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Bringing neurosurgery to life
Editorial
BBC/Laurence Cendrowicz
Bringing neurosurgery to life
For the paper on the public role of US physicians see JAMA 2006; 296: 2467–75
How many neurosurgeons does it take to cook enough king prawns to feed a small dinner party? Around four, according to this week’s episode of The Brain Hospital, a new three-part fly-on-the-wall documentary series about the staff and patients of the UK’s National Hospital for Neurology and Neurosurgery. Chief prawn chef was neurosurgeon Neil Kitchen, whom author Ian McEwan shadowed for a year while researching his bestselling book Saturday. McEwan’s book gives a fascinating insight into the world of the neurosurgeon and The Brain Hospital carries on in this vein with a moving portrayal of the life or death experiences of patients living with severe neurological deficits. Contrary to all popular stereotypes, the neurosurgeons in The Brain Hospital are kind and thoughtful individuals who care passionately about their craft and their patients. Neurosurgery is a high-pressure job at the best of times, but performing delicate operations with a BBC camera poised to capture any mistake must have upped the stakes considerably. But the surgeons came through with their reputations enhanced rather than tarnished.
The Brain Hospital is a fantastic showcase for the hospital and its staff, and does much to inform viewers about neurological illness. The medical community needs to find more ways to explain to a fascinated public what it is like to practise medicine and why health care is so important politically. According to a paper published in the Nov 22/29 issue of JAMA, around 90% of US physicians think that doctors should provide health-related expertise to local community groups; become politically involved in healthrelated matters at all levels; and encourage medical organisations to advocate for the public’s health. But only 25–50% of them had acted on these beliefs in the past 3 years. Perhaps surprisingly, physicians who did more than 50 h in the clinic per week were just as likely to participate in community activities as those who did less. Understanding the barriers that prevent greater involvement by clinicians in local, national, and global health issues is paramount. But in the meantime, a lot can be learnt from the example set by the neurosurgeons at Queen Square. Let the cameras roll. ■ The Lancet
Getty Images
Pakistan recognises women’s rights
The printed journal includes an image merely for illustration
1938
Every two hours, a woman is raped in Pakistan, with a quarter of the assaults being perpetrated by gangs. These shocking statistics from the Human Rights Commission of Pakistan are thought to be substantial underestimates because the country’s discriminatory laws deter women from reporting such crimes. However, Pakistan’s approval of the Women’s Protection Bill earlier this month offers hope that things may be set to improve. In 1979, the Hudood Ordinances were introduced to Pakistan. They form part of Sharia law, which aims to bring civil law into conformity with Islam, and include the crimes of Zina (sexual intercourse with anyone other than your lawful spouse) and Qazf (wrongful accusation of Zina). Rape cases are dealt with by the Sharia courts rather than the criminal courts, but under the Ordinances a woman’s evidence is not admissible. So for a conviction of rape the perpetrator must either confess, or four men must testify to eye-witness accounts. If a woman makes a claim of rape that does not result in a conviction, she has effectively admitted
to committing a Zina crime and can be charged as such—the maximum sentence is death by stoning. These laws are an infringement of women’s rights and many international agencies have spent years campaigning to have them abolished. Finally, on Nov 15, despite desperate opposition from some political Islamic parties, Pakistan’s parliament voted in favour of the Women’s Protection Bill, which allows rape cases to be tried under the civil penal code (where judicial decisions are based on forensic and circumstantial evidence) rather than under Sharia law. This commendable move is a step forward for Pakistan, and other Islamic countries, which should be encouraged to recognise women’s rights. This revolution of the country’s rape laws represents a valuable step towards meeting the third Millennium Development Goal: facilitating the empowerment of all women, especially those who are oppressed, in order to achieve gender equality throughout the world. This is a lofty ambition, but with Pakistan’s recent progress, achieving this goal looks more promising than ever. ■ The Lancet www.thelancet.com Vol 368 December 2, 2006
BBC/Laurence Cendrowicz
Bringing neurosurgery to life
For the paper on the public role of US physicians see JAMA 2006; 296: 2467–75
How many neurosurgeons does it take to cook enough king prawns to feed a small dinner party? Around four, according to this week’s episode of The Brain Hospital, a new three-part fly-on-the-wall documentary series about the staff and patients of the UK’s National Hospital for Neurology and Neurosurgery. Chief prawn chef was neurosurgeon Neil Kitchen, whom author Ian McEwan shadowed for a year while researching his bestselling book Saturday. McEwan’s book gives a fascinating insight into the world of the neurosurgeon and The Brain Hospital carries on in this vein with a moving portrayal of the life or death experiences of patients living with severe neurological deficits. Contrary to all popular stereotypes, the neurosurgeons in The Brain Hospital are kind and thoughtful individuals who care passionately about their craft and their patients. Neurosurgery is a high-pressure job at the best of times, but performing delicate operations with a BBC camera poised to capture any mistake must have upped the stakes considerably. But the surgeons came through with their reputations enhanced rather than tarnished.
