Subscribe via RSS Feed Connect on Google Plus Connect on Flickr

Health

David Foster Wallace on Robin Williams

Tuesday, 12 August, 2014 1 Comment

The writer David Foster Wallace committed suicide on 12 September 2008. He was 46. For those trying to make sense of the severe depression that Robin Williams battled, here’s how Wallace saw the condition and the despair it produces:

“The so-called ‘psychotically depressed’ person who tries to kill herself doesn’t do so out of quote ‘hopelessness’ or any abstract conviction that life’s assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire’s flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It’s not desiring the fall; it’s terror of the flames. And yet nobody down on the sidewalk, looking up and yelling ‘Don’t!’ and ‘Hang on!’, can understand the jump. Not really. You’d have to have personally been trapped and felt flames to really understand a terror way beyond falling.”


Dealing with dementia. Is there an app for that?

Tuesday, 29 April, 2014 0 Comments

Stats: As of last year, 44.4 million people worldwide were diagnosed as suffering from dementia. This number will increase to 75.6 million in 2030, and 135.5 million in 2050. Much of the increase will be in the developing world. The fastest growth in the elderly population is taking place in China, India, and their south Asian and western Pacific neighbours. Already 62 percent of those with dementia live in developing countries.

What is it like to suffer from dementia? It must be hellish. In aid of Alzheimer’s Research UK,Facebook users are today being invited to experience what it is like to live with the disease. The FaceDementia app “takes over” your page, and temporarily erases important memories, imitating how dementia affects the brain. Users can watch their photos and status updates disappear before their eyes. Terrifying.

In a related development, the creators of the Re-MindMe app are aiming to help dementia sufferers, their family members and care givers. The idea is to use mobile devices to preserve a person’s long-term memories and thereby keep them mentally active and interacting with people. The developers are seeking backers using the crowdcube funding platform and they’ve raised £30,240 of the £150,000 target for 15 percent of the equity so far.

If you want to learn more about the tragedy of dementia, go to a performance of King Lear. Shakespeare understood the descent into darkness: “Who is it that can tell me who I am?”


Coffee: Is there anything it can’t do?

Friday, 28 March, 2014 0 Comments

Note: CVD stands for Cardiovascular Disease. “Moderate coffee consumption was inversely significantly associated with CVD risk, with the lowest CVD risk at 3 to 5 cups per day, and heavy coffee consumption was not associated with elevated CVD risk.” That’s the conclusion of a paper titled “Long-Term Coffee Consumption and Risk of Cardiovascular Disease,” which appears in Circulation, the journal of the American Heart Association.

And there’s more good news in the specialist publications. Take the current issue of Alimentary Pharmacology & Therapeutics, for example. It contains a letter by R. Cardin, M. Piciocchi and F. Farinati on the matter of “coffee and chronic liver damage.” Conclusion? “In summary, coffee appears to be protective in liver damage progression, irrespective of the aetiology. Its use should be recommended and the mechanisms and compounds involved further investigated.”

espresso This comes on the heels of an article in the New Scientist by Simon Malkin titled “Drink two espressos to enhance long-term memory.” And that ties in neatly with the following: “In a 2012 experiment at the University of Illinois at Urbana-Champaign, mice were briefly starved of oxygen, causing them to lose the ability to form memories. Half of the mice received a dose of caffeine that was the equivalent of several cups of coffee. After they were reoxygenated, the caffeinated mice regained their ability to form new memories 33 percent faster than the uncaffeinated.”

That’s from “This Is Your Brain on Coffee” by Gretchen Reynolds, which appeared last June in the New York Times. Snippet: “In one large-scale epidemiological study from last year, researchers primarily at the National Cancer Institute parsed health information from more than 400,000 volunteers, ages 50 to 71, who were free of major diseases at the study’s start in 1995. By 2008, more than 50,000 of the participants had died. But men who reported drinking two or three cups of coffee a day were 10 percent less likely to have died than those who didn’t drink coffee, while women drinking the same amount had 13 percent less risk of dying during the study.”

