Reputation


Personal Stories of Recovery

“I do not have a single negative to pass on the time I have spend under the care of the staff of St. Patrick’s Hospital other than to say that it varied between very good and exceptional. The response and respect that I received to my written comments meant a great deal to me. I came to hospital feeling broken and despairing and leave now feeling renewed and well and looking to the future. Thank you “

“My five weeks in St. Pat’s has been an amazing journey. I can’t thank everyone enough. As I can’t meet everyone personally I would like to take this opportunity to say a huge “Thank You”. It is a new beginning for me and I will be certainly talking openly and trying to take the stigma out of mental health.”

“The atmosphere of the hospital is very bright, cheerful and friendly. The staff are excellent, uniformly helpful without exception and a credit to the hospital”

“I was most impressed with the care given to my daughter during her stay here. The ambience in the hospital is relaxed and caring. From the cleaners to the nurses, doctors and administrators everybody is on first name terms all working to a common goal of getting the patients better. Congratulations on a job well done”

“Excellent staff have finally helped me overcome my illness with the correct treatment and also using the recovery psycosis programme which opened my mind to what I suffer from. I have had this for 10 years but now I feel relaxed, free of all fear thanks to the A team. St Pats sets the standard for others to follow.”

“I would recommend St. Edmundsbury Hospital to all my friends and family to heal and recover from nervous exhaustion and breakdown. The staff looked after me very well and the counselling helped my husband and I tremendously. It was a turning point in my life and a good one. I will always have fond memories of my stay here because the overall feeling was of peace.”

“I would like to commend the staff in St. Pat’s. I cannot speak higly enough of their care and compassion for the patients on the Kilroot ward. They have played a very big part in my recovery and I am truly grateful to have met them all on my journey. Thank you one and all. “

“The Cleaners kept my room beautifully clean and the Temple Centre was spotless. The staff were so helpful and caring and gave me as much time as I needed. All in all I was very well cared for. Thank you very much”

“Today I’m sad as I leave ye all, but the sadness is one that I like, Because after 8 weeks on the bay, it’s time for me to take a hike, thanks to all the nurses and students, to the staff in the kitchen and OT’s too, to the lovely ladies who clean the ward, to the doctors where a bond we grew.”

“I had 10 unforgettable days with prime quality care and facilities. Most of all, I’ve met really nice people and hopefully not being wrong made some friends. Good work, keep it up”

“There is a very good atmosphere in St. Patrick’s. Communication is very good between patients and staff and should be maintained on an informal basis. Food is very good and is a very good morale booster for everyone. I would like to thank everyone in St. Patrick’s for input and kindness while I have been here”

“Fantastic Hospital, great facilities, programmes and staff. Keep improving! Loved the art expo spears of daylight, please do another. Well done in prompt follow up on complaint. Please keep twilight programme, very good.”

[From Examiner >] The stigma attached to poor mental health leads to one in five people delaying seeking treatment for a full year, according to research carried out by St Patrick’s University Hospital (SPUH).

Moreover, this stigma is costing lives, said Paul Gilligan, CEO of the country’s largest independent mental health services provider.

Speaking at the launch yesterday of the SPUH annual report 2011, Mr Gilligan described the stigma surrounding mental health as “often subtle”, “extremely damaging”, and “deeply engrained in Irish society”.

(more…)

By now a thesis might be emerging: that the classic, one-to-one model of treatment that makes the doctor so important a figure in an individual’s life, and gives her such rich and fascinating access to private narratives, and has raised her up on a pedestal of sorts in the eyes of the privileged people of the Western world, is in some ways a moral grey area.  It puts the needs of the one above those of the many to an extreme. And so, while so much time & money is spent in that model of healthcare in the West, there are millions of people in the “majority world” dying every year because of the neglect that arises as a result, whose (clearly, “less important”) lives could be saved if even a fraction of the money, medicines and manpower that we put into our systems were diverted to them.

Next week, in our final session, we will see the two forces (the needs of the one versus those of the many) played out dramatically in the story of Valentino Achak Deng as fictionalised by Dave Eggers in his novel What is the What? I am thrilled that Colman Farrell, CEO of Suas, will be joining us to hear Niall’s presentation and chat about his own experience of some of the issues raised.

Not in any way that I agree with her necessarily (I often don’t, and often particularly don’t like the way she expresses opinions), but Terry Prone writes in the Examiner today about doctors‘ powers of observation >>>

NOT reading X-rays is bad enough.

