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John Davies: Providing medical care in rural Brazil

26 Aug, 16 | by BMJ

Rio_Olympic_GamesThe Olympic Games are over, and what a wonderful two weeks they were. We finished the last events at the Olympic Stadium the day before the last day and there was a slight element of going mad. Hundreds of volunteers flooded onto the track. Shirts of different colours were swapped, and there were selfies and mass group photographs in all directions. No one was immune from the wonderful Brazilian enthusiasm for having good time. more…

Jeffrey Aronson: When I use a word . . . Junior

26 Aug, 16 | by BMJ

jeffrey_aronsonThe President of the Royal College of Surgeons of Edinburgh has asked Jeremy Hunt, the secretary of state for health (the SoSH), in a letter that also dealt with other more important matters, to find a less pejorative term to describe “junior” or “trainee” doctors, since “they are highly skilled, dedicated professionals and should be recognised as such.” Possible alternatives include “young doctors” and “non-consultant hospital doctors,” which isn’t very catchy; another suggestion, “Doctors In Training,” would make them acronymically ditzy. more…

Madhukar Pai: New insights into the tuberculosis problem in India’s private sector

26 Aug, 16 | by BMJ

Madhukar Pai

As a result of the overuse or misuse of antibiotics, antimicrobial resistant superbugs represent an extraordinary threat to global health. This threat is particularly great in India, the world’s largest consumer of antibiotics and the country facing the highest burden of tuberculosis (TB) in the world. Two studies, published simultaneously in The Lancet Infectious Diseases this week, provide several new insights into the problem of tuberculosis in India’s vast, mostly unregulated private sector. more…

Lisa Steen: The wilderness of the medically unexplained

25 Aug, 16 | by BMJ

lisa_steen2This patient perspective essay was written by Lisa Steen. She has since died. We have permission to publish the piece from her husband, Raymond Brown.

I am a GP, formerly a trainee psychiatrist and now 43 years old. In July 2014, I was diagnosed as having kidney cancer with multiple bone metastases. The cancer was extremely rare, associated with a succinate dehydrogenase B (SDHB) mutation. This genetic condition was later also found to be the cause of my carotid body paraganglionoma which had appeared when I was 18 and was finally excised when I was 27. more…

Rammya Mathew on the national childhood obesity strategy—doctors need to champion public health

25 Aug, 16 | by BMJ

rammya_mathewI was left mortified after reading about the long awaited national childhood obesity strategy. “Underwhelming” would be the single best adjective to describe it. On reading the newspaper headlines, however, it is all too tempting to pass the buck to Public Health England and Dame Sally Davies et al. However, there is a sense of unease about this. I can’t fight the feeling of responsibility to demand more of our government. It seems incongruous to dedicate our working lives to treating disease and yet turn a blind eye to public health policy that is set to fail a generation. more…

Nora Hellman: Responding to an outbreak of yellow fever

24 Aug, 16 | by BMJ

nora_hellmanResponding to an outbreak of yellow fever is not as exotic as you may imagine.

What kind of exciting and interesting things do you do as an emergency response nurse with Save the Children’s emergency health unit in the Democratic Republic of Congo (DRC) the day before one of the largest ever vaccination campaigns in Africa starts? Label things. 204 vaccine carriers, to be exact, carefully labelled in permanent marker. In a response of this scale the details are important—a label could make the difference between life and death. more…

Rachel Thomas: The final frontier

23 Aug, 16 | by BMJ

rachel_thomasSix weeks without gravity. Cushioned in a single white space for the duration. Air tanks, tubes, and pressure gauges surrounding me, the calendar days marking off a gentle, indistinct blur.

And now, finally, here I am, learning to walk again. My body shakes under the exertion. The simple act of straightening a leg, of now bearing weight on it, seems impossible. To hold up one leg is to hoist up a weight too great. The fat pads on my feet have dissolved, the bones rest directly on the concrete floor. While perhaps short of allodynia, the increased sensitivity on the soles of the feet mean a nauseating pain. more…

Richard Smith: In search of scandal in Scotland

23 Aug, 16 | by BMJ

richard_smith_2014I’m on my way to Dumfries to investigate the state of the NHS in that region, and the thought of the town is making me remember when I travelled there in 1974, 42 years ago, to investigate what I and a friend believed to be a scandal, a scandal of those times.

I was a co-editor of Synapse, the journal of Edinburgh medical students that we imaginatively and wittily renamed Prolapse and Perhaps. My co-editor, Peter Bloomfield (later a consultant cardiologist in Edinburgh), and I didn’t want the journal to be a “third division Lancet” filled with tedious articles rejected by other journals but rather a fearless, campaigning newspaper that spoke truth to the powers of Edinburgh medicine. We campaigned on issues like the poor quality of education we were receiving and the need for decent education on sex problems, and boldly we put the first “fuck” in the journal, which led to me being summoned by the professor of pathology for a wigging. more…

Christopher Martyn: Research round-up

22 Aug, 16 | by BMJ

chris_martynAnnals of Internal Medicine

Mistreatment of residents in nursing homes

Conditioned by reports in the media about mistreatment of residents in nursing homes, one leaps to the conclusion that it must be the staff who are doing the mistreating. This study suggests that it’s more likely that the other residents are to blame. Two thousand elderly people living in nursing homes in New York state were observed and interviewed over a month. More than 20% reported experiencing at least one episode of abuse from their peers. Verbal aggression was the most common form, but invasion of privacy, menacing gestures, and physical attacks also occurred frequently. more…

Sara Martin on emotional labour

22 Aug, 16 | by BMJ

sara_martinI work at a great place in the UK. We have gorgeous facilities, friendly staff, great benefits, and—most important to this American doctor—unlimited free coffee (and tea if you’re British).

But this summer, I will be heading back to clinical medicine. In preparation, I have been thinking a lot about what I have mentally termed the “emotionals:” emotional labour, intelligence, and resilience. more…

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