Chipped Tooth
The administrator now the
administered.
Pulse-oximeter sirens a frenzied fear,
friendly faces pace in busyness managing
checklists to the unknown.
Man-made epilepsy in-a-box.
Temples numbing – signify it is done.
Tooth is chipped.
We have moved on
‘We have moved on’ (said doctor Knows Best)
didn’t you notice?!
Today we have targets, tooled by incentive,
and our patients are our numbered ‘partners’.
Betjeman has been realised:
not in poetry but in his warning.
We must ‘Release time to care’
Illness is our paradigm.
Though (of course) we only seek health!
But sadly, long since did guid Dr Osler ‘move on.’
and Today disorder is our norm.
‘Neuro-everything’ may seem necessary, but it is never sufficient –
unless we are no more than ‘our brains’.
Peter’s principle that –
evidence can help inform,
but cannot be sufficient amidst poverty of thought.
‘We have moved on’ and ‘we can be certain’
said Dr Knows best:
history is ‘irrelevant’ and our social world ‘unreal’.
‘We have moved on’ and ‘we can be certain’
of the boundary between ageing and illness.
And more certain still
that we are (indeed) (today) more humane.
Dr Knows Best you are a marvel!
A neuroscientific wonder.
and we have moved on . . .
The PROTOCOL.
The Protocol asks:
“What year is it now?”
“1984” , I reply.
The machine stamps: ‘Cognitive impairment ESTABLISHED:
and I fall down a dystopian Orwellian memory-hole.
The Protocol knows what’s best:
do not stray from the pathway
Evidentially (or not)
The Protocol has no need to consider
maleficence and Hippocrates’
but I am an oaf.
The Protocol has moved-on:
ageing is a thing of the past!
Patterns of pathology
have become
TODAY.
The Protocol is unstoppable in its progress.
“It is an all out fight”
our Prime minister confirms.
The metaphors
engaged
are indeed pathological.
The Protocol fights stigma! [The machine confirms].
And any ‘diseased Other’ has nothing to fear
from The Protocol.
I need ethics because I am on my own
I can only see with my own eyes.
I try to shift my stance.
However, I do not always see what others see
I need ethics because I am ordinary and extraordinary
I can see with my own eyes
I try to shift my stance.
However, I do not always see what others see
[and then there is feel]
“The subjective—objective divide”
Within and outwith I cannot find a ‘dividing’ line:
backwards, forwards, inside-out and wonderfully Humpty-Dumpty,
no presence lives life:
div-ided.
VISITORS MUST REPORT TO THE OFFICE.
The number of lives that enter our own is incalculable.
Why select just a certain few stories to define yourself?
A Little Spartan
I am a little Spartan.
I retreat from Market forces, Ego and Ivory Towers.
I do not attack, but vulnerably question.
Neither science nor art can divide Little Sparta.
[Let me be sensitive]
The mainstream is not for me!
No wonder that this ancient rebel
will win no award
that he would not want.
I am a ‘Scottish Chapter’.
Recorded on a bit of faded paper,
a typewritten insert that was glued –
without feel – to a book
on waterfalls.
B E I N G [and let me be sensitive about this]
– is more than any sum –
between the ‘MAINSTREAM’ and me.
The Porsolt Forced Swimming Test (Behavioural Despair Test) is centred on rodents’ response to the threat of drowning. It has been interpreted as measuring susceptibility to negative mood in humans. It is commonly used to measure the effectiveness of antidepressants in rats.
The following is a poem written by me about this test. I wrote it in my mind on my way to Siberia. Once at Siberia I jotted it down in my commonplace notebook. This Siberia is a farm, now a ruin, in the East Neuk of Fife. It should not be confused with the extensive geographical region spanning much of Eurasia and North Asia.
The poem recounts the friendship of two rats: one rat is called ‘Hippocraticus’ and the other rat ‘583’. Hippocrates is often referred to as the “Father of Medicine”. Agnes Richter was a psychiatric patient and seamstress. She made herself a jacket whilst under psychiatric care. It seems that she was known as ‘patient 583’ and so she stitched this label into her jacket.
The Royal College of Psychiatrists has stated that “We know that in the vast majority of patients, any unpleasant symptoms experienced on discontinuing antidepressants have resolved within two weeks of stopping treatment”.
Dr William Sargant (1907-1988) was a British psychiatrist who is remembered for the evangelical zeal with which he promoted treatments such as psychosurgery, deep sleep treatment, electroconvulsive therapy and insulin shock therapy. He wrote, with Dr Eliot Slater in 1944 the influential Textbook: “An introduction to physical methods of treatment in psychiatry“.
“Real Psychiatry” is a blog written by an American Psychiatrist. In terms of psychiatry in the UK a new textbook is to be published this month: it is titled “The Medical Model in Mental Health: An Explanation and Evaluation”
P O R S O L T
Aye its cauld, like Siberia! Says rodent ‘583’
So keep swimming Hippocraticus
ye wud’nae want to SINK.
