Tuesday 27 August 2013


"People can try to reinvent themselves. I don't think you can really change who you are, though, because who you are is pretty much where you came from and what you've done up to now."

Eminem

Wise words indeed from the forty year old rap artist.


 I like the idea of reinvention; to change myself completely, to try out a little metamorphosis and become another being, to slip out of my old skin and become something quite different. To jump out of my very own cocoon and come out as something quite different to what I was before. Perhaps it isn't necessary, you could just reinvent parts of your life, little parts that could be changed into something completely different, perhaps your history, your past. Then if you believed it enough, you could make it true. It would be real because you made it so.

If you believed it enough it could change everything, self belief is a powerful thing. I believe it therefore it is true. I am this, I am that, I am whatever I want you to believe I am. I think people already do that, I don't think I'm making revelations, I just think that some people are better at it than others. Being candid, wearing your heart on your sleeve can be very endearing, but sometimes it might be better to lie and let people see what you want them to see, that way you can leave the reinvention to them. They can recreate you in their eyes and you can just nod your head and go along with it.

I think that's what I shall do, as long as they don't change me into something I don't like.


The above picture is of a piece of artwork by Kate MacDowell, more of her work can be seen on http://katemacdowell.com/index.html I think the picture suited my mood. The one at the top of the page is called "The God of Change" which I thought was rather appropriate.

Monday 26 August 2013

 
 
"Everything that kills me makes me feel alive."

On being insane in insane places.............

I don't know if you've ever heard of the Rosenhan experiment in 1973, it was a psychological experiment to explore the validity of psychology diagnoses. David Rosenhan called it "On being insane in insane places." It plays an important role in the study of psychology from A level standard up to degree level. It is still believed to be a significant piece of research today on the validity of a psychiatric diagnosis. It's enough to give you sleepless nights..........

What happened was this; there were twelve students and there were two parts to the study. The first part of the experiment consisted of eight healthy students, three women and five men, who pretended that they were suffering from hallucinations and attempted to get admitted to 12 different psychiatric hospitals in over 5 states in the USA,  they were ALL admitted with psychiatric disorders. AFTER admission they behaved normally and told the staff that they felt quite well and were no longer experiencing hallucinations. But in order to guarantee their release they were all forced to admit they were mentally ill and take antipsychotic drugs as a condition of being released. All except one were diagnosed with schizophrenia, even though there was nothing really wrong with them in the first place.

"These pseudo-patients telephoned the hospital for an appointment, and arrived at the admissions office complaining that they had been hearing voices.  They said the voice, which was unfamiliar and the same sex as themselves, was often unclear but it said 'empty', 'hollow', 'thud'.  These symptoms were partly chosen because they were similar to existential symptoms (Who am I?  What is it all for?) which arise from concerns about how meaningless your life is."

"Each pseudo patient had been told they would have to get out by their own devices by convincing staff they were sane."

In the second part of the study, the hospital administration of one hospital who'd taken offence at Rosenhan's study challenged him to send more "normal" patients to their hospital to prove that they could identify them. Rosenhan agreed to this and in the next few weeks out  of nearly 200 patients the hospital  detected 41 as perfectly normal (referred to as "psuedopatients") and 19 were suspected by one of the hospital psychiatrists and another member of staff. However, Rosenhan had not sent ANYONE to the hospital.

The BBC did something like this again on the Horizon programme in 2008 called "How mad are you?" There were ten subjects, with five having previously diagnosed conditions, and five who'd never had anything wrong with them. Three experts were used to determine which five had mental health problems, two were identified correctly , one was misdiagnosed and two healthy patients were diagnosed with mental health problems.

It's enough to keep you away at night - isn't it? And that's always been one of my major fears; being misdiagnosed with a mental health problem and never being able to leave, until in the end you DO end up with a mental illness, like a self fulfilling prophecy, oh that and being locked up for a crime you haven't committed.

A copy of the study is here if you'd like some sleepless nights:-

http://www.holah.karoo.net/rosenhanstudy.htm
 
On a final note Rosenhan said this:
 
"Rosenhan explains that psychiatric labels tend to stick in a way that medical labels do not and that everything a patient does is interpreted in accordance with the diagnostic label once it has been applied."

