BMJ 2001;322 ( 7 April )

Choice GP

The BMJ: competing with football

Who are the BMJ 's competitors? They certainly include the Lancet, the New England Journal of Medicine, and free medical newspapers, but they also include Manchester United, Hollywood films, digital television, computer games, and a walk in the park. If we are to flourish in the longer term in the "attention economy" we'll need to become ever more interesting, relevant, and fun. Although I'm hopelessly biased, this issue seems a step in the right direction. It includes for a start a joke that made me laugh out loud (p 831):

Dud: So would you say you've learned from your mistakes?

Pete: Oh yes, I'm sure that I could repeat them exactly.

This may be true too for the Harvard trained surgeon quoted by Minerva (p 874), who believes that "Surgeons are built differently [from other people] and become impervious to exhaustion." The same seems to be a belief of lorry drivers, which may partly explain why fatigue was associated with 10% of 68 000 serious road crashes in good conditions involving only one vehicle in France (p 829). An editorial argues that it's time to stop treating lack of sleep as a badge of honour (p 808).

One subject that must fascinate us all is prion diseases, and Paul Brown begins his review with a sentence worthy of Jane Austen (p 841): "It is sometimes forgotten that in the story of bovine spongiform encephalopathy and variant Creutzfeldt- Jakob disease there is but one incontestable fact, that bovine spongiform encephalopathy is the cause of variant Creutzfeldt-Jakob disease." All else is speculation, including the official British view that BSE was a chance occurrence resulting from a case of spontaneous disease in a cow. That's unlikely, argues Brown.

Another official British view takes a spirited beating in an editorial on the new national service framework for older people (p 807). Intended to "end ageism in the NHS," the framework is condemned as "institutionalised ageism" which betrays "moralising against ageism as cant." Even if you don't agree, you'll be exhilarated by the power of the language.

BMJ readers have higher intelligence quotients than average (or at least they did), so you'll want to know whether a higher IQ is associated with a longer life (p 819). It is. But perhaps you'll be even more intrigued by a Russian television programme that broadcasts car crashes, fires, murders, and domestic assaults four times a day (p 871). Maybe this "reality television" will spread. Meanwhile, on the other side of the former Iron Curtain, US contributors describe the growing fashion for whole body scanningprice $800 (p 873). There's enough in this BMJ to last you a whole football match, a boring one of course.

Footnotes

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