Women with agonising toothache in the 1980s used to encounter daftnesses like these:
Saying that you are in such agonising pain that you are contemplating suicide, proves you are 'really' depressed. You do not need your imaginary pain to be dealt with; you just need antidepressants.
"Prescribing
antidepressants to someone who is contemplating suicide because of the
intensity and long duration of pain is a life-saving measure and I am
proud of saving lives in this way." - A belief (about their women
patients) commonly held by GPs in the 80s.
"He wasn't being rude
to you. Speaking like that is just his way." - This was Miss Anne
Atkinson's response when I told her that Mr Reg Dinsdale had repeatedly
addressed me as "You Fat Depressives" (plural), instead of by my name.
These two misguided health professionals worked at the Charles Clifford
Dental Hospital. Mr Dinsdale was an 'eminent' oral surgeon. Miss
Atkinson was a Senior Lecturer in dentistry who claimed to be trying to
help me.
When I told my then GP, Dr Hazel Radley, of Mr
Dinsdale's insulting way of speaking to me, she described it as "Shock
Treatment", intended to 'shock' me out of believing that I was in pain!
Miss Atkinson demonstrated her own mastery of daft dental logic by insisting to me that I was not really in pain, I only thought I was in pain!
And when Mr Dinsdale was performing an apicectomy on my UL2, he told his
student assistant that Depressives did not actually feel pain, they
only complained about being in pain! - And when bone failed to
regenerate after his poorly performed apicectomy, which had left me in
greater pain than before, he told the student who was looking at the
X-ray with him that 'neurotics' were very poor at regenerating bone! - Very clearly, this man was deluded.
An 'ordinary dentist', a general dental practitioner, did a
re-apicectomy on the UL2 the following year, and this time the op was
done properly and the infection was properly removed so that the bone
did at last regrow.
I was sent by Roger Heesterman - Community Dental Officer, I think
his title was - in a further stage of the cynical game of pretending
that something was being done to help me, to see a Mr Hirschmann,
another high-up dentist at a dental hospital in another city,
(Heestermann could, and should, in my opinion, have helped me himself.
He was a qualified dentist after all. But I suppose there was some Dept
of Health rule that people complaining of dental negligence must on no
account receive any actual help, only exhausting hassle so that they'd give up their struggle.)
Hirschman said that no doubt I did have some dental
problems, but that the real problem was depression. He said that
he wouldn't indulge me by taking any X-rays and that none of the
dentists there would help me, but possibly one of the students could be
spared after the summer holidays...
In contrast to all this daft dangerous misogynistic nonsense:
I had an article published in Mensa magazine about my great suffering at the hands of high-up dental drips: Cruelty, Negligence and the Abuse of Power in the NHS: Fighting the System. Someone
sent a copy of the article to an academic health campaigner, and she
wrote to me to commend me for my "excellent piece in Mensa about
customer complaints". She continued, "I have been fighting the medical
attitude to consumer complaints - especially from women - for years - as
a member of a Regional Health Board, then Chair of the Patients
Association, now as a lay member of the General Medical Council.
I
certainly remember a number of cases from my days at the Patients
Association of patients with intractable dental pain who were treated as
neurotic or frankly loony - and all women. They were laughed at,
insulted and generally had a rotten time."
She went on to suggest
that I should write a similar article for the British Dental Journal to
get to the professionals directly. - I did, in fact, do this, but the
article was rejected, as you might, perhaps, have guessed it would be.
The
very top man in the whole world on the subject of pain used to be
Professor Patrick Wall of University College, London, who died in 2001.
In a personal letter to me some years ago, he wrote: "Simple-minded
doctors and dentists (the majority) have a built-in scale of how much
pain they expect for how much damage. If you fall outside their norm,
you are labelled as mad. It is they who need their heads examining. They
also need to read and think."
Wednesday, October 02, 2013
Deluded Dentists?
Sunday, February 12, 2012
Why do some Christians threaten some people that they will burn in Hell?
Why, I wonder, did the retired vicar not direct his remonstrations and threats to the dental staff who were responsible for my continued suffering and who could easily have dealt with the abscesses for me and ended my pain and sleeplessness? - That's an easy question to answer: he didn't have the guts. - He did say to me once that he had written to an important churchman he knew - a Dean of a Cathedral - and asked him if he would help me to get the treatment I was being refused! - This other guy - the Dean - also lacked guts. - He'd written back that he would ask the negligent dentists to deal with the toothache for me if I would first obtain a certificate of sanity that he could show people so that he didn't get into trouble for intervening on my behalf! - The retired vicar then toddled round to me and asked me if I'd let him have a certificate of sanity!
Wednesday, March 09, 2011
Ash Wednesday
Ash Wednesday is the first day of Lent, the Christian season that is customarily a time of reflection, repentance and self-denial. It symbolises the 40 days in which Jesus fasted in the wilderness and was tempted by the Devil. He withstood the three tests and banished the devil with the words, "Get thee behind me, Satan."
It was on Ash Wednesday years ago that the then Bishop of Sheffield, David Lunn, came to see me in my home.