You'd like to think things have changed, however with the stigma faced by millions of people everyday suffering from mental health issues you wonder whether the actual diagnosis is the beginning of your problems not the end and although his study was conducted over thirty years ago, keeping in mind the 2008 BBC Horizon programme it makes you wonder whether anything's really changed.

Whatever you do, don't complain about how meaningless your life is in public.......

Friday 23 August 2013

How to access the medical records of the deceased

People are often confused about how to access medical records especially those of the deceased. When I worked for the NHS it wasn't unknown for people to request the medical records of the deceased quoting the Data Protection Act 1998. Unfortunately, the Data Protection Act 1998 only covers the data of living persons. So, if you feel there is a good reason why you should access the health records of, say a deceased relative, how should you go about this?

People sometimes think that if they can no longer access the notes of the deceased via the DPA Act 1998 then they can take the route of the Freedom of Information Act 2000 instead. Although there are no specific exemptions regarding the deceased,  it is likely it will be made exempt under the provisions of the confidentiality exemptions (FOI). If someone wishes to access the health records of someone who died after 1991 then they can access them via the Access to Health Records Act 1990 under section 3 (1) -

Access to Health Records 3 (1) :-

(f) where the patient has died, the patient’s personal representative and any person who may have a claim arising out of the patient’s death.

If you have a claim arising out of the patient's death or you are a personal representative of the patient then you may be allowed access to the deceased person's notes. However, you would in all likelihood have to provide proof of this.

"To see a deceased person’s health records, applicants may be required to provide evidence to support their claim and may need to provide evidence of their identity."

Further advice can be found at NHS Choices :-

http://www.nhs.uk/chq/Pages/access-to-medical-or-health-records-of-someone-who-has-died.aspx

A love letter to Twitter....


Dear Twitter, my lovely adoring Twitter,   

Twitter, you love me right? You love me till you can’t get enough of me right? You want to hold me till the sun goes down right? See my latest pic, I look so cute don’t I, with my hair combed forward and my pretty pouting lips, and my eyes Twitter, don’t my eyes look ever so flirty, so come hither, so big, don’t you just want to get closer to me Twitter, don’t you just love me Twitter, right? Just the right amount of misty-eyed loveliness.

 I’m so witty, so funny, so creative, soooo artistic, I draw funny pictures and I write things. Yes, I'm writer and I'm deep and I'm creative. I’m sooo deep Twitter, I’m soooo deep, I say really meaningful things, so many things that make you want to retweet tweety me over and over again and tell me how funny I am, tell me how intelligent I am, tell me how you love my hair Twitter, how you love my eyes, how you love my lips, how you want to get to know me Twitter, how you want to get right deep inside my mind and understand me like no other Twitter, don’t you Twitter, don’t you?

And when something REALLY political and important happens Twitter and I can think up just the right soundbite Twitter, you’ll retweet me Twitter and then EVERYBODY will love me Twitter, everybody will love me just the way they should and when I’m down, someone will offer to hold me and tell me it’s okay, because I live in Twitter, THIS IS MY HOME, I’m popular Twitter, here in cyberville where you can be whoever you want to be. I don’t know those losers in their sweaty little clothes,  in their sweaty little houses in their sweaty little bedsits, hoping that they’ll meet me one day and that I’ll fall in love with them them right? It's just like I’m a celebrity Twitter, just like I’m a celebrity, a CELEBRITY ON TWITTER!

 And those celebrity B listers, they loooove me don’t they Twitter? I post cute pictures and give some really funny cutsey captions and those celebrity B listers love me soooo much they crave my attention, they want ME, not just anybody, but ME Twitter, because I’m so important Twitter, I rule, I rock this joint, I’m somebody, I’m somebody special Twitter, somebody special. They follow me Twitter, because they realise how important and special and clever I am. My jokes are funny, my puns are funny, my cutsey pictures are funny, oh me and that cute picture of me and my dog and my hair was just so fluffy and so cutesy and didn’t my eyes look like you could just see the windows of my soul Twitter? I’m so lovely and famous and special and, well I’m a WEBCELEB, I’m kind of as famous as those other celebrities on Twitter and I have so many followers Twitter, it just goes to show how popular I am on Twitter, thooooussssands of people follow me on Twitter, I spend so much time on here honing my skills, I’m a brand Twitter, I’m not a person anymore Twitter, I’m special, I’m somebody. If I take the right picture I look like a real cutsey pie cutey with my hair done a certain way and my eyes all big and flirty and my glasses just on the end of my nose and my lipstick just soooo, just the way you like it Twitter.
 
