Monday 19 March 2018

Rude health: The poor mouth

When the best health news is a new cemetery for Leo's constituents, Maurice Gueret examines 'beal bocht' politics

Lucinda Creighton - will Enda Kenny put her in health? Photo: Gerry Mooney
Lucinda Creighton - will Enda Kenny put her in health? Photo: Gerry Mooney
Dr Maurice Gueret

Doctors experienced a strange aura of deja vu before Christmas, when revelations emerged about swanky salaries and overflowing pension pots in the top barn of the Irish Farmers' Association. You see, the Irish doctor knows the Irish farmer well.

Though they don't see each other often at mart or under the glare of medical lighting, they have that mutual understanding of each other's precarious position, which goes back many generations. Both guilds have an innate appreciation of the pulling power of the human mouth, particularly the poor one. They also know that in this modern, competitive world of beal bocht one-upmanship, the more you pay, the greater the genius you can employ to do the beal bocht-ing for you. Putting on an effective beal bocht for any sector of human society takes consummate skill. Any old trade of fools can fall into dire straits from time to time. But the real skill is in the careful staged exaggeration of a profession's fall so that it evokes compassion, forbearance and generosity when the nourishing pie is being divided. 2016 may well bring new focus on the hired leaders of other professions. And when  all is done, dusted and exposed to public glare,  as Myles na gCopaleen would say, their likes might not be seen again.

There was some very good health news from Hawkins House recently, when the Minister tweeted to his 28,000 social-media followers that his Dublin West constituency was to get a new graveyard. Porterstown is to be the lucky recipient, and, according to Leo, the cemetery will also serve the willing population of neighbouring Castleknock and Clonsilla. Dr Varadkar proudly boasted that planning and design is to start immediately. Shovels and mechanical diggers are at the ready. You will have to join Twitter to see the fine collection of responses that Dr Leo's thoughtful tweet merited. When I was being trained up as a family doctor, it was always drilled into us that when you are building up a practice you should have nothing to do with undertakers, plot-diggers or cemetery committees. Grave but good advice.

This cemetery at Porterstown has been a long time coming. Back during World War II, a Monaghan dispensary doctor called Conor Ward was Minister for Health and Local Government. Ward had been a senior IRA figure in the War of Independence, and combined his medical and political work with a side-interest in a bacon factory. His personality was described as rough and abrasive, and he was bitterly disliked by elements in his own profession. In November 1944, Dr Ward answered a question in the Dail to say that he had sanctioned a new cemetery in Porterstown. Three-quarters of a century later, this place of eternal rest is coming to fruition. Soon it will be taking the very customers who were promised a national paediatric hospital when they were children.

2016 will be an interesting year for our Minister for Health. Taking a leaf from Micheal Martin's puffing ban, Leo seems to have accepted that tinkering rather than treating is the best legacy he can leave in health. You may have to wait until the end of your life to get tested, treated or palliated. But as you languish on your final trolley, you can draw terminal comfort from the fact that the campus is smoke-free and your hospital menu now has a calorie count, right down to the last oven chip. It's a hard election to call this year, but my expectation is that Fine Gael will march back with a different coalition rag-bag in tow. Leo's penance in Health for trying to unseat Enda will be over, and he will be asked to conduct Foreign Affairs for Ireland in that well-cut tailor's suit. As for Health? Well, that's a precious little gift that Enda takes sinister pleasure in carefully bestowing. The wise money might be on Lucinda.

I gave up finger-wagging many years ago, but from time to time a medical study lands on my desk that causes me to ring the bell. A small army-recruitment study of 500 young men in Finland examined their fitness levels. It was found that those whose mothers smoked in pregnancy, about 10pc of them, had lower aerobic fitness. The short-term effects of smoking are well known - a higher risk of miscarriage, stillbirth, pre-term delivery. The medium term risks are also clear - more asthma, more chest infections and more ear trouble for offspring. But this study hints that the effects of smoking while attending maternity hospitals last well into the next generation. That army of rotund, dressing-gowned ladies at the front door of our maternity hospitals really needs to be disarmed.

It seems that the young generation are switching off the TV, fed up with an incessant diet of new-age lifestyle preaching. Channel 4 used to run a series where a nutritionist dissected a family's faeces, accompanied them to a supermarket and harangued them about deadly food choices. It was funny for one show. There was another mad one, where a doctor's computer would tell patients how long they had to live! The latest wheeze involves doctors moving in with families to see, at first hand, what makes them unhealthy. They never seem to mention genes. I wonder what sort of medic would actually have time to participate in these charades. We were brought up to believe that the best doctors were those who never had any time to see you.

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

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