Madder and badder than the 15th

Thursday, 7 December 2006

Christmas Carols for...

To go with the psychiatric hotline help service comes


* 1. Schizophrenia --- Do You Hear What I Hear?

* 2. Multiple Personality Disorder --- We Three Kings Disoriented Are

* 3. Dementia --- I Think I'll be Home for Christmas

* 4. Narcissistic --- Hark the Herald Angels Sing About Me

* 5. Manic --- Deck the Halls and Walls and House and Lawn and Streets
and Stores and Office and Town and Cars and Buses and Trucks and Trees

* 6. Paranoid --- Santa Claus is Coming to Get Me

* 7. Borderline Personality Disorder --- Thoughts of Roasting on an Open

* 8. Personality Disorder --- You Better Watch Out, I'm Gonna Cry, I'm
Gonna Pout, Maybe I'll Tell You Why

* 9. Attention Deficit Disorder --- Silent night, Holy oooh look at the
Froggy - can I have a chocolate, why is France so far away?

* 10. Obsessive Compulsive Disorder --- Jingle Bells, Jingle Bells,
Jingle Bells, Jingle Bells, Jingle Bells, Jingle Bells, Jingle Bells,
Jingle Bells, Jingle Bells, Jingle Bells, Jingle Bells, Jingle Bells,
Jingle Bells, Jingle,Bells, Jingle Bells,

Wednesday, 6 December 2006

Tell the patient the answer may fix her problem today, show them how to research the answer may fix her problems for a lifetime?

Dear Editor Belfast Telegraph,
Having just read a story in your online paper... (referred from the 6Minutes website) I read your Belfast Telegraph article "I Dread the Web Surfing Patient" .

The author, Mr Curtis sounds very much like a surgeon and promulgates the usual derogatory ideas of the status of General Practitioners sic:

"Broadly speaking, hospital specialists (such as myself ) tend to be less fazed by the internet-savvy patient than our colleagues in general practice."

As a General Practitioner (albeit, in the antipodes, far away from Mr Curtis) I found this article demonstrative of many problems in Medicine and why patients tend to prefer CAM, quactitioners, snake oil salesmen with charm and something to sell and doctors that are approachable and have reasonable interpersonal skills (usually female).
For example, I refer to the part of your article about the error between bupropion and buprenorphine, I can only imagine the doctor's hubris in opening his esteemed BNF! It is just a book as far as the patient would be concerned. I can just visualise the doctor stating something like "See!, I am right! and you are wrong and stupid". Therefore, I am not surprised the patient responded negatively and was even more deeply cemented into his own opinion.

As for the denigration I felt was expressed toward sufferers of mental health conditions, some of the most interesting discussions I have had have been trying to convince some that they may have an Axis II condition, eg "Borderline Personality".
This is typically used in a derogatory sense like Supratentorial (all in the head), GOMER and FITH syndrome(F###ed in the head). When we (the patient and I) go through the Wikipedia on "personality disorder" and actually follow links with the bits they feel correspond to themselves, it can be amazingly heartening. With some insight and a little Googling, it is amazing what an interested and engaged patient can come up with.
This old saying comes to mind “Give a man a fish; you have fed him for today. Teach a man to fish; and you have fed him for a lifetime”—Author unknown.
Tell the patient the answer may fix her problem today, show them how to research the answer may fix her problems for a lifetime? - BenedictXVI

The role of the doctor is to be not intimidated and defensive about the patients understanding (or even misunderstanding)
but to congratulate them on their enthusiasm to understand their own health, and perhaps be a bit of a teacher, and show them how to learn and use the resources they have (like broadband). If a doctor cannot outperform a diagnostic algorithm perhaps they deserve to be obselete?

And as a specialist I would expect you to be able to clearly* explain why a particular type of suture would not be appropriate, and not just reply with "Well, who is the doctor here"**
As a generalist, and not a specialist, I do spend a lot of time explaining why perhaps DTC, pharmaceutical company and special interest (pressure) groups information is at times not the best advice available.

Please please forward this on to Mr Curtis, he sounds like many of the old Consultants I experienced in Medical School!

Benedict XVI

* and sympathetically
** Hearsay only, but a patient described a particular specialist surgeon to have said "Well who is the doctor here" in response to a serious concern they had about stents versus CABG, and with recent data all I can think is that perhaps the patient was right and the specialist less so!

Monday, 4 December 2006

Big Ted and Jemima had better look out...

So will they be axing PlaySchool next?
Maybe they should just rename the ABC to The Ministry of Truth?*

No so Cheers

* Except Rupert has probably already claimed that domain name?


From: "ABC Corporate_Affairs2"
Date: 04 December 2006 15:11:29 GMT+11:00
Subject: The Glass House

Dear Mr Viewer

Thank you for your email regarding The Glass House.

After more than five years, 218 episodes and much consideration, ABC Television has made the decision not to commission The Glass House in 2007. We believe that the program has done what ABC does best - bringing new talent to the screen and giving them the opportunity to create and deliver cutting edge topical satire.

The ABC is proud of the outstanding job The Glass House team has done over the past five years. However, we feel it is time to develop new programs and explore other opportunities within the genre.

The ABC has several new comedy shows in development and others commencing production and we hope that you will enjoy these programs as much as you have enjoyed The Glass House.

We would like to assure you that the ABC will maintain its commitment to bringing its audience the best in new and fresh satirical comedy. Your support for The Glass House is valued and your comments have been brought to the attention of ABC Television.

Yours sincerely

Lucy David
Audience and Consumer Affairs

Missives from on High

One day God was looking down at Earth and saw all of the rascally behaviour that was going on. So He called one of His angels and sent the angel to Earth for a time.

When he returned, he told God, "Yes, it is bad on Earth; 95% are misbehaving and only 5% are not."
God thought for a moment and said, "Maybe I had better send down a second angel to get another opinion."
So God called another angel and sent him to Earth for a time too.
When the angel returned he went to God and said, "Yes, it's true. The Earth is in decline; 95% are misbehaving, but 5% are being good."

God was not pleased. So He decided to e-mail the 5% that were good, because He wanted to encourage them. Give them a little something to help them keep going.

Do you know what the e-mail said?




Okay, just wondering; I didn't get one either...


PS In a bit of a weight lull at the moment... sigh, It's just redistributing itself, I am just going to keep telling myself that.