I only follow special people, people who are special just like me, people who love me and think I'm great, people who tell me all the time how special I am, how funny I am, how everything I say is sooooo witty and funny and amazing. I ignore the ORDINARY people Twitter, because they're such plebs, they have no place in my special world of special people, who are famous for being special and funny and witty and amazing, just. like. me. And when those special people tell me how great I am, well I retweet it OVER and OVER again, so everybody else knows how SPECIAL I am!!

 And I know my secret’s safe with you Twitter, because for as long as I live on here Twitter, I’m someone, I’m really special and you love me don’t you Twitter, don’t you? don’t you? I don't love you in return of course, because after all there's only room for one love in this joint Twitter and that's ME.

 

S.W.A.L.K



Thursday 22 August 2013

Simulacrum



Muriel examined her own image using a variety of different methods, and in each one her reflection seemed to take on a different identity each time. It was almost as if she were several different people at once.  Muriel often thought that she wasn’t altogether sure who she was at all anymore.  If her own reflection could deceive her in this way then how could she be really sure of who she was? She would often feel her face and stroke her features slowly of an evening so that she could be reassured by the tracing of those familiar lines of nose, mouth, and cheeks, so that she could see and feel that she was really herself and not someone else. She wasn’t sure who she was and if she wasn’t Muriel,  (and she knew that she was starting to believe that she could in fact be several different people at once), then who were all these different reflections staring back at her?

 Each image seemed different and unique in its own special way and at the same time achieved its own grotesqueness.  Who were all these people, these ghostly images, why were they impersonating her? Was this some kind of vile mimesis, some fraudulent sprite she could not escape from?

 She seemed to be spending an inordinate amount of time examining each reflection producing different poses and angles to look at various parts of her face in detail, each one seemed to have no verisimilitude to who she thought she was and who she expected to see.  Muriel came to the conclusion that perhaps she was spending far too much time alone and that she was going quite mad.

 For some reason the bathroom produced the most flattering image of herself. Here was the youthful woman she was most familiar with and it was the one image in the house that frightened her the least.  Also, and perhaps most importantly, the most truthful image of herself in the house, and one that gave her great comfort. And yet at the same, Muriel realised with a little unease that she could not still be this young, her face glow in the way that it did in the soft light.

 Her bedroom mirror produced a rather unflattering image of her face. Here she could pull a range of faces and each one would produce a rather loose and colourless mask that looked bloated and misshapen. Although she would often try to convince herself afterwards that anyone would look that bad if they pulled such ridiculous faces, some part of herself told her that those faces would not look anywhere near as ugly in the bathroom mirror. Was it the light? Why did her face look so bloated in this mirror and not in the bathroom? How could two images lie to her in this way?  Sometimes she would compare and contrast her image with the one in her bedroom mirror and the one in her laptop’s webcam.  This could sometimes take several hours of her time. Sometimes she would stare in frustration at the mirror and then take sidelong glances into the laptop’s webcam, compare and contrast she used to call it. In this way, Muriel could compare herself from the side and from the front while staring wide-eyed, although she found it hard not to blink.  She was sometimes surprised at how different she looked from the front, and how different she looked from the right side of her face, especially when she stared like that.

She saw nothing abnormal in her behaviour.

 Sometimes she would catch her reflection in the kitchen window especially around dusk.  She looked quite attractive in the soft glow of the window, although not as attractive as she did upstairs in the bathroom.  She looked mysterious and her eyes seemed more prominent, you know, the way men liked it, or so she thought. She would look from the left, and then from the right, all the time checking for jaw definition and saggage, and nose alignment from both left and right. Following this she would apply either lipstick or lip gloss and either pout or smile. She would try out different poses and check to see how they looked. This could take up to an hour sometimes. She knew that the person she saw here was not the beauty in the bathroom mirror, but was at the same time an attractive woman.

