Archive for August, 2012

From Behind the ‘Paywall’ of The Times:

August 27, 2012

(I’ll remove it if anyone objects.)

Theodore Dalrymple shows us that there is much scope for sadism in the role of prison doctor and how he himself derived much pleasure from this aspect of his role. I suspect that it was almost as much fun as having patients “injected in the buttock” in his primary role as a consultant psychiatrist at an inner-city general hospital in Birmingham. Note that he and the sycophants who surround him have stopped calling it a slum.

Weak doctors leave prisoners hooked on prescription drugs

Theodore Dalrymple: Former Prison Doctor.

The Chief Inspector of Prisons has reported that abuse of prescription drugs in prisons has increased to an alarming extent. I am surprised only that it took him this long to discover it.

By the time I left the prison service after 15 years, I had formulated a rough-and-ready rule: if a prisoner was willing to take medicine, he didn’t need it; and if he wasn’t willing to take it, he did. There were exceptions, of course; but every prison doctor must remember that medication, especially if it has a psychological effect, is coin of the realm in prison. A pill may change hands many times before it is actually taken.

There are several reasons for over-prescription of drugs in prison. Many prisoners arrive already on prescription drugs they don’t need. A high percentage of doctors have been assaulted or threatened by patients in the past 12 months, an even higher percentage in the areas from which most prisoners are likely to come, so doctors are inclined to prescribe potentially aggressive patients what they demand rather than what they need, which in most cases is nothing.

Doctors in prisons feel obliged to continue these prescriptions, partly because doctors do not like to stop other doctors’ prescriptions without deeper knowledge of the patient, and partly because it is easier. To stop a prescription is to court an unpleasant scene, in which the prisoner will accuse the doctor of negligence or worse, threaten to complain, shout and even menace. Not a few prisoners told me that if I did not prescribe the valium they wanted, they would attack or kill a prisoner or a prison officer.

“Let me give you a word of advice,” I would reply.

“What?”

“Don’t.”

They would look in my eye and see that I was not to be moved. Some would laugh, others would be angry with the anger of the justly accused. But it took experience and firmness to resist their blackmail.

Experience and firmness of character were just the qualities the NHS did not seek in its prison doctors when it took over healthcare from the Prison Medical Service. The prescription of codeine and other sought-after drugs shot up without the slightest medical reason.

In the modern world, compassion easily slides into sentimentality and moral cowardice. Doctors like to think that their patients are telling the truth. Prisoners are often not like that; but inexperienced and weak doctors are reluctant to recognise it or be “judgmental”, the worst moral failing in the modern world. And so it is Goldilocks against Genghis Khan.

Face it, Doc, your specialism is about as scientific as witch finding and your methods as sophisticated as the ducking stool.

Addendum: (11.2.2013) In 1994 in an article (an op-ed piece) in The City Journal (an American publication) entitled The Knife Went In  Dalrymple writes: ‘As a doctor who sees patients in a prison once or twice a week, I am fascinated by prisoners’ use of the passive mood and other modes of speech that are supposed to indicate their helplessness. They describe themselves as the marionettes of happenstance.’  Once or twice a week?  Interesting.

 

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Sylvia Plath was given ECT without anaesthetic shortly before her first nervous breakdown and suicide attempt. Collective guilt, anyone? Think about it people.

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August 19, 2012

“The politician and the psychiatrist have one thing in common: their mission in life is to fix what isn’t broken.”

“The difference between a psychiatrist and a backstreet drug dealer: the backstreet drug dealer doesn’t have the legal right to order a bunch of nurses to hold you down and forcibly medicate you.”

And that applies to everyone: prince or pauper, private or NHS. Psychiatry is an excellent social leveller.

They do like them young across The Big Pond. Check this out:

http://www.latimes.com/features/health/la-he-schizophrenia29-2009jun29,0,4834892.story

If you tolerate this then your children really could be next.

If You Could Introduce…

August 19, 2012

…just one ancient sport to the Olympics, which one would it be? For me, it would be duelling.

