So What Does Your Perfect Day Reveal?

'The perfect day exercise' (see yesterday's blog) is the ideal way of getting the conscious mind and unconscious mind to work together, often bringing your underlying unconscious motivation to the surface. It is what you would really like to do in life and what gives you real pleasure, not what society has enforced upon you. Perhaps contrary to evolutionary psychology, sex does not usually play a big role in the perfect day exercise, although if your ideal day involved waking up with James Bond or kissing Kylie Minogue, there’s no wrong day, and no two people’s perfect days will ever be the same. They are as unique as fingerprints.

Happiness will probably not be achieved by replication of this exact day, but it offers the opportunity to help consider a direction of travel, helping to align your conscious and unconscious motivations. In fact, it’s a bit like the so-called ‘Rorschah’ or ‘ink blot’ test, which asks you to make pictures out of ink blots, to see what the unconscious mind sees. The different images people see, come from everyone’s unique brain wiring, not the ink blot shapes themselves.

With the perfect day exercise it’s perhaps interesting to note that top achievers frequently do not have goal conflicts. For example, when Olympic gold medal winners are asked for their perfect day, it is often found that they will have dreamt about getting an Olympic gold on their perfect day. This shows the immense power and importance of the conscious and unconscious working in harmony. Most people find this exercise very helpful and I certainly hope you all enjoyed doing it.

Perfect Day

With morale within hospitals hitting rock bottom, and Patricia Hewitt remaining in post, all be it, for now.... I thought I'd write about the future and 'The Perfect Day Exercise' to lighten the tone.

Lou Reed (1972) wrote a song about his perfect day “Just a perfect day, Drink Sangria in the park, And then later when it gets dark we go home, Just a perfect day, Feed animals in the zoo, then later, a movie too, And then home”. If you don’t have a clear idea about your goals, then life can become a bit aimless. The ‘perfect day’ exercise asks you to consider what is your perfect day?

So, sit down and let your imaginative and creative juices overflow. In your perfect day you have a metaphorical blank cheque, so you could be anything and go anywhere in the entire world. The key is that it is your perfect day, nobody else’s and there are absolutely no wrong answers. Everyone will have a different perfect day, but you are not just thinking of a good day, but your perfect day, completely and utterly the best day ever. You should try and think about this day in as much detail as possible. The questions below may help you crystallise your perfect day:
What time would you get up in the morning?
Do you wake up alone?
What do you have for breakfast?
Would you have breakfast at Tiffany’s?
Where would you be?
What do you do after breakfast?
How long is breakfast for?

Then go through the day in as much detail as you possibly can. Some people may say that they are flying on Concord to pick up an award, others relaxing with their families whilst others might be catching their perfect wave. It is unique to you and can be as outrageous as you like. It is nobody else’s day. It’s important that before you read tomorrow's blog, you have a very detailed plan of your perfect day.

Flying Solo

The key players in the MMC debacle are falling like a house of cards. The resignation of James Johnson (BMA chairman) being the latest, and the call for Patricia Hewitt to resign has become even louder.

The result of the junior doctors v DoH Judicial Review is eagerly awaited, for justice and faith to be restored within the medical profession. Tonight, newsnight will debate 'morale in the NHS'. It has been reported that morale has never been lower amongst NHS staff, and for those working in the profession, that comes as no surprise. I have previously written an article about the medical professionals suffering from learned helplessness, because automony has been lost, and the professional voice silenced. For this to be reversed, the training of our doctors is key. After all, the government wouldn't enforce airline pilots to radically reduce flying hours before taking charge of solo flights; if they did, can you imagine the safety implications outcry? So, why has Patricia Hewitt been allowed to radically change doctor training without consultation?

Will the government listen?

As the Judicial Review continues in the High Court today regarding the enforced governmental changes to doctor training. A staggering 80% of consultants believe the implementation of the government's Modernising Medical Careers (MMC) programme should be delayed, according to findings published in the leading medical journal, The Lancet. Modernising Medical Careers (MMC) is the government’s new run-through training programme that aims to produce senior doctors in a streamlined manner. The programme has provoked major concerns over its potentially detrimental effects on both patient safety and medical training.

The Lancet's results were based on a survey of 3255 consultants and junior doctors on their attitudes to the proposed changes in medical training, due to be introduced in August this year. The results demonstrate clearly that doctors believe that MMC in its current form jeopardises patient safety, diminishes the quality and scope of training, and damages Britain's potential for innovative and life-saving research.

