28 August 2012

A very short video about Egyptian Medicine.

Yes - I'm playing with videos. I shot this on the phone just as a quick test to see what it would come out like.Your comments welcome; see if you spot the same things that also annoy me...

26 August 2012

I'm a doctor. I'm a doctor and I want my Moonbase!

Why do the supervillains get to have all the fun? Here we are in 2012, mourning the passing of Neil Armstrong - a legend and a hero to so many of us - and it has been over 40 years since anyone has been on the Moon.

As I mentioned previously, I am a big fan of our ventures into space. I feel that our civilisation has so much to gain by pushing outwards beyond our little planet, out to the Universe at large. I don't just mean psychologically. I'm not just talking about feeding our curiosity for the sake of it (although that has its place). It's more than that. This is about advancing.

I'm a geneticist. I try to diagnose and manage (as best I can) a wide range of genetic disorders affecting adults and children. I try to use my medical skills and the best technology can offer in order to fulfil my duty. Despite being at the cutting edge, we are severely cash-strapped. It's difficult to fund the tests and treatments that our patients need. Although we deal with rare disorders, there are a lot of them. Up to 6% of people will be affected with a rare disorder - that's quite a large demographic - much larger than the slice of the pie given over to, say, severe mental health or multiple sclerosis.

Given this, you might think that I would want research on Large Hadron Colliders and space programmes to be diverted towards rare diseases research, but I don't. I do want more money for rare diseases research, but not at the expense of these other projects. I've already outlined why in The Medical Case For Mars, but there is a general point that I think needs to be made very clear.

It is this. Most of the major enabling advances that have delivered real tangible benefit to health care, and have driven health technology forward have not arisen in the health sector.

Isn't that crazy? But it's true. The science that underpinned MRI scanners would never have been developed if research funds had been diverted from pure physics towards brain disorders. The science behind next-generation DNA sequencers - the technology that is completely revolutionising my field of genetics right now - would never have arisen had it not been for "blue sky" research in the fields of nanofabrication, lasers, high resolution optics (itself based to a large extent on tech developed for satellites) and several other fields that have nothing to do with genetics. Even the structure of DNA was only solved almost 60 years ago by the application of X-ray diffraction techniques that originated in physics labs while the world was struggling to find cures for TB.

We also hear the argument that research should not take place into rare diseases until the more common diseases have been tackled first, but the proof of the pudding here is that rare diseases very often provide the key critical insights into human biology that allow common diseases to be treated better. The "rare" disorder of familial hypercholesterolaemia allowed us to make the breakthroughs that resulted in treatments for heart disease. Research into "rare" (1/10,000) Huntington's Disease is already having benefits to patients with Alzheimer's disease. Rare forms of cancer are providing clues that allow more common forms of cancer to be treated - these are examples within the health sector, but there are many examples from outside too.

The point I am trying to make here is that our civilisation does not and cannot advance piecemeal. What we gain in one area can often cross-fertilise other areas. If we cut back on research into (say) high energy physics and concentrate everything on finding a cure for (say) muscular dystrophy, we run a very real risk of missing a trick that would allow us to develop a new treatment or investigative modality that might dramatically improve the lot of those patients we are trying to benefit.

I'm going to say this again, in a slightly different way: The critical enabling insights that have allowed most major medical advances in the past century have arisen from studying other things than the diseases they have ultimately come to benefit.

There is a major important big stonking implication from this: SCIENCE MATTERS.

It is not enough to pay lip service to science. We MUST invest in science and in scientific thinking. We need our scientists to think outside the box and across disciplines. We need polymaths. We need jacks of all trades. We need specialists who talk to the jacks. We need entrepreneurs. We need risk-takers. We need a scientifically-literate populace and scientifically-literate politicians. The benefits of research are not just seen in the citation indices of publications, but in the overall raising of that tide of scientific advance that our civilisation floats on. We need geeks. We need the pen-protector white-socked engineers that Neil Armstrong represented, and that all of a sudden people are emerging from the sociology-laced woodwork to belatedly salute.

