I thought later about the way we deal with risk in our different cultures. In Spain, if something looks dangerous you take care, in UK we either install so many safety features as to make the experience anodyne or we try to ban it. I wonder how far you can go in trying to make life safe. Imagine how many people would ever play sport if they were warned of the risks.

The winner of the award was Kenneth Gasque who was responsible for bringing the Ironman triathlon to the island. I see that at least 14 people died in triathlons between 2006 – 2008 http://www.medpagetoday.com/PrimaryCare/ExerciseFitness/19422 yet I don’t see any moves to ban triathlons, on the contrary, we applaud the brave athletes (gladiators?) who risk their bodies for glory.

Everything we do in life carries an element of risk, we learn by experience, it’s surely part of the human condition, so where do we draw the line between acceptable and unacceptable risk. Every time I go to a restaurant I risk food poisoning but I imagine the risk is small (provided I avoid oysters). If someone was to take me aside and give me the annual statistics for E-coli deaths and noraviris I might just decide to stay home and have something out of the freezer and miss out on a pleasurable experience.  Should we train our waiters to deliver such information as soon as the diner sits down? And by analogy should our colleges be training osteopathy students to deliver dire warnings of hypothetical and imaginary risks to already anxious patients?

Close up of Castillo staircase – lava holes, no handrails, steep staircase, lethal

Someone else comes down the river drowning. This time the Person turns and walks away upriver. One of the bystanders shouts "Where are you off to ? Aren’t you going to save that one too ?" The Person turns and says "No you can save that one. I’m going to find out who’s pushing them in." Sometime later the person returns downriver. Now there are many more people gathered on the river bank and many more people in the river sweeping past drowning. But the ones on the riverbank are not doing much lifesaving. Instead they have broken up into small groups, many of which are fighting each other or fighting amongst themselves. Quite a few people have bloody noses, there are black eyes and loose teeth are scattered here and there on the ground. The people are fighting about which are the best techniques for lifesaving; whether it is ethical to save lives and if so in what circumstances; whether only certain specially qualified people should be allowed to save lives; what should be done to prevent unqualified people from saving lives; the problems of the possible abuse of the drowning person; the structure of the committees that are needed to look into all the above issues; whether lifesavers have a sufficiently strong theoretical knowledge of the principles of lifesaving; whether only graduates should be allowed to save lives; whether anyone should be allowed to save a life until they have proved themselves competent at putting on their swimming trunks on at least two separate occasions; whether the best way to save lives is to review the literature and write a thesis and a few other important issues.

One group has named itself the British Lifesaving Association and feels that only lifesavers accredited by itself should be allowed to enter the water; it has set up an ingenious accreditation system based on the lifesaving techniques that the practitioner has studied but unfortunately it has forgotten to include any test of whether the practitioner can actually swim. Another group has named itself the Association of Complementary Lifesaving Practitioners; it is more forward thinking and includes in the accreditation process the consideration of whether real swimming can be undertaken but alas only on paper; no one knows whether its practitioners will actually sink or not when thrown in the water. Occasionally somebody jumps into the water and pulls someone who is drowning to the bank. There are mutterings of resentment and criticism from the onlookers. Meanwhile lots of people drown. No one wants to listen to what the Person has learnt upriver.

This was a popular story twenty years ago when osteopathy consisted of seven or more groups, each of whom believed that they were the best and looked slightly askance at the others. Then some of the smaller groups merged and there was a gradual realisation that our similarities were greater than our differences and the exclusive became the inclusive, culminating in the eventual unification of the profession. The Osteopaths Act was passed by parliament in 1993 followed by the opening of the register in 1998.

To get onto the register every osteopath had to submit a detailed "professional personal portfolio" and for many it was a painful and angst-ridden process. Some osteopaths opted for retirement, others gave up the title "osteopath" which was now a protected title, and became osteomyologists or orthopodists or manipulative therapists, but the majority complied with the rules of the new regulator and believed that they were bringing in the golden age of osteopathy.

Fast forward twelve years and there is an emerging feeling amongst osteopaths that the regulator has served its purpose, achieved its original goals and is now clinging on too tightly, indeed stifling the very profession that it once nurtured. This document http://bostforum.org.uk/media/Report_Blog.pdf written by Jason Cook is quite long, but for anyone with the patience to read it, it will give you a stark diagnosis of the current tension building between working osteopaths and their regulators.

I wonder how osteopathy compares. A lot of people find that massage and gentle manipulation eases their pain, maybe the increase in circulation makes the environment less attractive for these anaerobic bacteria. I know a lot of people would prefer not to have to take antibiotics for three months.

This website is going to be a blog about osteopathy, treatment, trauma and  sports injuries, useful products, pain and anything about the body.

Bill