Doctor's dispute

I am concerned about the doctors in Queensland. They work hard with the aim to help everyone in need. They are now stressed and I feel for their families as well. Now they are seeking a mass resignation. They have been told they will be replaced. This implies that they do not count as people, Queenslanders, voters. They are people with families, mortgages, who once had a bright future.
Now the employer, the government, is sueing their unions to enforce unfair contracts.
http://www.couriermail.com.au/news/breaking-news/qld-doctors-dispute-heads-to-court/story-fnihsfrf-1226869424274
Luckily the polling says that Queenslanders support their doctors- for which they are grateful. Queenslanders have seen enough government action/inaction over the years to know who has their best interest at heart. it is a shame that most of us are too complacent to act on the government that we employ to run our State.
I suspect that the government, State and Federal will be happy to have a medical system without doctors. That will save a lot of money. That will push people towards the private system. Unfortunately that will also mean that the poor will suffer and die without health care. It also means that people will be more unwell when they seek help, no more preventative strategies.
Seriously re-consider medicine as your career pathway. There is little future in it. 

Carer's health

More people are cared for by loved ones, family members and spouses than in formal mental health clinics, hospitals and NGOs. Partly this is because it is part of a loving family to care; a reciprocal arrangement of spouses  in sickness and in health); and if you are unwell who do you want near you and who can you trust. It is also economic rationalism to place people, no matter how sick, in the community and rely on loved ones to provide care.
This care is not without cost which carer's allowances clearly does not cover. It means an economic loss for the carer. The carer often has a 24 hour job with no or few breaks. The mental health for the carer needs to be considered. The demands of the job and, often demandingness of the patient, can be extreme and things for which the carer has little or no training. Burnout is common. Carers also have little room to set limits and boundaries that professionals can more easily do and  the lack of privacy for both patient and carer can become claustrophobic.
It can be rewarding of course, to spend tie with a loved one, be there for recovery and spend precious moments together especially in terminal illness. When the carer is supported by other family members, extended family and community, the model is a good one.
Carers however can be physically and verbally attacked or even killed in their role. Women take up the majority roles of carers, along with their domestic chores and the social roles of women in general.  This expands an already unfair social, economic and emotional distance between men and women in society. After the care situation ends it can be difficult for the carer to re-enter the workforce because they have not been engaged in paid work that looks good on a resume.
Carers are often left out of medical information and the treatment alliance between patient and professional health care provider. Mostly this is to give the patient some privacy and confidentiality. Not all carers are well meaning or capable of providing good care and abuse is a problem to consider. I think it is wise to divide up the appointment time between a private discussion and then ask the carer to join in, often able to give in depth discussion about the problems and observations on progress. It also give the professionals the opportunity to see how the carer is faring and if they need help.
Not all carers are fulltime. Not all patients are fully dependent and promoting as much independence as possible is a good approach.
There are often good self help groups for carers. There is usually respite available so a carer can take a break. Resources are low however and people in rural and remote areas often miss out.
Spare a thought for the carer's role.

skinny is happy????

Interesting site
https://www.google.com/search?q=skinny+is+happy&client=gmail&rls=gm&tbm=isch&tbo=u&source=univ&sa=X&ei=s2EqU5ylDI3ikAXmpoCIAQ&ved=0CDAQsAQ&biw=1366&bih=643
Could I suggest that healthy is happy and the concept that skinny and happy have a causative relationship is only in the mind of the weight loss industry. Sadly they target the young to sell their wares. The promise of happy of course can be blamed on you if you do not attain goals that have no boundaries.
Skinny clearly effects your brain and makes you depressed, not happy.
Healthy makes your brain function normally.
Happy - so many ways to achieve happiness, like getting into life, setting challenges and goals, meeting people, doing good things for your community, expanding your horizons, living life to the max, thinking positive thoughts..........

Boot camps for kids

Our Queensland State Government passed sweeping law reforms to incarcerated young people in adult prisons, force boot camps and 'name and shame' repeat young offenders.
 Shame.
 http://www.brisbanetimes.com.au/queensland/newman-announces-boot-camps-for-young-offenders-20130324-2gnp6.html
As we only have one house of government there is no balance of powers- there-in lies the first problem.
Where is the evidence that boot camps work? They do not. Kids might behave for the 4 to 6 weeks they are forced to be involved but the evidence is that they return to the same environment and the same behaviours the moment they leave.
Who is running the boot camps?  What are their credentials, their motives, their safety guidelines and who is supervising them? Will this be the next of a series of institutionalised abuses claims? Where is the information about these camps? Why are children treated more harshly than adults for lesser behaviour problems?
Of course dealing with the underlying issues and causes of recidivist youth crime is too hard it seems. Realistic education support; stop drugs and alcohol; employment for youth and their families; community services; support mothers to raise their children; community youth groups; family interventions all cost too much money it seems. So money will now be poured into programs after the horse has bolted, that may make the problems worse and lead kids into a life of crime as a career opportunity.
Despite valid information about the programs, legislation has proceeded as if this does not matter. Appealing to voters (and kids don;t vote so are disenfranchised) by strong arm tactics and short term solutions seems to be the order of the day. Shame!
Even more worrying is that the next news flash will move away from this crime against children and we will all forget that the abuse will continue, in our name. The news will briefly flash that one of these kids is raped, killed, maimed in custody, and then their plight will again be ignored.
Amnesty International is on the campaign trail to fight this legislation. Maybe you will feel moved to join their action http://www.amnesty.org.au/action/action/33834/

