HEART BEAT:Medical vision is at odds with reality in health services
IN A work called the Oneirocriticaby Artemidorus of Daldis, written in the 2nd century AD, attention is paid to the importance of dreams and soothsaying in medicine. Apparently, diagnoses by physicians could safely be ignored in favour of those prescribed in dreams. Nowadays, this is known as "alternative medicine".
Daldis is in Lydia, which is in the western part of Turkey. It was once ruled by King Croesus. Consultants there, whose practices were guided by the materia medica of dreams, frequently grew as rich as the king himself. “As rich as Croesus” became a term of opprobrium bestowed by the classically educated Irish on the poor and struggling members of the medical profession in Ireland. Daldis is near Ephesus and was a major city of the times. St Paul wrote an epistle to the inhabitants. Among the general advice to behave themselves, in the “You do not know the day or the hour”-type exhortation, he also wrote on the domestic front, “So let wives be subject in everything to their husbands”. The HA thinks he must have been out of his mind to put that on paper and that he needed to cop himself on. I said nothing.
Dreams figure prominently in Irish medical governance. Within a week of one another, I heard the Taoiseach and Minister for Justice Dermot Ahern independently refer to medical visions. Upon being castigated by a variety of peasants about the collapse of the economy and the squandering of the golden eggs of the “boom”, they both asserted indignantly that far from dissipating the riches accrued, they had wisely invested the monies in improving the national infrastructure.
Furthermore, they chanted in unison, the now familiar mantra that as they had created the mess in the first place, they were the only people qualified to get us lesser mortals out of it. It’s rather like claiming the credit for locking the stable door after the horse has bolted. This finds little credibility among those with a share in the horse.
This is akin to the “dream time” of Australian aboriginal culture in which the visions become clearer and more important than reality itself. It has been unkindly suggested that organic mood-altering drugs may have contributed to this separation of the real and the fanciful in the case of early societies. It is clear that is not the case in Ireland. We’re not a primitive society and we don’t have witch doctors. Mind you, we have spin doctors whose function is to lull the populace into a situation where anything goes. It used to be effective, but not any more I think.
Dreams or spin or whatever else you may call it can hardly account for the two officers of State aforementioned, actually claiming that among the infrastructural benefits they conferred on us ungrateful folk was the fact that they had constructed hospitals. I get worried here. Have I emerged from some Rip Van Winkle sleep and this has happened in my absence? When I went to sleep they were shutting hospitals, units, wards and beds as if there were no tomorrow. Did I dream about issues over Monaghan and Louth County hospitals in Ahern’s back yard? The same minister who told us, when argument had arisen over the planning of the new regional 350-bed hospital in the northeast, not to get too upset about location as there was no money to build it anyway. And then he obviously went and built it when I was asleep. Good for you, Minister, can you let us know where it is?
I am glad, however, that the good people of Tipperary and Clare and wherever else the axe has fallen can now relax and realise that the superior facilities they were promised when their units were shut or downgraded are now in place. They must be – the Taoiseach and Minister told us so. You can call off the protests in Navan, Mullingar, Ballinasloe and Roscommon – everything is going to be alright.
Meantime, there are as many and more patients on trolleys as there were one/two/three years ago. More beds are closed, more “services” decanted into a community that is ill-prepared to receive them. Shut St Ita’s, St Brendan’s, and St Senan’s in Wexford, and send the institutionalised patients somewhere, anywhere. Maybe put them in one of these fit-for-purpose new facilities that you claim to have built.
The author of the Oneirocriticabook would be chuffed to know that the Republic of Ireland was still accepting its prescription 2,000 years later.
mneligan@irishtimes.com