Monday, 27 February 2017

Nobody should die from an asthma attack these days

Many thoughts went through my head when the heartbreaking story of the death of a 5-year-old girl in Newport came on the Wales news last night. I remembered being that age or a little younger sitting alone at the height of an attack, not being able to breathe at the point of blacking-out and thinking "so this is what death is". I cannot remember precisely what happened after I came down on the right side of the crisis, but there would have followed a couple of days of misery as I slowly recovered. There was no certain effective relief available then. Ephedrine (nowadays better known as a banned substance for athletic competition) was effective in some cases but in the very early days of the NHS may not have been generally available. Various substances became available over the years which took the edge off attacks but were fairly slow-acting. Liberation finally came in the 1990s with inhaled Salbutamol for instant relief and corticosteroids for prevention.

The corticosteroids do not work for every one and there is now concentrated research in identifying the different types of asthma and how they may be treated. However, it seems to me that there is effective relief for the physical symptoms and nobody should die from an acute attack if they can be got to specialist treatment in time. 

The GP in Newport was clearly fit and healthy and ignorant of how dangerous untreated asthma can be. It is hard to explain the feeling. I imagine the best way to simulate it is water-boarding or being restrained in a too-tight corset. Did she really believe the little girl was complaining of no more than a wheeze?  Certainly she is officious, not a good trait in a GP. I certainly think she is not suited to general practice on the evidence of the media reports. Whether she should be struck off the medical register entirely is another matter. Pragmatically one would not want to lose any medical expertise in the public sector when even in Wales there is a flight of qualified staff. She will always have the death of this little girl on her conscience. That, and restricting the areas in which she may practise, may be punishment enough.

Coincidentally, the guest of the week on Essential Classics is currently Gerald Scarfe. Rob Cowan's interviews with him will have been recorded some time ago, so they will not take account of that distressing news story. However, I trust that they touch on the isolation which he suffered because of asthma as a child, referred to in previous pen-portraits like this one for the BBC.

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