Science Ain't So Bad

THE MISERABLE MALE MEMORY

THE BRAIN YOU’RE BORN WITH

Guys have a problem.

It’s their brains.

You knew that, of course. I’m talking about their memories here. We will defer the many other peculiarities of male thinking for another blog post if you don’t mind. A big honking study of 48,000 people in Norway was carefully done by a team from the Norwegian University of Science and Technology.

Here’s what was discovered.

Guys can’t remember worth a damn. (I sure can’t.) They’re really bad at names. (I really am too.) The Norwegian study, called Hunt3, was led by Dr. Jostein Holmen. It was published in  BMC Psychology.

The participants were asked about names and dates, details of past conversations. All the stuff you would expect, right?

The surprise? Guys were awful! They did much worse than women. Nobody knows why. They were bad when they were young, they were bad when they were middle aged and they were bad (just a little worse, actually) when they were old.

The age thing was a surprise though. The expectation was that younger guys would do a lot better on names and dates and such than they did in real life. More education was a good thing as far as good memory goes. And chronic depression was a bad thing. Neither factor was a surprise as the roles of education and depression have been known for some time.

The researchers were stimied. They couldn’t figure it out.

MISTER ScienceAintSoBad has a theory however. Back in the days before we were too enlightened to stick women with all the child rearing and family duties, the guys went out and threw spears at oxen while the women busied themselves with keeping track of several generations of kids and adults. Maybe there was a selective advantage to being good at knowing the names and ages and personal details of all those people in your charge. This theory, courtesy of ScienceAintSoBad, isn’t without its flaws but the price is right.

Anyway, that’s it for today folks. You’ll forgive me if I forget your birthday.

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Sure. That cartoon is mine.

MYSTERY SURROUNDING THE HEART OF G W BUSH

MISTAKEN SURGERY FOR GEORGE BUSH

President George W Bush recently got a stent for his heart.

Were it not for his great healthcare, he wouldn’t have.

He didn’t have pain or shortness of breath. No symptoms. No nothing. But those (few) of us who are former presidents have exemplary health care. Evidently, one of President Bush’s exemplary set of physicians said “Uh oh, Mister Former President, I don’t like the way that artery looks.”  One thing led to another and, before you knew it, the former President of the United States was  recovering from heart surgery.

Here’s the thing. The British Medical Journal isn’t sold on this.

Who asked them? I can not say. But their take is that this stenting was too aggressive and was unjustified by the data. Even if his arteries were a lot worse, they say, there’s no data to support such aggressive surgery with the attendant risk to former presidents and such.

“No data” isn’t the science equivalent of “expletive deleted” but it’s close. Modern medicine is supposed to adhere fairly close to the evidence.  Dr. Aseem Malhortra (Royal Free Hospital in London) was the author of the article.

MISTER ScienceAintSoBad loves the concern of the British Medical Journal. To be honest? I didn’t think anyone over there in England cared much whether GW Bush leads a long and happy life or not. He wasn’t too popular over there when he was in charge here.  Anway, Dr. Malhortra’s point has merit, I suppose, but I would say that doctoring is about striking the right balance. Evidence is a good guide. But it shouldn’t handcuff. There’s still room  for judgement from those on the other end of the scalpel I hope.

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The drawing is mine.

Please leave comments by clicking “comments” just to the right under the headline for this article.

BRAIN SURGERY

SOMETIMES A HOLE HELPS

It wasn’t as good as modern medicine but, at least you could get an appointment. The ancient Peruvians healers cured by drilling a hole in the head with a hand drill. It’s called trepanation. 

Danielle Kurin (UC Santa Barbara) was the lead researcher. Her team looked at Peruvian skulls from a 250 year period beginning in 1000 AD. She looked at skulls that had holes in them – holes that had  been made  by someone on purpose. Old time surgery.

Is it crazy to drill a hole in a guy’s head with a hand tool? Especially when you don’t have any of the modern stuff to prevent infection? When you don’t have anything to put the guy out, or control the bleeding? And when  knowledge of anatomy and physiology is iffy?

