Thursday, March 12, 2009

Abuse Abuse Abuse: Lord Laming & Tick-box Assessment

I published my book The Cockroach Catcher in January, 2008 and in it I lamented:

………“As we move into the new century child psychiatrists are faced with more and more guidelines and protocols.

Since Maria Colwell Social Services have been working under revised Guidelines and Child Protection Procedures. The sad truth is that more children continue to be abused and killed despite these tighter guidelines and procedures.

My hunch is that despite media coverage many of us still fail to grasp the dark side – the dark side of human nature. Until we do, we shall continue to read about child abuse, abductions and murders of the worst kind.

In our work, it is sometimes necessary not to follow strictly some of these protocols.”……

I have long suspected that guidelines and protocols are there to protect the staff but perhaps not anymore.

In The Times today:
Lord Laming: Social services failings are 'causing child deaths'
March 12, 2009

"A complete overhaul of operations within social services departments is urgently needed after serious flaws were exposed which put the lives of children at risk, the author of a Government-commissioned report said today.

"In a damning verdict in response to the Baby P murder, Lord Laming disclosed that many of the recommmendations he gave in a 2003 report into the death of Victoria Climbie had not been implemented and that society was 'letting children down' as a result.

"Outlining a catalogue of problems with the way social workers operate and are managed, he said breakdowns in information-sharing between agencies, poor training gvien to overstretched frontline staff, red tape preventing social workers from doing their jobs, and an obsession with targets had left the system inadequate.

"Disclosing that 55 children or babies were murdered by someone who knew them last year, the report said that 200,000 still live in homes where there is a high risk of abuse or domestic violence."

55 Children, that is a large number of children.

You can read the full report here. ©Crown Copyright 2009

"I think that maybe I failed in the Victoria Climbie report," he said, at the report's central London launch. 'Maybe I didn’t manage to get across the need to achieve that everywhere as well as I should.'"

"The report said that social workers’ professional practice and judgment were being compromised by an 'over-complicated, lengthy and tick-box assessment and recording system' which failed to therefore respond properly to individual cases."

An over-complicated, lengthy and tick-box assessment and recording system!!!

Wednesday, March 11, 2009

Food and Medicine: Fat Duck to Reopen ?Giardia or Thallium

Reuters News Flash:

Fat Duck is to re-open on March 12.

“The only thing that won't be on the menu is seafood, which the health authorities have asked not to be served until all their test results are back.”

So what happened to the Cockroach Catcher’s speculations: was it Giardia or was it Thallium?
Previous Posts

Food and Medicine: Fat Duck
Saturday, February 28, 2009
Blumenthal also suspected that as some of his staff had returned from Venezuela they might have picked up some bug and he is waiting for tests on them. Some of us can be symptomless carriers of germs or even protozoa such as
Giardia lamblia. Good luck with the tests.

Food and Medicine: Fat Duck-An Update
Friday, March 6, 2009
If it is sabotage, then
thallium, which is still available as a rat poison in some countries, will be the main suspect as it is so tasteless that even the highly sophisticated rat cannot tell. Nausea, vomiting, and diarrhoea are indeed the first symptoms that appear within 48 hours after thallium exposure.



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Monday, March 9, 2009

FSA: Probes Probes Probes

Reuters
UPDATE 3-Resolution's Cowdery, chairman, execs probed by FSA
Mar 9, 2009 9:42am EDT

"LONDON, - The founder of British buy-out company Resolution Ltd, insurance entrepreneur Clive Cowdery, is being investigated by Britain's financial watchdog (FSA), as is company chairman Mike Biggs and three others.

"Resolution Ltd said the probe into their actions as directors of Cowdery's previous investment vehicle, also called Resolution (Plc), would undermine its core business acquiring financial services firms because such deals needed Financial Services Authority approval.


"‘The company would not expect to ... complete any acquisition until this matter has been resolved,’ Resolution Ltd said in a statement on Monday.

"The FSA is also investigating three other former Resolution Plc executives who along with Cowdery are involved in running the new venture under the stewardship of John Tiner, a former chief executive of the FSA."


From the
FSA Web site:

“John Tiner joined the FSA in April 2001 after a 25-year career at Arthur Andersen, the accountancy and management consultancy firm. He was an Andersen partner for 13 years and was appointed head of the global financial services practice in 1997.”

He left Andersen just nine months before it collapsed in the wake of
the Enron scandal.


