Saturday, 24 September 2011

Spiritual spectacles

Anglican John Newton shared a delightful correspondence with neighbouring baptist minister Thomas Bull.  Newton was warm spirited towards other Christians despite denominational differences;
'You will find Mr Crawford a man to your tooth, but he is in Mr Wesley's connexion. So I remember venerable Bede, after giving a high character of some contemporary, kicks his full pail of milk down, and reduces him almost to nothing by adding, in the close, to this purpose, "But, unhappy man, he did not keep Easter our way." A fig for all connexions say I, and say you, but that which is formed by the bands and ligaments the Apostle speaks of in Ephesians 4.16.
Therefore, I venture to repeat it, that Mr Crawford though he often sees and hears Mr Wesley, and I believe loves him well, is a good man, and you will see the invisible mark upon his forehead if you examine him with your spiritual spectacles' 

7th July 1778 Olney


Tuesday, 20 September 2011

Watch a talk on 'The Praying Life'

Helping Your People Discover the Praying Life

A very helpful talk by the author of The Praying Life-one of my favourite books. Simple, profound, honest and powerful. Paul Miller is a self-effacing character with a disarming manner. Really worth watching.


"My face leaks when I eat"


My patient seconds after munching a cheese
sandwich -note the glistening 'sweat'!
(patient consent given for photo)

I've mentioned patient's opening lines before, and this morning's offering was one of the more interesting ones.

Her complaint was that, within seconds of eating,  the sideburn area of the right side of her face  became wet and indeed would drip down the side of her neck.

It transpired that in 1984 she had had a benign growth removed from her right parotid gland. The small scar on her face confirmed that. The previous surgery was the clue to what was going on.

During the healing process after the surgery the nerve supply to the remnant of the parotid gland her re-grown and was now innervating her sweat glands. When I discussed the problem with a local ENT consultant he told me that the problem was previously more common. Surgeons are now aware that this can happen and are careful to insert a layer of fascia between the parotid remnant and the skin to prevent the re-growth of the auriculo-temporal branch of the trigeminal nerve from reaching the sweat glands. The nerves that had once fired off to produce saliva were now stimulating the inappropriate production of sweat!

Apparently it's called Frey's syndrome name after Lucja Frey a Polish female neurologist who sadly died during the Holocaust. It results in gustatory sweating such that even the anticipation of food can produce the 'sweaty face'.

And what to do about it? Well either a powerful deoderant (my patient wasn't keen on that) or Botox injection. Apparently just one of two may lead to long term benefit. Still I have to confirm with my PCT whether the good old NHS will fund it. I would say she deserves it. Who wants to drip sweat on their steak?

As I've said before, it's boring being a GP!


Saturday, 17 September 2011

Christianity Explored

Great looking new web site from Christianity Explored. If you're not sure what you think about Christianity-take a look www.Christianityexplored.org

"The Christian ideal has not been tried and found wanting; it has been found difficult and left untried." G.K Chesterton



Friday, 16 September 2011

The garden of Eden...in Bedford

Just finished reading Octavia, Daughter of God:The story of a female Messiah and her followers. It tells the story of clergyman's wife Mabel Barltrop, who in the early years of the 20th century came to believe that she was to be  the world's saviour, since in her eyes Jesus had not done enough in dying on the cross because sin and suffering still prevailed.

The book is a fascinating piece of social and religious history which has been of particular interest to me since most of the activity of the book is centred on Bedford, the town where I grew up and still live. Living in and around Albany Road, a pleasant residential area of Bedford near the embankment, Mabel's followers gathered and gradually bought up several large properties throughout the 1920s. They created a garden between some of the properties that they really believed would be the renewed Garden of Eden.

Their beliefs were a very strange mix of Christian (especially of the Anglican variety since all the followers remained members of the Church of England) orthodoxy (eg belief in the physical return of Jesus Christ) and extremely unorthodox beliefs such as God being a foursome (as opposed to a trinity), with Mabel making up the four! Indeed Mabel was remaned Octavia because her followers believed she was the '8th prophet' (don't ask me who the other seven were-except Helen Shepstone who was the 7th-'a South African spiritualist who believed that she received frequent messages about the Second Coming of Christ from St Andrew and spirit guides'!!)

It's a salutary tale of misguided religiosity with an especially sad end to Ocatvia who died in 1934 aged 66 years from complications of diabetes.  And since 'the whole raison d'etre of the Society is to get together those who will not die-those who are predestined to live'-her death was problematic. Indeed her followers gathered in her bedroom waiting for a resurrection  after she died, only conceding the inevitable when post mortem changes were becoming unpleasant after 4 days.