Of course it is.

But if you are a Peruvian shaman, you follow tradition.This is what you do.  An ancient Peruvian with a serious head injury and a subdural haematoma – a bleed inside the head – would have had a good chance of dying unless the pressure  was  somehow relieved.

Here’s the thing.

If the head was whacked hard enough, you can probably skip the anesthesia anyway. And, even though infection’s a bad thing, the ancients had their tricks. Honey, for example.

For a bad head injury, what the Peruvian healers were doing was reasonable. Kurin’s team saw skulls where the holes had healed. “They must have gotten better,” she said. because “both the original wound and the trepanation healed”.

MISTER ScienceAintSoBad can’t say he likes this approach  for the spiritual or psychosomatic illness cases which Kurin says were also treated in that way. But what do I know? Am I a shaman? 

We’re lucky. We live in a time when so much is possible.

It’s great to see how we got here.

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The drawing is mine.

The article appears in the American Journal of Physical Anthropology.

To leave a comment, click “comments” which can be found at the top right of each article just beneath the headline.

BEST NOT TO OVER DO IT

WHY are doctors so arrogant and uncaring !!!

“They just speak to you about your symptoms for 5 seconds then prescribe you medication for the wrong diagnosis without first checking you out!!! I’M SICK OF THEM, then they complain that you’re a hypochondriac because they weren’t able to treat you for the same problem in the first place!!! 
They ignore your real symptoms and only derive what they wrongly think is causing your troubles.”   – from a Yahoo Pain Management forum

IS YOUR DOCTOR TOO “COLD”?

Doctors should be “caring”.

Every day. Every minute.

Does it really matter if it’s been a long horrible day for the doctor? Isn’t a patient entitled to a dose of sympathy along with whatever treatment is prescribed?

Once upon a time, when doctors carried black bags, they clucked over you constantly. They were sympathy machines.

“My, my. That looks just terrible!,” they would say.

In those day, doctors were your best friend. They knew all the kids. they knew you before you got married. They knew your secrets. They were very wise.

Why did they cluck over you so much?

What else would he or she (oh let’s stop this she crap – it was always a he) do? A stem cell transplant? I don’t think so. They offered sympathy because, often,  it’s all they had to give.

I have to ask. Does this  still make sense?

You’re talking to a stranger. A busy, busy stranger. You’re the 18th patient and there are two waiting in other rooms while you get seen. I know you feel bad. I know a little sympathy would be nice. But can we be realistic for a minute? That guy doesn’t even like you. You’re not his friend. He’s trying to fix what’s wrong with you, okay? Isn’t that what should matter?

I’m just asking.

Evidently, doctors buy into this emotional fraud because I’m looking at an article from the journal Health Expectations which aims to teach doctors how to speak the language of compassion.

Oh boy! The language of compassion! If you don’t feel it, at least learn to sound like you do.

Ronald Epstein, M.D.( University of Rochester, Center for Communication and Disparities Research) was the lead guy.  He worked with a group of oncologists, studying how they interacted with  some very sick patients.  They  worked on tone of voice, ways of expressing tenderness and understanding, and so on. Non-verbal communication too. Were the pauses and sighs right? The pitch? The tone? Metaphorical language? You really don’t want to choose a clumsy metaphor.

Here’s the thing.

The physicians who are involved in this stuff ARE  caring. They’re putting themselves through all this because they want things to be good for their patients. They know it sucks to be sick and they want, somehow, to be more comforting.

But there’s a risk.

“Getting the script right” can be dangerous. People sense it when you aren’t “real”. It can backfire. I’ve worked with doctors most of my professional life and, honestly? I think they’re great. Not one real clunker among the many I know.

MISTER ScienceAintSoBad thinks the emoting can be overdone.

Fix the disease.

That’s good enough for me.

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The drawing is mine.

To leave a comment, click “comments” which can be found at the top right of each article just beneath the headline.

