I want placebos for surgery!

Before any doc gives you a pill he should have tested that pill to make sure A). its not harmful and B). that it actually has benefit.

Right?

Randomised control trials (RCT’s) are done using the poison they want to sell vs a placebo sugar pill to see if the shit they want to sell you actually works and doesn’t kill you. *

SO:

What about surgery?

If a surgeon says “Let me cut you, it will help you, trust me, I’m a surgeon”, how do you know he’s right? In fact, how does HE know he’s right?

Answer: He doesn’t. At first. Established procedures may have accepted success rates, but new procedures don’t. So traditionally most surgery is done by trial and error. Cut, oops, bury.

So why don’t surgeons use placebos when testing new procedures?

Cos they can’t? No, they can. Especially nowadays with minimal invasive surgery (“keyhole surgery”).

http://jameslindlibrary.org/wp-data/uploads/2017/06/Wartolowska-et-al-2016-BMJ_feasibility-of-surgical-rctsx.pdf

The paper is called:
Feasibility of surgical randomised controlled trials with a placebo arm
Conclusions:
This review demonstrated that placebo-
controlled surgical trials are feasible, at least for
procedures with a lower level of invasiveness, but also
that recruitment is difficult. Many of the presumed
challenges to undertaking such trials, for example,
funding, anaesthesia or blinding of patients and
assessors, were not reported as obstacles to

completion in any of the reviewed trials.
——————————————————————————————–

* Just know that they cheat on these trials. If the pill DOES work the trial gets published 100% of the time.
Only 14% of trials where the pill DOESN’T work get published.

surgery2

What a Storm!

Left home at 9am and got back at 2pm. Never did get to work.

Sat the whole time in this storm. Thought it was bad till I saw the videos of the worst places! This was mild!

Montclair Storm (5).jpg

Meanwhile at the practice, the ladies were having their own good time:

Montcl Storm Damage (2).jpg

Bloody Tropical Storm Koos!

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Cleanup day today. Jessie and Tobias came in to help Raksha, Prenisha and Yandisa.

SS_Storm_Cleanup[1].jpg

After we’d mopped we got the pros in – R5000 for the wet vacuum cleaner hire!

Generations: The (rugby) Legacy

I lost a bet to Tom with the Springboks’ loss to the All Blacks this weekend.

Paying up was painless compared to sitting with him watching the match!

Then Sunday I went to Pietermaritzburg where I got a blow-by-blow “Hoor Weer” of the match from the Ole Man.

Both my deskundiges cannot BELIEVE how the Boks just don’t LISTEN to their (simple, foolproof) advice! One says they should just play like he played for Westville Boys last year and the other says they should just play like he played for Maritzburg College in 1937.

Fuckit I’m going to heaven I swear. Or at the very least I’ll get a diplomatic posting.


Hoor WeerKyk Weer, but aural – a verbal re-run and re-hash

Deskundiges – experts, but more than that

Old school rugby.jpg

Grave Problem, DIY Solution

The ole man is thinking burial sites. He has found out it costs around R11 000 to be cremated and he thinks that’s an awful waste of money. Someone also told him you can bury yourself anywhere. Especially in your own backyard, “There’s nothing to stop you”. As a mad-keen DIY guy, he thinks that’s a helluva good idea.

I said “Maybe, but the hard bit will be reaching up and shovelling the soil on top of yourself”.

“YOU can do that” he says.

I said “I don’t think I’d be allowed to. Maybe your friends meant literally YOU can bury yourself in your backyard, but maybe it would be illegal for ME to do it?”

“Oh” – That’s got his active 94yr-old brain thinking. He’s plotting something, you can be sure.

My Car Is Scotch-Guarded

A special place is Montclair. I’ve been here seventeen years now. Longer than I was in town, Musgrave or Pavilion!

My car guard is 80yrs old, a proud member of the McGregor clan. Knows exactly what the weather is going to do each day and tells me with unerring accuracy. “Sunny tomorrow”. The next day if it’s raining: “I knew it would rain today”. Never wrong. Knowledgeable on birds, too. Two drongos attack a kite, dive-bombing it. “Look, that mother bird is teaching the two young ones to fly”. Had me searching the skies hopefully recently for an albatross that hangs around here. “It just flew over. Yes, an albatross. It’s here all the time,” she says. It would be a lifer for me and it would have all the birders in Durban flocking to the centre if there really was an albatross in Montclair! Of course it could be a wagtail.