I had been seeking his help in my endeavours to put an end to the appallingly cruel treatment being meted out to some patients at the Charles Clifford Dental Hospital in order to cover up sustained clinical negligence. See the account of my personal experience of this. He had not wanted to help, but had not wanted to admit that he did not want to help. He had made several excuses first. Then at last he had had me to see him at the Bishop's Palace. I was shown into the library there, and waited a little while there, on my own, until he came into the room. I found it a forbidding room, with its daunting collection of commentaries on St Paul. I'd have felt happier with books about Jesus.
He had already checked up on me with Professor Eric Wilkes, whom we both knew and respected: checked that I was a person who told the truth, and Prof had assured him I was. I had told Prof that I was seeking the Bishop's help. At that meeting in his library, I left some further information with him and he later wrote to me arranging the Ash Wednesday visit.
He arrived in his purple bishop's cassock and stayed a long time - I forget how long. He said he would need some of the lords in the House of Lords to help him to deal with the matter. I had asked him to ensure that patients with agonising toothache, needing dental help, would not be told at that dental hospital (or indeed any other) that they were not in pain and were 'just depressed', without properly examining the patients' teeth! and to give the dentists a statutory duty to examine the patients' teeth. Mr Reg Dinsdale, the negligent consultant dentist who did me the most harm, had told me he was not going to 'indulge' me by having necessary X-rays done! (I have written about him in my short story, Long in the Toothache.)
So I set about getting some lords to help the bishop. I was already in contact with the secretary of a society - I think it was called something like The Human Rights Society. I had already helped her to help a guy in the North-East who had been so atrociously treated in his dealings with the NHS and was so sick of being ignored or insulted (but never helped) by the useless NHS Complaints Procedures, and by his MP, that he had gone to London to the Houses of Parliament and had nailed his hand to a door there! to try to get someone to do something about all the NHS cruelty. - He still didn't get any help... - I had talked about him on local radio, and sent him a recording of the interview, and it had lifted his spirits to know that his shocking treatment was at least no longer completely ignored.
I asked that secretary if she could help me. She said the society was only small and not very active, but it had several lords among its membership. She asked these lords if they would help and they said they would, but that the Bishop would have to introduce the matter in the House of Lords and then they would support him in the matter. When the Bishop had left me that Ash Wednesday, he had said to me that in approaching anyone about the matter after that day, I could quote him at any time and in any context (I remember those were his exact words) that he had investigated the matter and knew that I was telling the truth and he would support me in the matter. I asked him to write me a short note to that effect and sign it but he said that that would not be necessary; I could trust him to keep his word.
Excitedly, I wrote to him to tell him that there were these lords happy to support him in the House of Lords. I never heard from him again!
I wrote to him again. He did not reply. I rang him. His newly-appointed secretary had clearly been told by him that I was a nutter, and she spoke to me as though I was half-witted. Neither she nor he answered my letters and he refused to speak to me on the phone. I can only surmise that he had supposed that I would be unable to get any lords to back him up in the House of Lords and so had felt safe in assuming that his promise to speak on the matter would never need to be kept. And he had most shamefully lied to me when he had told me that I could quote him at any time and in any context that he had investigated the matter and knew that I was telling the truth and he would support me in the matter.
Monday, April 12, 2010
Long In The Toothache - Short Story by Margaret Wilde
"These Fat Depressives: they’re always complaining of pain; they’re never happy unless they’re moaning." The consultant was musing to himself. He was a very important man. He hadn’t much time to spare for this silly woman.
He glanced at the notes. She’d complained of an acute abscess to her dentist nearly a year ago and then come afterwards to the Dental Hospital with the same complaint. Well, clearly she couldn’t have had it all that time. She couldn’t have put up with the pain.
True, she’d kept going back to her dentist. But that was the way with Depressives: obsessive about health, always wanting attention. The dentist hadn’t pandered to her, sensible fellow. He hadn’t taken any X-rays. As he’d told the woman last summer when she’d had her breakdown, that proved the ‘pain’ was just her nerves.
Coincidence that she had, after all, developed an abscess on that tooth, and it must have been there a while or the bone wouldn’t have rotted so far. Still, it would have been chronic. Lots of people had so little discomfort from chronic abscesses that they were only discovered in the course of other dental treatment. The pain of acute abscesses was of a different order of magnitude altogether, though they all become chronic if left untreated.
He knew how to deal with Depressives: Shock Treatment. It never failed. Let them know you’ll stand none of their nonsense. They needn’t whine to you for sympathy. If only everyone would treat them in the same way. They’d soon snap out of their silly behaviour then. He prided himself on his decisiveness.
She entered his room nervously. Her eyes were puffy. She appeared tired and confused. Of course, she was on Librium and amitriptyline.
"You Fat Depressives!" he greeted her. "You grind your teeth, don’t you?"
"No," she replied, and started to cry.
"All Fat Depressives on amitriptyline grind their teeth."
"Well I don’t." The silly woman was weeping copiously and blowing her nose. What a mess she looked! No wonder no-one had ever wanted to marry her.