Is there anything it can’t do?


The Empire of All Maladies expands

Wednesday, 5 February, 2014 0 Comments

World Cancer Report 2014 Worldwide, some 14 million people a year are diagnosed with cancer and the number will almost double by 2030 says the World Health Organization (WHO), which has just published its World Cancer Report 2014. According to the 600-page work, lung cancer leads the list of the most common cancers with 13.3 percent of all cases worldwide in 2012. This was followed by breast cancer (11.9 percent) and colon cancer (9.7 percent).

The authors of the WHO report declare that the projected 70 percent increase in cancer over the next two decades is linked to people in emerging economies copying the harmful behaviours of those in richer states, especially when it comes to eating, drinking, smoking and physical inactivity. Add obesity and pollution into the mix and you’ve got The Emperor of All Maladies gone global.

“The landscape of carcinogens is not static. We are chemical apes: having discovered the capacity to extract, purify, and react molecules to produce new and wondrous molecules, we have begun to spin a new chemical universe around ourselves. Our bodies, our cells, our genes are thus being immersed and reimmersed in a changing flux of molecules — pesticides, pharmaceutical drugs, plastics, cosmetics, estrogens, food products, hormones, even novel forms of physical impulses, such as radiation and magnetism. Some of these, inevitably, will be carcinogenic. We cannot wish this world away; our task, then, is to sift through it vigilantly to discriminate bona fide carcinogens from innocent and useful bystanders.” Siddhartha Mukherjee, The Emperor of All Maladies

But there is some good news. More and more cancer patients are surviving a disease that was once regarded as a death sentence, and thanks to early detection, mortality from cancer is in decline, which means that up to half of those affected can expect to be cured. In light of this, some are suspicious that the constant alarm about cancer could be a stalking horse for all kinds of new restrictions on everyday activities from the breakfast fry to the pint in the pub at night.


Ambulator nascitur, non fit

Monday, 3 February, 2014 1 Comment

There are those who believe that poeta nascitur, non fit (a poet is born, not made), and those who don’t. The same applies to walkers. Well, that’s what Henry David Thoreau thought. A month after his death from tuberculosis, in May 1862, The Atlantic magazine published one of his most famous essays, “Walking,” which contains the observation, Ambulator nascitur, non fit. To someone who did some serious walking in January, the aphorism rings true. And the following passage is filled with goodness:

“My vicinity affords many good walks; and though for so many years I have walked almost every day, and sometimes for several days together, I have not yet exhausted them. An absolutely new prospect is a great happiness, and I can still get this any afternoon. Two or three hours’ walking will carry me to as strange a country as I expect ever to see. A single farmhouse which I had not seen before is sometimes as good as the dominions of the King of Dahomey. There is in fact a sort of harmony discoverable between the capabilities of the landscape within a circle of ten miles’ radius, or the limits of an afternoon walk, and the threescore years and ten of human life. It will never become quite familiar to you.”

In essence, Walking celebrates the rewards of immersing oneself in nature and mourns the inevitable advance of land ownership upon the wilderness.


The Daily Mail does not cause or prevent cancer

Thursday, 9 January, 2014 0 Comments

Cabbage prevents cancer, but cakes cause cancer. And are you aware that vitamins both cause and prevent cancer? Well, that’s what the Daily Mail says, and Paul Battley has now taken on the task of trying to make sense of the paper’s unending effort to classify cancer-causing/preventing stuff with Kill or cure? It was Ben Goldacre who inspired him to undertake this vital public service when he informed us seven years ago that, “The Daily Mail, as you know, is engaged in a philosophical project of mythic proportions: for many years now it has diligently been sifting through all the inanimate objects in the world, soberly dividing them into the ones which either cause — or cure — cancer.”

Kill or sure?

