This category includes posts that discuss a particular clinical issue such as unconsciousness, pain, or spasticity
First published: November 21, 2024 Last modified: November 21, 2024 I have agreed to talk, on 6 December 2024, to medical trainees about Acquired Brain Injury rehabilitation. I decided to write a post to help me set out six principles, but as I wrote this post, I realised there was a gaping hole around the […]
Acquired Brain Injury rehabilitation Read More »
Rehabilitation is associated with many R words: restoration, reablement, recuperation, reactivation, recovery, reintegration, and other variations on the theme. Is this a helpful disaggregation of the rehabilitation process, or does it confuse and obfuscate? This post explores this question. This is essential because many people draw distinctions between these and other terms, such as intermediate
Recuperation, recovery, and rehabilitation. Read More »
I am asked to provide second opinions when the local team has difficulty, usually when the patient and family disagree with the rehabilitation team, or there are disputes about funding more rehabilitation. I enjoy the challenge and typically find a way forward. This post is my reflection on how I approach challenging and complex cases.
Resolving complex clinical cases. Read More »
Virtual reality is frequently used to describe rehabilitation treatment and occasionally assessments. But what does the term mean, or, more accurately, what does the user mean by it? Was ‘Return of the [space] Invaders’, released in 1984, virtual reality? It certainly engrossed thousands of people, including me! Knowing what the term means is crucial when
Virtual Reality rehabilitation Read More »
Over 44 years of interest and research in rehabilitation, I have scarcely considered hope except as something likely to cause distress when it is not realised. My interest started on 9 June 2024 when I wrote a page on “goals and hope in rehabilitation,” now published. I only added hope to contrast it with goal
Hope in rehabilitation: an overlooked asset? Read More »
First published: April 6, 2024 Last updated: November 23, 2025 In healthcare, a diagnosis is a label assigned to a health condition. The Oxford English Dictionary defines diagnosis as: “the identification of the nature of an illness or other problem by examination of the symptoms,” and the Cambridge Dictionary as: “a judgment about what a
What is a diagnosis? Part 1 Read More »
The title of this post is deliberately ambiguous. It contains both the issue – how should you make a challenging clinical decision – and the answer – challenge each decision to check that it is sound and justified. Using four recent legal judgments, I will argue that the best way to make a difficult decision
Challenging clinical decisions Read More »
In 1978, I submitted my first paper to the British Medical Journal. It concerned what we now refer to as functional disorders, the phenomenon of illness with no identified disease causing it. I have been interested since. A recent editorial by an Oxford colleague, Anton Pick, discussing whether patients with Long Covid had a functional
Is Long Covid a functional disorder? Read More »
First published: July 20, 2022 Last modified: July 20, 2022 What is a person’s ‘Rehabilitation Potential’? Often this question is asked by one clinician of another about a patient. Still, there is a second interpretation, “What do we mean by Rehabilitation Potential when we ask that question?” I will discuss these questions, but before doing
Rehabilitation potential Read More »
Thinking about prolonged disorders of consciousness Consciousness implies awareness: subjective, phenomenal experience of internal and external worlds. Consciousness also implies a sense of self, feelings, choice, control of voluntary behaviour, memory, thought, language, and (e.g. when we close our eyes or meditate) internally-generated images and geometric patterns. But what consciousness actually is remains unknown. Our
Consciousness – cause and effect Read More »
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