 Her mobile phone gave off the most hideous image of herself. It did not seem like her at all. It seemed like someone else altogether, someone much older and much uglier than her true self. This was the most warped image yet. This could not be her; it bore no relation to who she saw in the mirror upstairs, the one in her bedroom, or the one on her laptop webcam. Well perhaps that wasn’t entirely true; there were some identifiable features and a vague familiarity in and about her eyes and nose, but that was it. This person was grotesque.  The nose from the side was hooked almost; her real nose wasn’t like that, not really. It had small thread veins and it looked much larger than it did normally. Her jawline definition was deeply flawed; there was definitely some saggage there and some flushing around the jaw area. Her eyes appeared sunken with bags directly underneath which gave her a rather hangdog expression. Her eyebrows drooped downwards somehow, and her eyelids were more hooded. Her whole face looked as if it was travelling downwards on a slow melt.  

She was starting to feel quite disturbed by all of these multiple and warped images of herself. She needed to guarantee that she (if this was in fact her and not some a collection of ‘others’ that were trying to impersonate her) could look the same in any reflection at any given moment regardless of which angle she looked at.

She came up with a variety of ideas on how to achieve this and finally whittled them down to two final ones that were the most engaging and workable (at least in Muriel’s mind).  The first one was to purchase more mirrors and place them strategically around parts of the house that could chart her reflection from any angle at any given moment. Then she could check how she looked and whether or not she was metamorphosing into someone else, and catch it in time. But she would always look different in each reflection wouldn’t she because this was how it worked? Therefore, what would be the point, and if she did catch herself changing then what could she actually do about it?

Her second idea was far more radical than the first. If she had some kind of surgery perhaps to certain parts of her face, (the aim would be to make it more symmetrical), then perhaps her image would look exactly the same then in each reflection she caught herself in.  All she needed was perhaps a half face-lift to the lower half of her face to give her jaw better definition and then she realised that her eyelids where perhaps more hooded than she realised and that the mirror was not deceiving her, or was it? She would need the top part of her face lifting as well. Therefore, she would have a full face lift; this would make everything clearer to her.  Then she WOULD look the same in every reflection because her face would have been stretched to accommodate any given reflection or mirror image.

There was also the small issue of how she was going to finance this. She could take out a modest loan, something which would tide her over and pay for any work to her face and also provide enough to pay for any extras just in case there were complications, for after care and such like, not that she foresaw anything untoward happening.

Muriel suddenly felt her stomach tighten and she felt clammy all over, she had caught another perhaps an even more grotesque image of herself reflected in the coffee table, she was almost too afraid to look. What kind of sick joke was this? This was wrong, her mind felt violated. Her chin was dropping and her face looked puffy and swollen, and why wasn’t her face staying where it was? Her chin hadn’t done that before, and those wrinkles around her lips were vile, they were more than vile,  they were enough to make someone sick. How could she go outside looking like that? Why the shock of it would be enough to kill someone.

If that was in fact her.

She stopped for a moment. Perhaps it was someone else, something else, some maleficence, some twisted creation from hell.  What if she was possessed?  There were some things that couldn’t be explained, things that even the laws of physics could offer an explanation for. She knew, she’d read about it on the internet.  Dear God this was getting too much.  The confusion she was feeling filled her with the kind of dread and terror she could barely cope with.  Something could be living within her, residing within her very being, clawing their way through her intestines, squeezing their way through her veins.  Their occasional appearances were carefully staged in order to show her their insidious powers and how much sway they held over her.  She knew that she did not look this bad really, she had always been an attractive woman and she had now come to realise that these sick visions from hell bore no relation to how she knew she really looked.

She would go ahead and book the surgery. She rested her plump fingers on her knees; she was starting to feel much more relaxed now. She felt she had made a sensible if monumental decision about her future, but this would be the best way to deal with it and her terrible situation. 

She also thought that she could put a mirror on the ceiling just above her head as she faced the front door, this was almost an afterthought really. When she looked up she would see a true likeness of herself because when she looked up she saw the person she really was – the tight skin, the familiar expression, the bright eyes.