With tongue in cheek, Battley says that, “In order to make sense of this vast resource of clinical information, I’ve scraped the Daily Mail website for articles mentioning cancer.” The results are, er, enlightening. As we can see, many things cause cancer and many others prevent it. In some cases, they do both. Well, according to the Daily Mail.

Daily Mail cancer


Why four doses of ipilimumab costs more than $100,000

Friday, 3 January, 2014 0 Comments

“Like all wars, the one against cancer is going to cost a lot of money, one way or another,” declares The Economist in its current issue in an article about a new campaign against cancer that’s being mounted by researchers and drug companies. Among the therapies examined in “Getting close and personal” is ipilimumab, a drug to treat melanoma that was launched in 2011 by Bristol-Myers Squibb and branded as Yervoy. This is a so-called “checkpoint inhibitor”, which allows immune-system cells called T-lymphocytes to attack cancer cells. Along with fighting melanoma, ipilimumab may also hinder lung cancer and prostate cancer. The stumbling block is the expense for the patient, especially in the US, where four doses of ipilimumab costs more than $100,000.

Why $25,000 a shot? Because bringing a new drug to market in America typically costs upwards of $100 million and can take as many as 15 years of research, testing and regulatory review. The drug companies, understandably, will want to recoup their investment after such a lengthy, pricey process. However, there’s hope on the horizon in the form of “adaptive trial design”, which looks at patients’ reactions to a drug early in a clinical trial to modify the way the rest of the trial is handled. The goal, according to The Wall Street Journal, is to more quickly identify those drugs that are working and those that aren’t. “Researchers Aim to Speed Cures to Patients” admits that the process is tedious but not without some glimmers of hope:

“In a recent hopeful sign, adaptive trial design enabled two experimental breast-cancer drugs to deliver promising results in a clinical trial after just six months of testing, far shorter than the typical length of a clinical trial. Researchers assessed the results while the trial was in process and found that cancer had been eradicated in more than half of one group of patients, a particularly favorable outcome. The breast cancer trial, known as I-Spy 2, is testing up to 12 experimental drugs.”

Faster, please.


When happiness is a warm Smith & Wesson

Wednesday, 11 December, 2013 0 Comments

Earlier this year, the German writer Wolfgang Herrndorf asked his friends if they knew someone who knew someone who could get him a revolver. He wasn’t planning to rob a bank or commit a crime of passion. Rather, he intended to fight cancer — his way. Before long, he was the owner of an unregistered .357 Smith & Wesson and he found it to be a thing of considerable beauty. “It possessed such a comprehensively calming effect that it’s unclear to me why the health insurance provider didn’t pay for it,” he wrote in his diary. On 26 August, he left his apartment in Berlin, strolled along the bank of the Hohenzollernkanal, found a seat, put the barrel of the gun in his mouth and pulled the trigger. He was 48.

Most modern German writing is unreadable. There’s no shortage of material, but it seems that the writers are more interested in whingeing about the “Kapitalismus” that has given them such an enviable standard of living, or they’re occupied with absurdities such as the Occupy movement, or they’re fomenting hatred of Amazon and Google and generally acting the Luddite when it comes to technological progress. All this is preferable to the hard work of writing. The result is an endless stream of turgid polemical tracts misleadingly labelled as novels and memoirs. Wolfgang Herrndorf was the honourable exception to this rule.

His novel Tschick (English: Why We Took the Car) was published in mid-2010 and a year later Sand appeared. The two represented the most exciting and stylish German fiction of recent times. Tschick was published in 27 countries and one million copies were sold in Herrndorf’s homeland. Along with writing novels, Herrndorf posted regularly at his blog Arbeit und Struktur and it was there that the wider world learned of his battle with cancer. After three operations and bouts of radiation treatment and chemotherapy he decided that he’d had enough of modern medicine and requested the revolver. The book of his blog is now destined to be a posthumous bestseller.

Smith & Wesson


Nurse!