The government has failed to address adequately the genuine concerns raised by the medical profession. Solutions provided by the initial review body, promising a single interview for each applicant, were deemed unsatisfactory by 75% of those surveyed. Findings of the second review will not be available until September.

The Medical Training Application System (MTAS), the online job application system for doctors, has been deemed unsatisfactory for further use by Patricia Hewitt (15/05/07). Hiding behind the inevitable collapse of this failed system, only highlights the fact that the DoH continues to fail to address the complex issues that fuel the shambolic reforms. Doctors are not opposed to change but Modernising Medical Careers in its current form is ill thought out and fuelled with potential problems.

With less than 11 weeks to go until doctors’ current contracts end, there is palpable tension within the NHS. With thousands of interviews still pending, 85% of doctors surveyed are calling for consultants to withdraw from the interview process completely. Changes to medical training will affect up to 32,000 doctors, yet only 10% of these think it will result in improved training. “That a crisis in medical recruitment and education has occurred is beyond doubt”, said Dr Jane Graham, a junior doctor from Addenbrooke’s hospital. “As the 1st August fast approaches, the question remains, how many patients must be put at risk before the Government listens to the professions’ warnings?”

Can the government prevent the impending disaster? I hope so; the message is loud and clear.

Who Are You Gonna Call?... The Ghost Cabinet

One dark night, some leading anti-government bloggers decided that it would be a good idea to form a crack unit to provide firm government opposition. They decided to form a Ghost Cabinet. This team is to be organised like a Cabinet. The initial appointments are all popular bloggers with a strong interest or expertise in the given policy area. Freed from usual constraints such as collective responsibility or needing to win an election or grab a headline, these ghosts eschew normal political conventions by presenting ideas that will actually improve the country.

Each ghost vows to haunt the relevant government minister on a regular basis. Further, ghosts offer alternative policies in monthly "blue moon thinking" slots and may also host a guest ghosts. The 'Ghost of Health' has been so named in memory of all the initiatives that have failed to improve patient care. The blog is being launched tomorrow at http://ghostcabinet.blogspot.com/. Watch this space!

Patricia Hewitt Answers Questions on the Channel 4 News

This is a clip from the Channel 4 news yesterday, showing Patricia Hewitt in action:

MTAS is over

Today the MTAS system was finally laid to rest. However, it will not rest in peace. It will be remembered as the system that wasted £6.3 million of NHS money, leaked confidential and highly personal information across the internet and had a never-ending list of problems. Patricia Hewitt said live on channel 4 news tonight that “criminal offences may have been committed” following the MTAS computer access and has handed over material to the police. For more on this story read the report from Dr Crippen. I am sure the police will be grateful that the MTAS system has been laid to rest, following reports in the Times newspaper about doctors' information being misused to potentially breach hospital security.

Channel 4's Jon Snow stated that “it’s hard to overstate the gravity of this disaster” and suggested to Patricia Hewitt that she would “have to resign.” She said that she would “take complete responsibility” for the computer shambles but felt that she still had widespread support. She went onto try and explain MTAS, MMC and the interview process; but she left the logic out of the explanation. Even Jon Snow said “we’re all getting a little confused.”

Professor Humphrey Hodgson went onto point out that patient care is being affected by MMC with a lot of non-emergency work being cancelled to sort out the mess that MMC has created. His final polite words on Channel 4 were about the poll of over 3500 doctors, which had showed that confidence in Patricia Hewitt was “low”. MTAS may be the first to fall, but it will not be the last.

Breaking news

The well overdue news that the MTAS system has been scrapped is welcomed. For the BBC report read here. This is the first important step – but a lot still remains to be done.

Missing Madeleine McCann

One family, one little girl, one possible suspect - a man, wearing light trousers, a blue top, with a partly shaven head was spotted a few hours before Madeleine disappeared. The search must go on:

Patricia Hewitt in the Dock

In a statement released by Remedy UK, a group representing junior doctors, describe how next week is an "historic week" for the medical profession. After doctors have marched together en masse, debated, discussed and lobbied as one, the finale" is that "doctors from all over the land will unite to take the Department of Health and the Secretary of State for Health to Court." This will be the first big test for Gordon Brown, after his pledge the make the NHS central to his campaign. It will also show whether he is going to side with real doctors or be advised by spin doctors.

