Tag Archives: Oblique view

This term has recently achieved particular recognition as part of the title of a bestselling book in 2003 by Mark Haddon and, even more recently, as a stage production. It derives from the following conversation between Sherlock Holmes and Police Inspector Gregory in one of Sir Arthur Conan Doyle’s 1892 short stories from the Great Detective’s memoirs, Silver Blaze. A racehorse by that name is stolen and the trainer − one John Straker − lies dead, with his head “shattered by a savage blow from some heavy weapon”. Gregory: “Is there any other point to which you would wish to draw my attention?” Holmes: “To the curious inciden

With regard to my title, I think that we sometimes struggle to get this right. As the years advance, it is almost a certainty that we will acquire some form of health problem along the way – and definite that there will be a terminal issue eventually. That said, our ability to deal with whatever pathology emerges might be seriously hampered by the small matter of being in possession of a medical degree. In a previous column (BJC passim), I alluded to the sad truth that female spouses systematically underestimate any disease process affecting their male partner. The example I used to illustrate this phenomenon was the notoriously unpleasant

I didn’t have a bike as a kid. I suspect this was simply because I didn’t need one. Being brought up in North London, the roads were not exactly free of traffic, and school was only a two-mile walk away making it easily – and probably more safely – accessible on foot. However, moving to Beverley in order to take up my first consultant post in Hull, I was seduced by the quiet, fairly straight and usually flat country lanes of East Yorkshire. This was the perfect opportunity to explore the possibilities of pedal power, and I later transported that enthusiasm to the Black Country when I moved to Wolverhampton and took up residence on the

I should have thought about writing something like this years ago. Increasingly, I encounter a regular struggle to find a suitable topic upon which to muse that is readable, interesting, vaguely cardiological and – importantly – about which I have not written previously (as for the last on that list, I am relying somewhat upon my memory being better than yours). This topic was staring me in the face… During my more than 20 years in consultant practice I have been privileged to work with a handful of medical secretaries. Previously, as a junior doctor, I recall my various bosses sitting in clinic and dictating letters directly to their s

A couple of years ago I published elsewhere some thoughts about the use of a specific checklist that preceded catheter lab procedures. This so-called WHO checklist, named after that well recognised international body, was initially applied to surgical practice with the intention of reducing mistakes, mishaps, accidents and disasters. It has since been embraced by hospital Trusts in order to cover an increasing variety of activities in which patient safety may be at risk. In any system, a negative outcome is not so much the result of one major element failing, but consequent more upon the coalescing of a number of minor factors. These apparent

Over the years they have been white, green, pink, lilac and even a rather unpleasant shade of yellowy-brown, reminiscent of vomit. I refer, of course, not to the various shades of automobiles I have gone through since my first car (a Morris Minor, circa 1972 – a dark green, D reg, ‘jelly-mould’ as they were affectionately referred to), but to the myriad of coloured theatre and catheter lab attire donned by yours truly over nearly four decades of invasive medical procedures. The first question must be, why? What is the rationale behind such clothing needing to be of any particular tint? I guess it starts with having to discriminate our d

Like it or not, we all have pressures upon us to meet a deadline of some form or other. It might be for a book chapter or an editorial invited by a journal. It might be for your considered peer review and refereeing of a manuscript submitted to an esteemed, high impact publication, or for a structured reference to support a promising trainee facing an imminent job interview. How we approach such a task, which by its nature comes with a defined timeline, is variable. Often the actual delivery of the piece is the easy bit; it is the creative aspect of the work that is so arduous and consumes most of the time period between accepting the proposa

It is that time of year; cold, grey, wet and windy. I am therefore prompted to put mouse and text to screen on a particular subject that has wound me up (literally) for many years. In 1978, Douglas Adams (1952–2001) wrote the script for the Hitch Hiker’s Guide to the Galaxy, a comedy that originally aired on Radio 4. It was stated in this memorable series that “about the most massively useful thing an interstellar hitchhiker can have is… a towel”. I would beg to differ. Five years earlier I had entered medical school and, in keeping with a tradition followed by generations of university students as they begin life as an undergraduat

Two recent, but completely separate instances, prompted me to produce the paragraphs below. The first was National Institute for Health and Clinical Excellence (NICE) guidance covering the management of patients with recent onset chest pain. As a cardiologist with more years of experience than I would wish to count, this will, of course, prove to be most helpful in the interpretation of the symptom complex with which our patients present. The second, and probably more pertinent, was a tutorial I was delivering (sic) to a small group of medical students about the clerking of cardiac patients. It dawned on me that the ease with which we chat to

The era of electronic communication has spawned a host of previously unimagined problems with regard to the written word. A recent news item revealed that Google has come up with a system that avoids an email being sent if the writer might, shall we say, be tired and emotional (a euphemism often used in the satirical – and iconic – periodical Private Eye, in place of the term ‘sloshed’). Before you are allowed to ‘send’ you have to solve a number of mathematical problems and thereby demonstrate that you are in reasonable possession of your faculties. Now there’s an idea … In what other ways could the art of e-letter writing b