Blogging on 20th August, I raised some questions about psychiatry and psychiatrists without saying much about my reasons for doing so - apart from noting that, in the face of growing problems of mental health, it's a 'science' that's regarded with much less scepticism these days than was the case in the 1960s.
This is a true story about someone who was treated by 9 different psychiatrists in 4 years, only three of whom were native-speakers of English. Having recently had some blood tests, he went to see his new GP for the results.
As he was worried, after 4 years under so many different psychiatrists, if his official medical records said that he was suffering, as he suspected, from 'vascular dementia'. And, if so, which of the many psychiatrists had mistakenly diagnosed him as suffering from this incurable illness.
Psychiatric provision in a small town and a recovery plan that failed In charge at the first hospital to which he was admitted, were two ethnic African psychiatrists, neither of whom were fluent speakers of English. After a few months they discharged him and he was treated in accordance with the recovery plan that they'd devised. This involved being 'treated in the community' by a locus-psychiatrist whose native language was Serbian. His English was very poor, added to which he had a serious hearing (and listening) problem.
At the first meeting, he told the patient and the other family members accompanying himthat he'd left his hearing aid in his car. But when one of them offered to go to the car park to get it for him, he said he didn't need it because he could lip-read English perfectly well - even though he couldn't actually speak English perfectly well.
The Serbian then sat down facing the family, with his back to the patient. In so far any of them could understand anything he said, he strongly implied that not all the drugs that had been prescribed by the Africans were necessary.
The patient therefore stopped stopped taking some of them and his condition gradually deteriorated.
After seeing the same consultant a few more times, he was sent (against his will) to another mental hospital 25 miles away from home - which was a blessing in disguise.
Psychiatric provision at a hospital in a bigger town and a recovery plan that worked
A notice board in his room at the second mental hospital informed him that his psychiatrist was no longer the Serbian, but a Dr W, whom he had yet to meet and who didn't come to see him for several weeks after he arrived.
Finding out where Dr W was quite a challenge. Some of the nurses said that he was on sabbatical leave somewhere in North America, some that he was on holiday in the USA and others that, as he'd taken early retirement, he could now afford to work when he felt like it.
The most promising news was that he was a native-speaker of English, who everyone agreed, got on well with his patients, was a good chap and a 'good psychiatrist'.
It didn't take Dr W and the nurses long to devise a recovery plan and discharge their patient fairly quickly.
His experience in these two mental hospitals demonstrated that there's a postcode lottery in the treatment of mental illness, just as there's a postcode lottery in the treatment of physical illnesses.
Compared with what happened at the local small town hospital, the effectiveness of the treatment (and aftercare) at the more distant hospital in the bigger town was far superior. Drugs are much more effective than they were in the 1960s and 1970s:
Although it's not at all clear how they all work, the drugs now available for treating depression, anxiety and other mental disorders seem to do more good and less harm to patients than they did in the 1960s and 1970s - when chemicals like lithium were dished out with little or no regard for their damaging side effects like Parkinson's disease.
Here, the Serbian psychiatrist's advice on medication was clearly wrong (as was that of his predecessors), whereas the medication prescribed by all their successors worked much more effectively.
This raises a number of rather important questions.
If a psychiatrist gets a diagnosis wrong, what chance does a patient have of winning a case against him/her when it's on the official medical record that he/she was mad?
Would this patient have a viable legal case against the African and Serbian psychiatrists were he to make a formal complaint against them?
And what about Dr W?
On asking his new GP whether it was on his official medical record that he suffers from vascular dementia, she confirmed that it was.
She also confirmed that the psychiatrist who put it there was none other than Dr W.
But Dr W had never bothered to tell his patient this.
He did, however, tell the patient's wife that (a) he was suffering from vascular dementia (b) it's incurable and (c) as he'd steadily get worse, she'd better prepare herself for a progressively more dismal future for both of them (on the seriousness of vascular dementia, see below the line at the bottom of this page).
All he told his patient was that he would never be able to drive again and that he should dispose of his car as soon as possible - which he did.
Three years later, thanks his GPs and two more psychiatrists, Dr W's confident diagnosis turned out to have been utterly wrong.
Last year, the DVLA medical group issued the patient with a new driving licence for a year - after which, he bought a new car. This year, they extended it for another three years.
Meanwhile, consultants in psychiatry like Dr W continue to behave as if their specialism is based on as sound a knowledge base as eye, heart and brain surgery.
The big questions are how much damage are they doing and how many mental health patients are suffering as a result???
Types of Dementia
Dementia is a broad umbrella term used to describe a range of progressive neurological disorders. There are many different types of dementia and some people may present with a combination of types. Regardless of which type is diagnosed, each person will experience their dementia in their own unique way.
Vascular dementia is also known as “multi-infarct dementia” or “post-stroke dementia” and is the second most common cause of dementia. Main symptoms:
Decrease ability to plan
Loss of motivation
Cause: Bleeding within the brain from a stroke causes brain damage. Treatments or therapies: Vascular dementia cannot be cured, but people who have the ailment are treated to prevent further brain injury from the underlying cause of the ailment. Like Alzheimer’s disease, numerous medication and therapies may be used to help manage the symptoms.
It rained heavily yesterday, but it didn't stop six of us from having a family lunch of fish and chips at the end the Grand Pier at Weston-super-Mare (left).
Known colloquially as Weston-super-Mud, it was very muddy indeed in the rain. It got me thinking about the apparent pretentiousness of adding a Latin suffix to the name 'Weston'.
