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Desmond O’Neill

Desmond O’Neill: Wheelbarrows, transport, and health

13 Jul, 15 | by BMJ

desmond_oneillThere is an old joke about a man who goes through a customs post with a wheelbarrow of sand every day. The increasingly frustrated customs officers make intensive searches of the contents, but never find any contraband. After many years, all are retired and meet by chance in a pub. When prevailed upon to reveal what he had been smuggling, he volunteers that it was wheelbarrows.

This story evokes parallels in many aspects of healthcare, whereby a focus on the tangible and the traditional can distract attention from the often less well defined, but bigger issue. more…

Desmond O’Neill: Surprised by beauty

19 Jun, 15 | by BMJ

desmond_oneillLike most doctors, my conference schedule is usually mapped out well in advance, anticipating the complex leave requirements of trainees and colleagues in an ever busier department of geriatric and stroke medicine.

This year, while on a 12 month secondment to the rapidly evolving Irish programme in traffic medicine, the constraints on my timetabling are correspondingly freed, and taking in an impromptu conference is now not only possible but also akin to a stolen pleasure. more…

Desmond O’Neill: The success and opportunities arising from population ageing

28 May, 15 | by BMJ

desmond_oneill

There is an extra uplift from spring conferences which mirrors the freshness of the season. My own traverse started in Vienna with a reflection on how the hegemony of the English language impoverishes our access to German speaking culture, distancing us from a rich spirit of inquiry that suffuses Germanophone congresses. Philosophical and cultural topics lie remarkably easily alongside the more technical aspects of gerontological science, in a collegial and relaxed ambience. more…

Des O’Neill: Flights of Imagination—Birdman and Still Alice

11 Mar, 15 | by BMJ

desmond_oneillBirdman, one of the most riotously entertaining yet serious movies of the last decade, deservedly won a clutch of Oscars. Dealing with ageing, the fear of irrelevance, and the nature of art, it wore these themes lightly, bearing us aloft through the imaginative direction of Alejandro González Iñárritu, skilled camera work, humour, and a superb script. more…

Desmond O’Neill: Older drivers and medical fitness to drive

19 Jan, 15 | by BMJ

desmond_oneillDoes life really imitate art, or is it the other way round? Listening to an exhilarating live performance by the Philadelphia Orchestra of Till Eulenspiegel’s Merry Pranks, the droll tone poem about a famous trickster by Richard Strauss, I was struck by the notion that this might be the first description of ADHD through music. more…

Desmond O’Neill: A gerontological fear of missing out

18 Nov, 14 | by BMJ Group

desmond_oneillFaced with a gerontology conference with 30 parallel sessions over five days, the texting argot of teenagers comes in handy. To LOL and YOLO has been added FOMO: Fear of Missing Out! Effective FOMO management strategies involve several ingredients. The first is not change between sessions as invariably the timetable has changed in the other room, undermining the experience of both sessions.

The second is reassurance that repeated scrutiny of the programme book to choose sessions bestows a flavour of the hot issues in gerontology. Mixing during coffee breaks and receptions to hear what other delegates found interesting is equally important.

Finally, the poster sessions offer the best opportunity to pick and mix, as well as for serious discussion. Platform presenters are as moved by fear of looking foolish as by science, so dialogue at oral sessions tends to be correspondingly less free-ranging. more…

Desmond O’Neill: Sky disc and the marvel of ageing

7 Oct, 14 | by BMJ

desmond_oneillOne of the great challenges of hospital medicine is retaining a sense of the marvel of ageing after a busy night on general take. The sheer complexity of the frail, multimorbid, and delirious nonagenarian can easily rattle junior trainees. Seeing beyond the losses to the accumulated richness of life experiences demands insight, but can be teased out by powerful metaphors.

When teaching students and trainees, I often lean on late life creativity in the face of disability: Matisse in his wheelchair, Renoir with the paintbrush strapped to his arthritic hands, Klee and his scleroderma.

A different parallel struck me recently at the combined German, Austrian, and Swiss congress of gerontology and geriatric medicine in Halle, a modest-seeming city in former East Germany. more…

Desmond O’Neill: Ageing, astronauts, and organists in Rotterdam

23 Sep, 14 | by BMJ

desmond_oneill“Le frime” is an almost untranslatable French word for doing something that seems superfluous for the fun of it. It is as good a term as any for the opening ceremonies of our European Union Geriatric Medicine Society conferences. These reflect how individual nations put their best foot forward for guests. While the content may at first sight seem to be tangential to the core business of geriatric medicine, linkages appear with reflection.

And so it was in Rotterdam last week, with a line up including an astronaut/physician, the city organist, a retired Dutch prime minister, and silent movies (old and new). The setting was the magnificent De Doelen concert hall, in a futuristic city centre with an iconic and dramatic train station that opened this year.

The presentation from Dr André Kuipers was witty, entertaining, and informative. Space medicine offers insights into accelerated forms of ageing syndromes, particularly osteoporosis and sarcopaenia; the responses, particularly through exercise, were very relevant to the science of geriatric medicine. more…

Desmond O’Neill: Stethophones and barriers to effective care of older people

1 Sep, 14 | by BMJ

desmond_oneillThere is a long tradition in medicine of accepting a degree of mismatch between labels and the functions that they address. A classic example is the stethoscope, through which few of us peer, but which only a terminal pedant would now agitate to be renamed a stethophone.

Recent debate over the redesignation of dementia as “major neurocognitive disorder” in the new DSM-V criteria highlights how the widespread acceptance of a somewhat less accurate descriptor may be more beneficial in terms of engagement with the public and among disciplines.

So, during the Berzelius symposium last month, I was surprised to come across a troubling barrier to developing better care for older people—the key adult users of health services—arising from resistance to an internationally accepted term. more…

Desmond O’Neill: Elective Dreams

19 Aug, 14 | by BMJ

desmond_oneillWith every elective student that joins our unit, I get a vivid flashback of my own electives. No matter how much water has flowed under the bridge since then, something particularly special endures about these less structured educational episodes. Even if undertaken in a local hospital, the elements of summer holiday, change of routine, and freshness suffuse the experience for both student and clinician.

My “formal” electives were a blast. Hamburg in the summer is green, leafy, and sunny—with water a constant presence from the huge harbour to the Alster lakes in the centre of the city. The first summer was spent in a large hospital there, St Georg, whose Wilhelmine ward blocks radiated the spirit of the great German pioneers of 19th century medicine. The second elective was in the racier setting of the small Harbour Hospital beside the red light district of the Reeperbahn, transvestites and sailors prominent among the clientele. more…

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