In any accident scene, rapid removal of the casualty to hospital improves their chances of survival. The term “Golden Hour” was first introduced in 1961 by R Adams Cowley, [1] but because of many misinterpretations as to what period this actually referred to, [2 3] a second concept, the “Platinum Ten Minutes” was proposed as […]
Azeem Majeed: Moving forwards with research on the “weekend effect”
Two articles published in The BMJ in 2015 on the “weekend effect” have sparked considerable debate in The BMJ and on social media. [1,2] A number of previous studies have reported that hospital mortality is higher for patients admitted at weekends than for patients admitted on other days of the week. [3,4] This higher mortality for […]
Robin Stott: In favour of constructive dissent
Constructive dissent is essential to arriving at the best possible solution to difficult problems. Jeremy Corbyn provided this useful service in the run-up to the debate on extending bombing into Syria. So I was outraged at David Cameron’s suggestion that those of us who support Corbyn’s views were a bunch of terrorist sympathisers. I wrote […]
Neville Goodman’s Metaphor Watch: Three weeks on the front line
This blog has so far picked a metaphor, or a theme for metaphors, and searched for them. There are many metaphors that are less overt. For the last blog of 2015, here are the metaphors from three weeks’ worth of editorials in print BMJs. There was a stronger role for preventive care in the NHS, […]
Aula Abbara et al: British air strikes may affect Syrian healthcare
The vote by the British parliament on 3 December for air strikes on Syria has consequences for the already catastrophic humanitarian and medical situation in Syria and surrounding countries. The four and a half year conflict has already led to considerable destruction of health infrastructure, hospitals, and clinics, and has resulted in the death of […]
Richard Lehman’s journal review—14 December 2015
NEJM 10 Dec 2015 Vol 373 Pacific treatments for scabies 2305 Wow. Here is the ultimate cluster randomised trial: an island randomised trial. First find your islands in the vastness of the Pacific Ocean. Make sure they are big enough for your power calculation, and that they have a similar prevalence of your target condition: […]
Richard Smith: Does it take a “bad” patient to make a good doctor?
Trying to define a good doctor is as elusive a task as trying to define a good life or a good death. Like good lives and deaths, good doctors will come in many forms, and I search for them constantly as I read. Most doctors in novels are “bad”—fools, crooks, sadists, and cold fish. But […]
Jonathan Glass: If surgeons lived Lewis Hamilton’s life
Many of the medical conferences I have attended recently have included sessions suggesting that the NHS is failing in its processes and that there is lots we can learn from industry. Most recently, I have been educated by the aviation industry, the energy industry, and the oil industry—as well as being shown what Formula 1 […]
Jeffrey Aronson: When I use a word . . . Fabian tactics
My pursuit of words that twist are repeatedly balked by a desire to comment on the way in which Jeremy Hunt continues to twist and turn over the junior hospital doctors’ contract. Did he really have a change of heart when, after first declining to do so, he belatedly agreed to negotiate, mediated by Acas, […]
Chapal Mehra: Is the world prepared to defeat tuberculosis?
On the eve of the World Lung Conference in Cape Town, many of us crowded into the auditorium at the convention centre to listen to Grania Brigden, MSF Access Campaign TB advisor, from Médecins Sans Frontières (MSF) as she presented highlights from the key findings of Out of Step—a report of a 24 country survey of […]