Have slides, will travel TTTnfamiliar envelope: invi-
making twentieth century skill: fun to imagine great minds of history distilling tation to wisdom into two by twos. If projectors lecture abroad. Plea- around in first century AD, might have had St sure tinged with Paul's slides to the Corinthians: disbelief-really 3 CHARITY necessary fly me all * suffereth long that way for just * is kind 45 minutes plus * envieth not \ questions? And * vaunteth not itself shouldn't they be * is not puffed up asking someone older? Accept with Stop daydreaming, return to slide cabinet alacrity before they for old faithfuls. Usually end up including change minds. If Hon Sec's head on platter something old, something new, something borrowed.... Prefer to take too many, make afterwards, his problem not mine. Months pass, then last minute dash to final selection just before lecture. Feel inmedical photography. Cynical cartoons on secure travelling with slides-can't trust wall, including picture of hysterical photo- them to suitcase. No use if sent Schipol, graphers saying "You want it wHEN?" Anchorage, Luton, returned three weeks Receptionist tries to keep straight face at yet later. Keep on person, ideally-should have another supplicant with impossible deadline. slide belt like money belt, coat with lots of Slides completed, minutes to spare. Photo- pockets like tout, or bandoliers (slidoliers?) grapher much better than desktop slide- like Mexican bandit. maker: computer doesn't frown and click Trouble is, slides very heavy en masse. tongue to discourage lecturer from producing Stagger through green channel with knees overcomplicated slides. giving way. Sure to be body searched. "ExEssential that slides are simple, even cuse me, sir. About these pictures. You say if they make lecturer look simple too. Slide- they are for a conference of gynaecologists?"
Medical audiences all supposed to understand English. Not .so projectionists. Like golf caddies they can humble the most experienced pro. In projection room they read tabloids during question time, create memorable experiences when lights go down. For example, Arabic speaking projectionist carefully took slides from holder row by row reading from right to left, not left to right. Worse things happen in China, probably. Big congress: load slides myself, watch carousel sealed, taken away. Night of separation anxiety. When correct picture appears on screen next day, relax-but too soon. Slides all different thicknesses, so each comes up slightly blurred. Lecture develops into series of epic struggles. First: lecturer versus projectionist ("I said focus, please"). Native speaker disappears into projection room to translate lecturer's pleas. Round two: projectionist versus projector. Audience agog as image expands, contracts, moves in and out of focus, while red dot of laser pointer bounces randomly around screen, walls, ceiling. Actual words of lecture now peripheral to gripping visual spectacle. Still, at least audience stay awake. -JAMES OWEN DRIFE, professor of obstetrics and gynaecology, University of Leeds
Burning down their houses H ow thin is the veneer of civilisation. Remember how quickly it came off in Luis Buniuel's film of the elegant partygoers trapped by an invisible angel in a closed room. This time round the Exterminating Angel, the pathogen, is the AIDS virus and the vectors are said to be the very people who each day may be risking their lives treating the victims of the disease. Recently a senator wanted to send HIV positive doctors to prison. Will he also, as in the days of the plague, burn down their houses? All this hysteria began when five people became HIV positive after being treated by a dentist who either infected them with his own blood or transmitted the virus from one patient to another. In a highly publicised case one woman subsequently developed clinical AIDS and the national newspapers displayed pictures of her wasted frame, describing how she had become emaciated, lost her hair, was covered with blisters and acne, and developed vomiting, cramps, diarrhoea, and unremitting fevers. Outrage and panic ensued, giving rise to widespread demands for compulsory testing of health workers. By June Vice President Quayle had joined in the fray by announcing that mandatory BMJ VOLUME 303
2 NOVEMBER 1991
testing was a good idea. The American house officer, "if I Medical and Dental Associations at first contract AIDS from opposed compulsory testing but later advised a patient I am told to infected doctors not to do invasive procedures stop performing and to disclose their condition to their patients. Several states passed laws requiring thanks," he goes on; hospitals to notify patients that they may "either I operate on have been exposed to AIDS through certain all patients, regardprocedures. Finally, a senator introduced a less of my HIV l1= X i biltin Congress imposing a $20 000 fine and a status, or patients 's 10 year prison sentence for doctors who and surgeons should knowing they are infected carry out invasive both have the option K I procedures without telling their patients. of selecting, each Yet so far a minuscule number of patients other." He points are believed to have been infected by health out that some day his care workers. Some 6000 health workers in family responsibilities may take precedence the United States (including 300 surgeons over medicine. and 1200 dentists), are said to carry the HIV Others have also alluded to the possible virus, and according to a mathematical consequences of foolish legislation. What if model their chances of infecting a patient those currently treating patients with AIDS are exceedingly small. They pale into in- were to question the wisdom of taking risks? significance, a recent editorial suggested, Already inner city hospitals, where most of compared with the enormous risks of smok- the AIDS victims are being treated, are ing and car accidents that society is willing to experiencing shortages. Why be a hero, they tolerate. might wonder, in a society that would show But why limit testing to doctors and little sympathy if they themselves were to dentists? ask some. Why not to manicurists, become infected in the course of carrying hairdressers, or barmen? Why not test every out their duties.-GEORGE DUNEA, attending patient? "Disgustingly," writes a surgical physician, Cook County Hospital, Chicago, USA 1141