DR. KNOW-IT-ALL

What if your doctor knew everything?

Instead of just acting like he did.

I mean what if your physician ACTUALLY had all those studies and papers – all the latest stuff – in his.her head?

Nobody’s saying doctors aren’t smart but they can’t be up on every possible disease or every possible drug. Nobody could keep all that information “upstairs”.

Except for Dr. Watson.

The latest incarnation of  Watson, IBM’s supercomputer, takes in the Internet as well as other sources of up-to-date medical information, sorts out all the useful stuff, and  shares this with busy medical professionals as it is needed. Easy access to everything. And an algorithm to help.

Maybe you remember Watson. From Jeopardy. Watson was a contestant on the show and trounced  all the other (human) players.

They never had a chance.

IBM now wants to get Watson in the medical game, offering direct help as well as second opinions to physicians. Maybe, eventually, aiding and abetting the delivery of primary health care. (This, by the way, is from Brandon Kleim, Wired Magazine).

Would it work? Is this a good idea? Well… doctors do make mistakes.

No. I’m serious. It can happen.

Like.. all the time.

Thousands of errors every year. People who should get better, don’t. People who should go home, die. Not knocking the docs. They are amazing. But nobody’s perfect, right?

“I am. I am.” (Shut UP Watson!)

Okay. That’s the idea, anyway – that a machine, indefatigable, without human biases, with always up-to-date information – can offer useful assistance to healthcare providers.

So.

Nobody’s threatened by THAT idea, right?

One of the doctors quoted in the article above reminds us that doctors have enough knowledge. No need to waste electricity. We’re fine here.

Mister ScienceAintSoBad will stand aside while the geniuses from medical school figure this out. Some would say that most medical errors can’t be prevented this way. Well, guess what? This one’s inevitable. Watson, Shmatson. Eventually? The strong right arm of every physician will be his Doctor In A Box.

I’m right on this.

Trust me.

Love,

MISTER ScienceAintSoBad.

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Credits for the animation: to Heather’s Animations. Please note that donations are gratefully accepted in return for which (or even without a contribution) you can utilize the work you find there in your emails, articles, and what not.

BLOOD TYPES

If you know your blood type it’s probably because you “gave at the office”.

Mister ScienceAintSoBad is proud of you.

If you ever need a transfusion, knowing your blood type may come in handy. A common complication of mis-typed blood is death. If you have trouble remembering whether you’re A, B, AB, or O (or Rh positive or negative), this isn’t exactly going to thrill your pants off but you now also have to know if you are “Langeries” or “Junior” too.

Actually? Hang on to those pants okay? There were already 30 recognized blood types before the new ones came along.

Didn’t know that, did you? Two more blood types brings it to 32.

This is the work of University of Vermont biologist Bryan Ballif (Nature Genetics). And he didn’t exactly “discover” Junior and Langeries. What he did was  get rid of the mystery surrounding them and their genetic structure. Now we know how and why they do what they do.

Your chances of being anything other than A, B, AB, or O are about the same as meeting a Martian on match.com.

(No KIDDING? Well sorry to rub salt into a wound then.)

Ballif’s work is a good thing. First of all, for the small number of people who are in these new groupings this reduces the risk of nasty transfusion reactions. And the proteins associated with these new blood types have some interesting anti-cancer properties which may lead to new therapies. Mostly, this is how science works. One step at a time. Little drama.. Put the pieces together, though, and suddenly things come into focus.

ScienceAintSoBadRating =9. Not bad!

Listen. I don’t want to leave you all worried about this. “Instant blood typing” is common now. So you don’t have to tape your blood type to your nose if you don’t want to. In fact, a team of chemical engineers  at Monash University headed by professor Gil Garnier (Analytical Chemistry) are working on a paper test strip for blood typing. 

