The new leader of the UK Labour Party is more kind than cruel, says Maurice Gueret, but he is no man of science
The election last month of a left-winger with a grey beard and bicycle clips, as leader of the UK Labour Party, has been a godsend for the rich man's press. The fact that Jeremy Corbyn survived relatively unscathed from his first month of unholy vitriol reflects well on his genetic constitution. Family history is crucial, and it was important that we knew that his great- great-grandfather was the monstrous master of a Surrey workhouse, whose 14-year reign ended only after the seduction of an inmate. The Daily Express dug out some old editions of The Lancet to find that Corbyn's ancestor once accused an epileptic patient who was recovering from a seizure of being lazy, ordering him to ladle out the cesspit. The man had a second seizure, and nearly drowned in the septic tank. When the workhouse doctor suggested reforms, Mr Corbyn's despotic great-great-grandfather threatened him with personal violence. Each ward in his workhouse was allowed two towels a week but no toilet paper. Nursing cover for sick patients was absent at night, patients went hungry and casual wards for vagrants were described as 'rabbit hutches'.
It's fair to say that Mr Corbyn is probably more trustworthy on healthcare than his ancestor. He plans better funding for psychiatric services and wants mental-health education to be taught in schools, probably after double geography.
If elected to Downing Street, PM Corbyn will reverse privatisation of the NHS, something that won't curry favour in the business circles that rent space in modern parliaments. Corbyn's views on quackery and alternative medicine are more suspect. He once tweeted that "homeo-meds" work for some people and suggested that homeopathic medicines complement conventional medicine because "they both come from organic matter". Such views are twee in the extreme, and hint at the gaping holes in Mr Corbyn's education. Every fool except Prince Charles knows that the only molecule contained in homeopathic remedies is water, and that they exert the same placebo effect as sugar lumps. I have no problem with Mr Corbyn's jam-making, vegetarianism, choice of wheels or allotment. I do have a problem with a PM who doesn't know the meaning of organic.
Most doctors are too busy to notice, so I may be a lone worrier about so many 'health stories' in today's media. Disease awareness is all very well, but we need to consider what is a reasonable and safe dose of disease awareness before our nation turns its neurotic dial too far. TV stations recently led with a story about one-in-three babies getting dementia in their lifetimes. Cameras were sent around to creches to sound-out mothers on this latest threat to public health. It was a strange thing to hear a mother in her 20s worry about the quality of dementia care for her infant son in 90 years time. I'd like to think that somewhere, there is a new mother who would tell the media and their frighteners where to go with this kind of news story.
Health screening is all very well, as long as patients know the downside. Despite everyone's best intentions, screenings can miss patients who are sick, and sometimes diagnose as sick people who are perfectly well. As a general rule, I'm not a fan of screening in caravans or hotel suites. And I'd also advise caution on the value of screenings that promise to leave you fully clothed and only demand that you remove your shoes and socks. The best screenings are on people who already don't feel very well. The tests that are not done may be far more important and relevant than those that are.
For example, I know one man who was feeling tired and breathless and so was sent for one of those full hospital-based executive sort of screens by his doctor.The man spent about €700 on it. He got the works. There were treadmills, cardiac ultrasound, X-rays and all, but nothing much showed up. But the doctor supervising the tests was on the ball - she noted unusual dryness on the skin of the shins and asked for an extra thyroid blood test that wasn't part of the routine screen. It turned out that the gland had packed up completely. The patient was put on hormones to correct things, and hasn't looked back since.
Our clinical examination arrives this week at the eyes, or to Cockneys, the mince pies. A good eye examination starts with testing of distance vision, then near vision, the field of vision and the ability to sense colour. Next, the eye itself is given a once-over. The shape of the eyelid is noted and whether there is any drooping. The upper lid can be too high and the eyeball over-prominent if you have an overactive thyroid gland. Inflamed eyelids (blepharitis) are common in dandruff sufferers and little cysts can also form under the lids. The doctor might examine your lacrimal tear gland by getting you to look down and inwards, as she stretches the upper lid.
The lining of the eyeball can get red and gritty in conjunctivitis, or pale in anaemia. The cornea is best examined with a drop of fluorescein dye, which shows up little ulcers as a greenish colour. The state of the iris and the shape, size and various reactions of the pupils to light and sharp focusing can also give the doctor useful information. The device with lenses and a pinpoint light is called an ophthalmoscope, and it's used to examine the interior lining or fundus of the eye. Many diseases can affect the optic disc, the retina and its blood vessels, so this is the way to see them, sometimes assisted by drops that dilate the pupils. I'll tangle with your hair next week.
Dr Maurice Gueret is editor of the
'Irish Medical Directory' drmauricegueret.com