9 July 2008

Palm reading and conjuring on the NHS

Here are two papers from the Journal of the Royal Society of Medicine. Click on the links to see the papers in full. Please mention the Journal if you choose to use them. Many thanks.

Palm reading might help diagnose cancer

A paper in this issue of the Journal of the Royal Society of Medicine discusses how thickening of the palms can in some cases be an indication of underlying malignancy - in particular, ovarian tumours. This palmar fasciitis or fibrosis - where the tissue on the palms feels hard, almost wooden - sometimes occurs in conjunction with polyarthritis (where multiple joints become arthritic). The syndrome appears to be more commonly associated with ovarian cancer - which is often difficult to detect in its early stages.

"Ovarian cancer continues to account for 5% of cancer related deaths among women," says author Dr Richard Stratton, a consultant physician at the Royal Free in London. "This case highlights the tendency of ovarian cancer to remain clinically hidden until an advanced stage. The syndrome of PFPAS (palmar fasciitis and polyarthritis), although rare, is important for clinicians to recognise because of its strong association with underlying malignancy, most commonly ovarian."

"Palmar fasciitis and polyarthritis syndrome - a sign of ovarian malignancy" by Dr Richard Stratton et al is published in the latest issue of the Journal of the Royal Society of Medicine.

Swapping stethoscopes for wands

Doctors could learn a lot about how to treat and interact with their patients by employing techniques used by magicians, says an article in this month's Journal of the Royal Society of Medicine.

Author Daniel Sokol, a lecturer in medical ethics and law and a close-up magician, draws comparisons with how a magician interacts with a spectator and how a doctor interacts with patients. He describes how "both groups deal with people, often in an intimate and intense context, and strive to effect a positive change in their audience. They rely heavily on trust, fairness and clear communication for their success." However, although both medics and magicians may use deception in their work, the magician has a harder time because, unlike the doctor, they work in an atmosphere of mistrust.

The author illustrates that, like a magician, "a doctor who wishes to influence a patient's decision can use similar techniques to indicate approval or disapproval." Desirable traits or techniques that a doctor could benefit from include; being clear and precise when presenting information, having likeable characteristics to reduce suspicion and build trust, and using different tones of voice or body language to convey different messages.

Dr Kamran Abbasi, Editor of the Journal, comments "Doctors and magicians, medicine and magic, were all once the same. A talented magician will leave you aghast at the sleight of hand, but a talented doctor might persuade you to consent to an operation or a change of lifestyle."

The authors made a total of 657 calls (at their own cost) over a one month period and at three specific timeslots on different days. The data measured answering times provided by human operators and answering services, and consistency of response.

"Medicine as performance: what can magicians teach doctors?" by Daniel K Sokol is published in the latest issue of the JRSM.

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The JRSM is the flagship journal of the Royal Society of Medicine. It has full editorial independence of the RSM. It has been published continuously since 1809.

Its Editor is Dr Kamran Abbasi.

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