Moving on

5 04 2012

Another 4 months has flown by, and I’m onto the last job of my FY1 year.

Started work in August on a ridiculously busy medical job, where I felt I never left the hospital, and certainly never separated from it mentally. But I worked with some great people, noone in the hospital is ever as good a friend to you as “med reg”, especially when they’re your own. Even after I finished on medicine, those links were what saw me through much of job number 2. I learnt loads, had to make decisions, and am definitely a better doctor (if not person!) because of my experiences.

Fast forward to Christmas and started on surgery with a little bit of apprehension. Lets face it, I’m not exactly typical surgery fodder, rarely cope well with *ahem* aggressive personalities, and whilst theatre is often hilarious, I’ve never really been into being the one actually cutting people up. But seems I lucked out. Fab bosses, hilarious registrars, great SHOs, and a wonderful bunch of assorted others. Life got left a bit by the wayside somewhere along the way, and suspect I have quite a bit of making up to do with the boy in the coming months. When the job was good, it was incredible. When it was bad… well…. I’m just glad the people around me provided the compassion, support and/or giggles neccessary to get through.

So now I’m just starting psychiatry. I’ve always had a bit of a soft spot for the subject, even ran a book club for a while with a strong psychiatric focus to the books we chose, and was quite keen for an F1 job involving it. 2 days of induction was gruelling though, so looking forward to getting stuck in for real after a wonderfully work-free weekend!

J





“no decision about me without me” part the first

14 07 2010

“No decision about me without me.” Liberating the NHS.

Some of you might have heard that – buried between an international footballing tournament and second by second updates on a gunman in Northumberland – the government has released their plans for a total upheaval within the NHS.

Now, whether you’ve been sat in a waiting room for 2 hours, or had the misfortune to go to a party with a ‘medical bore’, it would be difficult to escape the relentless manager-bashing that has grown over the past few years. When things don’t work as they should in hospitals, a mere reference to the problems being all because of “too many managers” explains the whole thing away. Health professionals and patients alike bemoan the powers granted to these people who – as far as we can see – often have little experience with healthcare, and maybe applying a business model to the lives and health of individuals feels a little… well, icky.

Well, it turns out some govenrment bod has listened to this common doctors’ gripe, and turned round to the PM and gone “y’know what, lets give them what they say they want”.

My understanging of the report – and I’m still digesting it, so expect an update over the coming days – has it boiled down to a few key points.

  1. The NHS is great – the government loves what it sets out to achieve and wants it to be even better.
  2. Patient choice should be in the forefront of everyone’s minds for the future of the NHS.
  3. “Targets” are to be replaced by “clinically credible and evidence based outcome measures”.
  4. The relationship between the government and drug developers may become interesting, and a fund will be set up to pay for those oh so expensive cancer drugs.
  5. The roles of the current commissioners (i.e. people who decide what the limitted pot of money should be spent on and wwhere provides services) with be taken over by groups of GPs who will be in charge of commissioning most of what their patients need, apart from the primary care bits, which will be looked at by another group (The NHS Commissioning Board).

This is potentially a massive change in how the NHS works. All I want to say for now is that I love our National Health Service. I am passionate about how fantastic it is. Sure, things could be better, but what we have in the UK is an example to the rest of the world. I look to see how this document will translate in practice with great interest.

Jx





Facebook linked to syphilis? Correlation does not mean causation.

24 03 2010

I have been following the aftermath of the Facebook/syphilis link all day with much interest.

Syphilis has been a twitter ‘trending topic’ – whether due to people discussing the scaryness of the initial story, or commenting on the lack of actual published data – so it seems to be a topic of interest to others as well as the sub-species I belong to, otherwise known as science geeks.

For those with a moment to spare, here is one of the articles, from the Telegraph 

“There has been a fourfold increase in the number of syphilis cases detected with more young women being affected.

“I don’t get the names of people affected, just figures, and I saw that several of the people had met sexual partners through these sites.

