School science

Nice little article in today's Observer about school science experiments.

Now it's a long time since I was at school (left 6th form in 1981 to be precise) but I remember some mad science teachers fondly.
Our chemistry teacher performed the Thermite reaction for us on more than one occasion. It was impressive. It was scary. There weren't enough safety goggles to go around. But the real danger was not in the classroom.
The reaction makes such an impressive flash, that it was seen by a cook in the school kitchens, whose windows faced the chemistry lab. This particular cook was so startled that she nearly sliced through her hand with a breadknife and had to be wheeled off to hospital.

Bad science. Naughty science.

I read Dr.Ben Goldacre's 'Bad Science' column in the Guardian each week, and of course have to agree with pretty much everything he says, because it's true, and not necessarily because he's a "serious fuck-off academic ninja" (ego check there, Benny boy.) And I know Gillian Mckeith is an annoying pretense at a charlatan, but give the girl a break. Please.

Of course I too could have done a masters in philosophy if I hadn't got sidetracked into saving the lives of complete no-hopers living in the armpit of society, but that's another story. One thing I really, really would like to get from a clinical trial paper some day is a conclusion that says something other than the results, whilst interesting, are far from conclusive. Further studies on a larger scale are probably warranted.
We must be able to do better than than, surely?

Lashings of whipped cream

We're getting a new vending machine in the waiting room. It will dispense a 'Whiplash pack' which consists of a sympathy card saying 'There, there, we're sorry you sprained your neck a bit'; a pack of Neurofen (or generic equivalent); an advice card saying that it will get better in a few days - or as soon as they fill in a compensation form; and some contact info for a no-win no-fee legal firm.
That way people who strain their neck in a car accident (MVI - motor vehicle incident - is the latest jargon) can avoid the lengthy queues to se a doctor, and also STOP WASTING MY SODDING TIME.

The over-papered office

Like a lot of NHS trusts, mine is busy sacking nurses. Funny, isn't it, how one moment everyone can be saying how we really need a couple of extra nurses per shift, then suddenly pretend that we can actually get by quite safely with a couple fewer, and that somehow this might actually be better for the patients.
Still, it's nice to know that we are still able to employ someone to write a 120-page plan for us to cope with pandemic flu. Seriously. 120 sodding pages.
I might ask a punter tomorrow which makes them feel better - knowing that they're going to wait an extra hour because we are a nurse down, or knowing that we have a set of draft guidelines (which, believe me, NO-ONE IS EVER GOING TO READ) on fecking bird flu.

No more room...

So our prisons are nearly full, and may actually fill up overnight.
Here's my take on why prison doesn't work - certainly not in terms of re-offending rates.

You know when you're waiting to pull out at a junction, and there's a constant stream of traffic with no-one letting you out? I bet you say "Come on, will one of you buggers let me OUT" don't you? You treat the stream of cars as a collective, a conspiracy, a group of like-minded individuals who are all sodding rude.
But they're not of course - they are a group of completely disparate individuals with little in common, and certainly not in communication with each other in any way.
So it is with law-breakers. No matter how much we would like to think of them as a homogenous criminal gang, they are just a load of individual people. So thinking that you can somehow appeal to 'them' with the threat of sanctions is simply ridiculous.
Two other reasons why prolonging sentences can never work; many who end up in jail lead totally chaoticl ives, and have difficulty planning from one moment to the next, let alone thinking of long-term outcomes of their actions. If they could think consequentially, they probably wouldn't hit the old lady in the first place. And the last reason? None of them are actually planning on getting caught.

Scary kids

Nothing much to report from the world of A&E yesterday... But...

I have just been reading this morning's Guardian, and come across this quote concerning the Guardian Children's Book Prize:

This is a staggering achievement with wonderful characters, one of the most imaginative plots I have ever seen, and beautifully imagined sets complete Reeve's repertoire of writing skills. I must also commend David Frankland; his illustration on the cover is absolutely fantastic.

This was said by one of the judges. He's EIGHT! Do you think it was really him, or did daddy write up his homework?

Top Gear presenters and their brains

Seems I was right about Richard Hammond. Word on the street (and thanks to Huggy Bear for his input) is that he had burr-holes done for an extradural haematoma. Pleased to see he is making a swift recovery.

To be frank, if you're going to have a significant brain injury, you could do a lot worse than have an extradural. Anything else is likely to be non-specific mushed brain, for which there is little effective treatment. But a rapidly expanding collection of extravasated blood ('extra'- outside, 'vas' - vessel) can be easily cured by someone weilding a power tool in a medical way.

More disturbingly, there are apparently copies of Mr. Hammond's CT scan alread being circulated via e-mail. I hope he has a good agent. Someone should copyright those.

Computers? Don't talk to me about computers...

Have you heard of NpfIT?
This clumsy acronym describes the UK’s Department of Health’s IT program, and it’s a mess.
Around £6bn (that’s six BILLION pounds) have apparently been spent so far, with little to show for it. Had that cash gone to NHS trusts instead, we wouldn’t be having to sack so many nurses. Or any.
The only bit of it we have up and running is the PACS system, which is actually quite cool. It gives you the chance to view x-rays on a computer screen rather than by having to print off an expensive film.
But everything else is a monumental cock-up of the dimensions only achievable by huge government departments. Systems that we don’t need, don’t want, don’t talk to each other, and don’t work anyway.
One of the big players in the program, iSoft, have recently announced very worrying financial figures, although their directors don’t see to be too badly affected, having quietly sold off their shares over the last few months. But you wouldn’t think anything much was up from their website.
Give me six billion quid. I could put it to good use. Get us a few patient trolleys that don’t fall apart for a start. Then maybe a CT scanner that gives decent images 24 hours a day. Ooh I could have LOADS of fun with £6bn.

