A place for things I read, write, and do Zola 2026-02-26T00:00:00+00:00 https://www.glfharris.com/atom.xml 2026-02-26T00:00:00+00:00 2026-02-26T00:00:00+00:00 George L. F. Harris https://www.glfharris.com/posts/2026/peoples-phantom/

<p>Ultrasound-guided vascular access is now a core procedural skill for anaesthetists and intensivists. Teaching it well requires practice on something that behaves like tissue — something that resists the needle, returns recognisable echoes, and lets learners make mistakes without consequences. Commercial phantoms do this. They also cost several hundred pounds each, degrade with use, and generate a meaningful quantity of non-recyclable silicone waste when they reach the end of their life.</p>

2025-07-01T00:00:00+00:00 2025-07-01T00:00:00+00:00 George L. F. Harris https://www.glfharris.com/posts/2025/argus/

<p>Medication errors are one of the more uncomfortable facts of clinical practice. They happen in approximately 10% of ICU patient days, and roughly half of those errors occur at the point of administration — not in prescribing, not in dispensing, but in the final step, when the drug actually reaches the patient.</p>

2025-06-27T00:00:00+00:00 2025-06-27T00:00:00+00:00 George L. F. Harris https://www.glfharris.com/posts/2025/ai-in-anaesthesia/

<p>Artificial intelligence already has changed anaesthesia. Before we called it AI, we called it machine learning, and before that it was simply statistics. These lie on a continuum of methods that allow us to offload thinking. We use their products daily in the form of risk calculators, pharmacokinetic models, and waveform analysis.</p>

2025-06-26T00:00:00+00:00 2025-06-26T00:00:00+00:00 George L. F. Harris https://www.glfharris.com/posts/2025/minerva/

<p>Single best answer questions are the backbone of written medical examinations. They are reliable to mark, hard to game, and well-suited to testing clinical reasoning across a broad curriculum. They are also expensive and slow to produce. Writing a good SBA requires a subject matter expert, familiarity with the examination format, careful calibration of the distractors, and usually several rounds of review before anything goes near a candidate.</p>

2024-12-22T00:00:00+00:00 2024-12-22T00:00:00+00:00 George L. F. Harris https://www.glfharris.com/posts/2024/person-who-has-everything/

<p>It’s that time of year. The one when you’re desperately trying to think of present ideas for your nearest and dearest – maybe they’ve given you a few ideas, maybe they have hobby which requires a steady supply of supporting materials, or maybe you’re just doing booze this year. Just possibly you’ve bought yourself a 3D printer, and are desperately shoehorning printed presents into people’s stockings. So that’s how I came to be printing my brother’s skull.</p>

2024-01-31T00:00:00+00:00 2024-01-31T00:00:00+00:00 George L. F. Harris https://www.glfharris.com/posts/2024/low-background-lexicography/

<p>Almost 79 years ago, in the deserts of New Mexico, atoms were torn apart, releasing colossal amounts of energy, and very importantly not igniting the atmosphere causing nuclear armageddon. Can you tell I’ve watched Oppenheimer recently? Politics, ethics, and morality aside, the 16th of July 1945 is a watershed moment in time. However, we may be standing at another brink in human history, and one that may have a reach further than nuclear fission.</p>

2023-10-02T00:00:00+00:00 2023-10-02T00:00:00+00:00 George L. F. Harris https://www.glfharris.com/posts/2023/be-kind-to-be-cruel/

<p>The General Medical Council wants doctors to be kind, and when the GMC wants doctors to be something, they add it to their set of standards, Good Clinical Practice. On the face of it, this doesn’t sound like it would be too controversial – who wouldn’t want their doctor to be kind? However, this has engendered a slew of discussion, critique, and in some cases, fear.</p>

2023-07-01T00:00:00+00:00 2023-07-01T00:00:00+00:00 George L. F. Harris https://www.glfharris.com/posts/2023/hunterian-museum/

<p>Like many an aspiring doctor, in my youth I undertook the pilgrimage to the Hunterian Museum at the Royal College of Surgeons, Lincoln’s Inn Fields. As London’s finest emporium of grisly things in jars, there was always plenty to entertain, and plenty to inflict on the squeamish. After a long-awaited revamp, delayed slightly by COVID, this Mecca of the medically inclined has reopened at last.</p>

2023-03-13T20:59:13+00:00 2023-03-13T20:59:13+00:00 George L. F. Harris https://www.glfharris.com/posts/2023/legality-of-long-pig/

<p>Medical professionals should not be allowed to congregate in public; that’s my stance, and I am sticking to it. When they do, conversation invariably tends gruesome topics such as rotas, frustrating colleagues, and human cannibalism — apologies to the other patrons of <em>La Terra</em> in Bath last Saturday.</p>

2023-03-11T00:00:00+00:00 2023-03-11T00:00:00+00:00 George L. F. Harris https://www.glfharris.com/posts/2023/anaesthesia-practice-medicine/