As an inhabitant of Westbury-sub-Mendip I understand that, in the early 20th century, such suffixes were added to make life easier for postal workers in sorting and deliverin
g mail, long before the invention of post-codes. So is it the same with places like Weston-suoer-Mare, Clacton-on-Sea and Southend-on-Sea?
I used to think this a not very cunning plan for estuary based resorts like Weston, Southend and Burnham-on-Sea to pretend they were proper seaside resorts. But my research has made me think otherwise.
Unlike Weston and Southend, Clacton really is on the Essex coast and has really sandy beaches. The 'on-Sea' was origina
lly added because there was a time (before the railways) when the only easy way to get there was via the sea.
The arrival of the railways also meant made Southend accessible to trippers from the East end of London. And, in case anyone pointed out that it was on the Thames estuary and not the proper sea, they built the longest pier in the world out into the 'sea'.
As for Weston-super-Mare and the apparent pretentiousness of adding a Latin suffix part of the problem was that Weston is a very common place-name, with about 60 in the UK, 30 in the USA and, in the diocese of Bath and Wells there are at least five.
Fans of an early Blackadder series may be as intrigued as I was to discover that the most plausible explanation for the Latin is that it came from an early bishop of Bath and Wells.
The earliest known reference to Weston-super-Mare is in the
register of Ralph of Shrewsbury, bishop of Bath and Wells, dated 1348. And in the pre-reformation church, of course, Latin was the common language of priests and bishops.....
I've been fortunate in never having to wear glasses for anything other than reading, drawing and painting.
I do of course occasionally wear sun-glasses. But whether using reading or sun-glasses, I avoid doing what the bloke above is doing - because, unlike him, I've still enough hair left that it would probably make the specs greasy and in need of a clean.
Yet these days, for no apparent reason as far as I can see, it's become very fashionable for men and women of all ages to rest their glasses on their hair when they don't need them.
Does anyone have any idea why this is?
Is it another pointless import from the USA?
If so, what prompted our American cousins to start doing it in the first place?
What about baseball caps that point backwards?
These young man are Americans, so it makes sense that they might want to wear a baseball cap. What makes no sense to me that they're wearing them with the peak pointing backwards.
I know that baseball caps have become fashionable here in the UK (but have no idea why).
I also know that a lot of our youngsters have taken to wearing them back to front. In fact, I've a young neighbour who never comes out of the house without wearing his baseball cap the wrong way round - regardless of whether it's hot and sunny, pouring with rain or cold and snowing.
A few years ago I blogged, to no avail, about why we Brits make so much use of baseball metaphors in presentations and business-speak (standing up to the plate, getting past first base, hitting a home run, etc.) when our national summer game is cricket, not rounders with a hard ball on a big field.
Now, the big question nagging away at me is: why so many men (of all ages) prefer US style baseball caps to traditional British headwear.
A few years ago, another neighbour of ours went skiing in the USA and told an American in a lift queue how much he liked his baseball cap and asked where he could get one that pointed backwards. When the American aid he'd got it at the local ski shop, my neighbour went there and asked if they had any backwards-pointing caps.
The shop assistant was serious and apologetic:"Sorry sir, but I'm afraid we only stock ones that point forwards and I'm not sure where you'd get one of the type you're looking for."
Now even outstanding cricketers like Kohli sometimes wear baseball caps
India's cricket captain Virat Kohl with baseball cap (and beard)
Proper cricket cap worn last week by record-breaking
former England captain, Alistair Cook
All of which is to ask: why all these things are happening and happening at the same time?
FACT FOR TODAY:
According to my 2018 diary, which has one historical fact for every day of the year, today was the day in 1698 when Peter the Great of Russia imposed a tax on all men with beards (for more information on which, watch this on Youtube). The tax remained in force for a further 70years after that.
Nicholas II Lenin
This was just as well, because beards had become so fashionable by the end of the 19th and early 20th centuries that Nicholas II and Lenin both had beards, as did Queen Victoria's two successors, Edward VII and George V.
Even one of my own great grandfathers had a beard and still had it when he died in 1950 at the age of 98.
But by the 1960s and 70s, beards went out of fashion - apart from exceptions like students and hippies (left).
BEARDS MAKE A BIG COMEBACK
For reasons that remain a mystery to me, the last few years have seen beards make a sudden and rapid return to the world of male fashion - regardless of age, occupation, social class. or politics.
Call me old fashioned, but I still haven't got used to watching bearded professional footballers and cricketers (of all nationalities) playing such sweaty sports.
During the recent hot summer when pollen counts were high, we were visited by a salesman in his twenties with an enormous red beard (and a shaved bald head) -who couldn't stop coughing and spluttering.
"Hay fever?" I asked, to which he replied "I've always suffered from it but it seems to get worse as I get older."
I was too polite to suggest that it had nothing to do with growing older and everything to do with the fact that his beard must have been full of pollen. If he could be bothered to shave his face as well as his head, his hay fever wouldn't be so debilitating.
A TAX ON BEARDS TO REDUCE NHS EXPENDITURE ON HAY FEVER
Were I advising Philip Hammond on a simple way to increase tax and reduce the deficit in these economically challenging pre-brexit times, I'd suggest he takes a leaf out of Peter the Great's tax book.
He could say that treating hay fever with antihistamines, nasal sprays, etc. is a cost to the NHS that's made worse by men who don't shave.
A tax on beards wouldn't affect the P.M., or many other Tory MPs - but would penalise the leader of the opposition, Jeremy Corbyn!