The bane of her life is school holidays when the youngsters of Montclair use HER roof to kiss, cuddle, grope and “who knows what else!” She chases them off like they’re alien vagrants. When pressed she will confess she was a handful herself in the old days in Joburg. She worked at the Norwood Pick n Pay and frequented the Braamfontein & Downtown pubs. Speaks fondly of the Victoria Hotel and the Station Hotel.

If I leave my lights on she marches into the shop: “Where’s your boss?” she’ll bellow. Stentorian, you could call her voice. Demure, not so much. And off she’ll go with my keys to switch them off for me. If I’m around when she returns she’ll deliver a short lecture about the battery. I know it off by heart, of course, but she’ll repeat it.

Knows all the skinder does Bridget. Which shop got robbed, who did it, what the cops said, her opinion. What the punters at the tote on the roof do and say, whether they have won or lost. How much they pusa (drink). Who drinks inside at the bar and who saves money by drinking standing around an open boot with a strong cane and coke mixture in polystyrene cups.

What a centre. Whose car guard comes to fetch them in the shop, pops up a golf umbrella and walks them to their car every time it rains? Mine does.

 

The Photo Archives

I hardly ever carried a camera back when I was beautiful and had just the one chin. “I’m video’ing it in my head” I would say.

Of course now I’m really grateful other people carried cameras and I could get pics from them. Even in the days when you loaded a roll of film in the dark and wound it on by hand frame-by-frame some people carried cameras. I salute them!

And I admit I would grumble when they said “Stand closer together” “Smile” “Hang on! Just one more!”. Of course some people would think they had put in the roll of film when they hadn’t and all our posing (“poeseer!” remember SanMarie the game ranger’s joke?) was in vain. Yes, I’m thinking of you Taylor. He posed us in various ways on a buffalo carcase and when we eagerly asked for the photies weeks later (they had to go off “for development” of course) he had to sheepishly admit he hadn’t had a roll of film in his steam-driven camera.

Anyway, my memory of that moment was much better than his pic would have been: I remember a bloody carcase with glistening red meat still on the bone and lion prints around the sandy scene. We were posing looking over our shoulder, worried the lions might chase us off their prey at any minute. When later we did get a pic from someone better organised than Taylor the truth was far more mundane. The photo spoilt a good story.

Wilderness Walk.jpg
Intrepid non-photographer on the left with empty camera

So although I do have some slight regrets I still think I was generally more “in the moment” than many camera-occupied companions over the years – and I saw more birds. Anyway, my memories of what happened are usually far better than boring reality. Usually I play the starring role in them.

Once I met Aitch things changed of course and we had a fulltime photographer in the house. The years from 1986 are well documented. Then the kids arrived and the number of pics went through the roof. Thank goodness for digital! Even now when we drive through a game reserve Jess will say “Mom would have said ‘Stop! Go back!’ and you would have to reverse and she’d take a picture of a flower, remember?”

With cameras as ubiquitous as they now are all this smacks of days gone by. I was prompted to write this post when I read this yesterday: ‘If a millennial goes to a beautiful place but doesn’t get a photo, did they ever really go?’…

To end, some advice for Taylor:

Life like Camera.jpg

Here’s a graph showing camera sales in 1000’s since 1933:

Camera sales.jpg

OKay Doctor!

An optometrist friend of mine is a bit scatter-brained at times. He wouldn’t argue with that. He got a phone call once while seeing his last patient of the day. He had fitted him in late and told the staff “You go home, I’ll lock up”. He took the call at the reception desk, listened carefully, said “Yes, Yes” and agreed to get home soon.

He then left the office, locked up and went home – a twenty minute drive.

After he’d been home awhile he suddenly remembered!!! Omigawd! He leapt into his car and roared back to the practice, unlocked and walked in to where the man was still sitting in the chair.

The poor man was the first to speak: “Doctor, I hope you don’t mind, I moved the machine away from my face a little”.

Ahem, “Not at all” said my man and carried on examining the poor humble guy’s eyes.

Man, was he lucky with WHO it was. He coulda got ROASTED! His staff told the story for years afterwards!