The stars of our Emer­gency Ser­vices are in the skies above, says Mau­rice Gueret, as he ex­am­ines he­li­copter medicine

Sunday Independent (Ireland) - Life - - RUDE HEALTH - Dr Mau­rice Gueret is ed­i­tor of the Ir­ish Med­i­cal Di­rec­tory. See imd.ie

based, the sort of large Siko­rsky he­li­copter that was lost in Mayo will not be able to land there. In­stead, these big he­li­copters would have to go to Tal­laght Hos­pi­tal, where the pa­tients would trans­fer by road, or try to get per­mis­sion to land at Kil­main­ham. This is far from ideal, but per­haps par for the course with health plan­ning in Ireland. At the cur­rent time, St James’s can­not ac­com­mo­date any land­ings at all, and he­li­copters must use open land half-a-mile away in the old Royal Hos­pi­tal. There are some regimes in the world that you don’t want to get on the wrong side of. Air­port hospi­tal­ity North Korean-style can be poi­sonous and hasn’t much to rec­om­mend it. But at least the exit door comes sooner than with the heavy-metal poi­son­ing of dis­si­dent Rus­sians. An­other as­sas­si­na­tion method came to light re­cently, when Alexan­der Perepilichny, a UK-based Rus­sian busi­ness­man, died shortly after en­joy­ing a bowl of sor­rel soup. It’s a pop­u­lar dish this side of the Volga, green in colour and sour borscht by taste. There is a the­ory around that some­body may have sub­sti­tuted gelsemium for his sor­rel. Gelsemium is a flow­er­ing plant with an al­ka­loid poi­son re­lated to strych­nine. One va­ri­ety is aptly named ‘heart­break grass’. Like all the best poi­sons, it was once used by doc­tors for the treat­ment of neu­ral­gias, fa­cial tics, and as a heart stim­u­lant. It didn’t last long, and nei­ther did some of the pa­tients. Per­haps the most fa­mous doc­tor as­so­ci­ated with gelsemium was Arthur Co­nan Doyle, creator of Sher­lock Holmes. In the late 1870s, as a young med­i­cal stu­dent in Scot­land, he be­gan ex­per­i­ment­ing on him­self with it, grad­u­ally in­creas­ing the dose each day. Botany was a big part of a med­i­cal ed­u­ca­tion in those days, and he may have be­come in­ter­ested in the plant at the Royal Botanic Gar­den in Ed­in­burgh. Luck­ily, side ef­fects of headache, di­ar­rhoea and gid­di­ness got the bet­ter of him be­fore its lethal­ity did. Co­nan Doyle stopped be­fore the dosage be­came fa­tal, and, as you do, wrote up his ex­pe­ri­ences for peers in a med­i­cal jour­nal. Ev­ery so of­ten, the news­pa­pers pub­lish a list of nurses who have been struck off by their reg­u­la­tor, An Bord Al­tranais. Oth­ers are lucky enough only to be ad­mon­ished or have con­di­tions at­tached to their con­tin­u­ing prac­tice. But those who have their names erased are un­able to work again in this coun­try as reg­is­tered nurses. Many must wish their names could be erased from the news­pa­pers, too. De­cid­ing that some­one is un­fit to prac­tice for the rest of their lives is a big deal, and not a de­ci­sion taken lightly. Names are erased by di­rec­tion of the High Court. There is a pat­tern to these reg­u­lar re­ports. It’s of­ten ward or nurs­ing-home neg­li­gence. There may be a case of pil­fer­ing from pa­tients, and the mis­use of drugs as­so­ci­ated with an ad­dic­tion is an­other reg­u­lar cit­ing. I some­times won­der which is the big­gest pun­ish­ment — not be­ing able to work, or hav­ing the whole coun­try know­ing about your in­dis­cre­tion. Some of those struck off must wish that the per­ma­nent record of a stain on their once proudly worn uni­form could be erased, too. Would it be too lib­eral to sug­gest that we make more ef­fort to re­ha­bil­i­tate fallen nurses and doc­tors, rather than pub­lish­ing and damn­ing them for eter­nity?

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