An unusually topical introduction to the best short story in the history of short stories. Voila and enjoy!

A Coward

Guy de Maupassant

SOCIETY CALLED HIM HANDSOME SIGNOLES. HIS NAME was Viscount Gontran-Joseph de Signoles.

An orphan, and possessed of an adequate income, he cut a dash, as the saying is. He had a good figure and a good carriage, a sufficient flow of words to pass for wit, a certain natural grace, an air of nobility and pride, a gallant moustache and an eloquent eye, attributes which women like.

He was in demand in drawing-rooms, sought after for valses, and in men he inspired that smiling hostility which is reserved for vital and attractive rivals. He had been suspected of several love-affairs of a sort calculated to create a good opinion of a youngster. He lived a happy, care-free life, in the most complete well-being of body and mind. He was known to be a fine swordsman and a still finer shot with the pistol.

“When I come to fight a duel,” he would say, “I shall choose pistols. With that weapon, I’m sure of killing my man.”

One evening, he went to the theatre with two ladies, quite young, friends of his, whose husbands were also of the party, and after the performance he invited them to take ices at Tortoni’s.

They had been sitting there for a few minutes when he noticed a gentleman at a neighbouring table staring obstinately at one of the ladies of the party. She seemed embarrassed and ill at ease, and bent her head. At last she said to her husband:

“There’s a man staring at me. I don’t know him; do you?”

The husband, who had seen nothing, raised his eyes, but declared:

“No, not in the least.”

Half smiling, half in anger, she replied:

“It’s very annoying; the creature’s spoiling my ice.”

Her husband shrugged his shoulders.

“Deuce take him, don’t appear to notice it. If we had to deal with all the discourteous people one meets, we’d never have done with them.”

But the Viscount had risen abruptly. He could not permit this stranger to spoil an ice of his giving. It was to him that the insult was addressed, since it was at his invitation and on his account that his friends had come to the cafe. The affair was no business of anyone but himself.

He went up to the man and said:

“You have a way of looking at those ladies, sir, which I cannot stomach. Please be so good as to set a limit to your persistence.”

“You hold your tongue,” replied the other.

“Take care, sir,” retorted the Viscount, clenching his teeth;” you’ll force me to overstep the bounds of common politeness.”

The gentleman replied with a single word, a vile word which rang across the cafe from one end to the other, and, like the release of a spring, jerked every person present into an abrupt movement. All those with their backs towards him turned round, all the rest raised their heads; three waiters spun round on their heels like tops; the two ladies behind the counter started, then the whole upper half of their bodies twisted round, as though they were a couple of automata worked by the same handle.

There was a profound silence. Then suddenly a sharp noise resounded in the air. The Viscount had boxed his adversary’s ears. Every one rose to intervene. Cards were exchanged.

Back in his home, the Viscount walked for several minutes up and down his room with long quick strides. He was too excited to think. A solitary idea dominated his mind: “a duel”; but as yet the idea stirred in him no emotion of any kind. He had done what he was compelled to do; he had shown himself to be what he ought to be. People would talk of it, would approve of him, congratulate him. He repeated aloud, speaking as a man speaks in severe mental distress:

“What a hound the fellow is!”

Then he sat down and began to reflect. In the morning he must find seconds. Whom should he choose? He searched his mind for the most important and celebrated names of his acquaintance. At last he decided on the Marquis de la Tour-Noire and Colonel Bourdin, an aristocrat and a soldier; they would do excellently. Their names would look well in the papers. He realised that he was thirsty, and drank three glasses of water one after the other; then he began to walk up and down again. He felt full of energy. If he played the gallant, showed himself determined, insisted on the most strict and dangerous arrangements, demanded a serious duel, a thoroughly serious duel, a positively terrible duel, his adversary would probably retire and apologist.

He took up once more the card which he had taken from his pocket and thrown down upon the table, and read it again as he had read it before, in the cafe, at a glance, and in the cab, by the light of each gas-lamp, on his way home.

“Georges Lamil, 51 rue Moncey.” Nothing more.

