How many older people enter hospital and never leave? Are never aware that the paramedics who carry them from their living-room floor will never bring them back; their secrets, mementos, curios, stashed-away in corners only to be discovered by relatives when clearing-out the house after they have moved-on or died.
Today, I was asked for the first time, by someone who isn’t my patient, as to whether they should have a colonoscopy. This is, a fibre-optic camera inserted into their large bowel, preceded by powerful laxatives, sometimes accompanied by a hypnotic sedative and followed by, I imagine a smattering of wind. I found the questionContinue reading “Colon”
Last night’s blog got me thinking about some of the over-and-above things we do to our patients during their time in hospital. Dalteparin, is, I wonder an example of this. For those of you unfamiliar with this drug – it is a relatively new class of anticoagulant which can be used to reduce the riskContinue reading “Dalteparin”
There is an assumption that when the lights go down and the night-staff appear on the scene that things become quiet and still – a little like a scene from Bambi.
Could you Facetime your doctor when you are on holiday in Greece rather than having to wade through the complexities of health insurance (yes, Brexiters) and a foreign health system?
Snap – your left hip.
She survived. She could have died – I never asked the question.
‘Did my dad die because someone didn’t follow policy, didn’t pay attention or, was the outcome inevitable?’ ‘Might my mum have survived the operation if she had a different surgeon or she was at a different hospital?’
You are unconscious, the focus for the doctors and nurses is maintaining your physiology with particular attention to your brain and heart.
Nevertheless, within the dark underbelly of medicine, where geriatricians live, there are some quite stunning effects often, from stopping and sometimes starting medicines.
They aren’t diseases or malfunctioning organs, they aren’t flow or machinations of the system; they are universes unto themselves and those who love them.
What could be better – working within science and the metaphysical, the harmonious synchronicity of mindful being and state-of-the-art clinical science?
In other words, intravenous saline although a fundamental part of modern medicine is nowhere near as good as a cup of tea.
The point, as is often the case, is my aversion to patients. Or rather, the existential construct that relates to the ‘patient state’ = they who suffer; with the principal goal of my life being to obviate suffering, my objective is to really stop people turning into patients.
And that is the role of the interceptors.
So long as you are still able to participate, join-in with the conversation, your perception of self is just as valid as that of the doctor or nurse.
How to change the system?
And so, back to the junior doctors –
Here we have it, a system that needs to be changed, a system that is changing and a process that is threatening to kill that system – you might think of puberty with anabolic steroids or platform boots – wobbly, unsafe and unsightly.
They came from across South Yorkshire and it was inspiring to be in a room with so many bright, young people
Our actions at times border on the holy, and we cannot allow the profane to defile the sanctity of the experience.
And so, to my colleagues, the team of Mallard, I say, here we are – we are something special, we are the exception to the exception that allows magical things to happen.
To a box, the world is the world, is the world.
Call me Rod and I’ll be happy;
Attribution is funny and not something I fully understand.
There has been a silent revolution happening…
An old man living alone, is that the problem? Is the problem that it is a problem?
I have recently been asked to show what I do, to demonstrate, I guess, how much value I am for the money spent on me.
Whether we follow the Japanese and find a new name, or work to continue to change attitudes and behaviours, steering people away from the stigma currently associated with dementia is unclear – it is certainly the bogeyman that TB, cancer and HIV once were, we just need to work towards finding better solutions and ways to support people until we find a way out.
Call the therapists, the carers, the teams who are out there
to keep me
Alan Paton wrote Cry the Beloved Country, I sometimes cry for the beloved, the forsaken who don’t fit into our systematic boxes.
We can look at quantity of life – something we have very little influence over, or, we can address, quality – an area we can influence tremendously.
I can’t imagine what modern medicine would be like without these colourful pieces of plastic.
You don’t have ‘x’ – this can be good news for some, for others it doesn’t really help… Let me explain. If a person feels ill or has a specific symptom – (the easier ones tend to be breathlessness, chest pain or cough), there are a fairly standard set of tests or investigations whichContinue reading “You don’t have ‘x’”
Patients in pyjamas – it might sound a little flippant, but I think this is something that is very important. I cannot comment on the behaviours of other patients outside of the UK – we, in Britain, approach hospital attire in a special way; pyjamas. I don’t know when pyjamas began in hospital – whether backContinue reading “Patients in pyjamas”
I guess, after the months that I have been writing about older people, memory and emotion, I should spend some time describing what, in my eyes, is Alzheimer’s disease – bearing in mind that this is my interpretation, rather than say the view you might get from another doctor, whether geriatrician, psychiatrist or neurologist. ThereContinue reading “Alzheimer’s – what is it?”
How can we change a 98 year old with pneumonia into a person, how can we sketch, add layers of detail that establish the place of this person in the clinical stratosphere? How can I convey their humanity?
I have spent the past few days feeling bad – It is strange, when you discover that something you have been doing, that you had considered ‘right’ is explained to be wrong; it is a little like breaking the law when you don’t know something is illegal … I can’t think of an instance (or,Continue reading “Therapeutic lies and false promises…”
If you go to an art gallery, whether the National Portrait in London or your local museum, where paintings are displayed, there is something mesmerising about the human face; when an artist captures the moment of silence, of stillness or of movement, when the years are brought into focus and a person is seen as aContinue reading “There is a strange aesthetic associated with care”
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”