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Culs-de-Sac and Bureaucracies 

Culs-de-Sac and Bureaucracies
Chapter:
Culs-de-Sac and Bureaucracies
Author(s):

Dieter Schmidt

and Simon Shorvon

DOI:
10.1093/med/9780198725909.003.0007
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date: 21 September 2020

This chapter examines some of the curate’s eggs of epilepsy. Examples in which the bright light of success is obscured by shadows cast from the dark side. It starts by pointing out the erratic nature in which science has advanced in the modern period, using the theories of causation of epilepsy as an example. This is not a linear path to the stars but a course influenced by societal and political fashion, with many culs-de-sac and wrong turnings, now as much as in the past. It considers, too, the extraordinary bureaucracies which underpin communication in epilepsy today—the journals, the congresses, and the professional organisations—and that govern the regulation of drug therapy. The landscapes within which these bureaucracies operate are often marked by short-termism, politics of the parish pump variety, the impact of often rather tiresome personalities, and the dead hand of regulation and ‘guidance’. There have been steps forward and some reverses, but most is Brownian movement.

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