Tuesday, 26 November, 2013 0 Comments

In William Boyd’s Solo, the latest iteration of the James Bond saga, 007 gets into a spot of bother in Africa, which leads to a spell in an intensive care unit at a sanatorium on a British Army base to the south of Edinburgh. There, he is attended to by Nurse Sheila McRae and such is the quality of her care that Bond begins to meditate on the heroic nature of her profession:

“She helped Bond on with his dressing gown after he’d dried himself and Bond reflected on the curious, intimate non-intimacy that existed between nurse and patient. You could be standing there, naked, as your bedpan was emptied or a catheter was inserted in your penis, chatting to the nurse about her package holiday in Tenerife as if you were passing time at a bus stop waiting for your bus to arrive. They had seen everything, these nurses, Bond realised. Words like prudish, embarrassed, shocked, disgusted or ashamed simply weren’t in their vocabulary. Perhaps that was why people — why men — found them so attractive.”

That James Bond. Along with being such an effective killer, he’s so wise when it comes to matters of the human heart. Nurses are, indeed, astonishing people and they deserve far more recognition and reward from society than they currently get.


Google on Life and Death

Monday, 23 September, 2013 1 Comment

“One of the things I thought was amazing is that if you solve cancer, you’d add about three years to people’s average life expectancy. We think of solving cancer as this huge thing that’ll totally change the world, but when you really take a step back and look at it, yeah, there are many, many tragic cases of cancer, and it’s very, very sad, but in the aggregate, it’s not as big an advance as you might think.” So says search engine entrepreneur Larry Page in “The Audacity of Google”, the main feature article in the current issue of Time magazine, which plays up the interview on its cover with the dramatic title: Can Google Solve Death?.

In a post on Google+ dated 18 September, Page wrote: “I’m excited to announce Calico, a new company that will focus on health and well-being, in particular the challenge of aging and associated diseases… These issues affect us all — from the decreased mobility and mental agility that comes with age, to life-threatening diseases that exact a terrible physical and emotional toll on individuals and families.”

Nabanita Das commented on the post: “quite an overpowering thought ….cancer is known to exist more than 5000 yrs back (as mentioned in epics ) ….it is the most persistent harbinger of natural (aging) death process ….any breakthrough will surely be multifaceted.”

But a close reading of Page’s comments in the Time interview suggest that “solving” the cancer problem is not what Page has in mind. Sure, the search for the cancer “cure” is regarded by many as the Holy Grail of modern medicine, but it does not follow that Page would see it this way. The reason is “Big Data”. More about that here on Wednesday.

Time


Stop Sepsis. Save Lives.

Monday, 9 September, 2013 0 Comments

The first-ever Berlin Sepsis Summit (PDF) opens today in Langenbeck-Virchow-Haus. Your blogger has a personal interest in the disease as he contracted sepsis, with near fatal consequences, while in hospital during summer and nothing concentrates the mind more wonderfully than the prospect of closure and its causes, to paraphrase Dr Johnson. For those unfamiliar with the syndrome, sepsis occurs when the body is unable to fight bacterial infection. Perversely, many of the advances in modern healthcare weaken our immune system, opening the door for sepsis. These include cancer treatments, medicines for gastro-intestinal illnesses and drugs that affect the immune system, like cortisone.

Every three seconds someone around the world dies of sepsis and, terrifyingly, it is now the second-leading cause of death in non-coronary intensive care unit patients. Even in first-world countries such as Germany, with a much-praised healthcare system, some 160,000 people die from the disease annually. Imagine, then, the havoc it wreaks in less developed societies?

The keynote address in Berlin today will be given by Ciaran Staunton, whose young son, Rory, died of sepsis in April last year in NYU Langone Medical Center. A preventable death in one of the world’s best medical facilities produced a storm of outrage and led in January to the enactment in New York State of “Rory’s Regulations“, a series of protocols to diagnose and treat sepsis before it turns fatal.

World Sepsis Day will be marked globally on Friday and the declared goal is reducing the incidence of the disease by 20 percent by 2020. Stop Sepsis. Save Lives.

World Sepsis Day