AJ Lees

AJ Lees

@ajlees.bsky.social

Professor of Neurology, National Hospital Queen Square, Institute of Neurology, UCL Writer, Rare Soul,

508 followers191 following166 posts

‘Dr Alberto de Quinteros broad forehead aquiline nose penetrating gaze the very soul of rectitude & goodness opened his eyes in his vast mansion stretched his limbs & felt that sense of well being that comes from 8 hours of restorative sleep and a clear conscience’ #VargasLlosa

I question Big Data driven by the view more is better, new is better and prevention is better I challenge the 4 P slogan of predictive preventative personalised participatory medicine tied to data science Go for a walk, let the music play

I question Big Data driven by the view more is better, new is better and prevention is better I challenge the 4 P slogan of predictive preventative personalised participatory medicine tied to data science Go for a walk, let the music play

I am pleased to report that the premature vested interest drive to introduce a biological definition of Parkinson’s disease a la Alzheimer has sunk like a lead balloon in the UK

‘As scientific explanation becomes more comprehensive, the contribution which may be claimed by an individual approaches zero. Man’s creative powers,achievements in art,science & morals & capacity to choose is inconspicuous in the new scientific self portrait’ B.F Skinner 1948

Listen to this salutary story that has so many lessons. if a normal DAT scan  doesn’t absolutely exclude early Parkinson’s disease why do it in the first place. Second if there is no sequence effect on 20s of tapping - hold your horses @Ed_Jabbari podcasts.apple.com/gb/podcast/2...

podcasts.apple.com2 Parkies in a Pod: a Parkinson's PodcastHealth & Fitness Podcast · Updated fortnightly · If you want to know more about Parkinson's, or how to cope with chronic illness, then this is the Podcast for you. Between them Clarky and Kuhan have b...

As H L Mencken said ' for every complicated problem there is an answer that is simple, plausible and wrong. An example in my field is the notion of removing Lewy bodies from the brain and stopping disease progression in its tracks.

Everyone in the NHS knows that there is not enough capacity in the system and not enough physicians to go round It is in the interest of all of us to pay more and to get rid of pony health insurance schemes that bail out when you get really sick No more elastoplasts

Bring back the Cocoa Tree, White’s and Ozindas the London chocolate houses and serve that dark deep molten cacao that only Andalucians and Madrilenos now know how to serve I miss too the Cocoa forests of Ilheus #TheChocolatePort @dubreviewbooks

I am weary of hearing well nurtured cultivated persons saying all is lost and clever young men and women saying they would have rather lived in the sixties Move on and embrace progress but try to know yourself better and avoid rogue machinery

When all the years of hard work is over, the book is published and the reviews are in the only pleasurable bit starts. Sitting with a group of close friends to discuss the cast for the film that will hopefully follow is a delight like a crumb of gold

“The trouble with quacks is that they cure people”. William Osler Can you be a quack without being a grifter or a privateer? If a quack uses placebos, avoids nocebos is good mannered and intuitive tells no lies and is a sound generalist. What is not to like?

I have always loved being recognised and greeted by baristas, porters and waiters. It has contributed to me being a person of habit. The delight is brief snd low voltage but always makes my day

Clare on Ragwort ( Mare’s Fart) ‘Thy waste of shining blossoms richly shields The sun tanned sward in splendid hues that burn So bright & glaring that the very light Of the rich sunshine doth to paleness turn And seems but very shadows in thy sight’ @JohnClareSoc #JohnClare

I have spent years and hours trying to make my writing clear and simple but still can’t resist throwing in a new word occasionally or using two adjectives when one would do

I have spent years and hours trying to make my writing clear and simple but still can’t resist throwing in a new word occasionally or using two adjectives when one would do

What I love about detective fiction is the mystery and the puzzle element especially when observation and abduction are at the fore. There is no need for violence or even a murder to send me asleep. A missing person or a poison pen letter is sufficient

