The Case for Teaching Ignorance @nytimes

The Case for Teaching Ignorance: Jamie Holmes in the New York Times, 24 August 2015:

“IN the mid-1980s, a University of Arizona surgery professor, Marlys H. Witte, proposed teaching a class entitled “Introduction to Medical and Other Ignorance.” Her idea was not well received; at one foundation, an official told her he would rather resign than support a class on ignorance.

Dr. Witte was urged to alter the name of the course, but she wouldn’t budge. Far too often, she believed, teachers fail to emphasize how much about a given topic is unknown. “Textbooks spend 8 to 10 pages on pancreatic cancer,” she said some years later, “without ever telling the student that we just don’t know very much about it.” She wanted her students to recognize the limits of knowledge and to appreciate that questions often deserve as much attention as answers. Eventually, the American Medical Association funded the class, which students would fondly remember as “Ignorance 101.”

Classes like hers remain rare, but in recent years scholars have made a convincing case that focusing on uncertainty can foster latent curiosity, while emphasizing clarity can convey a warped understanding of knowledge. …”

“Mapping the coast of the island of knowledge, to continue the metaphor, requires a grasp of the psychology of ambiguity. The ever-expanding shoreline, where questions are born of answers, is terrain characterized by vague and conflicting information. The resulting state of uncertainty, psychologists have shown, intensifies our emotions: not only exhilaration and surprise, but also confusion and frustration. …”

[highlighted in Mind Hacks Blog ‘Spike activity 28-08-2015‘]

Who is the external regulator for NHS Scotland?

Hole Ousia

For some time now I have been confused about which body is responsible for regulation of NHS Scotland. I had hoped that this recent draft, currently open to consultation, would clarify matters:IndependentregulatorNHSScotland04

This document appears to concentrate on bringing about cultural change. This is undoubtedly necessary; however I was disappointed to see that the thrust of this document appears to shy away from an external regulatory system. Instead the emphasis appears to advocate “improvement methodologies” as a means of bringing about cultural change in NHS Scotland.IndependentregulatorNHSScotland06

The following extract from this document would appear to marginalise the role of external scrutiny:IndependentregulatorNHSScotland07

This document was in part a response to the Crerar ReviewIndependentregulatorNHSScotland09IndependentregulatorNHSScotland09b

Healthcare Improvement Scotland itself has stated:IndependentregulatorNHSScotland08

This document does not appear to commit to an external regulator. The question that arises then is who is currently providing scrutiny.

Just before the Scottish parliamentary recess, the…

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NHS Forth Valley: “Everyone matters” #HoleOusia

Hole Ousia

I worked as a consultant for NHS Forth Valley for 13 years.

I resigned last year.

I received this feedback after my resignation.

Whilst I was an employee with NHS Forth Valley I raised concerns about the approach that my organisation took to  the care of our elderly.

In raising concerns I did my best to carefully follow the NHS Forth Valley ‘line-management’ pathway. I was never a “whistleblower”.

Yet I got nowhere.

For politely raising concerns, I was isolated within NHS Forth Valley, mischaracterised and sometimes left to feel like a pathological specimen.

Without any doubt, certain senior colleagues did their best to misrepresent my concerns.

Nobody from  “Everyone Matters” ever visited the community team that I was doctor for. It felt to me at the time that the elders of Clackmannanshire may have mattered less to my employers.

However this is what is said by NHS Forth Valley…

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Hadrian’s Wall @FemiMind [reblog]


view over the hills

We walked from Brocotia to Limestone Corner. It was the rarest day for the North East, warm, bright and even the breeze was not bracing! This was my first time walking any part of Hadrian’s Wall. Looking north towards Scotland, the Cheviots about forty miles away, rose gently in the background. The land rose and fell too, as Turgenev would say, like waves coming towards us. The hay, on some fields, had just been cut, and lay in bales. The patchwork of the fields was brown, golden through to green. Dry stone walls separated the fields. A solitary crow picked at the earth. But if you looked closely enough there was another in the brush.

path on the wall

Emperor Hadrian himself visited in AD 122. In Yourcenar’s words

I crossed to the Isle of Britain in a ship, which was flat as a badge. More than once the wind threw us back toward…

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Remembering Lorraine Nicholson: @mentalcapital [reblog]

My comment: “Chris thank you for writing this eulogy in memory of Lorraine Nicholson.