He examined the grouped letters; they seemed to him mysterious, full of confused meaning. Georges Lamil? Who was this man? What did he do? Why had he looked at the woman in that way? Was it not revolting that a stranger, an unknown man, could thus disturb a man’s life, without warning, just because he chose to fix his insolent eyes upon a woman? Again the Viscount repeated aloud:

“What a hound!”

Then he remained standing stock-still, lost in thought, his eyes still fixed upon the card. A fury against this scrap of paper awoke in him, a fury of hatred in which was mingled a queer sensation of uneasiness. This sort of thing was so stupid! He took up an open knife which lay close at hand and thrust it through the middle of the printed name, as though he had stabbed a man.

So he must fight. Should he choose swords or pistols?–for he regarded himself as the insulted party. With swords there would be less risk, but with pistols there was a chance that his adversary might withdraw. It is very rare that a duel with swords is fatal, for mutual prudence is apt to restrain combatants from engaging at sufficiently close quarters for a point to penetrate deeply. With pistols he ran a grave risk of death; but he might also extricate himself from the affair with all the honours of the situation and without actually coming to a meeting.

“I must be firm,” he said. “He will take fright.”

The sound of his voice set him trembling, and he looked round. He felt very nervous. He drank another glass of water, then began to undress for bed.

As soon as he was in bed, he blew out the light and closed his eyes.

“I’ve the whole of to-morrow,” he thought, “in which to set my affairs in order. I’d better sleep now, so that I shall be quite calm.”

He was very warm in the blankets, but he could not manage to compose himself to sleep. He turned this way and that, lay for five minutes upon his back, turned on to his left side, then rolled over on to his right.

He was still thirsty. He got up to get a drink. A feeling of uneasiness crept over him:

“Is it possible that I’m afraid?”

Why did his heart beat madly at each familiar sound in his room? When the clock was about to strike, the faint squeak of the rising spring made him start; so shaken he was that for several seconds afterwards he had to open his mouth to get his breath.

He began to reason with himself on the possibility of his being afraid.

“Shall I be afraid?”

No, of course he would not be afraid, since he was resolved to see the matter through, and had duly made up his mind to fight and not to tremble. But he felt so profoundly distressed that he wondered:

“Can a man be afraid in spite of himself?”

He was attacked by this doubt, this uneasiness, this terror; suppose a force more powerful than himself, masterful, irresistible, overcame him, what would happen? Yes, what might not happen? Assuredly he would go to the place of the meeting, since he was quite ready to go. But supposing he trembled? Supposing he fainted? He thought of the scene, of his reputation, his good name.

There came upon him a strange need to get up and look at himself in the mirror. He relit his candle. When he saw his face reflected in the polished glass, he scarcely recognised it, it seemed to him as though he had never yet seen himself. His eyes looked to him enormous; and he was pale; yes, without doubt he was pale, very pale.

He remained standing in front of the mirror. He put out his tongue, as though to ascertain the state of his health, and abruptly the thought struck him like a bullet:

“The day after to-morrow, at this very hour, I may be dead.”

His heart began again its furious beating.

“The day after to-morrow, at this very hour, I may be dead. This person facing me, this me I see in the mirror, will be no more. Why, here I am, I look at myself, I feel myself alive, and in twenty-four hours I shall be lying in that bed, dead, my eyes closed, cold, inanimate, vanished.”

He turned back towards the bed, and distinctly saw himself lying on his back in the very sheets he had just left. He had the hollow face of a corpse, his hands had the slackness of hands that will never make another movement.

At that he was afraid of his bed, and, to get rid of the sight of it, went into the smoking-room. Mechanically he picked up a cigar, lit it, and began to walk up and down again. He was cold; he went to the bell to wake his valet; but he stopped, even as he raised his hand to the rope.

“He will see that I am afraid.”

He did not ring; he lit the fire. His hands shook a little, with a nervous tremor, whenever they touched anything. His brain whirled, his troubled thoughts became elusive, transitory, and gloomy; his mind suffered all the effects of intoxication, as though he were actually drunk.

