Any story involving the unnecessary death of a child and the removal of a doctor from the medical register is going to hit the headlines, but why do the medical profession as a whole feel so affected? Two weeks ago, Dr Bawa-Garba’s name was reintroduced to the medical register and she was allowed to continue to practice medicine. I watched the BBC Panorama program “Doctors on Trial” and I was even more shocked at what has happened. I have also been asked for my opinion of the situation by a number of Medical Student and Junior Doctor colleagues and since one of the main areas of criticism of Dr Bawa-Garba was her apparent failure to recognise sepsis I felt I needed to blog about the issues raised.

While sat in the cystic fibrosis multidisciplinary team (MDT) meeting a tricky clinical question was asked…
 
“We have a patient with an infective exacerbation of their cystic fibrosis with Burkholderia multivorans but she is allergic to Ceftazidime and Meropenem and gets bad gastrointestinal symptoms with tetracyclines. What do you think?” asked the Respiratory Consultant.
 
I really like these types of MDTs when I have to scratch my head and try to work out a solution but this one was a bit of a puzzler. I know Ceftazidime and Meropenem are often used to treat infections with Burkholderia spp. and that Minocycline is also an option, but what to do when these can’t be used? I had to admit I didn’t know for sure and that I would have to go and look at the literature and get back to them. So off I went to consultant the “Interweb”.

***WARNING – SPOILERS***

​Previously …on Poldark’s “Brain Fever”…
Last week I looked at the curious case of Lieutenant Hugh Armitage who acquired a “Brain Fever” in a French prison before escaping with the help of Ross Poldark. Lt. Armitage then went on to seduce Poldark’s wife (that’s gratitude for you!) before eventually succumbing to “Brain Fever”, despite the excellent efforts of Dr Enys.

I’m not a big fan of television, which won’t come as a surprise to those of you who know me from working with me (I like books, the older the better). In the past I have even gone 3 years without a TV at home, it was very liberating! However more recently I have reluctantly bought a digital TV (when I returned my old analogue TV from storage, it turned on OK but had stopped “working”, I was puzzled for a good few days until my Registrar told me about the digital “switch over” which had happened over 6 months earlier, …huh, no one told me!). Anyhow I still try to keep my viewing limited but I do watch the occasional program. One such program is Poldark.

Previously I wrote a couple of blogs about Poldark’s Putrid Throat and Poldark’s Putrid Throat Revisited.  This time I am going to tackle a new diagnosis from the latest series of the hit BBC drama. If you haven’t watched series 4 yet and don’t want to know what happens then best not to read any further… there will be spoilers… you have been warned! ***WARNING – SPOILERS***
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Okay, so the big scandal at the end of series 3 was the illicit romance between Demelza Poldark and Lieutenant Hugh Armitage. Lt. Armitage was a companion of Dr Dwight Enys during his incarceration in a French prison after their ship was captured by the French. Dr Enys and Lt. Armitage were eventually rescued in a daring plan by Ross Poldark but it quickly became apparent that Lt. Armitage was not a well man.