Tuesday 21 November 2017

Rude Health: No harm to show a bit of leg now and then

There's a danger of exposure at the varicose-vein clinic, says Maurice Gueret, not to mention the Department of Health

Maurice Gueret
Maurice Gueret

Maurice Gueret

Of late, I have been reading up about the history of X-rays. The science of radiology is well over a century old and there has long been debate as to which hospital took the first X-ray in Ireland.

The first appointed hospital radiologist was a Dr Maurice Hayes. In 1907, he was given the grand title of Medical Electrician to the Mater Hospital. But it was a decade before, in 1896, that an orthopaedic surgeon called William 'Baldy' Haughton installed the first machine in Sir Patrick Dun's Hospital, and further machines followed that year in the old Meath Hospital and at Queen's College (now UCC) in Cork. Dr Haughton, the pioneer of this 
newfangled technology, did not appreciate the dangers of his new toy and suffered radiation-burn damage to his hands as a result.


By the middle of the 20th Century, the effects of over-exposure to radiation should have been well known, but this did not stop a new craze for shoe-fitting fluoroscopes or pedoscopes. These giant wooden boxes were all the rage at footwear establishments in the 1940s and 1950s.

They were marketed as the perfect way to ensure plenty of wiggle room and space for feet to grow in children's shoes. The radiation equipment was in the bottom of a standing box, and at the top were three viewing ports - one for the child, one for mother and one for the shoe salesman.

The craze originated in the United States and, by the 1950s, it is reckoned that there were 3,000 X-ray pedoscopes in the UK alone. That same decade was when medical debate began about their safety. The suspicion was that the person selling the shoes was very much at the greatest risk, as their exposure to leaks of ionising radiation would have been highest. Insurance companies began to make worried noises. In 1959, Ireland's Radioactivity Consultative Council stated that their use was unnecessary, potentially injurious and should be prohibited. By the time I was born in the 1960s, they had disappeared into the ether.

The giant reclining ruler, called the Brannock Device, had returned to pride of place. There are specimen shoe-fitting fluoroscopes in London's Science Museum and in the National Museum of Health and Medicine in the USA. I'd be most interested to hear if anybody has any memories of using these contraptions as children, or indeed, if any of the machines might still be lying out the back of Irish shoe shops. Letters to 
PO Box 5049, Dublin 6W, or email mgueret@imd.ie.


In 2005, I wrote that the sugar doomsday brigade were banging their bin lids and preparing to march. Well, they have arrived. When a surgeon said that sugar should be classified as a hard drug, and urged politicians to create anti-sugar agencies to criminalise its trade, the writing was on the wall.

The badge of 'Public Health Enemy Number One' seems to have been effortlessly switched this year from tobacco to sugar. Soft drinks are in the crosshairs, and I, for one, have been astounded to discover just how much sugar one can of fizz contains. Nine or 10 full teaspoons seems about the average, which means that a single litre bottle of your favourite fizzy beverage contains almost 30 spoonfuls of sugar. According to a doctor writing in the British Medical Journal this summer, it takes a full half hour of walking just to expend the calories of one small can of fizz. Think I'll stick to the tap water and dust down the SodaStream.


Three cheers for the great correspondents, within and without the world of medicine, who send me lovely anonymous stories about Irish healthcare. There is the true story of a woman who went to the varicose-vein clinic in a 
west of Ireland hospital. The doctor duly examined the leg with the bulges on it and politely asked her to roll down a second stocking so that he could see the other leg. (This was in the days before tights and trousers for ladies). "Ah, I couldn't do that, dochthur" said she, "Shure I only washed the bad leg".

And another true tale from the west, where a dispensary doctor was trying to talk to a lady patient about birth control in the 1960s. He told her that the Church no longer taught that one must have as large a family as possible and continued with a chat about the rhythm method. When the patient realised that it required partial abstinence, she said, "Ah, dochthur, shure what 
have I in life only that and the cup a'tae?"


If you are turning 70 this year, you are entitled to a free shingles vaccine. All you need is residency in Northern Ireland. The Public Health Agency there began their immunisation campaign last year and it is estimated that 20,000 Ulster men and women will receive Zostavax in its first year. Down here, Dr Varadkar is burning essential oils after midnight as he reads up on his brief.

Doubtless, he is being let into all the gory secrets of his department. He might rightfully ask why there are inordinate delays in making public health advances available in a supposedly free state. Shingles is just one case worth highlighting. He might also enquire why the rotavirus vaccine, which was strongly recommended for use last year by Ireland's advisory committee on vaccines, has not been placed on the schedule to prevent severe diarrhoeal disease in children. Infants in Northern Ireland have been offered this potentially life-saving vaccine since the summer of 2013. These desk-bound delays are inexplicable, and frankly, in the modern age, inexcusable. Do we have to live permanently in the shadow of another country's needles?

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


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