Black Magic & White Poison.

 Black Magic & White Poison.

Despite a lifetime of medical practice, it never grew dull. My last two patients that day, after a long day of seeing patients were enough to keep me wide awake. Not far from the teaching practice where I was working at the time was the Oneida Nation of the Thames Reservation.

Patrick , a fifty-five year old native patient, walked in at five o'clock.

"What can I do for you, Patrick ?" I asked him. I knew him quite well.

"Something is interfering with my thinking, Doc," he said.

"What do you mean?" I asked.

"Someone put a curse on me, Doc," he said.

"Tell me about it," I prompted .

" I think it was my cousin," Patrick said.

"Why would your cousin put a spell on you?" I asked.

"I think it was because he thought I was making love to his girlfriend," said Patrick

"When was this?"

"Oh, years ago. I took no notice, I didn't do anything, but he thinks I did, that's why he put the curse on me. Can you get rid of it?"

I knew that what I said next was going to determine whether Patrick was going to follow up with me or not. I took a careful psychiatric history. There were no florid psychiatric symptoms apart from the conviction that a curse had been put on him.

"Maybe I need some medication?" he asked.

"Let's just keep an eye on things for the moment," I said.

"So can you takes off curses?" he insisted.

"We will need to follow up on this." I evaded the question.

"So you can get rid of spells?"

"No, but we can get rid of your problem. I'm not going to write you a prescription right now. I'm going to see you again next week and see how you are doing."

"Okay, thanks. I'm glad you can help me."

I asked several more questions to satisfy myself that Patrick was not going to be a danger to himself or anyone else.

I walked him out to the desk to make sure he had an appointment for follow up in a few days.

"If anything changes in the meantime just come right in ." I called after him.

I breathed a sigh of relief as my last patient of the day walked in to the office.

He was about eighteen years old and had a restless, agitated demeanor. I was alerted when I read the name on the chart, because I had seen the boy's mother not very many days earlier and she had expressed some concerns about her son, Glen.

I invited him to sit him down across from me. I smiled at Glen, attempting to put him at ease but he avoided eye contact.

"What can I do for you today, Glen?" I asked him.

"I have a problem," he said, coming straight to the point. He thrust his right hand into his trousers pocket and pulled out a square tinfoil wrapper.

"I'm hooked on this and I need help to get off it," he said, with obvious agitation. "I feel so nervous all the time and I can't sleep. I lie awake most of the night sweating and twitching and I can't get up in the morning. I've been missing a lot of school."

I looked down at the discarded packet. Duragesic Transdermal Patch, This was not good news. This was Fentanyl,

"Where have you been sticking this?" I asked. A transdermal patch is applied to the skin, through which the active ingredient is absorbed. It is fifty to a hundred times more potent than morphine,

"The kids at school cut them into four and we suck them."

"This is heavy duty stuff," I said. I wanted to know where Glen had got hold of this stuff; this stuff came right out of a hospital. It sure as hell didn't come wrapped like that on the street, I'd have to find out how this was getting on to the street, but I didn't want to frighten him off by going down that street right now because I thought I was getting through to him.

"Yeah, I know. I have to do something about it,"

"I'm going to tell you what you have to do. I have to see you on a regular basis and you've got to join Narcotics Anonymous or Alcoholics Anonymous, you can't do this on your own."

Glen looked doubtful. " I think I can do this on my own, if you can just give me something to help me sleep at night."

"That's not the way it works,"I said. "Right now, you're at a crossroads in you life. If you do things the right way now, you have a chance. If you don't you're on the slippery slope to a life of addiction, detox centres, rehabilitation centres and worse. If you don't want to waste your life, you have a chance to act now."

"Okay," Glen agreed, perhaps a little too readily, I thought, "I'll do it"

I printed a list of of treatment centres near his address.

I said, "I'm going to make time to see you next week and when I do, I want to hear that you're been to an AA or a NA meeting and that you have plans to get set up with a sponsor. I'm going to give you a few pills to help you to sleep, just enough to last you until I see you next week. This is where you'll get help if you want it" I added, handing him the list.

" OK, " he said, "I'll see you next week."

I never saw him again.

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The Micawber Principle or 'How to be happy!'

    Mr Micawber, a character in Charles Dicken's "David Copperfield" said the following.

" Annual income twenty pounds, annual expenditure nineteen pounds nineteen and six, (almost twenty pounds) result happiness. 

Annual income twenty pounds, annual expenditure twenty pounds nought and six, (just over twenty pounds)result misery."

The Bleeding Plague.

 

an·ti-vax·xer

/ˌan(t)ēˈvaksər,ˌan(t)īˈvaksər/

noun

INFORMAL

1. a person who is opposed to vaccination, typically a parent who does not wish to vaccinate their child.

   "experts say several diseases that are avoidable are making a comeback due to anti-vaxxers who refuse to vaccinate their kids"

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Seven years ago I presciently blogged this:Anti-Vaxxers: Ignorance or Fraud.   In 1998, a British  physician named Andrew Wakefield and twelve of his colleagues published a small case series  in the Lancet, a prestigious British medical journal that suggested MMR (measles, mumps, rubella) vaccine may be  related to  autism.  MMR vaccination rates began to drop almost immediately as a result of that.  Subsequent studies  did not confirm  any such relationship. Ten of the twelve authors refuted the interpretation of the data on the basis of insufficient evidence.  Further, it emerged that Wakefield et al had failed to disclose that they had been funded by  lawyers who were engaged by the parents in legal suits against vaccine producing companies.  Ultimately, Wakefield et al were found guilty of deliberate fraud and fabrication of facts apparently for personal gain.   Wakefield was removed from the General Medical  Council of Britain's  register and was no longer permitted to practice medicine in the United Kingdom or Ireland.and emigrated to America, to lead and encourage the development of the 'Anti-Vaxxer' movement which would lead a significant group, most of whom should  have known better, back  into the dark ages.So how is it that so many allegedly educated elitists buy into this absurd theory that a measure that has done more to promote health and  eliminate devastating disease  is harmful and therefore should be avoided.  How is it that these allegedly educated dopes cannot understand that what is 'natural' often is for people to die of infection, of pneumonia and  of sepsis from an  infected finger?  Can they not understand that it was 'natural' for one  in five children to die during childbirth, along with a  goodly number of mothers?   Can they not understand that pain and suffering is natural and that it  is quite unnatural to remove those natural  warnings?  Do they not take antibiotics when infected or painkillers when in pain?  You bet they do!   Can they not understand that freezing to death is natural and that central  heating and burning of fossil fuels is unnatural?  Can they not understand heat and humidity are natural and that air conditioning is horribly unnatural?  Those poor feckless milksops are to first to cry out for those unnatural balms that they so despised, as soon as they perceive a little pain and suffering.  Of course they really do understand what it is all about.  They want to parade their ignorance as though it were knowledge.  Some believe that their unscientific and uneducated views are "equal" to  those of  scholars and scientists who have spent their lives studying those topics.   They are not, but unfortunately they can still do immense damage and enjoy some credibility, while the herd  immunity that the last generation ensured persists and offers them protection.  Fortunately,  most sensible folks protect their children, but we are likely to see more outbreaks of these once well  controlled diseases as immunity wanes. Meanwhile, the pseudo scientific simpletons will continue to consider themselves as an elite group entitled to  inflict their often ill-founded views on their fellow beings.         Dr. Wakefield and his ilk will thrive as long as they can recruit the un-informed, the misinformed, the self righteous and the gullible!