DISSECTING ROOM
LIFELINE Alasdair Breckenridge Alasdair Breckenridge is professor of clinical pharmacology in the University of Liverpool, UK, chairman of the North West Regional Office of the NHS, and executive and chairman of the Joint Medical Advisory Committee of the Higher Education Funding Council of England. Who was your most influential teacher? Sir John McMichael, who had three aphorisms: if a drug is doing a patient good, leave well alone; if the drug is not doing good, change it; never send your patients to surgeons. Which research paper has had most effect on your work? Herbert Remmer’s 1962 paper on drug-induced changes in the liver endoplasmic reticulum associated with drug-metabolising enzymes opened a whole new vista of clinical research for me. What would be your advice to a newly qualified doctor? Quickly acquire an academic “grandfather” to whom you can turn for advice at difficult points in your career. How do you relax? I would like to be able say golf and gardening, but in all honesty, I would have to admit that I regard being able to read the whole of the Spectator every week as a real achievement. What is your favourite film? Laurence of Arabia, which I saw each time before the three parts of the old MRCP exam. I reckon I know the dialaogue by heart. What is your greatest fear? That the new curriculum for medical students and their subsequent training will be the death knell of academic medicine. What are you currently reading? The Reader by Bernard Schlink. This must be one of the best books yet about World War II. What is your worst habit? Being unable to refuse new commitments. What or who is the greatest love of your life? My wife tells me it is work, or our Jack Russell terrier (now deceased).
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DNALTOCS ROF REVE—KO? t is strange how, now and again, your (well my) mind seems to go slightly out of control, a bit like a car swerving suddenly on a long straight road. I remember being very impressed the first time I came across the words of the 17th century poet, John Dryden: “Great wits are sure to madness near allied, and thin partitions do their bounds divide”. Now, while I would not put myself forward as a great wit (and most of my friends would rush forward in support of this), I have felt that there have been times when I have been about to “lose it”, if I can use the technical psychiatric term. Now I know that lots of people give psychiatrists a wide berth at parties or other social occasions, fearing they will be analysed as they chat pleasantly over a glass of sweet sherry. I have always believed this to be absolute nonsense. After all, would you expect a dermatologist to be giving the state of your skin the once over at a party or a neurologist straining to pick up the first signs of dementia? No way! In fact I have always sought out the company of psychiatrists at social gatherings. They are never difficult to spot since in any medical group they are the bearded guys wearing black leather jackets. OK, some of them may have smartened themselves up and shaved for their frequent television appearances, but mentally they are still in leather. My affliction, which still surfaces from time to time, is a compulsion to read things backwards. Psychiatrists must have a name for this—probably something like “RCD, retrolegeric compulsive disorder”, but every time I ask them at parties they just give me a funny look and quickly move off. I often indulge in RCD to pass the time when stuck in traffic jams or riding on buses, but every now and
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again it threatens to take over my life and I have to fight to contain it. However, there is a positive side to this condition, and I feel that it has given me insight into certain people and things. After all, as far as the 1970s singer and entertainer Val Doonican is concerned, I now see his oeuvre in a completely new light when I think of him as Lav Nacinood. In addition, I can abuse people loudly without giving offence. Only my closest friends know what I mean when I announced publicly that Dr X is “a complete dratsab”. I even remember being in an Edinburgh pub with a bunch of Americans, and, on being asked to lift my glass and say something very Scottish, I stood up and proclaimed “Dnaltocs rof reve”. They seemed quite happy when I told them this was an ancient Celtic toast. Is there a cure for my condition? Well, to be honest, at the moment I don’t want a cure because I think I can handle it (where have we heard that one before?). However, I do have a fall-back option if it really does get out of hand. I have not actually tried it but I have great hopes of success. Years ago someone realised that we read books in a very inefficient fashion, getting to the end of one line then sweeping back across the page and down to the next one. The solution was simple, read from left to right along a line and then at the end of it drop directly down to the next line and then read back across the page from right to left, the line having been reversed to make this possible. This printing technique is called “boustrophedon” (the way of the ox) since it resembles the path taken by a farmer ploughing a field. I feel that a spell reading a book printed in this way might contain my disorder if not cure it. Tell me I am right! David Jack
THE LANCET • Vol 352 • October 24, 1998