It's four years since I read and reviewed The Way We Die Now: The View from Medicine's Front Line (2017) by Seamus O'Mahony. That was essentially a reflection on how medical hubris had deluded people that they were going to live forever. That assumption may be uppermost in your 19 y.o. 'mind' when you launch your body off a cliff-face paragliding, base-jumping or mountain biking; at 79? not so much. The actuarial odds; your slowed reaction times; the leaching of calcium from your bones; the feebleness of your immune response; all these are stacked against you at 79. O'Mahony is six years younger than me but he retired in 2o2o just as soon as his pension enabled him to do so. His Death Book made him realise that he could do better with his literary talents than writing coherent case-notes and the endless reports required of him as a latter-day health bureaucrat aka consultant gastroenterologist.William Carlos Williams of the red wheelbarrow was another such.
- Problem: Bad headline about people stacked like cordwood on trolleys spilling out along the corridors from A&E
- Solution: Minister announces firm new targets for allowable wait-times; managers bully doctors into clearing beds in the wards
- Consequence: often no action because there is no infrastructure [nursing homes, district nurses, home-helps] to support folks who are still frail but no long need an acute bed.
- Problem: Stroke
- Solution: The Man sets targets for reducing the incidence of clots with the blood-thinner heparin
- Consequence: every patient is routinely heparinised on admission which makes them ineligible for surgery lest they bleed out.