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WITH DETRIMENT TO OURSELVES
69
Letters
to
the Editor
WITH DETRIMENT TO OURSELVES SiB,—In this country facilities for postgraduate medical training and research have been meagre, and interest in this branch of medicine has been slight. Vienna, Berlin, Paris, Lausanne, and other Continental medical centres have always attracted medical visitors. In these cities reception for the medical visitor has been organised, and he was treated as a welcome guest. London has been given a wide berth owing to the parlous state of such facilities. Some years ago a Dominion doctor ventilated his grievance in your Grains and Scruples.1 He wrote : "all declared they would never again bother to go to Great Britain unless conditions and the attitude (italics mine) of the men in the great hospitals changed radically. In London and Scotland we were made to feel, perhaps quite unintentionally, that the overworked hosts had no time to give us. At best we felt we were just tolerated ... certainly we were not welcomed." That was the lamentable state of affairs in pre-war days, and if a Dominion doctor received such a raw deal what hope was there for a foreign medical visitor ? Professor Grey Turner has pleaded’in your columns2 for the establishment of a Central Bureau of Medical Information. The British Postgraduate Medical School at Hammersmith has never really been a medical mecca worthy of the capital city of the Empire. With niggardly financial support and inadequate accommodation it could not hope to be. But now-praise be to Goodenough-a world centre for postgraduate training and research is to be situated in London. Let’s get on with it and quickly and without cheeseparing. Provincial centres must be included, since many of their medical schools have offered warm hospitality to the medical visitor which the London schools have often failed to do. The fault is ours, through neglect of this problem, that we now find ourselves caught on the wrong foot so far as our own demobilised doctors are concerned. Many are the friendly contacts that have been made between the doctors of the United Nations. Those who have been stationed in this country have expressed admiration for certain of our methods. They want to return at some future date to renew such contacts and they look to us as leaders in some branches of medicine. We have little to hide and much to show ; but we just don’t bother to do it. If in the testing time of war such liaison and interchange was possible, surely in peace it is not past the wit cf us to perpetuate such international comradeship ? The British Council is trying to cope with requests from doctors all over the world who are wanting to learn our methods and gain a first-hand experience of our way of doing things. There needs to be a committee, truly representative and of a high level, which would integrate all existing facilities in the United Kingdom. It would decide in which clinic the visitor would best be placed. It must make provision for (1) those who wish to work for one or two years in their specialty, and (2) the visiting professor who wishes to stay for three months seeing If Switzerland could organise our specialists at work. such a service (and benefit commercially), then surely The we, with our greater resources, can do the same. excuse of shortage of beds cannot be accepted, for there is a wealth of clinical material in the municipal hospitals that should be utilised. We need to establish a postgraduate service on the grand scale. One that would satisfy doctors from the Dominions, the Colonies (coloured or not), and foreign countries, and at the same time be attractive even to a visitor from the United States. If we fail, then these doctors will look to another country for what they want. One hopes the.Minister of Health is planning big in this -
respect.
It would be with detriment to ourselves if through economy and traditional insularity we failed to maintain a prominent position in world
short-sighted medicine.
W. C. W. NIXON.
London, W.I. 1.
2.
Lancet, 1938. ii, 1082. Ibid, 1940, i, 342.
R.M.B.F. CHRISTMAS GIFTS Sm,-It is with great pleasure that I can now announce that the Christmas gifts appeal which I launched through your columns has reached the magnificent total of .82127, a new record. In view of high prices and the scarcity of the amenities of life I asked my colleagues for 2000, a sum which in view of last year’s record I scarcely dared to hope would be achieved but which has actually been passed by a handsome margin. This means that all our beneficiaries are receiving J64 as a Christmas gift, and there is enough over to give some of the poorest 22 for the New Year. My committee and I are deeply conscious of the great help afforded by the medical press in supporting and giving publicity to this appeal, and to you and your colleagues of the press, as well as to all the generous contributors in the profession, we tender our most cordial and most grateful thanks. Royal Medical Benenevolent Fund, ARNOLD LAWSON, 1 Balliol House, Manor Fields, President. Putney, London, S.W.15.
