Den nuværende dille med at nedlægge de små sygehuse og erstatte dem med nybyggede supersygehuse er en international tendens, ikke kun en dansk.

Jeg vil spå, at om en årrække vil det blive set som en af vor tids største fiaskoer.

Idéen om at samle specialerne, så fx hjertekirurgerne kan operere på hjerter hele tiden i stedet for et par gange om året, er jo i og for sig udmærket.

De to hovedproblemer er flg.:

For det første bliver afstandene alt for store. Patienter ligger jo som hovedregel ikke alene på sygehuset, men bliver fra tid til anden besøgt af deres familie og venner. Det giver alt for meget besvær for dem, hvis de skal rejse i timevis hver gang.

For det andet bliver hospitalerne alt for store. Det betyder for det første, at de for personalet bliver meget svære at identificere sig med og tage ansvar for, og for det andet, at de bliver umulige at lukke ned, hvis der opstår et problem (fx infektioner).

P.g.a. disse problemer vil jeg tro, at man om et årti eller to vender rundt på en tallerken og begynder at erstatte de store sygehuse med en masse små lokalsygehuse, som de specialiserede læger så enten rejser rundt til eller hjælper på afstand v.h.a. internettet.

Små sygehuse (fx ét i hver kommune) vil få kraftig lokal støtte, og det vil være nemt at sætte navn på eventuelle problemer, så de ansatte vil føle et personligt ansvar.

Det bliver naturligvis lidt træls for overlægerne at skulle rejse land og rige rundt, men jeg vil tro, at videokonferencer og fjernstyrede skalpeller og den slags vil kunne minimere det.

Jeg gad vidst, hvad de nye supersygehuse vil blive brugt til i 2030 – lagerhaller?

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Som jeg sikkert har nævnt tidligere, skal Phyllis efter planen føde den 9. januar.

Det betyder, at afstanden fra skambenet til toppen af livmoderen gerne skulle være 28-29 cm.

Men da de målte hende i dag til et rutinetjek, var afstanden 34 cm.

De sagde først, det sikkert bare var for meget væske, men de sendte hente til scanning for at tjekke.

Men nej, det er rent faktisk pigen derinde, der er kæmpestor: De vurderer hende til at veje mellem 2500 og 3000 gram på nuværende tidspunkt.

Anna vejede 3500 gram ved fødslen, så det lyder jo umiddelbart ret stort.

De regner med at tjekke Phyllis for sukkersyge i næste uge, men der er ingen tegn på noget i urinen, så hvis ikke det er årsagen, er det sikkert bare en meget stor baby.

Det kan selvfølgelig godt være, at hun vokser meget langsomt fra nu af og altså kommer til at veje ca. det samme som Anna ved fødslen, men det kan man ikke sige noget fornuftigt om på nuværende tidspunkt.

Jeg er i øvrigt meget imponeret over billederne fra scanningen. Phyllis er aldrig blevet scannet så sent i graviditeten, og det gør altså en stor forskel.

Se blot, hvor tydeligt man kan se hendes profil på billedet øverst til venstre.

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As far as I remember, doctors’ salaries were bumped up a few years ago because it was shown that they could earn so much more abroad that more and more were emigrating, so it was agreed that higher salaries were the only way to retain and attract doctors here.

However, now that the pound has fallen dramatically against most other currencies, I presume this means that their salaries are again far too low compared to other countries.

So should their salaries be increased by 30% or so?

Given how much more a medical doctor already earns than most other people with equivalent education levels, that would be hard to swallow for most people.

And indeed the Treasury recently announced a pay freeze for GPs and other senior medical staff, so they’re clearly not seeing any need to keep doctors here at the moment – perhaps they’re hoping they’ll all emigrate so that the cost of the NHS will come down?

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I’m increasingly of the opinion that legalising drugs is the only way out.

At the moment, alcohol is often dearer than drugs, and tobacco carries more warnings, so the current situation clearly does not work.

There is an excellent blog posting in The Devil’s Kitchen about this topic.

Here are the three reasons he lists in favour of legalisation:

The first reason is that, like the US, a large part of Britain’s criminal activity—especially gang activity—is associated with the supply of drugs. Remove this trade and you remove a good deal of crime from our streets—or, rather, the motive for the crime. I am fully aware that criminal gangs will probably move onto something else but—given that we have limited law enforcement resources—whatever they move onto may be easier to police than drugs (which are relatively easy to smuggle).

Second, much of the damage done to individuals by drugs are a factor of their illegality. Although some drugs are strong and should be treated with caution (and at least with respect)—I would favour retaining some idea of drug classification to give users an idea of their potency—they are generally speaking short-lasting and put a small strain on the body’s resources. However, it is the brick dust with which heroin is often cut that blocks the capillaries and leads to amputations; it is the warfarin with which cocaine is mixed that all to often leads to severe bleeds in the brain (accentuated by cocaine’s raising of the heart-rate).

