The ugliest English wordsIn his 1895 novel The Time Machine, H G Wells described a time hundreds of thousands of years hence, when the planet is inhabited by two separate human species, one pleasant and childlike, the other savage and brutal.1 The two species are called the Eloi and the Morlocks. It’s not hard to guess, from their names, which species is which. The euphony of “Eloi” and the harsh sound of “Morlocks” gives the game away, mirroring their characters.This implies not two but three types of English words: those that are euphonious, pleasant sounding, and therefore in some sense beautiful; those that are cacophonic, ill sounding, and therefore in some sense ugly; and those that are neither. Deciding which is which is not straightforward. Many factors, other than the way they sound, are involved.I have previously discussed English words that are regarded as beautiful.2 I analysed 372 such words,...

A coroner in Surrey has raised concerns about the role of physician associates (PAs) in the NHS in response to the death of a woman with abdominal pain who was wrongly diagnosed as having a nosebleed.Coroner Karen Henderson published a report1 asking agencies including the General Medical Council and NHS England to take action to prevent future deaths, warning that patient safety is at risk unless greater clarity is provided about PAs’ role and scope of practice.Pamela Marking, who was 77, died in February 2024 because of complications of a strangulated femoral hernia. Four days before her death she experienced abdominal pain and vomited bloodstained fluid, and presented to the emergency department at East Surrey Hospital. She was reviewed by a PA who diagnosed her with epistaxis (nosebleed) and discharged her without a review by a doctor.Marking re-presented to the hospital two days later and was found to have grossly...

The BMA has agreed “in principle” to an £889m funding uplift to GPs’ contracts in England this year, on the condition that the government commits to negotiating a completely new national contract within the current parliament.1The 2025-26 General Medical Services (GMS) deal includes a reduction in bureaucracy for GPs, greater flexibility for practices in employing different healthcare staff, and an increase in the fees paid for routine childhood vaccinations (box 1). Patients will also be able to book more appointments online and ask to see their usual doctor.Box 1Breakdown of the 2025-26 GP contract deal£742m uplift to the global sum (amount per weighted patient will rise to £121.90)£18m uplift for vaccination and immunisation uplift£104m additional funding for the GP ARRS scheme£13m uplift to primary care network workforce streams£12m uplift to statement of financial entitlements for locum reimbursements£80m additional sum for advice and guidance (separate from the £889m funding uplift)After the...

Doctors who were incorrectly told they passed a crucial medical exam only to be told 18 months later that they had failed have now been told that their applications to higher specialty training this year will be withdrawn.One of the doctors affected, who asked to remain anonymous, told The BMJ that they were concerned they will be left unemployed in August when their current contract ends. They are the sole breadwinner for their spouse and small child. “It’s devastating,” they told The BMJ. “This has ruined our careers and turned our lives upside down.”The error affected nearly 300 candidates who sat part 2 of the membership of the Royal College of Physicians (MRCP) exam in September 2023. The exam is required for doctors wishing to apply for higher specialty training in medical subspecialties such as cardiology and geriatrics.The Federation of the Royal Colleges of Physicians of the UK, which administers...

bmj;388/feb28_1/r405/FAF1faAndrew studied medicine at Clare College, Cambridge, and St Thomas’ Hospital, London. After house jobs he did national service in Malta and then moved to Edenbridge, Kent, in 1957. Here he worked as a GP and trained as an anaesthetist at Queen Victoria Hospital.The three general practices in Edenbridge merged and Andrew enjoyed a long period in a stable and harmonious practice, while giving 25 years of service as an anaesthetist at Edenbridge War Memorial Hospital. He was awarded an MBE for services to the community, which continued long after retirement.As well as epitomising the era of personal care in general practice, he was an early GP trainer. A particular delight was his leadership of the longstanding Edenbridge Clinical Society, which met at 9 pm on Friday evenings, a tradition started at its inception to allow neighbouring doctors time to finish their evening surgeries before travelling.Outside work Andrew was happiest...

Health authorities have yet to identify the cause of outbreaks of a disease in the Democratic Republic of Congo that the World Health Organization has called “a significant public health threat.”Last week WHO reported 53 deaths and 431 cases.1 Its latest update, published 27 February, noted 60 deaths and 1096 cases from the three villages involved.2The outbreak began in Boloko village, Équateur province, in the country’s north west. Three children, who reportedly had eaten a bat they found dead, fell sick and died between 10 and 13 January. Four more children, aged 5 to 18, died over the following two weeks.The disease also appeared in the neighbouring village of Danda. There have been 10 cases and seven deaths in Boloko, and two cases with one death in Danda.Nearly two weeks after the Boloko outbreak the disease appeared in the village of Bomate, also in Équateur province but 190 km away....

F. Gordo Vidal
Med Intensiva. 2023;47:191-2

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Francisco Álvarez-Lerma, Mercedes Catalán-González, Joaquín Álvarez, Miguel Sánchez-García, Mercedes Palomar-Martínez, Inmaculada Fernández-Moreno, José Garnacho-Montero, Fernando Barcenilla-Gaite, Rosa García, Jesús Aranaz-Andrés, Francisco J. Lozano-García, Paula Ramírez-Galleymore, Montserrat Martínez-Alonso
Med Intensiva. 2023;47:193-202

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P. Perelló, J. Gómez, J. Mariné, M.T. Cabas, A. Arasa, Z. Ramos, D. Moya, I. Reynals, M. Bodí, M. Magret
Med Intensiva. 2023;47:203-11

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E.P. Gomes, M.M. Reboredo, G.B. Costa, F.S. Barros, E.V. Carvalho, B.V. Pinheiro
Med Intensiva. 2023;47:212-20

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L. Zapata, C. Guía, R. Gómez, T. García-Paredes, L. Colinas, E. Portugal-Rodriguez, I. Rodado, I. Leache, A. Fernández-Ferreira, I.A. Hermosilla-Semikina, F. Roche-Campo
Med Intensiva. 2023;47:221-31

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I. Astola Hidalgo, A. Fernández Rodríguez, E. Martínez Revuelta, M. Martínez Revuelta, A.M. Ojea, P. Herrero Puente, D. Escudero Augusto
Med Intensiva. 2023;47:232-4

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F.J. Casadiego Monachello, M.C. de la Torre Terron, J.A. Mendez Barraza, S. Casals Vila
Med Intensiva. 2023;47:235-7

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M.V.F. Garcia, R. Souza, P. Caruso
Med Intensiva. 2023;47:237-9

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J.M. Pérez Villares, L. Alarcón Martínez, P. Fernández Florido
Med Intensiva. 2023;47:239-41

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A. González-Castro, E. Cuenca Fito, C. González
Med Intensiva. 2023;47:242

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M. Cuervas-Mons Tejedor, J.D. López Castilla, E. Sánchez Valderrábanos
Med Intensiva. 2023;47:243

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L.I. Perez-Sanchez, N. Mamolar Herrera, J.J. Velasco Gómez
Med Intensiva. 2023;47:244-5

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M.C. Martínez-Ávila, C.I. Herrera-Arrieta, Z.M. Mondol-Almeida
Med Intensiva. 2023;47:246-7

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I. Keituqwa Yáñez, J. Navarro Martínez, M. García Valiente
Med Intensiva. 2023;47:248-9

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