"As boys we are told to be brave": men on masculinity and mental health

Efforts have been made to challenge traditional stereotypes, but there is still pressure on men to be strong, independent, stoical, competitive and tough. According to research published by the American Psychological Association, these “masculine traits” have been linked with mental health issues such as depression and substance abuse.

Joel Wong, who led the research team at Indiana University Bloomington, said: “In general, individuals who conformed strongly to masculine norms tended to have poorer mental health and less favourable attitudes toward seeking psychological help, although the results differed depending on specific types of masculine norms.”

The research collated results of more than 70 US-based studies involving more than 19,000 men over 11 years. It focused on the relationship between mental health and conformity to 11 masculine norms. They included a desire to win, need for emotional control, and risk-taking.

The traits most closely linked to mental health problems were playboy behaviour or sexual promiscuity, Wong said.

We asked a group to talk about their own experiences of mental health and what they thought of this new analysis.

Daniel Briggs, 44, from Stockton-on-Tees: ‘The pressure to be manly stopped me getting help earlier’

Depression feels like there’s a fog surrounding me. It is closing in and I cannot see what’s in front of me. It’s all-consuming and nothing else matters. I can see the fog building but I am powerless to stop it.

I experienced depression for about a decade before accepting what was going on. As a man it’s definitely much harder to talk about your emotions. It was my wife who made me go to the doctor. I had been behaving erratically: talking about killing myself, disappearing off for hours and leaving her worried sick. I was eventually diagnosed with clinical depression.

I used to work in a shipyard. Among those I worked with there was an old-fashioned view of being a man

Daniel

The pressure to uphold the traditional idea of masculinity stopped me getting help earlier. I come from the north and used to work in a shipyard. Among those I worked with there was an old-fashioned view of being a man – we don’t talk about our feelings. If you get upset about anything other than football you are considered a “sissy”. When people say, “How are you doing?”, if you say “A bit crap” the classic response was: “Could be worse.”

It was the same with older members of my family, who’d say, “Just get on with it”. Don’t complain or talk about what’s going on with you. It took me a long time to open up. Even going to a counsellor was difficult; talking about feelings was something women did.

But talking was exactly what I needed to do, and I am now training to be a counsellor. I lost a lot of friends, especially male ones, opening up about my depression. There’s a huge stigma around it. Doing counselling and getting involved with local charities, people have said talking to me made them feel better. I’ve had men thank me because it made them realise they are not alone. Men need to accept that talking is good and that the hardest part is showing emotion. Walking around with a smile on your face, telling jokes – that’s the easy part. But talking about life and your feelings, rather than how your football team did or how many pints you drank on Saturday night, is much harder.

Photograph: Peter Macdiarmid/Getty Images

Chama Kay, 25, from London: ‘My African parents wanted me to understand: you keep this to yourself’

I have suffered from poor mental health since I was about 16; I remember this vividly because I began to self-harm. It was also around this time that people started saying to me, “You need to talk to someone”. It took three years, two failed relationships and one botched suicide attempt for me to finally take this advice.

Looking back now, aged 25, I can see why, like many men, I found accessing mental healthcare so difficult. Masculine ideals of self-reliance, stoicism, sexual promiscuity and dominance over women do not lend themselves to emotional vulnerability. But it’s important to realise that this is not a mindset that suddenly appears. Rather, it’s instilled into men from a young age. I have personally lost count of the times I have heard parents of young boys admonish their own or other people’s sons for being “too sensitive” or “soft”. So acknowledging and addressing how we raise boys is vital here.

We must not dismiss the role culture plays in how men view and approach mental health. When I was diagnosed with borderline personality disorder there was one clear message my African parents wanted me to understand: you keep this to yourself. For years I was discouraged from getting help and actually felt guilty when I did. For many black communities taboos around mental health undoubtedly exist. But more than this, there is the awareness within these communities that structural racism means black boys, as well as black girls, are already at a societal disadvantage. Higher unemployment rates, longer prison sentences, lack of representation in media, politics and business and numerous other statistics will attest to this. The fear that poor mental health will simply be another stigma for black men to have to fight, coupled with many preexisting taboos, makes for a very tough battle for many.

