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Desmond O’Neill

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…

Desmond O’Neill: Blinded by science

27 Jun, 14 | by BMJ

desmond_oneillThe newest architectural gem in Trinity College Dublin is the award winning Long Room Hub, a slim and elegant presence inserted among classical, neoclassical, and modern buildings.

Just as its many windows offer unexpected vistas on to this beautiful campus, the activities of the Hub have injected fresh energy into interdisciplinary research and public engagement with the arts and humanities disciplines. The key to its success is skillful leadership and curating, ably primed by its director, Professor Jürgen Barkhoff.

Last week, the Hub hosted the most substantive and successful foray to date in Ireland into research in the medical humanities. Often held hostage by an overemphasis on teaching medical students—and thereby prone to spurious, sickly, and overreaching statements on perceived impacts, such as fostering empathy—this field of research has a hugely important role in calibrating the vast enterprise of healthcare. more…

Desmond O’Neill: Some illuminations on caring for older people

4 Jun, 14 | by BMJ

desmond_oneillGothenburg is a handsome city with imposing stone and brick buildings, simultaneously sober and ornamented, set among green hills falling to not one but two archipelagos.

It was particularly striking during the unseasonably fine weather that greeted the 22nd Nordic Gerontology Congress last week. This leading regional gerontology conference in Europe is biannual, broad in perspective, and meticulously organised.

Over 1100 delegates, mostly Nordic, attended this showcase for the remarkable progress that these countries have made in fostering research and education into ageing—including sociology, psychology, and the clinical sciences. Active PhD programmes are allied with a level of inter-institutional cooperation that few other regions of Europe match. For example, 11 universities in Sweden have developed the Swedish National Graduate School on Ageing and Health—a lead that many other European countries could do well to follow. more…

Desmond O’Neill: Expanding the imaginarium of ageing

23 Apr, 14 | by BMJ

desmond_oneillMy most formative experience in gerontology was a student gap year in Marseille. A volunteer with Les Petits Frères des Pauvres, a charmingly radical organisation dedicated to improving life for older people, I was fascinated by their motto—les fleurs avant le pain. At first sight, the focus on flowers ahead of bread seemed twee. more…

Desmond O’Neill: Combatting rigidity in medicine

8 Apr, 14 | by BMJ

desmond_oneillHigh quality films for children have a special place in our cultural landscape, an appeal which even embraces the medical humanities. To reach beyond children to the adults in their entourage requires a sure touch for tapping into the universal across the lifespan. In addition, many of the underlying fables are vehicles for deep and complex messages.

As teased out in Bruno Bettelheim’s remarkable Uses of Enchantment, the brooding themes of abandonment, death, witches, and injuries may allow children to come to terms with their fears and conflicts, particularly with parents and authority, in remote symbolic terms. more…

Desmond O’Neill on the power of cinema in discussing medical humanities

20 Feb, 14 | by BMJ

desmond_oneillOne of the pleasures of academic medicine, and a salve for the gentle disorganisation of Irish medical schools, is the initiative, enthusiasm, and broad ranging interests of the medical students and trainees. A recent taste of this was a play on anorexia from the Edinburgh Fringe Festival hosted by medical students at Trinity College Dublin. more…

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