making twentieth century skill: fun to imagine great minds of history distilling tation to wisdom into two by twos. If projectors lecture abroad. Plea- around in first century AD, might have had St sure tinged with Paul's slides to the Corinthians: disbelief-really 3 CHARITY necessary fly me all * suffereth long that way for just * is kind 45 minutes plus * envieth not \ questions? And * vaunteth not itself shouldn't they be * is not puffed up asking someone older? Accept with Stop daydreaming, return to slide cabinet alacrity before they for old faithfuls. Usually end up including change minds. If Hon Sec's head on platter something old, something new, something borrowed.... Prefer to take too many, make afterwards, his problem not mine. Months pass, then last minute dash to final selection just before lecture. Feel inmedical photography. Cynical cartoons on secure travelling with slides-can't trust wall, including picture of hysterical photo- them to suitcase. No use if sent Schipol, graphers saying "You want it wHEN?" Anchorage, Luton, returned three weeks Receptionist tries to keep straight face at yet later. Keep on person, ideally-should have another supplicant with impossible deadline. slide belt like money belt, coat with lots of Slides completed, minutes to spare. Photo- pockets like tout, or bandoliers (slidoliers?) grapher much better than desktop slide- like Mexican bandit. maker: computer doesn't frown and click Trouble is, slides very heavy en masse. tongue to discourage lecturer from producing Stagger through green channel with knees overcomplicated slides. giving way. Sure to be body searched. "ExEssential that slides are simple, even cuse me, sir. About these pictures. You say if they make lecturer look simple too. Slide- they are for a conference of gynaecologists?"
Medical audiences all supposed to understand English. Not .so projectionists. Like golf caddies they can humble the most experienced pro. In projection room they read tabloids during question time, create memorable experiences when lights go down. For example, Arabic speaking projectionist carefully took slides from holder row by row reading from right to left, not left to right. Worse things happen in China, probably. Big congress: load slides myself, watch carousel sealed, taken away. Night of separation anxiety. When correct picture appears on screen next day, relax-but too soon. Slides all different thicknesses, so each comes up slightly blurred. Lecture develops into series of epic struggles. First: lecturer versus projectionist ("I said focus, please"). Native speaker disappears into projection room to translate lecturer's pleas. Round two: projectionist versus projector. Audience agog as image expands, contracts, moves in and out of focus, while red dot of laser pointer bounces randomly around screen, walls, ceiling. Actual words of lecture now peripheral to gripping visual spectacle. Still, at least audience stay awake. -JAMES OWEN DRIFE, professor of obstetrics and gynaecology, University of Leeds
Burning down their houses H ow thin is the veneer of civilisation. Remember how quickly it came off in Luis Buniuel's film of the elegant partygoers trapped by an invisible angel in a closed room. This time round the Exterminating Angel, the pathogen, is the AIDS virus and the vectors are said to be the very people who each day may be risking their lives treating the victims of the disease. Recently a senator wanted to send HIV positive doctors to prison. Will he also, as in the days of the plague, burn down their houses? All this hysteria began when five people became HIV positive after being treated by a dentist who either infected them with his own blood or transmitted the virus from one patient to another. In a highly publicised case one woman subsequently developed clinical AIDS and the national newspapers displayed pictures of her wasted frame, describing how she had become emaciated, lost her hair, was covered with blisters and acne, and developed vomiting, cramps, diarrhoea, and unremitting fevers. Outrage and panic ensued, giving rise to widespread demands for compulsory testing of health workers. By June Vice President Quayle had joined in the fray by announcing that mandatory BMJ VOLUME 303
2 NOVEMBER 1991
testing was a good idea. The American house officer, "if I Medical and Dental Associations at first contract AIDS from opposed compulsory testing but later advised a patient I am told to infected doctors not to do invasive procedures stop performing and to disclose their condition to their patients. Several states passed laws requiring thanks," he goes on; hospitals to notify patients that they may "either I operate on have been exposed to AIDS through certain all patients, regardprocedures. Finally, a senator introduced a less of my HIV l1= X i biltin Congress imposing a $20 000 fine and a status, or patients 's 10 year prison sentence for doctors who and surgeons should knowing they are infected carry out invasive both have the option K I procedures without telling their patients. of selecting, each Yet so far a minuscule number of patients other." He points are believed to have been infected by health out that some day his care workers. Some 6000 health workers in family responsibilities may take precedence the United States (including 300 surgeons over medicine. and 1200 dentists), are said to carry the HIV Others have also alluded to the possible virus, and according to a mathematical consequences of foolish legislation. What if model their chances of infecting a patient those currently treating patients with AIDS are exceedingly small. They pale into in- were to question the wisdom of taking risks? significance, a recent editorial suggested, Already inner city hospitals, where most of compared with the enormous risks of smok- the AIDS victims are being treated, are ing and car accidents that society is willing to experiencing shortages. Why be a hero, they tolerate. might wonder, in a society that would show But why limit testing to doctors and little sympathy if they themselves were to dentists? ask some. Why not to manicurists, become infected in the course of carrying hairdressers, or barmen? Why not test every out their duties.-GEORGE DUNEA, attending patient? "Disgustingly," writes a surgical physician, Cook County Hospital, Chicago, USA 1141