<p>To those of us who’ve begun to dip our toes in the history of anaesthesia, the sordid days of ether frolicks, feuds, and misadventures in dental extractions are rather familiar. Involvement in the early phase of inhalation anaesthesia seems to have carried with it an astonishing self-inflicted mortality rate. However, what I’ve enjoyed most about <em>Anaesthesia and the Practice of Medicine: Historical Perspectives</em>, is about what happens next.</p>

2023-02-21T15:45:04+00:00 2023-02-21T15:45:04+00:00 George L. F. Harris https://www.glfharris.com/posts/2022/earl-of-dysart/

<p>Now strictly speaking this is a mark in a book, and not exactly a bookmark, but I have decided to expand the remit. This dedication is found in a copy of <em>The History of the Study of Medicine in the British Isles</em> (1908), by Sir Norman Moore, a famous physician and medical historian, but not a fan of short book titles.</p>

2023-01-24T00:00:00+00:00 2023-01-24T00:00:00+00:00 George L. F. Harris https://www.glfharris.com/posts/2023/the-bearer-of-bad-news/

<p>Breaking bad news is a skill; it’s not something that one is born great at, but takes learning and deliberate practice to improve. Unfortunately, bad news is common in healthcare, while we might wish that everyone gets better, it is the nature of the human condition that eventually we don’t.</p>

2022-11-14T00:00:00+00:00 2022-11-14T00:00:00+00:00 George L. F. Harris https://www.glfharris.com/posts/2022/negative-medical-exam-stereotypes/ <p>I’m currently revising for one of the seemingly endless postgraduate medical exams we have to stump up the money for. This largely involves smashing ones way through online question banks, that you guessed it, are paid for separately. Over time, this becomes a question of identifying give away phrases that point you towards various diseases. For example, if you spend too much time around armadillos you can catch leprosy, restoring an old house turns into lead poisoning, and dipping your toes in Lake Malawi becomes synonymous with schistosomiasis.</p> <figure> <img src="parrot.jpg" alt=""> <figcaption> No prizes for what this malevolent bastard can give you. </figcaption> </figure> <p>Most exams have moved towards the Single Best Answer (SBA) questions, where there is an introductory stem, a question based on that stem, and 5 possible answers. The aim of these questions is to test clinical knowledge and reasoning, and often include two steps, such as asking for the initial treatment for the suspected diagnosis.</p> <p>However, a common affliction amongst question writers appears to be the relaxation into lazy stereotypes in order to cue up a topic. Questions are written on absurd one-dimensional facsimiles of patients, not just targetting bird fanciers and koala huggers, but whole groups of society become indelibly linked with certain diseases.</p> <h2 id="the-businessman">The Businessman</h2> <p>This gentleman has usually recently returned from a business trip abroad, bonus points for Southeast Asia. What pray tell has he got up to apart from rigorous meetings? Unprotected intercourse with local sex workers of course! Because whatever the stem of the question, it is always some form of venereal disease.</p> <h2 id="the-student-nurse">The Student Nurse</h2> <p>Don’t worry, you don’t need to read the lengthy stem featuring nebulous symptoms, it’s Munchausen’s Syndrome. Whether they’re injecting themselves with insulin or stealing a patient’s medication, it’s apparently difficult to make it through nursing school without developing some form of factitious disorder.</p> <h2 id="the-insert-nationality-person">The <em>&lt;Insert Nationality&gt;</em> Person</h2> <p>Time to pick the <em>&lt;insert nationality&gt;</em> eponymous disease of choice.</p> <h2 id="the-female-exam-student">The Female Exam Student</h2> <p>Exams are stressful for everyone, including those slogging their way through postgraduate medical exam question banks. However, in the eyes of the question setters having an upcoming exam is a golden opportunity to snack on a relative’s miscellaneous tablets, especially those with well-defined toxidromes. Special marks go to female high achievers, because who can miss a chance to really hammer home that stereotype.</p> <h2 id="the-man-who-has-sex-with-men">The Man Who Has Sex With Men</h2> <p>It’s HIV. Even when his presentation and symptoms have nothing to do with HIV, it is always HIV. Presents with a cough – it’s an opportunistic infection secondary to his HIV. New rash – oh boy, there’s a whole array of HIV-related skin diseases out there. Comes in with a new presentation of diabetes – his feelings about his new diagnosis of HIV has driven him to indulge, driving a metabolic syndrome and insulin resistance. Starting to get annoyed and cognisant that the treatment and cultural perception of HIV and MSM has come on leaps and bounds since the 1980s? Don’t worry, sometimes it’s HIV and syphilis.</p> <hr /> <p>If you’re starting to see a pattern emerge, you’re not mistaken. It’s a <em>totally shock coincidence</em>, but many of the targets of these stereotypes tend to be the same groups that haven’t historically been treated well by the medical establishment at various points in time.</p> <p>These aren’t limited to revision materials, but feature in the exams themselves, for example the Royal College of Surgeons recently got into hot water for a question about blood-borne viruses in homosexual people. Given that doctors must sit these exams in order to progress in their careers, it doesn’t seem too far to say that we’re being trained to think in these stereotyped patterns.</p> <p>I’m not trying to say that exam boards should ignore demographic as a risk factor in various conditions, but that they should be aware of the assumptions implicit in the questions they set, and the effects this may have on their trainees.</p> 2022-11-10T00:00:00+00:00 2022-11-10T00:00:00+00:00 George L. F. Harris https://www.glfharris.com/posts/2022/tellskapelle-postcard/

