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).
Freya probably spent her days swimming between Shetland, Norway, and Holland because of Global Warming; another shitstorm caused by us, people.
And yet, it is very hot.
Well, not as hot as in Yorkshire.
And the irony?
There may be women in the Tory party, it is however a sexist juggernaut.
Sorry, you are inadequately tenacious to change the world. Go to prison. Do not stop at Go. Do not collect…
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.
Rod talks numbers, art and the imperfection of his face.
You are both more distant and more closely related to your next-door neighbour than you think.
Rod reflects on the interface between anxiety and a long-line of Jewish ancestors.
‘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.
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…
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.
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.
the back wings
What became even funnier was the background I occasionally use of a photo I took in the winter of a cob-web.
When I say be me, that is, have integrated all my past memories, thoughts and ideas, my behaviours, imaginings, hopes, anxieties, abilities and failings.
I am the Lorax.
I speak for the trees
For the trees have no tongues.
IDLES shout for me.
Heuristics are the pathways or grooves laid down in our subconscious that make us behave in a certain way; habit. Something works this way, I will do it again, and again and so long as all things are equal, I am ok. If a variable changes and I don’t notice, I can be in trouble.
And, yes, those bureaucrats, the apparatchiks who felt things were returning to normal will be once again on the back-foot and find themselves redundant, scraping the earth with their over-long arms, their Neanderthal gait giving it all away.
The colour of our skin is various, the shape of our face, head and hair, yet, our eyes, seem a constant.
He has brown eyes doesn’t mean a thing.
Thanks Jane for allowing me to continue today’s blog; that was about the ways in which Covid has forced a change in my behaviour (likely, yours too) which in turn has led to changes in my brain. It is along the lines of the blog I wrote ages ago after reading a Stephen King bookContinue reading “Covid, my brain and the computer interface”
Serial processing; switching backwards and forwards from concentrating on Word to Outlook to Chrome uses mental energy;
I have always accepted this concept; it has taught me humility.
The weather has changed; yesterday we were basking in too-hot sun, today, the wind and clouds have gathered.
Our growth, our evolution has happened unconsciously, at an intuitive, human level – we have been feeling not thinking, reacting not planning, doing what feels right rather than what we are told is right.
How do we cope with Covid when we want to minimise clinical examination?
There is still plenty of bread, flour and beans in the UK.
Fear of doing the wrong thing is a fundamental of quality improvement. If you are afraid to act because people might call you out or think you stupid, you won’t do anything, and the quality won’t improve. It won’t necessarily deteriorate either, yet, in times of radical change, that is worse.
Getting rid of the routine allows people to focus on what is important. (Bruce Lee said this in the 60’s – ‘Hack away the un-essential’)
Well, talking with my family when I had the distinct need to panic buy and hoard face-masks and rubber gloves the other day, (I didn’t); not only is this deeply rooted in the brains of every one of us, it is (at least I believe) amplified in some groups.
Anyway, death is out there.
What struck me was the similarity between bad leadership as described in the 256th US Army Air Squadron and… you guessed it, the NHS.
(Admittedly there are no bombing runs in most UK hospitals)
I don’t usually go-in for prediction. Sure, I think about the future, speculate on what might be, but jumping ahead 48 hours isn’t my usual thing. Tick, tock. It feels like one of those death clocks counting down. Measuring the minutes until everything is over. What happens? I don’t want to think about how IContinue reading “What will happen tomorrow if Labour don’t win the election”
Many are the result of an acute deterioration in the health of an older person, who, terrified of being admitted to hospital calls their GP. Many patients do not want to be admitted; they want to stay at home and recover.
..when you see society deteriorating, when there is so much potential for improvement, that is surely depressing; when you see vibrant doctors and nurses forced into early retirement because the work has become too much, that is bad; when you know that people have and will die because of cuts, what could be worse?
You see, The Plan says that more will be invested into community care, yet, the cumbersome nature of the NHS, again, the upside-down system of health and social care has resulted in lots or organisation and reorganisation but little transformational thought, little concept of how we can do things differently.
Maybe we should call it ‘hospital check-out’, to get away from the nonsense of fitness, when many of the people described are actually quite sick and are often even dying, it is just that their death need not require a bed on a hospital ward.
Great and awful events have happened throughout history sans likes and tweets.
A patient with a headache is more likely to receive paracetamol from a GP, a CT scan from a General Physician and an MRI from the specialist.
Who is more effective?
Mostly, my approach is to consider that we, that is the community services (those outside the acute hospital) can and do support a far broader range of patients than people realise and, when working well together, can care for a significant proportion of the people who otherwise arrive at the door of A&E.
I will not go into more detail about this but suffice it to say, this is congruent with my values and probably my purpose.
You see, nowadays, in order to study medicine, you have to be little short of an academic wunderkind.
A physiological determinism was accepted.
We have evolved to spend lots of time in the company of those we love.
