Sometimes scientific experiments and findings can be really beautiful. When this happens we see a real cross-over from science to art. I recently came across a rather technical study from the field of quantum mechanics. Researchers have used a laser to study the wave patterns of movement of nuclei inside hydrogen molecules. As well as producing amazing colourful images which clearly show exactly the phenomena revealed in the experiment, the scientists produced an acoustic version relating the frequencies at the subatomic level to frequencies which we can hear, so letting us understand what’s going on using the musical analogy of notes and chords. The whole experiment is reported here. Do scroll down to reference 2 which gives a clickable link to a short movie file where you can see and hear what happens.
Posted in from the reading room, science | 2 Comments »
I like to look out onto the hills every morning. You’ve maybe seen some of my photos that I’ve taken from my living room windows. In Tokyo, it’s not so easy to see the hills but when I looked really to the side out of my hotel room window, I could see them. Oh, yes, there they are!
Posted in from the dark room, photography | 4 Comments »
Michael Pollan has written a Change This Manifesto about his new book “In Defence of Food”. I love the opening line –
Eat food. Not too much. Mostly plants. That, more or less, is the short answer to the supposedly incredibly complicated and confusing question of what we humans should eat in order to be maximally healthy.
In a three part book, he attacks the dominance of “experts” who promote a reductionist idea of nutrition based on components which are not foods; the Western diet with its imbalances and overload of processed foods; and sums up with 12 commandments to escape from the effects of the Western diet.
Essentially, he is arguing for us to eat whole foods, not industriously produced so-called foods which are manufactured from components; to enjoy our eating as a social experience; and for us to eat more fruit and veg, and less meat. The conclusions then are not ground-breaking but I like the simplicity of the message and the call to treat food as food, not as some utility, and to enjoy the sharing of meals.
Posted in from the reading room, health | Tagged nutrition food | 5 Comments »
As the sun set over Tokyo I snapped this photo of the coppery-reddish sunlight illuminating this office block. It looked like a massive silicon chip or computer motherboard and, somehow, I thought that was really apt.
Posted in from the dark room, photography | 2 Comments »
I looked out of the window of my 18th floor hotel room in Tokyo and saw these guys cleaning the windows.
I loved the glass, the reflections and the sight of the two men perched up there…..I wonder how long it takes them to clean ALL those windows?
Posted in from the dark room, photography | 2 Comments »
Wow! This could be one of the best talks I’ve ever heard. Randy Pausch is a computer science professor at Carnegie Mellon. They run a lecture series entitled “The Last Lecture” where a professor imagines what he’d say if he only had one lecture left to give before he died. Randy Pausch was diagnosed with terminal pancreatic cancer not long before giving this lecture.
He called the lecture “Really Achieving your Childhood Dreams”. It’s funny, it’s inspiring and it’s deeply moving. Here is the video of the lecture. It runs for just over an hour, so I urge you to sit down, relax and watch it through. The hour will fly past, I promise you. And you’ll be SO glad you took the time to watch it.
If you’ve been as impressed by this as I was, you can find out a lot more here.
Here’s a man who knows what it is to be a hero, not a zombie……..
Posted in from the viewing room, life, personal growth, video | 4 Comments »
There has been an accepted wisdom in the management of diabetes. Diabetes, as you probably know is a disease which presents with abnormally high levels of sugar in the blood. It’s actually a complex disease and involves much more than sugar levels but doctors, dietiticians and other experts have always worked on the premise that if you can “normalise” the patient’s blood sugar level, then you’ll reduce the risks they have of the serious harms that come with this disease. One of the most serious potential harms is death from heart disease. Now a study which has run for four years has come up with a totally surprising result.