Keep swimmin’ Hippocraticus
We’re being ‘evaluated’ did ye nae ken?
And all will be ‘resolved’ when we stop
swimming.
Did ye nae hear:
Dr Sargant is giving a talk on ‘values and feeling valued’
Aifter a plush dinner at some Royal Society or anither!
So keep swimming Hippocraticus.
There’s gan tae be a Text book aboot us –
it will “explain” how we feel
based on the new brain cells that grew in oor brains
before we drooned.
The Text book is to be called “REAL PSYCHIATRY”
Keep swimming Hippocraticus!
“The Rules of Science”
are credible
and we
are not.
“I am sae tired 583
I don’t hae strength to swim much longer
Gie me a ‘choppy sea’ any day
tae P O R S O L T”
Keep swimming Hippocraticus! [rodent 583 is close to tears]
the imbalance is not ours.
Hippocraticus [sinking]
Now dead.
Dr Sargant enters the laboratory
and prepares the PORSOLT glass beaker for 583.
In Defence of War
Dr Sargant has issued a command
to be learned by heart
before entering
his laboratory-treatment room:
“it is moral cowardice not to go along with my
S U P E R I O R A C C U R A T E F A C T S”
This is a “rule of science”
hollers Dr Sargant, and
Vivendo discimus
nothing more than “propaganda”.
“words” are not relevant
yells Dr Sargant –
in his Defence of War.
S Y M B O L I C
‘Real science’, it is said, should be based on what science considers credible.
On hearing of this ‘science’ the philosopher felt a need to quietly say: “Numbers are symbols, as are letters: both are necessary in developing wider understanding, but neither are sufficient nor able [alone or combined] to translate experience in its entirety. Particularly when considering the science of the Mind, we must remember that much of what is claimed to be ‘objective’, or ‘real science’, is actually based on a symbolic reduction of subjective experience”
EVIDENCE BASED MEDICINE can be both evidence and medicine if it includes:
s u b j e c t i v i t y
– there is no view from nowhere [1]
EVIDENCE BASED MEDICINE can be both evidence and medicine if it includes:
the s o c i a l world
– no man is an island [2]
EVIDENCE BASED MEDICINE can be both evidence and medicine if it includes:
t i m e
– listen. time passes [3]
EVIDENCE BASED MEDICINE can be both evidence and medicine if it includes:
e x p e r i e n c e
– vivendo discimus [4]
References:
[1] The View From Nowhere – by Thomas Nagel. 1989
[2] No Man is an island – by John Donne. 1624
[3] Under Milk Wood – by Dylan Thomas. 1954
[4] Vivendo Discimus [it is by living that we learn] – Patrick Geddes. 1889
“Perceived”
Presented with uncertain symptoms
the doctor, a diligent scientist,
checked every bit of data that had ever been established:
evidence-based and randomised controlled.
This empathic doctor [a natural worrier]
re-checked every last bit of data and every guideline
[“Guidelines are not Tramlines”]
Always learning from the life of others
the doctor realised that there is more to evidence
than randomised controlled data.
It is by living that we learn:
or had the doctor “perceived” wrongly?
Footnote:
It is not uncommon to come across senior doctors describing reports of harmful effects of medical interventions as “perceived”. These same doctors then insist that the most important evidence is based on Randomised Controlled Trials.
This poem may be perceived as an ‘attack’ upon evidence. It is not. Evidence comes in all forms, and evidence-based-medicine, although necessary, cannot fully represent experience.
Order your MINCE now!
The MINCE Brand –
ready in just 5 minutes!
Alas there are no neeps, no tatties.
Just MINCE, MINCE, MINCE!
This is the MINCE Brand –
ready in just 5 minutes!
ENTERPRISE MINCING MACHINES
Are the BEST in the World!
‘ENTERPRISE MINCING MACHINES’
Are endorsed by the Royal College of Mincers.
‘ENTERPRISE MINCING MACHINES’
Are the reality not the perception!
‘ENTERPRISE MINCING MACHINES’
Reduce you to MEAT in 15 minutes!
Up the ANTI-
Up the ante!
Anti-this, Anti-that!
A binary absurdity dividing reality:
Making opposites of us all.
Up the ANTI-
Up the ante!
Standing outside the circle of listeners,
a Venn diagram without overlap
and we are cruel to one another.
Up the ANTI-
Up the ante!
A monstrously unreal Hydra,
where heads are chopped off
blood spills and stains.
Note: I was an NHS Psychiatrist for 25 years. This poem is a response to the rise of the term “The New Anti-Psychiatry”. This term has become widely used by a number of psychiatrists, often referring to anyone who has questioned the prevailing psychiatric narrative in any way. Unfortunately this divisive use of language has dismissed the opportunity to learn from real world experience of psychiatric interventions, and as such is “anti-science” in itself.
