Rethink Health - October 2011

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Self-respect is a cardinal sign of health, and in turn has two principal aspects: self-possession, and respect for others.

Self-possession is unfashionable, entailing as it does a calm, comfortable and centred bearing, as well as indifference to other possessions. This does not make a good consumer! It is the sort of person who attracts advice-seekers in bus queues and at supermarket check-outs. Lots of people would like some of what they see in you.

Respect for others is now often noted by its absence. "Dissing" has entered the language, mostly on the mouths of people in aching need of self-respect. Unfortunately, no amount of wealth or reputation can make up for this. Self-respect is acquired from birth by being immersed in the society of self-respecting people. The manner of their relationship rubs off, indelibly. It is sustained by finding a meaning to life, and having a purpose in living.

Good manners are, by definition, no more fashionable than the self-possession on which they are founded. Ballroom dancing, once a popular opportunity for the courtly display of good sexual manners, is practically forgotten. Barging forward in queues, reckless cycling on pavements, the unseemly rush for sale bargains - all these denote a distressing and widespread lack of self- and other-respect. 

Yet we are wistful for it. If self-respect fills the heart, the lack of it leaves one painfully hollow. Untameable yearnings arise, in the form of ambitions, drives, competitiveness and at worst greed, addictions and perversions. None of these can be satisfied. The unrequited need is miserable.

It is some comfort to hear this morning that the British still rank highly in the world for manners and politeness, though this may only imply even worse in other nations. But whatever our score, how can we all do better?

In the first place, set a high value on family life - especially for the benefit of its younger members. Respect must be demonstrated, and expected in return. Young children are very receptive and responsive, but become resistant as they advance into their teens. After that the pattern is largely set.

But not completely. Vacuum at the centre attracts one to self-possessed people. When you are asked in queues by complete strangers for advice to give their "friend", do your respectful best. A crumb of comfort goes a long way if you had none before. But don't overdo it. A whole slice is overwhelming!

 Prescription Arrangements 

The rules about dispensing medicines, and even prescribing them, are gradually becoming more restrictive. I can, for example, no longer prescribe privately drugs classified as dangerous, because my application to do so, when the restriction came in and I had the option, formed a minority of one and was ignored.

Similar changes are  happening in the USA, where one of our major items is manufactured. Forest Pharmaceuticals Inc have decided - for whatever reason, but probably under pressure from regulators - not in future to supply their products outside their national borders.

This has forced us to plan for the indefinite future. There will come a time when I am no longer in a position to prescribe, let alone dispense, under the provisions of the UK Medicines Acts. However, we have identified a way it can be done.

The Women's International Pharmacy ( is based in Madison, Wisconsin. They dispense for men as well as women. They are supplied by Forest Pharmaceuticals and other manufacturers. In particular, they can dispense Thyroid and Progesterone against prescriptions filed with them by UK doctors.

Our supplies of Thyroid are dwindling rapidly, and cannot be replenished. I am writing to each individual with a thyroid prescription explaining the new arrangements that will apply once ours have gone. Their supply should continue seamlessly. 

Eleven other UK doctors use this arrangement. So when rumours of my demise or incompetence eventually prove justified, it will be possible to transfer the care of each patient of mine to one or other of them.

Prices will inevitably be a bit higher, since we made no profit but the Pharmacy must. You will also be responsible for any duties and taxes imposed. But the impact of this will be mitigated by obtaining several months' supply at a time.

We could have arranged to hold here an "office supply" for each patient, mitigating further the inconvenience to you of carriage charges and duties. However, this increases the work for us of supplying you, and I have already pointed out that we have never charged anything like enough to cover this. We do have other lives to lead, so we have decided that this is the point at which to delegate more, rather than less. 

Progesterone is manufactured in Britain. Currently there is no forecast of any need to change our arrangements for progesterone prescriptions but a similar transfer can be made once the time comes.

I'm just happy and relieved that it will never be necessary to stop supplies of either of these items altogether, returning each affected individual to the plight you were in before you began treatment!