With all this in mind, I often ask myself what can be done to help. I do not believe any man wants to feel emotionally closed off, lonely and isolated and I know they don’t want to be taking their own lives at the rate they are. By looking at the most sacred commandment of alpha masculinity, I believe it is possible to start to allow many men to address what they truly value, ask whether they are living according to their own standards and hopefully in this way begin to form a healthier relationship with their mental health.

Robert Smith, 50, from Brighton: ‘It’s not about gender or masculine traits – it’s about how much empathy you have’

Over the years I’ve had bouts of depression and anxiety. I’ve experienced severe sleep problems and suicidal thoughts. With years of psychotherapy I now know that all these are symptoms of complex post-traumatic stress disorder (PTSD). This is like PTSD but instead of being caused by a single traumatic event with flashbacks, it is caused by chronic or long-term exposure to emotional trauma.

My mental health has been helped almost exclusively by strong friendships and professional relationships with women and their empathy towards me. Had I been sexist, I can’t see how these important relationships would have developed. So I imagine there is a correlation with sexism and poor mental health, but I doubt that “masculinity” is the cause of poor mental health, rather that classical masculinity, which involves objectifying others, is non-empathetic and perhaps indicates other issues. I would imagine there is a similar correlation with racists and poor mental health. So I would consider the key factor to be one that is not exclusive to men, but affects all people who severely lack empathy and isolate themselves as a result.

In the past I’ve maybe found it harder as a man to talk to people about mental health, but not nowadays. I used to find it harder, because to talk, you need a support network but with severe mental health problems you can scare people off and have no support. Now I have this and I have different people to talk to. But to have empathetic friends, it really helps to be empathetic too, so you can share problems.

Tom Ogier, 31, from London: ‘I’ve only quite recently felt comfortable talking about vulnerability’

It can be very hard to admit vulnerability. Perhaps being a fairly big guy it’s easy to appear manly, to play that role, but the traits of “manliness” leave so little space for other important elements of our humanity. Traits that society might portray as more “feminine,” such as compassion, understanding and care, are essential, and sources of great strength.

Men feel they aren’t allowed to open up, even to themselves, for fear of being seen as weak or unattractive.
From boyhood we are told to be brave and ambitious, overcoming obstacles on sports fields, battlefields, boardrooms. But we don’t see many of the mental challenges we face in this way. They are seen as weaknesses that shouldn’t be there, rather than parts of everyone’s lives.

We will all face grief, loss, and relationship issues, and these challenges take their toll, so we’d do well to seek to equip ourselves with understanding.

Photograph: Rob Mattingley/Getty Images

Being a man: it’s hard to know where to start

Thomas

There’s a Leonard Cohen line I often think of, when he went on stage and couldn’t perform for some reason. He said he didn’t feel strong enough because “somehow the male and female parts of me refuse to encounter one another tonight”. I like the idea of acknowledging that both need to combine in an individual for a person to function. The same is true of society. By balancing notions of strength which tend to be thought of in a binary way, as either feminine or masculine, people might be much healthier. A world without sexism would be better for everyone. Not only would women be respected, but men might be better able to appreciate more feminine traits and strengths, in others and in themselves.

"As boys we are told to be brave": men on masculinity and mental health

Steve Hewlett: ‘People say I’m brave about cancer, but I’m realistic. I’m a storyteller’

Back in March, the broadcaster and journalist Steve Hewlett received the sort of mortal shock that frequently opens a newspaper article about how to deal with a serious illness: he was told by doctors, almost out of the blue, that he had an aggressive form of cancer that would be difficult to treat.

But Hewlett’s long experience as a journalist and media commentator for the BBC meant his story has followed a far less private path than most.