So, dear readers, in this spirit, I want YOU to help ME change Northern Ireland from the world's perception of a sectarian backwater into a world leader in science. We can do that by making our presence and our attitude known to our politicians. You CAN make a practical difference - click here to see the pledge to send a copy of Mark Henderson's book "The Geek Manifesto" to every MLA in the Northern Ireland Assembly. This is only one small thing - you can think of how YOU would like to make a difference.

Did I say "sectarian backwater"? That is a view the world has of us, but bloody hell - we produced Lord Kelvin. We produced Ernest Walton, John Stewart Bell, Professor Dame Jocelyn Bell Burnell, Frank Pantridge and many other scientists and doctors who have revolutionised the world. Not bad for a wee country of only 1.8 million. We should be up there in the top league, and it's time our politicians realised this.

Now, where's my bloody moonbase?

In Memoriam

Neil Armstrong, 1930-2012 via 1969. Hero of Earth. RIP.

21 August 2012

Tiocfaidh ar Lab! For Science and For Ulster.

Mark Henderson has a vision. That vision is that science and, importantly, the scientific attitude have been neglected in our politics and in society for far too long. Sure, we've made some astonishing advances, but you'd hardly think so when you look at the Members of our Legislative Assembly up in Stormont, or in the political classes across the wider UK & Ireland. Politics is jammed full of humanities graduates who just don't understand the soul of the "geek" or the benefit that can be brought to society if those of us who care about science and skepticism (with a k) get working on proper solutions to the problems of our age.

I've set up a pledge to put a copy of Mark's book "The Geek Manifesto" on the desk of each MLA at Stormont, and I want YOU to help. Look, I even made you a video:

My aim is to ensure that our Assembly is aware that science cannot be sidelined or marginalised or fobbed off with the sort of nonsense we recently encountered from some in relation to the Giant's Causeway, the Ulster Museum or other aspects of our scientific heritage. We, the geeks of Northern Ireland, will rise up to protect our good name as one of the countries in the world with the greatest output of top scientists, from Lord Kelvin in the Victorian era to Dame Jocelyn Bell Burnell in our own.

So please have a look at the Pledge, sign it, and join the revolution. This is above politics, it is above the narrow tribalism of our "sectarian divide". Science unites people and drives us forward - not many activities are as positive as that. Furthermore, the potential economic benefits are enormous.

Geek the vote!

20 August 2012

Space science and ground science

Regular readers will know I am a fan of space exploration, and have recently set forth a few points making a medical case for a Mars mission. Just now we hear of a new development in Aerogel technology that shows, as if it needs to be shown again, that developments in technology in general hold out the promise to benefit our lives on this planet and out in the wider realms of space beyond.

Let's keep developing, and keep cross-fertilising, so that developments in disparate fields can influence each other, and drive our tech and our medicine forward. That's what we have been doing for years, and it's what we as an inventive species are getting much better at.

Flexible aerogels - I'm a fan already!

18 August 2012

07 August 2012

The Medical Case for Mars

I'm a Clinical Geneticist. That's a doctor who works in genetic medicine, dealing mainly with lthe diagnosis and management of patients with rare disorders and birth defects. Many of them have conditions you'll never have heard of, and often I'll never have heard of them either until they pitch up in my clinic.

The recent NASA triumph of landing the Curiosity Rover, also known as the Mars Science Laboratory, on the surface of Mars cost $2.5 billion, and many people have remarked upon what could be done in the field of medicine with that sort of money. Actually, it's not that far off what we used to sequence the entire human genome at the end of the last century, and that has kicked off a spectacular revolution in genetic medicine that we're still only scratching the surface of. Think about what we could do if that was diverted into genetic research!

