It is a sad reflection of the insecurity of most governments throughout
history that at some time or another they have attempted to suppress
linguistic differences. In the case of the deaf community across the world –
notwithstanding the fact that the motivation behind this particular
suppression may have been benign – this has been the cause of much mental,
and even physical pain. As recently as the 1970s, deaf children, myself
included, had their hands slapped and tied behind their backs as they
struggled with the Herculean task of reproducing the sounds of, for them, an
unnatural language that they had never heard.

Mercifully attitudes have changed in recent years. Nonetheless, the
struggle to win recognition for British Sign Language (BSL) as the first and
authentic language of an estimated 50 000 people in the deaf community in
Britain continues. The Dictionary of British Sign Language/English, with its
endorsement by no less an Establishment figure than the Princess of Wales,
is a major step in this struggle.

This volume offers far more than one would expect from a work described
simply as a dictionary. It is clear from quick perusal that the objectives
of the editor and his panel, as they moulded their material into shape, were
as much sociological and political as lexicographical. The descriptive
section of the dictionary follows an introduction dealing with the British
deaf community and its language. This includes a sketch of the history and
culture of deaf people and establishes beyond any doubt, through a careful
description of its morphology and syntax, the credentials of BSL as a
natural language worthy of detailed academic study – a theme which continues
into the heart of the work, the dictionary.

Here the authors get down to describing, in words and two-dimensional
pictures, the nuances of more than 1750 signs of BSL. The difficulties of
doing so are enormous, given that the meaning of each sign, when in use in
BSL, is contained in its motion in three dimensions, with the speed of
articulation, facial expression and lip movement all modifying the meaning
of the sign. The descriptions offered, nevertheless, are scholarly in their
preciseness and go almost further in capturing the articulation of each
sign than one would have thought possible on the printed page. The standards
they have set, even when eventually applied to more versatile technologies
(BSL must, logically, be the first linguistic candidate for description on
CD) will be impossible to better.

Of greater significance, however, is the fact this section of the book is
BSL-led, with signs catalogued according to hand-shape rather than by
alphabetical English gloss. This is the first book which I, at any rate,
have seen in which the principal section is more accessible to a deaf reader
than a hearing one.

Despite its initially rather forbidding weightiness, and its overall
academic tone, this work has already generated much discussion among deaf
people and students of deaf language, so achieving one of its primary
objectives. Having said that, I have two notes of caution. First, it would
be a great shame if the natural development of BSL as the organic, dynamic
language of the deaf community were to be interrupted in any way by notions
of ‘correctness’ which will inevitably accompany the publication of this
dictionary.

Secondly, the authors of the dictionary – and this is an easy criticism of a
work which has emerged over a number of years and cannot be expected to keep
up with every change in common usage – will need to pay attention to the
influence of political correctness, which has resulted in changes to many
signs in BSL in recent years. It is no longer acceptable to indicate that a
man is Jewish, for example, with an iconic sign making reference to a
crooked nose. This is something for exploration in the second edition, which
I hope to see before very long.

John Wilson is an actor and a teacher of BSL who works as a deaf arts
officer. He has been profoundly deaf from birth.

Today, I was asked to dispose of a large plastic bag of assorted tablets
following the death of an elderly lady. I quickly realised that, far from
being the remnants of her most recently prescribed medicines, the contents
were, in fact, the last four or five prescriptions that we had dispensed
for her, in their entirety, with virtually no tablets consumed.

This set us a problem – how to dispose of them. It is both illegal,
and unprofessional practice, to re-dispense medicines to another patient:
we could be accused of defrauding the National Health Service by being paid
twice for the same medicines. Although the usual recommendation to the public
is to flush unwanted medicines down the loo, the quantity that we received
back might, at the least, have blocked ours, and at the worst could contribute
to the overall level of pollution in the local waterways.

This problem of the hoarding of medicines has been recognised for some
years in many parts of the country, where regular DUMP (Dispose of Unwanted
Medicines Properly) campaigns are held. During a DUMP campaign, which is
often called a ‘drugs amnesty’ by the local press as it sounds more dramatic,
the public are invited to return any unwanted medicines and other poisons
to their local pharmacist for disposal.

The organisers of the campaign, who are usually the local authority,
arrange for the returned medicines to be collected at intervals for destruction
by incineration. But the collection of items is examined first, out of curiosity,
to see exactly what has been returned. The last DUMP campaign in Nottingham,
in 1990, produced some 1.8 tonnes of unwanted medicines. Experience in other
parts of the country suggest that this quantity of returned medicines is
quite normal, and indeed each DUMP campaign seems to produce a greater catch,
presumably because the campaigns become better known each time.

Many items returned to DUMP campaigns are quite old, and have obviously
missed the previous DUMP – so that the items returned represent, presumably,
only the tip of a large iceberg of unconsumed medicines. This raised the
obvious question – why don’t people take their medicines?

There has been much research into the problem of ‘patient compliance’,
or, more accurately, of non-compliance. Compliance, here, refers to the
patient following the doctor’s instructions to the letter. Many studies
have depended on counting the number of tablets left in the patient’s bottle
at the end of a specified period. Knowing the dosage schedule, simple arithmetic
will give an indication of the number of doses that appear to have been
taken.