On hearing his diagnosis, Hewlett, 58, found himself, almost without missing a beat, wondering how best to communicate his situation and explain what he was learning along the way.

“My initial reaction, quite genuinely, was just to think ‘OK. My luck has finally run out.’ But there is something about journalism that is quite central to the person I am – a tendency to ask awkward questions. And I have realised over time that if I don’t understand something, it is quite possible that other people don’t either.”

So last month, Hewlett recorded the first of a series of candid radio interviews with Eddie Mair, the presenter of Radio 4’s PM news programme. Hewlett’s illness was not a secret among colleagues, but the impact of his decision to go public and talk on air about his medical journey was to give him the second big shock of his year, and this one was much more welcome.

“The size of the response has been amazing,” he told the Observer. “Hundreds of people are in touch. My social media followers went up by a thousand, for a start. People say I am brave about cancer, but I am just realistic. I have my moments, of course, when I well up.”

Hewlett suspects the strength of the public reaction is due to the rarity of hearing a couple of men just talking in a relaxed way about cancer. Hewlett’s analytical approach has always been no-nonsense, whether interrogating media executives on Radio 4, producing an award-winning 1991 BBC documentary from the Maze prison, or interviewing the late Libyan leader Colonel Gaddafi.

Now, in a chatty style, punctuated by his trademark phrase “to cut a long story short”, he has offered his listeners a down-to-earth assessment of his prospects, with honest reactions to his treatment, from details of his chapped hands and feet to his use of a cold cap to try to prevent major hair loss during chemotherapy.

The veteran radio critic Gillian Reynolds summed it up: Hewlett’s instinct for a strong story, she wrote in the Daily Telegraph, is what “makes him the best reporter on the unfolding story of his own physical change”.

For Hewlett though, Mair is at least half of the reason why the radio interviews work. “I have known Eddie for a long time, though not particularly well. When I was offered the chance to talk about the cancer on air, I suggested his show because it is a fairly free format. If he was willing – and warmed to the idea – I said, go ahead. But I have been amazed by the amount of time given to it. The first was almost a third of the programme. The second almost crashed the 6pm pips.”

Gwyneth Williams, controller of Radio 4, has also suggested that Hewlett record a diary for a separate documentary. “I have never had much trouble talking, after all,” Hewlett drily notes. “And so far I have had few side-effects from treatment.”

The scale of listener reaction is “enormously gratifying” to him and he says he has been especially pleased to hear from former colleagues, from his time as director of programmes at Carlton TV, where he produced the acclaimed Second World War in Colour, and right back to Panorama, where he was in charge when Princess Diana gave her famous “there were three of us in this marriage” interview to Martin Bashir in 1995.

Aside from replying to kind correspondence, Hewlett is persisting with research into potential treatments for his condition: advanced oesophageal cancer. Many of his doctors seem, he says, grateful to discuss possibilities with an informed patient. “I’ve looked up clinical trials and drug development programmes because I have the time. I don’t know how much anyone can do to alter the outcome, but you can make the journey better for yourself.”

The latest news on his condition is not great because the first round of chemotherapy failed two weeks ago, after a beguilingly positive start: “It gave me three or four months of improvement and without that I might not be here now. Now I have uncertainty again. I feel as if I have been given notice, that’s all, but can’t know yet if I will be one of those who respond well to the next kind of chemotherapy. There is only around a 4% chance of full remission in any case.”

There is a tendency to endow people who are confronting death with a superior brand of wisdom. Some deliver on these expectations, providing memorable music, in the case of David Bowie, or poetic visions, like the playwright Dennis Potter. Hewlett, however, is not of a contemplative or morbid bent. He is an enthusiast and, in his own phrase, “a question-asker”. So he has straightforward advice to offer, like the tip, passed on to him by his BBC colleague Nick Robinson, that chemotherapy can make you prone to sunburn.