Over and over again he thought:

“What shall I do? What is to become of me?”

His whole body trembled, seized with a jerky shuddering; he got up and, going to the window, drew back the curtains.

Dawn was at hand, a summer dawn. The rosy sky touched the town, its roofs and walls, with its own hue. A broad descending ray, like the caress of the rising sun, enveloped the awakened world; and with the light, hope–a gay, swift, fierce hope–filled the Viscount’s heart! Was he mad, that he had allowed himself to be struck down by fear, before anything was settled even, before his seconds had seen those of this Georges Lamil, before he knew whether he was going to fight?

He washed, dressed, and walked out with a firm step.

He repeated to himself, as he walked:

“I must be energetic, very energetic. I must prove that I am not afraid.”

His seconds, the Marquis and the Colonel, placed themselves at his disposal, and after hearty handshakes discussed the conditions.

“You are anxious for a serious duel? ” asked the Colonel.

“Yes, a very serious one,” replied the Viscount.

“You still insist on pistols?” said the Marquis.

“Yes.”

“You will leave us free to arrange the rest?”

In a dry, jerky voice the Viscount stated:

“Twenty paces; at the signal, raising the arm, and not lowering it. Exchange of shots till one is seriously wounded.”

“They are excellent conditions,” declared the Colonel in a tone of satisfaction. “You shoot well, you have every chance.”

They departed. The Viscount went home to wait for them. His agitation, momentarily quietened, was now growing minute by minute. He felt a strange shivering, a ceaseless vibration, down his arms, down his legs, in his chest; he could not keep still in one place, neither seated nor standing. There was not the least moistening of saliva in his mouth, and at every instant he made a violent movement of his tongue, as though to prevent it sticking to his palate.

He was eager to have breakfast, but could not eat. Then the idea came to him to drink in order to give himself courage, and he sent for a decanter of rum, of which he swallowed six liqueur glasses full one after the other.

A burning warmth flooded through his body, followed immediately by a sudden dizziness of the mind and spirit.

“Now I know what to do,” he thought. “Now it is all right.”

But by the end of an hour he had emptied the decanter, and his state of agitation had once more become intolerable. He was conscious of a wild need to roll on the ground, to scream, to bite. Night was falling.

The ringing of a bell gave him such a shock that he had not strength to rise and welcome his seconds.

He did not even dare to speak to them, to say “Good evening” to them, to utter a single word, for fear they guessed the whole thing by the alteration in his voice.

“Everything is arranged in accordance with the conditions you fixed,” observed the Colonel. “At first your adversary claimed the privileges of the insulted party, but he yielded almost at once, and has accepted everything. His seconds are two military men.”

“Thank you,” said the Viscount.

“Pardon us,” interposed the Marquis, “if we merely come in and leave again immediately, but we have a thousand things to see to. We must have a good doctor, since the combat is not to end until a serious wound is inflicted, and you know that pistol bullets are no laughing-matter. We must appoint the ground, near a house to which we may carry the wounded man if necessary, etc. In fact, we shall be occupied for two or three hours arranging all that there is to arrange.”

“Thank you,” said the Viscount a second time.

“You are all right?” asked the Colonel. “You are calm?”

“Yes, quite calm, thank you.”

The two men retired.

When he realised that he was once more alone, he thought that he was going mad. His servant had lit the lamps, and he sat down at the table to write letters. After tracing, at the head of a sheet: “This is my will,” he rose shivering and walked away, feeling incapable of connecting two ideas, of taking a resolution, of making any decision whatever.

So he was going to fight! He could no longer avoid it. Then what was the matter with him? He wished to fight, he had absolutely decided upon this plan of action and taken his resolve, and he now felt clearly, in spite of every effort of mind and forcing of will, that he could not retain even the strength necessary to get him to the place of meeting. He tried to picture the duel, his own attitude and the bearing of his adversary.

From time to time his teeth chattered in his mouth with a slight clicking noise. He tried to read, and took down Chateauvillard’s code of duelling. Then he wondered:

“Does my adversary go to shooting-galleries? Is he well known? Is he classified anywhere? How can I find out?”

