paul jarman

Neurologist, runner, wine maker

[paul jarman @prjarman]

@smead2 I heard them speak many many years ago and read most of their books. Amazing climbers and amazing that they are still at it!

[Sarah Wollaston @sarahwollaston]

Fascinating listening to Paul Jarman @prjarman on #dementia prevention & being on the cusp of a new age thanks to the potential of disease modifying drugs https://t.co/B0wNjB9sOJ Also role of NICE & importance of early diagnosis

[paul jarman @prjarman]

@ajlees I do the same with a new diagnosis of PD. Many people assume the worst or have had such fears instilled by other doctors. Providing hope and the prospect of a good quality of life is essential at the time of diagnosis

[Andrew Lees @ajlees]

His 'second sight' and courage in confronting a malady that lasted more than half his lifetime has earned him a lasting place in the annals of neurology
Altamirage- a curiosity for cures.
When did Ray Kennedy's Parkinson's disease begin.
@TheCenci
https://t.co/fvELYf1yC3

[paul jarman @prjarman]

@DGlaucomflecken That’s good!

[paul jarman @prjarman]

@ajlees @UCLIoN @uclh I’m not an advocate of EPRs but I do think we have to adapt to them without compromising the clinician-patient interaction. Just as Gowers used shorthand, the new generation of neurologists touch type into EPRs while maintaining eye contact with patients in consultations

[paul jarman @prjarman]

@ajlees @UCLIoN @uclh It’s an interesting thought experiment to imagine what Gower’s would be doing now if he was practicing in 2021

[paul jarman @prjarman]

@ajlees @UCLIoN @uclh Once data is stored in the cloud its hard to imagine it wont be accessible in future in some form. Organisations have to future proof their records. Papyrus certainly has advantages, it wouldn’t still be with us after 1000s of years otherwise, but it has limitations also.

[paul jarman @prjarman]

@ajlees More resources are needed so that the doctor can spend time with the patient and someone else interact with the EHR (perhaps a way for trainees to spend more time learning from their mentors as they work). EHRs are designed to facilitate billing, definitely not research…

[paul jarman @prjarman]

@ajlees But for complex inpatient care EHRs are better than paper notes (which always seem to be missing when needed)

[paul jarman @prjarman]

@helengrote @Ashleyjgrote @GreatOrmondSt Well done Helen!

[paul jarman @prjarman]

@ajlees He also had a remarkable collection of antiquities.
Modern neuroscience seems to have explanations for some of his theories- the Id being the Limbic system and the superego the pre-frontal cortex.

[paul jarman @prjarman]

Dropped into the Freud museum on a run - He kept a picture of Charcot above his famous analysis couch!

[paul jarman @prjarman]

@ajlees It all depends on threshold for risk really. 95% of patients with episodic headaches don’t need imaging if you take a careful history and examine. Most patients with PD don’t need imaging. The threshold to image is reducing - driven by doctors, patient expectation and lawyers

[paul jarman @prjarman]

@ajlees I warn people in advance that ‘there is no such thing as a normal MRI scan’, as radiologists so often report incidental findings that sound concerning. The concept of normal for age is helpful. Patients often ask for copies of the MRI report so some explanation is usually needed

[Dimitri Kullmann @Newrotrash]

New scheme for neurology & neurosurgery trainees to undertake a PhD at the @UCLIoN | https://t.co/bOOwPpwVYo

[paul jarman @prjarman]

@smead2 That’s retrogressive and sadly typical of the current approach to medical training