And yet NASA have used all this money to build a rover and send it to another planet. How will this benefit my patients? Isn't it a spectacular waste of money? And what about all those people starving in Africa, or who could be cured or relatively simple diseases, if only we had $2.5 billion to spend on them?

You might therefore be surprised to find me, a doctor who doesn't deal with astronauts or fighter pilots (usually) or extremes of temperature or pressure or endurance, who treats people, not rocks or gullies or ice or asteroids, saying in no uncertain terms that we should push out beyond the bounds of our small planet, and explore the vastness of space.

Yet that is precisely what I will argue. Indeed, I feel very strongly that we should be pushing to land people on Mars, and establish colonies there and elsewhere in the Solar System. We should be putting money into space technology, and stretching the challenges we give our space agencies and their commercial partners.

I will freely admit that part of my motivation stems from the fact that when I was a little boy I had posters of all the Apollo astronauts over my bedroom walls. I was thrilled and inspired by the derring do of the Skylab and Salyut crews, and the probes we sent to other planets and out to Jupiter and beyond. I voraciously read science fiction and imagined what it would be like to sail among the stars, discovering new worlds and new life. I dreamt of giant orbital space colonies, containing thousands of people, drifting on the solar wind out to the moons of Saturn. In my mind's eye I gazed down at the Earth from the craters of the Moon. And that is all very well for a little boy, but here on Earth we have real problems to deal with, and as a doctor I have real patients with very real medical needs.

However, when I look at my patients, I see many of them who would not be alive, were it not for technology either directly or indirectly linked to one of Humankind's Great Projects. The Space Race drove rapid miniaturisation of electrical components, which has totally revolutionised investigative medicine. From endoscopes to imaging technology, many modalities that we take for granted would not have been developed (or at least not developed to the stage where I can access them for my patients in Belfast), had it not been for space. Techniques that we use for monitoring patients in surgery or intensive care were developed and refined by the need to use them in space to monitor astronauts. Image analysis algorithms used to investigate other planets (and our own from orbit) are now used to analyse scans on patients. Lightweight cheap disposable sensors are routinely used in hospital patients to monitor oxygen levels and other biological parameters, and are a direct spin-off, at least in production terms, of technologies that were developed alongside the space programmes.

And that's not even beginning to get to the massive benefits space technology has had in terms of monitoring and understanding our planet and putting people in touch with each other, allowing rapid sharing of information and research. The fact that we can feed 7 billion people is due in a large extent to our understanding and modelling of our planet from orbit. The fact that we don't feed 7 billion people adequately is down to all the bad things about human nature that space has the potential to lift us above.

In human history there are two major drivers of rapid technological advance. The first is War. The second is a Great Project. If we are to maintain peace on our fragile planet, I fervently hope that the second option is the one we choose to impel our civilisation onwards. If we choose to go to Mars - not because it is easy, to channel JFK, but because it is hard, we will be setting ourselves a tremendous challenge. A challenge to develop technologies to move people vast distances safely, to monitor humans, plants, animals and ecosystems in conditions that are very unfamiliar, to shrink scientific equipment, sensors and other items as much as possible, to learn much much more about human physiology and psychology, and perhaps even to value our beautiful blue planet that bit more, that we may take better care of it. As NASA showed with the Curiosity lander, if we set ourselves a challenge, and rise to it, we can achieve truly wonderful things.

As I look at some of my little patients, who are only alive because we have the spin-off technology to fix their heart defects or their diaphragmatic hernias, or because we were able to monitor them better in the womb, or because our supercomputers were able to analyse their scans, or because we were able to consult in real time with experts on the other side of the planet - as I see those kids, I don't begrudge NASA their $2.5 billion. The technology that put that lander on Mars is going to help people in the future. I can't foresee exactly how, but I know it will. And similarly, an effort by Humanity to reach out beyond our planet and colonise other worlds will yield benefits back here on our Pale Blue Dot.

And do you know what? Many of my little patients have posters of astronauts on their walls too, and they also have dreams of life among the stars.