The Independent

FSA chief Tiner to quit for top job in private sector
Wednesday, 17 January 2007

“The chief executive of Britain's City watchdog yesterday said he planned to quit his £572,000 post in July to seek work in the private sector.

"John Tiner, 49, will have been with the Financial Services Authority for six years when he departs, becoming chief executive in 2003. He will remain on the FSA payroll until 2008 and will not be able to work for any financial services business or listed company during that time.

"Mr Tiner has picked a good time to leave the FSA, with tributes from the City ringing in his ears and no major crises on the horizon.

"It follows the decisions of both Richard Harvey, the Aviva chief executive, and James Crosby, who held the top job at HBOS, to depart at times of their own choosing.”

He left the FSA in good time indeed. I wonder if they pay our
Chief Medical Officer £572,000.

Then I found this in the Financial Times Website High Net Worth.

From gamekeeper to poacher – mandarins easily shed their skins
Pádraig Floyd
Published: 01 September, 2008

"Until I got on the train this morning, I knew exactly what I was going to write about in this column. It was then, as I sat thumbing through the press releases on my BlackBerry, that I saw something that changed my mind.

"That something wasn’t that Resolution boss Clive Cowdery is going to float his business, although that was of course very interesting. No, what caught my attention was that he had managed to land the transfer of the season, by securing Jon Tiner, former chief executive of the Financial Services Authority (FSA), as the new CEO.

"
Maybe I am the only person who has a problem with this, because as I write this some hours later, there has been no commentary from any quarter outlining concerns about such an appointment.

"But can it really be right that a man who held the shape and direction of the financial services industry under his control between 2001 and 2007 should then be allowed to work for a company that operates within that regulatory regime?"

You can read the full article here.

New: from The Guardian.

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Friday, March 6, 2009

Food and Medicine: Fat Duck-An Update

Latest: HPA,Colchester Oyster Fishery

Blumenthal savaged by health watchdog

Previous Post:
Food And Medicine: Fat Duck.

Related Posts: Hospital Infection: Quorum Sensing
It May Not Be All In The Mind

The Independent reported:
A thousand of Heston's diners face medical tests
By Martin Hickman, March 6, 2009.

“In its first statement about the outbreak, the Health Protection Agency (HPA), which was called in by the council, said the Fat Duck's managers were ‘co-operating fully’, and added: ‘The number of possible cases reported to the restaurant has risen since media coverage of the outbreak, to about 400 going back to late January and mostly through February.’

“The HPA said it was investigating the characteristics of every person affected, their symptoms and the food they ate. It added that it was planning further tests on ‘all those who ate at the restaurant during this time, whether they reported being ill or not’.

When a large number of people are affected then a chemical poison has to be the prime suspect because some individuals have acquired resistance to infective agents, viral or bacterial. The exception is the highly virulent
E. Coli O157:H7 where as little as 10 can cause serious problems. There often would be fatalities though with E. Coli O157:H7.






Ducks in Teochiu, China © 2008 Am Ang Zhang

In one of my postings It May Not Be All In The Mind it was eventually proved that thallium was the culprit.

If it is sabotage, then thallium, which is still available as a rat poison in some countries, will be the main suspect as it is so tasteless that even the highly sophisticated rat cannot tell.

Nausea, vomiting, and diarrhoea are indeed the first symptoms that appear within 48 hours after thallium exposure.

That is serious sabotage though.


The race is on to find the culprit.

Good luck Fat Duck.


News Update: The New York Times

Thursday, March 5, 2009

Tasmania: Whales & Dolphins-Mother & Baby




The scene of a mass whale and dolphin stranding on King Island
Photographer: John Nievaart of Naracoopa Holiday units


“We see dolphins and whales beaching and dying for reasons we do not understand and men make all the effort to save them and nearly all the time fail.” The Cockroach Catcher


Jemma Blomhoff with her 4 months old daughter Jordyn on her back cares for this dolphin
Photographer: JAY TOWN

Someday Jordyn Blomhoff who was only 4 months old could tell her friends: I was there saving a dolphin. Would being taken to save whales and dolphins at 4 months of age appear on the new DSM or ICD code?

"When I heard, I grabbed some buckets. Jordyn was still in her pyjamas," said Ms Blomhoff, her mother.





Keeping cool
Photographer: John Nievaart of Naracoopa Holiday units

"They told us to find one [animal] and stick to it. Ours was a dolphin. We just tipped water over him continuously. When the water was on his face he would lift his face and open his blowhole as if he was really enjoying it.