She eventually decided upon nine extra mirrors and also invested in a rather expensive Nikon Coolpix P510 Bridge Camera which was just under £300, but was a rather handy piece of equipment for taking pictures of her real self ,and also, this camera was clever enough not to lie to her like all the others did.

However, she found that there was always somewhere in some part of the house where she found a rather startling image or reflection of herself which took her by surprise and filled her with terror.

Muriel also went ahead and had the surgery as well as investing in the camera and the mirrors, and her face was stretched into a blanched mask of smoothness, a perfect one dimensional symmetrical mask of blemish free skin, a blank canvass of youth. She was pleased with what it gave her, hope and certainty. The mirrors, the frightful reflections of the horror masks that had visited her without mercy would be a thing of the past. It would no longer matter from which angle she looked, only the face she had put there would stare back at her, those sprites of terror, those mimesis of the night would no longer haunt her dreams or invade her mirrors.


**********************************************************************************

 
This sometimes unpleasant and often compulsive psychological glow of illusion had almost consumed Muriel to such lengths that her neighbours and a few of her friends had become increasingly concerned.  Although they had seen her go into her house once or twice a while back, they hadn’t seen her come out for some time.

When they eventually saw her they were so shocked they could barely speak, whoever had done this to her face must have been blindfolded; Jesus, had she paid someone to do this her?

Of course Muriel took this reaction to mean something completely different. From what she understood, these ghouls of terror, these representations of horror had returned, to fill her days and nights with terror.

 Muriel would have to regroup, a full on attack on these unknown assailants would be the only answer…….

Speechless


Open thy mouth for the dumb in the cause of all such as are appointed to destruction.
 


 

What does the world sound like when it can no longer speak? Can it live without the spoken word?  

 Can we not just tap messages and text our loved ones sitting next to us; we do this all the time. I hear that some have been texting between rooms, and floors for years; it saves time on shouting and yelling up stairwells.

The world is about to be silenced. There is a gas, not enough to kill but one that attacks the vocal chords. No one knows exactly where it came from. There are various theories but no one can pinpoint exactly how it came, and perhaps more importantly, no one knows how to reverse its effects. The world is transfixed by its own muteness.

People aren’t affected all at once; its effects are piecemeal and gradual. Some towns and cities are affected quicker than others depending on how clear the air is. The countries who have made determined efforts to control and eliminate pollution suffer the most. It is easier for the gas to travel and permeate the air like a poison. In others, where pollution is more widespread, where governments have paid little notice to control their gas emissions, are slower to be hit. How ironic. The gas travels slower through the already noxious air; an invisible invader that finds its way into the human body. An irritant that cannot be expelled,
the left and right bronchi allows the trespasser in with a whisper; the bronchiole tubes pave the way for its conqueror.

The gas does not affect the lungs however, its only function is to deaden the vocal chords to a rasp of silence, and this it does with great effect. No one is immune except animals, insects, and birds.  Governments, scientists and the experts are at a loss as to what to do, no one really even knows what the gas is made of, and how it does what it does, least of all how to undo what it has done.

It is the epoch of a new dawn where man communicates only by electronic means, and is no longer reliant on speech.  It is a battle to create more sophisticated technology to deal with this new form of communication, to develop more sophisticated technology than what already exists. Technology needs to go beyond the IPhone, the IPad, and the Blackberry, and to create something for which man can make eye contact with fellow man. The government feels this is important, and is concerned at the lack of “feeling” between fellow humans, that could lead to misunderstandings, savage internecine warfare between groups of people which could escalate into something far more serious. A “feelings” zsar is appointed to encourage more eye contact, and to emphasise the importance of hand signals, and gestures. There is a certain degree of irony to this, and rude jokes are exchanged between those of a certain humour.

In the meantime however man struggles on, coming to terms with his new predicament. Facing the world mute and speechless and hoping for a miracle.

 

**********************************************************************

 
Man will evolve to fit this new and unique habitat in which he now finds himself. The mutation will be become the norm as it is passed down through the generations, that is if, of course, no cure is found. This would be considered improbable, this evolutionary novelty, but it may well come to pass. Humans will have to learn to live with this new state of being.


With advanced technology, human intellect may well improve and this in turn will have a positive effect on the economy, but how this will impact on society is not yet known. It is for the intellectuals and philosophers to discuss, if there are any left. Forums and discussion groups are created and ideas circulated in silence via IPads, and IPhones, and Blackberrys.


