Active Ingredient: Gabapentin
+ free Neurontin pill.
Like so many things, it is a different world to the day I started out on this quest. Back in those days, admission to medical school seemed more unpredictable.
Progress through training, particularly the separate clinical years, was somewhat unstructured, and there was a fashion with some consultants for teaching by humiliation of the student.
IT simply did not exist, and it was a world dominated by pen and ink.
Change, sometimes apparently for the sake of change, has been the pattern of practice in the health service. It became a victim of its own effectiveness with new perspectives and progress in practice.
Expectations from the delivery of health care have outstripped the ability of any government to pay for, and the managed care programmes seen in other economies have not necessarily done any better. At least we now have big data to support the decisions that we are expected to take.
Having said that, there have been some remarkable diagnostic and therapeutic advances that fundamentally changed the way that patients are managed.
The introduction of endoscopic examinations via every orifice, and imaging techniques that capitalised on the advances in information technology have improved the precision and sensitivity of diagnosis for many pathologies.
One of the most fascinating changes has been the shift in diagnosis and management of peptic ulcer disease.
In my training, diagnosis was dominated by radiology followed by forms of surgery around the upper GI tract, and then potentially followed by consequences of the surgery.
No one would have guessed that it might have been an infectious disease, treatable by receptor blocking and antibiotics, rendering hours of retractor pulling redundant.
It is the nature of retrospectoscopes to focus on the rose tinted, and to view changes with suspicion. One of the things that consistently features in the recollections of my peers is that there was a lot of fun to be had whilst working, and the glue that held professional colleagues together has been weakened by the removal of the old style teams.