Pictures, anxiety and Gouda

I have been getting worried about how I will describe all that I have seen and done during the past couple of days in Gouda – departing from my usual style, I am going to use my preferred means of communication… pictures – Note – anyone visiting or travelling here from the UK, the pronunciation…Continue reading “Pictures, anxiety and Gouda”

Where do you start when there is no beginning?

I have been listening recently to the Tim Ferris Podcast, and that, at the same time as the Brexit has left me in free-fall. I tried writing about this earlier, but caught-up in Tim’s talk about Stoics, Greek Philosophers and exercise, I was struggling. Those of you who have listened to the podcast will knowContinue reading “Where do you start when there is no beginning?”

The drugs don’t work they just make you worse

  The Verve released this song in 1997 in their album ‘Urban Hymns’. I was living in Dundee at the time and can remember walking down Perth Road singing this as I met my friend Phil who has walking in the opposite direction, singing the same song to himself. It is funny that so manyContinue reading “The drugs don’t work they just make you worse”

Dementia, Bruce Lee & Conservation of Energy

The law of conservation of energy states that in a closed system, energy cannot be created or destroyed, only transformed. Energy flows through every interaction, engagement or conversation between people; in everyday life, mostly there is a give and take, a volley of information, movement, listening and talking, acknowledgment and respect. This flow can beContinue reading “Dementia, Bruce Lee & Conservation of Energy”

Falling over & knots

I hate it when one of my patients falls over on the ward. Each time this happens, I feel as if I, somehow have personally failed to keep them safe, safe, when they are unwell and at their most vulnerable. It is true, that people falling in hospital is complex, it is equally true thatContinue reading “Falling over & knots”

Tigers, Scotsmen, and hospitals

Last night I watched a re-run of ‘Lost Land of the Tiger’ – this is a nature documentary with Steve Backshall, Scottish Wildlife Cameraman Gordon Buchanan, Scottish Entomologist George McGavin and others wandering about the highlands and lowlands of Bhutan in search of evidence of tigers. The programme focuses on the creation of a ‘tigerContinue reading “Tigers, Scotsmen, and hospitals”

Dentures, specs & hearing aids

Amongst the piles of lost-and-found that accumulate in wards, care homes, clinics and hospital laundries across the UK, surely the missing dentures, spectacles and hearing aids point to something wrong with the way care is operating. ‘I’m fine, thank you,’ smiles Mary. ‘Do you know where you are?’ No response A little louder, ‘Mary, doContinue reading “Dentures, specs & hearing aids”

Wandering & the Israelites

I just returned from wandering with my dog. We don’t tend to describe our everyday activities, particularly those associated with movement, as wandering. I walked the dog (although clearly, at times, she walked me – but that is besides the point.) How much of our everyday movement is with purpose, intention, a plan? If thereContinue reading “Wandering & the Israelites”

Moth-eaten fragments (1)

I remember reading a letter written by a hospital doctor to a patient’s GP, copying-in the patient. The individual had been experiencing problems with balance and the specialist had arranged an MRI scan – which is able to look in great detail at those parts of the brain controlling balance, movement, orientation, etc. What struckContinue reading “Moth-eaten fragments (1)”

Positively deviant

What makes some groups succeed where others have failed? When equivalent teams, cohorts or communities are exposed to similar pressures, provided the same resources, training and education, outcomes vary, and, in some instances, certain groups can produce results that so far exceed those of peers that they become deviants. Skewed away from the average. WorkContinue reading “Positively deviant”

I learned a little about suffering this week…

Fortunately nothing bad happened to me, in fact, the experience was wholly positive – I was in Macclesfield for a course on Mindfulness and Leadership run by the King’s Fund (yes, the same one as the tiger). Our instructor, Byron Lee described a fascinating aspect of Mindfulness that I had somehow managed to miss whileContinue reading “I learned a little about suffering this week…”

Into a soul absolutely free, from thoughts and emotion.

Into a soul absolutely free From thoughts and emotion, Even the tiger finds no room To insert its fierce claws Bruce Lee, Tao of Jeet Kune Do. I spent two days this week on the King’s Fund Compassionate Leadership through Mindfulness Course in Macclesfield. During that time, I had the opportunity to meet some great peopleContinue reading “Into a soul absolutely free, from thoughts and emotion.”