"The last three Fat Depressives I had all ground their teeth. Why should you be any different?"
"I’m not a Fat Depressive; I’m a person. And I’ve got a lot of toothache. My mouth is a sheet of pain."
"A bit of sensitivity: we all get that as we get older. Don’t be childish. The fact is you grind your teeth while you’re asleep and that makes them hurt a bit."
"But I don’t sleep! That’s the point! I’m in too much pain. That’s why I had the breakdown. I’m so desperately tired."
"Rubbish, Woman! Of course you sleep. You just think you don’t. Pull yourself together!"
“And I’m very concerned about my work. I have a good honours degree and a distinction on teaching – but how can I give of my best to my pupils when most of my concentration is focussed on this excruciating pain and I’m so tired I can’t think properly?"
Ah that was it! She needed something to blame for poor performance in the work situation! – A classic example of neurosis!
He raised his voice to drown hers: "It is no good being hysterical with me, Young Woman. You’ve got to learn to be quiet and listen. You Neurotics are fond of the sound of your own voices."
"Tell me, Mr Lambert, don’t ‘Depressives’ ever get toothache? I have had an acute abscess left untreated for nearly a year; I have had a just-detected cracked cusp which has been painful for almost as long, one tooth just filled because it had decay and another still awaiting treatment. There are sympathetic pains all over my mouth. I am in torment."
"Stop exaggerating. - You Fat Depressives are all the same. You eat oranges and drink fizzy drinks all day, don’t you? I know these fad diets."
She looked bewildered at the change of direction of his questioning. "I don’t eat oranges. My teeth hurt too much. I never drink fizzy drinks. And I’m not normally fat. The amitriptyline holds water in my body and has caused me to gain two stones. – But what has any of this to do with the abscess, the decay and the cracked tooth?"
"Fat women always claim they never eat. - I’ll make you a bite-guard to wear at night to stop you from grinding your teeth."
She realised the advantage to the Dental ‘Mafia’ of covering up gross diagnostic errors over such a long period, but surely a consultant would have had a greater allegiance to truth and scientific exactitude than to negligent incompetents, professional colleagues or not. Surely he must realise that it was stretching credulity and coincidence too far to maintain that an abscess, a cracked tooth and two decayed teeth had all appeared by magic on the day that, fighting her appalling weariness, she had made a scene and insisted that her ex-dentist write a note for the Dental Hospital to have another look at the abscess!
The interview was at an end. He had not looked at her teeth, of course. You didn’t need to, with Depressives. The diagnoses were always the same: tooth-grinding, ‘target teeth’, acidic foods, sugary drinks, imaginary pain and exaggeration.
Well, he’d do the operation to remove the abscess and the rotting bone in June. At the same time he’d excise the scar from a previous mouth operation as it had healthy nerve tissue trapped in it. There was no urgency. She was a healthy woman in no pain and could wait four months.
He informed her doctor that she was just a Depressive. It wasn’t possible to have pain in so many teeth. "We have a Pain-Prone Neurotic here, Doctor. If I were you I’d treat any pain she complains about with a pinch of salt. These people waste a lot of our time."
The day of the operations came. He had not told her what to expect. She lived alone and would have made suitable preparations had she known how ill the operations would make her, how long they would take, how much blood she would lose. She was in ghastly pain in some other teeth. They had been treated at last, but the trouble had gone on so long before they were treated that they were taking months to ‘settle down’. Her tongue was exquisitely sore from contact with rough edges of temporary crowns and from encountering oil of cloves – balm for aching teeth but corrosive to tongue and gums. She was desperate, absolutely desperate – genuinely suicidal because of the continual pain, tension and lack of sleep. - She forced herself to remain calm. Some relief was at hand.
He had a student to assist him. He talked ‘at’ the patient. - It was only a local anaesthetic despite the operations lasting well over an hour. She had her mouth open and the scalpel and aspirator in it. Blood and saliva were removed as they appeared. She was unable to reply even if she had wanted to.
"Well Miss – Er -, you will have followed the Falklands Campaign. Brave men. They know what genuine suffering is."
As he cut through the gum during the apicectomy he accidentally cut deeply into the dentine of the perfectly healthy tooth next to the abscessed one. – God! - That’d be painful when the anaesthetic wore off! Rather her than me! Still, she’d be in shock today and it wouldn’t be absolute agony till tomorrow. It’d do her good to have some real pain for a change, anyway.
She was, after all, extremely fortunate to get the services of so eminent a dental surgeon on the National Health!
The following day, after a night of sitting upright to keep the swelling to a minimum, she was amazed to discover its actual extent. Her nostrils were splayed out to either side far wider than the outer corners of her eyes. The space left was too narrow for breathing. She had to breathe through her mouth. Blood and saliva ran down her chin. The upper lip was so swollen that it extended right over her lower lip, touched her chin and turned up at the bottom so that the inside was on the outside, so to speak. She strongly resembled the snouted Trolls she had once seen in a performance of ‘Peer Gynt’.
