From the front

  Victoria, a new consultant, pushed for the procedure. It was, as they say, a ‘multi-disciplinary decision'. A consensus had been reached and the views of all those involved was clearly documented, but it was Victoria who made it happen. She had seen that Mr S. would go nowhere until a decision was made. Due... Continue Reading →

Reputations: the light and the dark

  A recent thread on Twitter brought up a subject that is really spoken about. Elin Roddy kicked it off with a comment that patients admitted to nursing homes should routinely be engaged in conversation about their preferences towards end of life. With habitual frankness, she later commented that there is a danger that those... Continue Reading →

Not in my name

  A recent coroner’s report caught my attention (highlighted by HSJ's Shaun Lintern via Twitter). A patient died from a ruptured aortic aneurysm, and during the investigation it was discovered that it had been seen on a CT scan four years earlier. However, the patient never came to hear of it, the GP was not informed, and... Continue Reading →

Curators of compassion

Mechanical medic, by Ben Mauro (concept art for the film Elysium)     “When I was hospitalized for multiple cancer surgeries, it was my #nurses who provided the compassion many of my doctors lacked.” – a Tweet I saw this week.   Why is this? Do doctors not care?   The question was brought into... Continue Reading →

ABCDE…X – hierarchy and lost opportunities

The accumulated knowledge within a typical medical ‘firm’ is great, but the way a typical firm functions may not allow much of that knowledge to see the light of day. If all the decisions made by that peculiar monster originate from its 'head'  - the consultant - opportunities can be lost. The situations described below... Continue Reading →

Interactive Ward Ethics 3: Obedient

Having survived the challenges presented to her in Collusion and Dangerous, Nina must now negotiate her way through another nightmare week, in Obedient. Here she finds herself questioning a consultant’s decision to set limits of care on a young patient with a life threatening problem. What should she do – obey, question, or seek alternative opinions?... Continue Reading →

Leadership – the immediacy of example

Leadership, I am sure, takes many forms, but explicit exposure to the theories and approaches that might have helped develop doctors of my generation was lacking. The leadership that I was conscious of, as a trainee, was the example set by my seniors. Thus, as a consultant myself, the most direct route to leadership that I... Continue Reading →

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