“I ain’t turning no machine off” said Kelly, as if she was a teenager talking about shutting down her Playstation. In fact, she was a mother talking about turning off the life support for her very premature baby.
And so it was that last night’s BBC2 documentary 23 Week Babies: the Price of Life exposed one of the central dilemmas at the heart of the medical and ethical minefield that is whether to resuscitate very premature babies. Kelly was clearly up for not turning no machines off. Whether she was up for understanding, let alone navigating, the medico-moral minefield was another matter altogether. She hadn’t even in fact been asked to turn no machine off, only what her views were on aggressive resuscitation should her baby take a turn for the worst. The program’s presenter, Adam Wishart – a thoughtful cove whose brief onscreen appearances featured averted eyes, even if the eyes of his cameras probed mercilessly – asked: is it right to place such a burden of responsibility on the parents?
Following some excellent posts by the medical blogosphere’s resident 
“In a shock U-turn yesterday, Sports Minister Mr Andrew Lansley removed all references to bare-fist fighting in the ‘free-fights-for-all’ Boxing Bill currently before Parliament. Earlier drafts of the Bill had allowed ‘any willing contestant’ to fight ‘with or without gloves’. Critics of the Bill, including the British Medical Association, had pointed out that the wording ‘or without gloves’ provided an opportunity for contestants to fight bare-fisted if they so wished, a practice known to increase serious injury and fatalities.
It is said British general practice is a broad church, and indeed it is. No branch of medicine collects under its wing such a panoply of talent and motivation. While most GPs sit somewhere near the centre, the tails of the bell shaped curve contain a diverse collection of crackpots, duds and no-hopers at one end; and at the other a rare collection of the exceptional – the exceptionally talented, the exceptionally compassionate – and the exceptionally greedy. 
This is my last Chair as Postman of Council, and I write it with great joy. The last three years have been the most wonderful time; it’s been a great privilege to travel the length and breadth of the UK telling the great unwashed 
RNLI crews, expert mariners that they are, often have to deal with casualties. The Institution has recently attempted to simplify first aid for crews by introducing ‘Big sick/Little sick’, an approach which reduces initial assessment of a casualty to simple question. It is a clever approach, and Dr No has decided to apply it to a question that has been ruffling him lately: whether Scot Junior was entirely innocent in his fate? He did, after all, build an impressive log cabin, and dumped it where it could be read. Might he in some more significant way have been the architect not just of his cabin, but of his own fate? In the battle between Needham and Scot Junior, who of the two is the bigger Richard? Who, when we get to the bottom line, is the ten bob note, and who the two bob bit?
Dr No doesn’t really do duty of care. Instead, he just cares. When he sees a patient, he does what he does simply because he cares for his patient, just as he always has, and always will. He suspects – but isn’t over-bothered, perhaps even doesn’t care – that what he does in fact more than satisfies any duty of care baloney, which in the real world he steers clear of, finding it to be tedious, tiresome, distracting, legalistic, defensive, job-serving, and all about doing the minimum to cover one’s back, rather than aiming to go the extra mile and do the best for one’s patient. In all this, Dr No is no doubt frightfully old-fashioned, maybe even old-fashioned enough to trigger the crackle of snapped pencils in the legal offices of his professional indemnity society. But Dr No remains resolute. True care is always better than duty of care; for the former is human and comes from the heart, the latter formulaic, and from the law.
Pandora Needham, Postgraduate Medical Dean (North Region), has recently opened her box and set loose a fury of furies. A number of medical bloggers and other commentators, wide-mouths, forum sharks, hucksters, ne’er-do-wells and other assorted busybodies, including Dr No, have asked the obvious question: why open the box at all, and why now? Had the box remained shut, the 
Once upon a time, in a hospital far away, a frustrated junior doctor suddenly found himself in very hot water. Dr Scot Jnr – as he became known – had expressed himself vigorously – exceedingly vigorously – on a doctors-only forum. He had even dared to call the great and the good in his profession Richards. Even before anyone had time to cry ‘Foul!’, let alone Code Brown, red lights were flashing in Deaneries up and down the land. Deans – senior doctors responsible for junior doctors training – got on their hot-lines, and then their high horses, and before anyone could say appendicectomy – Scot Jnr was said to be a surgeon – he had been suspended.
It is a wonder they haven’t called in Mary Portas, Raptor of Retail, to fix the NHS. Nice Gerry tried a while ago, but tea and biscuits, even Nice Gerry’s 24/7 tea and biscuits, failed to hit the fan when it came to fixing the NHS. Nice Gerry’s biscuits did what biscuits do when faced with a sea of NHS tea. They got dunked – and disintegrated.