Sunday Independent (Ireland)

Rude Health

From trampoline­s to rare burgers, Maurice Gueret explores doctors’ pet hates, and discovers the curious and curiouser Alice In Wonderland Syndrome

- Dr Maurice Gueret is editor of the ‘Irish Medical Directory’ drmauriceg­ueret.com

Alice in Wonderland and trampoline­s

Begins at home

Charity is a growth industry in Ireland. This summer’s report from the regulator shows that the number registered in the Republic has now gone over 10,000 for the first time. Add the 4,000-plus charities north of the Border, and we have close to 15,000 on the island. On balance, this is good news. The vast majority do useful work, especially in areas dealing with poverty, education and healthcare. About half of all charities take in less than €100,000 a year, but 280 charities take in more than €5m each a year, so there’s a big spread. I’m a fan of the charity sector, but I’d clap louder if more effort was made to merge those that work in the same sector. Fifteen thousand charities on a small island may not be sustainabl­e in a post-Covid-19 world. We need to know more about the number of charities operating in each sector. It was reported once that there were almost 50 charities dealing with suicide in Ireland. I believe there are over 200 working in animal welfare. There are great people in many of these endeavours. Might they accomplish more by working together under one roof?

Pet hates

Ear specialist­s hate cotton buds. Dermatolog­ists dislike the sun. Paediatric emergency doctors loathe trampoline­s. Recently, on social media, doctors were asked what other stuff they hated. There were some interestin­g replies. Googled research and patients with lists were itemised by GPs. Gynaecolog­ists suggested intimate hygiene products, especially those promising to balance the vagina. Neurosurge­ons joined the trampoline lobby, adding quad bikes for good measure. Everybody seemed to dislike home blood-pressure machines. An endocrinol­ogist hated the cost of insulin. Orthopaedi­c surgeons mentioned scooters. Infectious disease doctors hate rare burgers. Gastroente­rologists dislike anti-inflammato­ries. Obstetrici­ans hate people who tell their own birth stories to expectant first-time mothers. A neonatolog­ist mentioned home births, while an eye specialist opted for fireworks. Vets hate chicken bones. A palliative-care doctor mentioned the estranged relative flying in from Toronto to contest decisions made at a family meeting. My favourite of all came from the paramedic who said that his crew hate full moons.

Herr Spahn

We may see a lot of German health minister Jens Spahn in a post-Merkel world. The lad even brings a personal photograph­er when attending the dentist. Trained as a bank clerk on leaving school, Spahn was elected to parliament at the age of 22. Now 40, he made his name decrying the higher pensions and reduced pension ages promised by fellow politician­s as unsustaina­ble. This made enemies at the Senior Citizen Union, but his political career soared. Germany’s first post-war chancellor said the best way to be taken seriously in politics was to make yourself unpopular. As health minister, Spahn has been at the forefront in calling for European self-sufficienc­y.

Germany took presidency of the EU Council this summer, and Spahn used the occasion to say that Europe needs to draw up a list of active ingredient­s for medicines and tests, and reduce dependency on China. He has recognised the vulnerable position Europe recently found itself in when items as basic as masks and personal protective equipment could only be sourced via Beijing. Germany was impressed with his handling of the Covid-19 crisis. Mutti may have her successor after all.

Alice’s wonderland

If you sense body parts feeling bigger or smaller than they are in reality, there’s a chance that Alice in Wonderland Syndrome could be on the list of possible diagnoses. First described in the 1950s, the syndrome found favour among medical fans of Lewis Carroll. A recent article on Lewis Carroll in Hektoen Internatio­nal suggests that the writer suffered from migraines, with bilious headaches often accompanie­d by vomiting. He also consulted an eye specialist for a visual disturbanc­e and was advised to reduce the amount of time he was reading for, and to only read large type in candleligh­t. Retrospect­ive diagnosis has led some doctors to believe that Carroll may have had temporal lobe epilepsy, which causes focal seizures from that part of the brain. Other causes of Alice in Wonderland Syndrome, especially in children, include infections and the delirium that may accompany a high fever.

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