h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

I was wondering where you had got to.

Tell me, do you know why doctors are referred to Dr XXXXX but surgeons are always Mr....?

A very good question, and one I can't remember the answer to. Its got something to do with the fact that surgeons are even more arrogant than physicians, and in order to disappear completely up their own rectum, they change their title from Dr to Mr when they obtain their Fellowship of the Royal College of Surgeons (FRCS). This way that can smugly differentiate themselves from the lowly pill pushers.

Strictly speaking, medical doctors shouldn't call themselves Doctor, as the qualifications we get are only Bachelor degrees (I have MB BS after my name - Medical Bachelor and Bachelor of Surgery. My dad has MB ChB - Medical Bachelor and Chirugeum Baccalorum, or somthing - its Latin and pretentious anyway).

It gets even more confusing:

Surgeons (who are technically right to call themselves Mr.) can get a Doctorate of Surgery (and then are technically Dr.), but they still call themselves Mr.(and now they are wrong).
Physicians (who are technically wrong to call themselves Dr. and should be a Mr.) can get a Doctorate of Medicine (MD), and they are then technically right to call themselves Dr. (or should that be Dr. Dr.?)

Glad you asked?

- Adam

Ooh ooh ooh! I think I remember why surgeons are Mr.
Its something to do with the fact that surgeons historically weren't part of the medical profession (and quite right too).
They were part of the worshipful company of Barber Surgeons - they used to cut hair, pull teeth, and cut limbs off (hence the red & white stripy pole outside barber-shops these days. Its a gammy wound).
Therefore, they weren't allowed to be Dr.
Physicians, on the other hand, used to be part of the Worshipful Company of Apothecaries, along with pharmacists, herbalists, witches, etc. And they could be Dr.
Then it all merged and became very confusing.

Still glad you asked?

Correct - the same reason as Dentists and Vets are Mr. Because Doctors went to university and the others didn't.

I did medical history at uni.

Which Uni did you go to?

Warwick - well I did history but medical history was a special subject and it was fab!

I nearly did medical history for my intercalated BSc. We had lots of medical history at Barts. We were knee deep in the stuff.

Absolutely - they had lots of Barts stuff at the Old Operating Theatre in Southwark. Well worth going to see!

When my old man was extending his GP surgery about 10 years ago, they discovered an old bricked up cellar. It was full of some wicked Victorian implements. He found an old apron with a full set of amputation saws in the pockets, and I've now got a great collection of delivery forceps, silver plated reusable syringe sets, a really really nasty looking thing for taking your tonsils out and a jar of the most toxic ointment you will ever see in your life - its full of mercury.
Aah, the good old days, when we could get by with not knowing anything, cos there was nothing *TO* know. Long live quackery...

BTW, are you going to get that horse then?



- Adam

Can I just say how much I like the new look of your personal space. Very stylish and can I say that Matt's guide to everything sounds like a spanking good read!

No I am not. I can't afford it at the moment and I think the flat mates might object even though it is a small horse. But give me a couple of months to move to the country and a bit longer to raise the dough and ... well I think it is more then likely. Possibly not that one, but defenitely a fell pony. Small but strong enough to take an adult.

*blush* Why thank you madamoiselle

My friend Mat honestly did write that - it was only about 2 pages long (8 year olds don't really know that much about everything). He's a writer now, halfway through his first book. I am sure he's going to go very far. I'm writing a book at the moment - it will be great for insomniacs.

I thought you were going to move iminently. You could always go for a rescue horse or pony - there are far too many unloved and unwanted animals in the world - it would be much cheaper, and you'd get a lovely warm glow in your heart!

Hello!

How are you?Your medical presence was sorely missed!

Tell me about your book - I tried writing one over the weekend. It was about vikings - this was probably because I watched the 13th Warrior (viking film) 5 times! So I gave up!

Ahhh there you are! Good to see you back in the land of the living

Hope you're feeling better
Hows your foot?

