Making a baby takes time...

Our world is filled with music. From the great symphony halls to the blaring boom boxes of summer; from the lullabies that drift babies to sleep to the spiritual music that inspires us; from weddings to funerals; from cell phone rings to marching bands to singing in the shower. Music can soothe or arouse, excite or relax us. It is perhaps the oldest language and it carries messages and affects how we respond to stimuli. Mehr

Büchertisch

1. Merchants of Doubt: How a Handful of Scientists Obscured the Truth on Issues from Tobacco Smoke to Global Warming von Naomi Oreskes, Erik M. Conway, London 2012
2. Eine bessere Welt unternehmen. Wirtschaften im Dienst der Menschheit von Peter Spiegel, Herder
3. Social Business für ein neues Miteinander.Der Anfang einer Welt, wie wir sie uns wünschen von Franz-Theo Gottwald, Karl Peter Sprinkart, Herbig
4. Kreative Revolution. Was kommt nach dem Industriekapitalismus? von Wolf Lotter, Mumann 2009
5. Früher war alles besser. Ein rücksichtsloser Rückblick von Josef Joffe, Piper
6. Schöner Denken. Wie man politisch unkorrekt ist von Josef Joffe, Piper
7. Fremde Heimat. Das Schicksal der Vertriebenen nach 1945 von Henning Burk, Rowohlt
8. Ritter, Räuber, Spökenkieker. Die besten Sagen aus dem Ruhrgebiet erzählt von Hartmut El Kurdi, Sauerländer 
9. Afghantsy. The Russians in Afghanistan 1979-89 von Rodric Braithwaite, Profile Books
10. 1812.Napoleons Feldzug in Russland von Adam Zamoyski, CH Beck
11. Schönheit und Schrecken. Eine Geschichte des Ersten Weltkriegs, erzählt in neunzehn Schicksalen von Peter Englung, Rowohlt

Wer nennt Sie fett?

Who are you calling fat?

Tony Delamothe, deputy editor, BMJ
tdelamothe@bmj.com
As England’s adults and children are plumping up (doi:10.1136/bmj.e2332) doctors are tying themselves up in knots over the right words to use with their podgy patients. It’s a minefield out there. On a ward round Ian Seetho wondered aloud whether a patient was too heavy for the hospital’s CT table—only to see his patient’s demeanour rapidly deteriorate (doi:10.1136/bmj.e1370). Apparently, studies show that patients prefer terms like "body mass index" and "excess weight" to "fat," "obese," and "extremely obese." Seetho’s bottom line: "When describing a diagnosis or talking to patients, it is important to be ever so mindful of our choice of words in relation to how they feel about their condition."
I wonder. Operations, pregnancies, and yes, even some investigations are riskier in obese people. Shouldn’t doctors be able to speak these simple truths in simple words? Seetho worries that the use of potentially pejorative terms may be interpreted as moral judgments. Perhaps, but I’m reminded of Robert Hughes’s lament at the heart of his Culture of Complaint: "It’s as though all human encounter were one big sore spot, inflamed with opportunities to unwittingly give, and truculently receive, offence."
2120).
Des Spence believes that medicine’s challenge this century is to fight the pandemic of iatrogenic harm, and general health screening checkups are firmly in his sights. They lack any scientific basis and lead to more investigations, anxiety, and profit—although not for patients. He blames these checks for the overtreatment of breast and prostate cancer (doi:10.1136/bmj.e2346).
Nevertheless, screening retains its allure. As part of his plan to make the UK a world leader in dementia care, the prime minister announced this week that everyone aged 65 to 74 will be screened for early signs of dementia (doi:10.1136/bmj.e2347). Does such a programme satisfy the UKNSC’s criteria for introducing a new screening test (www.screening.nhs.uk/criteria)? I don’t think so.
Cite this as: BMJ 2012;344:e2363

Ärzte und Klimawandel

Fiona Godlee, editor, BMJ
fgodlee@bmj.com
Last week was Climate Week in the UK, featuring a host of awareness raising activities across the country. And next Wednesday, 28 March, is NHS Sustainability Day (http://doc2doc.bmj.com/forums/off-duty_general_nhs-sustainability-day-of-action). So it seems a good moment to be publishing our Spotlight on climate change. The seven articles have been specially commissioned from among the speakers at last year’s high level conference on climate change, hosted by the BMJ in partnership with a consortium of other organisations (http://climatechange.bmj.com).
In case there are any remaining doubters reading the BMJ, we begin with the science. "No science is ever completely settled," writes Chris Rapley in the first article (doi:10.1136/bmj.e1026). "However, among the tens of thousands of scientists working in the field of climate science worldwide there is almost complete agreement that our climate system is changing, and that human activities are the predominant driving force." Equally firmly agreed upon are the risks to health and life, summarised by Tony McMichael and colleagues—risks that are already realities for many of the world’s more vulnerable people (doi:10.1136/bmj.e1359).
What is less clear is how to reduce or even start to reverse the damage before it’s too late. I agree with Robin Stott that a global policy of "contraction and convergence" offers the best hope for our future, addressing climate change and social inequity (doi:10.1136/bmj.e1765). But the political will to achieve this remains elusive. Public engagement and greater efforts to convince politicians will be needed to keep climate change high on the political agenda when the problems of the global economy are so pressing. The question is, can we find a new economics that doesn’t rely on environmentally catastrophic growth, and can we find it in time?
In his introduction to the Spotlight Tony Delamothe finds one ray of sunshine: that low carbon economies can improve health (doi:10.1136/bmj.e2207). In their article, Andy Haines and Carlos Dora explain that health professionals are uniquely placed to promote policies that are good for the planet and for people (doi:10.1136/bmj.e1018). Whether doctors are willing to take a lead on this remains to be seen and is the subject of this week’s poll on bmj.com.

Cite this as: BMJ 2012;344:e2232