At last some good news for democracy. Brazil is more democratic and less corrupt than the United States. It also has a much more sophisticated electoral voting system. Viva Lula

Pappworth told us when presenting a neurological case offer up what we had deduced in a 3 stage answer Start with the anatomical site which often begged the next question, what path process? eg neoplastic, Then the denouement ‘what would you think the likely cause’ glioma

Precision medicine means to me taking a medical history and performing a neurological examination. It is personalised and always informative. It also guides my choice of ancillary tests.

Another Pappworth tattooed on my brain ‘History recording should never be a stereotyped performance but should be evolved like a well written edited narrative with literary form and style’

I find Bluesky like blowing a horn alone in my front room for my own pleasure. Where is the sparky cut and thrust and disagreement?

Sargant is a monster: Laing is a saint. No nuance, no context The tragedy of whiggishness in psychiatry and universities @MikeJayNet @rcpsychNeuro @The_BNPA @Lit_Review

The condemnation of Jean-Martin Charcot for one aspect of his multifaceted work, which posterity disapproves of needs to stop. The presentist critics behave as if medical practice, culture and ethics, do not evolve. They lack sensitivity and choose to ignore context #CharcotBicentenaireParis

FND signs a cautionary note from @jonstoneneuro.bsky.social

Perhaps another way to express it is that The Menu is not the meal The map is not the territory The patient is not the measurement Scientists need to embrace both common sense and nonsense

Some scholars have become so preoccupied with turning reality into definitions that they have totally lost sight of what Parkinson’s disease and Alzheimer’s disease actually are. They are so fixated with galaxies they can no longer see the stars

There is no such entity as academic medicine. There are doctors paid by universities and others paid by governments or through private practice but we all should be enthusiastic teachers of our craft to the next generations of apprentices

Any soulful neurologists out there in the blue sky?

Bar Italia today The souvenirs of an Italian Soho coffee house thriving on Froth Street.Through the glass darkly The modernists are back. @TheBaristas @Tim_R_Nicholson @RichardSearling @AnaZumaR @LondonBookBoy #Northernsoul

Dice @ajlees.bsky.social en este artículo que les comparto: "Gabriel García Márquez: the greatest of the amnesia writers", a lo que habría que añadir: "atrapado por la amnesia". academic.oup.com/brain/articl...

I keep hoping BlueSky will fire up but for now it is hard work with negligible feed back at least in neurology

Mild memory impairment, difficulties in expression, mental dullness and a sense of head muzziness are a cluster of symptoms that are common in Parkinson’s disease and are usually intermittent. Is this brain fog? My patients never use that term in their description

Most physicians see only what they are looking for and recognise as significant only what they know. Medicine is very difficult and a closed mind makes it much harder

‘Each motion of our rolling world, each wave of light that reaches us from the far-off sun,each wind that bears us to the warmth of tropic seas or cold of mountain snows determines some change in us’ #WilliamGowers @neurolib @UCLIoN @UCLBrainScience

What has happened to the high quality teaching I received from my medical school and university? Why has high quality experience and charisma been sidelined by the new control towers and why are so many serious academics being pilloried by an illiberal politburo?

I find it disappointing that the role of my mentor Gerald Stern in founding Parkinsons UK in 1970 together with Mali Jenkins the sister of one of his patients has been rubbed out of the charity’s annals. @ParkinsonsUK @CureParkinsonsT

You write the paper, sign off copyright, reviewers and authors receive nothing, editors a niggardly stipend, and then the final indignity you need either an institutional or personal subscription to read the journal in which it is published Talk about rip offs?

Never assume what you hear from a patient is irrelevant fluff. Every word, every concern, every gesture is leading you to the neurological diagnosis and best treatment To work backwards from an MR scan report ordered without a face to face medical interview is a cardinal mistake

It seems to me that personalised medicine has very little to do with clinico-pathological definitions or with suspect biological definitions in neurodegenerative disease and everything to do with phenomenology. What matters to patients is their subjective experience of the disease and their symptoms

I recently opted out for two of my books despite the bribes offered and warnings given by the publisher. It is anti- scholarship, parasitic and another level of exploitation www.bbc.co.uk/news/article...

The National Hospital for Nervous Diseases, Queen Square last night

'every background, no matter how sublime, has now to be seen against a universal foreground imposed by modern man, of posters, wire, disused petrol pumps, car parks, conifers, institutions for the insane, cement works, sanitation plants, generator stations, the wreckage of wars and War Departments.'

Salpêtrière en hiver

Parkinsonism & Related Disorders www.prd-journal.com/article/S135...

Parkinsonism & Related Disorders www.prd-journal.com/article/S135...

Its been a 20 year struggle but finally American citizens can be treated with apomorphine pumps. A momentous day in PD therapeutics www.michaeljfox.org/news/second-...

I just learned Charcot devised a hot and cold shower for therapy which became very popular especially in Russia

It was Charcot who proposed the name ‘maladie de Parkinson’ as preferable to paralysis agitans. Today,150 years on, there are peacockian colleagues who want to rub the disease he described out and replace it with the name of a protein. @TheLancetNeuro #Parkinsonbicentenary

In the 1970s it was estimated there were 50000 people with Parkinsons disease in UK, now it is 153000. Life expectancy has improved and the population has grown, but I am sceptical that underdiagnosis or misdiagnosis are important addditional explanations.

If you had symptoms would you want to be seen by a Chairman of Neurology in a University or a Consultant Neurologist who likes people and has a competence across the board? a no brainer Yet despite their remoteness from reality some of these eminences try to control how neurology is practised

I have never done this but there are colleagues ,and not only those with a strong genetics background who start thr medical interview with the family history.

Une vie (1883) by ‘the happiest and unhappiest of men’ A wonderful naturalist novel by one of the celebrated French luetic writers . Does the treponeme stimulate literary output?

This morning my mind is full of archipelagos but then I think of the richness of John Clare’s life in Helpston where he felt no need to travel beyond the horizon. He knew there was nothing better in Peterborough, London or Northampton. It was where he belonged

All the most efficacious types of medications for Parkinsons disease are at least 50 years old. The sixties and seventies were a golden age These treatments are vastly superior to anything molecular biology has come up with for any of the other common neurodegenerations.

And this magnificent suggestion should occur at every living birthday an inheritance track, a eulogy and a reading of our choice by a friend or a family member @dr_mattmorgan @bmj_latest search.app/3NA5yUpmQv1h22…

I want to work in a country where I have a responsibility for my patients, where there is minimal wastage of resources and where overdiagnosis is frowned upon. I want to be able to refer to a colleague if I am in doubt and where other doctors opinions are recorded in the notes

I do not want to live in or work as a doctor in a country where a bilan of expensive investigations are available but there are no opthalmoscopes, peak flow metres or urine dip sticks a place where there are many specialists for the rich but no connected referral pathways

We need to nurture and insist on physicians who are able to deal with any neurological symptom and also clinics where specialists from two main medical specialities work together. Too many subspecialists is not healthy

Many of the journals I enjoy and the articles I would like to draw attention to have no link to blue sky seriously limiting my input. It also seems a bit like an empty space as far as neurology is concernd. Hope it will go on improving but glad Ive kept my twitter account even for academic birdsong

For anyone interested in the history of British Neurology this book is a must. It also provides a fascinating insight into specialisation in one of London’s greatest and busiest teaching hospitals @qmul.ac.uk @charlesmarshall.bsky.social