What can you say? People like Humph are supposed to live for ever. He was the Prince of Irreverent Humour; completely irreplaceable. I expect a minute’s silence at a certain Underground station and people to throw flowers in front of the funeral cortege as it wends its solemn way down the Mall. The Queen must surely make an announcement.
More about aortic aneurysms later maybe. Suffice to say they can be fatal to jazz musicians.
The film director and screenwriter Anthony Minghella has died unexpectedly, a week after undergoing surgery for what sounds like tonsillar cancer.
Ever since I found out about its existence, tonsillar cancer has been top of my list of things-I-don’t-want-to-get. It’s a horrible disease, just like other forms of cancer. But this one is particularly nasty as it tends to present late, and the treatment is particularly aggressive and often disfiguring. [Read more →]
I work in a UK A&E department. That’s Accident and Emergency (NOT ‘Anything and Everything’ as it sometimes feels.)
A lot of senior A&E docs in the UK, members of the College of Emergency Medicine usually, get very precious about what our medical specialty is called. They certainly don’t like ‘Casualty’, a name whose roots are planted in the dim and distant past, when patients without a referral note from their family doctor could come to hospital as ‘casual’ attenders instead. But ‘Casualty’ is nice and snappy, and the name of a popular BBC TV Show as well.
They are not that keen on ‘Accident and Emergency’ either, and prefer the American term ‘Emergency Department’, or ED. That means they can also say they work in the ‘ER’ (emergency room) which makes them feel like George Clooney. But if you Google ‘ED’, all you usually get back is stuff about erectile dysfunction.
So I’m going to stick to referring to my specialty as ‘A&E’ for now. Because a lot of my work is to do with accidents, and some of it is to do with medical emergencies. And most UK hospitals still have signage that directs people towards ‘A&E’, not towards the ‘ER.’
Here’s a useful tip. If someone is about to stick a needle into you in the name of the healing arts, don’t piss them off beforehand. Even if you’re drunk and normally quite obnoxious. Here’s why.
It only works with intra-muscular (IM) injections. I’ve never practised it myself, or indeed seen it done, but I am quite certain it exists.
Most IM injections are drawn up into the syringe out of the phial they come in, using the same needle that you inject into the patient. The needles are actually little miracles of engineering, with an angled, sharpened point at the end. If that point is tapped firmly on the bottom of the glass phial while the drug is being drawn up, the point bends round very slightly at the tip. You now have a barbed implement. It goes in alright, but on withdrawal it catches on muscle fibres and tears them, causing unnecessary pain and a very nasty bruise afterwards.
As I say, I’ve never done this or seen it done. But the very fact such a phenomenon is even talked about is one very good reason to be nice to your nurse and your doctor. If you need one.
Stories of moronic patients are second on the list of the most popularly-requested A&E ‘anecdotes (number one being, of course, the sorts of things that people insert inside themselves and then get x-rayed when they won’t come out again.)
So here’s the first of what will probably turn out to be occasional brief rants about such people.
The woman who booked in because her false fingernail had come off and she wanted us to stick it back in place.
The woman who actually called ‘999′ (the emergency services number) for an ambulance because she had chewing gum stuck in her hair. In fact the trick to get chewing gum off clothes is to put the clothing in a freezer for a couple of hours so the gum goes hard and can be cracked off. So I advised the patient to go home and stick her head in the freezer for a couple of hours.
Of course I didn’t actually. The General Medical Council frown on that sort of thing. But it’s what I wanted to tell her.
The weird thing is that a lot of medical soaps cover exactly this sort of thing these days - inappropriate use of resources, ambulances tied up with trivia while the elderly man quietly dies form his heart attack - that sort of thing. But the eejits who pitch up with their gummed hair and broken nails either don’t watch popular TV shows as they are too busy attending museums and art galleries (unlikely), or they are just so stupid that they can’t see the comparison.
The British newsreader Carol Barnes has sadly died, from ‘a stroke’, and the actress Samantha Morton has just revealed a stroke as the reason for her 18 month disappearance from Hollywood.
In English medical vernacular, the term ’stroke’ is usually used to describe a catastrophic Cerebro-Vascular Accident (CVA). In more common English, that means something really nasty and unpredicted (catastrophic and accidental) in your brain (cerebral) to do with your blood vessels or blood supply (vascular). [Read more →]
A lot will no doubt be written in the next few days about the undisclosed data from Seroxat trials, and the possible increase in teenage suicide associated with the drug’s use.
A lot will be said about commercial pressures, publication bias, and the like.
But the first and last word on some of the movers and shakers in the pharma sector should perhaps be left to Dr. Percival Cox of Sacred heart Hospital:
They’re bastards. Bastard-coated bastards with bastard filling.
OK, this will probably only be of any appeal to other registered medical practitioners like me who pay £290 a year (£390 from next month) for the privilege of being abused, spat at and vomited on, but have you seen what the GMC (General Medical Council) have just decided to spend some of that money on?
A lucky web designer has just been paid a small fortune to produce an interactive video web tutorial to teach doctors how not to be complete idiots. You can see it here. It’s very pretty and very well done, but as to the content…
In fact that’s the problem with a lot of the GMC’s guidelines. I guess they have to be actually written down somewhere, but if a doctor really needs to be told that it’s best to be polite where possible, honest, not to kill patients or to have sex with them (with or without their informed consent), then that person is probably already heading down the wrong career path.
12 BILLION pounds they’ve spent. Of your money. And to show for it? Well, we can now get xray images electronically, which is nice. But also means that instead of losing the odd xray like we used to, now when the server goes down (which it does about once a fortnight - despite promises made that it never would) we can lose all the xrays at once. That’s progress. [Read more →]
The Welsh Assembly have just announced that hospital parking in Wales is to be free. Where I work, and in just about every other hospital in England and Scotland, you have to pay money to the hospital if you want to visit a loved one, or even if you need to attend the hospital as a patient. [Read more →]
