UK Medical News Round Up

Circumcision:
I'm religious and am probably going to get any male children I have circumcised (would prefer waiting actually until they can decide themselves, but it seems like it's psychologically better for them to just have the same-looking genitalia for their whole lives). It's well known that the process reduces the rate of infection. However, let's not ignore the drastic complications that can occur. Having herpes, HIV, HPV or another sexually transmitted disease is one thing. Having mutilated genitalia from a botched-up procedure is another. There're well publicised cases on this with dramatic consequences with mental stability, gender and sexual identity. As with any other surgical operation, it depends on the experience and skill of the surgeon.

What can you do? Whoa, there, cowboy. Easy, now, and take into account the risks.

The Pope & Aids:
I have no idea why anyone would expect the Pope -- of all people -- to endorse condoms over reforming behaviour. This is a religious and moral figure; of course he has to endorse that and that's the way he thinks. If not, he wouldn't have ended up where he was. Also, I dislike most Parisians. They're fairly elitist. France is really making itself out to be very anti-religious, nevermind being just secular.

What can you do? Don't start a riot.

Increased suicide in children by three times:
This could be a bad thing or a good thing. Either more children want to kill themselves or more children feel they can talk about it to a helpline (assuming wanting to talk a helpline doesn't mean less children are getting support from sources other than the helpline). Number one reason for children wanting to kill themselves, clearly visible in the quotations in that article? Family, family, family: their parents' mental health problems, their marital problems and so on. That's not to say that is strictly true for each case (e.g. sexual abuse by non-relative). I wonder if relatively recent cuts in mental health budgets, the very recent recession or other factors have influenced this?

What can you do? Help the NSPCC.

Eczema:
More things strike the poor kids! I wonder if we simply have kids who're simply less fit thanks to advances in medical technology. This means that the more advanced the medical technology, the more alive sick kids who didn't die of something else earlier in their development. Could be a factor with some figures.

What can you do? Keep your and your kid's genes toxin free (smoking, drugs and alcohol: I mean you) as well as apparently subjecting kids to soap and bathing less.

More growth, more sweeties:
It makes sense to want more nutrition if you want to eat more.

What can you do? Don't misinterpret this piece of news. Obtaining nutrition through healthy foods is the better choice; it is not ok to allow a kid to stuff themselves with Mars Bars simply because you think they might be tall. Preventing obesity and the formation of unhealthy eating habits is more important, especially since it can lead to complications that give normal growth a hit.

Bone Marrow Transplant:
It's not all bad news! Successful bone marrow transplants for unrelated donors are life-saving.

What can you do about it? Absolutely free/all expenses paid -- join one of the bone marrow registeries, either in the UK or your own country. It should be no more painful than the process of giving blood and I know donors here are given general anaesthetic and sufficient painkillers if they have to undergo the less likely to occur method of direct bone marrow harvest. Blacks, mixeds & asians (i.e. non pure whites): they especially need you although everyone eligible signing up would be great due to the greater chances of a perfect match.

Early diagnosis of cancer:
I had to look at the video, just to see if a typical dude from Essex really came out with ' lethargic'. I didn't see him use that word but 'mate, you're an egg with eyeballs' was brilliant.

What can you do? Keep yourself fit, eat healthy, get yourself screened when you get called up to. Some diseases, though, you just can't avoid. Try not to panic, it can be as bad as the disease. throwing up at the idea of getting treatment that makes you throw up is ironic: you've achieved the same result without even anything given to you! Because you're in pain or can't do quite what you used to, it really doesn't mean you can't continue to enjoy life. Disease is a fact of living, and coping with it is something that -- to some extent -- everyone has to do.

Red Meat:
Is this really news?

What can you do: eat as much as recommended in the article (lean red meat, 30grams a day). More realistically, you can just cut your consumption of red meat (burgers, steaks) to once or twice per week.


Teenage pregnancy and sexual education:
You have to be careful with this. I'm all for giving kids the maximum information and I do mean the maximum information. Giving them figures and contraceptive methods is all well and good but you've also got to give them the figures of the psychological effects of using these methods if there are any (this particularly applies to issues such as abortion or coming from a family with a religious background. They're not going to stop feeling guilty just because they were sexually active for whatever reason). You've got to give a child social and psychological support for sexuality and monitor them for turning into a welfare-state-dependent-

stressed-out single mother.

