Anatomy of a short migraine

Doctors who relish linguistic precision call it hemicrania, Greek for "half a head". The term refers to the first of the classical triad of symptoms: unilateral, or one sided, headache. The other two are nausea/vomiting and visual hallucinations.

Most people demonstrate their own distinctive pattern which is a combination of one or more of these. In my case, I don't get the headache or the nausea (thank Christ) but only the visual phenomena, plus a vague sense of malaise.

My hallucination is remarkably consistent: a backwards "C" shape which initially resembles a floater but enlarges to fill the visual field. The "C" contains jagged lines of colour; this morning the colours were black, yellow and white. The shape gradually enlarges until it sort of zooms out altogether, leaving the vision clear. The process can take a couple of hours; this morning, thankfully, it lasted only half an hour. They say migraine is stress related, but as my friends would doubtless tell me: you're semi-retired now, so what stress? A good point. I can only say it started when I was accompanying my FiL to the local newsagent to secure a morning paper, and it occurred that my duty was a very sad one: not so long ago he was perfectly capable of performing this task by himself, but now he would only get lost and be found wandering by the police, perhaps hours later. That's why he had to go and live in an OPH. It's necessary I know, but no less heartbreaking for that..

Andrew Mitchell: an apology

Andrew Mitchell: sorry.

Speaking of apologies, I was able to watch Oprah's interview with Lance Armstrong last night, and I could then see for myself his body language as well as his words. His words were unimpressive in so far as he felt sorry, though more for the fact that he got caught than anything else. He seemed to be saying he had to keep up his blood doping and EPO injections year after year in order to compete, and completely failed to appreciate that this gave him an unfair advantage over anyone who was not using drugs. And that, Lance, is why it's called cheating. His non verbal utterances were equally revealing. In particular there was his closed, pinched face, full of unexpressed anger at being placed in such an embarrassing situation; unable to accept the fact that he put himself in said position.

So it now seems that Armstrong was not the greatest cyclist in history; only one of the cleverest, in that he avoided being found out for so many years. Hence he is not the greatest drug cheat in history: that accolade really belongs to Florence Griffiths-Joiner. You'll remember in the 1988 Olympics in Seoul, Flo-Jo won gold in both the 100 and 200 metres, putting in world record times that no other woman has ever got even close to since. And she never got caught, though her sins came home to roost when she died too young, of heart disease which it is hard to argue was not a consequence of the huge doses of steroids her body absorbed, though they were never detected at the time. Drugs are illegal for 2 reasons: because, as we have seen, they offer an unfair advantage, but also because they can kill.

Armstrong worst drug cheat in history? I don't think so

There are reports emerging of Lance Armstrong's appearance on The Oprah Winfrey Show in which he was apparently less forthcoming about his sins than we might have hoped. He does, after all, stand condemned by the US anti doping agency and other regulatory bodies for what has been called "the most sophisticated and far reaching campaign of drug enhancement 'in history'". But aren't they forgetting something? How about the East German athletic team, where a corrupt state actively encouraged, and indeed, insisted upon, a culture of steroid usage for more than 20 years, thereby securing innumerable world championships and Olympic gold medals, virtually all of which are secure because the testing regime simply wasn't up to detecting them at the time.

Want an example? Try Marita Koch, who set the incredible time of 47.06 seconds for the 400 metres in 1986, a record which still stands, despite the (in athletic terms) immense lapse of time since. She and many other East German athletes have come clean over the years and admitted they were given no choice about whether they took performing enhancing drugs- the team boss's word was law, and so it was take the drugs or off to the Gulags.

What Lance Armstrong did was terribly wrong, but he was one guy determined to win at all costs. But compared to the deceitful actions of an entire state over two or more decades, what he did is relatively small beer.

Pelagius enters the Twittersphere

I turned 62 on Friday, and just to illustrate that you can teach old gits new tricks, I have signed up to Twitter, thereby keeping me in line with half a billion modern folks, all of whom are doubtless exchanging (a maximum of 144 characters) pearls of inestimable wisdom as we speak.

I haven't begun to follow anyone yet, having resisted Twitter's own suggestions of Seth McFarlane (the idea has possibilities) or Simon Cowell (I'd rather be nibbled to death by an okapi). Neither have I tweeted anything yet- but never fear- I will. I've gone in under my real name (which for obvious reasons I cannot reveal here) and I intend to follow some of my friends who are already part of the Great Scheme. I also want to post a "picture of the day", though I haven't worked out how to do that yet. But my wife does, and she'll be assisting me.

Will it change my life? I'm not sure. I went on facebook for nearly a year, but eventually became so irritated with the supreme banality of most people's contribuitions I signed off wishing a plague on all their houses. Whether twitter  is an improvement on that remains to be seen. But I'll give it a good shot and see what happens.

See you out on the Twitterthing soon!