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Image credits: Maybe I should have said discredits. This one isn’t exactly inspired. But, anyway, it’s all mine

THE NOTORIOUS BULLS EYE

TICKS

Dear Mister SASB, I live out in the woods with three dogs. I get a lot of ticks on me. No Lyme disease yet but it’s just a matter of time!!! Is there anything I should do? – WoodyLane5

Image credits” Yersinia Pestis. 
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License.

Dear MISTER SASB: My grandmother’s got stomach cancer. She’s had surgery, drugs, and chemo. Now the doctor says she should get hospice care which totally (if it’s okay to say) sucks big time. Grannie taught me to read and to ride a bike and even how to cut cocaine. There MUST be something they can do! –  Nancy Trill

Dear Nancy:

It sounds like yer granny could open up her own pharmacy.

Anyway, to answer your question, her Docs COULD get your granny hooked up with a clinical trial that offers some new hope. But they probably won’t. Denise Mann (Web MD) says most patients who could qualify for clinical trials, won’t even hear about them. At least, not from their own doctors.

This doesn’t mean doctors are a bunch of bums. The ones I’ve worked with (and consulted) are almost uniformly terrific. They work hard and they’re, mostly,  very smart. BUT they are human (surprise!). Just so many hours in a day. Just so many dollars in a paycheck. They can’t be everywhere. Can’t do everything. Gotta go home sometime. And this has a lot to do with why they’re shy about introducing their patients to clinical trials. Keeping up with 8,000 trials is SLIGHTLY impossible. When would that “keeping up”  happen? Before 5 AM? Or after 2 PM? Medicine is intense. The hours are long and the stakes are high. And there’s a lot of required reading just to stay current in day-to-day practice.

Also, there’s the relationship thing.  Maybe a particular clinical study does offer “a shot” (usually a long one). Still. It probably means the patient’s off to some distant place at a time that’s infinitely crappy and emotional horrendous.  And the patient and his.her doc often have a thing going, a doctor patient relationship. Believe it or not, separating from the Doc who took the patient this far down  Dismal Road  can be tough for both the patient and the physician.

INVESTIGATE EARLY

People, naturally, do the regular stuff, first. If things don’t work out, maybe they start looking around for unregular stuff.  It’s tempting to see clinical trials like the extra innings. After the first nine. (A little baseball metaphor here.) Well, sorry, Bub, but that may be too late. Some of these trials won’t let patients who are practically gonners into their programs. They need to get at them earlier in the progression of the disease.

THE RIGHT ANSWER

You’re kidding, right? If I knew the right answers to this stuff, do you think I’d be sitting here cranking out blog articles? I don’t know how to get doctors back into this loop either.  But something’s gotta change. That’s for sure. It’s not right to expect patients, on their own and at the worst possible time in their lives, to become medical detectives, capably sorting through the relevant research. And it’s not like NO doctors are referring to clinicals. Maybe we need to understand what the doctors who get this right are doing.

Mister ScienceAintSoBad‘s an optimist. He thinks things will improve.

Sooner’s better than later.

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Credit for above cartoon (which I don’t exactly understand either) to, xkcd.

CHEAPER THAN MEDICAL SCHOOL

I guess you’ve been watching all the smuggies with their smartphones.

You can live without one, right?

Till now.

Here’s an app so good you gotta buy a phone to carry the app around.

I think I’m serious.

Healthagen developed this thing called iTriage

Stunning!

iTriage’s brilliance is the way it puts a simple interface over medicine. Your phone becomes your Startrek Tricorder. The pain’s in the biceps? All the time? Just at night?

Click “look up symptoms” to search an ordered list of likely symptoms.

Once you think you know what’s causing the problem, you can “Find Medical Treatment” or “Learn About Procedures”.

You can even “Find A Doctor”.

If you don’t understand a medical term you can look that up.

I was chicken to try the “Emergency” button . Was it gonna make an entire team of paramedics materialize right out of the phone? What would I tell ’em? Just looking?

Jabber, Jabber, Jabber

Test: How is political debate different from science?

I will pick up your papers at the end of the class. I don’t want you looking at anyone else’s answers.