For a Christian like me it's a reminder that there is nothing inadequate about Jesus Christ and what he accomplished, but also how personal opinion and impressions from God have to be tested against the specific teaching and broad sweep of the Bible and also in consultation with other believers committed to the sufficiency of Scripture. I think one would have to say the the Panaceans were simply odd and I don't believe that followers of Jesus today should be known as such, on the contrary the apostle Paul exhorts Titus to 'make the teaching about God attractive in every way'. Attractive and challenging but not weird.

Dementia and divorce

Big debate in US over comments made about the legitimacy of divorcing a spouse with dementia on one of the blogs I follow. There are significant criticsms from those who feel that the Christian gospel is compromised by such a concession. Although I agree with the criticism I felt that one aspect had been forgotten. To see the article and follow the comments go to Justin Taylor.

My comments to the blog (and I guess you need context for them to make sense!!)
Yes I agree that Pat Robertson’s judgement in the matter of divorcing a spouse with dementia is profoundly biblically wrong, but…..please be cautious in your attitude towards those who may be exhausted emotionally, physically and spirtually by caring for (or giving up to other’s care) a severely affected spouse.


I have worked as a family doctor for 30 years and have seen the overwhelming sadness and anguish that such a situation brings. Yes, correct false teaching but remember to be ‘kind to one-another, tenderhearted and forgiving…remembering that we do not have a High Priest who cannot be touched with the feelings of our infirmities’

Tuesday, 13 September 2011

Rugby and Rembrandt

Part of the enjoyment of watching rugby on the tv is to listen to insightful commentary from the likes of Brian Moore. Alas ITV has gone for Phil Vikery for the World Cup matches. He's truly useless. I'm glad that a Telegraph writer feels the same,
'Now. Vickery, it scarcely needs to be said, was not selected as one of ITV’s expert rugby analysts on the basis of his devastating acuity. He’s a World Cup winner, a national hero and hugely experienced. And as he showed during England v Argentina on Saturday morning, he tells it like he sees it: Nick Mullins: “What’s going on in that scrum?”
                    Vickery: “I don’t know.”

                    If the art of commentary is silence, Vickery is its Rembrandt.

"Are you any good with things you don't understand?"

Such was today's greeting from one of my cheerful patients.

As a GP I inhabit a world of many medically unexplained phenomena. The textbooks next to my desk just don't seem to explain the unique individual sitting in front of me whose constellation of symptoms is ill-fitting for any known syndrome. Gone are the days of simply sending the patient away with 'it's all in the mind' ringing in their ears.

The fact remains that there is just so much we do not know and understand. Indeed rather counter-intuitively I remember being taught that there is an inverse relationship between the size of a medical text book and valuable knowledge of the condition written about. In other words the bigger the book the less we know!

'Medically unexplained' at least has some humility about it. Frustrating I know but at least neutral in its assessment.

That isn't to say that there's nothing I can offer. General principles are always worth considering. Try to get more and better sleep, look at your work-life balance, try to exercise regularly, eat healthily, lose weight, cultivate friendships, do random acts f kindness and be generous-none of these are likely to make the condition worse.

And what about Christian faith? The current onslaught against Christianity by Dawkins et al implies a kind of omniscience of the new atheists which I prefer to reserve for the creator God.

Sunday, 11 September 2011

Oh no, Doc Martin's back

I read in the Radio Times that Doc Martin is back on our screens next week. The all knowing, medical encyclopaedia who is now a GP in coastal Cornwall, has somewhat fallen from the heights of being an  'eminent' surgeon in London (pity those surgeons in London who are not eminent).

It's hopelessly inaccurate although quite fun to watch. General surgeons are certainly knowledgeable in their chosen field, but are completely out of their depth when dealing with general medical problems.  Having said that,  GPs are frequently criticised for not knowing enough about various conditions.

I noticed on the Migraine Action website their concern that doctors have so little training in migraine. In fact their comment was misleading. To speak of how much time is spent as an undergraduate learning about certain illnesses is quite irrelevant to a qualified doctor's subsequent management of that same condition. In training to be a GP it is at least 2 years after qualifying before one even begins to make management decisions, and even then the decisions are closely monitored by senior collegeues for a further 3 years.