Researchers took people who have “Type 2” diabetes (by far the commonest form of diabetes, and not the kind that usually required insulin treatment – that’s the kind that affects younger people mainly) and they randomly assigned them to different groups. The study is looking at management of sugar, cholesterol and blood pressure. The groups studied for sugar control were divided into an “intensive” control group and a “less intense” control group. The former group has had diet and drugs to try to maintain a blood sugar level the same as that found in people who don’t have diabetes. Everyone expected that the less well controlled group would suffer more heart disease but the study has just been stopped because so many more people in the “intensive” control group have died from heart disease than in the less well controlled group. This is totally contrary to expectations, and, so far, nobody has come up with an explanation.
The researchers are at pains to say that diabetics shouldn’t give up their drugs because we don’t yet understand what’s going on here and there is still clear evidence that blood sugar levels which go sky high pose a serious immediate risk to health.
Here’s the statement which really struck me though –
Clearly, people without diabetes are different from people who have diabetes and get their blood sugar low.
I suspect the answer to this puzzle will be found when that conclusion is taken on board. Human beings are just not like machines, and the idea that health can be achieved by managing to control the level of a single particular component of the body within an artificially set of “norms” is misguided. You don’t cure diabetes by assuming the only difference between a diabetic and a person without diabetes is the level of the blood sugar.
This is an excellent example of why we need to understand health and disease from a complexity perspective rather than a simplistic, reductionist one.
Posted in from the consulting room, health | 3 Comments »
I lived in Edinburgh both as a medical student and as a general practitioner for a couple of decades. One of my most favourite places in the world is in Edinburgh – The Royal Botanic Gardens. The gardens are pretty extensive and you can see something different every single time you go. I used to go several times a week when I lived close by. Click here and you’ll see a satellite photo of the gardens to give you an idea of their scale. Whenever I had visitors come to stay for a few days, I’d take them to “the Botanics”.
So one day I took two Dutch doctor friends of mine for a visit to the gardens. Like me, they specialise in homeopathic medicine and as we walked around the gardens they were telling me about a homeopathic medicine prepared from the Diospyros kaki tree which survived the nuclear blast in Nagasaki. They’d had some experience using it in helping patients to recover from severe shocks – specifically patients with either Post Traumatic Stress Disorder, or with cancer.
[NB – this is NOT a cure for cancer! Note my colleagues were saying it was of use in helping a patient to recover particularly from a psychological trauma. Homeopathic treatment is not aimed at pathology, the intention is to stimulate the normal repair and recovery processes of a human being, whatever the actual diagnosis. It can be a useful adjunct to treatments designed to deal with any pathologies, but if there is an improvement in the disease, then that improvement is due to the stimulation of self-healing]
Back to my story……….well, I had never heard before that any tree had withstood the blast in Nagasaki but apparently one did. It was a Japanese Persimmon tree (Diospyros kaki), one of the Ebony family of trees. The particular Nagasaki specimen has had cuttings taken and sent all around the world to be planted and nurtured as a “peace tree”. We chatted as we walked over the bridge and into a copse of trees.
What does this Diospyros kaki tree look like I asked my friend. Well, she said, it looks quite like that tree over there and pointed to the nearest tree to where we were standing.
Let’s go and take a closer look I suggested and used my usual technique for identifying trees in the Botanics – I looked at the label!
Well! We were stunned! Of all the trees in the Botanics what on earth were the chances that we’d be standing next to the one example in the gardens of the particular tree we were discussing?!
My Dutch friend said, “I don’t know what you believe about how the world works, Bob, but I’m going to send you a sample of the remedy prepared from the kaki tree.
Before I tell you the next part of the story, have a look at the bark of this tree.
You begin to have an idea why this particular species managed to withstand the nuclear blast. Still, for any tree to withstand it was quite amazing. Diospyros kaki means fruit of the gods and this tree is recognised as highly significant in Japan, the kaki fruits being placed in Shinto shrines. Here’s the fruit at an early stage of development –
My colleague was as good as her word and the following week two vials of the homeopathic remedy arrived for me at the dispensary in Glasgow Homeopathic Hospital.
