Saturday, 29 March 2008

Is Apple Mac's Cool evaporating?

And so nowadays it's Apple Mac this and Apple Mac that - particularly amongst the hip metrosexual young professional brigade who are all tapping away on their shiny white machines in your nearest Starbucks.

But aren't they trying a bit TOO hard? Yes, they are beautiful and well designed in the same way that an audi TT is but now they are the must-have accessory haven't they become a bit passe?

Surely the new cool is the cheaper, tweakable, geekier PC Laptop, probably manufactured by Asus or Dell, which is chic in the same way a Lancia Delta Integrale is. Don't you get the feeling Mac users are desperate for you to admire how elegant they are?

If your doctor is striding up and down the wards with an Apple Mac under his arm I would be deeply suspicious - it probably shows a lack of moral fibre. If, on the other hand he is working on a stripped down PC running Linux you can bet he means business.

Doctors are encouraged to look at the smallest details in their patients to determine what sort of person they are - however this should really cut both ways. So next time you see your physician, make a note of what type of computer he has tucked under his arm; it could very well be a matter of life and death.

Thursday, 20 March 2008

Unconventional Wisdom

In many ways, being a Doctor is the worst thing that you could let yourself in for (despite what your parents may tell you!) and whenever College work-experience Students ask about the Profession, I invariably tell them to do something - anything - else with their lives whilst they still have the chance (unless of course, they are not going to be based in the UK). However, there are occasions when I am given to think that there may just be an upside to it all.

Perhaps the most valuable thing is the ability to think critically about a subject - and in fact I can think of no other vocation where you will be so utterly and mercilessly exposed to the extremes of humanity and have the opportunity to see how effective your blend of science, art and philosophy actually is.

The fact is that no-one really understands how the human body works. We only have a rough idea of how a typical person functions - and the differences between individuals are of a magnitude that constantly surprises me; most of the time we don't even fully understand how our medicines really work.

This is a scary notion that increasingly seems to miss the comprehension of most people.
It is comforting to think that if you have condition X,Y or Z then treatment A,B or C will be appropriate for you - but this is not always the case.

The only way to delineate what the right thing to do is therefore to use Scientific Evidence to guide decision making - but its only when you understand how science works and how evidence is produced that it can be grasped just how limited Evidence Based Medicine (EBM) is.

Nevertheless, this has not discouraged our political masters to introduce hordes of Nurse Practitioners to practice "cookbook Medicine" where they can huff and puff and vehemently argue that the "evidence shows this" or "the evidence shows that" without having any expert knowledge of the field or any ability to critically appraise that very evidence.

And, as in many other spheres, the evidence is often produced to support an argument that has already been formulated rather than in a spirit of genuine intellectual curiosity and, as in many other spheres, this reflects the conventional wisdom of the era.

In many ways, it is not in times of conflict that the greatest courage is seen; after all, if the barbarians are at the gate, it is a relatively straightforward course to take up arms and repel them. There is no choice to do anything otherwise. It takes considerably more courage to forment a response when there is no immediately obvious threat and when the way ahead is uncertain and perilous.

The second situation arises many times during a medical career. Life, and medicine, are not straightforward and that is why medicine is hard. Are you the kind of person who wants to think for yourself rather than be told what to do? Even though you may be unsure, do you have the courage to do what you hope is right even when the consequences of making the wrong decision might result in the death or disability of a fellow human being? Are you ready to take an insane gamble with your career prospects, financial stability and family life?

If so, perhaps medicine is the job for you. If not, do something else - anything else.

Wednesday, 19 March 2008

Run, Dwain, Run!!

There has been much heart rending sanctimonious guff about not letting the Athlete Dwain Chambers represent Britain following his exposure as a drugs cheat. Unlike Amy Winehouse who has allegedly been using Class A illegal substance and yet remains a hero to our children however, Chambers has taken the decidedly legal steroid THG and has received nothing but brickbats and approbation. Why such a difference?

Chambers has served his ban and yet is being frozen out by track and field bosses who find the sight of him running for Britain unedifying. From a moral point of view only, I believe they are right - certainly if I was an athlete in a similar position I would be too ashamed to represent my country even if I was technically within my rights to do so.

But there is a trend in modern Britain to escape censure by sticking to the rule though ignoring the spirit of the law. Thus we see Government Ministers clinging to office by their fingernails on technicalities until they are forced out by colleagues or police investigations. A man is executed by the police on the London Underground without them even being sure of who he was or if he represented a threat and yet no-one, including the person supposedly in charge of the organisation, takes responsibility and everyone stays in their jobs. Even the Speaker in charge of the Parliament that makes our laws clings to the rules despite there being a strong moral case for him to consider his position.

Within the world of surgery, the Chief Medical Officer and Government Stooge, Sir Liam Donaldson, has wreaked havoc by introducing the ill-thought MMC process which has, at a stroke, sacrificed thousands of Doctor's careers and will usher in the subconsultant grade. Trainees, trainers and the medical community want this man to go thanks to the destruction of our profession that he has left in his wake yet he also refuses to give up his substantive salary and chauffeur driven car.

No morals, no scruples, if there is a way to escape responsibility for your actions it should be taken.

So let Dwain Chambers run. After all, who could be more representative of our once noble country?

Saturday, 15 March 2008

So What?

Well, I thought I would take my first faltering steps in the blogosphere by highlighting a subject that is close to both my heart and my wallet; namely the ungodly amount of hard earned money that this shambolic Government has p*ssed up the wall in the name of "progress".

You may have witnessed David Cameron, the leader of the British Conservative Party, trying to respond to NuLabour's soporific budget speech with a well reasoned argument about exactly why our economy was heading for the rocks. When he got to the thorny issue of our inordinate tax burden, he was shouted down by the aptly-named Mr. Balls - a friend of the Dear Leader and Secretary of State for Children, Schools, Families and Fluffy iddy biddy Pets - before he settled himself back into his seat with a smug grin on his face.

The phrase which he used when our tax burden was mentioned was "So What?" (incidentally not a phrase he was brave enough to stick with when the official transcript of the exchange was published in Hansard).

The smug, arrogant, patrician and downright nasty attitude of NuLabour is ecapsulated by that single phrase.

Electing NuLabour to power has been like giving the drunks the keys to the wine cellar. They have systematically hosed any conceivable problem with liberal quantities of our cash and, with the genius that can only come with never having had a proper job in their lives, have dreamt up all sorts of half baked and idiotic solutions to problems that have amazingly left us worse off than before.

So now we wait longer on average for NHS treatment, violent crime has soared in the UK, inflation and unemployment are on an upward trajectory and we have "staggering" problems with basic literacy and numeracy even after a decade of compulsory education. Worst of all, our brave servicemen have been sent to fight and die in the sands of Iraq and Afghanistan without adequate equipment because we can't afford it!

And Labour's response to their own disgraceful failings?

"So What?"