However, this does not mean that the tablets were taken according to
the correct regimen, only that they are no longer in the container! It requires
a leap of faith to assume that the missing tablets were actually consumed
in compliance with the prescriber’s instructions. Recent studies have involved
a small electronic device attached to the tablet bottle, which records the
time of opening. This gives an accurate time of opening, but it still does
not indicate that the medication was taken. Also, the mere presence of the
recording device may influence the patient’s medicine-taking behaviour.

Most studies indicate a generally low rate of compliance with doctors’
instructions. This is very worrying, particularly where the patient is being
treated for a potentially serious condition such as high blood pressure.

Many drugs are presented in convenient once-daily dosage forms, for
instance, tablets which dissolve slowly to release the drug over a period
of hours. Often, the tablets are packaged in ‘calendar-packs’ which have
the days of the week printed on the foil. (The first drugs to have this
kind of packaging were the oral contraceptives.) But even this packaging
is no guarantee of patient compliance.

Why should this be? Theories range from the frankly political (people
do not value things that they have not paid for, and 80 per cent of NHS
prescriptions are free to the patient) to the more mystical. Perhaps the
mere possession of the medicine, in its elegant packaging, may help the
patient to feel better: the presence of the package of tablets in the handbag
or pocket is the ultimate placebo.

A more likely possibility is that people, ill or not, simply dislike
doing as they are told! In spite of frequent complaints about long waiting
lists for appointments, the level of non-attendance at hospital clinics
is far higher than one would expect. Indeed, in the National Health Service,
the letters DNA on patients’ medical case notes have nothing to do with
nucleic acids. They stand for Did Not Attend. This has probably not been
adequately researched.

Overall, the problems, and waste of national resources, represented
by people not following instructions, must be very considerable. A careful
study of the Colman Effect may well pay substantial dividends in health
care. I commend this to Mr Waldegrave.

John Wilson is a pharmacist currently engaged on research into how medicines
are used.

Its origins probably lie in the days of Queen Victoria. Surgeons of
that era, we are told, performed operations in frock coat and top hat, often
not even bothering to roll up their sleeves. The design of the lab coat,
therefore, was probably borrowed from the skirted frock coat; both can be
either single-or double-breasted.

But why white? It is a thoroughly impractical colour for showing dirt,
although perhaps this adds to its attractions for laboratory workers. Mucky
coats were at one time permissible only for individuals engaged in prestigious,
important, expensive or arcane research. In addition, the dirtier the coat
then, by implication, the more prolific the researcher.

Recent correspondence in the pages of the Pharmaceutical Journal on
the wearing or not wearing of the white coat by pharmacists in their pharmacies
has shed some light on one aspect of the history of this rather strange
apparel. It seems that in Glasgow, at the turn of the century, certain pharmacists
in that great city wore black coats, because of the problems of stains from
the sometimes hazardous chemicals that they handled. Those of Scottish descent,
like myself, will applaud this practical and thrifty attitude, although
we might feel concern that the funereal image so presented is somewhat inappropriate
for a supplier of medicines. Most pharmacists, however, have to this day
worn the traditional white coat.

The white coat, in various guises, is the insignia of the worker in
a variety of medical fields. Many health care staff – physiotherapists,
dieticians and others – have smart, distinctive uniforms, usually slacks
and white tops or T-shirts. Dentists and male nurses affect the button-to-the-neck
style with short sleeves. This type of white coat has always struck me as
being eminently sensible and practical: one’s tie cannot flop into one’s
gravy at lunch, or into the pool of blood on the bench, and one could get
away with wearing no tie in summer. However, on the only occasion in several
years’ working in the health service that I wore one of these, I was constantly
being asked for double whiskies. Back to the ordinary lab coat, smartly.

The white coats worn by those working in Britain’s hospitals all look
the same, whether intended for ladies or gents. How then, to distinguish
the profession of the wearer? This is an easy task, since it is not so much
the style of the white coat as the way in which it is worn that identifies
the doctor, pathology laboratory technologist or medical secretary.

Junior doctors always wear their coats open, half off the shoulders.
An obligatory part of the dress is the T-shirt with a slogan; about Nicaragua
if working in a university teaching hospital, and about Bondai Beach for
those based in a provincial general hospital. Senior medical staff, particularly
those consultants of the Old School, like to wear a dark suit, with white
handkerchief peeping from the breast pocket (obviously a vestigial white
coat, left behind during the evolution of their careers).

Those senior staff more concerned with a ‘hands-on’ approach to clinical
medicine, but not wishing to be mistaken for administrators or general managers,
do still retain the white coat. In this case, though, the coat is kept firmly
buttoned. Why, one asks? Two reasons spring to mind. One is to indicate
that the wearer is no longer a junior. However, at what point in their career
progression do the buttons become fastened? An interesting investigation
for a sociology student. The other reason is probably more concerned with
concealing an expanding girth than with sartorial elegance.

