu, what about the news?”

Boxing day reflection

Death – tradition – Jewishness – family – education – self-consciousness

Bob Ross, Happy and Unhappy accidents (healthcare and filler-TV)

I brought-up Bob when explaining to my colleagues the meaning of ‘happy accident’ – I was being flippant although the context was not.

Three days, 15 points and just starting to recover from the British Geriatric Society Autumn Conference

For the most, this was people showing-off their successes, how many older people they had saved from peril (mostly keeping them out of hospital), how many standard deviations from the mean their intervention had generated and so on.

Broken hearts, or why telephone consultations are less than 35% effective (homage to Heathcote)

Although doctors are being battered over the head for not enough F2F appointments, in reality, telephone reviews are much harder than seeing a person in the surgery.

Take away, facial expression, eye contact and body-language and it is far more difficult to know or understand what is going-on.

Anxious Jew

Rod reflects on the interface between anxiety and a long-line of Jewish ancestors.

Thinking mindful – geriatrician asks his followers to ‘get high’

My mind has been in a Japanese meta-reality rather than on Wong Lane

It’s worse than it’s ever been. Just kidding… Not.

‘When will I receive my Covid booster?’ Asks patient Annie, 98, unable to leave her house for the past three years.

‘We are working-our way round,’ Says the doctor.

A confrontation with the awareness of my outdateness.

I don’t even want to talk about the masks. We were at a cinema in Bristol this evening to celebrate my birthday. We saw The Harder They Fall. No, it wasn’t the movie that made me realise how far away I am from where I could or should be, nor the paper cups we wereContinue reading “A confrontation with the awareness of my outdateness.”

Tell Me Why.

At different times I feel I am closer to gaining an understanding, at others, I have never been further away.

Detour into etymology via hell and the NHS.

For all they care we could go to hell, so long as they can keep going.

It’s a bit shit.

#NHS #scapegoating #primarycare @BMA #justtryingtodoourjob

Woman vs Land Rover

I have just watched a short video clip of a woman driving a big black land rover over a woman protesting in the street. It was one of the worst things I’ve seen. The woman whose face was blurred had long fingernails. Like a witch. I don’t remember much else about her although I amContinue reading “Woman vs Land Rover”

Indulgence – Sunday morning in Waterstone’s Cafe

I read this morning about patients waiting 11 (eleven) hours outside of A&E departments.

Caveat emptor – learner beware.

That doctors and nurses aren’t working hard enough, that the poor are poor from choice, and, that good things come to those who deserve it or who were born lucky.

I am long and thin by the end of the summer… Who am I?

You know the game. A cryptic clue and an unexpected answer. It came to me this evening, when I was discussing my role with colleagues. I am a hospital trained doctor who works in the community and helps older people, although sometimes young ones too. Who am I? I am a geriatrician. Although I hateContinue reading “I am long and thin by the end of the summer… Who am I?”

The offer of a natural death.

Occasionally the nurse in attendance might advise the paramedics or the doctors, ‘He was 100 years old, he was very unwell,’

Manor Field Surgery Blog 10 Dizziness (three-part series)

The most significant, particularly for older people (the definition of older is anyone who is older than you) when the effects of ageing can impair balance, coordination, and reflexes.

A Grand Unified Theory of Nowt

I popped into Tesco yesterday; there was no pasta on the shelves (no petrol in the pump either).

The default mind network, flow and magic mushrooms

I worry that I might not have enough time to complete all the work I have planned on Monday prior to the deadline when I will be asked to present the results of the…

Shady Towers, Social Care, Nora and Whitey on the Moon.

The PM announced a rise in NI tax this week. I understand this is to offset some of the damage they have done to the NHS over the past decade. Fantastic. (And yes, Whitey is still on the moon).

Israel / Sheffield / Palestine & Stone throwing

There are 8.8 million people living in Israel.

That is 0.11% of the world population.

Around 20 per cent of children in the UK’s 68 million are living in poverty.

Consider the involvement of Russia and China in perpetuating the Syrian crisis.

Sorry

Sorry for the preamble.

Balance

Perhaps I’ve had too many knocks on the head.

The Twa Dogs (Dugs)

For the first two or three weeks after she came home I had to physically drag her out of her crate to let her pee or poo – she was terrified

To stop or not? (Jerzy Kosinski, Oliver Sacks & other ideas)

If you watch the Robin Williams / Oliver Sacks movie/book Awakenings you will see what dopamine can and cannot do to the brain.

You get what you pay for. (this is not a happy one)

No, not the climate, not the uncollected bins, the zero hours, no, not the Shitty White Men travelling on purpose-built spaceships that fly over the filth and poverty of a world falling apart, all of it together.

Chaos theory. Calamity in action.

The misdirected guided by the uninformed.

Babyteeth

It’s a comedy,

Although I don’t remember laughing.

If I told you I’m good, you would probably say I’m boasting & Teamworking

We want to be associated with the best – the best team, country, organisation.

Others don’t really care.

Some see the whole of the moon.

Others Brigadoon.

Occupational hazard – emotional blunting.

‘She’s probably holding something in her mouth,’ I said – since the arrival of pup, she has taken to hoarding all sorts of toys and chews in her mouth.

It’s not all about falling over

One of those instances that over time becomes part of how you see the world.

Mystical motor forest

I guess the trees were too closely packed, or, I never found the entrance.

Cars, Communism and Consumerism

‘Are you some sort of Communist?’ He asked.

Two worlds

If their lack of safety is 10 times greater than your perception of safety, are they safe? Are you?

Four pounds

‘Think of it as an internship.’

‘I don’t want to be a waiter,’ he says.

‘I know, you are gaining life-skills and, well… Experience.’

He doesn’t answer.

To what extent has Covid damaged medicine?

the back wings
of the

hospital where
nothing

will grow…

Nakata, Aphasia and Sylvia Plath

Imagine being able to converse with a cat.

That’s what Nakata can do.

Roundabout discovery of a great French composer.

Facts can be convoluted or linear.

They can be jaggedy or zigzag.

They can be true or false.

Every time I stand up I fall over.

Older people falling is often a bad thing. The Kersh Condition and diagnostic heuristics.

What matters.

Anyone who has spent much time in hospital will recognise the phenomenon of the invisible patient.

Muffled sounds, drum beat and dementia

Norwegian Wood

Yesterday

Michelle

Penny Lane

All resonating, taking me back and creating an atmosphere.

Phone fraud and Mammeloshen*

I remember experiencing a sensation similar to that which a fly must feel as it slips down the throat of a pitcher plant. Suspicion mixed with curiosity.