BMJ No 7123 Volume 315 Saturday 20/27 December Christmas 1997

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Editorials

1633 An ethical code for everybody in health care
Donald Berwick, Howard Hiatt, Penny Janeway, Richard Smith

1634 Social suffering: relevance for doctors
Solomon R Benatar

1636 Choosing the best research design for each question
David L Sackett, John E Wennberg

1637 Just what the doctor ordered - more alcohol and sex
Anthony J Cleare, Simon C Wessely

1638 Festive cheer for all?
Ian R White, Martin McKee

1639 New Labour, new NHS?
Jennifer Dixon, Nicholas Mays


Papers

1641 Sex and death: are they related? Findings from the Caerphilly cohort study
George Davey Smith, Stephen Frankel, John Yarnell

1644 The earth may move, but let's keep our feet on the ground
Matthew Hotopf, Simon Wessely

1645 Risk factors for winter outbreak of acute diarrhoea in France: case-control study
Laurent Letrilliart, Jean-Claude Desenclos, Antoine Flahault

1649 Death rates of characters in soap operas on British television: is a government health warning required?
Tim Crayford, Richard Hooper, Sarah Evans

1652 Reliability of distance estimation by doctors and patients: cross sectional study
Basil Sharrack, Richard A C Hughes

1654 Births at Christmas are different: population based survey of 2 million deliveries
Mads Melbye, Jan Wohlfahrt, Tine Westergaard, Anne Kristine Valeur Jensen, Anders Koch, Henrik Hjalgrim, Annemette Kristensen, Peter Aaby, and the Christmas Paper Study Group

1655 Do you know your chocolates? Recognition survey among medical staff of various grades
Fiona Cooke, Rhian Morse

1656 Increasing handicaps in hospital medicine: two point cross sectional study of golfing activity among doctors
John M Eagles, George B Rhind

1657 The colon in medicine: nothing to do with the intestinal tract
Hamish Cameron, Annette Robertson


When I use a word ...

1658 Crosses and stars
Jaff Aronson


General practice

1659 So many precious stories: a reflective narrative of patient based medicine in general practice, Christmas 1996
Glyn Jones Elwyn

1663 Do overweight people remove their shoes before being weighed by a doctor? Consecutive study of patients in general practice
Timothy Harlow


Clinical review

1664 One for the heart
Richard Doll

1668 What's in a Gnome?
Peter J Scheuer


Education and debate

1669 Medicine as a profession: Hip, Hip, Hippocrates: extracts from The Hippocratic Doctor
John Fabre

1671 Swearing to care: the resurgence in medical oaths
Brian Hurwitz, Ruth Richardson

1674 Professionalism must be taught
Sylvia R Cruess, Richard L Cruess

1677 Medicine needs its MI5
Duncan Campbell

1680 The BMJ and the 77 specialties of medicine
Richard Smith

1682 How to do it: How to acquire a coat of arms
John Thurston

1685 A difficult case: Diagnosis made by hallucinatory voices
Ikechukwu Obialo Azuonye

1686 History: Two hundred years since Malthus
John A Black

1689 Sailors and star-bursts, and the arrival of HIV
Edward Hooper

1692 The electronic future: What might an online scientific paper look like in five years' time?

Length - and other strengths
Lisa Bero

From snapshot to movie
Tony Delamothe

Variation adds value to the author's logic
Anne Dixon

Looking to the future: amazon.com and four trends
Ronald E LaPorte, Akira Sekikawa, Deborah Aaron, Rimei Nishimura, Benjamin Acosta

It could fulfil our dreams
Faith McLellan

"Papers" will still exist
Peter Newmark, Vitek Tracz

Something for everyone
Richard Smith

Competition


The muses

1697 Illnesses and creativity: Byron's appetites, James Joyce's gut, and Melba's meals and mÍesalliances
Jeremy Hugh Baron

Commentary: Ambivalence toward fatness and its origins
Arthur Crisp

1704 How Renoir coped with rheumatoid arthritis
Annelies Boonen, Jan van de Rest, Jan Dequeker, Sjef van der Linden

1708 La salle de garde: bastion of the French lunch hour for junior doctors
Bernard D Prendergast

1709 The hidden delight of psoriasis
Frans Meulenberg

1712 Books: Gimme five - books, that is
Kate Adams, Jeremy Anderson, James Barrett, Solly Benatar, Chris Bulstrode, Simon Chapman, Linda H Clever, Frank Davidoff, Tony Delamothe, Michael Farrell, Carlo Fonseka, Paul Glasziou, Brian Haynes, Jonathan Hobson, Olivia Horner, Richard Horton, Zviad Kirtava, Carl Kjellstrand, Irvine Loudon, Nabil Nassar, Roger Robinson, Jaime Sepulveda, Jenny Simpson, Richard Smith, Tony Smith, Pritpal S Tamber, Jessica Westall, Steinar Westin


Poems

1718 A history
Visual acuity
A minimental status examination

Glenn Colquhoun


Rap

1720 BMJ rap
Mark Sutherland


Soundings

1721 The session
Liam Farrell


Photofinish

1722 Photofinish


S2 Career Focus Classified supplement

Tackling the midlife crisis
Joan Rogers


Editor's choice

From the deadly serious to the downright barmy

The Christmas issue is the usual cocktail of the deadly serious, the poignant, the speculative, the frivolous, and the downright barmy. Most of the material is submitted rather than commissioned, giving insight into what's on the medical mind. Last year it was death, this year it's hedonism: sex, drink, golf, chocolates, and overindulgence (p 1637). One subject that doesn't feature is religion, raising again the question whether we should rename the Christmas issue. The "midwinter issue" would strike a discordant note in the southern hemisphere, while the "end of the year issue" would sound exclusive to those who live by different calendars. Any suggestions?

A serious note is struck by journalist Duncan Campbell, who argues that medicine needs an investigative agency that would use covert methods to detect doctors behaving unethically (p 1677). Four editorialists propose an ethical code to cover all those working in health care (p 1633). Brian Hurwitz and Ruth Richardson describe how medical oaths are enjoying a fin de siécle resurgence (p 1671), while John Fabre takes us back to the writings of Hippocrates (by not one person but many): "The dignity of a physician requires that he should look healthy, and as plump as nature intended him to be (p 1669)." Jennifer Dixon and Nicholas Mays comment on the British government's new plans for the health service and conclude that they amount to three things: "softening the harsher edge of the internal market ... involving all general practitioners in purchasing ... and strengthening central control over the quality of ... clinical care (p 1639)."

The poignant is sparser than usual, but Ikechukwu Obialo Azuonye tells a remarkable tale of how a healthy woman heard voices telling her she had a brain tumour - and she did (p 1685).

The speculative comprises several views on how the scientific "paper" will look in five years' time (p 1692). A competition invites you to make your prediction. Judgment will be in 2002, and the prize will be a 2003 subscription to the electronic version of one the five main general medical journals (if they still exist).

The frivolous predominates and includes the excesses of Byron, James Joyce, and Nellie Melba (p 1697); colons (the literary kind) (p 1657); gluttony and lewdness in French hospitals (p 1708); mortality rates in soap operas (p 1649); and a BMJ rap written by a 7 year old (p 1720).

Top of the barmy contributions are a president of a royal college wearing a gnome's hat (p 1668) and the vital question of whether fat people are more likely than those who are thinner to remove their shoes when being weighed (p 1663). Discuss this question with your loved ones before turning to the answer. It may ease the traditional Christmas tension.


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