Thursday, April 20, 2017

The Dubya Philosophy

Remember Dubya? 43rd President of the United States of America. George W Bush- man at the helm when the September 11 atrocities happened. A man who always divided opinion- and roundly mocked as well as admired for his macho lines of "Either you are with us- or you are against us".
To be fair to the man, this wasn't his creation- you can scour the textbooks of history and find plenty of examples...Mussolini, Lenin- heck, if you look into the Bible, even Jesus is attributed to have said..""Whoever is not with me is against me, and whoever does not gather with me scatters" (Matthew 12:30). My Bible knowledge is a bit rusty, its been some time since I was in school- so my apologies if I got that one wrong- but you get the idea..the principle isn't new.

So its actually shouldn't come as a big surprise when in our world, the same thing plays out again and again. I must admit to me now having to change my views on some things- especially that its possible for all simply to get together, have a mature respectful debate at all times. Its not. I think we probably have to best do with trying our own best- and accept there will be variations on what Dubya said- from different quarters.

I will give you a few personal examples. Lets start with the discussion about "Low carbs"- I will- someday write a blog about my own personal views on it and the evidence- but for now, I will limit it to the Dubya philosophy. I understand the passion- and also do admire the inherent belief that this is the answer to improving health. No issues with that- and as regards passion? Excellent too. I am happy to engage, debate and even ask relevant bodies to review the evidence. However, when that suddenly takes a quantam leap to direct abuse- you have to stop and think...is that right? Do I ignore or do I try to reason? How do you reason with a racist? Or do you accept thats a part of society- a darker part- which is just an inherent side of life? I suspect that cuts both ways- if the "lowcarb lobby" can go overboard with their passion, the flip side isn't to mock them, deride their understanding of science and call them quacks either. But then again, "with or without me" seems to be a part of our lives- so maybe all sides just need to take that into stride...maybe...I don't know.

Here's another one- I recently tweeted that the actual long term condition experts -beyond the patients- are GPs- and there isn't a need to create another specialty. A generally rational discussion ensued but in between there were some suggestions of me being blinkered, short sighted, assumptions I worked only in acute trust...all these from folks who have never met me, not heard me speak and be clear in public meetings that nurses are the backbone of diabetes care. However,nurses help in delivery of care- if you had to follow a clear line of expertise or uniform evidence of training- its the GPs. (I am not aware of a standardised programme for nurses to do before they deliver diabetes care at the moment- with huge variations as to how this is done- so here sits an opportunity perhaps)
Now that's a personal view- so of course it can be challenged...why that has to translate to me being labelled as being disrespectful to nurses...I will never know. That too from folks who probably don't know that my present Clinical Director is a nurse- and am very proud of it too. It's as if there are no middle ground- you either love X (substitute X with doctors, nurses, managers) or you hate them. Fascinating.

But then again, there's hope too. A recent discussion on CT scans and acute abdomens was actually good fun. Humorous yet with plenty of good debate from all corners- so who knows- maybe there is hope. As was a discussion on a recent trial in Insulin Pumps. However, to be honest, I think the realisation sits that passion, 140 characters and instant snap judgements will never allow a utopia of calm, tranquil, mature debates...so be it. I suspect my appeal is not to go personal...play the ball, not the person-as it takes away from areas of good debate and a lot of fun which human interactions bring. I also know from the experiences of Brexit and with GE2017 around the corner, its a naive, perhaps even foolish ask- but there you go. As for me, go personal- and I mute or block you- the loss-to be perfectly honest- isn't mine.

Debate is fun- sometimes you make a statement to provoke that and make people think. Thats what human interactions should be about- and the reach of Twitter, the flat hierarachy offers huge potential. A little less of the Dubya philosophy may serve us even better.
As the kids like to say.... #JustSaying

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