Abstract
‘Always Room for One’ has become one of my mottos with regards content for the SMJ. This issue’s example is perhaps a paradoxical novelty. Not a quiz, nor a student’s lament, nor a slice of Christmas humour; it is, in fact, a little bit of science.
It has to be said that the SMJ is a clinical-based journal. Basic sciences feature rarely, and animal studies not at all. It is for the general physician or surgeon in us. Something to catch our eye, teach us a lesson – or remind us of a lesson we learned long ago, but has been lost in a maelstrom of constant specialist updating.
But there is always room for one, and this issue includes an Iranian study on the relationship between two molecules involved in the mechanistics of cardiac failure. The association is striking. Almost – to my unpractised eye – at the level where they turn out to be the same thing (like cachectin and TNF-alpha). But they appear to be unconnected (one is a glycoprotein, the other a ‘small peptide’) except in function, and I am with the authors that further work needs done to validate and further investigate their findings. It’s a bit of a step for the SMJ, but I believe these preliminary results should be ‘out there’.
In other research papers, public health and orthopaedics feature in more local studies, before clinical medicine raises its head and wonders why, when statins are being considered as specific therapies in Parkinsonism, they are still underprescribed in Parkinsonian patients where their use is justified for other reasons.
And it wouldn’t be complete without a Case Report on a syndrome I have never heard of. This issue, it’s Platypnoea-Orthodeoxia … but I’ll not spoil the plot.
A good mix.
Parthian Shots
Whilst on the lookout for non-controversial fodder for editorials, I was reminded that the SMJ is constantly assailed by press releases. Interesting research, NHS announcements, the imminence of Africa Fashion Week…something was bound to turn up.
A survey undertaken by no less an authority than Spotify blew apart my approach to ambient sound in the operating theatre portrayed by TV and cinema productions, viz:
Silence = normal.
Cassical music = quirky sophisticat surgeon.
Rock music = weirdo rebel surgeon who clearly murdered the young resident in order to cover up his …
But no.
A whopping 90% of surgeons listen to music in the ‘OR’, with half of them preferring heavy metal/rock. Music, they tell us, ‘calms the nerves and improves staff morale’. Guns N Roses, Led Zepellin and The Stones all feature in the top 10 favourite auditory wallpapers.
Apparently, the music is often turned down during critical points in the procedure. Sounds reassuring … but is there an inconsistency there?
Many press releases emanate from the ‘NHS Confederation’, with statements on recent events. One caught my eye. It welcomed the reappointment of Jeremy Hunt as Health Secretary, lauding the ‘continuity’.
A ‘Note to Editors’ informed us that the NHS Confederation was ‘the only membership body … to speak on behalf of the whole NHS’. I queried this in an email. To their credit, a spokesman kindly responded by telephone.
I repeated my query, suggesting the confederation – previously the National Association of Health Authorities and Trusts – represented, for want of a better word, ‘management’ rather than the whole NHS.
Failing to reach agreement, we moved onto firmer ground, and he admitted – nay, volunteered – that the confederation does NOT include Scotland.
Moving on further, I felt that welcoming Jeremy Hunt plus stating they represent the whole NHS wasn’t exactly accurate. I know many doctors and nurses (not even counting Twitter) who are not keen. They may be hugely mistaken, but you should probably alter your statement that you represent the ‘whole NHS’.
As we were parting on good terms, he opined that they probably wouldn’t change the claim.
‘But … it’s wrong’, I pointed out.
Pause.
‘We are happy with the wording’.
We said our goodbyes.
Leaving me wondering: which entity upsets me more by not being part of the NHS? Doctors… or Scotland?