The Brain Hospital is a fantastic showcase for the hospital and its staff, and does much to inform viewers about neurological illness. The medical community needs to find more ways to explain to a fascinated public what it is like to practise medicine and why health care is so important politically. According to a paper published in the Nov 22/29 issue of JAMA, around 90% of US physicians think that doctors should provide health-related expertise to local community groups; become politically involved in healthrelated matters at all levels; and encourage medical organisations to advocate for the public’s health. But only 25–50% of them had acted on these beliefs in the past 3 years. Perhaps surprisingly, physicians who did more than 50 h in the clinic per week were just as likely to participate in community activities as those who did less. Understanding the barriers that prevent greater involvement by clinicians in local, national, and global health issues is paramount. But in the meantime, a lot can be learnt from the example set by the neurosurgeons at Queen Square. Let the cameras roll. ■ The Lancet
Getty Images
Pakistan recognises women’s rights
The printed journal includes an image merely for illustration
1938
Every two hours, a woman is raped in Pakistan, with a quarter of the assaults being perpetrated by gangs. These shocking statistics from the Human Rights Commission of Pakistan are thought to be substantial underestimates because the country’s discriminatory laws deter women from reporting such crimes. However, Pakistan’s approval of the Women’s Protection Bill earlier this month offers hope that things may be set to improve. In 1979, the Hudood Ordinances were introduced to Pakistan. They form part of Sharia law, which aims to bring civil law into conformity with Islam, and include the crimes of Zina (sexual intercourse with anyone other than your lawful spouse) and Qazf (wrongful accusation of Zina). Rape cases are dealt with by the Sharia courts rather than the criminal courts, but under the Ordinances a woman’s evidence is not admissible. So for a conviction of rape the perpetrator must either confess, or four men must testify to eye-witness accounts. If a woman makes a claim of rape that does not result in a conviction, she has effectively admitted
to committing a Zina crime and can be charged as such—the maximum sentence is death by stoning. These laws are an infringement of women’s rights and many international agencies have spent years campaigning to have them abolished. Finally, on Nov 15, despite desperate opposition from some political Islamic parties, Pakistan’s parliament voted in favour of the Women’s Protection Bill, which allows rape cases to be tried under the civil penal code (where judicial decisions are based on forensic and circumstantial evidence) rather than under Sharia law. This commendable move is a step forward for Pakistan, and other Islamic countries, which should be encouraged to recognise women’s rights. This revolution of the country’s rape laws represents a valuable step towards meeting the third Millennium Development Goal: facilitating the empowerment of all women, especially those who are oppressed, in order to achieve gender equality throughout the world. This is a lofty ambition, but with Pakistan’s recent progress, achieving this goal looks more promising than ever. ■ The Lancet www.thelancet.com Vol 368 December 2, 2006