Day 955

GMC says

Saying sorry

A letter I wrote this morning to the world’s first medical defence organisation that is proud of its rich history of guiding, supporting and defending its members:

Dear Medical Defence Union,

Here, I speak more as the mother of a deceased child than as a Consultant Anaesthetist. When a patient comes to my hospital to have surgery, there is a legal contract between him/her and the hospital. As per that, the hospital is obliged to safely complete his/her operation.

When I see that patient on the morning of their surgery, I speak with them and gain their confidence. The trust they place in me when I look into their eyes and assure them safety is not legislated for. Trust is an empowering human sentiment essential to the patient, enabling them to come for their operation. Trust is the basis of any meaningful relationship.

2 days before my son died, his GP, Dr F assured us that he was on the right medications and would soon start showing signs of improvement. After my 20 year old son, Saagar Naresh’s death on the 16th of October 2014, I didn’t hear at all from our GP. Not a word of condolence or sympathy. Complete silence. At the Coroner’s court the GP said that he followed the advice given to him by the MDU, to not call me after my son’s death.

Considering he knew me for 10 years and I entrusted my child’s well-being in his hands, I think it would have been ‘basic decency’ for him to call or visit. Legally speaking, a 20 year old is not a child. But for me he is. Human relationships are way beyond ‘legal’.

In light of GMC’s Duty of Candour, please rethink your advice in the future. The practice of medicine is founded on humanity.
Please do not take it away.

Kind regards,
SM.

Day 954

Posted by kidsaregifts20

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Recovery Room is also known as POCU – Post Operative Care Unit. While most patients have a smooth emergence from anaesthesia, others may feel disorientated or confused. They might feel mild pain, nausea or experience other side effects of surgery and anaesthesia. The calm and caring presence of Recovery nurses helps them smooth over all these turbulences and come back to themselves before being sent to the ward.

K is one such nurse. Her sweet voice and soft Australian accent is unmissable. She smiles all the time. She listens and asks intelligent and relevant questions. She is full of kindness and clever ideas to get around problems. She respects other people’s priorities and time. She is an old soul.

Last Saturday, after work she went out to a pub with friends. She heard some troublesome noises on the street and went out to help. I can picture her excusing herself, ”I’ll just nip out and be back in a sec.” Little did she or her friends know that that would be her last act of kindness. She was killed in the incident near London Bridge that night.

How is it that some people can go out of their way to be vicious and others can show extraordinary kindness at a huge cost to themselves? We all belong to the same race. We all cry the same salty tears and bleed the same red blood. We all feel the same insane love for our kids and the same burning pangs of hunger. Ultimately we all want to be free, to be loved and understood for who we are. Why this deep divide?

Can I imagine K not offering to help? No. That is just the kind of person she was – true to herself till the very end. Bless you K. We love you and miss you. Recovery Room is not the same without you and this world is a better place because of you.

Love and blessings from London to all broken lives and hearts, everywhere.

Day 951

Posted by kidsaregifts20

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Who? The young.

1 in 6 people is an adolescent. More than 3000 adolescents die every day from largely preventable causes, according to a new report from WHO and partners. That amounts to 1.2 million deaths per year. Many key risk factors for future adult disease start or are consolidated in adolescence. Adolescent mental health and well-being are often overlooked.

In 2015, more than two-thirds of these deaths occurred in low- and middle-income countries in Africa and South-East Asia. Road traffic injuries, lower respiratory infections, and suicide are the biggest causes of death among adolescents.

Most of these deaths can be prevented with good health services, education and social support. But in many cases, adolescents who suffer from mental health disorders, substance use, or poor nutrition cannot obtain critical prevention and care services – either because the services do not exist, or because they do not know about them.

“Adolescents have been entirely absent from national health plans for decades,” says Dr Flavia Bustreo, Assistant Director-General, WHO. “Relatively small investments focused on adolescents now will not only result in healthy and empowered adults who thrive and contribute positively to their communities, but it will also result in healthier future generations, yielding enormous returns.”

Suicide and accidental death from self-harm were the third cause of adolescent mortality in 2015, resulting in an estimated 67 000 deaths. Self-harm largely occurs among older adolescents, and globally it is the second leading cause of death for older adolescent girls. It is the leading or second cause of adolescent death in Europe and South-East Asia.

“Improving the way health systems serve adolescents is just one part of improving their health,” says Dr Anthony Costello, Director, Child and Adolescent Health, WHO. “Parents, families, and communities are extremely important, as they have the greatest potential to positively influence adolescent behaviour and health.”

At long last, the world is waking up and so is the World Health Organisation.

Podcast:
In conversation with Meera S and Dr George at Business FM, Malaysia:

Doctor in the house: Adolescent Health

Day 950

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Let me not defer…

Rush hour in London is a perfect example of organised chaos. Buses, cycles, pedestrians, taxis and cars miss each other by millimetres and head purposefully towards their respective destinations. The sun shone generously this morning, throwing light on every minute detail.

He sat on the edge of a low shop window on York Road. I saw him on my way from the bus-stop to the hospital. He sat there holding his head in both his hands – the classic pose. He must have been in his mid-twenties. There was darkness in his eyes, a small blue travel bag by his right foot. Not sure if he spoke English. He didn’t look drunk. I walked past him. I wanted to stop and talk to him but I knew this could take time and I would get late for work. I kept walking. Hundred yards ahead, I turned around and looked. He was still there. Still in the same position. Something needed attention. I thought I would quickly go to work, see if I could be spared and come back asap.
I did exactly that. I came back after 40 minutes but he was gone.

What could I have done? There are so many people, each one with their own problems and stories. What difference can I make?

I can ask – Are you ok? Can I help you?
I can offer my phone if they want to make a call.
I can have a phone number handy – 0808 800 4444 (Shelter)
I can have the belief that there is something I can do.

Postponing a positive action is a sure way of missing the entire fleet.
I was unaware that every day 150 families in Britain become homeless.

Day 949

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Iatrogenic

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Antipsychiatry – I knew the sentiment but I didn’t know the word.
Dr Bonnie Burstow has helped hundreds of “highly suicidal patients,” as a psychotherapist. She’s come to believe that conventional psychiatric treatment isn’t in their best interests.

For half a century, scholars have been looking closely at Psychiatry as a coercive instrument of oppression. Dr Burstow is a prominent figure in the field of antipsychiatry, which she describes as “a movement of both psychiatric survivors and professionals saying that we need to abolish psychiatry”. She’s the author of “Psychiatry and the Business of Madness” and “The Myth of Mental Illness”.

“Longitudinal studies have shown that people who go off their drugs after a few years do better in the long run than people who stay on them. But guess who does the best of all? The people who were never on them in the first place. So, then the answer is, no one should be on them in the first place. These are not medical substances. They do not address a single chemical imbalance. They, in fact, cause imbalances and not surprisingly they cause all sorts of problems for people who can then never get off them because they now have a disordered brain that is caused by the medical profession. You know I spend a lot of time building up that and showing how it happened. But once you take in that position, it is a very convincing argument for abolition.

Since the 19^th century, psychiatry has been defrauding vulnerable people. There was dunking people in cold water. There was rotating people in chairs. There was also opium. There was bleeding. Remember we had bleeding for a long time. There was also genital mutilation, just don’t forget they thought madness was being caused by masturbation.”

The University of Toronto has recently started a scholarship in Antipsychiatry. It is a historical breakthrough and hopefully a precursor to a better society. It signals to the world that this field of inquiry has come of age.