Free the amygdala and you have Abstract Expressionism; terrorise it and you are cowering for shelter, hoping to survive the day.
Us, being our country, the West, the media, call it what you like.
Our strained state of frustrated cynicism.
Clearly this is tricky, as, at the end of the day, I am a doctor and I can’t just say any old thing; (i.e. not a politician)
I have done some research and not seen that anyone else has written about this subject. Therefore, this could be something that affects me and no one else, or, this could be a true breakthrough in 21st Century problems. Recently I was on holiday, and, having just landed in the country and picked-up my mobileContinue reading “Reception Envy”
…dementia, for example is more than a broken gene, it is how society acts and behaves, it is relationships between families and friends, nothing a pill can magic.
Well, part of how they work affects certain enzymes and chemicals in the body that stop or reduce inflammation (duh!), and, somewhat unsurprisingly, inflammation although a problem at times, for example, a sore knee, is also part of our general human adaptation to life, in other words, it is how we have evolved.
Hopefully, after that cocktail of metaphors and images you get my point.
Moving (change) is difficult.
This is where a camel’s hump is useful in the desert but would be a drag on a cat. Different environments and times, require different stages.
It is a highly successful way to arrive at a result that no one necessarily desires or wants and that might just kill us all.
I see that despite the wonders that take place in big hospitals, much of what is needed by patients and people across society cannot be delivered inside the walls and congested car-parking spaces of these institutions.
Like baby ants we scuttle around, working away or in retirement, too busy to look up and out.
This will be short. Only a few lines are required. Marx underestimated the powers of religion. He didn’t perceive Netflix Amazon Love Island And PS4. All too occupied with Android, iPhones Or potential harm Of 5G To notice the mismanagement Of our society (UK) And Our Planet (Gaia).
This tells you how many boxes are ticked – it doesn’t tell you anything else.
And that is the thing.
It doesn’t tell you about quality or whether the interaction led to change or care.
I had become more relaxed; I was taking her on longer walks. My demeanour had settled into something less than fraught.
…made me think of pirates, smugglers and caves (a weird cocktail of Enid Blyton and Pirates of the Caribbean)
…you see your destination and intuitively perceive that the way to arrive at that goal is not straightforward, indeed, you might learn that it is only a stepping-stone towards something else.
You didn’t mess with these guys or their followers, and, consequently they ruled the world, or what was known of it at the time.
It became us versus them; a competition for resources, doctors, nurses, pathways and investment.
It is more than this.
It is survival.
At this level of development or, evolution that was what worked at that time; what more was there?
…all the way from human genome project, face transplants, over-the-counter Viagra, genomics and gene therapy to long-length of stay, delayed discharges and workforce crises.
All of these add richness to relationship and whilst not essential for me prescribing penicillin are essential to my humanity.
The greater the number of people present the greater the complexity and the higher the risk of falling into what I have decided to call the ‘Korzybski Trap’
They are in the community, but not in the community in the sense of hospital specialists, rather, they are sitting at their kitchen table struggling with beans on toast, or negotiating the short distance between front and back room
Richard Feynman – a physicist considered amongst the greatest minds of his generation (also a crazy bongo-player, linguist and lock-picker)
In the hospitals (the hole) we sit and wait.
Eventually, inevitably, the older person will fall-in;
I watched Attenborough’s programme last night. Climate Change – the facts. My daughter called me in As This was the second time She had seen the bats dying And the rescued babies. What could be more pathetic? The four of us sat, Listening to the words of the scientists, Patagonia jumpersContinue reading “What we are losing and what we will gain”
So, the net investment in more doctors (and nurses and therapists and pharmacists) training is we stand still.
Overcoming our own fears, preconceptions and biases is surely a hope for the future as we continue to grow as a community.
Already you can get a named person on your bottle of soap from Lush; how soon will this apply to our sausages, kebabs or doctors?
Before I begin, I will say that I have not read any of the science, pseudo-science or even tabloid reports about the pig brains that have been supposedly, transiently, restored to function.
As to what this says about me and chickens, I don’t know.
Yet, who has written this sentence? Me or Apple? Is it based on my ideas or those of others?
Their eyes were dull, tired, their postured stooped; they emanated nothing more than a faint flicker of a need to keep going, to survive today in order to continue the next.
Thank you to my friend and avid reader Freda for pointing-out something I had missed in today’s blog about the Jean Bishop Integrated Care Centre in Hull. ‘So many assessments – completed individually or as a panel? Tiring? Was thinking Doris would have to stay overnight?’ That was her consideration of someone visiting the centreContinue reading “Health Care Support Workers (Jean Bishop II)”
Yet, between Monday and Tuesday one abandoned wreck is transformed into a gleaming, state of the art facility; I don’t know, maybe selling bagels.
It is hard to be an Outsider.
It is hard to go it alone.
We humans aren’t designed for prolonged battles of isolation;