Carl Gray
Harrogate and District NHS Foundation Trust
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BMJ | 1998
Carl Gray
![][1] Lifelong learning should include doctors too. Happily, “The evidence suggests that humans everywhere on the planet see, talk and think about objects and people the same basic way.”(1) Reassuringly, this must apply to doctors also. And excitingly, the neurobiology of the mind has leapt forwards lately. Pinkers superb book tells all in a racy style. The medical mind is merely a special case and its owner rather ordinary in human terms. But, as humans, there is great scope for development. Are you sitting comfortably? “Feather-footed through the plashy fens passes the questing vole.”(2) All questing creatures have brains made of nervous tissues acting as Turing machines. Even tiny insect and bird brains can navigate and can transfer information. Larger brains, such as those of us mighty mammals, are universes of billions of smaller computational units: “demons” in the jargon. These operate on bits of data received from sense organs, held in various memory files, and shared to different extents. There is no single homunculus watching a screen within - rather, there is a jostling bazaar of mental organs, modules, and demons competing for data and attention. The awesome features of the human brain are its powerful visual interpretation, enormous memory, and symbolic coding for thought and language. Think on this as you stroll into your next postgraduate examination. Its weaknesses are the tiny focus of attention and the episodic spurts of consciousness. The mind is explained by natural selection. We evolved to meet the challenges of the African savannahs: long grass, large animals, and competing tribes. Mental mechanisms which conveyed advantage survived, which means the modern medical mind is strong on detecting fierce animals, recognising friends and relations, and defending its own territory: all are used in the clinical jungle. We are apes with attitude because primates happened … [1]: /embed/graphic-1.gif
BMJ | 1997
Carl Gray
How did that get decided? How on earth did he get elected? Why was she awarded those discretionary points? Why is the duty roster so unfair? Why is the new consultant post not funded? What are “they” up to? No one asked me! “Oh”, people will say, “its politics-what can you expect?”. The haunt of scoundrels, the dishonest art, the least valued and second oldest profession: politics is not respected, especially in the glare of an election year. Young doctors-particularly young female doctors-may well wonder how it all works. How can they get their good ideas implemented? How can ones voice be heard in the specialty or hospital medical committee? What happened to ideals and morality? Should one enter the public life of organisations for part or all of ones career? Or is putting your head above the parapet the one sure way to get it knocked off? Lots of politics seem to be going on at all levels and we are not short of great issues of the day. But few of us bother to have anything to do with it, and professional societies and associations struggle to fill their committees and events, especially with doctors under 50. Political outfits everywhere are crying out for new blood and ideas. Medical elections traditionally draw a low turnout of voters. Yet most power lies in the hands of small groups of individuals-compare oligarchy (rule by the few) to “medarchy”-rule by (mostly) middle aged white men. Medical politics spans the range between the doings of a local medical society or BMA division through Westminster and into Europe. Politics writ large is the national drama of general elections and government policy; writ small it is the lifeblood of all organisations, and unless you are self employed, your …
BMJ | 2002
Carl Gray
BMJ | 1999
Carl Gray
BMJ | 2005
Carl Gray
BMJ | 1999
Carl Gray
BMJ | 1997
Carl Gray
BMJ | 1997
Carl Gray
BMJ | 2006
Carl Gray
BMJ | 2005
Carl Gray