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Archive for the ‘humour’ Category

Dr Tom Bibey’s blog is worth reading. He’s the kind of family doctor I like. He recently posted about laughter and I thought I’d post this just for him and his good wife. Hope you enjoy it!

While you’re here, and if you feel you need something to cheer yourself up try

this superb piece of video-editing or

this great mime.

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Every Christmas issue of the British Medical Journal, now known simply as the BMJ, has some really fun articles. I haven’t opened this year’s issue yet but when I picked it up from behind my door just now a study from old BMJ Christmas issue came to mind. It was a systematic review of the evidence base for the use of parachutes. In the introduction they say –

The perception that parachutes are a successful intervention is based largely on anecdotal evidence. Observational data have shown that their use is associated with morbidity and mortality, due to both failure of the intervention1 2 and iatrogenic complications.3 In addition, “natural history” studies of free fall indicate that failure to take or deploy a parachute does not inevitably result in an adverse outcome.4 We therefore undertook a systematic review of randomised controlled trials of parachutes.

The authors completely failed to find a single randomised controlled trial of parachute use! This article is typical of the BMJ Christmas editions. It’s funny, tongue in cheek, but thought-provoking and makes serious points through the use of humour. I love their conclusion –

Only two options exist. The first is that we accept that, under exceptional circumstances, common sense might be applied when considering the potential risks and benefits of interventions. The second is that we continue our quest for the holy grail of exclusively evidence based interventions and preclude parachute use outside the context of a properly conducted trial. The dependency we have created in our population may make recruitment of the unenlightened masses to such a trial difficult. If so, we feel assured that those who advocate evidence based medicine and criticise use of interventions that lack an evidence base will not hesitate to demonstrate their commitment by volunteering for a double blind, randomised, placebo controlled, crossover trial.

Any volunteers? (and, no, you’re not allowed to volunteer anybody else!)

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One of the things that depresses me most is the tendency to write off whole swathes of humanity by sticking a label on them and dismissing them. I sat on the train this week and two guys, a Scotsman and an American with a comb-over, spent the whole journey doing just that. Huge numbers of people were judged, given a label and dismissed.

Here’s an example “I work with medics. I know what they’re like. They’re only interested in one thing. Money.”

Here’s another “Everyone below the Mason-Dixon Line is an in-breeder”

Want more? No, I didn’t think you would.

So here’s a counter to all that. There is a beautiful piece of journalism in today’s Guardian about people with Down’s Syndrome. Read right down to the last paragraph – it’s the clincher! I meet people who says things like this every week. It never ceases to humble me.

And here’s another counter. Sugar Mouse in The Rain sent me a link to a video on youtube. (By the way, go see his blog. It’s lovely and he’s a lovely man) Here’s the video –

Thank you Sugar Mouse

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Dying for drugs

One of the doctors who trained me told me “If you send your patient to a man with a knife he’ll use it”. The advice was about referring to surgeons. He meant if I sent a patient to a surgeon it was highly likely that the patient would end up with some kind of operation, so I should ask myself if I thought that possibility was in the best interests of the patient. All operations carry risks after all.

It was much later when I realised that the same kind of advice applies to specialists who specialise in the prescription of drugs – physicians. Let’s face it, drugs carry risks too.

In the BMJ this week, we are reminded of just how dangerous they are –

The number of reported serious adverse events from drug treatment more than doubled in the United States from 1998 to 2005, rising from 34 966 to 89 842, says a new study.

Almost 90,000 serious bad reactions to drug treatments in the US alone in 2005!

Over the same period the number of deaths relating to drugs nearly tripled, from 5519 to 15 107, show data from the US Food and Drug Administration’s adverse event reporting system, which collects all reports of adverse events submitted voluntarily to the agency either directly or through drug manufacturers (Archives of Internal Medicine 2007;167:1752-9).

15,000 deaths related to prescribed drugs in one country in one year!

I work in Glasgow Homeopathic Hospital and I know that for some people homeopathy is a controversial method but in 250 years do you know how many people have died from the effects of a homeopathic drug? NONE. ZERO. NIL. Nope, not a single one. And yet, all the UK NHS Homeopathic Hospitals have shown that they typically make a difference for two thirds of the patients who attend their clinics – a difference the patients themselves rate as significant (ie changes that make a difference to daily life).

What happened to “first do no harm”? Now don’t get me wrong, there are some highly effective drugs which can, in certain cases, be life-saving. There are many people who live better and longer lives because of the drugs they take. But drugs are dangerous. They should be used with caution. And we should never rely solely on drugs. We need to pay attention to interventions which facilitate recovery from illness and which foster resilience. We need to find ways to reduce the lifetime load of chemicals patients with chronic illnesses end up taking.

Finally, we need to investigate and learn from every single death from medication. To die from a treatment is a tragedy.

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Have you come across gapingvoid? It’s the website of Hugh McLeod who draws business card sized cartoons. His top post of all time is this one on creativity. It’s long but it’s worth it! And some of the cartoons are hilarious.

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I enjoyed this.

 

You might too

 

 

 

 

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Here‘s more to enjoy. Brilliantly observed and very funny.

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