I was telling you recently about an obesity congress in Prague where it was predicted that Irish men could soon be the widest goalkeepers in Europe. You might remember that I called for the elimination of the complicated Body Mass Index (BMI), the mathematical formula that takes only height and weight into account when assessing your beefiness. Well, salvation is at hand.
At the same congress, researchers from Oxford suggested that a piece of string may be just as useful as the BMI in assessing the risk of heavy folk keeling over from heart attacks. The theory goes like this. Your waist measurement should be no more than half your height. So you measure your height with a piece of string and cut the line to the exact length. You then fold the string in half and circle it round your waist. If it doesn't fit, you may need to avoid the biscuit aisles of Lidl or Aldi for a few weeks.
Now it would be remiss of any doctor to mention the waistlines of patients without giving clear instructions on how to measure them. The human waist is a movable feast, depending on who is doing the measuring. Waterford GP, Dr Mark Rowe, wrote knowledgeably about this topic in The Men's Health Book some years ago. Mark said that many men are astounded to find that their waist measurements can be four inches greater than the size of their trousers. To measure the midriff accurately, you need to find the midpoint between your lowest rib and the curvy iliac crest which is the highest part of your hip bone. If layers of fat prevent you locating these bony structures easily, then prepare yourself for some bad news. Usually the midpoint is at or just above the belly button. Tapes (or strings) should be absolutely level all the way around. The measurement is taken after a big breath out, and sucking in the belly renders the test void. Loud gasps are allowed only after the measurement is taken!
Death of Charles Kennedy
I don't know if Charles Kennedy's waist measurement played any part in his demise, but his death earlier this month at the age of 55 has left many political colleagues reeling. Reading between the lines of the many warm tributes, you sense some guilt for the manner of his passing. Kennedy had been a prominent Scottish MP for more than 30 years, and leader of the UK's Liberal Democrat party for seven of those. It was particularly poignant that a man who had lost his parents, his marriage, his leadership and his seat in parliament, was found dead alone in his Scottish highlands bungalow. Kennedy seems to have been a much-loved man with many well-meaning and caring friends. But he wasn't so good at taking their advice. He had a lifelong aversion to walking, a smoking habit that he never kicked and a well-documented fondness for alcohol. Charles Kennedy wasn't the first or last 'shy man' to hire drink as a good companion. Psychiatrists all over this country and others can tell you about the casualties and the risks inherent in all parliamentary careers. Be wary of any job that shuns morning work and provides subsidised alcohol on the premises late into the evenings.
My annual waiting-room survey continues and I greatly value the many letters and emails that I receive on the subject. Noise is a particular bugbear. Sean attends a busy general practice on the northside of Dublin, and the television in the waiting room is always turned up so loud that he struggles to even hear his own name when called by the doctor. He is in his 30s and has perfect ears, but wonders how patients with hearing difficulties manage. Sean suggests that one day a year, medical staff should put themselves in the position of the people who use their service, and sit in their own waiting room. Bill attends a large rural practice with four doctors and the same number of nurses. They all summon their patients in different ways. Some just nod and others come into the waiting room and whisper your name. One doctor stands outside his office and shouts the name of the next patient at full voice. One day, a grumpy nurse shouted out a patient's name in a most aggressive, insulting manner as he was waiting in line for a blood test. The temptation was to make a complaint, but Bill chose to bite his tongue and not react. The matter was resolved 'in-house' and the 'calls' aren't as aggressive any more.
Wales health service
For reasons unknown, the principality of Wales seems to spawn the most amazing health-service stories. I wrote earlier this year about a Welsh paediatric clinic that had to chain children's toys to the walls because of a spate of dastardly thefts. And also I related the story to you about the employee of a Welsh hospital who began to sell rubber gloves, uniforms and assorted medical equipment from the wards on eBay. The latest medical crime to make headlines concerns a 60-year-old man who was jailed for disguising his Renault estate car as an ambulance. The man was a full-time carer for his wife who had a serious and chronic medical condition. To make frequent hospital visits easier for her, he purchased a blue flashing light and a paramedic uniform on the internet, and used both gallantly to improve her clinical access. But when he used them to run shopping trips and household errands around the town of Neath, his cover was blown. A speed camera caught the 'emergency responder' doing 73 miles per hour and breaking red lights. His poor wife died before the trial and the judge's jail sentence means he won't be doing any more blue-light trips for at least 20 months.
Dr Maurice Gueret is editor of the 'Irish Medical Directory'
Sunday Indo Life Magazine