Items tagged with: Quote of the month

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Laziness is the mother of good science. Creation comes from moments when you don’t have anything to do. When you have no teaching, and basic admin, and extra commitments are seen to interfere with research, what if you have strong motivation, and don’t know what to do? If you are teaching, you can fill your gaps by teaching, but researchers have to fill the gaps with thoughts.

The Northwick Park Hospital was being designed... and there were two other things which were mentioned and thought about, but some of them never eventuated. One was the importance of isolation of people who are producing and shedding organisms which are resistant. We were in favour of having isolation rooms in the hospital, but this was very unfashionable and thought to be retrograde. The days when you had to worry about infection were in the past and not something which the 1970s hospital needed to concern itself with!
Now I know that Defra have the prize-winning Twitter team. They use Twitter more skilfully than any other government department, which I think is really interesting. And I also know that the NFU (National  Farmers Union) put in place a Twitter mechanism and encourage their county chairs to use Twitter. These are really big changes – this technology didn’t exist in the early part of the period that we’re reviewing. But nevertheless it is about social engagement and it’s about trying to influence policy, which is based on something very complicated.

A large trolley was wheeled around the wards, which had the monitoring apparatus, the ECG, the blood gas analysis and so on, and much recording apparatus. Ron and I – I had the privilege of working with him then – were deemed the ‘death watch beetles’, because unfortunately we weren’t always successful. Dr Margaret BranthwaiteHistory of British Intensive Care, c.1950–c.2000

What dialysis did as regards the changing attitudes to patients: I remember clearly the business of sharing accommodation between males and females and we were having to defend ourselves to the matron. She was astonished that we had put a female patient with a male patient for dialysis. We said: ‘Do you want her to die or do you want her to live? It’s as simple as that.’ Dr Rosemarie Baillod, History of Dialysis in the UK: c. 1950-1980.

That was always a problem at Christmas because people would put a Christmas tree down. What would be the easiest way to put a Christmas tree into an 18ft gap, you would put it in root first so that the branches, but now the branches have opened up inside, refuse has gone inside and gone on top and added weight to those branches and now it becomes a blocked chute. So people keep putting refuse in so the refuse is piled up with a Christmas tree stopping it and someone has to unblock the chute.

While we’re talking about the Christmas party for the children, which Ian’s talking about, I was organizer for that for I don’t know how many years... The main thing was we had these two entertainers called Naughty Uncle Wally and Aunty Wendy who would come in and they would do the bulk of it. The main problem I had was whether they would turn up... We also had Walt Disney cartoons – this is before television had cartoons on. We used to get those from the Rank Organisation in the Great West Road – they had a place there.

Westminster had 42 major hospitals and clinics within its boundaries at the time and there were no clear guidelines and no definition of who did what with clinical wastes: they just all went in the bin. We had a number of instances where refuse collectors were covered with blood because blood bags would go in the bins and when the compression plate came down it sprayed them. We had needle stick injuries and everything else.

...we had to go up and be what was called ‘desensitized’... We had to go in to the National Centre for Social Research (NatCen) office for two days and sit there while every term connected with sexual activities was told to us, because the project managers were concerned that when we all went out to do the interviews, we would come across all these sorts of things and we were not supposed to respond, obviously. We had to be separate from it. Do you remember that? Two days we were there.

… I think we’ve found that the general public, when it becomes aware of post mortem brain research into autism, is very positive about that area of research and also about what they could contribute in terms of control tissue. I think the issues are much more with the autism community in the UK and overcoming some of the misconceptions and fears that are still very strong there. Ms Brenda Nally: The Development of Brain Banks in the UK c.1970–c.2010, pp. 33

I know that Henry Thompson (Surgical Officer, St Mark’s hospital) one day went to visit someone at home who wouldn’t agree to be screened, and Thompson was an Oxford blue boxer and the person that he went to visit was from an East End London boxing family.And he said that he would challenge the man who wouldn’t be screened to a boxing match and the purse would be the examination. So there were lots of stories like that from the early days when the surgeons really went out of their way to find these people.

...we did a series of studies, paid for in part by the Ministry of Health. It was most unusual in those days for the Department to admit that they didn’t know something and to pay us to find the answer, but the sad part was they never paid any attention to the answers that we provided.
One reason why this paper caused a paradigm shift was that the received wisdom was that light did not suppress melatonin in humans and that light did not affect circadian rhythms in humans. The received wisdom then was that social cues were the main synchronizers of human circadian rhythms, that humans had evolved in such a way, that we were so intelligent, that we had risen above control by the light/dark cycle.