Person-centred care & Perthshire

Today, I heard about a system in Scotland to help people refer themselves to their local memory clinic. In England and probably all of the world beyond Perthshire, the system is that people wait until their memory, emotional or cognitive decline has deteriorated to an extent that they can no longer ignore or avoid theContinue reading “Person-centred care & Perthshire”

We don’t talk… any more

In the rapid-paced landscape of a hospital ward, multitudes rush hither and tither doing their best to provide great care or treatment. Hierarchies, built upon historical, organisational and traditional structures dominate. Usually, the doctors are on top. If someone isn’t going to wash their hands or apply the alcohol gel, you can bet, it is usuallyContinue reading “We don’t talk… any more”

MBTI, Starsky & Hutch and the world is my idea (part 2)

This isn’t really ‘part 2’ – I just felt the need to write more about part 1; When thinking of birds in trees, particularly, for some reason, during the autumn, or perhaps even the winter, I think back to my literature lessons in school. The poet, Chaim Nachman Bialik, one of the pioneers of modernContinue reading “MBTI, Starsky & Hutch and the world is my idea (part 2)”

MBTI, Starsky & Hutch and the world is my idea (part 1)

Schopenhauer said, ‘The world is my idea’ – as to what he meant by this I am not altogether certain. I think he was getting at something to do with perception, the world is how I see it, just as yours is as you see it. Most of the time, people seem to be ableContinue reading “MBTI, Starsky & Hutch and the world is my idea (part 1)”

Asymptomatic bacteruria and Bear Grylls

It is easy to forget how much medicalese and jargon exists within the world of health and social care. As to what stops us speaking English, either to each other or more relevantly to patients, clients and carers, I am not sure – I suspect that most of the time we aren’t aware we areContinue reading “Asymptomatic bacteruria and Bear Grylls”

Is my husband OK?

So… here I am, planning a presentation to the hospital tomorrow on dementia; I have added ‘delirium’ to the title as for me the two conditions are synonymous – people living with dementia have a ten-fold greater risk of experiencing delirium than others… Where to I begin? I start with Wendy Mitchell – she hasContinue reading “Is my husband OK?”

So, what is delirium?

When you search ‘delirium’ on Google images you find lots of pictures to do with delirium tremens – the clinical syndrome associated with alcohol withdrawal; while this is delirium in one sense, it is not the one I am discussing – The usual textbook definition for delirium is a fluctuating state of consciousness developing overContinue reading “So, what is delirium?”

The Tao of Dementia & Delirium (part 2)

So, what do we do when a person, say a ninety-year-old woman is climbing on a window ledge, at risk of falling, or hitting you with a telephone or pouring water over your PC? What do you do when you have tried to talk, tried to communicate as best you are able? This is whenContinue reading “The Tao of Dementia & Delirium (part 2)”

The Tao of Dementia & Delirium (part 1)

‘Do not prescribe anti-psychotics!’ I usually include this phrase when inducting new doctors into my department. In recent years there has been a great deal of discussion about the potential harms of anti-psychotic medications, when used inappropriately to sedate or tranquillise people who are either living with dementia or experiencing delirium. The old standard, inContinue reading “The Tao of Dementia & Delirium (part 1)”

Healthcare Improvement and Bruce Lee

In April I attended the BMJ/IHI Forum on Quality and Safety in Healthcare in London. Maureen Bisognano, President and CEO of the IHI was one of the main speakers. Maureen discussed an area of healthcare we haven’t been fantastic at improving in recent years; funnily enough, she didn’t talk about innovation, but exinnovation – thisContinue reading “Healthcare Improvement and Bruce Lee”

Mindfulness and patient safety

Being aware is one of the first lessons in patient safety. Awareness of self, of environment, of our patients; so often we walk around with our head in clouds of worry and thought, so called, mind-wandering – thinking about the shopping, the cooking, the cleaning, what others think, what I thought. A jumble of misrememberedContinue reading “Mindfulness and patient safety”