GODDAMIT!
The EXPERT said:
‘I am an EXPERT in what is right and wrong.
I am an EXPERT, literally, GODDAMIT!’
The EXPERT said:
‘Hippocrates and all his followers were wrong.’
That’s what the EXPERT said, GODDAMIT!
Alas, there was no evidence-base to support the EXPERT’S ‘Literal EXPERTNESS’.
However the EXPERT said he was right, GODDAMIT!
Note: A response to Dr Tyler Black, MD, who stated, 12 October 2021: “If someone cites ‘first do no harm to me as an argument, I immediately know they have thought very little about medical philosophy or ethics at all”
and get it wrong
Number me
[I am numberless]
Label me
[I am labelless]
Judge me
[and get it wrong]
K I N G S E A T H o s p i t a l
It was the 1994 FIFA World Cup,
141 goals were scored that summer.
I saw nearly all of them on the old wooden television in the doctors’ residence!
The microwave no longer worked, but the kettle did
and I did just fine!
The faded curtains in the doctor’s bedroom
a green and white pattern of ivy,
failed to meet in the middle –
through the gap you could see the stars shine bright.
The reassuring early morning sound of the gardener’s lawn mower:
the bowling green ready to play
Never did I hear the clatter of bowls.
The doctors’ library opened out into the doctors’ residence:
what the whole of this society owes to Aesculapius!
But it was the ill-arranged ephemera of gathered time
that captured me.
Here I grew to appreciate the company of people
who listened to the world.
Kindness of being was there in Clouston ward:
led by a doctor
who without ever really knowing,
made you feel better through just being there.
30 summers have passed since those days,
And today, up and down that dip from Newmachar,
I returned to Kingseat Hospital.
A new housing estate greeted me,
almost a new town,
with no school, no shop,
off-the-peg street names
off-the-peg houses.
Planners imaginations stifled for profit.
And sitting puzzled amidst this new world,
the roofless hospital ruins.
This is no healing landscape.
Trees planted when the hospital was first built, now mature
Autumn colours comfortingly vivid
the dappled, darting, reflected light,
impossible to catch.
Your Pharmacy
Gilbert, your pharmacy has closed,
your old shop is too small.
Business is still booming:
‘cures’ for ALL
This is no fairy tale.
GABERSTON BOYS
When we last met
you were young men,
really just boys –
certified or not –
Designated insane.
I was your visiting doctor
In Gaberston house.
Yesterday, I met you again,
you were leaning over the wall of my garden:
we chatted together as auld men
the Passing of time making our conversation
beautiful, real.
Vox humana –
never was there a wall.
TIPPERLINN
SUNSHINE.
A cluster of small cottages
women handloom weavers
Tipperlinn, with a ‘reputation’
for sunshine, and
the ‘best people’ in Edinburgh.
RATIONAL + PRACTICAL.
The sunny cottages replaced
by a grand house and an Asylum
that was never to be
big enough.
Tipperlinn, the new mansion
built of warm-hued sandstone,
windows floor-to-ceiling
home of Dr Skae, Physician Superintendent,
protégé of Dr Batty-Tuke – another
large-headed man.
July 1863, at Tipperlinn:
that famous address to the emerging establishment
‘A Rational and Practical Classification of Insanity’:
brainful and weighty,
it was well received,
though had a few critics.
CATRIONA.
Years collapse now.
You were born, October 1965 –
from birth your eyes blazed: everyone remarked.
I arrived late, backwardly, 1967.
From the start, sister + brother
we were ‘ROUGH PROOF’.
[Photographs survive to confirm this!]
THE BANK.
Catriona, when wee, our childhood
seemed endless.
Today, it feels like
a momentary passing.
Memory, young and old, not being
always reliable,
yet Granny’s letters read like yesterday:
“Most of the time is taken with Stuart talking about the Bank”
“It is grim and exhausting”.
THE MEADOWS.
1969, Tipperlinn House has a new role:
‘The Young People’s Department’.
Aged just 8, you were to be
one of its youngest ‘guests’ –
your bright eyes dimmed instantly.
I recall ‘family Therapy’
dressed up in shirt and orange tie,
aged just six.
Interviewed behind a two-way mirror
That was blinding.
GUESTS OF THE REAL.
You escaped
from Hospital.
Granny describes, in her letters,
how you were ‘captured’ in the Meadows.
Dr Wolf, like all the adults,
got you so wrong.
Yes, it was Dr Wolf who wrote that celebrated book:
‘Children Under Stress’.
PERSISTENCE OF WOUNDS:
Four decades of Psychiatric drugs:
this is your ‘later’.
Practically and Rationally, you are considered
Mentally ill, Majorly, so. Intractably meadowless.
But Catriona, I see your eyes as they once were,
so bright,
my creative
brilliant
older sister.
I guess that we weren’t so
“ROUGH PROOF”
Thank you.