Still bailing out the gene pool

I’m a child of the 1960s, the summer of peace and love and rock’n’roll, of Woodstock, Janis Joplin and Country Joe and the Fish.

We were free-thinkers, we were sexually liberated (though our bonds ran much deeper than mere sex), we were socialist (the communes were a great place to meet Scandinavian babes, right-wing parties were distinctly uncool), we were brothers and sisters all across the world, we were flower children, we were star born. We thought we could change the world, but we've been sadly disappointed.

Our nadir was the Thatcher years, when greed was good and there was no value to the old, the sick, and the poor. 'You can't buck the market,' was their mantra, but by the same set of ethical values you can't buck survival of the fittest either; Darwinian selection suggests that any delicacy or infirmity should be ruthlessly eradicated to improve our species' fitness.

But it's our job as doctors to do exactly that, to stick our fingers in the dyke, to confound Darwinian selection and the millions of years of unrelenting evolution, not to regard someone with diabetes or rheumatoid arthritis or cystic fibrosis as a weak point in the gene pool, but as someone who should be valued as an individual.

John Major and Tony Blair may have had many bad points, but they always had this one great and redeeming virtue; they weren't Thatcher.

And after all these years I'm still a socialist, although I would like to submit one minor caveat which I hope my many years of service will allow.

Prescribing long-term hypnotics is one of the most annoying aspects of the general practice. The BNF advises short-term use only, we know the drugs are addictive and tolerance develops early, yet still the patients are able to wheedle them out of us.

But consider how many of your patients on long-term hypnotics actually get up in the morning and go to work; a very, very small proportion, I'll guess. Anyone who has just done a fair day's work for a fair day's pay will be tired at the end of the day and therefore will be able to sleep; they won't have got out of bed at 11:00 and spent the day on the sofa watching soaps and genuflecting to the microwave oven and the TV, and their major exertion won't have been rolling down to the surgery for yet another repeat prescription, before picking up a DVD and a pizza.

Unfortunately, I can't envisage any practical application for this insight; unless, of course, Margaret makes a comeback.

- Dr Farrell is a GP from County Armagh.

Email him at GPcolumnists@haymarket.com

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