I learned as a young man that girls did not like grumblers and I have done my best to restrict my curmudgeonry to male company. I remember once being told by my future wife that I had better go home rather than spoil her pleasure through my incessant grousing

If at 80 you're not a cripple or an invalid, if you have your health & still enjoy a walk a good meal & can sleep without a pill, if birds and sea inspire you, you are most fortunate & should get down on your knees & thank the Lord for his savin' & keepin' power. #HenryMiller

Mirabeau Diptych Beach reading while you dance the shag to the Tams, Larry Williams and Chairman of the Board Makes a good present for your doctor and royalties to Parkinson's disease

Another ‘renegade’ who had an enormous early influence on me through his writing was Richard Asher “if the cause of an illness is not known it is necessary to invent one’ Asher believed medical overinvestigation was a form of cruelty as well as profiteering

We need more neurologists who are competent to diagnose and treat all patients with neurological symptoms presenting for the first time in clinic and the emergency department. The growth in subspecialists has become a sort of lifestyle choice

Neurologists are attracted to microscopes and psychiatrists to wide angled lenses Neurologists are noticers psychiatrists are listeners Soulful neurologists and sensitive psychiatrists combine both approaches to explore the pathology of self

The AI developer should be accountable and responsible for rigorous pre and post market efficacy and safety evaluation not the ‘doctor in the loop’ If i dont trust its validity then it is of no value

Proponents for the new anti-amyloid drugs make a comparison with the multiple sclerosis scene 20 years ago believing their introduction will lead to a momentum swing in dementia care and more efficacious immunotherapy All the same i am pleased they are not available on the NHS

Clinical researchers are now counterculture. What was once mainstream is now the province of mavericks and the avant-garde They are adrift between university and public health system, derided by the customer friendly in the emporia

In the NHS control tower devoid from patient care it is the government machinery not the manifesto or the Hippocratic oath that counts- Kafkaesque

Leave your e-silo . Get out into the hospital, walk the walk linger on the wards talking to your patients. Pop down stairs and search out a neuroradiologist Never buzz patients into your clinic. Have a post clinic debrief with the juniors. Skip the hot air meetings

More specialists fair reimbursement of the neurological consultation (should be costed at at least twice an MR scan) Removal of profligate wasteful imaging and unnecessary gadgets Is anyone listening in the bunker?

For evaluating the course of treated Parkinsons disease there is nothing better than the medical interview comparing it with the written previous consultations ( takes 30 minutes) . The examination is a momentary snapshot.Scales are for trials, wearables a waste of time.

I carried out my best research at a time when it was still possible & acceptable to talk with & observe patients over hours in hospital & serially over months. In this way I garnered much more clinically relevant information than could ever be obtained by a battery of wearables

I have been struck how something closely resembling the methods of the Spanish Inquisition has been set up in many universities for the fun of the institutional inquisitors

Who wants to be a fossil before his or her time? - a powerful incentive to discard my old textbooks and continue to attend Grand rounds. But in so doing I have learned that new is not always better and that much important & hard gained knowledge is in danger of being lost

Before ward rounds we convened as a firm over bourbons or croissants to discuss the ward patients and their diagnoses for 1 hour, then do the business round requestioning and reexamining and then communicating the planned management. The nursing sister was always present

I remain fascinated by my ‘lizard brain’ with its prehistoric fears, intuitions, elations and soulfulness. I have always preferred cellars to attics #Basalganglia #amygdala #nucleusaccumbens

I'm talking about emergent grass-roots dancing of the brain that is far greater than its component parts. Cheaper than a Big Mac royalties go to Parkinson's research Press your Amazon button now. A great gift for neurologists psychiatrists and neurophiles. www.amazon.co.uk/Murmuration-...

Old age is a planet to itself where all those minor psychic and physical bumps and scratches are suddenly disinhibited taking on new and suddenly robust lives of their own. Anything that has been ignored or closeted is now lit like a Noir film, shadows looming over the everyday.