🎉that took a little bit longer than anticipated but plugs a small gap in the COVID lit, and is my first first-author publication, which is very exciting. Thanks, @NeonatalEthics for all your patience!🦠 @matthewjrowland
@wmarybeard@CharlotteCGill Mixed experience, personally, and highly dependent on degree. The amount packed into a medical degree allows for limited (not zero) independent thought, philosophy should allow for a lot but certainly not without limits.
A rather poetic moment starting my final training rotation at Broadmoor, which means returning to Berkshire, where I started working as a doctor in 2018, and to West London Trust, where I started my career as a psychiatrist two years later.
The level of personal hostility directed at Keir Starmer over the last week deserves scrutiny in its own right. Not because he should be immune from criticism, but because the tone and intensity of the attacks tell us something unhealthy about the state of democratic politics.
1. Starmer is a conventional political figure. Cautious, legalistic, incremental. He frustrates people precisely because he is managerial rather than messianic. Yet the reaction to him often goes far beyond disagreement, tipping into visceral hatred more commonly reserved for authoritarians or demagogues.
2. Much of this hostility is disconnected from concrete policy. It is not about specific votes, proposals or outcomes, but about projection. A belief that Starmer embodies betrayal, bad faith or hidden malice. That kind of politics runs on suspicion rather than evidence.
3. This matters because democracy depends on the assumption of good faith among opponents. You can think a leader is wrong, timid, or misguided without believing they are fundamentally illegitimate. Once politics becomes moralised to the point of demonisation, compromise is reframed as treachery and pluralism as weakness.
4. The pattern is familiar. In fragmented, polarised systems, anger concentrates not on extremists, whose intentions are clear, but on moderates, who disappoint maximalists on all sides. The centre becomes the lightning rod precisely because it resists totalising narratives.
5. There is also a media and online dynamic at work. Incentives reward outrage, not proportionality. Algorithms favour contempt over analysis. Over time, this creates a political culture in which relentless personal attack feels normal, even virtuous, rather than disgusting.
6. None of this is a defence of Starmer’s decisions, instincts or record. Those should be argued over robustly as you do in a democracy. The problem is the substitution of critique with hostility and the quiet erosion of democratic norms that follows when political opponents are treated as enemies rather than rivals.
7. A democracy cannot function if every election is framed as an existential struggle against internal evil. At some point, the target may change, but the damage to trust, restraint and culture remains.
Every parents nightmare
The non blanching rash of meningitis (neisseria meningitidis) infection
Vaccine preventable
As of today dropped from the US vaccine schedule
@dredbeveridge@BPPA_Official@rcpsych Hi Ed, I wanted to ask you about use of / guidelines re semaglutide without the physical comorbidities in the SMI group with obesity. Any movement toward including schizophrenia in the list of comorbidities? Happy to take this conversation elsewhere..