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Notwithstanding the quote from Ecclesiasticus—“Death is better than a miserable life, and eternal rest than chronic sickness”—and consequent argument,1 I am compelled to counter Romain and Carey’s article on assisted dying with the disability paradox2 and my 30 years of experiences of enduring, awe inspiring, resilient holiness in scores of people with disability, including people with spinal cord injury who …

Aided by its relatively small size, Northern Ireland is already tracing over 90% of positive cases within 24 hours—but the system has not escaped scrutiny and criticism, writes Chris Baraniuk

After house jobs in Bristol Alan George Blandford joined his brother in law, Michael Bourke, in a semirural practice in Shepton Mallet, where he spent the rest of his working life. Embracing …

With a key case due to come before the High Court, Clare Dyer looks at the legislative options for bringing the province into line with the rest of the UK

Darned if I could remember where I had left my glasses, but I carefully retraced my footsteps of the day before. Sure enough, in the gentlemen's rest room near my office, there was …

As NHS systems have moved in different directions, Nigel Hawkes examines the challenges of determining whether one country is doing better than the rest

Kathleen Mary McCartie entered general practice in Hanley, Stoke-on-Trent, where she stayed for the rest of her career. She had a leading role in the local medical committee and served as chairman. Her …

The NHS in England needs to rediscover its zeal for making healthcare safer because energy for the cause has “dissipated,” a leading health improvement expert has said. Stephen Thornton, chief executive of the Health Foundation, told the Patient Safety Congress 2012 in Birmingham on 29 May that there was a “problem” with patient safety in England compared with the rest of the UK. He said he could not see the same passion of a decade ago which stemmed from a “real sense of moral outrage” over care deficiencies and took its cue from inspiring national leadership in the NHS. He said more effective coordination was to be found in Wales, …

It is strange how a phrase that you have not heard used for several decades can, like Proust’s madeleine, stir the deepest, though not necessarily the fondest, memories. I happened recently to be leafing idly through Sir Charles Symonds’s Studies in Neurology , a selection of his papers published in 1970, when he was 80 years old. The book begins with an autobiographical introduction, and on page 18 three words, followed by their acronym, stood out from the rest of the page as if in pink neon lights on a pitch black night: “lack of moral fibre”—or LMF. How, I wonder, do the eyes, guided by the mind, …

What picture of doctors emerges from this week’s journal? Forget the news stories—which have the usual fare of doctors up before the GMC (doi:10.1136/bmj.c4194), being investigated for conflicts of interest (doi:10.1136/bmj.c4083), and defending themselves and their patients against various sorts of bureaucracy (doi:10.1136/bmj.c4168). Look instead at the rest of the journal. Here is a succession of images of doctors as people who think completely differently from their patients; are part of the problem when it comes to social inequality; are susceptible to moral deformation through the pursuit of ambition; yet talk to each other across a big divide. Not surprisingly, most of these images come from the review pages. They start with Christopher Martyn’s …

Life is tedious monotony interspersed with occasional memorable moments. My wife and I have never stood on the bow of a ship pretending to fly, nor have I wrapped my arm around her while making a clay pot on a potter’s wheel; but like everyone else I have my own memorable moments. Memorable moments are more frequent when we are young and are woven of optimism, recklessness, youthful invincibility, and an overwhelming sense of wellness—a sense more mental than physical. The rest of life is spent …

In the past clinical entries were short and illegible, because doctors’ handwriting is notoriously poor. This was explained by their being pressed for time, but for me it is because I could spell only the first three letters of most medical conditions so blurred the rest. Fountain pens were given as presents, adjustment made with whitening fluid, and final copies sent by post. But in the 1990s came word processors with spellcheckers, cut and paste, and infinite redrafting. This allowed me to start journalistic writing. And in 1995 I licked four envelopes to the leading magazines for general practitioners and posted my article idea—“Let me through”—of vaguely rude parodies of doctors (see box). By return of post I received four rude but amusing rebuffs. But I kept on writing because writing is therapy, and with the advent of email I could send the same article to multiple publications for rejection. But the media are …

Carol Seymour, medicolegal adviser for the Medical Protection Society, looks at everything you need to know to work in the rest of Europe

Edward Davies looks at pay in four other careers and finds out how it compares with doctors’ pay

Soon you’ll be free. You’ll shut the diary, activate the “out of office” email, and get away from it all for a fortnight of rest and recreation. What have you got to look forward to (apart from the cancelled flights and lost luggage)? Well, there’s no more journal reading for a start; in fact, no reading at all, unless you count the novel that will end up as a face screen during the sunlounger snooze. Now’s probably the worst time, therefore, to suggest that a recent research paper …