Third, although providing services to addicts is a reasonable thing to do, it is still a strain on the public purse. If drugs were legalised, they could be taxed. This is, by the way, a perfectly free-market policy (and not only because I favour consumption taxes to pay for any state): it is not a “sin tax” but is based on the concept of Pigouvian taxation—that is, you are using tax to reflect the true costs of goods on the market that would not otherwise be reflected in the price (internalising market externalities).

Unlike the author of that blog posting, I don’t have any experience with hard drugs, and I’m not tempted by them either.

But I think legalisation would actually lead to less drug consumption.

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The Scotsman claims today that the government is planning to vaccinate the entire UK population against swine flu.

That might turn out to be a wise decision, but I’m a bit concerned about the timescale:

The last people won’t get their flu jab till November 2010.

I’m not sure it can be done any sooner, but if it turns out to be a fast-moving pandemic, I presume half the population might be dead before the government gets a chance to save them.

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This will probably make most readers of this blog envious, but I am curious to find out whether I’m unique in this respect.

I seem to be unable to get a headache.

Even when I have a hangover, I only have the other symptoms without any headache at all.

I had some kind of mild headache a couple of years ago, but that what as part of some viral infection that caused pain in most of the body, too, so I’m not sure that counts.

A google search for unable headache seems to return only pages about people who can’t get rid of their headaches rather than being unable to get them in the first instance.

So am I a mutant, or is this actually pretty normal?

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Jeg havde da haft lidt ondt i halsen i længere tid, men det var da ikke noget alvorligt.

Men så eskalerede det pludselig torsdag aften – mit hovede blev varmere og varmere, og min krop koldere og koldere.

Jeg gik i seng, men jeg sov elendigt – jeg vågnede hele tiden op med den samme meningsløse drøm.

Fredag morgen var jeg slet ikke i stand til at gå på arbejde, og jeg sov næsten uden afbrydelser til sidst på eftermiddagen.

Så stod jeg op, spiste en banan, så lidt TV, spiste en sandwich og lidt is, og så gik jeg i seng igen.

Kl. 5 om morgenen vågnede jeg brat op, feberfri og klarhovedet, men meget, meget træt.

Det tog mig så det meste af lørdagen at komme til kræfter igen, og først i dag har jeg været mig selv igen.

Og stakkels Phyllis ser ud til at gennemleve samme sygdomsforløb, blot med et døgns forsinkelse, så hun har ikke været meget værd i dag.

Nu håber jeg blot ikke, alle børnene følger efter på rad og række!

Opdatering (17/12): Jeg var ved lægen i dag og fik antibiotika (cefalexin).

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I must say I thoroughly enjoyed the first two thirds, although the book is a tiny bit out of date. It’s one of those nice examples of popular science that actually gives you a feel for how things happen in the engine room, rather than just presenting the results.

However, towards the end he starts writing fictional stories about the seven “clan mothers” of Europe, and this is definitely the weakest part of the book.

He assigns hair colour and other physical characteristica to them, although he obviously doesn’t know this.

Also, to make the descriptions seem realistic, he strays into areas about which he clearly has little knowledge.

For instance, he writes about one of them that their “language was not elaborate, but quite sufficiently developed to impart [...] basic information.” As a linguist, I know this is nonsense. All human languages, whether spoken by hunter-gatherers or by invest bankers, are equally elaborate and highly developed.

So read the first part of this book, but skip the seven fictional chapters.

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There’s an important article in The Times today about how to deal with pædophiles.

It basically argues that we normally either punish criminals and then let them get back to normal life afterwards (even though we know they might reoffend), or we decide they’re ill and offer them treatment (possibly for the rest of their lives) instead.

However, we seem to want to do both when it comes to pædophiles: First we punish them, and we then stigmatise them for the rest of their lives because they’re sick.

I had never thought about this before, but I think it’s true.

When it comes to deciding whether to opt for bad or mad, I think we should split the group into two.

An 18-year-old who had consensual sex with a 14-year-old is not a pædophile in my book, and if we think it’s not OK, it’s definitely a crime, not an illness, and when he’s completed his punishment, he should be free to live a normal life afterwards.

On the other hand, middle-aged men raping small kids are in a very different category. It makes much better sense to try to cure them of their urges in high-security psychiatric hospitals and only release them back into society when (or if) the psychiatrists think they have been cured.

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There’s an excellent article in The Independent today about transfat.

I knew Denmark had outlawed transfat altogether, but I didn’t realise so few countries had followed suit so far (only Switzerland in Europe).

Also, I didn’t realise the results were so staggering. According to the article, “the rate of heart disease among Danes has dropped by a staggering 40 per cent” since the ban was introduced five years ago.

I think there should be an EU-wide ban, but until that happens, I definitely think Scotland (or the UK if it’s not devolved) should introduce a complete ban, the sooner the better!

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