Free Will versus determinism

One hopes that we make our choices from free will. We like to think that our thoughts are generated by us alone. We definitely like to think that our behaviours are in our control.
Is it possible however that most of these things are controlled by our genes or learned in early infancy as programmed pathways in our brain. Freud seemed to think that we had repetition compulsions, automatic ways of thinking and behaving. The grace here was that we can become aware of these and consciously think about them, choosing to change if we wished. This clearly requires more energy and is unlikely to happen of there is no reason to do so.
So maybe we are not in control of our lives as much as we think.Perhaps we can live a more authentic and connected life but we need to work hard at that. This is usually called transformational thinking. If we aim to learn from the past, aim for better in the future then we can live a good life. We don't need to be anxious about the past, so long as we learn from it.
Of course, not everyone wants to improve and learn. Many people are happy with the place they are in. Many people cannot see the problems, especially if they blame everyone else rather than looking inwardly. It looks like they have little free will.
Where do you think you might be with respect to free will or automated living?

Coroner slams mental health system

Harrowing outcome
http://www.abc.net.au/news/2014-03-12/mental-health-service-under-fire-in-coroners-findings-on-teenag/5315328
Someone has finally said something of the truth for once. Pretending that it is ok for children/ teenagers to not see a psychiatrist because somehow their mental illness is not as bad, or severe or real as an adult has lead to this disaster a well as many others no doubt. Of course children do not have a vote so lack the power to do anything here. Therefore they rely on adults to look after them and lobby on their behalf.
It concerns me that there is a code of silence around the poor mental health services because it is such a political hot potato.
I just hope that one coroner is enough to shake the system rather than someone makes another feel good statement, covers up the trail and its business as usual.
Please think about this and start lobbies for investigations of mental health resources and proper health care.

Mental Health Care

This report on the ABC News this morning  is important.
http://www.abc.net.au/news/2014-03-11/reachout-ceo-jonathan-nicholas-speaks-with-abc-news-breakfast/5311636
I would like to point out that although the best of intentions are being discussed her, that Jonathan Nicholas has a huge bias in his presentation. he is selling/ lobbying the government to spend not insignificant amounts of money on his early intervention program.
Where is the evidence that the things Reaachout offers has any validity in treating depression?
Is this just delaying people from seeking treatment when they detect problems early but are deflected by the concept that they can just pull up their socks and fix the problems themselves, not annoying specialist services like doctors, psychologists and psychiatrists, as he says? This means maybe another six months wait before again seeking help, by which stage the person is much more ill and suffering loss of friends, physical health, work, study and maybe becoming suicidal.
Where is the research that says that people are minimally ill by the time they seek first point of contact. What is the qualifications and abilities of Reachout staff? Is their agenda to stop people seeking medical care?
He specifically targeted intervention with children. he has specialist qualifications, as does his staff, for working with children? Is it possible that Reachout assumes that children are just small adults and the same things apply? What about notification of the parents of children and young people when they discuss their depression and suicidal thoughts? What are the confidentiality statements?
I have no doubt that Jonathan Nicholas and many other agencies and organisations that look on in horror at the lack of services for mental health, have the best intentions. I just ask that we stop accepting all the feel good stuff and look seriously at how we help, prevent, triage, resource the area and make responsible decisions that will not make things worse.
First- do no harm!

Depression and cancer

Most people do not link cancer with depression. despite many studies showing about 90% of cancer sufferers suffering depression.
I draw your attention to some extra reading on the matter
http://www.cancer.gov/cancertopics/pdq/supportivecare/depression/Patient/page2
http://www.cancer.org/treatment/treatmentsandsideeffects/emotionalsideeffects/anxietyfearanddepression/anxiety-fear-and-depression-toc
In fact it is more worrying when someone has no emotional response to a serious medical condition. Cancer however carries an emotional load in the very word. This i think is due to the fact that 50 years ago, cancer was a death sentence. Luckily today, cancer is mostly manageable and sometimes curable. Early intervention, prevention, community education have worked well and Australia has the best outcomes for management of cancer in the world.
Depression however can be caused by more subtle processes than our cognitive/emotional responses to threat to life and fear of medical treatments. There is a reciprocal problem that stress and depression can lower the immune system, causing cancer.
\http://www.cancer.gov/cancertopics/factsheet/Risk/stress
http://scienceblog.cancerresearchuk.org/2009/05/19/us-research-suggests-that-cancer-cells-trigger-depression/
There is also evidence that depression lowers survival rates in cancer.
So the link between cancer and depression is important. Prevention is the best approach. I suggest that information about the risk of depression in cancer be given to all patients with cancer and their families. I also suggest that screening for symptoms of depression and offering early treatment is important. Maybe there is room for cognitive retraining for cancer sufferers although there has been little research in the area. I know clinically that many people benefit from cancer support groups- self help groups where you do not feel alone and people can get on with life and living.
There is also little research into the effects of cancer on family members, especially children. It makes common sense to understand that this is a major problem because these people have little control or decision making. They can often feel guilty for being well and give up their lives to support their family member, worrying all the time over them and there is a breakdown of communication about how people really feel.
Unfortunately i suspect that this area is under-serviced and lacks research and resources because we continue to divide the mind from the body and fail to understand how united they really are.
If you see depression, there is help.  Call your doctor.

New rooms

Hi everyone
Thanks to the people reading my blog.
I have moved.
New Address is
6th Floor, Watkins Medical
225 Wickham Terrace
Spring Hill
Queensland 4000
phone is 07 38395626.
same email drjoycearnold6120a@gmail.com