The medical director of Australia’s only medically supervised injecting centre has called for it to be recognised as a legitimate health facility and for an end to its trial status. Speaking on the eve of her departure from Sydney’s Medically Supervised Injecting Centre (MSIC), Ingrid van Beek said it was time to declare the seven year trial a success. “I wholeheartedly support the ongoing rigorous evaluation and monitoring of health services to ensure their effectiveness, particularly in the illicit drugs area, as needs can change over time, but the MSIC’s apparently endless trial status is a barrier to its integration with the rest of the public health system,” she said. “This affects …

“Your next batch of students arrive tomorrow,” the administrator told me, “and one of them has a visual impairment.” It turned out that 20 years previously he had had retinitis pigmentosa diagnosed, and by the time he joined medical school he was registered blind. My colleagues were sceptical about his choice of profession, and we pondered how best to deal with this situation and what impact his presence would have on the rest of the team and the patients. …

“This did not happen. I'm not really here.” Martha Millstone sat on Hubert's desk and did up her bra strap. “How can you say that?” Hubert slid his hairy hand inside Martha's bra. “I say what I mean,” said Martha. “This last hour did not happen. You must erase it from your memory.” Martha pushed Hubert's hand away and pulled her shirt on. “I will not forget a minute of it.” Hubert was completely naked. His right arm and shoulder were covered in thick black hair. The rest of his body was pallid and hairless. “Think of it as a mistake,” said Martha. “You're used to making mistakes. Like selling the doctors' residence.” She pulled her tights on. “I didn't sell the doctors' residence, nor did David.” “You are the chief executive.” “So you assume I have some power? I am a cog in a badly functioning system.” “Stop making excuses.” “Martha, I've waited nearly two years for you to come back to me. Let's not spoil it by arguing.” Hubert looked at Martha's legs. “It didn't happen.” Martha picked up her jacket. “Stay with me,” said Hubert. “I've a clinic to do and people to see.” Martha marched out of the …

PLAB 2 (the Professional and Linguistic Assessments Board test part 2) consists of 16 objective structured clinical examination (OSCE) stations, which usually include one rest station and one pilot station. Each station is graded from A to E. (www.gmc-uk.org gives further details.) It covers a wide range of tasks including history taking, examination skills, practical skills, use …

Editor—Alderson and Groves suggest that “what we don't know we don't know would be a good topic for a BMJ theme issue.”1 But, do you know what? It couldn't be done. For to write about what we don't know, we must surely know we don't know it first, otherwise how could it be an issue? The only way it could work would be that those who know they don't know something, but think the rest of us don't know we don't know it, write about it so that the rest of us then also know we don't know it. Then everything in that issue will no longer be unknown unknowns, but known unknowns. Do you know what I mean?

Surgeons have an image of being control freaks, but today's operating theatres are more democratic than you think. Few of us surgeons enjoy sitting in a circle and sharing our thoughts in an egalitarian way, but then nor do the rest of the team. Each member—nurse, technician, anaesthetist—is proud of his or her role and knows that the rest do not fully understand it. Nevertheless, most decisions are shared. Patient and surgeon together decide whether …

Excellent Scrabble players may know more words than the rest of us but not necessarily their meaning. Although Scrabble experts know lists of words that most of us do not use on a daily basis, they cannot use these words in a sentence. Scrabble experts practise for competitions by memorising …

Two exhausted cyclists from Burkina Faso take a rest at the end of the Tour du Faso, Africa's greatest cycle race. The picture is …

It was about the beginning of September, 1664, that I, among the rest of my neighbours, heard in ordinary discourse that the plague was returned again in Holland; for it had been very violent there, and particularly at Amsterdam and Rotterdam, in the year 1663, whither, they say, it was brought, some said from Italy, others from the Levant, among some goods which were brought home by their Turkey fleet; others said it was brought from Candia; others from Cyprus. It mattered not from whence it came; but all agreed it was come into Holland again.

Those who believe the French scientists' claim that the Murorua explosion is perfectly safe should have a word with the citizens of Caithness in Scotland, whose fast breeder nuclear reactor programme spewed out lumps of radioactive waste to the extent that the beaches near Dounreay had to be closed. Scientists in both France and Caithness offered reassurances about the safety of their schemes—often in the tones of weary patronage so beloved of scientists talking to their public. When it comes to knowing which side their bread is buttered, however, scientists are no different from the rest of the population: it's hard to face up to …