“Most of us will end up in my position at some point, although it is not quite the same when an older person dies,” Hewlett says. “Then there is something almost orderly, or even natural, about gradually sloughing off this mortal coil. This is different.”

An avowed rationalist, he has now had to reconsider his easy dismissal of the “touchy feely” rhetoric of care. He now “listens to his body”, he says, and admits that the aromatherapy sessions set up by the Royal Marsden have helped him to relax: “It has challenged my attitudes.”

This week he is scheduled to rejoin Mair on PM alongside his three sons, Fred, 29, Bill, 24, and Bert, 19. His openness has helped them, he thinks.

“Some ill people feel an instinct to protect their family and say nothing, and that is common among men, apparently, as well as among mothers. But I found talking helps because it gives them a reason why I am behaving in a particular way. It seems important to tell people who might feel they can only see the same grumpy bastard.”

Hewlett’s long streak of luck, he recounts, started when he was taken from a children’s home in Birmingham as a baby and handed to his adoptive parents, Larry and Vera. “I did luck out there,” he says fondly, before listing a further series of fortunate incidents that shaped his career, starting with the moment he was on hand when the BBC needed a local Manchester journalist to find the identity of two men involved with a crime.

The fates nearly turned against him in the mid-1980s when his student activism was detected by the BBC’s covert vetting system and his contract was terminated. In 1985, his evidence to Observer journalists David Leigh and Paul Lashmar helped reveal the processes by which MI5 once controlled the hiring and firing of BBC staff.

Offered a job on the BBC1 consumer show That’s Life, Hewlett instead took a production role with independent company Diverse, making his name with The Friday Alternative and Brass Tacks, before joining Channel 4, then Carlton, then returning to the BBC.

He has, he says, a “tenacious” grip on a story and remains determined to tell this one. All the same, he is unsure whether to track down his birth parents. There is, he points out, now a genetic interest in finding out what happened to them. He would like to give his sons the information.

“It is a hard one,” he says. “It might be worth it, or it might bring someone a brief agony after a lifetime of emotional pain.”

Maybe caution will win out here. Or possibly Hewlett’s instinct is too strong. “I now realise that is really what I am about. I am a storyteller.”

Steve Hewlett: ‘People say I’m brave about cancer, but I’m realistic. I’m a storyteller’

One dying patient taught me that doing nothing can be brave

“There is something actually, doctor.”

I turned around in relief.

Anxiously twirling my pen, the piece of armoury I still felt most comfortable with as a junior doctor, I hurried back to her bedside, drug chart poised.

Annette was an 82-year-old lady with lung cancer. It was my first month at the hospice. We’d been trying everything to ease her breathlessness. From medications to mindfulness, chest physiotherapy to visits from the chaplain … nothing helped. And now a lump formed in my throat every morning, as I tentatively roused the frail outline curled into a ball, each day bearing a starker resemblance to a child. Her words were interspersed with a soft, gasping rattle, as I’d ask the same question: “What can I do for you Annette?”

I don’t remember learning much about end-of-life care at medical school. Or perhaps I didn’t pay much attention. After all, I went into this job to keep my patients alive. Thinking about death wasn’t a subject that resonated with the newly qualified me, raring to go into action, scenes of bloody heroics reflected in my eyes as I was unleashed onto the wards.

I spent six years being trained how to deploy our ever-expanding arsenal of technology. My satisfaction, and my identity as a doctor, came from a feeling of competence. Just as a sculptor feeds his passion by constructing new statues or a carpenter by chipping away at fragile antiques to restore them to their beauty, so I fed my sense of worth by fixing what was in my control.

I had just about grasped the choreography of medicine: people agree to become our patients and we agree to try and fix them until the very end, as all manner of machinery trill and beep around their frail figures.

But Annette was not being fixed. And I was running out of tools.

“Do you know what I’d really like, doc? Some KFC.”

As I sat with her later, watching her surprisingly nimble arthritic fingers tear apart a bucket of chicken wings, I couldn’t shake the feeling that we’d surrendered. I knew our battle with death can never be won, but I had a niggling unease that we were retreating prematurely.

