Sunday, 6 December 2009


As far as I am aware it is impossible to work in healthcare without eventually becoming a cynic. Here are a few of our more regular experiences.

Drunks who have fallen into the gutter and as a result are covered in minor abrasions and have suffered a possible head trauma. Observe them for four hours, take blood, hook up to a big bag of sober-up-juice(saline) take GCS every half hour, listen to them explain how they only had one pint.

Women who have been beaten(and occasionally raped) by their spouses, several broken ribs, lacerations to the face and possible skull and limb fractures. X-Rays to all effected areas, GCS every half hour, ECG to rule out cardiac damage as a result of thorasic trauma, listening to them explain how they either fell down some stairs or how their spouse is a good man and wouldnt have done it if they hadnt set him off.

Parents who when faced with a child suffering a high temperature, vomiting and diaorrhea decide that they dont need a doctor, they need homeopathic herbs and spices. By the time the child reaches us they are massively dehydrated with a blood pressure so low it can barely push blood around their body and a pulse so fast that the chambers of the heart barely have time to fill. Listening to them explaining how medicines are poisons and pollute the body and soul*.

Parents who are themselves vegans or vegetarians and are forcing such a diet on their infants, as a result the infant is now in the lowest survivable body mass index and will probably suffer permanent damage to all their bodily systems.

As a result of this I think its understandable that I have become a little more pragmatic and cynical. I still treat every patient with respect and ensure whatever dignity they have left is maintained. I perform tests both based on what they tell me and what I suspect to be the truth knowing that the day I refuse to believe a patient is the day I am wrong. It also appears that I can be a cynic and an optomist.

*The comedian Tim Minchin has an eternal place in my memory for this line - "Alternative medicine is either not proved to work or proved not to work, do you know what they call alternative medicine that is proved to work..............medicine".