The following day I had a new patient, a young woman whose recurrent breast cancer disease had recently been described by the oncologists as terminal and who had been told she had very few weeks left to live. She was suffering from nightmares and sleeplessness which none of the sedatives she’d been prescribed had helped and she wanted to try a homeopathic medicine. I’m not going to give any more detail than that here but suffice it to say, I gave her the Diospyros kaki remedy and her sleep immediately returned to normal. In fact, more startling than that, she went on to experience an improvement in her energy and well-being and she went on to live for another couple of years. In those two years she stopped her career, trained in another area altogether, and worked successfully in her new field for a few months before the cancer overwhelmed her and she died.
I’ve used this remedy a few times since in similar circumstances. It’s one of the remedies which really makes me think about our basic concepts of health and healing. It does not cure cancers, but in the right circumstances, in my very small experience with this, it can help a patient cope, and, more than that, even to grow in the presence of severe disease.
[Let me just finish this with a short paragraph about the homeopathic method, because this, I think, is an amazing story. However, I want to make very clear that not only is this not a cure for cancer, but it’s not the relevant medicine for just anyone who has cancer. Every homeopathic prescription is individualised on the basis of the patient’s unique personal story, taking into consideration the disease, the person who has the disease, and the contexts of their life. The patients for whom I’ve prescribed this kaki remedy, and who report that they benefited from it, have all been strikingly remarkable people – pragmatically positive, creative and caring individuals – who share a number of characteristic features]
Posted in health | 6 Comments »
Maybe, like me, you have a collection of “significant” books. By that, I mean books which had a big impact on the way you think, or the way you understand life. I’ve written about some of those books here already, but here’s another one which I read a few years ago. Hans-Georg Gadamer‘s “The Enigma of Health: The Art of Healing in a Scientific Age” is a collection of essays by this professor of hermeneutics (I know, I had to look it up in a dictionary too, but, trust me, this man had a brilliant mind!)
Gadamer died in 2002, and while I was visiting Tokyo, a copy of the Japan Times slid under my hotel room door early one morning, included an obituary about him. I’d never heard of him, but it’s amazing what you’ll read in the wee small hours in a foreign country when your body and your head are still half a day away in your home town! I was completely fascinated with what I read and his thinking about health really captured my imagination so I went online and ordered up “The Enigma of Health” from Amazon. By the time I got back home it was waiting for me. Let me share a few quotes with you. I wrote them down in my Moleskine (as I do!)
Although health is naturally the goal of the doctor’s activity, it is not actually ‘made’ by the doctor.
I make this point with every new patient I see. It’s the big unspoken truth about medical practice. Doctors’ treatments might reduce or remove a pathology, might even redress an inner imbalance, but they don’t cure – only the body does that. He says more about here –
Yet the goal of the art of medicine is to heal the patient and it is clear that healing does not lie within the jurisdiction of the doctor but rather of nature. Doctors know that they are only in a position to provide ancillary help to nature.
Franklin put it another way when he said “God heals and the doctor takes the fees”
I often ask medical students to tell me the answer to this – if a patient with a urinary tract infection gives a urine sample which grows bacteria which the lab shows are sensitive to a particular antibiotic and the patient is prescribed that antibiotic, what will the antibiotic do? The ones who don’t think carefully say the antibiotic will cure the infection. It won’t. It’ll kill the bugs. That’s it. The inflamed bladder wall, which might even be bleeding from the effects of the infection will be restored completely by the body’s repair processes. The healing is natural. The antibiotic only removes the offending bug to let the healing system do its job. This might seem like nit-picking, but it isn’t. It involves a profound change in thinking. Doctors aren’t gods. At best they assist healing and all healing is a natural process.
…the doctor’s power of persuasion as well as the trust and the co-operation of the patient constitute essential therapeutic factors which belong to a wholly different dimension than that of the physico-chemical influences of medications upon the organism or of ‘medical intervention’.
