It might seem odd that the most challenging folk to work with here are not the Sierra Leonean ones.  Sometimes the toughest part is dealing with the endeavours of my fellow “whiteman”. more…

Ineffectively communicated clinical information has been estimated to be responsible for up to 10% of all preventable medical errors.  Stanton et al, in their recent book on clinical leadership, reveal that 70% of information is communicated non-verbally. more…

A debate on the harms of drugs and alcohol hosted in a pub - surely not?

This week I was lucky enough to visit the epicentre of drinking and critical thinking at what claims to the be the world’s largest regular pub meeting.  An open invitation to join a garrulous group of sceptics at a forum hosted by the Westminster branch of Skeptics In The Pub promised to be loud, messy, and disorganised - and very democratic - according to the Economist. more…

Clinical trials are the cornerstone of medical research. Multiple publications of the results of a specific trial as well as non-publication of unfavorable results are among the problems facing the medical literature. To avoid such problems, the idea of trial registries has been proposed, and nowadays authors cannot publish the results of trials in most reputable journals without prior registration. more…

Attending the graduation ceremony for the Royal College of Paediatrics and Child Health Child Health Diploma programme in Ramallah I fantasised over the effect of the course on children’s health. We want to see the following: thriving, well nourished infants, lively and independent minded children, healthy teenagers with high self esteem, disabled youngsters who are well rehabilitated and integrated in society … all topics being covered in our teaching. more…

As the mother of a severely disabled child and a psychiatrist working with learning disabled children, I was particularly interested in this BBC documentary which highlights the enormous challenges families face in bringing up a child with disabilities. more…

With the World Food Summit happening this week in Rome, and thinking about my experience of working in the field of malnutrition, two very strong images came to mind. more…

How does a doctor obtain informed consent for H1N1 immunisation consistent with General Medical Council guidance? The Department of Health’s guidance does not provide sufficient information for this.  This is our attempt to rectify this omission, providing information required for informed consent consistent with good professional practice. We outline the main principles of General Medical Council on the responsibilities of doctors in seeking informed consent into practical guidance.  more…

Plagues create business opportunities and the worried well in any era present a commercial opportunity. In the Middle Ages, the Black Death and the Great Plague saw brisk sales in fumigators, herbal remedies, and the plague suit - predecessor of the DuPont TK555T HazMat suit, and equally unsettling for nervous patients. Quacks (from the old Dutch word Quacksalver, for one who boasts or “quacks” about his or her salves) thrived in an era unchallenged by scientific evidence and online Cochrane reports. more…

“Bring sac close to peritoneum, drain its purulent liquid content, and have the shrunken pouch squeezed through this tiny hole.” Such was the senior surgeon’s instruction at the conclusion of a gallbladder removal operation. more…