All was stiff – stiff as a board, she started to think, but realised that if a board were pressed, its rigidity would resist. If this stiffness were to be pressed, what would happen? The blood-gorged flesh would surely tear internally? She must try to keep very still and not touch it or stretch it.
But it was necessary to eat and drink to restore her strength after the loss of blood.
This was not only painful; it was extremely difficult. Her lips did not make a seal, since the upper was so much bigger than the lower. To drink in the normal way was impossible, as the upper lip was unusable. She had to introduce a small spoon into her mouth and ‘pour’ a little liquid from it into the bottom of her mouth and then bend her head backwards for it to reach her throat. It was a messy, immensely slow business.
She had not believed her ordeal could worsen so much. The healthy tooth which had been damaged by the surgeon’s carelessness astonished her by being the most harrowing of all the teeth. The scar excision had proved a much bigger operation than she had been led to expect. Painful throbbing extended from her mouth, up the side of her nose and as far as the outer edge of her left eye.
Her mouth was to her the very jaws of Hell.
The sweet focus was her TONGUE.
How deliciously sensitive the tongue to delight! – How agile a member when all had been well with her mouth! But for three months now it had been constantly chafed by the temporary crown and sticking-up point of the tooth which had been cracked. She had been embarrassed at school by having to use chewing gum to cover the sharp point. This was effective but it had to be continually chewed in order to function. If just left on the point without chewing, it went flaccid and soft in the heat of her mouth and slipped its mooring.
But how was she to chew? – With the great need for inactivity for healing to take place and the swelling to subside?
Unhappily, there proved to be no choice. The tongue’s demands were the most strident. She chewed all day – and all night, since the pain from the tongue would not allow her to sleep. In sleep the chewing gum would leave the tooth, the tongue would relax onto the point and the pain would wake her from that tiny sleep.
How could this torture have been allowed to happen? If an I.R.A. prisoner had been made to suffer as she had, Amnesty International would have intervened. But she was allowed no advocate. Her torturers were the prosecution, judge and jury.
She could feel the tight flesh tearing as she chewed. She could feel the stitches tugging through the delicate skin. She knew that she was doomed.
Lack of sleep. Horrendous pain.
She had the stitches out a week later and begged that the sharp point be ground down. It was, a little, but the remaining tooth tissue had to be conserved at all costs, apparently, even the possible cost of her sanity. She had no strength to argue and her tongue did not permit much speech.
Three days after this the migraines began. She took paracetamol and embarked on a futile expedition to find and purchase a glue to stick the chewing gum into position. She obtained some, but the glue remained in position and the gum slid off! Then the next shopkeeper told her that the glue was poisonous.
The fifth migraine in a day – she had not believed so many were possible in a day – attacked her on her way home. It was the end. No-one would help her. No-one understood her wretchedness and it increased when she sought to explain it. since this involved moving her tongue. So many teeth hurting; gums throbbing; face painful; head pounding; eyes aflame and unseeing.
As a stumbling, purblind, weary, yet supremely lucid and logical act, in order at last to end the pain and blessedly to go to sleep, she stepped in front of the approaching car.
………………………………….
Notes.
Every word I have put into the mouth of the surgeon in talking to me is what Mr Reg Dinsdale (I have used a pseudonym in the story) actually said to me, but there was more than this, of course.
I have telescoped two ghastly interviews into one.
Much of what ‘she’ says in the story was actually written for the surgeon, as I was far too ill to speak much.
He did look in my mouth actually, to see if an apicectomy on the Upper Left 2 would be feasible. But this was only after he had made his ‘diagnosis’ – of Depression and Tooth-grinding!
The car stopped (end of story). I felt contrite that I had frightened the driver – though it was not a pre-meditated act. I went to Dr Hazel Radley and told her I had just attempted suicide. – Please would she help me to get the dental treatment I needed? – Coldly she told me not to be silly. – I was not in pain, she assured me.
Margaret Wilde
Monday, December 21, 2009
Fighting the System: NHS Complaints Procedures
The first feature article I wrote for Mensa’s monthly glossy magazine was about medical and dental negligence and the uselessness, cruelty and bias of the NHS Complaints Procedures, and was entitled ‘Fighting the System’. In the years since then there will have been changes to the Complaints Procedure, but I am confident that it still harms complainants rather than helping them or reforming the system.
This is a slightly shortened version of the article:
Fighting the System
An abscess flared up on one of my front teeth. Talking was difficult and sleep impossible. My dentist said there was nothing wrong. So I went to the Dental Hospital. The pain – sudden, acute, accompanied by swelling, most severe when biting – was exactly characteristic of an acute abscess. But the pain was discounted and the abscess not treated.
When you have toothache you chew in strange ways to avoid exacerbating it. This puts unnatural pressures on teeth and it is easy to crack them. This happened to me. A cracked cusp, a separate agony, went untreated. Tooth-brushing was an ordeal and could not be as thorough as before the pain. Decay started, causing further severe toothache. This also went untreated. It was almost a year before the abscess was treated. It was over two years before I obtained treatment for all the dental disorders causing the toothache!