Remedy UK are standing up for "everyone who has felt that the unfairness and... has been the product of a downtrodden emasculated profession." So, don't miss the drama on Wednesday and Thursday in the High Courts of Justice on the Strand. The time has come to finally to draw a line in the sand that it is not acceptable to behave or treat people in this way. If Gordon Brown wants "to listen" as he so pledged in his leadership campaign, he should know where to start. His spin doctors may try and advise him that this group are not representative of the profession. However, real doctors have already done their research and published it. The leading medical journal, the Lancet, has published findings from a recent survey of 3255 consultants and junior doctors calling for a halt to proposed changes in medical training due to be introduced in August this year. A staggering 80% of those surveyed have "major concerns that MMC will have detrimental effects on both medical training and patient safety." The evidence whether academic, legal or professional is the same... listening will be the key.

It's the Final Countdown

As the news of the day has been the historic announcement that the legacy is over, I'll leave a picture to paint a thousand words:

Is it all Womens' Fault?

Famous astronomer Sir Patrick Moore who holds the Guinness Book of Records title for the longest-serving TV presenter, having appeared on his show about astronomy since 1957, has claimed that British TV standards are deteriorating because the BBC is "run by women". He has called for separate channels to cater for the needs of the different sexes. He went on "I would like to see two independent wavelengths - one controlled by women, and one for us, controlled by men." Claiming "The trouble is the BBC now is run by women and it shows soap operas, cooking, quizzes, kitchen-sink plays. You wouldn't have had that in the golden days."

I am not sure that you can blame women for his claim about 'banal' television; he could have claimed that the medical profession is suffering under the reign of female Patricia Hewitt - but I can assure him not all women would do such a thing!

The Medical Heroes Unite

An open letter has been sent to Consultants, on behalf of: Prof Morris Brown (Cambridge), Dr Mei Nortley (London), Dr Helen Wise (Wessex), Dr Sarah Spencer (Bridgend, Wales), Dr Chris Allen (Cambridge), Dr Gordon Caldwell (Worthing), and many other concerned consultant and junior doctor colleagues in the UK. Parts of it are reproduced here:

"Many of you find yourselves in the position, at once enviable and difficult, of having more say now over the fate of the Juniors than the DoH mandarins and quangos who have ridden roughshod over just process and individual rights. This opportunity arises because MTAS cannot proceed without the collaboration of Consultants in the round 1b interviews. Some of you will be well aware of the flaws and injustices of MTAS, and just need to know your views are shared by the majority of colleagues. We have conducted an online poll at http://www.cai.cam.ac.uk/people/mjb14/ which shows that 81% of 813 Consultants and 85% of 2422 Juniors want a Consultant boycott...

The week-long shut-down of the MTAS computer due to leaks of confidential information has added to both the agony of applicants awaiting news of interviews and to the incredulity that this untried system will deliver matching of applicants and posts – with sensitivity to the needs of partners and families – by 1 st August. Channel4 News has reported that "Hundreds of junior doctors in Scotland have had details of interviews lost in the latest IT chaos to hit the NHS". Their full report can be viewed at here.We believe that the spiralling debacle of MTAS and our poll results will embolden Consultants to follow those in Trusts and specialties who have already declared themselves against further participation in MTAS interviews. The sooner this happens, the sooner Deaneries can activate their contingency plans for a temporary solution, and a revised date for the August changeover can be set, thus preventing any further harm to our service to patients...

We believe the recent intransigence over revisions to MTAS make it essential to halt any MMC appointments before a thorough Review is complete. Otherwise we will be told it is too late or illegal to make major changes."

I would like to thank all those consultants taking an interest and leading the way in making medical history. Their actions are both appreciated and needed and I hope they are heeded.

We all know that Patricia Hewitt's days are numbered leaving someone to fill her shoes, all be it messy shoes. As everyone seems to be predicting who will take over from Patricia Hewitt, anyone interested in my bet - it would be Ed Balls!

Thought of the Week

As everyone has enjoyed the hottest April for 300 years, reader (Deborah King) wrote to me asking to blog a piece about the environment, and so thought of the week is - "We can all make a difference".

Sometimes the problem when considering the environment is that the issues are so big they can be perceived as overwhelming, and this can lead people to conclude that they are unable to have any effect. However, as Edmund Burke poignantly said, "No one could make a greater mistake than he who did nothing because he could do only a little." We can all make a difference not only through the effect of our own actions on the environment around us but also by the intangible effect of our own actions potentially inspiring others. Perhaps the best known example of whether humans can make a difference to the environment is the way the destruction of the ozone layer by CFCs was turned around in the 1980s and 1990s following the original discovery of the hole in the ozone layer by a British Antarctic expedition in the 1970s.

