Category Archives: medical

Quotes of the Week

Just three this week …

It is good to rub and polish your mind against that of others.
[Michel de Montaigne]

Our life depends on others so much that at the root of our existence is a fundamental need for love. That is why it is good to cultivate an authentic sense of responsibility and concern for the welfare of others.
[Dalai Lama]

I’m selfish, impatient, and a little insecure. I make mistakes, I’m out of control and at times I’m hard to handle, but if you can’t handle me at my worst, then you sure as hell don’t deserve me at my best.
[Marliyn Monroe]

Quotes of the Week

A rich vein of quotes this week. Here are some of the best …

A committee is a cul-de-sac down which ideas are lured and then quietly strangled.
[Sir Barnett Cocks]

It is a primitive form of thought that things either exist or do not exist.
[Sir Arthur Eddington]

We [doctors] do things, because other doctors do so and we don’t want to be different, so we do so; or because we were taught so [by teachers, fellows and residents]; or because we were forced [by teachers, administrators, regulators, guideline developers] to do so, and think that we must do so; or because the patient wants so, and we think we should do so; or because of more incentives [unnecessary tests (especially by procedure oriented physicians) and visits], we think we should do so; or because of the fear [by the legal system, audits] we feel that we should do so [so called covering oneself]; or because we need some time [to let nature take its course], so we do so; finally and more commonly, that we have to do something [justification] and we fail to apply common sense, so we do so.
[MS Parmar, “We do things because”, British Medical Journal Rapid Response, 2004, March 1 quoted in Imogen Evans, Hazel Thornton & Iain Chalmers, Testing Treatments: Better Research for Better Healthcare]

A wise man makes his own decisions; an ignorant man follows public opinion.
[Chinese proverb]

I am proud that our country remains the scourge of the oppressed. Freedom is once again on the march, as the good people of America join together to wave it goodbye.
GEORGE W BUSH
[Craig Brown; The Lost Diaries]

Born to American-Indian parents, he spent his formative years in abject poverty in Ireland, nibbling on crusts in a tepee in the exclusive slum area of Limerick. Though there were no books in the family home, he occupied his childhood reading the tepee’s assembly instructions over and over again, and in this way gained an unsurpassed command of the English language, as evidenced by his early Tepee Trilogy: Lay the Fabric Flat (1968), With the Long Side Facing Up (1972) and Now Set the Pole in an Upright Position (1975).
[Craig Brown; dust-jacket of The Lost Diaries]

Maturity is only a short break in adolescence.
[Jules Feiffer]

Marriage isn’t a passion-fest; it’s more like a partnership formed to run a very small, mundane, and often boring non-profit business. And I mean this in a good way.
[Lori Gottlieb]

Bullshitology

Having been laid up for the last few days with a nasty stomach upset I’ve been catching up on a bit of reading, and finally finished Bad Science by Ben Goldacre.  As it says on the cover, this is probably “the most important book you’ll read this year”, and that’s if, like me, you’re a scientist.  If you’re one of those weedy, innumerate humanities types it is probably the most important book you’ll read this decade.  Your life will never be the same again!

In the book Goldacre takes the lid off the way in which quacks, Big Pharma and journalists mislead and misinform (deliberately or otherwise) in order to sell their product to the gullible public who have no understanding of the scientific method or how to analyse, interpret and present data meaningfully.  Inter alia he digs the dirt on cosmetics, nutritionists, drug testing and the MMR vaccine scare, examining the way in which the data are misrepresented, misunderstood and outright fiddled.  Goldacre is a practising doctor as well as writing the Bad Science column (and blog) in the Guardian, so he knows whereof he speaks.

You’ll get scared when I say he shows how we all misunderstand risk and the way it is presented, but don’t be!  The book isn’t technical, there’s no nasty maths and lots of explanations and real life examples.  And only a small part of the book is about risk and statistics, although it is a recurrent theme.  You don’t need any maths beyond the ability to do simple arithmetic.  Not only does Goldacre know his stuff he writes in a light readable style which keeps you engaged, incredulous and turning the pages.  Some of it is truly fascinating; some truly horrifying.

If there is one important thing to take from this book it is the way in which risk is not understood and is misrepresented – by most of us and by the media.  Indeed it is so important I’ll run through it here using a simple example I’ve just made up.