If consulted by a man with an abscess and weeping in agony, surely the most negligent dentist would take note of the signs and symptoms and would treat the abscess in its acute phase, ending the pain. In a full year of many attendances at the Sheffield Dental Hospital I was constantly insulted and left in agony. One consultant called me ‘You Fat Depressives’, plural, instead of using my name. It was clear that he habitually addressed suffering women in this way.
I eventually found a dentist brave enough to try to put things right. He dealt with the gross infections, etc but tragically much of the pain had by this time become chronic, which often happens when the cause is not dealt with promptly.
I heard from other women who had had their pain derided or been told that it was ‘nerves’ or ‘all in the mind’. One Rotherham woman had endured agony from trigeminal neuralgia for 13 years before someone (a neurosurgeon in private practice) took her pain seriously and operated. The pain then stopped. Trigeminal neuralgia mainly attacks women and its only symptom is pain. It is not uncommon for people to kill themselves because of severe toothache or because of trigeminal neuralgia, so intense is the pain.
Thirteen years of needless agony. Why does such cruelty flourish? The answer is many-faceted, of course. It includes ignorance and arrogance. Pre-eminent, however, is the health professional’s demeaning attitude towards women, coupled with the scandalous fact that in this country doctors and dentists are accountable to no-one, not to the patient, not to the hospital, not to the NHS.
Women are sub-human, second-class citizens whose voice need not be heeded. Everyone knows, don’t they, that whatever a woman complains of, the ‘real’ cause is usually psychological, and instead of investigation and treatment all she needs is a brusque injunction to pull herself together and a prescription for tranquillisers and anti-depressants. That’ll settle her!
In my desperate efforts to obtain the treatment I needed I turned to every health agency. All pretended that negligence does not occur. No-one insisted that my teeth be examined and my agonising toothache dealt with. The health agencies and the people to whom complainants must address complaints are financed by the DHSS or the NHS and by definition not impartial. The Complaints Procedure routinely adds to the difficulties of complainants rather than dealing with their complaints of negligence.
Why are the legislators not moved to effective remedial legislation? There are many reasons, I suppose; laziness, fear, the myth of medical infallibility, the desire to keep in with medics and their retinues, the fact that most MPs use private medicine rather than the NHS and that when they do use the NHS they get preferential treatment. Surely, also, a lack of imagination – failure to comprehend the scale of the suffering, the profound and terrible difficulties of damaged victims – trapped in pain and distress and worry, trapped in misunderstanding, trapped in bewilderment that those to whom they turn for help and from whom they have been led to believe they will receive it, adopt a confrontational stance. There is no-one in the entire edifice of the Health Service from whom victims of medical negligence can be assured of receiving help. They do not know where to turn.
In the Sheffield Star of August 20th 1986, the Administrator of the Sheffield Family Practitioner Committee is quoted as saying of complaints that most of them ‘were dealt with amicably, although in some cases the patient was struck off’. Dealing with complaints is clearly thought of as a matter of smoothing ruffled feathers or of placating/punishing the complainant, rather than of examining faults that need to be put right. If you made a complaint about trains, you would not consider it resolved by being forbidden to travel by train any more, would you? Why should a complaint about a doctor be considered resolved by crossing the complainant off his list?
When in the press someone criticises the medical profession, another person is certain to write in to protest that they themselves received wonderful treatment. e.g. the dreadful way that Sue Arnold was treated at the Moorfields Eye Clinic in London, reported a few months ago in her column in the Observer magazine. The following week someone wrote about their wonderful treatment there. If you publicised finding a dead mouse in a loaf, no-one would dream of writing to say that they had had a loaf from the same shop and it hadn’t had a dead mouse in it! Officials aver that the public makes few complaints about the Health Service. Like saying that most of our loaves don’t contain dead mice.
The official claim disregards the justifiable fears many people have about making a complaint. You risk being struck of a doctor’s list (and often the family of the complainant is also struck off) and may find it difficult to get a doctor at all.
The main reason for outraged complaint is being treated as sub-human. As I was. Callously left in agony which could easily have been treated and which I clearly could not treat myself. Agony for which it was impossible to get relief without the treatment that was being denied me. Abscesses and caries cannot ‘get better’. There has to be professional intervention.
By allowing medics to insult people under the guise of diagnosing them, by allowing honourable people to be treated in this appalling way, humanity is defiled. By categorising the person who then complains as a nuisance who must be pacified if possible and quelled if not, no-one is safe from such defilement.
There are moves to tinker with the Complaints Procedure. The Primary Health Care leaflet, with the Government’s proposals for discussion on health services outside hospital, suggests that there should be informal conciliation procedures to settle less serious complaints quickly and effectively. Again the ruffled feathers syndrome. Complainants do not want conciliation, they want remedial action taken about the complaint. Officially, negligence does not occur. So nothing is done about it.
It would be salutary to cause to be published a sample of the complaints of the last year and what the Complaints Procedure did about them. This would show it up for the charade it is. One only hears of anything being done if the matter is given publicity, which seldom helps.
