Tuesday 24 April 2018

Rude health: Finding mojo... how the Taoiseach bounced back

A fertility centre might be the answer to Waterford's woes, says Maurice Gueret as he unravels sprankes and torticles

Enda Kenny. Photo: Damien Eagers
Enda Kenny. Photo: Damien Eagers
Dr Maurice Gueret

September was a momentous month in the office of our Taoiseach and the world of reproductive medicine. Just as our dear leader announced that his long-lost mojo was back, scientists in the UK and Germany unveiled a litter of healthy white mice who were conceived without the usual interaction between sperm and egg. There is, of course, I hasten to add, no connection between the two events. However, scientists are now alive to the possibility that future babies may be born from embryos created from skin cells rather than eggs. Men will now speculate on the possibility of merging their own skin cells with their own sperm to create designer 'mini-me' babies, complete with mojo. There are hurdles the size of mountains to overcome before these techniques come to a fertility clinic near you. But, in the meantime, a lot of vain men can start thinking about cloning their mojos for posterity.

* Pneumonia is back in the news as illness puts the skids on Hillary Clinton's White House campaign. I don't have any familial insight into my distant cousin's clinical condition, but I think it's reasonable to suggest that she has had more than her fair share of funny turns. I'd like to see her on a seven-day cardiac monitor and the results of any recent brain scan. We know Hillary is prone to thrombosis and takes anti-clot medication. What we don't know is whether there is another underlying illness. Next year, she turns 70, the same age as her rival Donald Trump. Her campaign team is worried about how she will manage the next few months of the election trail. Her people might wonder how her health will stand up to four or even eight years in the Oval Office.

* Doctors can have different perceptions of what pneumonia is. We were trained to believe that it was principally an X-ray diagnosis of a particular shadowing in the chest. It refers to a deeper infection in the spongy part of the lung, as opposed to bronchitis, which is another chest infection confined to the major breathing tubes. It takes longer to clear a pneumonia. In very frail patients at the end of their lives, untreated pneumonia has been known as an 'old man's friend'. It's often the final illness that carries them off, consciousness ebbing and flowing, to the other side. Medical writers over the years describe it as a dignified way to go. I'll let you know, if it ever happens to me.

* I could shed a tear or two for Waterford. The recent review of cardiac services in their local hospital was only ever going to finish one way. And it wasn't going to be popular on the banks of the Suir. Ireland's oldest city has been in the doldrums for decades. In distant times when the British ruled our waves, the major centres of medical activity were Dublin, Belfast, Cork, Waterford and Limerick. Each had voluntary hospitals and ran their affairs independently. Waterford is unique among the five cities in that it never got its University. Instead, it was fobbed off with a few grand-sounding titles for Ardkeen, the latest of which is University Hospital Waterford. The county fought a partly successful war over cancer services, but now they are looking at some emergency cardiology services being shifted to Dublin and Cork.

* Waterford has two major problems - poor politicians and a stagnant population. Its TDs have been sideline-runners for years. All they dish out are oranges. None has the magic sponge. Many are poorly established in their own political parties, and even less influential where decisions are made in Dublin. Waterford's bigger problem, though, is that it simply doesn't have enough people. The hospital claims an inter-county catchment area of 497,000 people. But the recent heart review assumed its catchment was a full 210,000 less than this figure. If you look at populations in the 32 counties, Waterford lags in 20th place with under 120,000 people. Neighbouring Wexford has a stronger claim on resources with 30,000 more patients than its neighbour. Perhaps it is fertility services they should really be chasing in Waterford.

* Those clever folks at Oxford have been busy adding the works of Roald Dahl to the English dictionary. I used to think that scrumdiddlyumptious was a posh ice-cream shop in Dun Laoghaire, but those better in tune tell me that I must be thinking of Teddy's. Another word that the boffins have now added to our lexicon is 'moobs', which I am reliably informed is a condensed version of 'man boobs'. I am not convinced that the world needs man boobs - or moobs, for that matter. Most men simply have glorious pecs, and those few who have an overabundance of soft tissue already have gynaecomastia, a perfectly good medical term to describe their chests. Every medical student knows that 'gynaeco' refers to 'womanly' and 'mastia' means 'too much breast'. A man with gynaecomastia has no need for moobs or suchlike. The causes are many, and are drummed into would-be doctors up and down the land: liver disease, gland disease, tumours that secrete oestrogen, syndromes that deplete testosterone and, paradoxically perhaps, starvation. Not to mention an unusual side effect of some medicines, particularly those in the fields of psychiatry, ulcer healing, blood-pressure treatment, hormonal therapy and marijuana. Optimistically, in more than half of cases investigated, doctors find no cause of alarm. I am now planning a campaign to have my own condensed words added to the Oxford English Dictionary. If moobs can make it, then so too can grumblix (grumbling appendix), sprankle (sprained ankle) and torticle (torsion of the testicle).

Dr Maurice Gueret is editor of the 'Irish Medical Directory'


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