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