Posts Tagged ‘Birmingham’

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.

Malingerers, Malingerers Everywhere

September 16, 2010

I am currently reading the seemingly endless output of Dr. Theodore Dalrymple,  (Now, remember kids, prolificacy in itself is not a virtue) nom de plume of Dr Anthony Daniels: retired consultant psychiatrist in a hospital situated in a run-down district of Birmingham (in a fit of shrieking hyperbole the good doctor calls it a ‘slum’).  He also spent two afternoons a week working in the city’s Winson Green Prison.  In other words he has spent the latter part of his career treating (to put it bluntly) the criminal and the insane and sometimes the criminally insane.  The kind of people who have been told in no uncertain terms by the judiciary and the medical profession that their behaviour is unacceptable. That is how they wind up in hospital or prison. Dalrymple’s advocates often argue that his experiences in these institutions give him a clear view of the decline of civilization. Well, no, not really; he had been given a clear view of the behaviour and worldview of social deviants.

These people are called ‘deviants’ because they deviate from the norm and yet Dr Dalrymple/Daniels tells us that their worldview and the behavior that emanated from this is prevalent across the country amongst the law-abiding and the non mentally ill.  I am reminded of something a war-veteran neighbour told me about a medical officer he once worked under when he was overseas. Some members of the conscripted lower ranks, shell shocked before they’d set foot on any battlefield, feigned illness in order to avoid being sent into battle. The phrase ‘to shoot oneself in the foot’ is a reference to military personnel who would literally shoot themselves in the foot to render themselves unfit for armed conflict.  A tiny minority of new recruits were willing to do anything to avoid what was coming.  The medical officer wised up to the fact that a small proportion of those who came before him were ‘malingerers’.  In time he began to see ‘malingerers’ every where even when there were none.  And, because of this, many genuine invalids suffered more than they should have.  (There is a similar situation replicating itself in the benefits system in that, according to some sections of the media, some benefit claims are fraudulent so all benefit claims must be fraudulent.)

I strongly suspect that the Dalrympian worldview can be partially attributed to the fact that he spent the twilight years of his medical career treating the mad, the criminal and sometimes the criminally insane therefore, to his mind, many people he sees outside the world in which he once moved are possibly mad, criminal or criminally insane. ‘Mad people, mad people everywhere and I’m not permitted to forcibly medicate a single one.’


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