I have long believed that first impressions, and even visual clues generally, can cause trouble. Indeed, it is my view that their (mis)use is possibly a key component in the development of prejudices such as racism and sexism. My ideas about first impressions came to me in rather odd circumstances. I was timetabled to give the last lecture on the last day of the Christmas term. The lecture, which was on the clinical pharmacology of phaeochromocytoma, was destined for first year medical students. The lecture theatre would be full, and things were bound to be festive – more banter, certainly some bunting, a few twigs of mistletoe, and an abundance of streamers. Nevertheless the lecture itself, like any other, was a serious business. more…

One thing about the current swine flu pandemic is that it has brought with it a universal sense of fear. As with all fears, individuals respond differently, but we know what they are feeling because the sensation of fear, which varies from a mild anxiety to incapacitating panic, is so much part of our constitution that some see it as a normal component of the human condition. more…

I have never liked the idea of showing respect for people simply because of their social standing. I am in favour of treating people with respect in a general sort of way, so being polite and considerate. I respect nature or property, so protecting or nurturing rather than damaging or destroying. I respect people for their ideas or achievements. I respect someone’s office, such as that of a judge in court or a chair at a meeting, but this certainly does not equate with respecting them personally. more…

Two things are certain. First, I am a teetotaller. Second, UK society (in common with society in Europe generally) is awash with the influence of alcohol. If ever there were a risk of a clash of interests, this is one. more…

From the outside, most people appear to conduct themselves in a normal, essentially humdrum, manner. However, in many (possibly most) of us there are odd, and often secret, compulsive behavioural traits which, in extremes, can dominate a person’s life and occasionally be a wrecker. Classic examples of such behaviour are the compulsive alcohol drinker (as in the alcoholic), the compulsive food eater (as in bulimia), and the compulsive cigarette smoker (the chain smoker). Added to these are the physically less damaging but similarly well recognised compulsions that include the workaholic and the shopaholic (a subgroup of which is the ‘fashion victim’), the bookworm and the compulsive gambler. more…

Over the years I have sat through plenty of lectures that have been plain awful. There have also been those which simply glued me to my seat, where time flew by, where information just flowed in, and after which there was a glow of satisfaction. more…

How best to set the ways we communicate with each other, and so to establish our “rules of engagement”, can be difficult’. Moreover, any “rules” we establish may vary over time, either in the long term (plenty of doctors who meet in the work place later marry), or more acutely if circumstances change (one moment I may be talking to a neighbour as a friend and then seconds later, and in the event of a medical emergency, as a doctor). more…

Although many see me as sociable, and in some respects I know this is true, in reality it is only partly me. In many ways I am much more at home being unsociable, a trait which I believe generally deserves recognition (and respect) as a positive, rather than a negative, attribute. Indeed, I feel strongly that we now live in an over-sociable society (witness, the compulsive use of texts, twitters and Facebook), that a bit of unsociableness would do us the world of good.  more…

If I am to believe my critics, I am arrogant. By definition, arrogance is usually used pejoratively (as are such terms as unpatriotic, subversive, anti-establishment, irreverent, all of which I have been accused over the years), and describes people who have an exaggerated (inflated) view of their abilities (especially when compared to other’s); tend to dismiss the views of others in preference to their own; are interested in themselves rather than in others; and are self satisfied or overbearing in their comportment. While this set of definitions paints a picture of people who are unsavoury, is there another side to the story? Can aspects of arrogant behaviour be normal, defendable, and in some circumstances a necessary (probably an essential) part of conduct? Does this sort of label matter and anyway, who decides? Is it time for a rethink? more…

Training to be a clinician is so much more than simply accumulating facts. It is easy to forget, for example, just how much time and energy we spend on learning to use our senses. Despite having served the owner well for 18 or more years, the senses of the “raw” student still need much honing if they are to be used as part of medicine, and learning to use them is very revealing. more…