Like a billion demented cicadas the humans tap their way through each day, the littlest ones – those little cicada nymphs crawl off to school each day to tap out the 5 hour stretch till home time.

Eyes are the windows to the soul, but they are empty and barren of light as they stare into their screens. Eyesight deteriorates over time, the stress of too much close vision work. It is not uncommon to see people walking around in magnified spectacles, like large fly eyes magnified to the power of ten. It is a strange state of being.

 

But people find a unique way of communicating with each other regardless of the situation they have found themselves in. They return to cave art, graffiti, and painting as well as their computer screens to tell their loved ones how much they are loved. It is not the disaster that some foresaw, and the strongest always survive the weak. The most original among us think up the most unique ways of communicating and interacting with fellow man. It has become a much more rich and tactile environment in which to live, and in some ways more pleasant. Man is tired of his technology although they serve a purpose it is his ingenuity, and originality that holds sway.


***********************************************************************


Although man adapts to his new environment there are certain things he does struggle with. Face to face arguing is not without its problems. It is farcical to attempt arguing with someone directly in front of you without the power of speech. It is much like a comedy mime act as couples arguing in the street struggling to communicate their anxieties and distress with arm movement and mimed insults. Arguing by Ipad is futile, it neither serves the purpose nor is it quick enough as angry responses are slow to arrive. Now everyone is reliant on electronic media most of the time, signals are slower than they once were. Arguing is done with speed interspersed with breaks to storm off and re-enter the room. The dramatic entrance after a bout of fitful arguing with one’s partner is rendered obsolete when one is reliant on a keyboard to restart the argument again. Mobile phones and electronic tablets have been smashed in frustration during a lover’s tiff.

There is in increase in accidents; garden accidents, car accidents, all sorts of accidents because we cannot hear a voice behind us warning us of impending disaster.

 There is talk of using electronic text to speech voice generators, and prices would be modest keeping mind those who cannot afford high tech equipment so that there is equality of communication for all. No one is keen on this, after all it will still mean being heavily reliant on the use of keyboards, and for the most part, people are done with this now.

 The theatre perhaps is left in less of a quandary than the rest of us mere mortals as they return to mime; to illustrate the ills of mankind and how we have arrived at this current situation. They attempt to show us the scientific and underlying environmental forces the world man now faces, and what will happen if we continue as we are. Many scenarios are presented to the audience and they leave with a sense of fatalistic acceptance – for what can they do?

 Television is almost redundant. The world is faced with endless repeats, repetition of a world gone by when man could speak. A million scenes that we’ve seen played out a million times before, music videos and dance become a popular source of entertainment, but people would rather see this live than from a TV set or from their Ipads and laptops, films are endlessly on repeat.. Radio is obsolete bar repeat shows. News is now only in print and from the laptop screen. Live performances hold sway now as we remind ourselves what it is to feel alive.

 People become quite adept at lip-reading and they also learn a great deal from the use of sign language. Those who are both deaf and mute are in demand for their skills in lip reading and sign, as these are needed far and wide for those without this new form of communication.

 Sign language is not without its beauty and those balletic hand movements and elegant dancing of fingers make for a moving scene as women and children, men and boys all use their new found skill to communicate messages to each other. Once the deaf were unimportant, now there is new found respect. How did they manage to communicate in this way?

 Hospitals have no cures until the scientists have made their discoveries – they therefore continue to cope with the usual maladies and injuries that come their way, and all those silly accidents that come from the new speechless world. However, they are hampered more by the fact that their patients cannot communicate with them in the conventional way. They rely on electronic text to speech voice generators which have been issued to all hospital areas or sign language. This is difficult as not all doctors have picked up these new skills yet, and it is even more complicated as some of their patients don’t even speak the same language. This can be frustrating to say the least, and translators, also trained in sign language skills, are drafted in. This is quite expensive and people are expected to bear the brunt of this expense through their taxes.