I always understood that the prime function of the white coat is to
protect the clothes of the wearer from harm at the hands of the scientific
environment. The only occasion when I have actually spilt chemicals onto
my clothing was many years ago, when I happened to be carrying out an ether
extraction of a highly coloured phenothiazine derivative used as a drug
for destroying intestinal parasites in horses. Yes, the stopper blew out
of the separatory funnel, and the mess went all over my new trousers, not
onto the firm’s old lab coat.

One of the most useful features of lab coats is the pockets. Most of
us, in whatever scientific profession we work, need to carry certain items
with us when we move from our desks. In my case, a pocket calculator is
essential. The status of a scientist can often be told by the number of
items in the top pocket. The more junior the worker, the more pencils, biros,
spatulae and other impediments protrude from the region of the left breast.
Very impressive, until one has to bend down to pick up something from the
floor. Gravity then plays a part in the wearer having to retrieve even more
items from the floor than he or she stooped to pick up in the first place.

Despite all its disadvantages, not least of which is that it is very
hot and uncomfortable to wear in the sort of temperatures that parts of
Britain have recently experienced, most scientists still feel sentimentally
attached to their lab coats. Certainly, the white coat is firmly associated
with science and medicine in the public perception. Anyway, until someone
comes up with a more satisfactory design, most of us will continue to wear
traditional dress in the laboratory. Now, where did I put my calculator?

John Wilson is a pharmacist now engaged in research on doctors’ prescribing
habits.

It was, of course, my treasured slide rule. My father had bought it
for me in 1956 for the princely sum of Pounds sterling 4 10s, as a boost
to my hoped-for career as a scientist. What pride he took in trying to understand
my attempts at explaining the intricacies of the scales, and the purposes
to which it could be put (apart from drawing straight lines!). The slide
rule in my youth was the unmistakable insignia of the technologist – indeed,
Nevil Shute, the aeronautical engineer and novelist, had entitled his autobiography
simply Slide Rule.

Many of my school friends had also purchased slide rules, or received
them as gifts. There were a great many designs and types to choose from.
Although all slide rules had the same basic set of logarithmic scales, different
rules had additional scales, and the various collections of scales were
often given names. Mine is the ‘Darmstadt’, named after the town in Germany,
and was made by Faber Castell.

Many rules were for specialist types of calculations – one could even
get slide rules for financial operations, interest repayments and so on
(would they have coped with today’s interest rates, though?). Although one
could buy cheaper slide rules made entirely of plastic, the best were of
boxwood, with plastic faces. Mine, in addition to wood, also included strips
of brass, to keep the rule perfectly straight over the anticipated years
of use. The slide needed to move very smoothly in the stock, and one could
obtain small pots of special slide-rule lubricant from the stockists, much
as musicians use lubricant for the slide on a trombone. My physics teacher
at school, a great slide-rule enthusiast who owned several, advised me to
use an ordinary candle for lubrication. This I did, and the rule, when I
recently used it again after many years, was still as silky smooth as ever.

Slide rules are by no means a recent invention. Probably the earliest
known was that of Edmund Gunter, who in 1620 plotted logarithms on a 2-foot
linear scale. Addition and subtraction of the logarithms, which allowed
multiplication and division, were carried out by means of a pair of dividers.
Later 17th-century workers placed two logarithmic scales side by side and
moved them parallel to each other, so as to avoid the use of dividers. These
were the forerunners of the slide rule proper, with a slide moving within
a fixed stock. Later, a cursor, consisting of a brass slide moving on the
outside of the stock, and engraved with other lines to aid in complex calculations,
was added. One disadvantage of the linear slide rule was that one could
run off the end of the scales. This was overcome by the creation of circular
slide rules. These were more difficult to make, but gave more convenience
in calculation.

Slide rules were made in all manner of shapes and sizes, ranging from
6-inch versions, made to fit in the top pocket of the ubiquitous white laboratory
coat (the design of which does not seem to have changed in many years, but
that is another story), to monster rules several metres long. The degree
of precision of a slide rule is dependent upon the eye being able to judge
the coincidence of two lines, and of the user’s ability to estimate the
difference if the two lines do not match exactly.

The longer the rule, the greater the precision, and, in theory, the
greater the accuracy of use. In my first job, as an analytical chemist with
a pharmaceuticals company in the early 1960s, we did all the calculations
on a cylindrical slide rule. This consisted of two concentric cylinders
almost a metre long, and was known to us as The Engine. The scales were
wound round the two concentric cylinders in a spiral. This giant corresponded,
or so the handbook said, to a linear rule 90 feet long! Its use was limited
to multiplication and division and the extraction of logarithms – a far
cry from today’s powerful pocket calculators. However, it performed calculations
reliably to four places of decimals.

The advent of the pocket calculator brought a revolution to calculating
as great as that of the digital watch in time-keeping. The most recent calculators
have the power of some of the larger computers of years ago. Indeed, the
Hewlett-Packard HP41CV that I use in my daily work will carry out quite
complex statistical calculations, and is more truly a pocket computer than
a calculator. For all their power and speed, though, calculators do not
have the romance of the slide rule. However, when I demonstrated my rediscovered
treasure to my son, his only comment was ‘I’d rather press buttons’. Such
is progress.

John Wilson writes from Arnold, Nottinghamshire.