Dr Robert Lefever

Shapely

Robert Lefever — Fri, 05 Sep 2008 11:35:24 +0000

Some women are too thin. They may not think so but I do. Some women are too fat. Again they may not think so but I do. Some of them are just right – one of them in particular and I tell her so every day.

The Upright Posture

Robert Lefever — Fri, 05 Sep 2008 11:34:06 +0000

Walking on our back legs gives mankind a significant advantage through being taller and therefore able to see further. The disadvantage of chronic backache (the spine wasn’t made to be vertical with one vertebrae pressing down upon the one below. My own spine is crumbling. I am three and a half inches shorter than I was when I was twenty. The x-ray of my lower back is a disaster area. Even so, I don’t find that my spine gives me any great problem. I get the occasional twinges and I just ignore them. I keep myself reasonably fit and that’s that.

There are some patients, whose x-rays look a lot less pathological than my own, who make a great performance out of back pain. One can never judge anybody else’s pain but it seems to me that they may need more help for their heads than for their backs. How we assess our problems, and how we think ourselves through them, may be much more effective than physiotherapy, osteopathy, chiropractic or any number of medicinal or surgical therapies. Backache is simply part of the human condition: it doesn’t necessarily need treatment of any kind.

Decisions

Robert Lefever — Fri, 05 Sep 2008 11:32:33 +0000

I never criticize staff for taking decisions in my absence. If they can’t find me, they need to do what they think is best. They are there on the spot and they can assess the immediate situation. I can’t do that if I’m not there. Therefore I have to respect the decisions that they make. I may subsequently show what I might have done in similar circumstances – but I acknowledge that those circumstances could never be identical to the one in which the staff member had to take the decision. Staff deserve to be backed up: they are doing a difficult job. Anyway, the only way they can learn is to get things wrong sometimes and get things right on others. To take no risk would be a very poor training for any position of responsibility.

What Goes Around Comes Around

Robert Lefever — Fri, 05 Sep 2008 11:31:23 +0000

I gather that after resigning his position at PROMIS (on the strength of wanting to spend more time with his family) he has taken three former patients of ours and set up as a one-to-one counsellor. This happens periodically and I’ve got used to it as part of the inevitable consequence of working with addicts as staff members. Sometimes their recovery isn’t very strong. It cannot be when they have so many hoops to jump through in justifying behaviour that is professionally unacceptable.

I created PROMIS from scratch. I have the capacity to create it again. I don’t need to poach anybody’s patients. My ideas are published: anyone can have them. For that matter anyone can take my patients – if my patients want to go. I don’t own patients: they’re not mine – they are free agents.

The poachers will meet their comeuppance in due course. If they need my patients to start them off, what are they going to do when they need more?

I remember another doctor pinching material of mine to get himself a job in America. He got the job but it was a fatal error. Tenure doesn’t last for more than three years in American Universities. If he needed my work to get him the job, he won’t have the originality to be able to keep it in three years time.

Arrogance

Robert Lefever — Fri, 05 Sep 2008 11:29:24 +0000

He has talent. So has she. Unfortunately they have also got something else in common.

French

Robert Lefever — Thu, 04 Sep 2008 16:15:28 +0000

We have so many French patients in the Recovery Centre at present that I may have to learn their language. Despite having a French (Huguenot) name, I have always held out against that. Why can’t the French do the sensible thing and learn to speak English?

Stroke Update

Robert Lefever — Thu, 04 Sep 2008 16:13:21 +0000

At last he is beginning to do what he is told and spend some time listening to the NLP CDs that are designed to get his non-dominant cerebral hemisphere functioning. This should result in progressive improvement.

The real difficulty with strokes is that they damage the brain so that it doesn’t think and perceive as accurately as before. It is very difficult to motivate a lump of jelly. Also the sheer frustration of not being able to do what one could do previously must be very disheartening. Treatment has to be directed not simply towards physical movements but much more towards mental stimulation. By challenging him in that way, I hope that he will get progressively better. We shall see.

Bicycles and Buses

Robert Lefever — Thu, 04 Sep 2008 16:12:08 +0000

There are too many bicycles and buses in London. I don’t use my car any more. It stays in the garage all week. There is no room on the streets. I know that was precisely Ken Livingstone’s intention but couldn’t he have kept London as it was and relieved overcrowding by encouraging his favourite people to go to Venezuela or Cuba?

Maestro

Robert Lefever — Thu, 04 Sep 2008 16:11:17 +0000

I watched one of the BBC programmes getting amateur musicians to conduct a professional orchestra. What it illustrates most to me is that the orchestra can do without conductors altogether for most of the time. The purpose of the conductor is not simply to best time or give the entries but to inspire. This isn’t a question of public emotionalism but a question of deep understanding of the score. Colin Davies (with whom I had one conducting lesson – in which I recognised that I really did not have the capacity to be a professional conductor) told me that conducting is five percent inspiration and ninety-five percent perspiration: it is sheer hard work.

The Mouse Man Cometh

Robert Lefever — Thu, 04 Sep 2008 16:10:15 +0000

Again. But so do the mice.