That suffering, ill, exhausted people damaged by the medical profession have the right to redress in the civil courts is no right at all. Only 3% or 4% of cases get to court and they take a minimum of 4 years to get there. Everything is weighted against the victim, especially the hostile attitude of the Health Authorities. In any case, action in the civil courts has only individual relevance. General reform cannot result.
What victims most need is remedial treatment. There is no provision for this. What can be more important than the right to urgent remedial treatment when you have been harmed by hospital personnel? Gross medical negligence is compounded by the implacable unhelpfulness of the Health Authorities.
The NHS should be accountable to the consumer – i.e. the patient. Medical and dental staff have absolute power to give or to withhold necessary investigation and treatment to patients, to treat them with insolence, to defame their characters in privileged communications, etc. provided only that they call this the exercise of ‘clinical judgment’. (Compare this with, in recent times in Parliament, the ritual incantation that a matter is one of ‘national security’ and as such no-one has the right to question it.) Such power is clearly dangerous, is open to abuse and is clearly being abused. Terrible suffering like mine would be totally prevented if medical and dental staff were accountable.
Negligence
There can be nothing in this country more heinously unjust than the lack of help for the suffering victims of medical negligence. Patients have no protection whatsoever from the ignorance, incompetence, negligence and sometimes sheer malice of doctors and dentists. People who are not victims of the system are unaware of the situation. That negligent doctors and dentists incur neither censure nor sanction from the system ensures that negligence flourishes.
It is a moral imperative for caring people to do what they can to bring a speedy end to this cruelty.
The Complaints Procedure needs to be scrapped and replaced by a system providing immediate help for the victim of negligence (I don’t mean money; I mean remedial treatment and support) and an independent inquiry into the negligence with the purpose of apportioning responsibility and instituting reform to protect potential future victims. I stress that I am not interested in legal redress. I am asking for legislative action to remedy a national scandal.
The Health Ombudsman defines instances of medical negligence as matters of clinical judgment, and matters of clinical judgment, conveniently for negligent doctors and dentists, are outside his terms of reference. So he does not help. His reply to my letter made clear that he had given scant attention to my arduously compiled material. My evidence was ignored.
This state of affairs is independent of who the individuals are who become victims, being only dependent on the deficiencies of a system which allows the magic phrase ‘clinical judgment’ to override reason, humanity and justice. Clinical judgment cannot, by definition, obtain, where clinical diagnostic procedures have been waived. To pretend otherwise is an abuse of language, an abuse of trust, effectively an abuse of power and in practice a physical and psychological abuse of individual victims.
These abuses are systemic and must be rooted out. The powerless and suffering need protection from such cruelty.
There was a public inquiry about Wendy Savage, a doctor neither negligent nor incompetent, and about whom no patients had lodged complaints. There are no inquiries into real cases of negligence, initiated by the victims. Health professionals would be much more careful if their actions were to be subjected to public scrutiny.
Margaret Wilde
Thursday, December 03, 2009
After reading a very interesting article by John Kay about the undesirable outcomes that, in practice, tend to result from seeking Consensus
I came across this very interesting article by John Kay, about Consensus and the undesirable outcomes that, in practice, tend to result from seeking Consensus. I do urge you to read it. He summarises his thesis in these words:
"Just as universities need to tell people to stop quibbling and work towards a common objective, companies need to realise that clustering around a corporate conventional wisdom that has not been subject to analysis and debate is also not a recipe for success."
Earlier today, on Radio 4, I heard someone (sorry, I didn't catch who he was) speaking critically about Wikipedia, and, if I remember correctly, criticising it essentially for tending to move towards Consensus, rather than towards Truth. Like him, I favour Truth, backed up by Evidence, rather than Consensus, backed up by Assertion.
The Climate Change Science Scandal that has featured prominently in the news recently, rested in essence on one set of scientists, led by Professor Phil Jones, director of the climatic research unit at the University of East Anglia, seeking to manipulate access to data and interpretation of data in order to bring more scientists to a consensus favouring his views, in the hope/expectation that consensus would be accepted as truth, even though the data had been doctored.
When I use the word 'doctored' in this context, I do so advisedly. - For many years, law courts and judgments were over-influenced by so-called 'expert' opinions expressed by 'expert' witnesses, in particular by 'expert' medical opinions. Such was the deference the judicial system accorded to these expert medics, that in practice the opinions they expressed were mostly accepted as evidence, rather than opinion. This institutional prejudice was compounded by what was called 'The Bolam Test', which was adopted by some other countries - former British colonies, I believe - as well as Britain.
A doctor, dentist, nurse, etc is deemed to owe "a duty of care" to the patients they treat. But when a doctor, say, was negligent in the way he treated his patient, according to the Bolam Test, it did not necessarily amount to negligence if support could be found for it among other members of his profession - even if there was not a lot of support. This ruling meant in practice that a doctor accused of medical negligence needed only to find an expert who would testify to having done the same thing or would testify that he would have made the same diagnosis as the accused doctor.