17 billion worlds and counting

In what must have been music to the ears of Seth Shostak, it was announced yesterday that the latest estimate of stars in our own galaxy with Earth-like planets circling them may be as high as 17 billion. The figure makes a lot of sense. Stars are formed as dust clouds gradually come together to form a central massive object which is surrounded by an "accretion disc", where secondary less massive objects form and begin to orbit the central mass, or star. That's the way our solar system formed 4.6 billion years ago, and it has to be the way stars and their satellites form everywhere. Most of these planets will be lifeless balls of gas or rocky deserts, but statistically some will form, like our own Spaceship Earth, right in the optimal, or "Goldilocks" zone where there is at least a chance of life developing. In our own case, there are only eight planets plus some rubble; yet it happened here.

It's all a question of maturity. 4.2 billion years ago Earth was struck by a Mars size proto-planet which has been named "Thea". Fortunately it hit us at an oblique angle (a direct hit would have vapourised the whole planet) and a huge slew of material was blown off into space where it hardened and formed our moon. It took a few hundred million years for the whole "double planet" system to cool down, during which we were struck repeatedly by asteroids and comets rich in water. And the evidence suggests that no sooner had the Earth cooled to the point where this water could exist in a liquid state, life began to form: algae and bacteria to begin with, then more complex life-forms, leading eventually to our good selves. It's a wonderful story, better in fact than anything the creationists could ever come up with. Good for you Seth. Seems like you were on the right track after all, and, like you say, it's only a question of when, and not if, we make contact with another life form out there. And that, let me tell you, will be one helluva day...

Superiority TV: why it's better than jeopardy TV

The most excellent Janet Street Porter has coined the term "jeopardy television" to describe the glut of programmes where there is some sort of competition, and where we the viewers can share the joy of victory and exercise our schadenfreude by pouring scorn on the losers. X Factor is perhaps the best example of this genre, though there are many others, like Strictly, Big Brother, Britain's got Talent and I'm a Celebrity.

I now propose a new category: "Superiority television", in which we see people behaving badly or illegally, and sometimes, taking the consequences of their unacceptable behaviour. Thus we, the viewers, are able to bask in a haze of euphoria and self-satisfaction as we appreciate the fact that we would never find ourselves in these predicaments because we are so much better than they are. So in this category we find all the real-life cop shows like Road Wars, Motorway Patrol and Cops (perhaps the original progenitor of all the others) as well as the hospital based shows like Sun, Sea and A and E. Finally we have programmes like The Jeremy Kyle Show where a procession of hideous low-lives are presented before us, each one with a sleazier back-story than the last, so that we may bask once again in our own superiority.

With enormous pleasure I watched two of these programmes this morning before finally climbing out of bed to do a session on my hand-weights (see how good I am?) In the first, Emergency Abroad, based around the casualty department of a Majorcan general hospital, we saw first an elderly lady with chest problems (actually she wasn't elderly; she just looked that way after a lifetime of drinking and smoking) sitting on a gurney waiting for a chest X ray while bemoaning the fact she couldn't go outside for a fag, then a young man who had fallen flat on his face after drinking ten shot-glasses of vodka and broken his nose. Finally another young man who, rendered psychotically stupid through drink, had so annoyed a local he had received a punch in the mouth which split his lip so badly it required reconstructive surgery. You see where I'm going with this?

Then it was Road Wars, where we saw a young man pulled over for erratic driving by cops prepared simply to give him a caution and allow him to continue on his way, become so aereated by being stopped that he began abusing the officers so vilely, and refusing so adamantly to "calm himself down" as he was continually urged to do, he ended up being arrested and taken to the cells for a "Section 5 public order offence" and fined 80 quid. What a fucking idiot eh? I'm glad I'm not like that, aren't you?

The dark heart of fundamentalism

The New Year broke to murder once again in Pakistan, where more teachers and heath workers were murdered yesterday for the capital crimes of educating girls and immunising children against fatal diseases. As someone who has been immunising children for more than thirty years, the latter outrage shocks me all the more deeply. A lot of what I do in general practice could be seen as pandering to an over-privileged, neurotic middle class, but looking back over my career, I am convinced that preventing serious and fatal disease by immunisation is undoubtedly the most valuable thing I have offered to the community.

On the face of it there is no possible justification for these disgraceful crimes against humanity, but we need to remember something: during the hunt for Osama Bin Laden, the CIA infiltrated local health workers and intimidated them into obtaining DNA specimens of their child patients so that the Americans could work out if they were the offspring of OBL I am not saying this appalling act of subverting a legitimate aid effort justified the response of the Taliban, but at the very least I shouldn't think it helped much. You can certainly understand how the Taliban would view any kind of medical aid programme with the deepest suspicion.

Foreign aid workers always work under the severest difficulties from every side, and the interference from a foreign intelligence service has now rendered any aid effort in central Asia virtually unworkable. You reap what you sew...

The Taliban in central Asia, and Al Shabbab in sub-Saharan Africa believe that everything the West offers is tainted and should be de-constructed immediately. Again, it's easy to sit on our comfortable sofas and say "How terrible!" when this sort of thing happens, but remember: things are rarely as simple as they appear.