Not reading patients is a hell of a lot worse. It’s also more widely distributed than the X-ray issue and undoubtedly causes commensurate failure to accurately diagnose.

If I had the money, I’d sponsor a study into the gaze patterns of doctors. All doctors. GPs, consultants, A&E registrars, psychiatrists. The methodology would rely on filming the medics in their normal setting, as they meet new or returning patients. At least some of the filmed clips, and probably a majority of them, would show the doctor paying more attention to the records on their computer screen than to the patient. Of course, they’d be listening while reading the most recent prescriptions issued to the patient or (in A&E) the notes taken by the triage nurse. But they would not necessarily be LOOKING at the patient.

The notion that you can learn a great deal about somebody has gone so out of fashion in medical circles that the exceptions are interesting. Here’s an example of an exception. A consultant examining a woman patient, post-surgery, surrounded by student doctors, completes the examination and straightens up to leave the room. As he turns, he comes face to face with the woman’s partner.

“Have you had your cholesterol checked recently?” he asks. The man shakes his head. He’s never had his cholesterol checked. Dammit to hell, his expression says, I’m a non-smoking reasonably fit guy who’s not overweight. Cholesterol? The doctor turns the non-patient around so the students can see his face and points out a couple of bumps like cottage cheese under the skin beneath his eyes. They, he says, and a couple of other features he also points out, might indicate raised cholesterol levels. He then departs, leaving the patient’s partner floored and the patient in the bed looking mad that the spotlight has been taken off her miseries.

I witnessed that incident some time back. Significantly, I’ve never witnessed another example of that kind of acute observation. That’s because, according to Dr Joseph Bell, “Most people see, but they do not OBSERVE. Look at a man, and in his face you will find clues to where he comes from. His hands will show what work he does. The rest of the story is told by the clothes – even by a piece of cotton sticking to his coat”.

Dr Bell was a surgeon who taught at the University of Edinburgh in the late 19th century. He constantly stressed that anyone planning to become a doctor must learn to use their eyes intelligently. His work with students was a constant illustration of this core proposition. He would, for example, deliberately avoid learning anything about a patient before they arrived in his consulting rooms, thereby forcing him to watch them with intense attention. In one case, he told a male patient he was a cobbler by trade, because Bell had copped on that the man’s trousers were worn smooth on the inside of the knee, where, typically, a cobbler would hold the shoe on which he was working.

One of Bell’s students was a young man named Arthur Conan Doyle, who, when he left the university in the 1880s, found it difficult to make a living as a GP and began to supplement his sparse earnings by publishing detective stories based on what he had seen Joseph Bell do on his rounds. He transformed Bell into Sherlock Holmes, and made a fortune.

In some cases, Conan Doyle actually lifted real encounters between Bell and patients and inserted them into his books, because Bell, like Holmes, didn’t just observe, analyse and make a judgment, but, because he was a gifted teacher, would also explain the steps of the process, as did Holmes.

It can be argued that watching patients closely is not as important as it was in Bell’s time, because of the ready availability of tests. It can be counter-argued, however, that healthcare would be considerably less expensive if doctors did not so readily reach for the testing option, and that each time they do – particularly in the case of GPs – they are contributing to their own de-skilling and becoming little more than gateways to a multiplicity of mechanical interrogation processes.

Of course Bell was working at a time when more people worked in trades or crafts that carried direct, explicit threats to their health. Coal-miners could be expected to suffer specific lung problems. Hatters, because of their use of mercury, had a greater tendency to become somewhat unhinged. (Hence Lewis Carroll’s Mad Hatter in Alice in Wonderland.) Soldiers returning from overseas theatres of war were likely to be sickened by malaria or other tropical diseases. It was, accordingly, important that a man’s trade be taken into account when assessing what ailed him, whereas today’s office workers and electronic engineers tend not to develop profession-specific illnesses or disabilities other than obesity or backache from sitting too long.