Obviously this ruling was widely abused and there was no shortage of venal health professionals willing to testify in such a way as to favour a fellow member of their profession. - I remember when I was on the Steering Committee of the RSI Campaign that we had a young lawyer come to speak to us one evening and he told us that lawyers could always find a doctor to give any opinion their doctor client wanted to be given, provided they paid him enough.
This, of course, is disgraceful and unjust enough, but the Bolam Test spread its baleful tentacles into the clinical sphere, and has had the effect of increasing the incidence of medical negligence. Medical and dental practitioners regarded themselves as pretty safe from being found guilty of negligence because all they had to do when a patient made any charge or complaint of negligence against them was to ensure that colleagues in the profession would back them up in the course of action/inaction they had taken. This was easily achieved because there tends to be a feeling within their profession that "there but for the grace of God, go I", and a tendency to support erring colleagues in the profession, in the expectation that if you got into the same situation, your colleagues would similarly support you.
Thus it was that when I suffered sustained negligent and appallingly cruel treatment at the Charles Clifford Dental Hospital years ago, it proved almost impossible for me to get the treatment I desperately needed, despite seeing several dentists well able to have provided the treatment. See Fighting the System, my first Mensa article.
One of the negligent dentists, Stephen Hatt, Head of Restorative Dentistry, sneeringly invited me to write a letter of complaint about him. - "Much good it will do you!" he jeered, in complete confidence that nothing whatever would be done about his cruel treatment, which had caused me such long, agonising pain. And he was right. Nothing at all was done about the letter I arduously compiled and sent.
I talked about the matter to a young dentist from a different town long after this and asked him why it was that whenever I tried to get help from another dentist at that dreadful hospital, they scrupulously examined the notes about my treatment, instead of examining my teeth! He explained that the system was that they would all say that they would have made the same diagnosis as the negligent senior dental staff who had harmed me, and so that treatment would have been considered correct and they would not have been deemed to be at fault. - This is an example of the law of unintended consequences, and leads to the extraordinary probability that if ALL would have treated the patient badly, then NONE is considered negligent!
Officially the Bolam Test is no longer part of the legal process, but in practice its spirit lives on, and most health professionals do not worry much about getting into trouble about their poor treatment of a patient, because there remains the implicit assumption that doctors and dentists are altruistic, omniscient beings who do not make errors, or if they do, it is not their fault. You have only to remember the terrible harm done by the arrogant, ill-informed Professor Sir Roy Meadow in the case of Sally Clark, and to realise that even now, despite all the tragic consequences of his flawed testimony, colleagues in his profession continue to defend him!
I remember reading years ago - I think it was in The Politics of Schizophrenia by David Hill - that the only time doctors/psychiatrists all agree on a psychiatric diagnosis is when they are all wrong...(o:
You will have gathered that I do not favour consensus as being a reliable guide to the truth of any belief. I look back on those two very famous errors of hundreds of years ago that held sway because of being the consensus view, namely that
1) the Earth is flat, and that
2) the Sun goes round the Earth.
I rest my case.
Saturday, November 08, 2008
The uselessness and cruelty of the NHS Complaints Procedures: FIGHTING THE SYSTEM.
This is a slightly shortened version of the article:
An abscess flared up on one of my front teeth. Talking was difficult and sleep impossible. My dentist said there was nothing wrong. So I went to the Dental Hospital. The pain - sudden, acute, accompanied by swelling, most severe when biting - was exactly characteristic of an acute abscess. But the pain was discounted and the abscess not treated.
When you have toothache you chew in strange ways to avoid exacerbating it. This puts unnatural pressures on teeth and it is easy to crack them. This happened to me. A cracked cusp, a separate agony, went untreated. Tooth-brushing was an ordeal and could not be as thorough as before the pain. Decay started, causing further severe toothache. This also went untreated. It was almost a year before the abscess was treated. It was over two years before I obtained treatment for all the dental disorders causing the toothache!
If consulted by a man with an abscess and weeping in agony, surely the most negligent dentist would take note of the signs and symptoms and would treat the abscess in its acute phase, ending the pain. In a full year of many attendances at the Sheffield Dental Hospital I was constantly insulted and left in agony. One consultant called me 'You Fat Depressives', plural, instead of using my name. It was clear that he habitually addressed suffering women in this way.
I eventually found a dentist brave enough to try to put things right. He dealt with the gross infections, etc but tragically much of the pain had by this time become chronic, which often happens when the cause is not dealt with promptly.
I heard from other women who had had their pain derided or been told that it was 'nerves' or 'all in the mind'. One Rotherham woman had endured agony from trigeminal neuralgia for 13 years before someone (a neurosurgeon in private practice) took her pain seriously and operated. The pain then stopped. Trigeminal neuralgia mainly attacks women and its only symptom is pain. It is not uncommon for people to kill themselves because of severe toothache or because of trigeminal neuralgia, so intense is the pain.
Thirteen years of needless agony. Why does such cruelty flourish? The answer is many-faceted, of course. It includes ignorance and arrogance. Pre-eminent, however, is the health professional's demeaning attitude towards women, coupled with the scandalous fact that in this country doctors and dentists are accountable to no-one, not to the patient, not to the hospital, not to the NHS.