06 August 2012

Microwaves: they lurk you know.

Click to enlarge. Ding!
I'll be honest - I don't usually expect very much from the Northern Ireland Healthcare Review. But, seriously people, if you are pitching your rag at the cream of the medical establishment in our esteemed Province, at least have the decency not to fill it with total crap.

Like the article to the left. This month's incarnation of the Fastest Diabetic Foot Ulcer Dressing Nurse Practitioner of the Year Award Magazine has a hilarious story on page 63 of how we are dramatically increasing our risk of a lingering death by using a microwave. Perhaps the most surprising statistic in this litany of ripped-off shite is the revelation that 80% of people in Northern Ireland use a microwave. Seriously. What the hell are the other 20% doing? Microwaves are a "lurking danger in your kitchen" (they lurk?) and "ingestion of microwaved food caused a higher percentage of cancerous cells in the blood."

This "research" (which is uncited, and the article doesn't even tell us who wrote this bullshit) is actually largely re-packaged (that's a polite word for "plagiarised" from an  altie website on tripod.com (yes - it still exists!). Interestingly, the website in question, http://healingtools.tripod.com , contains all sorts of warnings as to what will happen to people who misuse their copyright - presumably the wrath of the Lord will be invoked, or some similarly evidence-based smitery.

Be that as it may. Normally the NI Healthcare Review is considered a bit of mindless junk entertainment for Northern Irish medics. It is not usually taken that seriously. You look at it to see your colleagues in silly suits or dresses, holding shapeless bits of glass that are going to end up shoved to the back of the top of a very high cupboard. However, I feel a line has been crossed here. How dare Medical Communications Ltd foist this cobblers on the medical community in Northern Ireland? Why not contact them and let them know how you feel? If medical professionals are being pissed over in this tawdry manner, spare a thought to the quality of the information that the glossy media are pouring down the throats of our patients. It's time to make our voices heard.

03 August 2012

Canyons of Mars - the Kitchen Table Version

Just recorded this on the phone in the kitchen tonight, for those of you who like your music raw, uncut, slightly out of time and key - EXACTLY as it would be if you were on Earth and I was hammering it out on whatever old guitar they let me take to Mars. Except the kitchen may be smaller.

"Canyons of Mars" (C) Shane McKee, 2012. (minor lyric updates 2013)

We work the red ground here - I can't call it earth;
This isn't the soil of the land of my birth.
"We can't bring you back," they said, leaving no doubt we were true pioneers.
In this desolate landscape we're staking our plot,
But dreams still return me to one pale blue dot
Lost in the heavens, whispering echoes of triumph and tears.

But all we can do is step forwards each day,
Because entropy's journey is only one way
From the footprints they left in the Turkana clay,
Walking under the stars I can see from the canyons of Mars.

The next ship from Earth will bring four new recruits -
We'll fit them with visors and helmets and boots,
And we'll set them to work on reactors and rovers and solar arrays.
They'll join the endeavour and never return
To the places and people they loved, and they'll learn
To adjust to their destiny,
Factor it over the course of their days

But all the psychologists can't tell me yet
If it's best to remember or try to forget
How we stood there in Belfast when the sun had long set,
Gazing out at the stars I now see from the canyons of Mars.

Now Sarah and Ravi have just had their kid;
You followed the pregnancy - the whole of Earth did,
Through broadcast and podcast and media storm -
She's the first of her breed.
We're extending the habitat under the ground,
We'll fill it with air and with colour and sound;
And we'll love them and feed them and keep them all warm -
Is that all that they'll need?

Because her generation's the next link in a chain
Stretching out from a planet of forests and rain,
And the one point of reference that can help us explain
Is: we saw those same stars they can see from the canyons of Mars.

But the frail force of gravity won't hold them here
As they look to the heavens with no trace of fear.
And we'll watch them lift off, and then disappear,
As they carry our dreams to the stars from the canyons of Mars.