Informing them that there is always a way out of pregnancy (or the consequences of STD; remembering that condoms do not completely eliminate risk), will only encourage promiscuity and perhaps misuse of contraception (well if it fails, there's always an abortion) as well as underestimating the psychological effects of having an abortion. You can't ignore that religiously, socially and by evolution, women were built for motherhood and acting against these instincts can have devastating effects on them.

Focusing on methods to discourage young sexual activity is the ideal. Pregnancy and abortion are risky particularly for very young women e.g. these sad cases of girls who died here in the UK.

What can you do? Not much, unless you're a parent or a teen. Keep discussion open so that they're comfortable talking to you in a toned down way about who they like or about sex or contraception, even if you might view their activity as inappropriate. Explore your family's differing views on your stances on contraceptive methods, abortion and sex. Doing this clinically, rather than personally, can help.

Just another doc:
Hopefully, all doctors would do what he'd done.

What can you do? Thanking your docs, nurses, health assistants and other team members -- while heartwarming and helps with job satisfaction -- isn't necessary. Showing your real appreciation for these masochistic professionals through your votes or protesting anti-healthcare professional policies/cases (e.g. victimising whistleblowers). That's where you really count.

Teenage drinking:
I'm fairly optimistic about a lot of things, but definitely not drinking. Binge drinking is too ingrained in British culture and these kids will find the money somewhere, somehow.

What can you do? No clue. Lots of silly ideas flying due to desperation of the situation. The problem with education is that people will think that they are responsible enough to do it, therefore drinking earlier. Stop encouraging teenage kids to drink heavily if you do so. If you're at university, minimise the act of drinking heavily as your idea of a fun night out: a play, the cinema, sports activities and other activities yield much more long-lasting pleasure accompanied of course with a modest glass of red wine if you're not teetotal. Dammit, people, use your brain cells instead of bidding them silent; you're a fun person and you don't need drink to have a damn good time.

Disclaimer: I'm a simple medical student, prone to mistakes. Obtain proper health advice from a fully qualified health professional whom you trust and who knows you & your history.

Pointless Arguments: She's Not Fat!

We had just left a birthday party. The last words my mother had given the girl as we were leaving had to do with her weight: I didn't hear the whole exchange but I at least heard a reference to 'pills'. My brother and I were upset with my mother about this; not the nicest thing to leave a birthday girl with!

Me: "She's not obese." Why was I saying this? I had seen the girl, she was quite badly off. Just because she still maintained something like the hourglass shape did not mean she was not clinically obese. Thinking about how overweight and obese practically looked like, my mother was probably right.

My mother: "Did you see her? She is!"

Me: "She's only overweight." Why was this point so important to me? Was I prejudiced in some way? Did I need to think of this girl as "only overweight" because I liked her? Because she was a nice girl from a lovely family, who couldn't possibly let this happen to their lovely girl? Has my training in medicine already caused such a terrible overreaction to anything I perceive as unhealthy? I had even begun to go as far as to consider obese children as neglect and bad parenting; was I unwilling to apply this harsh label?

Mother: "It's causing her liver problems!"

Me: "The one thing obesity does not cause or worsen is liver problems." I was not even 100% sure about this, but I said it anyway. I checked with my friends later: forgot about non-alcoholic fatty liver disease.

Ever since I've started my course, I seem to have developed an allergic reaction to smoking, drugs, alcohol and obesity to name a few things. I'm not sure how much of this is an overreaction, especially compounded on top of my Islamic beliefs.

I just don't want to turn into my mother in this scenario, overzealously dispatching advice 'as a friend' or in unsuitable situations. I don't want to see everyone as a disease or a potential disease, not a person. The last thing that girl wanted to be reminded of was her health problems, on her own birthday party!

From The Pan Into The Fire

Seeing as how I have recently dissed the Daily Mail, I shall illustrate the principle I was trying to expound. Like a skeptical reader of romance acknowledging that there can be brilliant romance novels, I will acknowlege that the Daily Mail can talk sense occasionally as seen in this article here.

No Daily Mail panic or hyperbole there! I don't think anyone's happy with this situation and I can't imagine the strain in America; the prevalence there seems comparable to here in the UK.