Women are sub-human, second-class citizens whose voice need not be heeded. Everyone knows, don't they, that whatever a woman complains of, the 'real' cause is usually psychological, and instead of investigation and treatment all she needs is a brusque injunction to pull herself together and a prescription for tranquillisers and anti-depressants. That'll settle her!
In my desperate efforts to obtain the treatment I needed I turned to every health agency. All pretended that negligence does no occur. No-one insisted that my teeth be examined and my agonising toothache dealt with. The health agencies and the people to whom complainants must address complaints are financed by the DHSS or the NHS and by definition not impartial. The Complaints Procedure routinely adds to the difficulties of complainants rather than dealing with their complaints of negligence.
Why are the legislators not moved to effective remedial legislation? There are many reasons, I suppose; laziness, fear, the myth of medical infallibility, the desire to keep in with medics and their retinues, the fact that most MPs use private medicine rather than the NHS and that when they do use the NHS they get preferential treatment. Surely, also, a lack of imagination - failure to comprehend the scale of the suffering, the profound and terrible difficulties of damaged victims - trapped in pain and distress and worry, trapped in misunderstanding, trapped in bewilderment that those to whom they turn for help and from whom they have been led to believe they will receive it, adopt a confrontational stance. There is no-one in the entire edifice of the Health Service from whom victims of medical negligence can be assured of receiving help. They do not know where to turn.
In the Sheffield Star of August 20th 1986, the Administrator of the Sheffield Family Practitioner Committee is quoted as saying of complaints that most of them 'were dealt with amicably, although in some cases the patient was struck off'. Dealing with complaints is clearly thought of as a matter of smoothing ruffled feathers or of placating/punishing the complainant, rather than of examining faults that need to be put right. If you made a complaint about trains, you would not consider it resolved by being forbidden to travel by train any more, would you? Why should a complaint about a doctor be considered resolved by crossing the complainant off his list?
Saturday, May 05, 2007
Epilepsy drug, valproate, may lower children's IQ
Epilepsy drug may lower children's IQ, study shows - Guardian
Extract:
"Women who took an epilepsy drug during their pregnancy are at greater risk of having children with lower IQ, according to a study. Taking the drug valproate - which is already at the centre of a British court action after claims that it has damaged children - seems to double the chance that the woman's child will be born with mental retardation.
Around 140 British families claim their children are suffering from foetal anti-convulsant syndrome because their mothers took valproate during pregnancy. The syndrome encompasses a range of neural, behavioural and physical disorders such as cleft palate and spina bifida, learning difficulties, behavioural problems and abnormalities in movement, speech, vision and hearing. Many mothers were prescribed the brand Epilim, made by Sanofi-Synthelabo, though the drug is also available in generic forms. So far, Sanofi is the only company involved in the court action, with a trial date set for October 2008.
In the research, Kimford Meador, of the University of Florida in Gainesville, looked at IQ results of 187 children born to mothers who had taken the epilepsy drugs carbamazepine, lamotrigine, phenytoin, or valproate during pregnancy. The results, presented yesterday at the American Academy of Neurology's annual meeting in Boston, showed 24% of the children of mothers who took valproate had an IQ low enough to be defined as mentally retarded, compared to 12% for carbamazepine, 9% for lamotrigine, and 12% for phenytoin.
Children whose mothers took carbamazepine scored an average of 93 points on the IQ tests, those on phenytoin 93, lamotrigine 96, and 84 for valproate. "Our findings are consistent with other studies, which have shown valproate poses an increased risk for foetal death and birth defects," said Dr Meador."
Doctors are supposed to avoid prescribing drugs to pregnant women unless the drugs are absolutely necessary because so many drugs are particularly dangerous to unborn babies. I know personally, however, that valproate is a dangerous drug and that it is not only unborn babies that are affected. - I used to know a woman whose only child, a beloved daughter, died because an obstinate doctor had insisted to her mother that the drug was safe and that the little girl was just attention-seeking and not really ill...)o: - And I, in my innocence years ago, took Epilim for some weeks. I was told that it would lessen the chronic toothache I suffered because of the sustained gross negligence of senior dental staff at the Charles Clifford Dental Hospital. - It did not lessen the pain at all; what it did do was cause some of my hair to fall out. It has many adverse side-effects. - For years now I've been punctilious in avoiding all drugs that I can; I'm certain that on the whole they do far, far more harm than good.
Lose weight by eating less salt! Go on! - Try it! - You will feel so much better!
See my website www.wildeaboutsteroids.co.uk
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Thursday, January 18, 2007
SPEECH IMPEDIMENT - Short Story by Margaret Wilde
SPEECH IMPEDIMENT
“Does that hurt?”
Rigid with agony, breathing arrested mid-inspiration, fingers digging into the arms of the chair, thrust skull pinning the headrest, she waited for the end of eternity – waited for the drill to stop. It stopped.
Limp and drained, she breathed again.
“Did that hurt?” he asked impassively.
Margaret Wilde ©2007
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