It can seem that we are constantly bombarded with ideas about how to help the environment and often it’s hard to boil them down into some simple practical steps. But here are a few suggestions which are commonly made:
1. Drive less and keep your tyres inflated for better fuel efficiency.
2. Re-cycle where you can.
3. Use less electricity by adjusting the thermostat, changing to energy-saving light bulbs and considering low-flow showerheads and washing clothes in warm as opposed to hot water.
4. Save electricity by turning off electrical devices such as your TV, DVD player, stereo and computer when you’re not using them.
5. Avoid products with a lot of packaging.
6. Consider moving to a green electricity provider such as one which uses wind power as opposed to fossil fuels in its processes.
7. Consider off-setting either some of all of your emissions through, for example, joining a scheme which plants trees in proportion to your carbon footprint.

Many Thanks to all who Voted.

I’d like to say many thanks to all the people who voted for me yesterday in the local election, with a resulting 8% swing to the Conservatives. My congratulations go to the winner (Lib Dem, Mike Pitt).
Today I’m taking a break, after a long night at the count, but Ellee Seymour’s blog is worth a special mention today as she tackles the question ‘are you a psychopath?’

Voting Day!

Today is local election day and I’m off to vote… but by clicking here you can see and hear who I voted for in the last general election... I should give a prize to the first person who spots me!

A New Medical Illness

An e mail was sent to me today, it made me smile, so I thought I'd share it with you:

"Medical Training Anxiety and Stress disorder (MTAS)

A new psychiatric disorder is sweeping across the nation at an alarming rate. Officials have not yet been able to control the epidemic of a new condition that has been named Medical Training Anxiety and Stress (MTAS) disorder. The disorder, which appears to be affecting primarily junior doctors, is characterised by a previously unseen cluster of symptoms including thought disorder, hallucinations, escalating paranoia and obsessive behaviours.

Epidemiology and Aetiology

It is estimated that there have been as many as 34,000 new cases of MTAS disorder since January 2007, though this may be grossly underestimated. The lifetime risk for developing the disorder is thought to be as high as 100% in the at-risk groups. MTAS disorder appears to affects junior doctors at any stage in their careers and the severity does not appear to be affected by gender, race or duration of medical working life.

Clinical features MTAS disorder is characterised by a number of psychological and physical symptoms. Remarkably this disorder seems to be characterised by one common delusion; those affected are convinced that they are in regular communication with government officials via Internet websites and that their lives and career aspirations are being monitored. Thought insertion is a common symptom. Individuals describe government dictation of life plans, most specifically career choices. Many also report thought withdrawal, describing that previous career aspirations have been removed from their heads. Thought broadcasting is another common theme. Many individuals report that their thoughts and work-related experiences have been documented and broadcast via the Internet. Those affected have developed obsessive behaviours, repeatedly describing difficult cases they have been involved in, when their patients have made them feel upset or angry. Other obsessive behaviours have been observed; those affected are rendered incapable of being in the vicinity of a computer without trying repeatedly to access government websites describing grandiose ideas that they may be called to attend interviews across the lengths and breadths of the country at a moments notice. Physical symptoms include disturbed sleep pattern, palpitations, tachycardia and those with severe obsessive behaviours have developed repetitive strain injury from overuse of computers.

Management

Early indications are that psychosocial therapies are ineffective in the management of MTAS disorder. Trials into medical therapies are continuing but so far anti-psychotic medications have done nothing to reduce paranoia, delusions or persecutions. The spectrum of symptoms is worsening despite frantic research and trials of therapy.

Prognosis

Though little known is known about MTAS Disorder it is thought to have a poor prognosis. The long-term effects are not known but there are indications of likely long-term psychological damage with significant destruction of morale, self-esteem and ambition. Experts have been called in but so far their efforts have been negligible. There are serious concerns regarding what is to become of the medical profession. The world will watch with scrutiny over the next few months as the disaster unfolds."

Are you Sure you want to Follow the Yellow Brick Road?

Patricia Hewitt told the House of Commons today that the security breaches in the doctor job application system, which leaked highly sensitive data such as sexual orientation and criminal records, were "utterly deplorable". Andrew Lansley said that the medical profession had lost confidence in her and junior doctors wanted her to resign. He continued "She is not going to go but the next prime minister ought to move her. I hope he does." For the BBC story read here.

Patricia Hewitt perhaps wants to be remembered as ‘the iron lady’, refusing to back down on the shambolic process of modernising medical careers. However, it may be more fitting to remember her as ‘the tin man’. Only a woman without a heart could continue with such a system that will endanger patients under her ‘modernising’ regime from 1st August. Tony Blair and Gordon Brown be warned - following that yellow brick road has no happy ending.