It soon became a ritual. Every few days I sat with her as she licked her fingertips and painted stories of her childhood. She soon confessed her biggest fear – dying alone at home. She didn’t want us rummaging in our armoury for something else to deflect the grip of death, as it inched closer.

So we listened, and we stopped. A week later, Annette passed away, surrounded by her family. I had never before thought of what a good death should look like. But as I stroked her hair with prickling eyes, I knew that I had just witnessed one.

I began to change my view of end-of-life conversations. I soon saw an irony in them: when it came down to it, done well, they were not about the end at all. They were more about life than any other conversations I had ever had with my patients.

This job has made me contemplate the questions Atul Gawande, a surgeon, writer, and public health researcher, so eloquently asks. Have we built our system around the few patients that exceed survival expectations, at the expense of preparing the rest for a more likely outcome? Through our struggle to curb our medical urges, are we failing to hear what really matters to them at a time when their choices should be most respected? Is there a tendency to preserve every fibre of life, to glorify longevity, over what actually makes our lives worth living?

Our lives are stories, and we want to be the authors. And in stories, the endings count. I’ve learnt that, as doctors, we need to be better at shaping those narratives, at helping patients with their endings.

After six years of medical school, death is a certainty that I must admit I shrank away from. But a picture of Annette and her bucket of KFC is now etched in my memory. I thank her for the lesson she taught me: that sometimes, doing nothing is the bravest decision of all.

If you would like to contribute to our Blood, sweat and tears series which is about memorable moments in a healthcare career, please read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

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One dying patient taught me that doing nothing can be brave

The Brave Previous World of Genetic Engineering

Even after two decades of spectacular scientific, humanitarian and monetary successes and an admirable record of security, the application of genetic engineering (GE) to agriculture is still beleaguered by activists and over-regulated by bureaucrats.  This opposition and obstruction can be traced back to a basic fallacy – namely, that the terms “genetic engineering” and the common shorthand “GMO” (for “genetically modified organism”) represent a meaningful grouping of issues, a “category.”

Genetically engineered organisms and the food items derived from them do not in any way constitute genuine classes, which makes any decision of what to contain in them wholly arbitrary and misleading.  Nor have they been shown to be much less secure or, provided the pedigree of the foods in our diet, in any way less “natural” than thousands of other typical foods.  As FDA has stated in response to calls for mandatory labeling to identify meals created with present day genetic engineering tactics, such labeling would erroneously imply a meaningful difference exactly where none exists.  (And since it would be misleading, it would render the foods “misbranded,” creating its sale a violation of the Federal Food, Drug and Cosmetic Act.)  Although FDA has regularly rejected calls for both a mandatory security assessment or labeling primarily based on the use of specific methods, legislation just proposed in the Residence of Representatives would demand the former.

Best: Lesser cornstalk borer larvae extensively damaged the leaves of this unprotected peanut plant. (Image Variety K8664-2)-Photo by Herb Pilcher. Bottom: Right after only a couple of bites of peanut leaves of this genetically engineered plant (containing the genes of the Bacillus thuringiensis (Bt) bacteria), this lesser cornstalk borer larva crawled off the leaf and died. (Picture Variety K8664-1)-Photograph by Herb Pilcher. (Photo credit: Wikipedia)

Genetic modification by means of assortment and hybridization has been with us for millennia, and the strategies employed along the way, up to these days, are part of a seamless continuum.  Breeders routinely use radiation or chemical mutagens on seeds to scramble a plant’s DNA to produce new traits, and much more than a half century of “wide cross” hybridizations, which involve the motion of genes from a single species or one genus to yet another, has given rise to plants that do not exist in nature they consist of the varieties of corn, oats, pumpkin, wheat, rice, tomatoes and potatoes we buy routinely.  (Yes, even “heirloom” types and the overpriced natural stuff at Whole Food items.)  On common, we eat dozens of servings of these genetically enhanced types of fruits, greens, and grains each and every day: With the exception of wild berries, wild game, wild mushrooms and fish and shellfish, almost almost everything in North American and European diets has been genetically improved in some way.