CONDITIONS OF MENTAL HEALTH
Sin,-Lead-poisoning is a notifiable disease, and if a man develops evidence of intoxication steps are taken
by the Inspector of Factories to eliminate or minimise the risk of further cases arising. A diagnosis having been made, no-one would think of telling the man that his symptoms are due to the nature of his work, and that as that work is part of larger industrial interests there is nothing that can or will be done about it, so that under the circumstances he will have to continue to expose himself to the toxic effects of lead. Yet in a leading article on The Injured Back in your issue of Oct. 6, which has just reached me, it is implied that a workman who breaks down because of an " intolerable work situation should be referred to a psychiatrist. Surely the more logical procedure would be to notify psychosomatic disease, arising from the conditions of work, to the Factory Inspector, who should have legislative powers to insist on the necessary improvements. In the same issue Sir Adolphe Abrahams draws a cross and inserts the words " love," " play," " work," and " worship " at the four corners. Work, he states, must be " psychically satisfactory, free from monotony, drudgery, anxiety, fear, gross physical insults, lack of progress or of production ; the foundations of ’ overwork,’ " and he goes on to say that fatigue is the result of irregular living. But surely it is useless to instruct patients in correct living if, unlike Sir Adolphe Abrahams, they are not among the privileged few, who, merely by an effort of will, can satisfy conditions of mental health. Grays, Essex.
R. N. HERSON.
BIOLOGICAL DANGERS FROM ATOMIC FISSION SiR,-The fact that I have been closely associated with Dr. Wiesner in work on male infertility makes me hesitate to comment on the subject he raised in your last issue, lest my intervention should not seem spontaneous. Before his letter appeared, however, I had already despatched an article on the same subject to another journal. In any case, the subject is of such importance that all personal considerations may be put on one side. When any advance made by the technicians is found afterwards to have unexpected repercussions on health, the doctors are called in to discover an antidote ; health material progress. This measures follow in the wake of is generally inevitable, since the injurious effects of the new discovery do not manifest themselves until it has been put into general use. But in the case of atomic energy there can be no excuse for postponing the study of its biological effects. We plan to make use of a force which is already known to have a profound influence on living tissues, and (as Dr. Wiesner has emphasised) more particularly on the cells responsible for continuation of the race. Surely therefore no time should be lost in planning the appropriate research. Much work has already been done on the action of X ravs and radium on tissue cultures and also on the structure of the testes, and methods have been devised for protecting from injury those who work with them. But the quantity of radium handled in hospitals only amounts to a few milligrammes, and the quantity of
Letters
to
the Editor
WITH DETRIMENT TO OURSELVES SiB,—In this country facilities for postgraduate medical training and research have been meagre, and interest in this branch of medicine has been slight. Vienna, Berlin, Paris, Lausanne, and other Continental medical centres have always attracted medical visitors. In these cities reception for the medical visitor has been organised, and he was treated as a welcome guest. London has been given a wide berth owing to the parlous state of such facilities. Some years ago a Dominion doctor ventilated his grievance in your Grains and Scruples.1 He wrote : "all declared they would never again bother to go to Great Britain unless conditions and the attitude (italics mine) of the men in the great hospitals changed radically. In London and Scotland we were made to feel, perhaps quite unintentionally, that the overworked hosts had no time to give us. At best we felt we were just tolerated ... certainly we were not welcomed." That was the lamentable state of affairs in pre-war days, and if a Dominion doctor received such a raw deal what hope was there for a foreign medical visitor ? Professor Grey Turner has pleaded’in your columns2 for the establishment of a Central Bureau of Medical Information. The British Postgraduate Medical School at Hammersmith has never really been a medical mecca worthy of the capital city of the Empire. With niggardly financial support and inadequate accommodation it could not hope to be. But now-praise be to Goodenough-a world centre for postgraduate training and research is to be situated in London. Let’s get on with it and quickly and without cheeseparing. Provincial centres must be included, since many of their medical schools have offered warm hospitality to the medical visitor which the London schools have often failed to do. The fault is ours, through neglect of this problem, that we now find ourselves caught on the wrong foot so far as our own demobilised doctors are concerned. Many are the friendly contacts that have been made between the doctors of the United Nations. Those who have been stationed in this country have expressed admiration for certain of our methods. They want to return at some future date to renew such contacts and they look to us as leaders in some branches of medicine. We have little to hide and much to show ; but we just don’t bother to do it. If in the testing time of war such liaison and interchange was possible, surely in peace it is not past the wit cf us to perpetuate such international comradeship ? The British Council is trying to cope with requests from doctors all over the world who are wanting to learn our methods and gain a first-hand experience of our way of doing things. There needs to be a committee, truly representative and of a high level, which would integrate all existing facilities in the United Kingdom. It would decide in which clinic the visitor would best be placed. It must make provision for (1) those who wish to work for one or two years in their specialty, and (2) the visiting professor who wishes to stay for three months seeing If Switzerland could organise our specialists at work. such a service (and benefit commercially), then surely The we, with our greater resources, can do the same. excuse of shortage of beds cannot be accepted, for there is a wealth of clinical material in the municipal hospitals that should be utilised. We need to establish a postgraduate service on the grand scale. One that would satisfy doctors from the Dominions, the Colonies (coloured or not), and foreign countries, and at the same time be attractive even to a visitor from the United States. If we fail, then these doctors will look to another country for what they want. One hopes the.Minister of Health is planning big in this -
respect.
