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Desmond O’Neill

Desmond O’Neill: Peak medical students

4 May, 16 | by BMJ

Des O Neill 2015Asked to do a column on medical education for an Irish newspaper, I was struck by how little professional debate we have had on the extraordinary increase in student intakes in these islands. Traditionally Ireland has had a large number of medical schools proportionate to its population: recent presentations in the Royal Colleges of Physicians and the Royal College of Surgeons 2016 of Ireland on the centenary of the 1916 rebellion revealed that Irish graduates represented a substantial proportion of the doctors in the Royal Army Medical Corps of the British Army during the First World War. more…

Desmond O’Neill: HIP medicine

14 Apr, 16 | by BMJ

Des O Neill 2015In the last month I have had two wonderful musical experiences in Dublin, each causing me to reflect on one of the key challenges of medicine, that of getting to the core of what is troubling people who seek medical attention.

Each of the performances was from music ensembles who seek to perform music in a fashion that as closely as possible resembles what the composer would have heard at that the time. Tuning, instruments, and musical styles have changed over the years and what we now hear is substantially different from what listeners in the baroque and classical eras would have heard. more…

Desmond O’Neill: Combating bar stool gerontology

11 Feb, 16 | by BMJ

Des O Neill 2015One of the greatest challenges for us as we age is “bar stool gerontology.” For most complex subjects—nuclear physics, molecular biology, or philosophy—most of us recognise that some learning and education are required to grasp their fundamentals.

Yet despite the fact that we are at our most complex in later life, it remains acceptable in many walks of life to ignore advances in research on ageing—presumably on the basis of, “Sure, we all know what ageing is.”

A staggering example of this gerontological illiteracy was the recent pronouncement by the head of acute care for NHS England that loneliness was driving older people into emergency departments. more…

Desmond O’Neill on Star Wars: The Force Awakens—and matures

23 Dec, 15 | by BMJ

Des O Neill 2015Exams and the pre Christmas rush notwithstanding, a triple-line party whip was in force within the family for the midnight first screening of Star Wars, The Force Awakens. Sitting in the back row of a packed, expectant, and goodnatured cinema, I was struck by the number of contemporaries also attending with adult and teen children.

They, like me, almost certainly had vivid memories of the “real” first Star Wars movie of 38 years ago, screened when I was a student in first med. A histology practical took a severe hit as a goodly proportion of the class went to a matinée showing of the movie, and light sabre battles with bicycle lamps in the darkened locker room were the order of the day for weeks thereafter. more…

Desmond O’Neill: The Healing Touch

20 Oct, 15 | by BMJ

Des O Neill 2015Although not as grand as the Museum Quarter of Hapsburg Vienna, Dublin has a proportionately rich concentration of museums, galleries, and Victorian heritage alongside Trinity College Dublin, our own mini Museum Quarter. The analogy is not entirely without basis as both concentrations arose in the context of large empires, and elements of both have taken some time to adapt to new forms of existence within relatively small democracies.

In Ireland this change was largely entwined with the recalibration of the status and relationships of an Anglo-Irish and largely Protestant establishment within a new state, which from the 1930s assumed a markedly different theocratic direction to the existing orthodoxy. Many of these institutions went into a form of inward looking hibernation for a number of decades, emerging eventually strengthened and revitalised by the fusion of traditions in a pluralist society. more…

Desmond O’Neill: Welcoming the new ageing in a global context

12 Oct, 15 | by BMJ

Des O Neill 2015

Expenditure in older populations is an investment, not a cost, according to the World Health Organization (WHO)

With relatively little fanfare, the World Report on Ageing and Health—one of the most important WHO documents in recent years—was launched in New York to coincide with the UN International Day of Older Persons on 1 October. It represents a historic change of emphasis for an organisation whose focus in the past centred largely on infectious disease and childhood.

However, in a changing world with reduced child mortality and a major shift in disease patterns, non-communicable diseases (such as heart disease, stroke, cancer, and traffic accidents) now represent the major threat to global health. more…

Desmond O’Neill: Nordic insights into the art of ageing and dying well

23 Sep, 15 | by BMJ

Des O Neill 2015I hate to miss the opening ceremonies of European geriatric medicine conferences, with the individual interplay between this most complex of medical specialties with the national characteristics of the host nation.

Norway is notable for its ability to fuse simplicity and sophistication, typified by the striking new Opera House in Oslo where the sloping roof provides not only a promenade for its citizens, but also echoes of its mountainous and snowy landscapes. It is also home to an energetic and cheerful body of geriatricians who hosted the well-organized and cutting-edge 2015 Congress of the European Union Geriatric Medicine Society in Oslo last week. more…

Desmond O’Neill: 45 years of solitude

15 Sep, 15 | by BMJ

Des O Neill 2015One of the rare pleasures of life is to encounter a movie without the encrustation of prior critical approval, hype, or derision. One of my stand-out cinematic experiences occurred at a very busy stage of my life when I was brought to The Matrix without any prior awareness of plot or critical reception. The sheer pleasure of an unencumbered fresh take on cinema added immeasurably to the experience.

Sadly, the PR machine of modern cinema is such that pre-release interviews, puffs, and early reviews now contaminate the quasi-totality of cinematic viewing. Cinema reviewers are a breed unto themselves, their columns founts of wry urbanity and knowingness. This chic cynicism retains a blind spot, a quasi-monarchical reverence for certain actors and directors, usually those fêted at Sundance or with Un Certain Regard at Cannes or an aristocracy of the daring and experimental, from Isabelle Huppert to Quentin Tarantino. more…

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…

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