The erroneous assumption that “genetic engineering” or “genetic modification” is a meaningful group has led to numerous types of mischief, such as the vandalization of area trials and destruction of laboratories state referendum issues and legislative proposals that would require pointless, costly labeling of some GE food items local bans or restrictions and a spate of spurious lawsuits of numerous varieties.  Probably worst of all, it has also led to a quarter-century of unscientific regulatory approaches at the federal level that inhibit the sorts of agricultural innovations that can provide less influence on the all-natural atmosphere, solutions to the troubles of American farmers, and greater food protection for many of the world’s bad.

Despite the fact that laboratory investigation on plants has been robust because the advent of molecular genetic engineering tactics in the early 1970’s, the commercialization of merchandise has been disappointing, largely since of unscientific, extreme government regulation that discriminates against modern day, molecular GE strategies.  For a quarter century, GE crops have been the most scrutinized in human background, with out any scientific justification for such a burden.  They are far a lot more exactly and predictably crafted than their predecessors, and none has triggered even a single instance of documented harm to people or disruption of an ecosystem.  Yet, they are subjected to disproportionately extensive and high-priced regulation.

Despite the fact that hundreds of scientific studies – both formal danger-assessments as nicely as observations of “real-world use” – have confirmed the security of the technology, not only has there been no reduction or rationalization of the regulatory burden positioned on plants created the newer tactics of genetic engineering, but in a lot of circumstances regulatory stringency and burdens are really increasing.

Last December, the European Food Security Authority published a “Scientific Opinion” which concluded that a range of soybean genetically engineered to have increased than normal ranges of oleic acid (which yields a more healthy cooking oil) “is as risk-free as its typical counterpart with respect to likely results on human and animal well being and the surroundings that “bioinformatic analyses and genetic stability studies did not increase security issues” and that the range “is agronomically equivalent to non-[engineered] reference soybeans.”  Moreover, the EFSA security assessment “identified no issues with regards to likely toxicity and allergenicity” and the dietary evaluation of the soybean variety’s oil and “derived foods products did not recognize issues on human wellness and nutrition.”

This kind of conclusions following the evaluation of new genetically engineered crops are common – and yet the panel advised for higher-oleic acid soybeans a “post-marketplace monitoring prepare, focusing on the assortment of consumption data for the European population, for the marketed meals and feed.”  This recommendation is inconsistent, baseless, wasteful, and just plain asinine.

Pursuing what would seem to be an official policy of wastefulness and cluelessness, on January sixteen EFSA held its seventh meeting with representatives from customer and NGOs to “discuss scientific troubles concerning environmental threat evaluation (ERA) and danger assessment concerns for plants” in the non-group of “new biotechnology-based breeding techniques.” However once more that begs the question that those considerations are by some means distinct from people for older, typical biotechnology-based breeding strategies.  It makes 1 wonder why European regulators really don’t convene meetings to go over new designs for perpetual-movement machines or approaches for estimating the variety of angels that can dance on the head of a pin.

The regulatory obstacles that discriminate against genetic engineering impede the improvement of crops with both commercial and humanitarian prospective, and a lot of of the GE crops foreseen in the early days of the technologies have actually withered on the vine as regulatory costs have created testing and business improvement economically unfeasible.

The degree of regulation ought to be commensurate with the degree of risk.  Given the two theoretical considerations and the huge experience accumulated in the course of the past two decades, none of the regulatory regimes for the discipline trials and commercialization of GE crops around the world are scientifically defensible or justifiable.  USDA’s Animal and Plant Well being Inspection Support is no far better than EFSA.

