6th January 2004
Decades ago I had a massage in a Japanese hotel. A young samurai chopped me into pieces and for three weeks afterwards I had to wear black tights due to the bruises on the back of my legs.
Recently, I flew to Bangkok to the International Medical Parliamentarians Organisation (IMPO) meeting, a thirteen hour flight. I felt so mangled on arrival that a sign at the hotel saying "massage" was very appealing despite my Japanese experience!
If you have seen the contortions of temple dancers from that part of the world you will have a fair idea of the shapes into which a very slight Thai woman managed to get me. While her English was limited she did ask every now and then "pain?" which was very reassuring. I felt the proverbial new woman after her ministrations and recommended her to many others at the meeting.
This, I want to explain, was the 500 Baht Thai massage. I have no idea what the 1400 Baht one involves but there are signs up for those as well all over Bangkok.
There has been talk recently about the level of prescribing of drugs by doctors in Ireland, Dr. Mary Gary of Limerick making her usual useful contribution. The withdrawal in the U.K. of so many anti-depressants which were being prescribed for children was alarming, too.
But what are doctors to do when there appears to be little alternative to giving drugs?
The reason I described the massage I had was because like so many others I have back trouble. I acquired it with style, too. I slipped in the bathroom nearly two years ago - no water or alcohol involved - and fractured the bodies of T 12 and L 1.
As one who has a great deal of trouble with most painkillers after a few months I found that a massage was the best thing to help me. Now that was fine for me, I could pay. But what about a GMS patient? I know one lady whose doctor tried to get her seen by a physiotherapist over a year ago - she has back trouble too - and the lady is still waiting for her first appointment.
How much have the drugs cost that she has been on and is still on in the meantime? Her doctor must be fed up with having to continue prescribing them having decided on another line of treatment for her but been unable to achieve what he wants.
I'm as concerned as anyone else about patients with serious illness who get involved with alternative treatments about which there is little knowledge of their efficacy or composition. An example is a friend of mine, who decided to try to find out what exactly was in the Chinese herbs she was taking. She requested information from the practitioner who supplied them. He sent her a leaflet in Chinese. She speaks nor reads either the Mandarin or Cantonese versions. Those who promote these therapies really need to supply proper information to those people they are treating.
Earlier I mentioned the withdrawal in the U.K. of anti-depressants which were being prescribed for children although not authorised for such use. A report on them in the Guardian (10/12/03) was most alarming, suggesting that some pharmaceutical firms had known for years that these drugs could cause suicidal tendencies in some children taking them but had not published these reports.
Now, I'm sure some doctors in this country have been prescribing them, too. I don't know what the situation is like in the U.K. but here I know that the possibilities of getting treatment for a depressed child with a psychotherapist, which the doctor may think is the best way to proceed, are nearly non-existent.
The lack of facilities for those trying to treat children with psychiatric illness is truly terrible. Doctor Kate Ganter speaks repeatedly about this issue, as do many of her colleagues but it's hard to believe anyone in the Department of Health or the Health Boards hears them.
It must be extremely frustrating for doctors to have to keep prescribing drugs for patients when they feel another treatment would be better. It is also very expensive and very wasteful. And it is very hard on patients who must suffer on under a regime which their doctors do not feel is the best one for them.
And what of the IMPO meeting? It was very interesting, well worth the journey although I do not recommend flying to Bangkok on a Friday night and back on a Monday. There were 110 parliamentarians there from 52 countries, all doctors, nurses or allied professions. A meeting of that size is so good because one can talk to people. The only depressing note was about HIV/AIDS - some people were despondent enough to say they thought we had lost the fight. The face of AIDS, they said is now a young woman and as we know young women have little education and few rights in large parts of the world.
Senator Mary Henry, MD
