Thursday, September 21, 2006


My mate Pete has himself a new job as Director of Software Development for

I worry about Pete: he's living several thousand miles away and can't buy me beer anymore.

So I checked out the PayPerPost website at and they seem to be a very interesting company, just the sort of thing that will help Pete keep his mojo going.

It seems a very sensible way for people to do business, you sign up and get paid by companies who want to advertise on blogs by writing posts about the subject they ask of you.

As Pete says in his blog:
"...despite what some would have you think, blogs are not journalism. Blogs are personal, and PayPerPost's model is a very real financial enabler for a huge portion of the Blogosphere; the single-mom trying to raise a small family, the student trying to make ends meet, the video game junkie looking for a means to fund his ever growing game collection. In fact, if you're human and have a blog, PayPerPost probably has something you can write about for cold, hard cash."

So good luck Pete, and good luck PayPerPost. More power to you...

Tuesday, September 19, 2006

Waste in the NHS

I've come across two posts on blogs which I enjoy. I commend both to you if you are curious as to why people like me think New Labour are full of shit when it comes to public services, being more concerned with their historical legacy than actually providing good services.

The first is an example of how pointless some of the exercises which take place in the NHS really are, from the estimable Dr John Crippen at NHS Blog Doctor, and is basically "How to have a crap, a user manual".

I kid you not.

The second is from Shiny Happy Person at Trick-cycling for Beginners. SHP describes the waste that is rampant in the NHS using a specific example.

Well, I say specific. This sort of thing goes on all the time.

I shall refrain from mentioning what others think of the way the Government spends billions on while hospitals and PCTs struggle to make ends meet.

Up the Revolution (and here's looking forward to the next election)!

Monday, September 11, 2006

Its all back to front...

A busy Monday morning today, as you might expect.

One of my nurses gave a print out of an email a friend sent her which she thought might tickle me. I assume its one of those things that goes round the internet every so often like a cold, which everyone in the wolrd gets, only to see it again a few years later. This one was new to me.

She was right about it tickling me (actually I snorted a half-chewed plum all over my keyboard), so here it is for your delight and delectation:


"You should start out dead and get it out of the way.

That way, you wake up in a retirement home feeling gradually better every day.

You get kicked out eventually for being too healthy. You go and collect your pension, then when you start work after a decade or two you get given a gold watch on your first day.

You work for 40 years until you're young enough to enjoy your retirement.

You drink alcohol, smoke, party and are generally promiscuous and you get ready for school.

You eventually become a kid, you play, you have no responsibilities, you become a baby and then...

You spend the last 9 months of your life floating peacefully in luxurious, spa-like conditions: central heating, room service, larger living space every day.

And then, you finish off as an orgasm."



Monday, September 04, 2006

I like my job

Well, I've had a week off but today I'm back at work and running late already...

It seems the more things change the more things stay the same: same old faces, same old problems. A bit like a favorite old jumper.

My most recent patient (whom I shall call Daphne, as that is of course not her name) has been suffering from anxiety. Doesn't sound too major, does it?

Except that Daphne has had symptoms for years. It stops her going out, predominantly because she gets diarrhoea whenever she gets anxious. It makes her go home early for the same reason. She avoids doing things she used to enjoy just in case she gets diarrhoea while she's out. She suffers palpitations on a regular basis, which make her feel even more anxious in case there is something wrong with her heart. Her appetite could best be described as "variable", which becomes a problem when you realise that she hovers at a BMI of 19-20 (so any weight loss makes her underweight, although there are of course arguments about the validity of Body Mass Index as an appropriate measure of health in isolation). She smoked to help herself cope. She used to argue frequently with her husband and felt abandoned by her friends. She couldn't sleep because she kept mulling things over in her mind.

Three months ago, Daphne came to see me about her tummy problems. It had taken her a long time to summon up the courage to do that. After all, she said, I'm a very busy man. I don't need frauds like her taking up my time when there are people who are actually poorly who need me, rather than just people like her, "being stupid". She was sure that it was "just nerves". She asked why she couldn't just pull herself together. She asked me if there was anything I could give her and then followed that question immediately with a statement that there was nothing that could be done for her as she was just a pathetic waste of space. She didn't want a sedative or an antidepressant or anything like that, apparently.

I felt very sorry for her. Given she had said she didn't want anything which would actually help, I explained that she might like to reconsider, but that in the mean time we could try an antispasmodic.

She came back to see me about a month ago. The antispasmodic hadn't worked. She was now prepared to try something else.

Anxious people often have poor self-esteem. They sometimes don't come to see me when they should because of this. Which is a shame. Sometimes (as with Daphne) they come with something else, an excuse if you like.

Anxiety is usually very treatable. There are a variety of non-pharmacological therapies available, some with an evidence base, some without. However, in todays NHS, certainly where I work (at the moment, but there may be a post on this at a later date), the only readily available therapy involves pills on prescription from me.

Mind you, that isn't necessarily a bad thing.

Daphne, for example, left me after about 25 minutes with a prescription for a few diazepam and a month's supply of citalopram. I asked her to come back after a fortnight to see how she was getting on. When she came back, things weren't quite so bad, but she still couldn't go out for fear of an episode of diarrhoea. She was sleeping better though. Oh, and she'd stopped smoking.

She came back to see me this morning, after a further two weeks.

She tells me she hasn't felt so good in years. The diarrhoea has gone. She went into the local shopping centre early in the morning with her husband over the weekend for the first time in several years and apparently burst into tears because she was so relaxed. She feels normal again. Her husband says she is the calmest he's seen her in years, much more like the woman he married 40-odd years ago. She had a new hair-do. She is also wearing a new smile.

She's not there yet. But she is getting there.

I like my job.