You *really* wouldn't want to read my book when its finished - I'm writing a book on Informed Consent with a surgeon friend of mine. It will be aimed at house officers and senior house officers so the don't say something that will get them struck off when consenting a patient. Hopefully it will be included in the pocket textbook series edited by Kumar & Clarke (of big textbook fame, and old teachers of mine at my alma mater). It will definately be tedious!

Can I read a passage from your Viking book?

I might be back in the Land of the Living but I feel horrible. I think it was the antibiotics that did it for .... hold on just down to the bookies. What a fast living editorial team we are! Back shortly.

In the mean time can I have your medical opinion on why I have gone down with cellulitis three times in 9 months. first in the left leg and then twice in teh right.

right where was I?

Your book sounds good - is it going to be 100% serious or are you tempted to include some in joke just to see who is paying attention?

I am afraid I only got as far as writing out the plans for the first three chapters of my viking book before I realised that I did not know that much about vikings in the first place and would have to do some research. So now I am toying with a sort of modern version of Pygmalion.

Stick a fiver each way on the favourite in the 3:15 at Doncaster for me please!

Recurrent cellulitis... hmmm...

Well cellulitis is due to an infection of the soft tissue. It is usually found in the leg, and is most often due to an infection with Streptococcus or Staphylococcus.
It presents as a hot, pink, tender swelling, and it can make you feel generally unwell.

Often there is an obvious site where an infection has got in:
- Scratches or abrasions
- Bites (midges, etc)
- Ingrowing toenails, or atheletes foot (often barely noticable).
- Blisters, etc. Check your shoes! Especially new ones!

If you contaminate a wound or scratch, cellulitis can occur - easily done if you work around horses.
If you suffer from swollen ankles, you are more at risk.

It is most likely just bad luck you have had recurrent cellulitis, but if you are worried, get your GP to give you a once over.

Treatment is with antibiotics - usually Penicillin V or Erythromycin.
In recurrent cellulitis, some doctors advocate antibiotic prohylaxis ( eg penicillin V 500mg twice day orally).

Hope that is of some use! I know from personal experience how painful cellulitis can be - I had it around my elbow due to a Staphylococcus infection getting in through a *tiny* scratch. My whole elbow swelled up, I couldn't move my arm, and I had to have a needle stuck into my joint to make sure it hadn't spread to the joint. I ended up prescribing myself a very powerful and somewhat dangerous antibiotic called Fucidin which made me feel even worse.

Oh, and some other things can increase the risk of cellulitis:

- Taking steroid medication,
- Immunosuppressant medication,
- Diabetes,
- Peripheral Vascular Disease.

- All things I'm sure you'd know about if you had them

*digs the good Dr in the ribs* How much of a star are you?

Well the first time was mosquito bites and the local river in the Transkei over the millennium (I was very unwell - ravings, hallucinations the works as my temperature rocketed until my Godmother saw my foot and realised it was not gastric flu) The other times probably blisters I suppose. Any way I had 1500mg a day of something (I am allergic to Erythromycin) and it seemed to work.

I got ill on Monday night - it felt like cramp initially but by about 9pm I could not walk on it at all and I knew that I was coming down with it again. By 4am I was in such agony I was about to take myself to casualty! Weirdly my Dad was diagnosed with it in the same leg on the same day and he did not respond to the pills and ended up in hospital over the weekend. We were comparing colours - his leg was bright red, mine a kind of plum colour presumbably cos the pills were working.

Any way enough of this - how was your weekend?

That is spooky! Hope your dad is OK now

I had a really boring weekend doing my CV. I was meant to go to the PLASA (Professional Lighting and Sound Association) show at Earls Court on Sunday but didn't get round to it. Big sound systems and mixing desks!!! Its a boy thing

Did you manage to get out & about?

He is fine - he was admitted because there was a possibility it was a deep vein thrombosis so he was treated for both. Infact he was looking much better then I have seen him for ages on Sunday in his Dennis the Menace PJs. Bupa had coughed up for a private bed - he even instructed my brother to go to the shop at the 'front of the hotel' so he must have been feeling better.

You are right it is a boy thing. I managed to hop to the car and then into the cinema to see Snatch but other then that I took to crawling everywhere in the house which confused the hell out of the dog!