“Social networking sites are making it easier for people to meet up for casual sex.”

OK, this may be true. However, a quick Google Scholar search hasn’t shown any published research supporting this, and it is unclear where the data is coming from, how it was collected… In short, anything that might make this a real story!

I hope that real research has been done, and that given time, we will hear about it. But so far, Teeside have kept remarkably schtum.

With far greater journalists than I already having attempted contact, I shall leave it until we know more to make any further comments.

For a more in depth look at this, please check out Dr Petra’ blogpost. If nothing else, she argues, this could be an excellent route in to educating the public about this disease.

J x





remote, retroactive intercessory prayer

11 02 2010

Famous and hilarious study. Praying for people 10 years AFTER they’d been in hopsital lead to better outcomes. Maybe they repeated the study with different patient groups until they got the magic p value, maybe they just got lucky, still, shows why it’s important to ask the right question when thinking about conducting research. But lead to a lovely, controversial Chrsitmas BMJ issue!

BMJ 2001;323:1450-1451 ( 22-29 December )

Beyond science?

Effects of remote, retroactive intercessory prayer on outcomes in patients with bloodstream infection: randomised controlled trial

Leonard Leibovici, professor

Department of Medicine, Beilinson Campus, Rabin Medical Center, Petah-Tiqva 49100, Israel

leibovic@post.tau.ac.il

Objective: To determine whether remote, retroactive intercessory prayer, said for a group of patients with a bloodstream infection, has an effect on outcomes.
Design: Double blind, parallel group, randomised controlled trial of a retroactive intervention.
Setting: University hospital.
Subjects: All 3393 adult patients whose bloodstream infection was detected at the hospital in 1990-6.
Intervention: In July 2000 patients were randomised to a control group and an intervention group. A remote, retroactive intercessory prayer was said for the well being and full recovery of the intervention group.
Main outcome measures: Mortality in hospital, length of stay in hospital, and duration of fever.
Results: Mortality was 28.1% (475/1691) in the intervention group and 30.2% (514/1702) in the control group (P for difference=0.4). Length of stay in hospital and duration of fever were significantly shorter in the intervention group than in the control group (P=0.01 and P=0.04, respectively).
Conclusions: Remote, retroactive intercessory prayer said for a group is associated with a shorter stay in hospital and shorter duration of fever in patients with a bloodstream infection and should be considered for use in clinical practice.





Knackered and busy!

14 01 2010

Those of you who know me will realise that it’s starting to get a little frantic here! With exams a couple of months away, a project in another country to plan, and a placement that’s eating every spare second to travel or being in theatre, I barely have time to breathe!

xx





Teaching and learning

2 12 2009

Well today the tables were turned. As a student, I’m used to sitting in lectures, absorbing. Feeling something of a sponge, although knowledge rarely sticks beyond 24 hours, as it is wrung out to make room for the new! But that probably says more about my innability to remember than any fault on the lecturers part.

Today, however, was my turn.

I had 1 hour, 1 subject, and 4 eager students (well, 3 students and 1 GP) to impart knowledge and wisdom to!

Choosing a topic largely within my comfort zone, but also learning a lot in the process seemed a sensible direction to go. And in the end, I figured that by the time I’d left time for questions, and a fun game of snakes and ladders (with medical questions before anyone was allowed to move forwards lol), I only really needed 35-40minutes of material. This was fine, I could answer almost every little problem, and even took some time to explain how I remembered some of the equations involved. Lets just say I’m not usually a visual learner, but in this case I imagine a lady made of china and a yuppy in London (wearing a hat for reasons that make sense only to me!). Odd, but even odder is that it actually works!

Finally, as I’d heard that chewing improved memory (http://www.newscientist.com/article/dn2039-chewing-gum-improves-memory.html), I reassigned some of the chocolates I’d brought from the game to help with memory during the seminar parts of the session, in the hope it might help… well it kept them happy (and sugared up!), anyway! 

All in all, a success!

Jx