Legislation launched in April in the U.S. Property of Representatives by Reps. Mike Pompeo (R-Kansas) and G.K. Butterfield (D-NC) would mandate but one more escalation of regulation, with no any justification for it.

At current, the FDA operates a voluntary consultation system for genetically engineered food items during which the developer gives the FDA a variety of types of info about the merchandise. Without any recognized exceptions developers have engaged in this voluntary consultation, which is much more than ample to defend American buyers. As mentioned above, there is a broad consensus that there is no scientific explanation to see foods manufactured with modern day molecular techniques as fundamentally different from other meals, so even the “voluntary” consultation – which no food producer dares to flout – is gratuitous and excessive. (Almost identical meals made with older, much less precise and less predictable techniques would not routinely be subject to overview, voluntary or otherwise.)

An additional concern is that a mandatory FDA overview of new genetically engineered foods could constitute a “major federal action” that would trigger FDA procedural obligations below NEPA, the federal National Environmental Policy Act.  In the past, activists acting in poor faith have delayed approvals by bringing several nuisance lawsuits that claimed purely procedural deficiencies below the Act.

Other concerns consist of gratuitous delays and political interference in the assessment of applications.

The Brave Previous World of Genetic Engineering

Oscar Knox, the brave five-12 months-outdated whose battle against cancer moved 1000"s, dies

His family’s fundraising appeal raised the £250,000 needed to spend for immunotherapy remedy in America and his mothers and fathers set up the Twitter account to enable family and pals to obtain updates on his progress. The account quickly acquired thousands of followers.

The political leaders led the tributes following information of Oscar’s death. Mr Robinson said his ideas and prayers have been with his mother and father and sister Isobella.

“Their sense of reduction and devastation is immeasurable,” he explained.

“When I met Oscar I was struck by his infinite vitality and sense of exciting. He had a great capability to conquer the problems he and his loved ones faced together.

“Oscar was an amazing small boy who lived his life to the total and filled those close to him with admiration and hope. He will be deeply missed by absolutely everyone who met and loved him.”

Mr McGuinness stated: “Oscar touched the hearts and minds of everybody and inspired numerous folks by way of his constructive mindset and resilience.

“The day Oscar and his loved ones visited Stormont was one of my most uplifting days in politics and you couldn’t assist but be enthused by his vibrancy and spirit.

“Oscar was a small warrior who faced down sickness and setbacks and showed all of us how precious daily life is.”

Oscar was an enthusiastic Celtic supporter but his campaign was also backed strongly by Glasgow Rangers fans – a measure of the boy’s capacity to unite.

When Celtic played Belfast side Cliftonville in Glasgow final summer time in a Champions League qualifier Oscar was the crew mascot.

Celtic chief executive Peter Lawwell mentioned: “This is totally devastating information and our thoughts and prayers are with Oscar’s mothers and fathers, Stephen and Leona, and his small sister, Izzie, at this desperately sad time.

“We can not even start to recognize the soreness of their loss, but I hope that there will be a modest measure of consolation in realizing that there was real love and affection for Oscar from the Celtic family members during the world.

“Oscar’s courage throughout his sickness was really inspirational, and it was a real pleasure for everyone at the club to meet Oscar when he was our team mascot last July.

“This is a very sad day for the Celtic loved ones but, much more importantly, for the Knox family members, and our thoughts and prayers are with them right now.”

Oscar Knox, the brave five-12 months-outdated whose battle against cancer moved 1000"s, dies

The brave physician taking on Huge Brother

While the HSCIC stresses the alleged benefits of the data collection for epidemiological research, it plays down the commercial implications, yet I suspect it is this that is fuelling the determination to quash rebellion. Researchers have, for decades, found ways of collecting data on population health – information approved by ethics boards and scrutinised to ensure it does not violate confidentiality. Given that researchers have managed until now does suggest that having yet more data is not essential in identifying trends and patterns of illness, and the HSCIC has failed to make a convincing case for it.

