Provocative, entertaining, infuriating: I'm going to miss Louise Mensch

How many British backbenchers are reliably interesting?

So, farewell then, Louise Mensch. I'm going to miss you.

How many backbenchers are reliably provocative, entertaining - and occasionally infuriating? Very few. Our 24-hour news cycle, and the "fishing for gaffes" this inevitably encourages, mean that most junior MPs keep their mouths firmly shut on anything which doesn't directly concern them. (Incidentally, this is why we all fall on the latest story about Boris Johnson whipping Princess Anne with a conger eel or being "ironically" offensive like a man dying of thirst.)

Nowhere was Mensch more effective than on Twitter. Politicians' feeds tend to be a blather of trilling proclamations about their constituency duties, interspersed with solemn attacks on the other side. Not so with Mensch. Every so often, she would toss some chum into the piranha-swamp of lobby correspondents, just for the hell of it. 

Her name change. Her announcement she'd have to be quick at the select committee questioning James Murdoch because she needed to pick up the kids. Her photoshoot for GQ. Her Newsnight appearances. Her alleged facelift. Her mad decision to launch a social network named after her. All these were endlessly pored over, probed for What They Said About Society.

Possibly my favourite Magic Menschment, though, was her admission she'd taken drugs with the violinist Nigel Kennedy. This is how to respond when someone accuses you of getting high in a club in your twenties:

Although I do not remember the specific incident, this sounds highly probable. I thoroughly enjoyed working with Nigel Kennedy, whom I remember with affection. I am not a very good dancer and must apologise to any and all journalists who were forced to watch me dance that night.

Of course, there were plenty of journalists who were ready to dismiss her as a tedious controversialist -- yet this never prevented their papers writing up her latest provocation. (Just a few days ago she stirred up a perfect storm about Labour supporters wishing Margaret Thatcher dead.) 

For all that Mensch was an attention-seeker, the British political press liked having its attention sought. And, presumably, its readers lapped up stories about Mensch even as they loudly proclaimed how much they didn't care about her. Clicks don't lie.

By resigning mid-parliament, in the quiet August recess, Mensch has once again guaranteed herself coverage far out of proportion to her importance. Stand by for articles on whether women can have it all, which will completely ignore the fact that very few women marry someone who lives on a different continent. Brace yourself for pious warbling about her lack of commitment to politics (as if most of our politicians are motivated by nothing but the highest ideals of public service). But most of all, prepare for British politics to get a lot duller. 

We created Louise Mensch: built her up through our desire for someone, somewhere, to say something interesting. And we'll miss her more than she misses us. 

Louise Mensch: so long and thanks for all the LOLs. Photo: Getty

Helen Lewis is deputy editor of the New Statesman. She has presented BBC Radio 4’s Week in Westminster and is a regular panellist on BBC1’s Sunday Politics.

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Want to know how you really behave as a doctor? Watch yourself on video

There is nothing quite like watching oneself at work to spur development – and videos can help us understand patients, too.

One of the most useful tools I have as a GP trainer is my video camera. Periodically, and always with patients’ permission, I place it in the corner of my registrar’s room. We then look through their consultations together during a tutorial.

There is nothing quite like watching oneself at work to spur development. One of my trainees – a lovely guy called Nick – was appalled to find that he wheeled his chair closer and closer to the patient as he narrowed down the diagnosis with a series of questions. It was entirely unconscious, but somewhat intimidating, and he never repeated it once he’d seen the recording. Whether it’s spending half the consultation staring at the computer screen, or slipping into baffling technospeak, or parroting “OK” after every comment a patient makes, we all have unhelpful mannerisms of which we are blithely unaware.

Videos are a great way of understanding how patients communicate, too. Another registrar, Anthony, had spent several years as a rheumatologist before switching to general practice, so when consulted by Yvette he felt on familiar ground. She began by saying she thought she had carpal tunnel syndrome. Anthony confirmed the diagnosis with some clinical tests, then went on to establish the impact it was having on Yvette’s life. Her sleep was disturbed every night, and she was no longer able to pick up and carry her young children. Her desperation for a swift cure came across loud and clear.

The consultation then ran into difficulty. There are three things that can help CTS: wrist splints, steroid injections and surgery to release the nerve. Splints are usually the preferred first option because they carry no risk of complications, and are inexpensive to the NHS. We watched as Anthony tried to explain this. Yvette kept raising objections, and even though Anthony did his best to address her concerns, it was clear she remained unconvinced.

The problem for Anthony, as for many doctors, is that much medical training still reflects an era when patients relied heavily on professionals for health information. Today, most will have consulted with Dr Google before presenting to their GP. Sometimes this will have stoked unfounded fears – pretty much any symptom just might be an indication of cancer – and our task then is to put things in proper context. But frequently, as with Yvette, patients have not only worked out what is wrong, they also have firm ideas what to do about it.

We played the video through again, and I highlighted the numerous subtle cues that Yvette had offered. Like many patients, she was reticent about stating outright what she wanted, but the information was there in what she did and didn’t say, and in how she responded to Anthony’s suggestions. By the time we’d finished analysing their exchanges, Anthony could see that Yvette had already decided against splints as being too cumbersome and taking too long to work. For her, a steroid injection was the quickest and surest way to obtain relief.

Competing considerations must be weighed in any “shared” decision between a doctor and patient. Autonomy – the ability for a patient to determine their own care – is of prime importance, but it isn’t unrestricted. The balance between doing good and doing harm, of which doctors sometimes have a far clearer appreciation, has to be factored in. Then there are questions of equity and fairness: within a finite NHS budget, doctors have a duty to prioritise the most cost-effective treatments. For the NHS and for Yvette, going straight for surgery wouldn’t have been right – nor did she want it – but a steroid injection is both low-cost and low-risk, and Anthony could see he’d missed the chance to maximise her autonomy.

The lessons he learned from the video had a powerful impact on him, and from that day on he became much more adept at achieving truly shared decisions with his patients.

This article first appeared in the 01 October 2015 issue of the New Statesman, The Tory tide