It would be with detriment to ourselves if through economy and traditional insularity we failed to maintain a prominent position in world
short-sighted medicine.
W. C. W. NIXON.
London, W.I. 1.
2.
Lancet, 1938. ii, 1082. Ibid, 1940, i, 342.
R.M.B.F. CHRISTMAS GIFTS Sm,-It is with great pleasure that I can now announce that the Christmas gifts appeal which I launched through your columns has reached the magnificent total of .82127, a new record. In view of high prices and the scarcity of the amenities of life I asked my colleagues for 2000, a sum which in view of last year’s record I scarcely dared to hope would be achieved but which has actually been passed by a handsome margin. This means that all our beneficiaries are receiving J64 as a Christmas gift, and there is enough over to give some of the poorest 22 for the New Year. My committee and I are deeply conscious of the great help afforded by the medical press in supporting and giving publicity to this appeal, and to you and your colleagues of the press, as well as to all the generous contributors in the profession, we tender our most cordial and most grateful thanks. Royal Medical Benenevolent Fund, ARNOLD LAWSON, 1 Balliol House, Manor Fields, President. Putney, London, S.W.15.
CONDITIONS OF MENTAL HEALTH
Sin,-Lead-poisoning is a notifiable disease, and if a man develops evidence of intoxication steps are taken
by the Inspector of Factories to eliminate or minimise the risk of further cases arising. A diagnosis having been made, no-one would think of telling the man that his symptoms are due to the nature of his work, and that as that work is part of larger industrial interests there is nothing that can or will be done about it, so that under the circumstances he will have to continue to expose himself to the toxic effects of lead. Yet in a leading article on The Injured Back in your issue of Oct. 6, which has just reached me, it is implied that a workman who breaks down because of an " intolerable work situation should be referred to a psychiatrist. Surely the more logical procedure would be to notify psychosomatic disease, arising from the conditions of work, to the Factory Inspector, who should have legislative powers to insist on the necessary improvements. In the same issue Sir Adolphe Abrahams draws a cross and inserts the words " love," " play," " work," and " worship " at the four corners. Work, he states, must be " psychically satisfactory, free from monotony, drudgery, anxiety, fear, gross physical insults, lack of progress or of production ; the foundations of ’ overwork,’ " and he goes on to say that fatigue is the result of irregular living. But surely it is useless to instruct patients in correct living if, unlike Sir Adolphe Abrahams, they are not among the privileged few, who, merely by an effort of will, can satisfy conditions of mental health. Grays, Essex.
R. N. HERSON.
BIOLOGICAL DANGERS FROM ATOMIC FISSION SiR,-The fact that I have been closely associated with Dr. Wiesner in work on male infertility makes me hesitate to comment on the subject he raised in your last issue, lest my intervention should not seem spontaneous. Before his letter appeared, however, I had already despatched an article on the same subject to another journal. In any case, the subject is of such importance that all personal considerations may be put on one side. When any advance made by the technicians is found afterwards to have unexpected repercussions on health, the doctors are called in to discover an antidote ; health material progress. This measures follow in the wake of is generally inevitable, since the injurious effects of the new discovery do not manifest themselves until it has been put into general use. But in the case of atomic energy there can be no excuse for postponing the study of its biological effects. We plan to make use of a force which is already known to have a profound influence on living tissues, and (as Dr. Wiesner has emphasised) more particularly on the cells responsible for continuation of the race. Surely therefore no time should be lost in planning the appropriate research. Much work has already been done on the action of X ravs and radium on tissue cultures and also on the structure of the testes, and methods have been devised for protecting from injury those who work with them. But the quantity of radium handled in hospitals only amounts to a few milligrammes, and the quantity of