He bethought himself of Baron Vaux’s book on marksmen with the pistol, and ran through it from end to end. Georges Lamil was not mentioned in it. Yet if the man were not a good shot, he would surely not have promptly agreed to that dangerous weapon and those fatal conditions?

He opened, in passing, a case by Gastinne Renette standing on a small table, and took out one of the pistols, then placed himself as though to shoot and raised his arm. But he was trembling from head to foot and the barrel moved in every direction.

At that, he said to himself:

“It’s impossible. I cannot fight in this state.”

He looked at the end of the barrel, at the little, black, deep hole that spits death; he thought of the disgrace, of the whispers at the club, of the laughter in drawing-rooms, of the contempt of women, of the allusions in the papers, of the insults which cowards would fling at him.

He was still looking at the weapon, and, raising the hammer, caught a glimpse of a cap gleaming beneath it like a tiny red flame; By good fortune or forgetfulness, the pistol had been left loaded. At the knowledge, he was filled with a confused inexplicable sense of joy.

If, when face to face with the other man, he did not show a proper gallantry and calm, he would be lost for ever. He would be sullied, branded with a mark of infamy, hounded out of society. And he would not be able to achieve that calm, that swaggering poise; he knew it, he felt it. Yet he was brave, since he wanted to fight I … He was brave, since….

The thought which hovered in him did not even fulfil itself in his mind; but, opening his mouth wide, he thrust in the barrel of his pistol with savage gesture until it reached his throat, and pressed on the trigger.

When his valet ran in, at the sound of the report, he found him lying dead upon his back. A shower of blood had splashed the white paper on the table, and made a great red mark beneath these four words:

“This is my will.”
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Allow Me A Brief Reflection on India

August 18, 2012

In the light of this:

http://blog.skepticaldoctor.com/2012/08/17/india-is-heading-for-mars-it-doesnt-need-british-aid-money-to-pay-the-bills.

An extract: “Whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine, whine.”

Ad infinitum. Or until his oesophagus finally gives way beneath the weight of all that bile. (Enough to fill a thousand oceans.)

How are the Dalit People getting along these days?

Now, that’s the way you measure the calibre of a country: the way in which it treats its ‘untouchables’, not by the technical quality of the probe it dispatches to Mars.

Long Live Phoolan Devi.

Or maybe not cos she is dead.

‘Raj’ is a really good word to use in scrabble, by the way.  

And if you want to read a magical, kaleidoscopic novel about India, the Great Game and the North West Frontier, then you could do worse than Rudyard Kipling’s  ‘Kim’.

Does That Taste Nice, ‘Doctor’?

August 9, 2012

Someone is biting the hand that fed him, for many years.  And it still sustains him via his French born wife who is an NHS geriatrician.  Let’s hope his dentures fall out.

http://www.latimes.com/news/opinion/commentary/la-oe-dalrymple-british-health-system-20120808,0,7412265.story

The good doctor spent the latter part of his life as a state employee.  Why?  We do have a private sector, one that is particularly friendly to unconventional psychiatrists.  Was he just not good enough?    Did he fear that no one would wish to consume the service he was offering?

His American acolytes should plead with The Greatest Doctor in the Entire Universe to come out of retirement and start a whole new career in the good ole U.S. Of A.  Let’s see how he copes with a more open Market.  Given the litigious nature of the US I’d bet my bottom dollar he’d be in court before you could say ‘Class Action Lawsuit’.

Funny how the American airbases here in the UK never had a problem using the NHS to treat US servicemen.  You’d think they’d want the very best for their armed forces.

Or maybe Dull Rumple’s American apostles share his disdain for the armed forces, illustrated perfectly in an ‘essay’ on Gulf War Syndrome which can be found here:

http://www.gulflink.org/GulfWeb/uk_news/te080397_1.html

‘Many servicemen – who appear to have joined up imagining that war was a thing of the past, and that armies are now purely ornamental or a form of disguised unemployment.’

The right wing ain’t what it used to be, that’s for sure.


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