Saturday, 27 June 2009
I recall at medical school the caution from using 'always and never' so would not want to raise a concern about all patients bearing lists, but there are some days when Osler's words ring true.
Just yesterday I saw three patients with long lists all of whom are somewhat introspective and 'incurable' in the sense of bearing symptoms which are predominantly medically unexplained. I'm not sure that using the word neurotic is all that helpful since it carries such perjorative baggage (Indeed the American Diagnostic and Statistical Manual of Mental Disorders (DSM) has eliminated the category of Neurosis, reflecting the dawning recognition of psychoanalysis' status as art rather than science, and a decision by the editors to provide descriptions of behavior as opposed to hidden psychological mechanisms as diagnostic criteria).
Nonetheless what can we say about lists? I have to confess that I encourage my patients to take lists with them when they are facing a consultation with a speclialist, especially for the first time. So I wouldn't want to type cast. But still 'un morceau de papier' remains just one of many cues which experienced doctors use to form an assessment of a patient-just so long as it doesn't so prejudice and obsure the multpile other cues presented to them during any consultaion.
Wednesday, 24 June 2009
Monday, 22 June 2009
AC Grayling writes in the Times...But real hope is the sustainer of all that is possible and good, and it is creative. Antoine de Saint-Exupéry demonstrates this in his advice about getting people to build a ship: “Do not cajole them to cut down trees, saw them into planks and nail them together,” he said, but rather “teach them to long for the immensity of the sea.” Every teacher should have this remark pinned up somewhere.
Being a Christian isn't just believing certain basic facts- 'Jesus died for my sins' but loving and living for a great God who gave up his immensity to win us back to his rightful rule.
Isaiah 40 v23 onwards is great
To whom then will you compare me,
that I should be like him? says the Holy One.
Lift up your eyes on high and see:
who created these?
He who brings out their host by number,
calling them all by name,
by the greatness of his might,
and because he is strong in power
not one is missing.
Sunday, 21 June 2009
we joyously come together to worship,
realizing we need not summon you into our midst,
for you are here.
We need not call you into the secret places of our hearts,
for you are there.
We need our eyes of faith to be opened,
that we may see you;
our ears to be unstopped,
that we may hear you;
our minds to be sensitive,
that we may know you;
our hearts to be tender,
that we may receive you.
Grant each one a blessing, O Lord,
as each has need,
in the name of Jesus Christ, our Lord. Amen.
Thursday, 18 June 2009
Sunday, 14 June 2009
Thursday, 11 June 2009
Wednesday, 10 June 2009
No, not that side! But thank God got through surgery ok yesterday. And thanks to all for love support and prayer.
So my wee book, The Art of General Practice on soft skills for GPs is finally published today. The publishers bumpf on the back is mostly ...
Blimey am I that old? So 13th April 1978 I finally qualified as a doctor. It had been a long journey. My first inkling of wanting to be ...
Like much else in life, sleep is something we take for granted until we no longer have it. As a GP I've become increasingly convinced ...