Obama wins the Nobel Peace Prize. Is this a joke?

I am still rubbing my eyes in disbelief - UPDATED

So what are the odds? The week I write a cover story for the New Statesman, arguing that President Obama has turned into "Barack W Bush" and is emulating his predecessor's policies on human rights, civil liberties, Afghanistan and a host of other issues, the bloody Norwegians go and give him a Nobel Peace Prize. You couldn't make it up.

Over the past couple of years, the cult of Obama has elevated him to a godlike, saint-like, superhuman position in the global political landscape. He is a celebrity, he is an icon, he is a political phenomenon. And just when you thought his international sheen was rubbing off, with his failure to win the 2016 Olympics for his adopted city of Chicago, he goes and wins the world's most prestigious civil liberties award. Obamaniacs, rejoice!

So why has he got the prize? Here is the flaw in the Norwegians' groupthink, as reported by the BBC:

Asked why the prize had been awarded to Mr Obama less than a year after he took office, Nobel committee head Thorbjørn Jagland said: "It was because we would like to support what he is trying to achieve".

"It is a clear signal that we want to advocate the same as he has done," he said.

So the Nobel guys are giving him an award for peace before he has actually achieved peace -- specifically, they say, in the field of global nuclear disarmament and the Obama resolution at the UN last month -- which, of course, they have a bad track record of doing. Remember when they awarded the Nobel Peace Prize to Yasser Arafat, Yitzhak Rabin and Shimon Peres in 1994? Perhaps the news hasn't reached Oslo yet but, 15 years on, the Holy Land remains mired in bloodshed, hatred and conflict, with no Palestinian state in sight.

And then, of course, there's Henry Kissinger. His receipt of the prize in 1973, in the wake of his war crimes against Vietnam, Laos and Cambodia, prompted Tom Lehrer to remark: "Political satire became obsolete when Henry Kissinger was awarded the Nobel Prize."

I'm not sure what the satirists will say this time round, but I eagerly await Jon Stewart's take on The Daily Show on More 4 next week . . .

UPDATE I (10 December): So Obama has accepted his prize this afternoon, in Oslo. Since I last blogged on Barack and the Nobel [above], the US president has decided to heed the advice of his generals and send 30,000 extra troops to fight and die in the valleys and mountains of the Hindu Kush. The Times headline says it all: "Barack Obama accepts Nobel Peace Prize with stern defence of war". How absurd. And depressing. The 2009 Nobel Peace Prize winner had to start his speech by acknowledging the controversy over the choice of a wartime president for the prize. When Henry Kissinger was awarded the prize in 1973, Tom Lehrer remarked: "It was at that moment that satire died...There was nothing more to say after that." Touché.

UPDATE II (10 December): Simon Reid-Henry has blogged from Oslo for the NS here.

Mehdi Hasan is a contributing writer for the New Statesman and the co-author of Ed: The Milibands and the Making of a Labour Leader. He was the New Statesman's senior editor (politics) from 2009-12.

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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