"They took him to the water in the carrier and when they put him back, he went silly. They had to hold him so he could get some strength back. He was lifting his tail. It was excellent. So it had a happy ending." From Tasmania’s paper
The Mercury

Others are not so lucky.
It has been a horror summer for Tasmanian whale strandings.



Pilot whales stranded on Seven Mile beach.
Photo: Peter Lord

On November 22, 64 long-fined pilot whales stranded at Stanley in the state's northwest. Eleven were rescued.




The rugged coast of Tasmania which claimed the lives of 155 whales.
Photo: The Examiner Newspaper

On November 29, 155 long-finned pilot whales died south of Arthur River on the West Coast and 32 were saved.

And in January, 48 sperm whales -- the huge species mythologised in the novel Moby-Dick -- died on a sandbar near Smithton in the state's North-West.
Some strandings have been linked to naval sonar activity. In 2005 the Royal Australian Navy said it would avoid areas where whales were known to be stranding.
There is still so little we know about the natural world and the last words go to Sir Peter Scott:



Photographer: JAY TOWN

"We shan't save all we should like to,
but we shall save a great deal more than if we had never tried."

Sir Peter Scott (1909-89)
WWF founder 1961


Grand Rounds Live: Doc Gurly
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Tuesday, March 3, 2009

Seroquel and Sex: Tigger and Eeyore

Cockroach News Catches
For all the news that the Cockroach Catcher finds interesting!


News Updates: Reuters

The domino effect is not just hitting banks but the big Pharmaceutical companies.
Now it is AstraZenica’s turn, AstraZenica is the maker of Seroquel (Quetiapine).
In the Times Business Section:
AstraZeneca tried to 'bury' bad news on Seroquel drug

March 2, 2009

“AstraZeneca tried to “bury” adverse medical studies about Seroquel, its blockbuster drug, internal company memos released in an American court case have revealed.

"The Anglo-Swedish drugs group is being sued by a total of 9,200 patients, most of whom allege that the Seroquel treatment for psychiatric disorders gave them diabetes. As part of a class-action case before a federal court in Florida, AstraZeneca released 102 documents, including an e-mail in which a member of staff praised a colleague for doing a ‘great smoke and mirrors job’ on company research known as ‘study 15’, which found that Haldol, a cheaper generic rival, was more effective than Seroquel.

"John Tumas, head of the company's publications team, said that it had “buried” three studies and was considering burying a fourth, called Costar. Mr Tumas said:

“The larger issue is how do we face the outside world when they begin to criticise us for suppressing data.” Another e-mail implied that the Costar study showed that Risperdal, a rival medicine, was more effective than Seroquel.”

Just as you might think there is some off-label sex use of Seroquel that you are not aware of, calm down. No such luck.

From Florida (not
Alaska) The St Petersburg Times:
Facing numerous Seroquel lawsuits, drugmaker AstraZeneca releases documents By Kris Hundley, February 28, 2009

“The public got a glimpse into the inner workings of a global pharmaceutical company Friday when AstraZeneca released more than 100 sealed documents in a tsunami of lawsuits claiming its powerful antipsychotic Seroquel caused diabetes, weight gain and other health problems.”

Among the documents:

“A Chicago psychiatrist who claimed patients lost weight on Seroquel had his research touted in AstraZeneca's marketing materials — then trashed in interoffice memos.”

Amongst the arguments:

“Steve McConnell, AstraZeneca's attorney, argued that the remaining papers must remain confidential because they contain trade secrets and other proprietary information. Among the sealed documents are results of two clinical studies, sales' reps call notes since January 2004 and correspondence with foreign regulatory authorities.”

“But U.S. Magistrate Judge David Baker was skeptical. ‘What about the public interest in reviewing the integrity of the FDA's administrative process?’ he asked from the bench.”


Could it be this that AstraZeneca wanted to hide?

From BNET Pharma:
AstraZeneca's Sex-for-Studies Seroquel Scandal: Did Research Chief Bias the Science?
By Jim Edwards February 25th, 2009

“An AstraZeneca executive in charge of clinical research on Seroquel had sexual affairs with a researcher and a study writer, plaintiffs in a Florida lawsuit claim.
BNET first wrote about the sex-for-secrets aspect of the Seroquel litigation on Feb. 17.