... I got home and it was a Friday and The Lancet had arrived in my mail that day. I just picked it up and looked through it and there was a paper in it by Kay Tee Khaw, who was Professor of Clinical Gerontology in Cambridge, on seasonal changes in fibrinogen, which she thought might be due to seasonal infections or something, that allowed for temperature. I just suddenly thought, ‘That’s it! It’s air pollution that is changing fibrinogen. Fibrinogen makes the blood clot and blood clots cause heart attacks.

I remember medicine before the NHS, I had my tonsils out for example. It was an unpleasant experience in a nursing home before the NHS. I remember my mother having to pay the bills of the doctors, and that sort of thing, and I remember my first essay at school, at the age of about six, I was asked to write an essay having been told that doctors were going to be nationalised. I wrote an essay in favour of it. So I’ve always been a great supporter of the NHS...

What was fascinating to me was that medical sociology had, again, no category for the actual experience of being ill. They did epidemiology, they did professionalization of medicine, they did organization of hospitals but…  being ill, simply wasn’t on the academic agenda at that point. Professor Arthur Frank: The Development of Narrative Practices in Medicine c.1960–c.2000, pp. 15

Screening for a genetic disease is often seen as genetic screening in the world out there. It’s not, it’s case identification. Neonatal screening is case identification for management, like screening for non-genetic diseases. What we’re talking about here is screening for identifying carriers in order to inform them of risk, to allow them to manage their risk. Prof Bernadette Modell, Clinical Molecular Genetics in the UK c.1975–c.2000

... the Pill might be causing thrombosis. With some difficulty I organized a national study, picking out all deaths within the childbearing age group that would occur in 1966. I had to wait for them to occur and follow them up. By that time I had recruited a team of field workers – we called them Derrick’s Dolls – they were personable, mostly young, doctors who visited the general practitioners to get the information at first hand, which the doctors appreciated. We got the cause of death from death certificates, and I used the same team to follow up the yellow card reports.

May I share one anecdote that reflects the naivety of the Genetic Nurses and Social Workers Association in the early days? We didn’t know what we were doing and it was decided that a constitution should be established for this new association. But no-one had ever done that before and one of the members of the group was a member of a sailing club and she went and got the constitution for the sailing club and they crossed out ‘sailing’ and put ‘genetic nursing’.

In terms of lessons learnt, it’s totally clear to me that at the beginning of the journey for anti-TNF antibodies... it seemed unachievable clinically to get the required amount of antibodies produced... I think the lesson to be learned from that for us as basic scientists interested in finding new ways to treat diseases is: don’t let yourself be talked down by people telling you, ‘Oh, we cannot make this into a drug.’ Professor Henning WalczakThe Recent History of Tumour Necrosis Factor (TNF).

So amongst the other circadian rhythm disturbances one can think about, let me just briefly mention delayed sleep phase syndrome. This is when people have a terrible problem trying to get to sleep at night at a reasonable time and then of course they can’t get up the following day. And David Parkes at King’s and we, together, treated people with this delayed sleep phase syndrome with melatonin to advance them. It worked a treat.

What we were worried about was delivering our professional duty of care, and in other parts of medicine the professional duty of care focused largely on the individual was much better defined than with clinical genetics initially. We were feeling our way, particularly in the 1970s and 1980s. And just to talk about giving bad news, in 1966 when I was a house officer, I told a patient who was having a biopsy for what might be Hodgkin disease, I think, I promised that I would tell her the result when she came back from the operation. My consultant was horrified.

But I just can’t imagine how such a drug [as sumatriptan] would be discovered today. First of all if someone said: ‘Well, there are 14 different 5‑HT receptor types and we know that 5‑HT aborts a migraine attack, you go and find the right one.’ You know with just the molecular biology and paucity of whole tissue and in vivo pharmacology, it just wouldn’t work. Then if you have the Clipboard Charlies going around telling you how to run your project and how you should be doing it, that would kill it as well.

A phenomenon was mentioned earlier today about the supposedly strange reaction of one of the original donor relatives who wished to visit the recipient in whom the heart of his daughter beat. It is, in fact, a common reaction. That aspect of organ transplantation has been present since its inception and is very much with us today.

… criticism is so characteristic of nomenclature, it’s always so controversial and people get so het up about it. Their gene is like their baby and everyone always agrees that one gene should only have one name but they are sure it should be theirs. Professor Sue Povey, Human Gene Mapping Workshops c.1973-c.1991, pp. 66-67

At a clinical level one experience that stood out from my houseman days, we admitted patients usually overnight and in the morning had a ward round with the Consultant. And I was talking about this young African boy, he was about in his teens, and he’d come in and I said he was extremely uncooperative, he wouldn’t open his mouth, I couldn’t see what his throat looked like, and I couldn’t examine his abdomen because he was very uncooperative, and wouldn’t relax and so on.