Rude Health: Doctors facing Sumo on the Sabbath
Need to wrestle a doctor on Sunday ? Try the tea dance first, writes Maurice Gueret, followed by a GAA stretcher
You might have seen the GAA football championship episode earlier this month, when a Donegal team doctor was flung violently to the ground by an opposing Armagh player.
The incident has been successfully swept under the carpet with a yellow card, quick apology and gracious acceptance by the victim. Having reviewed the video evidence at length, I would say that the surgeon in question was lucky not to have a dislocated shoulder, fractured collarbone or an unfunny fracture of his humerus bone.
It was certainly no Ronaldo-type dive. The relationship between the GAA and doctors around the country is an interesting one. I was told once that one of the things which prevented doctors taking up positions as GPs in rural parts were the demands that GAA personnel made on them at weekends.
County senior teams now look after their medical personnel for time and effort put in, but difficulties could arise at junior and local level when teams wanted to have professional doctors in attendance at distinctly amateur rates.
There might have been an assumption in rural parts that the local family doctor had nothing better to do on the Sabbath than pack a Gladstone bag with sutures, dressings and slings and separate youths of warring parishes with not a single fee in sight. The truth of the matter was that many a lonely rural GP preferred nothing better on a Sunday afternoon than to drive 100 miles to look for love at a tea dance in the Burlington. Less energetic doctors resented the fact that their working week never seemed to end.
One lady doctor got around the Sunday rule by insisting that she would only attend camogie matches. Another conscientious objector would quietly buy extra club raffle tickets in lieu of match attendance. Ten years ago, the Gaelic Games Doctors Association was formed. It has almost one hundred members in all 32 counties and holds educational meetings on health and sports medicine. Sumo wrestling injuries might be a good topic for their next seminar.
Medicine constantly invents new specialities, with patients often the last people to hear about them. Doctors make little effort to educate the sick about what various differentiations actually mean.
Just the other day, a man told me he had to visit an En-Doctor-Ologist. His wife interjected to say that she thought it was an En-Doctrine-Ologist. Neither had the term correct, and why would they? The specialist was an endocrinologist. The correct pronunciation is closer to a tearful Taoiseach - Enda-Crying-Ologist. Life could be a lot simpler if we used the older term Gland Man, but the new ladies in this field would rightly object.
So I thought we'd have a look over the next few weeks at a few medical specialities, and explain what they do a bit better. So starting today with the endocrinologist, this is the doctor who is interested in diseases of all glands except sweat glands, and the various hormones they secrete.
The disease which keeps this specialist busiest is diabetes, but they would also seek out patients with malfunctioning thyroids, faulty adrenals, wonky pituitaries, a few bone diseases and less mentionable problems with sex hormones. In times past, it was general physicians with a bent for hormonal disorders who would have diagnosed and tended to these diseases. In days of yonder, Dublin's Mater Hospital had Professor Drury, while Sir Patrick Dun's Hospital had Professor Micks.
It was not until the mid-1970s that hospitals began to appoint dedicated endocrinologists, and their sub-species, the diabetologist. As with all newfangled disciplines, they began in huts and Portakabins out the back near the mortuary, but some of the luckier ones now rule very swanky roosts indeed. According to the current Irish Medical Directory, there are now 51 consultant specialists in endocrinology to deal with our nation's raging hormones. Next week, we'll share some joints and cast an eye over what exactly rheumatologists do.
I was writing recently about the sort of sensible person we need to appoint to run the modern hospital. A patient had suggested to me that appointments should come with an estimated guide as to how long it takes to access the actual department from the front gate or door of the hospital. They also suggested to me that a successful gardener is really the sort of person who should be put in charge. They can plan ahead, they improvise on the spot when plants (like patients) invariably do their own thing anyhow, and are usually sole board members who can be designer/ project manager/ financial manager all rolled into one. Sounds good to me. But they may have to spend more time dead-heading than they bargained for.
Nominative determinism is a kind of pseudoscience that believes a person's career is pre-determined by the surname they are born with. There are many examples in medicine like Mr Butcher the surgeon, Mr Flood the bladder specialist and Mr Butt who specialises in colo-rectal diseases. A reader who had her camera out in Paris sent me photo of an allergologue's brass plate at the junction of Rue St Antoine and Rue de Rivoli. The name of this allergy specialist - Dr Sauvan Pistof.
The British Medical Journal holds weekly polls. It fills space and gives doctors a sense that somebody is actually interested in their opinions. Last week, 78pc of readers said that GPs should also work in emergency departments. But when, exactly? After the Under 12's hurling or before the tea dance in the Burlington?
Dr Maurice Gueret is editor of the 'Irish Medical Directory'