Tuesday 23 January 2018

Rude Health: The physician's egg

A New Year's resolution runs into trouble at the supermarket for Maurice Gueret, as he has difficulty locating the eggs

Minister for Health Leo Varadkar. Photo: Gerry Mooney
Minister for Health Leo Varadkar. Photo: Gerry Mooney
Maurice Gueret

It's never too late for a dose of New Year resolve. Some recent study on the ever-widening subject of obesity has led me to the conclusion that many of us curvy folk could do with more protein and fat in our diets. Both are a damned sight better at satisfying appetite and reducing cravings than modern carbohydrates, which can have the exact opposite effect.

So, where might we find these magic ingredients? Well, you can't beat eggs, though locating them in a modern supermarket can be a marathon. Eggs on shelves move in the most mysterious ways. Last time they were in with the Christmas cards, and before that, they were down beside the Halloween treats. The conclusion to draw is that there is feck-all money to be made on eggs. They don't pay IFA  salaries or attract fanciful advertising about boosting immune systems and preventing flu. So senior shelf-stackers keep them low-key, under wraps and constantly on the move. Of course the game of Find The Eggs is all good aerobic exercise, but the real damage is done when you have to traipse 18 times down the crisp and sweet aisles to find them.

In the summer of 2003, I took a call from the editor late one Friday, asking for an urgent piece on hormone-replacement therapy for that weekend's Sunday Independent. The cosy world of women's problems turned on its head that weekend, when a report from Cancer Research UK suggested that as many as 15,000 cases of breast cancer in Britain over the previous decade may at least be partly attributable to long-term HRT. I wrote a piece that now reads rather like an obituary. In the intervening dozen years, hormone replacement has not stopped, but it is certainly not requested anything like as frequently as it was. This may be about to change. New guidance in the UK, from the review body known as NICE, suggests that the relative risk is small and says that the 20pc of women who suffer debilitating menopause symptoms need to bring them to their GP's surgery rather than suffer in silence. The best understanding of the risk I have come across is that 22 women in every 1,000 who don't take HRT get breast cancer in a seven-year period. If they do take HRT, the number goes up from 22 to 27. That's a rise of one-half of one pc. Not an easy call. But when menopausal symptoms are particularly debilitating, it may be a risk well worth considering.

I greatly enjoyed receiving Ireland's favourite Christmas present. Sales of Joe Duffy's Children of the Rising will have helped many bookshops stay open for another year in our ink-declining world. This beautiful book affords names and stories to 40 forgotten children who perished at the end of April 1916. It brims with new historical detail and photographs that capture perfectly the mood of the time. The only pity, perhaps, is that the book is printed in Germany, the country 350,000 Irishmen were laying down their lives against in 1916. The story I hopped to first was that of Lionel Sweny, whose family opened their chemist at Dublin's Lincoln Place in 1853. The shop remains open to this day, though no longer as a dispensing pharmacy. Lionel was born into the tradition in 1902, into one of the first merchant families in Dublin to have a telephone. He was killed by a gunshot wound two days after the Rising began. Confusion remains as to the exact location, and whether it was on Mount Street or O'Connell Bridge, but the belief now is that it was the former, and that he was trying to revive a dying British soldier with a drink of water when he took a bullet. The pharmacist's son was just 13 and he was buried in a mass grave in Deansgrange Cemetery.

Every story in Children of the Rising is told with great respect for the lives of children who had things an awful lot grimmer than our own button-twiddling generation. Joe Duffy also really captures the essence of a neglected old city. I had not realised how far Dublin had slipped down the British pecking order, with its port the 12th busiest in the UK, three places behind Belfast. The book documents the fact that a shocking 142 out of every 1,000 Dublin babies born never made it to their second birthday, far more than in London. It was a Dublin where doctors made their services unaffordable for most, and chemists were the most welcome port in every storm. You'd have to say it hasn't changed that utterly, has it ?

These new hospital groups that Leo has put together are almost as mysterious as the eggs. They are all up and running with chief executives for a year now, and I have been searching far and wide for their contact addresses without much success. They haven't yet discovered the internet and by Jove, have they chosen unwieldy names. There is the South South West Hospital Group; the Dublin Midlands Hospital Group; the Ireland East Hospital Group; the West/North West Hospital Group, which I think is now called the Saolta Hospital Group. Then there is the University of Limerick Hospital Group, often called the UL Hospital Group; and another called the Royal College of Surgeons Hospital Group, which may, in fact, be Dublin North East Hospital Group too, and it includes the Louth Hospital Group which last year was called the Louth Meath Hospital group. The only one that's clear to me is the Children's Hospital Group, who are still waiting to lay the first brick of their hospital. The good news about our hospital groups is that they are now to ape the UK and redesignate themselves as Trusts. Leo will foot the bill for seven designs for seven new logos.

Dr Maurice Gueret is editor of the Irish Medical Directory


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