![]() For two years, the club occupied a North Hollywood storefront (the name is an allusion to a nearby coffeehouse called Aroma Café) it moved to the grocery-store space in 2000. The Smell, in a former Mexican grocery store on a desolate downtown block, was founded ten years ago by Jim Smith, a union organizer, and two partners. punk rockers-has been reborn in an appealingly communal form, thanks in large part to a local club called The Smell, to a noisy and often brilliant duo called No Age, and to the group’s tight circle of friends. Now the punk-rock phase-which was also a golden age of skateboarding, the primary recreation for L.A. In the early eighties, a loose aggregation of punk-rock bands, including Black Flag and X, were responsible for an explosion of musical activity in the area, and by the end of the decade the hard-rock scene in Hollywood had yielded Guns N’ Roses-along with a fashion for teased hair and tight leather pants, which helped propel the careers of similar but lesser bands. Perhaps the sounds most closely associated with the region are the sunny harmonies of the Mamas & the Papas and the Beach Boys, from the nineteen-sixties, or the soft rock of the Eagles, from the seventies. Popular music in Los Angeles has passed through several golden ages, each unlike the others. As a direct result, patients risk having poorer, less safe care, in hospitals and in the community.Dean Spunt and Randy Randall of No Age, a band at the center of L.A.’s punk-rock scene. It’s difficult not to be angry, as this current surge of cases and burden of suffering was predicted and preventable: we had a chance to flatten this wave, and our government chose instead to do nothing. Crucially, it involves knowing our patients, which might mean visiting elderly and housebound patients with 15 medications and five intersecting diagnoses, helping them achieve the most comfortable life they can, or getting to know complex families on our list so that we can contribute to child safeguarding when they’re in trouble. In primary care this includes all of the organised preventive work we do around long term conditions such as diabetes, hypertension, asthma, and cancer screening. If every day is spent dealing with the urgent, there’s never time to consider the important. But with the acute stress of the pandemic, coupled with an underlying shortage of GPs, for many of us general practice feels increasingly like firefighting. We can manage a few days with an emergency-only primary care service-we do it each Christmas and Easter. ![]() If we have to repeatedly cancel routine clinics, when do we see those displaced patients, who aren’t sure whether they should be worried about their weight loss or who can’t sleep because of pain or worry? They don’t always need to be seen today, but if we only have the capacity to see the most urgent cases, eventually they become emergencies because the patient is more unwell or the pain is intolerable. Of course, we’ll always have a duty doctor available to see anyone who needs urgent assessment, but such on-the-day emergencies should be only a small part of general practice. We managed last week, but the margins are very tight, and I worry about what will happen if more doctors go down. The difficulty of predicting which staff will be in the building on any given day makes it hard to organise a good service for our patients. If they test positive, the shortening of the isolation period from 10 days to as few as seven has not helped hugely, as many remain unwell or still test positive at the end of the first week. Staff must isolate when they have household contacts with proven covid, to keep patients and colleagues safe. Our practice currently has some staff members absent with covid, and several others have been working from home while we try to access PCR tests. There’s no reason to think that the absence rate will be dramatically different from that seen in hospitals-estimated at one in 10 staff members 1-but as most practices are small organisations and the blows fall randomly and unevenly, some may be relatively unscathed while others are on their knees. .ac.uk Follow Helen on Twitter: no centralised data collection, it’s hard to know exactly how short staffed general practice is in this omicron wave.
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