There are some who think that health and illness can be understood in purely physical terms and that treatments can be understood to work, or not work, on the basis of their physico-chemical effects. That’s a limited way of thinking. Healing involves more than that, and may not even involve any physico-chemical intervention at all. Those who think medicine can be reduced to a science (as opposed to a science and an art) rely on measurements of phenomena. Gadamer is brilliant about this –
….modern science has come to regard the results of such measuring procedures as the real facts which it must seek to order and collect. But the data provided in this way only reflect conventionally established criteria brought to the phenomena from without. They are always our own criteria which we impose on the thing we wish to measure.
I believe it was Max Planck who said “facts are what can be measured”. Well, reality cannot be reduced to facts. The tendency to reduce understanding to physical measurements is accompanied by a concept of health as some kind of product – an end point or state which can be known and measured. Gadamer argues instead –
…physicians do not simply create a product when they succeed in healing someone. Rather, health depends on many different factors and the final goal is not so much regaining health itself as enabling patients once again to enjoy the role they had previously fulfilled in their everyday lives.
This clear statement suggests to us that health is an experience and it’s an experience which in its detail will be different for every person depending on the characteristics and environments of their lives. Later in his essays Gadamer considers how far from being a measurable product, health is really what is experienced when illness is not present or goes away. This is the “enigma” of health – that we only know it by its absence. Consider the fingers of your right hand. Right now you’re not really aware of them. Trap them in a car door and then you instantly become aware of them. You get the idea?
This post could go on forever! I’ll stop, but suffice it to say this is a deeply thoughtful consideration of our concepts of health, illness and healing.
Posted in books, from the reading room, health, philosophy | 8 Comments »
Sometimes these days, with the dominant biomedical model of health and illness it can seem like people don’t actually matter. The individual stories of patients are dismissed as anecdotes and treatments are divided into one of two categories “proven” or “unproven” on the basis of statistical analyses of clinical trials (experiments on pre-selected groups of volunteers). The implication is that what works in health care is the intervention, be that a drug or a surgical procedure. Who the patient is, and who the doctor is, seems to be of secondary, or, sadly frequently, of no importance at all.
Yet, if you are ever unwell, I bet it matters to you who you consult and how they behave. I think we all want to consult a doctor who, frankly, gives a damn! I know I do. How many of us would seek a health care system based on dispensing machines which dole out drugs after you input your symptoms?
Amazingly, this idea of the importance of the person in medicine is having to be fought for. So, it was with great interest that I read a review of a book in the BMJ this week. The book is “When Doctors become Patients” by Robert Klitzman (ISBN 978 0 19 532767 0). The author is a psychiatrist who became depressed and was so shaken by his experience of becoming a patient that he set about interviewing other doctors who had become patients too.
Time and again Klitzman found that becoming a patient transformed the doctors’ views (and of practice) of medicine.
Non-specific complaints, side effects such as weight gain and fatigue, fear, humiliation, and spirituality acquired new significance. Struggling to adhere to burdensome schedules, they became less draconian about poor adherence to treatment. In presenting medical information, they became aware of the importance of framing the information sensitively.
I guess this is not a surprise. You’d expect experience to change your views. However, you’ll probably find it more than a little shocking that the doctors needed the illness experience to figure this stuff out. We’re clearly missing something in medical education.
The phrase that really hit me between the eyes though was this –
In choosing their own doctor, most interviewees preferred bedside manner over technical skill.
It’s what I’ve always felt personally. I’ve always felt that what’s really important is that you find a person who cares, listens and puts your interests at the heart of the consultation. I take the technical skill bit as kind of a given. ALL doctors should have the technical skills they need to do the job and the processes of continuing education, annual appraisal and the coming revalidation procedures of the General Medical Council are all designed to ensure that. But what about the human bit? What about the importance of the person? We need to make this case more clearly. Too often, the technical skills are attended to, and then we stop.
Finally, the BMJ reviewer concludes –
Klitzman, like Gawande and Groopman, is part of a contemporary group of reflective doctors who, through their writings, contribute to the less palpable but nevertheless crucial moral, social, and experiential dimensions of medicine.
