Medicine

The mayor of London, Sadiq Khan, is planning to install a statue of John Chilembwe in Trafalgar Square. Mr Chilembwe was a Malawian Baptist famous for, among other things, leading an uprising where the head of a Scottish farmer was chopped off and put on a pole. He is much revered in his home country for all this and his face has appeared on banknotes. In truth, Mr Chilembwe didn’t incite the murder of many people, in the great scheme of things. If the mayor is searching for a murderer who did punch his weight, he could do worse than hoist up a statue of Francisco Macías Nguema, the former

Right from its first issue in 1823, the Lancet was more than just an ordinary medical journal. Its founding editor, the dyspeptic surgeon and coroner Thomas Wakley, purposefully gave the journal the name of a sharp scalpel that could cut away useless, diseased tissue: he used it as a campaigning organ, to push back against injustice, bad ideas and bad practice. What bothered Wakley most was the establishment. Not only did the Royal College of Surgeons care little about quacks and snake-oil salesmen, but its members were also engaged in corruption and nepotism, ensuring that their cronies got the best positions and filling their pockets with lecture fees. Wakley wrote

The last patient I treated was 105 years old. She has lived through two world wars, a depression and at least five pandemics. It’s a real honour to treat centenarians. They teach me much about life: how it is and how it ends. I can also lighten the mood with my 80-year-old patients by telling them that they’re still young. It’s common to hear talk about an ‘ageing society’ being some kind of disaster befalling the country. Yes, people are leading longer, healthier lives now than ever before. Is this really a ‘demographic timebomb’? I’d call it the greatest achievement of our time. When my patient was born in 1915,

In 1846 Vienna, as across much of the world, a relatively new disease called puerperal (or ‘childbed’) fever had reached epidemic proportions in the local maternity hospital. Death rates of mothers and babies after childbirth were averaging 10 per cent, sometimes twice that. Across the western world millions were dying, the rate reaching 40 per cent in some hospitals. A Hungarian doctor in Vienna’s hospital, Dr Ignaz Semmelweis, began to wonder whether the problem might be something on the hands of doctors who’d been conducting post mortem examinations on the fever’s victims. He suggested handwashing with a chlorine solution. It worked. Deaths plummeted. But Vienna’s medical community would have none

Could the future of pandemic planning lie in our past? A century ago, there were hundreds of so-called ‘fever hospitals’ dotted across Britain. These small institutions were built for diseases of a bygone age – smallpox, scarlet fever and typhus – but were designed for precisely the same problems we face today.  They contained isolation wards, separate accommodation for different infections, laboratories, operating theatres and convalescent wards with activities for recovering patients. Given the current problems of the Covid-19 outbreak, we need to re-establish these medical relics.  The lessons that led to the fever hospitals’ formation were paid for with the lives and suffering of our fellow human beings Fever hospitals were often built so

Coronavirus is revealing many good things about our society: the number of people willing to volunteer to help tackle the outbreak and help the isolated, the number of former doctors and nurses keen to return to the front line, and the number of businesses that have switched to making equipment and protective clothing for those healthcare workers. But it has also revealed our ignorance about many matters that are still important outside of a pandemic. Today’s example comes, inevitably, from our general reluctance to think about what old age and end-of-life care look like. Care homes have expressed concern that residents and their families are being pressured into signing ‘do not resuscitate’

From the moment when Boris Johnson announced that the country was moving from containment to ‘delay’ in handling coronavirus, the world’s biggest healthcare organisation has been on a war footing. What doctors like me have witnessed over the past days and weeks has been nothing short of extraordinary. Trusts in the NHS declared a ‘major incident’ on the evening of the announcement, and emergency plans swung into action within hours. By the time I came into work the next morning, managers, who had been up all night, had already started to implement profound changes to the way in which the hospital and services were run, and this continued over the

Some medical experts claim that Lyme disease is worse than cancer. It’s not a competition, but I do know one thing: at least if you’ve got the Big C you get sympathy, understanding and prompt treatment. With Lyme you’re pretty much on your own. This isn’t a plea for public sympathy. I’ve had Lyme for God knows how long — decades possibly — and though it has disrupted my health and my life in myriad weird, torturous and sometimes hideous ways, I still consider myself one of the fortunate ones. First, it hasn’t killed me; second, I’ve had some state-of-the-art stem cell treatment which with luck will eventually cure me.

Something interesting is happening in the House of Lords. Baroness O’Loan’s Conscientious Objection (Medical Activities) Bill, now at the committee stage, has put on the agenda an issue which well-deserves to be there. Its point is simple: all healthcare professionals should have a legal right to opt out of certain procedures which they find objectionable. It specifies three areas: abortion provision, withdrawal of life-saving treatment, and actions relating to certain reproductive technologies. This is not particularly radical; the 1967 Abortion Act already explicitly protects conscientious objection. Indeed, it could even be asked why this should, in a country with a tradition of liberty like ours, even be up for debate.

In George Bernard Shaw’s play The Doctor’s Dilemma, written early last century, the knife-happy surgeon invents a nut-shaped abdominal organ, the ‘nuciform sac’. It is situated near the appendix, ‘full of decaying matter’, and requires removal, assuming the patient can afford the fee. The surgeon, Cutler Walpole, has the line: ‘The operation ought to be compulsory.’ Bernard Shaw labours the point that removal of the nuciform sac equals 500 guineas, and not removing it equals nought guineas. He then suggests, wickedly, that we want our surgeons to be mortal, ‘quite as honest as most of us’, not God-like. Which of us, he asks, would not be influenced by the financial

All along Harley Street, charlatans and medical experts have set up side by side with no obvious way to tell them apart. The same wide steps lead up to the same glossy front doors, all with prestigious brass knobs. Each separate house is itself a layered stack of quacks and docs: radiology one floor above absence healing, flower therapy down the corridor from paediatric ENT. The magnificent Harley Street address confers a blessing on every dubious therapy. Perhaps it has a placebo effect all of its own. I know the street quacks well, or used to. My mother had a horror of antibiotics and would pack us off to Harley

For technology manufacturers, healthcare is already big business, and, with an ageing population increasingly comfortable with technologies that would’ve been unthinkable even a decade ago, the opportunities to innovate are only going to increase. The Future Health Index, a global report commissioned by Philips, supports the fact that it is not just the UK’s younger generation that are embracing these technologies. However are these products – from popular or trendy FitBits to state-of-the-art imaging equipment – really going to revolutionise the country’s medical care? And will the NHS require a head to toe change of ethos to accommodate them? Spectator editor Fraser Nelson is joined to discuss all this by