BMX Jab Doubles Wobbly Cancer – Mothers Demand Ban says the tabloid headline.  Maybe the BMX vaccine does double the risk of Wobbly Cancer, but what does this really mean?  And are the mothers right to demand a ban?  BMX protects children against Cox-Strokers Disease, a nasty infectious illness which leaves 10% of those infected (boys and girls) either blind or infertile or both.  That’s 1 in 10 of those who get the disease become blind and/or infertile, so for 1000 cases there are 100 children with their lives ruined. Cox-Strokers is endemic in this country with thousands of cases a year and the government insists every child is vaccinated before they start pre-school. But mothers want the vaccine banned because the preventative vaccine puts their kids at double the risk of Wobbly Cancer.  Should they worry?  How much Wobbly Cancer is there?  The data show that the likelihood of any child getting Wobbly Cancer is 1 in 100,000 per year.  BMX doubles that rate so for every 100,000 vaccinated children there would be 2 cases of cancer each year – or one extra case (remember there is one anyway!).  But if we don’t vaccinate the kids for every 100,000 there will be 10,000 (or 1 in 10) cases of blindness and/or infertility.  Now you decide which risk you’d choose for your child – and whether the tabloids are scaremongering!

Even as a scientist I hadn’t fully appreciated the significance of how risk was being (mis-)presented – and I’m supposed to know!  One thing this book has done for me is to stop me reading health and science articles in the mainstream media unless from a reputable science-qualified writer.  Better to keep up with science through blogs written by scientists who do understand and can correctly interpret what data and risk mean.

You really should read this book!

Nobel Prize for Medicine

This year’s Nobel Prizes are being announced this week. In general the Nobel Committee makes good decisions on who deserves recognition in the sciences and it isn’t often that I would quarrel with their choice. I’m not really competent to judge when it comes to the Literature prize. And it seems to me the Peace prize is always something between the doings of the court jester and a political football.

The first of this year’s prizes, announced on Monday, was the prize for Medicine which was awarded to Prof. Robert Edwards who devised (and with Prof. Patrick Steptoe developed) IVF.

I apologise in advance if my view upsets anyone (I know it will some) but this is one science award I will quarrel with. In my view IVF should have been strangled at birth.

I take a basically “egalitarian” view of our relationship with Nature: “Nature must be interfered with as little as possible. There are no safe limits so we must always show caution. Nature is fragile. Any risk is unacceptable.” (OK like all these generalisations that is a slight exageration of the detail of what I believe, but I certainly tend more towards the “egalitarian” view than any other.)

In consequence I feel that if a couple are unable to have children naturally then Nature has some good underlying reason for this and perhaps we should not be playing God. To me IVF is not a step forward but something which we should not be meddling in; it is the medicalisation of a normal part of normal life. Not being able to have children isn’t a life-threatening, debilitating or even disfiguring disease. Compare it with, for instance, on the one hand elective cosmetic surgery and on the other type 1 diabetes. (It is also the first step on the path to eugenics, but that’s a completely different argument which we won’t go into here.)

As such to me IVF is not something worthy of a Nobel prize. That is in no way to belittle Prof. Edwards’ and Prof. Steptoe’s undoubted medical and technical skills and their vision of how to solve the problems from which much has indeed been learnt. (For example, Prof. Steptoe was a pioneer in the development of laparoscopy as a surgical technique.) But just because we have the technology to do something does not mean we have to do it.

Prof. Edwards is on record as saying “The most important thing in life is having a child. Nothing is more special than a child.” All I can say is that if he thinks that putting another mouth to be fed on this planet is the most important thing ever, well I despair. Where are his ethics? Where was his Ethics Committee? Oh, hang on, back in ’60s and ’70s when the work was being done there probably wasn’t an Ethics Committee. Hmmm.

Ig Noble Awards

This year’s Ig Noble Awards for wacky and improbable science discoveries were announced a few days ago. The awards are always fun and often thought-provoking. Here are this year’s highlights. [As usual my comments in italic.]

Physics: Researchers in New Zealand found that wearing your socks over your shoes improves your ability to walk on ice.
[In what way is this not self-evident?]

Management: A mathematical study in Italy found that in some business situations, it is better to promote randomly than the choose the most qualified candidates.
[And you thought the corporate world worked on the basis of who was prepared to sleep with whom.]

Engineering: A team from the UK and Mexico found the perfect way to collect whale snot: despatch petri-dishes attached underneath a remote controlled helicopter to hover above the whale when it blows.
[Ingenious, no?]

Public Health: A study of bearded scientists working in microbial labs found that they carry along a hoard of microbes in their facial hair and may literally be taking their work home with them at the end of the day.
[Again how was this not self-evident?]

