Doctor Henry Marsh

Tuesday nights on SBS at the moment are medical night, starting with "Blood and Guts: A History of Surgery", a very informative show.  But last night I caught the better part of a documentary called "The English Surgeon" which was screened later in the night.

The central subject is Dr. Henry Marsh, a British neurosurgeon who has been making trips, in his own spare time, to the Ukraine to assist an out-of-the-box doctor named Igor Kurilets.  I use the term more for his treatment setup than his personality.  He works in a country historically dogged by the Communist regime and its manifold ways and structures that have left it with a health system, among other systems, that many western nations would consider barely functioning.

Unfortunately I missed the beginning of the show, unaware that it was on.  I was hooked once I stumbled across it, even though it was a quarter done.  In one of the first scenes I caught it showed Dr. Marsh, annoyed at the bureaucratic tangle of the UK health system, leaving his computer and stalking off to cool down.  He explains to the camera once at home that he is taking medical equipment to the Ukraine on his next trip, displaying drill bits that the UK system disposes of after one use.  They have a plastic insert, so cant be re-sterilised, and at £80 for each one, he estimates that they use, in his hospital alone, 10 of them each week.  And then they throw them out.  £800 a week, £4000 a year, more or less.  He and Igor open one up after he arrives in the Ukraine, remove the plastic insert, sterilise it, and it is soon put to good use with a Ryobi cordless drill to remove a brain tumour from a young man suffering epileptic fits.

Dr. Marsh himself proved to be fascinating man of some depth.  Throughout the documentary, a young girl named Tanya is mentioned.  His face and speech seem to change whenever she is discussed.  Dr. Marsh had bought her to the UK a few years before the documentary was shown to remove a tumour that had paralysed the side of her face, after Moscow and Kiev surgeons said it was inoperable.  He looked and sounded genuinely haunted by the fact that Tanya had suffered as a result of what he had done.  Her quality of life suffered after two operations he performed on her, her death seemingly inevitable by Ukrainian standards, but possibly not by UK standards.  He visits her mother at her home at the end of the documentary, wholly welcomed by the family.

He sits in Dr. Kurilets office meeting with patients, honestly and rapidly assessing their chances, realistic that the majority of cases are inoperable or too far developed to render enough assistance because of the systems in place.  While a brain scan may only cost $50 to $100, many Ukrainians cannot spare that amount.  And when they do manage to, or are forced to through physical problems caused by the tumours, they often result in a dire prognosis.  We see a young girl who is already blind from her tumour growth.  The grandmother who is told her young granddaughter is inoperable and left with a year or so to live.  The 23 year old woman with the spreading tumour that no surgery anywhere could repair.  And Marian, the young man with the epileptic seizures who is operated on with the home handyman tools available.

I hope I can see all of this in the future. If you get a chance to watch it, it's well worth seeing.

Handy Henry Marsh at the Times Online

Henry Marsh interview at NPR.org (transcript and download at US National Public Radio)

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A few of problems I have with governance and money

A few things have happened lately that have irked me a lot. Not just a bit, a whole lot. So much so that I question certain systems. Everyone does this now and then. But these ones just really got me annoyed.

The first is the Superannuation system, and the government mandated 9% contributions.

A lot has been made of superannuation funds losing money, causing some people nearing retirement age to think again. Their super fund is suddenly worth 20% less than it was twelve months ago, and they simply cant afford to retire.

As was pointed out, and I completely agree with, why should something we are legally obliged to contribute to, and have little control over, be able to lose money hand over fist?

Why should I pay 9% of my wage into a pool that may well disappear before I have a chance to use it? Can I not contribute that money where I control it? Then again, who wants the trouble of doing that? If I am being forced to pay this, then it should be protected, in the same way that banking deposits are treated. I dont give the bank my wage and then go to withdraw it only to be told "sorry sir, its all gone". Superannuation should not be any different.

Of course there is the demand that superannuation grow and prosper, leading to risk and exposure. So make it 15%, protect it, and retire later. The days of retiring at 55 and then taking a world trip are long gone. Jet travel has seen to that. People see the value in spending now, leaving the super as a necessary evil until they absolutely need it.

The second thing is Medicare, bulk billing, and child immunisations.

Again, this is another case of one of those things you have to do, at your own peril. Some people dont agree with immunisation for various reasons, and rightly so. They can be risky. We all know someone who has been impacted by immunisation side-effects, in mild or severe forms.

Case in point: #3 went for her 12 month immunisation this past week. $62 for three needles.

$62 for something that any school in the country will ask for proof of. $62 for something that if she didnt have them, she would not be allowed in daycare. $62 for something that the government medical offices have sent us letters asking "why is this overdue?". $62 for something that nobody obviously sees as 'optional'.

How much did Medicare reimburse us for the privilege of doing what is required? About half. What is going so wrong behind the scenes that the doctors feel obliged to charge double the going rate for sticking required needles into kids for three minutes? You can bet if we were in a lower socio-economic suburb we'd be bulk-billed without question.

I'm not demanding free national healthcare, but its things like this that really irritate me.

Which brings me to my third item. What compounds the doctor issue for me is the private healthcare for over 30's issue. If you're over 30 and dont have private health insurance, the government will increase your tax for the rest of your life. You have no way to remedy this. You are marked for life.

This has the seeminlgy nett effect that private hospitals are turning into money factories, and the funds are coming from private health funds. As people opt for surgery in private institutions due the 'ailing nature of public facilities', they see the cost as their basic excess. Surely $250 for fixing that dodgy knee is a small price to pay now rather than wait 2 years to get it done free by so-viewed 'second rate' doctors forced to work in the public system? It may seem a good option, but the doctor at the private institution charges the fund five times that, and the premiums inexorably go up to cover every man and his dog getting it done.

Dont sit back and say the thought hasnt crossed your mind that private hospital doctors are a better class of doctor just because of where they work. You know it has.

Its a cycle of money feeding on money, and its just one thing that stinks.

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G.E.R. is a B.I.T.C.H.

A few troubles over the past month or so led me to consult the family doctor.

A chest x-ray, a reassurance that I wasn't about to have a heart attack or stroke, and a couple of weeks later, I have been diagnosed with G.E.R. Some people use G.O.R., which I guess is more correct once you read the extended name.

G.E.R. is gastro-oesophageal reflux. Different from G.E.R.D. in that is not a disease, hence the lack of D., and implies a short term inconvenience rather than a non-reversible disease. If you read the articles, you'll see there is various symptoms. My main symptom is the shortness of breath. Which can prove a mite difficult now and then, especially after eating.

The majority of the 'net based information says lose weight, stop smoking, minimise coffee intake, dont eat fatty or acidic foods, and eat less at one time. It can be controlled with diet, or in extreme cases, once you earn the extra D., surgery may be required.

It's funny, but I dont have the breathing difficulties if I'm riding, only if I'm sitting still, at work, or driving home. Maybe this is 'The Sign' that it's time to lose weight? According to the Australian Health guidelines, I am 'Preobese', with a BMI of 26.881. Get it under 25 and you're magically healthy! Harry Potter and the Chamber of Exercise...

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