I was very sorry to hear the news on Thursday through social networks. I felt sad and angry at the same time. Sad at the loss of Lorraine to all of us in Scotland’s mental health world and further afield. Angry that mental health services are not better resourced and I say this as a writer, activist and campaigner. A psychiatric survivor and mother of sons who have been/are challenged by “mental illness” labels/diagnoses.

Let’s change the world. Yes I agree.”



It has happened again. Another mental health champion has lost their fight, and died too soon by suicide.

Lorraine Nicholson was  quite simply one of the most warm, authentic, honest and discreet people I have met in nearly twenty years of mental health activism and campaigning.

There are activists who talk loudly, activists who work tirelessly, activists whose opinions clash, those who like power, those who reject power…those who thrive in the system and those who reject it or disrupt it. Our movement is broad.

Lorraine had the rare gift of being able to bring something to almost every corner of the movement, and to earn respect across the board and in any room.

Our movement has never needed people like Lorraine like it needs them now.

In mental health the term peer seems to be diluted, assumed, or mortgaged as much as it is cherished, valued and prioritised. I…

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Leaving Accident & Emergency @MentalHealthCop

Mental Health Cop

This is one of those BLOG posts that I feel I’ve written before – but I keep getting queries and long email threads to read from various professionals who’ve clearly been engaged in an epic-email debrief of some previous  melodrama where everyone thought they were a barrister.  The questions relate to frustrations about how to safeguard someone in an A&E department – this stuff just never seems to abate.  Of course, many people self-present to A&E in distress and we know from this year’s Care Quality Commission 2015 report Right Here, Right Now that around 5% of all patients in A&E are there for mental health problems.

We’ve seen the expansion of liaison psychiatry services and mental health nurse support to their A&E colleagues.  We also know that the ambulance service, bereft as they are of referral pathways to specialist mental health services, have no other option in many areas…

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Patient safety as delivered in Scotland risks failing to reach an acceptable level

Hole Ousia

In my last post I included the recent response from the Chair of Healthcare Improvement Scotland regarding regulation of healthcare in Scotland.

In this post I include my reply:

Dear Dr Coia,
Re: Building a comprehensive approach to reviewing the quality of care 

Thank for your letter of 14th August 2015. I am grateful that you wrote to try and clarify the issue of the regulation of healthcare in Scotland.

From your reply it is clear that we have no external regulation of NHS Scotland.

The Board of Healthcare Improvement Scotland will be well aware that in order to comply with the law there must be effective regulation to make sure that legal compliance in Scotland is achieved (HSWA s18).   Healthcare Improvement Scotland will also be aware, from page 1 of the second Francis Report, that the situation we have here in Scotland is untenable as well as illegal.

Healthcare Improvement Scotland…

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#WEcan Expose The Wannabe Tory Councillor Behind The DWP’s Workfare Campaign (reblog)

the void

After failing to become a Tory Councillor Laura-Jane Rawlings decided she was the voice of youth employment instead After failing to become a Tory Councillor Laura-Jane Rawlings decided she was the voice of youth employment instead

It’s been a humiliating week for the DWP on social media.  Yesterday hundreds of people used the hashtag #fakeDWPstories to take the piss out of the them after Welfare Weekly revealed that they were inventing case studies in support of benefit sanctions.

Whilst all this was taking place the DWP were desperately trying to rescue their #WEcan campaign which had also become a laughing stock on twitter.  This was a shabby attempt to promote unpaid work schemes, and came with a gushing press release promising that up to 12,000 young people would be posting ‘workies’ and sharing their stories of unpaid work experience.  Those 12,000 young people were supposed to come from their campaign partners Youth Employment UK (@YEUKYouth).  They never turned up.  Fucking kids eh.

At first glance Youth…

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Digital tech, the BMJ, and The Baroness

Mind Hacks

CC Licensed Photo by Flickr user World Bank Photo Collection. Click for source.The British Medical Journal just published an editorial by me, Dorothy Bishop and Andrew Przybylski about the debate over digital technology and young people that focuses on Susan Greenfield’s mostly, it has to be said, unhelpful contributions.

Through appearances, interviews, and a recent book Susan Greenfield, a senior research fellow at Lincoln College, Oxford, has promoted the idea that internet use and computer games can have harmful effects on the brain, emotions, and behaviour, and she draws a parallel between the effects of digital technology and climate change. Despite repeated calls for her to publish these claims in the peer reviewed scientific literature, where clinical researchers can check how well they are supported by evidence, this has not happened, and the claims have largely been aired in the media. As scientists working in mental health, developmental neuropsychology, and the psychological impact of digital technology, we are concerned that Greenfield’s…

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