Now Furious Seasons blogger Philip Dawdy revealed a dynamite legal filing describing how Dr. Wayne MacFadden, AZ’s former US medical director for Seroquel and director clincial research in CNS had affairs with a clinical researcher who authored publications favorable to Seroquel, and a medical marketer who promoted Seroquel through medical publications and other means.”
The plaintiffs claim the affairs may have biased the science. AstraZenca is seeking to exclude the evidence.


AstraZenca made this statement to
Furious Season (apparently the only organization that did reply and to a blogger!):

“MacFadden became involved in a sexual relationship with an Institute of Psychiatry (London, England) researcher who, as well as being involved in other Seroquel-related projects, participated in the clinical research and abstract preparation relating to the effectiveness of Seroquel for use in the treatment of schizophrenia. Their affair lasted from 2002 to 2006.


“Sometime during 2004, while collaborating with Parexel and while still involved in a sexual relationship with the IOP researcher, MacFadden became involved in a sexual relationship with the Parexel Program Manager responsible for AstraZeneca.

“The nature of their communications suggest a level of control and dependence between Macfadden and these women.

“The IOP researcher suggested that Macfadden would ‘punish’ her if she even looked at studies that were favorable to Seroquel’s competitors. He actively encouraged her to conduct research the results of which would be favorable to Seroquel and AstraZeneca, and promised sexual favors in exchange for intelligence on Astrazeneca’s competitiors.

“In addition to his sexual involvement with the Parexel program manager, it appears he [Macfadden] also provided her with prescription painkillers.”


Now would the FDA need to look at Bolder 1 and Bolder 2 again and revise its approval of Seroquel for Bipolar Disorder. The Cockroach Catcher always feels that there is great snobbery in Psychiatry. Bipolar is an acceptable diagnosis but not Schizophrenia. So drug firms preferred to have their anti-psychotics approved for Bipolar.

An eight week trial for Bipolar (which Bolders were) is hardly long enough in my book but it would not have mattered:

“Macfadden agreed that sexual relationships between clinical researchers and management members of pharmaceutical companies can create bias which can affect the integrity of the science. Macfadden also acknowledged that sexual relationships can affect a person’s judgment. Although Macfadden denies that his multiple sexual relationships with these women created a conflict of interest, he in fact teased the IOP researcher about the obvious conflict of interest as he reviewed drafts of her papers on Seroquel.”

You can download the filing for yourself
here.

Last year BNET had an interesting report on AstraZeneca.
AstraZeneca Allegedly Recruits Tigger and Eeyore to Sell Seroquel
By Jim Edwards November 6th, 2008







A. A. Milne /E. H. Shepard


“According to Ed over at Pharmalot, ‘the idea was conveyed at a national sales meeting and on field rides with sales reps, who were told to use Tigger as a bipolar patient and Eeyore — the down-in-the-mouth donkey — as a depressed patient. The reps were allegedly encouraged to use Tigger dolls (licenced to Disney) as giveaways, for instance.’”


Tigger bipolar! Com'on, something should remain sacred for our children’s sake.




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Saturday, February 28, 2009

Food And Medicine: Fat Duck.

Latest: HPA,Colchester Oyster Fishery

The Guardian Headline:
Heston Blumenthal's Fat Duck shut over food poisoning scare
Friday 27 February 2009

"He is often described as a 'culinary alchemist' and tonight the owner of the Michelin starred Fat Duck restaurant was desperately seeking a panacea after a food poisoning scare closed his dining room.

Heston Blumenthal has shut the award-winning eatery - described in 2005 as the 'the best place to eat on earth' - after up to 40 diners called in to say they were feeling unwell."

The first idea that came to my head was that it must be the work of the Norovirus which normally hits luxury cruise ships such as the QE II in 2007.

Unlikely though as the environment was different.

The time lag of symptom emergence points to some clever bacteria, perhaps the ones equipped with
quorum sensing powers. Salmonella and E. Coli all carry such power. E. Coli would have been detected by now and the symptoms a good deal more serious.




Ducks in Teochiu, China © 2008 Am Ang Zhang



Duck is famous for harbouring

Salmonella typhimurium which of course is hitting the headlines in the USA for peanut butter contamination. I doubt if Heston Blumenthal would be using any contaminated peanut butter in his “alchemy”.

“In 2004 - the same year it was awarded a third Michelin star - food and safety officers found 'borderline' levels of listeria in the foie gras and expressed concern that 'no core temperatures of the meat are taken'. The problems were swiftly dealt with, however, and Blumenthal has since introduced stringent procedures.”
The Telegraph.

