My recent scribbles on the apt naming of haemorrhoid clinics rekindled a memory in one correspondent of an old story, which was about a referral letter sent by a GP to a country surgeon. An elderly farmer had presented to the doctor, complaining of the dreaded haemorrhoids and, after closer inspection, the GP decided to refer him on for surgical treatment. The letter went something like this: "Dear Mr So and So, Thank you for seeing Mr Whatever, a local farmer, who has both piles, and piles of cash. Please be careful to remove plenty of each!" This may well be an urban myth, but, as my correspondent says, when did we ever let that get in the way of a good yarn?
I'd like to write a few words about anaphylaxis in the wake of that terrible tragedy before Christmas, where a young girl died on Dublin's O'Connell Street from a peanut allergy. Doubtless, the City Coroner will assemble all the facts of the case and issue some recommendations with his verdict, but I think it's high time that the management of children and adults with life-threatening allergies was given the priority it deserves by our public health service. Ireland has probably the worst allergy services in Western Europe. Education is woefully lacking in this area, as are trained specialists. It would also seem like an opportune time to set up a national anaphylaxis clinic that would register and manage patients who are potentially one ingested allergen away from sudden death. This country was able to spend millions placing thousands of never-to-be-used, rusting defibrillators all over the country, yet, when a life-saving adrenaline pen is required, there is none to be found. I don't know if it's feasible to put a publically accessible EpiPen in every surgery, pharmacy, school or restaurant in the country, but this awful tragedy reminds us that some serious lessons need to be learned.
While doing some research last year for my own book, What the Doctor Saw, my wife picked up a gem of a new title for me in the Rathgar Bookshop. It is called Hanged For Murder by Tim Carey, published by Collins Press, and it goes into terrific detail about all 29 executions carried out by the Irish State between 1923 and 1954. I have previously written about my own grandfather's horrific experience of a hanging as a young medical officer in Mountjoy Prison. While many of the executions were for well-proven murder cases, the guilty verdict and subsequent hanging of a Laois man called Dermot Smyth for the alleged murder of his best friend, Con 'The Butterman' Dennehy, in the summer of 1938, certainly had a hefty dollop of reasonable doubt. Smyth had a young daughter and, in his final court appearance, said that he hoped the real killer would be caught "so that no man can ever say of my child that her father was a murderer". That daughter, if still alive, would, perhaps, be approaching 80 years of age. It's a pity that, with all the lawyers this State employs, so few of them are engaged in investigating possible miscarriages of justice – no matter how distant.
The absence of the Rude Health column in LIFE magazine in December has caused some consternation among readers. Pat, in Tipperary, worried that I had been fired, kidnapped, hijacked or – worse – had entered a monastery, saying that his family struggled to get through Sunday breakfast with the absence of what they called a weekly dose of "wit and wisdom". The truth is less dramatic. It's a bit like the HSE – insignificant physicians can easily get swept under the carpet among the big-shots at Independent House. I'll be arming myself with lethal injections next Christmas should they try to railroad this column off to the North Pole again. And, while Pat was on, he asked me to explain the medicinal function of barley sugar sticks. He remembers these in a glass jar on the counter of his chemist shop as a child. His mother would drag Pat and his sister in to purchase some vile-tasting concoction designed to cure some ailment they had. He recalls that they were bright orange in colour and had a twisted shape, like the old liquorice of his granny's sweet and grocery shop. The truth is that barley sugar had damn-all medicinal use, and probably just created more cavities for the dentist to fill. The barley plant, in history, was often touted for lowering blood pressure, easing stomach cramps and relieving bronchitis, but I suspect the barley sugar stick had about as many active ingredients as the jar of lollipops today. Something to keep the hands of mischievous children occupied while their mothers purchased vile-tasting concoctions. If any patients or, indeed, pharmacists can enlighten me further, I'm all barley ears at firstname.lastname@example.org
Richard is my south-eastern correspondent, and my recent piece on some unappetising hospital dinners led him to get in touch about cabbage. Now Richard is a man with some fine engineering experience, and he tells me that, in hospitals, patients will always smell their food long before they actually get to see it. It would appear that hospital designers and restaurant designers are two completely different breeds. In hospitals, he says, designers stick on feeding arrangements almost as an after-thought, so that the smell that wafts along the corridors, for ages, always smells of cabbage – even if cabbage isn't on the menu. He says that, when the patient gets the meal, they already don't like it – except in the case of first-day patients, whose noses are not yet influenced. This phenomenon also occurs in work canteens, because the food is presented as a jumbled lot and ends up smelling like cabbage. He says that hospital designers need to get in touch with designers of intimate bistros, who have their art so finely crafted that smells from the kitchen, including cabbage odours, stay in the kitchen. Food for thought.