The critical list

Still no hard news on Richard Hammond, and although I do have inside sources, I think best to leave well alone for now.
Just FYI, there is no such thing as a 'critical list'. Doctors never describe anyone in real life as being 'critical', or 'critical but stable', or use any other similar cliche. It's journo-speak only.

Sharia law - an opportunity not to be missed

Just been listening to John Humphrys on Radio 4’s Today Programme, interviewing Abu Izadeen, who is quite open about wishing to introduce Islamic sharia law in the UK.
So here’s an idea. Given that this may one day soon come about, I am offering fellow medics the opportunity to be in at entry-level on an exciting new business. I’m planning to call the company ‘HandsOff’, and it will train surgeons to perform swift, neat amputations of the hands of criminals.
And on a separate but related topic, it might be wise to sell any shares in Guiness, or Ladbrokes, that you have.

Tricky treats

Just when did 'Trick or Treat'-ing become such an integral part of UK yoof culture?

I can remember when Hallowe'en meant apple bobbing and pumpkins (although I can't remember why it did). Trick or Treat has, I believe, crossed the Atlantic from our colonial cousins, and it's a pain in the arse. "Give us some sweets or dosh, grandma, or the flowerbed gets it." Nice.

There is an apocryphal story of an Italian diplomat who visited London for the first time and found small boys begging for money on virtually every street corner. he reported as much back to his shocked superiors in Italy. The explanation was that he visited on November 4th, the day before Guy Fawkes Night, and children were doing the 'Penny for a Guy' thing.

Guardian website

OK, so why is it that whenever I'm up this late the Guardian website is always late at getting its act together? I don't want to read yesterday's news.
Talking of news, my take on Richard Hammond's accident is that he has had an extra-dural haematoma which has hopefully been successfully drained.
I hope so. He's a lot more watchable than Jeremy Clarkson. But then I guess who isn't?

Mots d'escalier

Went to see Dara O'Briain at the Salford theatre some weeks back. He has this bit of the show where he challenges racial stereotypes, and wants responses from the audience to questions like 'All Americans are...?' (usual replies to this are apparently 'Fat' and 'Stupid'. They're not of course, not all of them - that was the point.)
Anyway, next question is 'The Dutch are ...?' About three minutes too late I realise I should have yelled out 'Mostly from Holland.' Hilarious. I might have even got to go up on stage. But it was too late by then.
The French have a phrase for these little ripostes that you think of too late, or when you're heading on up the stairs afterwards - Mots d'escaliers.
This has nothing to do with what this blog is supposed to be about - but now I can't sleep.

Screaming Popes...

Just while I think of it...
So the pope right, has a little dig at Islam. Although he now claims, and correct me if I'm wrong, that all he was doing was quoting someone else from a long time ago, who was having a little dig at Islam.
Either way, the dig has been made, that Islam may be associated in some people's minds with violence. And offence is duly taken.
And the response? Pretty much along the lines of 'behead the infidels' and 'death to the pope' (I paraphrase, naturally.)
Talk about making your opponent's point for them.

Here we go again...

Nearly time for bed.
Can't wait until tomorrow - another rewarding day at the frontline, the coal face, if you will, of today's National health Service.
Tending the sick. Helping people. Saving lives. Fantastic.

Or possibly dealing with the very week-old earwax of society. People whose only contribution to the planet they inhabit is small but regular emissions of greenhouse gas, but who appear to think it is right and reasonable to summon an emergency ambulance when their armpit becomes a little more fetid than usual. People to whom I HAVE TO BE POLITE AND PROFESSIONAL at all times because if I'm not they will find someone to act as an advocate for them (i.e. someone who can spell) and complain, and that complaint will have to be dealt with within a certain time-period or it will trigger another complaint. And then some grey suit will decide that because I am not POLITE AND PROFESSIONAL enough I am not worthy of the title 'doctor.' Ah well.
You know what happened last week?
This woman complained - and she was a district nurse. Or a chiropodist. Or something like that anyway. She'd turned up with some infection somewhere, and needed a 5-day course of antibiotics. The pack she got dispensed was a 7-day one (they come like that from the manufacturer.) So she decides to complain about the wasted 2-days'-worth of anthibiotic. No, really. In writing. Of course answering her anally-retentive squealings will cost far more than the six tablets she has had to flush down her toilet, but presumably that thought has not crossed her teeny weeny polka dot bikini brain.
We all know that there is a sizeable proportion of the population without which the rest of us would all be better off. Most of them are to be found hanging around emergency departments a lot of the time, because they are so stupid they end up doing things to themselves that you would really not think possible. They are a drain on Earth's resources. While a few of them take themselves out of the system there are many, many others who do not quite have the get-up-and-go to get-up-and-fuck-off. They may need a little push.
The 'captive bolt' system used in the foot-and-mouth outbreak would be useful. I just haven't thought how to dispose of the bodies.
Only kidding. Docs should not talk about bumping off their patients these days. I know that.