We need more of this. Maybe we are building a body of knowledge and opinion but we’re sadly lacking in the areas of research into the “experiential dimensions of medicine” and in providing medical education which considers this as of equal importance to the knowledge of drugs, trials and the technical skills required to do surgical procedures.
Posted in education, from the consulting room, from the reading room, health | 8 Comments »
-
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.5 UK: Scotland License. -
Join 2,047 other subscribers
Top Posts
Categories
- art
- books
- creativity
- education
- from the consulting room
- from the dark room
- from the living room
- from the music room
- from the reading room
- from the viewing room
- health
- humour
- life
- movies
- music
- narrative
- neuroscience
- perception
- personal growth
- philosophy
- photography
- psychology
- science
- Uncategorized
- video
- writing
Pages
Meta
Category cloud
Commenting Policy
Archives
- November 2026
- October 2026
- July 2026
- June 2026
- May 2026
- April 2026
- March 2026
- February 2026
- December 2025
- November 2025
- October 2025
- September 2025
- July 2025
- June 2025
- May 2025
- April 2025
- March 2025
- February 2025
- January 2025
- December 2024
- November 2024
- October 2024
- September 2024
- August 2024
- July 2024
- June 2024
- May 2024
- April 2024
- March 2024
- February 2024
- January 2024
- May 2023
- April 2023
- March 2023
- February 2023
- January 2023
- December 2022
- November 2022
- October 2022
- September 2022
- August 2022
- July 2022
- June 2022
- May 2022
- April 2022
- March 2022
- February 2022
- January 2022
- December 2021
- November 2021
- October 2021
- September 2021
- August 2021
- July 2021
- June 2021
- May 2021
- April 2021
- March 2021
- February 2021
- January 2021
- December 2020
- November 2020
- October 2020
- September 2020
- August 2020
- July 2020
- June 2020
- May 2020
- April 2020
- March 2020
- February 2020
- January 2020
- December 2019
- November 2019
- October 2019
- September 2019
- August 2019
- July 2019
- June 2019
- May 2019
- April 2019
- March 2019
- February 2019
- January 2019
- January 2018
- June 2017
- May 2017
- April 2017
- March 2017
- February 2017
- January 2017
- December 2016
- November 2016
- October 2016
- September 2016
- August 2016
- July 2016
- June 2016
- May 2016
- April 2016
- March 2016
- February 2016
- January 2016
- December 2015
- November 2015
- October 2015
- September 2015
- August 2015
- July 2015
- June 2015
- May 2015
- April 2015
- March 2015
- February 2015
- January 2015
- December 2014
- November 2014
- October 2014
- September 2014
- August 2014
- July 2014
- June 2014
- May 2014
- April 2014
- March 2014
- February 2014
- January 2014
- December 2013
- November 2013
- October 2013
- September 2013
- August 2013
- July 2013
- June 2013
- May 2013
- April 2013
- March 2013
- February 2013
- January 2013
- December 2012
- November 2012
- October 2012
- September 2012
- August 2012
- July 2012
- June 2012
- May 2012
- April 2012
- March 2012
- February 2012
- January 2012
- December 2011
- November 2011
- October 2011
- September 2011
- August 2011
- July 2011
- June 2011
- May 2011
- April 2011
- March 2011
- February 2011
- January 2011
- December 2010
- November 2010
- October 2010
- September 2010
- August 2010
- July 2010
- June 2010
- May 2010
- April 2010
- March 2010
- February 2010
- January 2010
- December 2009
- November 2009
- October 2009
- September 2009
- August 2009
- July 2009
- June 2009
- May 2009
- April 2009
- March 2009
- February 2009
- January 2009
- December 2008
- November 2008
- October 2008
- September 2008
- August 2008
- July 2008
- June 2008
- May 2008
- April 2008
- March 2008
- February 2008
- January 2008
- December 2007
- November 2007
- October 2007
- September 2007
- August 2007
- July 2007
- June 2007
- May 2007
- April 2007
- March 2007