Needless to say man goes on, and there are some small groups within society who have found new and novel ways of communicating – oh and the art work! Man’s interpretations of his predicament are novel. A triptych of the world’s fate adorns the walls of a building just 3km from here. Written and drawn upon it are people’s messages of hope, love and anger, a  far more interesting and promising interpretation of their muteness than crude imploring hands gesturing in cheap lurid colours, which seem to have been the trend of late. Mystical card drawings are intricately detailed in muted autumnal colours, but capture the mood perfectly. A man leans over an oval table knarled with age, whilst a young girl’s left arm gestures towards the spread to illustrate her message. Knowing little of these cards or their meaning is lost on many, as to the message the overall painting gives, but it is beautiful nonetheless.

They do say that it is possible for humans to lose their ability to speak temporarily or permanently after shock or extreme emotional experiences, although in this instance, that is not the case, or at least this is what we have been led to believe. Perhaps it is what we want to believe, rather than what has actually occurred, in that our muteness had been caused by some external force greater than ourselves. Man has always needed to believe that there are greater forces than himself. Nature is powerful it’s true, but man may have caused his own demise, his own muteness, his own helplessness. Perhaps we have become speechless for a reason that we do not yet understand. We may never speak again, but man will evolve and adapt.

 
 

Monday 19 August 2013

Grief

 
 

"Grief turns out to be a place none of us know until we reach it. We anticipate (we know) that someone close to us could die, but we do not look beyond the few days or weeks that immediately follow such an imagined death. We misconstrue the nature of even those few days or weeks. We might expect if the death is sudden to feel shock. We do not expect the shock to be obliterative, dislocating to both body and mind."

Joan Didion. The Year of Magical Thinking. 2005

Wednesday 14 August 2013

What do you do if want to challenge what a doctor's written about you in your notes?


What happens if when you visit your doctor, either your GP or a specialist Consultant
 and you realise that perhaps the whole thing isn't going to plan. Perhaps you're not happy with his/hers interpretation of events, or they've come up with a diagnosis your not happy with? What can you do? You may have been a patient in hospital and you're unhappy with what the doctors written in your notes. You've put in a subject access request to see part of your notes and when they arrive he or she has said something that you're in complete disagreement with - what then?

Doctors are not omnipotent; they're not always right, but if you disagree with what's been said or the diagnosis itself what can you do? Well naturally, you can put a complaint in to the hospital, most have  rigorous complaints department that will put the wheels in motion to investigate your complaint and in some cases invite you in to discuss it further with the doctor and a member of the complaints team. This of course depends on whether all parties involved are happy to do this.

But what if you want what the doctor's actually written taken off your clinical notes and off any correspondence? Or if you feel he's said something to your GP in a report on your progress and you feel it gives an inaccurate record of events.

In all likelihood the doctor's opinions will have to be left untouched, any factual information can be challenged as stated in the Act; however the Information Commissioner points out clearly that:

"The Act cannot be used to challenge a professional
opinion on the basis that it is inaccurate just because another person, even
another practitioner, may have a different opinion. If the opinion contains
factual information that is incorrect then it could be challenged. A challenge to
a factual inaccuracy or the reliability of an opinion may be recorded alongside
it, since it will usually be important to maintain the original record."
 
The doctors' professional opinion is a chronological record of events, remove any part of it and it could make it difficult to challenge should you wish to complain about your treatment at a later date. The Information Commissioner gives clear guidance for good and bad practice however:-
 
Good and Bad practice

A patient gets a copy of his medical file from his GP and disputes an opinion recorded in it. He also provides convincing evidence that it includes incorrect factual information.

Good practice

The surgery explains that it has to be kept as a true record of the doctor's professional opinion, but agrees to include the patient's comments clearly on the file. The correct factual information is recorded but a record of the error may continue to be held to explain possible unforeseen consequences.
 
 Bad practice

The surgery refuses to record the patient's objections to the opinion and only notes the factual inaccuracies.
 
So to summarise; if you feel that you're not happy what a doctor's written in your notes or correspondence regarding your care, then you have every right to challenge it. They not be able to remove it completely, but they can record your comments disputing what the doctor's written next to it.
 