I would have thought, nevertheless, that for doctors and nurses, it’s vital to develop the capacity to hoover up at least some of the myriad clues to health and illness manifest in someone’s appearance. Yet, although commercial firms spend a fortune training their salespeople to use their eyes to pick up relevant clues about their prospects, the emphasis placed in medical training on the same skills seems to be minimal. Every now and again – usually after medical scandal – someone remarks that communication skills should play a greater part in the education of medical professionals, but this tends to be interpreted as either referring to the development of a better bedside manner (which is always a good thing) or the inculcation of an understanding of media, so the doctor or nurse can acquit themselves creditably on a radio or TV programme (which is also useful.) The less flamboyant skills of listening and watching are core to good communication, but rarely figure in discussions of improving doctor/patient interactions, perhaps because their results are unmeasurable.

Conan Doyle’s observation of his mentor persuaded him otherwise. He realised that what Bell did was forensic examination, using his eyes and ears and applying critical thinking to the product. He further realised that one of the great benefits of this approach was that it could disprove patients who chose to lie to their doctor, having watched Bell tell a patient that the patient had been an army man, probably playing a musical instrument, only to have the patient deny any musical knowledge or army experience.

Bell quietly asked him to remove his shirt, which action revealed the letter “D” in scar tissue on his chest, the result of having been branded as a deserter. When Bell silently pointed to the brand, the man admitted that he had once been a bandsman in a Highland regiment. It was at that point that Bell used a sentence close to the one always associated with Sherlock Homes, although Holmes aficionados swear it never appeared in any of Conan Doyle’s books.

“It was elementary, gentleman,” was the surgeon/teacher’s summation of his observation and analysis.

This story appeared in the printed version of the Irish Examiner Monday, March 15, 2010

Article from the Irish Times (full article here):

Unless GPs join in the discounting craze, the days of paying self-satisfying visits for minor ailments are over, writes ORNA MULCAHY

THE COLD season has arrived in the office, along with packs of Lemsip, red-rimmed eyes, hacking coughs, sore-looking noses and conspicuous swaddling in pashminas. Hot honey drinks are all the go, and there’s a lot less dashing off to the doctor during lunch hour. Too expensive – €60 or €70 for a visit to find out you have a viral infection for which nothing can be done? No thank you. Another €15 for antibiotics that will have no effect whatsoever? I’ll try some Echinacea instead.

GPs must be feeling the pinch, but where are their special offers, now that discounting is the name of the game? Say three for two on sick children, or buy one consultation, get the next half price.

What about four tests of your choice and the fifth one free? Perhaps the GPs should consider it, if their waiting rooms are looking a little sparse. After all, if the price of so many other services is coming down, why shouldn’t health follow suit?

“We’re not shopkeepers or merchants,” said a consultant friend frostily when I asked her whether doctors should offer deals. “There is no Lidl or Aldi equivalent in the medical profession. If there was, people would really have something to complain to Joe Duffy about.”

Meanwhile, another friend who is married to a doctor took exception to the man who came to light her Aga after it had gone out, ranted about the costs of doctors’ visits at €55 a pop, and charged her almost three times that to set a match to the cooker.

(This article appears in the print edition of the Irish Times)

A LEADING health official has described some medical consultants as “peacocks who walk around with their heads in the air”, after it emerged over €9 million was outstanding to hospitals because forms had not been filled out by the doctors.

Cllr Pádraig Conneely (FG), chairman of the HSE West Health Forum, said €9.2 million could not be collected by two Galway hospitals because consultants had not filled out insurance forms. The money is due to University College Hospital and Merlin Park Hospital from patients who had private health insurance cover.

“Is it because these consultants are too busy in their private practices that they can’t be bothered to fill out the forms?” he asked.

Madam, – I wish to respond to your article on Caesarean section in Ireland (HEALTHplus September 8th). I have grown increasingly weary of the constant subtle attacks by some midwives on consultant obstetricians in this country. Regardless of the allegedly high rates of Caesarean section in Ireland, the fact remains that this country is among the safest places in the world for a woman to give birth. Since the development of the active management of labour in Dublin in the 1960s, Irish obstetricians have gained an international reputation for clinical excellence.

There are few fields of human endeavour where Irish professionals can be said to have led the world, but this is truly one of them. Unfortunately, some midwives appear incapable of acknowledging these facts. Rather than focus on the outstanding record of Irish doctors, and the hundreds of thousands of healthy women and babies that have resulted, they instead choose to constantly snipe at rates of Caesarean section.

This self-serving approach is insulting to many of Ireland’s finest doctors. Their outstanding work should be acknowledged by all health care professionals.

– Yours, etc, Dr RUAIRI HANLEY, Francis Street, Drogheda, Co Louth.