<p>This postcard came to me by way of <em>The Story Of A Surgeon</em>, the autobiography of Sir John Bland-Sutton. It’s a rather rambling book, that surprises with the somewhat fast and loose nature of medical education in the period. Now I admit, this bookmark did prove somewhat challenging, as the tight cursive German quickly defeated the limited amount I can recall from my GCSE classes. However, thanks to some kind internet strangers, I have a translation.</p>

2022-07-02T00:00:00+00:00 2022-07-02T00:00:00+00:00 George L. F. Harris https://www.glfharris.com/posts/2022/the-medical-war/

<p>The First World War is notorious for demonstrating the devastating effects that follow when industrialised nations commit to total war with each other. It is among the bloodiest wars thus far in human history, only eclipsed two decades on by World War II, and has shaped international relations in the century since. The world was introduced to chemical weapons, military aircraft, and mechanised tanks, but alongside these offensive innovations was the beginning of what we might call modern medicine applied to the battlefield.</p>

2022-06-23T00:00:00+00:00 2022-06-23T00:00:00+00:00 George L. F. Harris https://www.glfharris.com/posts/2022/letter-to-dr-hern/

<p>Nestled between the pages of <em>Selected Lectures And Essays</em> I found this letter from J. G. Harbottle, a stock broker and mayor of Darlington. Regrettably this is the only half that made it into my book, so what he had the pleasure to enclose is left to the vagaries of time. Regardless, our Dr Hern does not appear to have made it far through his book, as this letter, dated the same year it was published, resided approximately a third of the way through.</p>

2022-06-20T00:00:00+00:00 2022-06-20T00:00:00+00:00 George L. F. Harris https://www.glfharris.com/posts/2022/lag-in-covid-admissions/

<p>During the interregnum in COVID-19 waves in the latter portion of 2020, there was much debate about just when we would need to see the return to mandatory lockdown. From calls for circuit breakers, to desperately trying to hammer home the nature of the phrase “exponential growth”, the general consensus agreed that by the time we started to see a significant shift in the numbers, a large part of the damage would already have been done.</p>

1900-01-01T00:00:00+00:00 1900-01-01T00:00:00+00:00 George L. F. Harris https://www.glfharris.com/about/ <p>I’m a core anaesthetic trainee in the Peninsula Deanery. I studied medicine at UCL, where I also did an intercalated degree in Medical Physics and Bioengineering — which goes some way to explaining what came after. After an academic foundation programme in Wales, I spent two years in ACCS acute medicine in the Severn Deanery before moving into anaesthetics in 2023. Along the way I picked up an MRes in Applied Biomedical Sciences and a PGCert in Clinical Education.</p> <p>Outside of clinical work I build things. Argus is a head-mounted barcode system designed to reduce perioperative medication errors; the People’s Phantom is an open-source ultrasound training phantom that costs under £5 to make; Minerva uses large language models to generate FRCA exam questions indistinguishable from the real thing. Most of this ends up on GitHub.</p> <p>I’m also a reader — specifically of things most people find niche. WWI and WWII military medical handbooks, early physician memoirs, South American botanical expedition diaries documenting the origins of curare. I collect antique medical textbooks with more enthusiasm than shelf space.</p> <p>According to the GMC’s guidelines on <a rel="external" href="https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/doctors-use-of-social-media/doctors-use-of-social-media">Doctors’ use of social media</a>, anyone identifying themselves as a doctor must identify themselves fully by name. My name is George Harris and I can be found on the <a rel="external" href="https://www.gmc-uk.org/doctors/7663041">GMC Medical Register</a>.</p> <h2 id="about-the-site">About the Site</h2> <p>Built with <a rel="external" href="https://getzola.org">Zola</a> and hosted on <a rel="external" href="https://pages.cloudflare.com">Cloudflare Pages</a>. The styling is my own.</p> 1900-01-01T00:00:00+00:00 1900-01-01T00:00:00+00:00 George L. F. Harris https://www.glfharris.com/contact/ <p>Everything here is presented only as my own thoughts and opinions. Where I’ve attempted to make factual claims, I have endeavoured to reference them appropriately. Where I’ve made reference to specific cases, I have redacted or modified details to maintain confidentiality.</p> <p>To anyone I’ve met in real life and lost touch with: I apologise, and would genuinely love to reconnect. I have essentially no social media presence, so email is the best way to find me.</p> <p>If you’ve stuck with me through all that, please feel free to get in contact about anything on or off this site via <a href="mailto:me@glfharris.com">me@glfharris.com</a>.</p>