Druin Burch

People who drink coffee and tea are less likely to suffer dementia, according to a large study published this week. The research is from Harvard and appears in the Journal of the American Medical Association (JAMA), one of my profession’s top outlets. There is every reason to presume its conclusion is wrong. A total of 131,821 people were followed over a period of up to 43 years. The number of dementia cases was high, giving the study good statistical power. Every few years a dietary questionnaire asked participants how much tea and coffee they drank: After adjusting for potential confounders ... higher caffeinated coffee intake was significantly associated with lower dementia risk ... and lower prevalence of subjective cognitive decline.

Tesla’s last quarterly report revealed that deliveries had declined for the second year running and, for the first time, annual revenues had fallen. “It is starting to look as if Tesla is finished,” concluded a piece in The Spectator. To what extent Musk will succeed can’t be known, but his track record demands thoughtful uncertainty at the least If you felt you’d read about Tesla’s death before, you would have been right. Success in one arena guarantees nothing in another – brilliant men, such as Tesla's boss Elon Musk, can be bafflingly stupid. Writing them off too soon, though, can become a bad habit.

A patient, an old woman with white hair, stripped of speech by dementia, followed us each shift, staying an inch behind, wanting nothing more than human presence. We let her into the staff room, where she hovered behind whoever was nearest, her tattooed number visible on her forearm. They found a young girl, Doris, who could speak some English. Malnutrition had left her mouth and face gangrenous I am aware of only one other patient, these past thirty years, who had survived the Nazi death camps. Normally sane and sensible, dusk brought confusion, dragging him backwards in time. Each sundown he began screaming and we could not console him; he took us for guards. I drugged him.

'We will tread more lightly on your lives,' promised Keir Starmer in his first speech as Prime Minister. Yet his government has not lifted the weight of the state in their 18 months of power but made it more intrusive. Today, as part of a new road safety strategy, Labour is proposing cutting the drink-drive limit from 80 to 50 milligrams per hundred millilitres of blood, matching the stricter Scottish limits. I'm not convinced this crackdown will save lives. I have not had to peel the remains of mangled children and adults from cars and pavements, as many police officers and paramedics have. But as an A&E doctor I have heard their stories and looked after those they brought in who survived, sometimes only long enough to die as I tried to keep them alive.

In 1946, buoyed by post-War optimism, the World Health Organisation adopted a famous definition. Health, it declared, was more than the mere absence of disease or infirmity, it was 'a state of complete physical, mental and social well-being'. A beautiful and tyrannical idea, sentimentally idealistic and setting an impossible standard for human lives. In these qualities of cheerful and unreasonable despotism, it resembles Christmas. Our wish to make kids happy at Christmas turns us into untiring fifth columnists of festive tyranny On the first of November, collecting my cardboard cup of coffee in Costa, I noticed it was decorated with a festive scene. I scowled, which comes naturally, but felt a small and undignified flutter of pleasure.

Each winter our NHS is struck by an ‘unprecedented’ number of cases of seasonal illness. Politicians talk gravely of the hard work done by our doctors and nurses, and ask the public to do what they can to help. Newspapers and scientists describe the influx of cases in meteorological terms – a ‘surge’, a ‘wave’, perhaps a ‘viral maelstrom’ – and the bugs themselves, which are biologically ordinary, are given glamorous names. This year, influenza A strain H3N2 became ‘superflu’. We’re told the strain on the NHS this winter is unparalleled, but it’s really only slightly worse than last year. For the three decades I’ve worked in British hospitals, each winter is meant to be a uniquely terrible flu year. In actuality, every year largely resembles the one before.

Micheál Martin, Ireland’s Taoiseach, said he is shocked by the anti-Semitic slaughter on Sydney’s Bondi Beach. Ursula von der Leyen, the president of the European Commission, is shocked too. So is Christopher Luxon, the prime minister of New Zealand. Yet there is really nothing shocking about the Australian attack. Insanity, as the saying goes, is doing the same thing over and over again and expecting a different result. Australia's ABC News is reporting this morning that one of the Bondi Beach gunmen was previously investigated over his ties to a Islamic State (IS) terrorism cell. An Isis flag was also reportedly found in the car of the gunmen. Islamic terrorist attacks on innocents happen over and over again.

Mulled wine and Heckler & Koch assault rifles don’t belong together, except in Christmas films like Die Hard. Festive visitors to Christmas markets in Berlin, London or Strasbourg this year will notice the pairing all the same. Concrete blocks surround fairy lights, and the scent of cloves and cinnamon wafts over armed police carrying submachine guns. Concrete blocks surround fairy lights, and the scent of cloves and cinnamon wafts over armed police carrying submachine guns Since an Islamist drove a lorry into the Breitscheidplatz market in Berlin in December 2016, killing twelve and injuring dozens, we deck the halls with blast protection.

'Nothing prepared me,' said Baroness Amos as she released her 'reflections and initial impressions' about England’s maternity and neonatal services, 'for the scale of unacceptable care that women and families have received, and continue to receive, the tragic consequences for their babies, and the impact on their mental, physical and emotional wellbeing.' Amos's words today paint a bleak picture of English maternity services, staffed by people who often don’t care, don’t listen, and deliver worse outcomes for the working class and people who aren’t white. It's a picture that many parents – including myself – recognise. But is it right to suggest that black mums are being discriminated by the NHS?

These days I barely know what my own handwriting looks like; about my friends, the knowledge is all but lost. Seeing their pen strokes has grown rare. But, for a brief period each winter, that odd intimacy returns as Christmas cards – some with messages, most with just a scribbled name – land on my mat. I adore receiving cards. Even ones from people I cordially dislike, or frankly loathe, are welcome There used to be something exciting about the sound of the postman’s footsteps, of letters being pushed through the door, of their thump as they landed within. That was during the days when there was a great deal of post. Even then, unexpected letters from old friends arrived rarely and, strange to say, the endowment begging me to write full time never arrived at all.

'Moaning Minnies' is how the Health Secretary Wes Streeting has described GPs opposing his rollout of online appointment booking. Originally, that moniker referred to German artillery pieces – and it’s pleasant for a doctor like myself to imagine we still possess that sort of firepower. But Streeting meant that the British Medical Association’s GP committee, which he has accused of undermining the attempt to make primary care more accessible, are a bunch of whining complainers, rather than us ordinary doctors. So, is Streeting right? General practice, as everyone is painfully aware, is in trouble. Except in a shrinking minority of places, the old model that made it so valuable is dead.