Listeria can be a problem and as so many customers were involved, they must all have had some foie gras! Chef’s compliments perhaps!

Or was it the cheese table? Many cheeses harbour listeria.

Blumenthal also suspected that as some of his staff had returned from Venezuela they might have picked up some bug and he is waiting for tests on them. Some of us can be symptomless carriers of germs or even protozoa such as Giardia lamblia. Good luck with the tests.

Then there is Ciguatera poisoning, from exotic tropical fish but as the symptoms did not seem to include rash it is unlikely.

Of course one cannot rule out sabotage. Being at the top, you are likely to upset someone some time.

The race is on to find the culprit.

Good luck Fat Duck.

Thursday, February 26, 2009

Cockroach News Catches: Paroxetine and Citalopram

For all the news that the Cockroach Catcher finds interesting!

Looks like GlaxoSmithKline PLC (GSK) is in the news again and this time it is not about
Ribena.

In today’s Wall Street Journal:

U.S. Probes Emory Doctor's Glaxo Ties

FEBRUARY 26, 2009, 12:02 A.M. ET
By
DAVID ARMSTRONG

“Federal officials are investigating Emory University to determine if the school misled the National Institutes of Health about its star psychiatrist's lucrative consulting work for big drug makers, people familiar with the matter said.
The probe by the inspector general for the Health and Human Services agency, which investigates fraud in NIH programs, concerns the work of Charles Nemeroff. From 2003 until last year, Dr. Nemeroff served as primary investigator on an NIH-funded research effort to study five GlaxoSmithKline PLC drugs for use as antidepressants. During that time, Dr. Nemeroff also received hundreds of thousands of dollars from Glaxo.
The NIH requires universities to report potential conflicts of interest to the agency and to ensure research is carried out objectively.
Schools that violate those policies could face sanctions, ranging from fines to a freeze on funding. Emory received $251 million in NIH grants last year, more than half of all the Atlanta school's outside research funding.
An Emory investigation of the matter in December concluded that Dr. Nemeroff failed to report more than $800,000 he received from Glaxo from 2000 to 2006. Dr. Nemeroff stepped down as chairman of the psychiatry department and the school said it wouldn't submit any research requests to the NIH involving Dr. Nemeroff for at least two years.”
This bit in the WSJ is worrying:
“Records obtained by Mr. Grassley show that Dr. Nemeroff played a role in a Glaxo program that was established to aggressively promote the British company's top-selling antidepressant, Paxil (Paroxetine).
Glaxo described this "PsychNet" program in an internal 2000 document as "an ideal way for key opinion leaders to influence clinicians...on the benefits of Paxil versus competitors" and to train doctors to "help build Paxil advocacy."
Dr. Nemeroff was listed as one of two speakers at a March 2000 session in Naples, Fla., to train doctors "on the efficacy of Paxil and the PsychNet presentations." Doctors were paid $2,500 per talk and required to sign agreements barring them from saying how much they were paid or sharing materials Glaxo provided.”


Paroxetine has been in the
UK news before now.

But GSK may not be alone and this time it involves the company directly.

In the New York Times:

Drug Maker Is Accused of Fraud

By BARRY MEIER and BENEDICT CAREY
Published: February 25, 2009


The Justice Department charged the drug maker Forest Laboratories on Wednesday with defrauding the government of millions of dollars by illegally marketing the popular antidepressants Celexa and Lexapro (versions of citalopram) for unapproved uses in children and teenagers.


In a civil complaint filed by the United States attorney’s office in Boston, federal prosecutors alleged that former top executives at Forest concealed for several years a clinical study that showed that the drugs were not effective in children and might even pose risks to them, including causing some to become suicidal.
From 2001 to 2004, Forest heavily promoted results from another clinical trial it had financed that showed that the drugs were effective, without disclosing the negative study to those researchers, its own medical advisers or its sales representatives, the complaint said.


Celexa and Lexapro are two versions of the same drug, citalopram. The drugs are currently approved by the
Food and Drug Administration only for adults.

Prosecutors said in the complaint:

“Forest told prescribing physicians a half-truth and thereby prevented them and the public from having all potentially available information when making decisions about how to treat a serious medical condition in pediatric patients.”


Wednesday, February 25, 2009

Picasso: Challenging the Past

National Gallery
25 February - 7 June 2009



'Seated Woman', 1920 Musée Picasso, Paris

(MP67)© RMN / Jean-Gilles Berizzi / Succession Picasso / DACS 2008






From the National Gallery Website:

The exhibition is organised thematically, showing how Picasso repeatedly returned to the great subjects of the European painting tradition, analysing them as his personal style developed in myriad directions. Sections include self portraits, the Spanish tradition of male portraiture, the female nude, still life, and the seated female figure.


