Winner of the Wakley prize 2010

Abstract

The “dramatic impact of loneliness” on the life chances and quality of life of many older people in the UK is highlighted in The Forgotten Age, a recent report for the UK’s Centre for Social Justice. This issue prompted Ishani Kar-Purkayastha to write “An epidemic of loneliness”, the winning essay of this year’s Wakley prize. Kar-Purkayastha writes movingly about the profound loneliness of an elderly widow who does not want to leave hospital, and of her own ambivalent feelings towards this patient. At the prospect of “the inevitable infl ux of unwanted grandparents” who will be admitted to the hospital over the holidays, Kar-Purkayastha wonders “how it is that things could have gone so badly wrong”. Her question is central to our beliefs and prejudices about age and ageing. Kar-Purkayastha, who is in her fi nal year of specialist training as an Academic Clinical Fellow in Public Health at the London Deanery in the UK, is a promising writer: her novel Moyna’s Stolen Dances will be published by HarperCollins next summer. The Wakley prize is awarded for the best essay on a clinical topic of public health importance; the winning essay is selected by Lancet editors (masked to the identities of entrants). This year we felt that two other essays were strong contenders and publish them as runners up. “An essay on a topic of international health importance” is written by an Iranian physician who gives a voice to “the medical staff of a hospital in Tehran” and refl ects on the professional and personal constraints of working under a politically repressive regime. In “Health district development and the need to dig deeper”, Ellen Einterz, the District Medical Offi cer for Kolofata Health District in Cameroon, reminds readers of the importance of the district health system and powerfully argues that “It is also the system more sabotaged than sustained by international aid organ isations whose white-knuckle grip on diseasespecifi c pro gram mes prevents them from embracing broader possibilities.” These three essays explore the very diff erent pressures faced by individual doctors practising in contrasting settings—their prose prompting refl ection about the wider role of medicine. For the fi rst time you can listen to all three Wakley essays on The Lancet’s website. We hope you enjoy reading and listening to them.