The saga of Brexit continues and dominates the national conversation. I have learnt a new term, “Prorogation” and become familiar with Backstops, Virtual Borders and American chlorinated chicken. However, the stark reality, and its lack of appreciation by our political leaders, was amply demonstrated by an exchange between Dr David Nicholl, a neurologist and Jacob Rees-Mogg, Leader of the House of Commons, during a live radio exchange. Nicholl and Rees-Mogg were discussing YellowHammer, a report by the current government, which assessed the impact of a no-deal in relation to shortages of medicines, food and fuel. Nicholl asked Rees-Mogg, “What level of mortality rate are you willing to accept in the light of a no-deal Brexit?” I shall not provide the details of Rees-Mogg’s response but suffice to say it completely ignored the question and reverted to the persistent and stock reply to any negatives of a no-deal as “Project Fear”. Even when Nicholls pointed out that he had been engaged by the government to provide the, not worst-case scenario, just likely outcome, of a no-deal scenario, his credentials were undermined. A true case of shooting the messenger when you don’t agree with the message.

En passant the NHS and academia have already been affected. My conversations, a light litmus paper of evidence, is that doctors are less willing to come here from the EU despite the recruitment drives by the NHS for GPs and Hospital doctors. Recently I spoke to an academic from University College London who indicates that average numbers of applications for researchers’ post have plummeted from 100 to 10, as the EU pool is drying up. Clearly, Nicholl’s question was valid and apposite and the political response invalid and inadequate.

We can be forgiven for getting depressed and older folk like me are inching toward this state given our national political climate, vitriolic discourse and lack of statesmanship and leadership. Lewis et al (p.6) on Depression in the elderly is a must read. Social media, and frequently an irresponsible press, have also led to the immunization scare, with low uptake of the MMR vaccine. In the USA increasing adult mumps figures are a major concern. Elliman et al (p.24) highlights the need and timetable of the evidence-based vaccination pathway for children. The paper on Non-Thyroidal Illness Syndrome by Seedat et al (p. 57) is a must read so you may avoid the pitfalls of interpreting thyroid function tests during an illness.

Please participate in the CPD elements and use it as part of your appraisal and re-accreditation. I am very happy to receive correspondence and ideas to make this journal address the needs of its readership.

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