 

 

 

Gillian Jones is a full time freelance copywriter, further details are available here: www.taith.net/











 

 

 

Thursday 8 August 2013

Information security and the NHS


Its 2 years since I last worked for the NHS. However, the same problems regarding information security seem to be happening again and again. Not in my own backyard at the hospital where I used to work, but all over the country. Although technological advances have meant that we now have more sophisticated ways of communicating with the rest of the world and with each other, simple information security seems to elude us. It’s bad enough if you lose your own information, that it might be floating in cyber space waiting to bite you on the arse when you’re least expecting it, but what happens if it’s detailed medical information about you, or a member of your family?

Having a quick trawl through the Information Commissioner’s (ICO) website news releases is enough to give you sleepless nights. As recently as July of this year the ICO fined NHS Surrey the sum of £200,000 after 3,000 patient records were found on a second hand computer, which unbelievable as it might seem, had been bought on an online auction site. The information had been left on and sold by a data destruction company employed by the Trust in 2010 to destroy the information that was on there. The service was carried out by the company for free with an agreement that once wiped, the company could sell on any salvaged materials. It was brought to light when a member of the public bought a computer online and found the details of thousands of patients on his hard drive. As well as sensitive personal data and HR records, information pertaining to children as well as adults was discovered. Since then NHS Surrey has reclaimed some of the computers that were sold, however, many more are still out there with no way of knowing which ones may still be holding personal sensitive information.


Back in February of this year the Nursing and Midwifery Council were issued with a £150,000 penalty for breaching the Data Protection Act. Three DVDs regarding a nurse’s misconduct hearing and containing the personal information of two vulnerable children were lost, when the ICO investigated it turned out the DVDs had not been encrypted, which means anyone could access it. David Smith, Deputy Commissioner and Director of Data Protection said:

“It would be nice to think that data breaches of this type are rare, but we’re seeing incidents of personal data being mishandled again and again.”


He went on to say:

 
“….they forget that personal data comes in many forms, including audio and video images, all of which must be adequately protected.”


The council had been bringing evidence to a hearing venue regarding a “fitness to practise” case; however, the discs were not with the other evidence provided and have not been discovered since.


David Smith continued:


“The Nursing and Midwifery Council’s underlying failure to ensure these discs were encrypted placed sensitive personal information at unnecessary risk.”


If even large scale organisations such as the NHS are failing then what hope is there for the rest of us? Do you run a business or company that holds personal information, not just on a laptop, but on video, DVD, with images and are they adequately protected?

 
The eight principles of the Data Protection Act are clear:-


•Fairly and lawfully processed

If you have sensitive information in your possession then only do what the law says you can do with it

•Processed for limited purposes

There are limits as to what you can do with sensitive information in your possession, use it only for the purposes for which it was intended, nothing more.

•Adequate, relevant and not excessive

Don’t collect reams and reams of personal sensitive information in case it might come in handy for a rainy day, you create situations where the information can be lost or stolen.

•Accurate and up to date

It must be up to date, no missing or incorrect information about any personal information you may have on someone. If you’re informed of any changes then modify your records as soon as possible.

•Not kept for longer than is necessary

Your company or organisation should have a retention or disposal schedule or policy on exactly how long you are going to store records before destroying them CONFIDENTIALLY.

•Processed in line with your rights

People have rights under the Data Protection Act 1998; they can see the information when they want to, (unless there are exemptions), if they want to inform you of changes, or want to inform you of incorrectly held information, you must rectify it unless there is good reason not to.

•Secure 

If you hold information that is both sensitive and personal then it is up to you to keep it secure. YOU are responsible should anything happen if the information is stolen or carelessly lost. You should make sure that there are appropriate steps taken to protect information held online or on paper. Try to work towards a clear desk policy for your staff and always make sure that staff keep their passwords hidden and that they never write them down. Make sure that DVDs, memory sticks or any movable media is encrypted and password protected.

•Not transferred to other countries without adequate protection

NEVER transfer sensitive personal information outside of the EEA unless the ICO says they have adequate protection. The ICO has a comprehensive list of countries within the European Economic Area that have adequate data protection and countries outside the European Economic Area that do.
There is further guidance on that here:


Next time: What happens if you disagree with a doctor's opinion, and you're unhappy with what he's written in your medical notes, can you ask to have it removed?

Gillian Jones is a freelance writer and copywriter with 10 years experience in the NHS. Further information is available at www.taith.net/