Medschool & "Sex Wars": A Collection

Lecturer A (male): "Women live longer than men... probablybecauseyouladiesdon'thavetodoanywork"

*protestations from the audience who heard him despite the fast guilty talking*

Lecturer A: "I know what you girls are thinking; you're thinking 'I can't believe he just said that.' *guy-caught-in-the-cookie-jar-unregretful-grin* My wife would kill me!"

~~~

Later in the lecture, Lecturer A says: "Married men live longer; it makes no difference to married women. Probablybecausethey're too busy chasing all those guys with abundant spermatogenesis I mentioned in the previous slides. God, this is turning into a misogynist lecture, isn't it?"

~~~

Lecturer B (male): "Believe me, those guys that work in [insert noble profession here] are really stupid. My ex worked for them and she's... *long pause* yeah, she's not very bright."

*everyone laughs*

Lecturer B: "The divorce was amicable."

~~~

Psychiatrist A(male): "Boys are a little bit slow in many things. Let's not get into it."

~~~

Psychiatrist A: "The peak age of bullying is around eight years old. That is when boys hang around [only] with boys. After seven years of age, boys become more scared of girls than girls are scared of them."

~~~

Psychiatrist A: "How we apply Freud's theories [...] is that the mother must let go of her boy and the father must claim him away from the mother so that he can choose to emulate his father at the expense of his mother's attention [..] They [Oedipean boys] form relationships with women that are more mother and a child rather than a man and woman."

~~~

Lecturer C (female): [on molar pregnancies] "Female DNA is necessary for human life. There have been cases of successful parthenogenesis; where female DNA only creates life. When sperm combines with another sperm, what you get is a cancerous mole. Only female DNA is necessary for human life."

~~~

I don't think this needs that much commentary! I'll leave that, and picking apart individual points, to you.

Diabetes: Excercise & Diet versus Pills

I've seen this bit of news and I'm honestly not that surprised. A GP with a lot of experience will know that lifestyle changes are something very unlikely to occur. If they do occur successfully, they have to take the form of a perscription.

Basically, it is unlikely for a human being to go off and do more exercise unless I as the GP -- after discussion with them -- tell them they have to go to the following so and so classes or see the practice's exercise/diet specialists (ah, the ideal multidisciplinary team, such a beautiful dream) and bring evidence of this, lose some weight and produce a satisfactory diet diary otherwise I won't put them on the drugs.

According to this, there seems to be agreement with the idea that there should be some sort of structure to the throwaway advice 'get more exercise' with an actual practical, individualised approach e.g. taking into account the back and knee problems people may have.

I suspect part of the grumbling may be due to diabetes patients getting their medication for free. Let's assume the Department of Health doesn't hold this as its primary concern.

Obesity's sending everyone into a panic. It's hard to differentiate the beneficial thing to do from being a nanny state but I know when the 'too far' line has been crossed and thank God, so do most GPs at the moment. Some blasphemous ideas have been circulating. It's not that I have a conflict of interest except for my intractable addiction to the little tastes of heaven that go by the mundane name of chocolates, of which it would be a crime surely not to have at least one a day.

Spiders on Drugs

This video is amusing, therefore I link it.



I'm going to pretend this is remotely medically related and say it's a concise introduction to the psychosocial aspects of drug abuse, as demonstrated by a spider experimental model.

Any animal rights activists out there: what say you?

Wrecked Rectum

This article about the purpose of the rectal exam is amazingly helpful; the inevitable jokes are of course excruciating. Seeing as how such intimate examinations are so critical, I'm wondering how well I'm going to cope with this. I've only been doing exams that involve exposure at the chest and abdomen; I've seen nothing yet.

I have not been focusing too much on that and I'm wondering how much my reservations about physical contact are keeping me back. Will I be the type of practitioner who will examine physically only if I think it's necessary rather than if it might be helpful?

One of my OSCE stations last year was a disaster: I was so distracted by the examiner's questions while I was examining that I pressed too hard and hurt the poor volunteer. This is the gravest sin when doing a physical examination: as a student, you are allowed not to know the correct answers but you are never allowed to cause discomfort to the patients. Even though not much clinical teaching is happening in this year of study, it is evident that I need to practise if I want to be competent later. Yet, I haven't been doing this, using lack of clinical teaching as a justification for my avoidance of "unnecessary" physical contact.

Have your personal reservations ever held you back in your chosen profession?