Everybody knows that men think about sex every seven seconds. What people haven’t perhaps considered is that means more than 8000 times a day or 56 000 times a week. Despite the joke that if men only think about sex every seven seconds what on earth do they think about the rest of the time, that’s a lot of mental energy devoted to sex. The selfish gene may demand that we reproduce, but 8000 thoughts a day on sex is surely excessive. (But then again the average ejaculate contains around 300 million sperm, which seems even more excessive.) So can it be true that men think about sex 8000 times a day? more…

“Longevity is one of the greatest curses introduced by the scientists,” wrote Evelyn Waugh in a letter to Harold Action in 1961, a few days after his 58th birthday. I read this a few days after I had given a talk on the pandemic of NCD (non-communicable disease) where I emphasised that the pandemic was the result of “success” in extending life expectancy. But could Waugh be right?

Minutes after reading Waugh’s statement I read Matthew Arnold’s bleak poem on growing old, written in 1867, when he was 45. more…

Last week the World Health Assembly adopted some tough targets for NCD, including reducing deaths among those under 70 by 25% by 2025. The rhetoric is that a “whole of government, whole of society” approach will be needed, but in fact the agenda is dominated by health bodies. The Young Professionals Chronic Disease Network is keen to break out of this straitjacket and modernise global health, and earlier this week Alessandro Demaio, an Australian doctor who has just completed a PhD in global health in Copenhagen, told a C3 breakfast seminar how they intend to do it. more…

Recently in preparing a talk I was giving in Bologna I found a copy of a talk I’d given to WONCA, the world meeting of general practitioners, back in the era before Powerpoint existed, and it contained information on a study that has stuck in my head for 20 years, but which I couldn’t find. (And after 20 minutes of searching I still can’t find the study, but perhaps you can.) It’s a study that suggests that patients are regularly misled, even abused, because they are not given full information. more…

We all know about obesity. We can see fatness. Obesity belongs to all of us, and it’s a global problem. Politicians care about obesity. But who cares about blood pressure? Raised blood pressure may be a bigger risk factor for premature death and suffering than obesity, but people don’t see it. Blood pressure belongs to doctors. Well, it’s time for a revolution. The people must claim blood pressure. more…

The Saturday before last I was rung up by a fellow of the Royal Society who was having trouble with the New England Journal of Medicine, and our conversation soon moved to the irrationality of “the REF” [research excellence framework].

We made the move because I asked why the results of a major trial undertaken in Britain were being submitted to an American journal.

“You know why,” he answered, “because of the REF.” more…

Last week for the first time I examined a PhD, and one of my co-examiners, a moral philosopher, told us of “Hume’s guillotine” and taught us a lesson that all doctors should know.

The defence of the PhD was in Copenhagen and in public, as is the custom in Denmark. Around 80 people were there, and it was an excellent occasion. The PhD, Conflicts of Interest in Biomedical Publishing, was by Andreas Lundh and very strong. It comprised seven papers, six of them published (one each in the BMJ, Lancet, and PLOS Medicine) and one accepted for publication on the morning of the defence. more…

Émilie du Châtelet, the French aristocrat, philosopher, lover of Voltaire, and interpreter of Newton, had highly original (and possibly even correct) ideas on the route to happiness. Those who are tired of the drab and soulless maxims of today’s self-help guides might like to try her more exciting advice.

Something that conflicts immediately with today’s thinking is that she insists that gambling is essential for achieving happiness. And she doesn’t mean a flutter on the Grand National or doing the football pools weekly; rather she means betting your house or entire savings in a game of chance. She did this regularly, gambling all night for night after night. Her logic is simple: “The soul,” explains Nancy Mitford in Voltaire in Love, her book on the long love affair of the two philosophers, “needs to be shaken up by hope and fear. Gambling brings it within range of these two passions and keeps it in a healthy state.”  Du Châtelet notes that it’s an advantage to be poor as it’s easier then to gamble your whole livelihood. Perhaps this is why billionaires like Roman Abramovich, the owner of Chelsea Football Club, seem so miserable. more…

A woman I hardly know and I are sat in a café in a country far from Britain, and the conversation turns to death. She tells me of two deaths in her family in the NHS. The first is remarkable.

An elderly woman, my companion’s mother, is waiting in a hospital for news of her elderly husband. A doctor comes out and tells her that he has died. Unfortunately, she doesn’t understand the very thick accent of the doctor, but she gathers that she can see her husband. Without understanding that her husband is dead she goes and sits beside him. The body is still warm. After about half an hour a nurse arrives, and the woman tells the nurse that she thinks that her husband would like a drink. The nurse realises that things have gone horribly wrong. more…

 My early years at the BMJ were very bound up with Margaret Thatcher. I started as an assistant editor a month before she became prime minister in 1979 and was appointed editor just before she was dethroned as prime minister in 1990. Whatever I write about her will evoke fury in some quarter, and despite our present prime minister saying that she saved the country it’s probably still too early to make a confident judgement on her performance. But I have my memories. more…