I meet a fair number of GPs each year in my role as an appraiser and the vast majority are conscientious and give considerable time to ongoing professional development and learning. It's disheartening to read so frequently that GPs need more training in migraine, depression, Crohn's disease, Aspergers, asthma, diabetes, meningitis, prescribing, commissioning, lupus (thanks to House!!)...Of course we need good knowledge of all these and much more, but consultant colleagues are there for the simple historic reason of being consulted! When I'm not sure I want quick access to a specialist colleague. It's a great shame that in so many areas of medicine expert colleagues are becoming harder to reach-not necessarily through fault of their own, but through the ungainly 'choose and book' with the resulting break down of long established relationships between consultant and GP. In some specialities such as psychiatry it's virtually impossible for a GP in my area to get a consultant opinion.

I must find out where Doc Martin trained.

Tuesday, 6 September 2011

Big society and Christians

Tom Wright the former Bishop of Durham had an interesting short piece in The Spectator recently. It's excellent stuff on what contribution Christians  (in the context of the article predominantly Anglicans) make to the 'Big Society'
Saying that Jesus is now in charge, still more that the church is the agent of this project, has been rubbished for generations. The litany is familiar, though interestingly limited and repetitive: crusades, the Inquisition, witch-burning and so on. No church worth its salt will deny that it has made huge mistakes. We still say ‘forgive us our trespasses’ every day, only wishing that others would join us in this penitence. But the reason the anti-Christian brigade point out the Church’s failures is that, just as in Marxist totalitarianism the state replaces God, making it atheist de jure and not simply de facto, so in secular democracy the state attempts to replace the Church. That is why the Church is pushed to the margins, told to mind its own spiritual business and not to get involved in international debt or the treatment of asylum-seekers. As we survey the result — crooked politicians, bent coppers, bloated bankers, spying journalists — it may be time for the church to be more humbly confident in getting on with its proper vocation, leading the way in the true Big Society, bringing healing and hope at every level.


Read the rest here

Thank you for the cross Lord

Thank You for the cross Lord
Thank You for the price You paid
Bearing all my sin and shame
In love You came
And gave amazing grace

Thank You for this love Lord
Thank You for the nail-pierced hands
Washed me in Your cleansing flow
Now all I know
Your forgiveness and embrace
Worthy is the Lamb
Seated on the throne
Crown You now with many crowns
You reign victorious
High and lifted up
Jesus Son of God
The treasure of heaven crucified
Worthy is the Lamb
Worthy is the Lamb

Saturday, 3 September 2011

Nigglements

I learn so much from patients. Just yesterday I was greeted by a cheerful bus driver patient who wanted to discuss his various 'nigglements'. It struck me immediately as a wonderfully appropriate word for a combination of niggles (ie symptoms which are a nuisance and may well not indicate serious disease), and ailments, which are conditions probably previously diagnosed and 'simply' need managing.

Some GPs may want to take a hard line on the 'one problem only per consultation'. I really don't find that necessary nor helpful. Indeed it can be very difficult for patients to disentangle their nigglements and that's one of the reasons I'm there as a general practitioner. OK at times a further consultation may well be a good idea, but first do the disentangling.



Friday, 2 September 2011

My grief observed

Just over 50 years ago C S Lewis wrote the little masterpiece A grief observed in which he grappled with his own emotions and faith in reaction to the loss of his wife Joy Gresham. He fiercely expresses his doubts about God,  and it does contain unsettling language for a Christian believer. But doubts expressed are not resented by God but neither are they left to dominate us.

In a small aside from a recent sermon on Genesis 15 by Tim Keller preaching about God's promise to Abraham to provide him with multiple progeny, Tim says,
'Churches in which it's unsafe to doubt create skeptics...because if you're unable to be open about your doubts you get no answers. On the other hand living in New York city, secular sophisticated culture assumes that anybody who has any kind of certainties about faith at all is a naive rube. Its considered to be sophisticated to be doubtful any everything, who knows anything. So you have modern culture which makes doubt a virtue and some church cultures which make doubt a no-no and then you have.......God and the Bible...gentle with those who doubt, but never accepting that that's a place that you can live forever'


Mum at her Easter table just 3 weeks before she died
I mention these things because today is exactly three months since my dear mother passed away. Mum was a Christian believer and was 84 years of age, and died lovingly cared for in a hospice, so in many ways I haven't experienced the anger and desperation of Lewis, but rather uncalled for sudden moments of sadness and of  emptiness and of a wishing mum was there to tell some fairly ordinary piece of information to. I reflect upon her committed love for her family and so many others and of course I wish I had done more for her. Helping my sister clear mum's lovely warm home has been one of the saddest activities of my life, but how touched I have been to find evidences of my thoughtfulness everywhere.

O death where is thy sting?



ps I had to look up 'rube' too-a country bumpkin!!



A light touch

Just pebbles Its great to be back in the Hebrides. Although lots of rain is forecast this week, yesterday was a pleasant surprise. So we...