Initially, the Government had intended the scheme to be compulsory, as medical records technically belong to the Health Secretary rather than patients. However, ministers have backed down and people are now able to opt out, but only if they state they wish to do so. The Government is clearly hoping most won’t bother because they believe that the new scheme will be anonymous.

I share some of Dr Gancz’s concerns about confidentiality, but I resent also the underhand way that the Government is going about this and the degree to which the public is being hoodwinked.

There are safeguards in place to protect individuals but they are not fail-safe. Given the speed of technological advancement, those safeguards will be breached in time. Maybe this doesn’t matter and, on balance, the benefits of access to such a rich seam of health data outweigh the risks. But if it is really so vital, then why not make the case and allow us to choose? If it’s simply that ministers have identified a novel source of much-needed revenue, then put the economic argument to us and, again, let us decide.

In trying to quash Dr Gancz’s act of rebellion, NHS bosses have made him a cause célèbre for those who feel the Government is becoming Big Brother-ish and dismissive of people’s concerns about confidentiality and privacy. We owe a debt to Dr Gancz, because in taking a lone, principled stand, he has ensured the issue is given the prominence it deserves and that those in power wanted to avoid.

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A ‘cancer envy’ campaign won’t help survival rates

_{Patrick Swayze is one of several celebrities to have died from pancreatic cancer}

To raise awareness of their cause, charities jostle for space in an increasingly crowded market place and some have resorted to shocking and attention-grabbing tactics to get heard.

But the latest campaign from the UK charity, Pancreatic Cancer Action, has gone too far. In print messages and an online film, real patients reveal the stark facts about pancreatic cancer – that, despite it being the fifth most common cancer, survival statistics remain shockingly low at just 3 per cent. Then the patients who feature go one step farther, revealing that ”I’d rather have breast cancer’’.

Of course, I understand the sentiment behind this. It is a chilling fact that pancreatic cancer survival rates remain so low and have barely improved despite decades of research, in sharp contrast to other common cancers.

Regardless of wealth or status, pancreatic cancer is a near-death sentence. Sir James Goldsmith, Luciano Pavarotti, Patrick Swayze and the journalist Simon Hoggart are among those who have succumbed to the disease.

But is ”cancer envy’’ really the way to get this message across? I recently went to a talk arranged by the charity Breast Cancer Care to highlight the plight of those with terminal breast cancer. Around 48,000 women are diagnosed with breast cancer in the UK each year and nearly a third of those will go on to develop the advanced form of the disease, which is terminal. Whilst early breast cancer receives substantial media interest, advanced breast cancer gets little attention, leaving sufferers feeling isolated and forgotten.

Imagine how those women, facing death, feel when they see or hear this campaign. The fact is that all cancer is awful. It disrupts lives, causes pain, suffering and death. Surely we don’t need to descend into a ”my cancer is worse than your cancer’’ competition in order to get a message across.

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Why don’t hospitals train health-care assistants?

One year on from the Francis report, which was sparked by the Mid-Staffordshire scandal, and what, if anything, has changed?

An investigation by the Nuffield Trust has found that more than 80 per cent of NHS hospitals have brought in reforms since the report’s publication last February. The health service is recruiting more nurses to improve care on wards, and there is a noticeable shift in the culture around honesty and openness when it comes to mistakes.

But why, then, according to a report by the Health Services Journal, are a quarter of all hospitals not giving health-care assistants any training before they begin work on the wards?

These assistants have one of the most important jobs in a hospital. They are the people who directly interact with patients – and do so more and more now that so much of nurses’ time is taken up with administration. They are the individuals who will often be delivering the actual care.

You can’t even get a job cleaning pens in an animal shelter without undergoing training. How on earth can hospitals think it is safe and proper to allow health-care assistants to start work without proper training?

Have lessons really been learnt?

Max Pemberton’s latest book, ‘The Doctor Will See You Now’ is published by Hodder. To order a copy, call Telegraph Books on 0844 871 1515

The brave physician taking on Huge Brother