Rude Health
Dr Maurice Gueret hails Minister Boo-Boo
A professor of surgery once asked a Dublin medical student where McBurney’s Point was. “I think you’ll find it if you turn left on Westmoreland Street onto Aston Quay, sir” was the unexpected reply. It’s true that generations of Irish children saw their very first Santa Claus in McBirney’s department store along the River Liffey. It was the Virgin Megastore in my heyday.
Now it’s a SuperValu, but the old shop name remains over the main doorway. The professor’s question, however, related to a differently spelled McBurney, an American surgeon who described a point in the abdomen south-west of the belly button where a prodding finger might find maximum tenderness in a patient with appendicitis. Charles McBurney was a medical graduate of Colombia University in New York. He became chief surgeon in the city’s Roosevelt Hospital and led the post-operative team that pronounced President William McKinley out of danger following an assassination attempt in 1901. McKinley perished from gangrene four days later.
Missed diagnosis
You could be forgiven for thinking that all medical research is now focused on coronavirus and nothing else. But a whole host of other diseases know nothing of this exotic virus and continue their dastardly ways as before. I have been looking at a new American paper from researchers in Michigan on the misdiagnosis — or, more particularly, the missed diagnosis of appendicitis.
Their study of almost 125,000 patients diagnosed with appendicitis suggests that the condition was missed in 6pc of adult cases and just over 4pc of children. This has a significant cost to patient health and to medical insurers who pay out in malpractice claims. The open-access paper in JAMA suggests that emergency departments are more likely to miss the diagnosis in females, in constipated patients, and in those who have other abdominal pains or other illnesses. Food for thought for those who keep their patients fasting.
Minister Boo-Boo
I felt a bit sorry for our health minister, who will forever now be known on corridors of officialdom as Boo-Boo Harris. The fact that those twin words of apology were of his own choosing was his more serious error. Quite what possessed him to make the assumption that there were 18 coronaviruses before Covid-19, we may never know. He suggested that there had been no luck preparing 18 vaccines, either. A good lesson for any student when confronted with a novel word, phrase or term is to read up on its origins. Most of the world understands boo-boo to be a minor, inconsequential error. But in America it is also used to describe a small injury like a sprain, scratch, cut or bruise. If Donald Trump had ever possessed a dictionary, he might have learned that the first recorded use of the word ‘disinfectant’ in the English literature was a news item about a Paris morgue being instructed to conserve dead bodies in it. If there is a patron saint for removal of hopeless cases from the Oval Office and restoring dignity to a nation, we should pray hard for a mighty broom this November.
Late exams
Parents and students are up the wall about this year’s Leaving Cert. I think it a poor decision to postpone exams, effectively until August. Why not conduct them as usual in June? Outdoors, under tents and marquees, built by the army — and invigilated by them too, if needs be. With social distancing, masks, hand spray — the lot. Universities stepped up to the plate and held final medical exams early. The students graduated in
April with virtual ceremonies, and will be taking up the 1,000 intern places offered by the Taoiseach. Some parents cannot fathom the idea that Leaving Cert students need to go back to school for two weeks before the exams start. Many worry that their learned offspring may come down with coronavirus as the papers begin. Thinking back almost 40 years to my time on that particular stretching-rack, I made the decision fairly early in my final year to skip school and home-study my way to the Leaving Certificate. My parents were cool about the whole thing and the school was probably happier still, with one less troublemaker on the horizon. In any case, I had the words of another genius of Rathmines to rescue me. George Bernard Shaw once declared that the only time his education was interrupted was when he was at school.