Hidden in plain sight.

  Patients do not come with diagnoses attached to their foreheads.  If only they did,  huge numbers of hospital visits and admissions could be avoided. To overcome the ever increasing number of potential diagnoses, and the rising tide of illness encountered by our ageing populations, we rely ever more heavily on investigations to guide us […]

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Fashionable inequality?

Modern life in developed societies is a world away from the lives our recent ancestors lived. Better sanitation, advances in farming and food supply, the cumulative effects of public health interventions over the years, and huge advances in medical knowledge and technology have also shifted the landscape of disease. As a society, our preoccupation is […]

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It’s good to talk…

When I think about my work on the acute medical unit, or my clinics, it is almost mind boggling, the number of interactions I have with other humans – trainees, consultant colleagues, radiographers, radiologists, professionals from other hospitals, biochemists, nurses, physios, therapists, and of course – patients.  As Atul Gawande points out in this splendid […]

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I took the road less traveled by…

Picture the scene – it’s the wee small hours, say around 0330, when the energy really ebbs on a night shift – it is still pitch black and the gentle lightening in the east is still at least a couple of hours away. You’ve been on the go since you started your shift at 2030 […]

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Too much medicine…

  A famous quote from the eminnet paediatrician Sir Cyril Chantler was published in the BMJ in 1998: “Medicine used to be simple, ineffective, and relatively safe. It is now complex, effective, and potentially dangerous.” As medicine progresses, it is worth keeping this in mind.  The complexity of modern medicine is one of the challenges […]

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It’s all the little things.

This week I have been privileged to be at “the Forum” or to give it it’s full title, the 19th International Forum on Quality and Safety in Healthcare. The Forum is an impressive event – there were over 3000 delegates from 78 countries, and over the week the virtual presence of the event was significant. […]

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How to mend a broken heart…

photo credit: Mrs Magic via photopin cc “Doctoring her seemed to her as absurd as putting together the pieces of a broken vase. Her heart was broken. Why would they try to cure her with pills and powders?”   So, it is Valentine’s day – and what better than a bit of medical education about broken hearts.  As it […]

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Help! – I need somebody…

One of the best school mottos I have encountered is that which introduces the General Knowledge Quiz of King William’s College on the Isle of Man.  The motto is:  Scire ubi aliquid invenire possis, ea demum maxima pars eruditionis est.  It  essentially translates as, ‘ to know where you can find anything is, after all, […]

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Burnout – its not just the hours.

  Burnout is a condition which is all too common amongst junior doctors. The accepted research definition is: ’emotional exhaustion and a reduced sense of personal accomplishment associated with prolonged occupations stress.’ This is probably a familiar state of mind to many junior doctors out there, and many senior doctors – either from their current […]

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