‘Picasso: Challenging the Past’ culminates in a display of the artist’s Variations where, late in life, Picasso makes direct reference to masterpieces such as Velázquez’s ‘Las Meninas’ and Manet’s ‘Déjeuner sur l’Herbe’, turning them into “something else entirely”.




Le déjeuner sur l'herbe after Manet27 February 1960

Oil on canvas
London, Nahmad Gallery© Succession Picasso, 2008

Picasso's Prints: Challenging the Past



This display of 13 prints by Picasso coincides with the major exhibition 'Picasso: Challenging the Past'. It expands on many of the themes of the major exhibition, particularly his exciting ‘variations’ after the masters.




1971© British Museum Images/ Succession Picasso / DACS 2008
The Times is media partner of the Exhibition.

From an earlier Post:

Wednesday, March 12, 2008


Picasso and Tradition
This is how Ibsen was mentioned in The Cockroach Catcher

“The early seventies was a very exciting time in London as the first ever course in Family Therapy in the U.K. was just launched. Gregory Bateson just published Steps to an Ecology of Mind, which to this day still manages to be exciting for anyone interested in family systems – a term coined to describe the interaction within a family or extended family. Of course years before that, Ibsen neatly observed family interactions in Ghosts and Wild Duck. Both plays vividly captured family interaction that has hardly been bettered by any other modern writings.”
Duveen was introduced to me very early on in my career, by the same guru who suggested that I should read Ibsen.
“A startling number of masterpieces now in American museums are there because of the shrewdness of one man, Joseph Duveen, art dealer to John D. Rockefeller, Andrew Mellon, Henry Clay Frick, and William Randolph Hearst.”
I have been visiting museums in the U.S. since the early 1980s. Outside LondonNew York is an excellent place for one’s artistic ventures. Many other cities also have treasures and you may be surprised to hear that Las Vegas is the latest to join the list. It must be the money.

New York © 2008 Am Ang Zhang

When visiting a museum, I am not in the habit of joining guided tours, but prefer to explore on my own. However at one time at the New York’s Metropolitan Museum of Art there was just such a tour starting and I thought I should put away my prejudices and follow the guide.
We stopped in front of a painting, Picasso’s Harlequin (1901), that was to start me thinking about change. Change in every field is often met with criticism and sometimes hostility. Picasso was very talented and he could paint and draw in the classical sense, unlike some modern artists.


Harlequin, 1901 Pablo Picasso 
© 2003 Estate of Pablo Picasso/Artists Rights Society (ARS), New York

Our guide talked about the time when Picasso painted this:
“His friend had just committed suicide. Picasso has in this picture revealed the private sadness behind the public face of this character—an interpretation that has greater resonance when one considers that the artist often regarded his clowns as representations of his alter ego.”
I consider painting a superb way to deal with loss and bereavement and Picasso did it in his own way.
The Girl in a Chemise (1905, photo shown in my previous posting on Anorexia Nervosa) drew attention to Picasso’s astute observation power that made him one of the greatest artists of modern times. The Tate’s own display caption stated:
“…… She is fragile, perhaps sickly. Her delicate pink flesh evokes the skin-colour that Picasso’s friend Guillaume Apollinaire identified among street performers: ’that purplish pink one finds on the cheeks of certain fresh young girls close to death’.”
The next painting we looked at was Gertrude. There was something peculiar about this painting and without the guide, I probably would not have paid much attention.
Gertrude Stein, 1906 Pablo Picasso

© 1999 Estate of Pablo Picasso/Artists Rights Society (ARS), New York
She told us the story of Gertrude Stein, herself a writer and her contribution to modern art was well recognised. When she was in Paris she sat for Picasso – many many sittings indeed. Now look closely again. Gertrude is truly the transition from Harlequin to Cubism. To appreciate this, we were urged to go to MOMA to have a look at Les Demoiselles d'Avignon.

Les Demoiselles d'Avignon 1907 Pablo Picasso, MOMA Collection
©2008 Estate of Pablo Picasso / Artists Rights Society (ARS), New York

The impact of Picasso on the world of art and beyond is immeasurable. One should be encouraged to be innovative and creative in all fields, including psychiatry and medicine.
Review: Telegraph


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