Thus, one doctor might say ‘chest infection’ another ‘bronchitis’ another ‘pneumonia’ and a fourth, ‘chest clear, probable urine infection.’
The humans built the tower to reach heaven or God and their punishment to forever live in perplexity, to hover above or alongside the dark matter.
Life lesson for those in authority.
Imagine you are approaching Bambi when the moment matters.
Healthcare staff working in the late 90’s and early 00’s will be familiar with the airplane analogy. Sometimes a double-decker bus was used. This supposedly equated either (depending on who was talking and their level of cynicism) to the numbers of patients harmed or killed in US and UK hospitals every day. The UK planesContinue reading “Winter cannibalism, a theory of economics, healthcare, and D:Ream”
Yes, the NHS and the Tory.
Sure, the Tory has never liked the NHS, it is too leftie, too socialist, democratic, and yet, it is central to UK political debate; it is locked-in to our psyche.
This, for mum was a terrible disability as language, conversation and socialising was one of her superpowers. Mum could talk with anyone at any time about anything.
If you don’t agree, or even if you do, if you are in doubt, call an ambulance. I am sure the crew will be pleased to see you.
Many are unaware of the pain and sometimes indignity facing the patients (as Old Adam waits on that stretcher, in hospital gown, bottom or testicle peeking-out, he needs the toilet, ‘Just go in your pad,’ he is told.)
He has a glass that is so half-full that the Kool-Aid is spilling over the rim.
For the most, I think I know what I am talking about when I talk about dementia.
Vaccinations and Mystery photo…
Doctors are great at diagnosing or assigning diagnoses. It is something that makes many of them very happy. It provides the doctor with certainty, a finite box in which to insert their patient and to focus treatment – antibiotics, pain killers or anti-depressants. (I am sure there is a dopamine release every time a doctor signs a prescription).
I even recently read in a patient’s notes the following:
‘Called patient for telephone appointment. There was no answer. Patient has not attended the appointment. See again in six months.’
I know the people who can’t ‘get to see the doctor’ presume they are sitting around playing Wordle; this is not the case.
Recently, I received a message that my patient’s battery was running low.
…if I don’t have that additional jam sandwich I might be in trouble.
The pressures, whether overt or not, the unreasonable demands, the pushing, pulling, bullying and intimidation inherent in many workplaces or the uncertainty of tomorrow, the zero-hours tightrope, all make us human, fragile.
No one in healthcare works harder than GPs.
I started writing around six years ago as I was convinced, I was going to die from a heart attack.
(Can you hear the crickets? The Bouzouki?)
Family-doctor-dietician and still losing weight; you must be failing the person, not meeting their needs, not creating innovative or adequately tasty food, not supporting mealtimes, not doing your job.
What happens when you blame others (things) for your own failings. Look within young Padawan.
Yesterday, Friday, I was out and about visiting some of our patients. We have an odd or you might say unusual model of healthcare provision in the surgery, I, as a geriatrician, not a GP don’t see a significant number of the ‘regular’ patients, instead I focus on those who are older or living withContinue reading “I was taken aback yesterday (Human Factors, Elaine Bromiley & your local medical school)”
They perceive the wonder of human spontaneity, the fragility of hope and fear, the layers of anxiety, of prejudice, hope, joy and deprivation spinning atomic around the patient’s sense of self.
The doctor might say, ‘I won’t give you any more pain relief until you have a test,’ a kind of pharmacological blackmail.
Sorry, you are inadequately tenacious to change the world. Go to prison. Do not stop at Go. Do not collect…
What makes a GP special is their knowledge of a patient, their insight over months, years, even decades into a person’s life. The bond that continues after the acute illness has passed, the person recovered, perhaps passed through school, left for college and returned, married then divorced, raised children.
We are the finite of our bodies and we are the infinite of our minds.
We are a walking anachronism.
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.
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?￼”
It is more a chaotic butterfly of cause an effect, a stochastic randomness that nudges the world in a certain direction.
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.
Not so much, ‘When in doubt, act,’ more, ‘When in doubt, care.’
Incivility from me to you is as bad as my stabbing you with a knife, just less bloody.
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
To me it means ‘oy vey’ and ‘there you go’.
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.
For me, the difference between the two belts and their equivalents in medicine can be described as transactional and transformational care.
One patient recently attempted to resuscitate her (toy) baby when the batteries ran-out.
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’
Sure, some readers will think, ‘Honestly, this isn’t nannyworld, people have some responsibility, they should use their common sense.’
Still recovering from IDLES my daughter tested positive for Covid.
You can ghost, delay, emoji respond.
Have I adapted to text or have texts adapted to me?
Makes my think of my grandfather and his dilute Dettol baths or his pronunciation of Argos
…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.
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.
“whistle”… Rover, where are you? Oh, he must be upstairs on the bed, that old dog.
The guest that over-stayed its welcome.
The Waltzer that doesn’t stop.
Death – tradition – Jewishness – family – education – self-consciousness
I brought-up Bob when explaining to my colleagues the meaning of ‘happy accident’ – I was being flippant although the context was not.
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.
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.
My mind has been in a Japanese meta-reality rather than on Wong Lane
‘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.
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
I read this morning about patients waiting 11 (eleven) hours outside of A&E departments.
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.
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?”
Occasionally the nurse in attendance might advise the paramedics or the doctors, ‘He was 100 years old, he was very unwell,’
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.
I popped into Tesco yesterday; there was no pasta on the shelves (no petrol in the pump either).
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…
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).
Perhaps I’ve had too many knocks on the head.
If you watch the Robin Williams / Oliver Sacks movie/book Awakenings you will see what dopamine can and cannot do to the brain.
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.
The misdirected guided by the uninformed.
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.
‘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.
One of those instances that over time becomes part of how you see the world.
‘Are you some sort of Communist?’ He asked.
If their lack of safety is 10 times greater than your perception of safety, are they safe? Are you?
the back wings
Imagine being able to converse with a cat.
That’s what Nakata can do.
Older people falling is often a bad thing. The Kersh Condition and diagnostic heuristics.
Anyone who has spent much time in hospital will recognise the phenomenon of the invisible patient.
All resonating, taking me back and creating an atmosphere.
What became even funnier was the background I occasionally use of a photo I took in the winter of a cob-web.
Nothing works with Florence, distraction, diversion, joking, cajoling, all the old tropes fail. You have to accept that Florence isn’t eating and leave her alone.
We lapsed into singing The Automatic’s ‘What’s that coming over the hill, Is it a Rabbi…”