SHOCK TREAT­MENT

The State could take prac­ti­cal steps to com­bat life-threat­en­ing al­ler­gies, says Mau­rice Gueret, to pre­vent sud­den deaths

Sunday Independent (Ireland) - Life - - HEALTH - RUDE HEALTH

My re­cent scrib­bles on the apt nam­ing of haem­or­rhoid clin­ics rekin­dled a mem­ory in one cor­re­spon­dent of an old story, which was about a re­fer­ral let­ter sent by a GP to a coun­try sur­geon. An el­derly farmer had pre­sented to the doc­tor, com­plain­ing of the dreaded haem­or­rhoids and, af­ter closer in­spec­tion, the GP de­cided to re­fer him on for sur­gi­cal treat­ment. The let­ter went some­thing like this: “Dear Mr So and So, Thank you for see­ing Mr What­ever, a lo­cal farmer, who has both piles, and piles of cash. Please be care­ful to re­move plenty of each!” This may well be an ur­ban myth, but, as my cor­re­spon­dent says, when did we ever let that get in the way of a good yarn? I'd like to write a few words about ana­phy­laxis in the wake of that ter­ri­ble tragedy be­fore Christ­mas, where a young girl died on Dublin's O'Con­nell Street from a peanut al­lergy. Doubt­less, the City Coroner will as­sem­ble all the facts of the case and is­sue some rec­om­men­da­tions with his verdict, but I think it's high time that the man­age­ment of chil­dren and adults with life-threat­en­ing al­ler­gies was given the pri­or­ity it de­serves by our pub­lic health ser­vice. Ire­land has prob­a­bly the worst al­lergy ser­vices in Western Europe. Ed­u­ca­tion is woe­fully lack­ing in this area, as are trained spe­cial­ists. It would also seem like an op­por­tune time to set up a na­tional ana­phy­laxis clinic that would reg­is­ter and man­age pa­tients who are po­ten­tially one in­gested al­ler­gen away from sud­den death. This coun­try was able to spend mil­lions plac­ing thou­sands of never-to-be-used, rust­ing de­fib­ril­la­tors all over the coun­try, yet, when a life-sav­ing adren­a­line pen is re­quired, there is none to be found. I don't know if it's fea­si­ble to put a pub­li­cally ac­ces­si­ble EpiPen in ev­ery surgery, phar­macy, school or restau­rant in the coun­try, but this aw­ful tragedy reminds us that some se­ri­ous lessons need to be learned. While do­ing some re­search last year for my own book,

What the Doc­tor Saw, my wife picked up a gem of a new ti­tle for me in the Rath­gar Book­shop. It is called Hanged For Mur­der by Tim Carey, pub­lished by Collins Press, and it goes into ter­rific de­tail about all 29 ex­e­cu­tions car­ried out by the Ir­ish State be­tween 1923 and 1954. I have pre­vi­ously writ­ten about my own grand­fa­ther's hor­rific ex­pe­ri­ence of a hang­ing as a young med­i­cal of­fi­cer in Moun­tjoy Prison. While many of the ex­e­cu­tions were for well-proven mur­der cases, the guilty verdict and sub­se­quent hang­ing of a Laois man called Der­mot Smyth for the al­leged mur­der of his best friend, Con ‘The But­ter­man' Den­nehy, in the sum­mer of 1938, cer­tainly had a hefty dol­lop of rea­son­able doubt. Smyth had a young daugh­ter and, in his fi­nal court ap­pear­ance, said that he hoped the real killer would be caught “so that no man can ever say of my child that her fa­ther was a mur­derer”. That daugh­ter, if still alive, would, per­haps, be ap­proach­ing 80 years of age. It's a pity that, with all the lawyers this State em­ploys, so few of them are en­gaged in in­ves­ti­gat­ing pos­si­ble mis­car­riages of jus­tice — no mat­ter how dis­tant. The ab­sence of the Rude

Health col­umn in LIFE mag­a­zine in De­cem­ber has caused some con­ster­na­tion among read­ers. Pat, in Tip­per­ary, wor­ried that I had been fired, kid­napped, hi­jacked or — worse — had en­tered a monastery, say­ing that his fam­ily strug­gled to get through Sun­day break­fast with the ab­sence of what they called a weekly dose of “wit and wis­dom”. The truth is less dra­matic. It's a bit like the HSE — in­signif­i­cant physi­cians can eas­ily get swept un­der the car­pet among the big-shots at In­de­pen­dent House. I'll be arm­ing my­self with lethal in­jec­tions next Christ­mas should they try to rail­road this col­umn off to the North Pole again. And, while Pat was on, he asked me to ex­plain the medic­i­nal func­tion of bar­ley su­gar sticks. He re­mem­bers th­ese in a glass jar on the counter of his chemist shop as a child. His mother would drag Pat and his sis­ter in to pur­chase some vile-tast­ing con­coc­tion de­signed to cure some ail­ment they had. He re­calls that they were bright orange in colour and had a twisted shape, like the old liquorice of his granny's sweet and gro­cery shop. The truth is that bar­ley su­gar had damn-all medic­i­nal use, and prob­a­bly just cre­ated more cav­i­ties for the den­tist to fill. The bar­ley plant, in his­tory, was of­ten touted for low­er­ing blood pres­sure, eas­ing stom­ach cramps and re­liev­ing bron­chi­tis, but I sus­pect the bar­ley su­gar stick had about as many ac­tive in­gre­di­ents as the jar of lol­lipops to­day. Some­thing to keep the hands of mis­chievous chil­dren oc­cu­pied while their moth­ers pur­chased vile-tast­ing con­coc­tions. If any pa­tients or, in­deed, phar­ma­cists can en­lighten me fur­ther, I'm all bar­ley ears at mgueret@imd.ie Richard is my south-east­ern cor­re­spon­dent, and my re­cent piece on some un­ap­petis­ing hos­pi­tal din­ners led him to get in touch about cab­bage. Now Richard is a man with some fine engineering ex­pe­ri­ence, and he tells me that, in hos­pi­tals, pa­tients will al­ways smell their food long be­fore they ac­tu­ally get to see it. It would ap­pear that hos­pi­tal de­sign­ers and restau­rant de­sign­ers are two com­pletely dif­fer­ent breeds. In hos­pi­tals, he says, de­sign­ers stick on feed­ing ar­range­ments al­most as an af­ter-thought, so that the smell that wafts along the cor­ri­dors, for ages, al­ways smells of cab­bage — even if cab­bage isn't on the menu. He says that, when the pa­tient gets the meal, they al­ready don't like it — ex­cept in the case of first-day pa­tients, whose noses are not yet in­flu­enced. This phe­nom­e­non also oc­curs in work can­teens, be­cause the food is pre­sented as a jum­bled lot and ends up smelling like cab­bage. He says that hos­pi­tal de­sign­ers need to get in touch with de­sign­ers of in­ti­mate bistros, who have their art so finely crafted that smells from the kitchen, in­clud­ing cab­bage odours, stay in the kitchen. Food for thought.

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