The fourth of Galen’s four fluid humours of the body, μέλαινα χολή, black bile, was associated, when in supposed excess, with a melancholic temperament, as defined in the OED: “Originally … sullen, unsociable, given to causeless anger, brooding (obs.). Later: liable to melancholy; depressed, gloomy, mournful”. The IndoEuropean root MEL described any dark colour, typically black. […]
Amar Mashru: Passports, smokescreens, and the vanishing NHS budget
Chris Wormald, senior civil servant at the Department of Health, has suggested that patients should prove their eligibility for NHS care by showing their passport to receive treatment. The proposal was presented as a solution to “health tourism,” a problem which may be responsible for around 0.5% of the total NHS spend. The cost of […]
Jamie Murdoch: Nurse or non-clinician in the delivery of telephone triage?
The question of who should triage patients over the phone is critical to delivering safe and effective care and has become a contentious issue for healthcare systems. Belgium is currently undergoing important changes in how it provides healthcare to patients in this respect. On 21 October 2016, Maggie De Block, the Belgian minister for health, […]
Trevor Plunkett: Dementia is not a disease
Recently I read in at least three daily newspapers that dementia is now the leading cause of death in the UK. It appears that such statements arise from figures supplied by the Office of National Statistics (ONS), which wrote, “Dementia and Alzheimer’s (sic) has replaced ischaemic heart disease as the leading cause of death in […]
Sara Hamilton: Pioneering open heart surgery
My brother died in 1964 at Guy’s Hospital. He was 15, I was 12. He had a congenital heart problem which I believe was a ventricular septal defect. He was under the care of Lord Brock, a leading British chest and heart surgeon and one of the pioneers of modern open heart surgery. He had […]
Desmond O’Neill: Technology and the medical humanities
One of the great challenges of progress in the medical humanities is that of time and space. Interested clinicians tend not to work in the arts blocks of universities, and humanities scholars rarely frequent clinical settings. The hard graft of interdisciplinary research is ever more elusive without the opportunity to mingle, discuss, and challenge. Our […]
Planning a network for randomised trials in global surgery
Surgery has been called the “neglected stepchild” of global health. Of the surgical research that is done, virtually none of it is relevant to patients and surgeons in resource limited settings. GlobalSurg is a collaborative of surgeons and methodologists who are developing pragmatic, patient facing research focused on low and middle income countries (LMICs). Since […]
Avril Danczak: When does risk factor management lead to harm?
“The operation was a success but the patient died.” This old jibe, usually aimed at surgeons taking a narrow technical view of the outcome, seems out of date now. There is rather less arrogance around in medicine—no one can feel they know it all in today’s complex world. However, perhaps the spirit of the accusation […]
Richard Smith: Working to make cholera a disease of the past
Until last year the Cholera Hospital in Dhaka, Bangladesh, could have a thousand admissions a day before and after the monsoon. On a calm day now it still has hundreds. Not all the patients, many of them children, have cholera but many do. Many of the children also have malnutrition, sometimes severe. In order to […]
The consequences of repealing and replacing Obamacare: A troublesome paradox
To the approval of millions of Americans, President-elect Donald J Trump campaigned on directing the US Congress to repeal the Affordable Care Act (ACA or Obamacare). As the dust settles from Mr Trump’s surprising victory on 8 November, the Republican Party finds itself with looming control of all three branches of the US federal government. […]