Past Posts...

The Rhett Butler Moment

Dr No has a close non-medical friend – a salesman - who is forever trying to sell Dr No the idea that medicine is really just like any other job. All that special pleading, all that vocation nonsense, is so much hot air, he says. Other jobs have just the same stresses and rewards. Medics have no ‘special case’.

Dr No begs to differ. Dr No suspects that most doctors have an affair with medicine, and that that adds an intensity to the relationship that most jobs lack. He is not convinced that those who sell stationery for a living – as his friend does – have affairs with selling, let alone selling stationery. If they do, then there must be an eroticism to ring binders that has quite passed Dr No by.

Going for a Barton

Language, they tell us on Radio 4’s ‘I’m Sorry I Haven’t a Clue’ is constantly evolving. If Clue should ever find itself down Gosport-way, it would find that ‘Going for a Burton’ - the WW2 euphemism for taking a shufti – has evolved into ‘Going for a Barton’ – meaning admission to the town’s War Memorial Hospital, and subsequent death while under the care of the visiting Diamorphine Queen, Dr Jane Barton.

The ongoing story of the Diamorphine Queen has been well covered by Rita Pal and others, including affected relatives. At its heart, it is one of a unfettered doctor initiating a zealous programme of ‘anticipatory prescribing’ of opiates and other powerful sedatives to patients, whether they needed the drugs or not. The disinhibitory effect of this cavalier prescribing led inexorably to unnecessary deaths. No one knows for certain how many, but the figure runs to tens of not hundreds of affected patients.

Snake Oil

Yet another study has been published showing that prescription antidepressants are no better than snake oil - that is to say, placebo, or sugar-pill - for treating mild to moderate depression. Yet in 2008 - the latest year that figures are available for - UK doctors doled out a staggering 36 million prescriptions for antidepressants to patients - almost enough for one prescription for every adult.

How can this be? To answer this question, we have to go a bit further than the usual – and highly important – profit motive of Big Pharma. We have to ask the question: why is it so easy for Big Parma to shift 36 million prescriptions a year? The answer lies in the history and nature of General Practice - which is of course where the vast majority of these prescriptions are issued.

The Tory Party at Work

Just as the Church of England is the Tory party at prayer, so is the Medical Profession the Tory party at work. Doctors, for all sorts of reasons, are natural conservatives.

But they tend – they are doctors after all – to be a particular type of conservative. They tend to be ‘One Nation’ conservatives. And that allows them to be both conservative, and, at the same time, as most doctors do, value the principles, if not the day to day practicalities, of the NHS, and all that it stands for.

Medical Armageddon

There are those who say that the Isle of Wight is one big Departure Lounge in the sea, an Island of Biddies and Gilberts waiting for their Final Flight. As it happens, Dr No knows the Island well. It certainly has more than its fair share of Departure Lounges, but it is also a very beautiful Island. Dr No has spent many a happy day savouring its special blend of peace and tranquillity.

Some time ago, Rita Pal, fancying herself a cushy number, took up a medical SHO post at the Island’s main hospital. Needless to say, all those Biddies and Gilberts meant not less but more medical work. She uses the occasion to remind us that not all GPs are paragons of virtue. Some are dreadful. She tells a gruesome tale of not four but five Horsemen of the Apocalypse, masquerading as GPs, who helped one Island Gilbert on his way.


The ever-interesting Witch Doctor has made a welcome return to the blogosphere. It seems that while she was away in the witchosphere, she spent time contemplating one of her persistent themes – that of creep. The Witch Doctor, she says, believes in creep. So does Dr No. But, it appears, not everyone is familiar with the term as the Witch Doctor and Dr No use it. A little while ago, one of Dr No’s confidants – a well read and intelligent woman - was reading a post and remarked on what she read as a grammatical error. Dr No had missed out a subject to the verb creep. She had not before come across the word creep used as a noun to describe a social process. Dr No wonders if there may be others unfamiliar with this usage.

The Cart and the Horse

Sir Liar ‘Tombstone’ Swansong, ex-CMO-elect, has let it be known that he intends to use his retirement to persuade government to impose a binding minimum price for alcohol, in the hope of curbing alcohol related harm. A figure of 50p per unit sold has been suggested – which would raise the minimum price for a bottle of 12% ABV wine to £4.50, up some 50% on today’s minimum prices.

The Year of Living Dangerously

There is a curse, some say of ancient Chinese origin, which runs: ‘May you live in interesting times’. It seems the interesting times are already upon us. There is mayhem and mischief abroad. A long chill shadow has settled on our profession; and in the gloom that lies beyond, unsettling forces are at work. We shall face, in the months ahead, renewed and ferocious attacks, and on the outcome the future of our profession will depend. We are about to enter the year of living dangerously.

Good Nooze

It is a truism of the festive season that, as the party lights come out, so to do the Temperance Brigade. Last week we had two pronouncements: one from Sir Liar, advising no booze for under fifteen year olds, and another from Alcohol Concern, telling us we grossly underestimate our consumption when answering drink surveys. What Alcohol Concern didn’t say – probably because they hadn’t realised it – is that the study data behind their pronouncements show that the current safe drinking limits of 21 units/week for men and 14 for women – already known to be arbitrary – are also misleadingly low.

Totto Blotto

The planet may be heading for Gas Mark 10 – and the country half buried under snow – but that is not the only science anomaly in the news.

Yesterday, we had Pants telling us that not a drop of the demon drink should pass the lips of children. Where once we had Gin Lane, we now have middle class parents weaning tiny tots into blotto tots. Pants even managed to tot up some figures of his own: half a million of England’s 11-15 years olds had been drunk in the last four weeks, he wailed, before switching to Full Temperance Mode: childhood was being robbed of its ‘clear-eyed innocence’, only to be replaced with the ‘befuddled futility’ of ‘dirt cheap alcohol’.

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