You don't need masks guys; the turbulence in the air caused by fervent clapping disperses the viral particles in such a way that infection risk is massively reduced. And that is true even if the clapping only happens once a week and several kilometers away./s.
Aspirants to a career in frontline medicine- take note of how the government values you, your life and well-being.
DOI- I would be classed as "BAME"- a term I despise which is riddled with divisive identification, the same as all identification from choice of football team, sexual identity etc.
I note the slimy self-aggrandizement of Dr Zaman, who doffs his cap for the privilege of being a GP and the holiness of the Trinity of being clinician, educator and leader. We all are aware of the effect of scattered attention in place of focus which leads to sub-optimal multi-tasking, and produces just the kind of material for prominent roles in the RCGP which can justify to one self many good reasons why direct patient contact has to be limited "to achieve higher aims". The allusion to his mother whilst not devoid of truth presents a partial picture- racism abounded but like many who came to the UK to work in many spheres the recognition existed that prospects existed in the UK which did not at home, and on balance the racist bullshit they faced was a price they were wiling to pay at the time. There are also mentions in the article about the "right side of history"- notice how this is appealed to whilst conveniently overlooking how individuals also have a tendency to construct narratives which change with time.
Racism remains and is a function of identity, producing self (and "mine") vs other. Quotas are a "solution" which misses this reality of human cognitive function, and cynically I suspect many a large ego with a distaste for frontline clinical work (and quite possibly of questionable clinical ability) are able to cement a sense of "worthwhile self" by seeking positions in a defunct outfit such as the RCGP, not even truly earned but instead bestowed through others fearing the charge of racism if they do not accede to a quota system.
I love to carp and I offer no solutions other than do your job so damn well that it is apparent to all, and in spite of their seething dislike, even the racists are made to keep their beliefs to themselves.
"Well, if people insist on breathing let them accept the consequences". The esteemed members of the RCGP demonstrate their clinical acumen once more.
The wonders of EPS and the stacatto-chatter of "click, click, click". And this, in my experience, applies to many medications whose careless prescribing might not be as overtly egregious but still has implications.
Doctors, like the public, will get the best.
"Here's the details of a website. Next.".
The writer could have enlightened the ignorant GP by informing her that cannabis reached the West Indies in the 1850s by indentured servants moving from the Indian sub-continent taken there by..... their British masters.
I'm sure the author means well but, truly, a little part of me dies when confronted with a really troubled individual and I know that whatever I can offer is utterly inadequate despite the vacuous statement that those "most in need" are still able to access mental health services. Provision of this service was shamefully inadequate before covid-19 for those deemed "most in need" then; it would appear that the cream of this crop should only merit such consideration now.
My colleagues should be mindful of the shift of responsibility which is being alluded to above.
All composite phenomena are impermanent- said the Budda apparently. The body is such a phenomenon, composed of mostly empty space according to quantum physics, and not separate from the rest of existence, and hence destined to decompose and recirculate. Consider the fact that your toe-nail clippings may once have been part of a dinosaur, and your thoughts, memories and emotions have even less substance than your toe-nails.
In the grand scheme of things, this business of living is the exception, super-imposed on non-existence. If people really were conscious of this, including doctors, it would put this "noble vocation" of ours into a wholly different light. But hey, no need to think too hard, just take the wages and distract yourself even more with activities and possessions to obscure this unpalatable truth a little more.
(Damn you, Schopenhauer!).
I think the idea of "examination" should be widened to include a proper examining of the notes, medications, results and correspondence so the issues are identified. Particularly with older multi-morbidity patients there tend to be matters found which need some action/input and unless the issue of providing the necessary time to allow this analysis is considered, the remote and telephone consults will serve to entrench superficiality, poorer outcomes and an increased risk-burden for clinicians.
Intentions create a reality which evolves along with all else that changes perpetually. The evidence base which proves that perpetual hand-clapping fed directly into the ears of grieving orphans or those with PTSD has a curative effect is currently lacking, along with a psychiatric service infrastructure that could help .
The author should elaborate of what is meant by "focal neurology".
Also, blood tests can be useful in orange situations namely inflammatory markers re temporal arteritis and I would contend others in subtle personality change evolving less than acutely.Sodium and calcium spring to mind.
Also a strategic location without big size may also cause headache and CT can miss these much more readily than MR.
History and a comprehensive exam have an integral role to play in evaluating these patients, something that I hope doesn't get overlooked as the love affair with remote consulting seems to be coming to the fore.
Cluster headache is not related to PMR/GCA which are vasculitic. Steroids can be dramatically effective in CH but shouldn't be used long term. Don't forget a baseline ECG if you are going to start verapamil, and watch BP/pulse.
Re pituitary tumors- the visual field exam is your friend (remember the bi-temporal hemianopia? Focus on finding the field restricted more so in the upper halves). You would be hard-pressed to find a neurologist who would not arrange a brain MR despite a normal CNS exam and a good history for CH. This is in part due to hypothalamic lesions not always being readily detectable on exam; lesions here can cause CH and dysfunction here in part explains the periodicity of the symptoms.
Good to see Pulse addressing some "proper medicine"!!
I discussed this with NHSE and was told that from the spiritually enlightened perspective time is an illusion. I thanked them for the reminder.
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Interviewer-"But what about PPE?"
Matt Hancock-"Ah yes- I fondly recall my carefree days at Exeter College studying PPE. Wonderful curriculum".
Interviewer is rendered dumbstruck.
"Being remote? How difficult can it be- just follow my example and you will see its not hard. You can't get much more remote than I am from the reality of the NHS frontline". Attributed to Matt Hancock, allegedly.
Dr Gin, 3 Mar 20 @11.11am.
Read Ninjadocs past again. Its written in English and is not a Rorschach chart.
But they are our critical friends.
"Listen, you piece of sh~t, this hurts me more than it hurts you".
In the 14th paragraph, should it not say 14 hours as opposed to 14 days? ( Or are those lazy bast@~d GPs exaggerating their woes again?).
So much wisdom in the comments, and commendable openness from contributors who have direct experience of such matters.
I would imagine that any support the GMC would offer would be somewhat analogous to the reported procedures used in certain prisons in post-revolution Iran where dialysis was provided to prisoners who had sustained rhabdomyolysis during their interrogations. Just to ensure they were well enough for more of the same.
And the paradox of it all is that the governmental approach allows this "assisted decrepitude" to flourish but withdraws the right to assistance to actually end ones sorry life at the very last.