A corker of a journal?

BMJ 1998; 317 doi: (Published 19 September 1998) Cite this as: BMJ 1998;317:0

Is the BMJ any good? As the editor, I regularly ask myself that question—often in the middle of the night with screaming arteries. The sad truth is I can't know. I meet some doctors who tell me that the arrival of the BMJ is the highlight of their week. But others write and tell me that I should be ashamed to have let a once great journal deteriorate to such a state and that the sooner I'm fired the better.

I thus wonder if I may have lost all touch with reality when I conclude that this is a corker of an issue. (“Corker,” for non-native English speakers is slang for “a person or thing that is an excellent example of its kind.”) There's solid ideas from clinical medicine (p 792); the start of an ABC on oxygen, a lifesaving drug that is regularly prescribed wrongly (p 798); a fascinating paper on whether overwork will give you a heart attack (p 775); important insights into patient preferences when receiving chemotherapy (p 771); a broad debate on the implications of the Bristol case for medicine (p 811); a summary of the best evidence on sildenafil (Viagra) (p 759), which is launched onto the European market this week, together with a starter for the discussion we are going to have to have in Britain on its availability (p 760); controversial evidence that general practitioner fundholders have increased the rate at which they remove people from their lists since becoming fundholders (p 785); evidence based advice that it's not worth prescribing donezepil to patients with Alzheimer's disease (p 802); some diverting observations that cardiopulmonary resuscitation is done well in British soap operas (p 780); a personal account of the discovery of cortisone 50 years ago this week (p 822); a book review of what sound like two compelling accounts of having cancer (p 825); and much more. Surely, most readers can find something interesting and useful in this lot. If not, perhaps I should become a street sweeper, as one correspondent suggested.

Despite this rich mix it is, as so often, a short account by a junior doctor that appeals to me especially (p 783). Dawar Abbas describes his encounter with “a senior professor who was famous both for his surgical skills and gentle nature.” Dr Abbas had admitted a fit young man to have a varicocele treated. “What is his blood pressure like?” the professor asked on the ward round next morning. “Normal,” said Dr Abbas, who hadn't actually taken it. Who can't empathise? We've all been there and done that: told what seems a small lie to make life easier. The professor took the young man's blood pressure, and it was high. Dr Abbas prepared for the worst scolding of his life. “Had you checked it?” the professor asked. “No,” Dr Abbas admitted. “Never again,” said the professor politely.

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