Chemistry: A team including BP were awarded an Ig Nobel for their studies over the summer of how oil, natural gas, and water interact.
[Yeah, the Gulf of Mexico makes a great summer field trip for the graduate students.]

And finally …

Biology: A UK team discovered that fruit bats engage in oral sex to prolong their sexual encounters.
[And you worried about human sexuality!.]

You can find the complete list here.

Capital Cures

Browsing Shakespeare’s London on 5 Groats a Day by Richard Tames the other day I came across the following remedies.

Loss of hair. Try doves’ dung, burnt, failing that the ashes of a small frog

Nits in the hair. Comb with mercury ointment and pig fat
Yep that should see off the nits, if it doesn’t see you off first

Head colds. A sliver of turnip in the nostril

Tinnitus. Oil of hempseed in the afflicted ear, followed by hopping on that side

Retention of urine. Three large lice inserted in the penis
Hmm, I can imagine that might work too; not sure I fancy the side effects though

Asthma. The lungs of a fox washed in wine, herb and liquorice
OMG

Tuberculosis. Incurable, but for relief try asses’ milk and snails in their shells

I think on balance I’m glad I live in the 21st century!

'eye 'eewls

High Heels Cause Long-Term Damage says the headline.

We needed scientific research to tell us this?

Twenty years ago I had a colleague who was having serious physiotherapy because she was unable to put her foot flat to the ground, caused by spending too many years wearing 4 inch heels.

Quotes of the Week

Another in the series of things which have struck me, or amused me, this week.

So look, I’m going to say this thing, and you’re going to listen and believe me because … I don’t know, why would you believe me if you haven’t believed it from anyone else? […] Because in the patient corners of your heart, you’ve ALWAYS known it’s true. It’s this:
You’re not broken. You are whole. And there is hope.
[Emily Nagoski at ]

There is evidence that male babbling (what you kindly call Punditry) is a Zahavian handicap.
During both foetal development and puberty, male brains are subject to damage from hormonal processes that convert the female body and neural system into a male one (more or less). This causes males to be, on average, poor at communication. They don’t understand what they hear as well as females, can’t form their thoughts into words as well, and most interestingly, can’t think about one thing while carrying on a conversation with another human at the same time, as females routinely do.
Therefore, ability to communicate at all, let alone well, is very difficult given the handicap of this developmental brain damage. Public communication (babbling/punditry) would indicate relatively high quality for any male that could do it. Thus, all that male babbling.
[Greg Laden in a comment at http://blogs.discovermagazine.com/intersection/]

The Chap Olympiad has a number of things to recommend it, apart from the variety of potential experiences. One is that its resolute promoting of amateurism, eccentric sporting and events cocks an elegant snook at the revolting orgy of corporate arrogant dullardism that infuses all major sporting events. We don’t need their cocacolaMacanike extravaganzas in citizen murdering nations. Stuff ‘em.
[“Minerva” at http://redlegsinsoho.blogspot.com]

There are two means of refuge from the miseries of life: music and cats.
[Albert Schweitzer]

Just as we should cultivate more gentle and peaceful relations with our fellow human beings, we should also extend that same kind of attitude towards the natural environment. Morally speaking, we should be concerned for our whole environment.
[Dalai Lama]

Minds are like parachutes: they only function when open.
[Thomas Dewar]

Quotes of the Week

Another in our occasional series of quotations encountered during he week which have struck me.

Bodies are … I mean, what are they? They’re these sacks of bone and meat and water held together by 2 meters of integumentary tissue. They’re battlegrounds of infection and injury
[…]
A body is a life. My opinion is that bodies, lives, people who have suffered and survived are the MOST beautiful. The marks left on their skins tell us of the strength, the resilience, the power of the person. The so-called flaws of a body show you what a person has made of themselves
[…]
Real bodies, real lives, real people. Real things have scratches.
[Emily Nagoski, ]

“D’you get any good presents?”
“Yeah, me Aunty Jean got me a goat, but they delivered it somewhere in Africa … unbelievable”
[from a Christmas card spotted at ]

Life is full of miracles, minor, major, middling C. It’s called “not being in a persistent vegetative state” and “having a life span longer than a click beetle’s.”
[Natalie Angier, The Canon]

unconstitutionally vague
[US Federal Court of Appeals in rejecting the policy of the FCC on indecent words in broadcasts]

One of the great tragedies of mankind is that morality has been hijacked by religion.
[Arthur C Clarke]