Bring back the calm

All of us go through some ‘A-ha’ moments in life. It could be the wondrous feeling on discovering something amazing, something that you probably knew exists somewhere, but didn’t knew it had a name. Or it could be the chess Grand Master-like feeling on getting the better of my 9 yr old in Wordament.

I first came across the expression ‘calm technology’ in Hyderabad, way back in 2003, when my class mate made a mess of his power point presentation owing to the complex animations. Our teacher, Dr. Mahapatra said, “First get a handle on technology before using it in front of an audience. Technology should be calm”. What we saw on the screen was “Chaos technology”. That was one such A-ha moment that stayed with me (and not just because my plain text presentation got the highest grade in class.)

What would a calm technology look like? Technology should be a facilitator, present somewhere just around the corner, able to effortlessly move to the center of our attention when needed. No fuss. It should not be taking us out of our work. But, all too often it works quite the opposite. Like the i-phone automatically pausing the music, every time the ear phone comes off your ear. Is this a calm technology? I would have said yes. But sometimes in a perverted sense – it makes my teenager believe that studying is just a quick interlude – an undesirable interruption in the flow of music.

The perils of information overload are obvious enough, be it the barrage of candy crush requests or the classical case of harassed husband desperate to make a statement by his “I love you wife” -like status updates. I got digressed here.

That is not to say that all information is undesirable. Without technology, medicine wouldn’t have been where it is today. Diligence then is the key word. Calm technology would help us focus on things that we actually care for and not making us do things that it wants us to do. For all its side effects, social networking is playing a unique role in academia and professional research. Who would have thought that a search query “twitter” on PubMed would produce more than 600 peer-reviewed studies. Evidence-based tweeting’ or ‘tweeting the meeting’, then are the new buzzwords.

Indeed, these are interesting times..For one, twitter is a game changer in epidemic intelligence. Many outbreaks get picked up by alarms raised from by automated algorithms, every time a certain pre-defined hashtag or keyword exceed a certain pre-determined threshold level.

So how does calm technology fit into medicine. Dr Arul Withey wears many hats. This historian of medicine (also a “BBC-New generation thinker’) blogged on the return of leeches in mainstream medicine. Below, I reproduce a few lines verbatim from his blog.

“…To get rid of excess blood was to rid the body of potentially harmful substances. One means of doing this was by visiting a barber-surgeon who would open a vein and take a few ounces. The ideal amount would see the patient light-headed and nearly fainting, but not actually unconscious…”  “… leeches, by contrast, with their 300 tiny teeth, were incredibly effective….. (leeches) had the added advantage of simply dropping off when they had gorged themselves, but also left a ‘thank you’ gift in the form of a coagulant that helped to close the wound.”

Here is the link to his blog = https://dralun.wordpress.com . You can read the complete post here – “Bloodletting in Medicine: The return of the Leech”.

Who knows we might see more treatments like this getting into mainstream. That’s it from me for now. Do you know of anything that could fall under calm technology ? (not those wearable gadgets that tell you whether you are feeling nostalgic right now or are just pissed off”). Take Care. Enjoy the weekend!

Its ciau for now.

Coming up next week: Part-2 of the calm technology series where I also talk about Clinical decision-support systems and how they are affecting health care in U.S. I’d  be great to have your comments.

Image of the Week: Leech jar

A sneak peek at history (@ Wellcome Trust Blog)

Wellcome Trust Blog

Leech Jar

This decorated pottery jar, made by Samuel Alcock and Co, was once used to store leeches in a pharmacy before they were sold to physicians.

Historically leeches were used thought to cure all sorts of ailments, from fever to haemorrhoids – and even black eyes. Leeches were used as a method of bloodletting, which was based on the idea that “humors” (blood and bodily fluids) needed to be in balance to ensure health.

In the early 19th century, at the peak of medicinal leech usage, around 35 million leeches were used every year in France. By the late 1800s bloodletting and leech therapy began to lose favour.

Although we have moved on from the humors-based understanding of how the body works, there is still a place for leeches in modern medicine in select circumstances, such as when a severed finger is reattached. While arteries can be reattached, veins are…

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Whither Medicine !

US National Library of Medicine
[Source: Horder, 1949: British Med. Journal;2;1(4604): 557–60 US National Library of Medicine]

Whither Medicine ? 

The incredible story never ceases to fascinate.The story of medicine. From the quirky medieval quack and the 17th century barber-surgeon, to the near god-like wizadry of the transplant surgeon.

Intriguing. At times disconcerting. Fascinating, nonetheless

Intriguing as its past reeks of perpetual opportunism. Make no mistake, medicine of its times has always taken the side of the powers-that-be. Not for anything else, but for its own survival. Pretty much like the proverbial shadowy past. ‘Disconcerting’, as its motives today increasingly get questioned; ‘Suspect’ since its boundaries are no longer clear.

Never before in history did medicine had such capability as it has today – to save lives, overcome disease and even manipulate death. “Why then, at the peak of its prowess, the profession is besieged by an unmistakable disquiet and distrust ?”, writes Roy Porter in The Cambridge – History of Medicine. Food for thought!

Look into the past and you might just see the future.

Not sure if somebody said that before, but that’s pretty much the take home message. History is like a mirror for gazing at our future. Reflect on history and you might just see the future. speaking of metaphors. At least anthropologists would swear by it.

Imagine the world has no such thing as a mirror… imagine that mirrors, pictures just don’t exist; No visual cues to tell us how we look like. How will you know what your own face looks like. You won’t have a clue, even if your identical clone (yes that’s possible these days) is standing right in front of you. One just wouldn’t know.

Sounds weird? But isn’t it weirdness that makes the world go round. Go back a couple of decades back, many of the things that we are now so used to, would have felt weird to most of us. And I am not even talking about the app that tells you which friends stress you out or the programmable make-up for your lady. Talk about 20 GB wearable smart eyelashes that anyone would crave to hack into.

Whither Medicine ?

The expression more or less mirrors the blog’s raison d’etre. Here you will find my thoughts on the art and science of medicine. The narrative would back and forth in time as that is how our brains work best. Here I’ll be pouring my random rantings. Its not going to be cynical all the time. Just my version. My distorted world view, if you please. The ’emic perspective’ of Medicine, yet, through a sociologist’s lens. Learning, Explaining, Making sense. but most of all Enjoying.

I can’t do anything for you but I’d still like to see you every 2 weeks until you run out of money. [Photo credit: David Cooney (US)]

History repeats itself

Medicine is a noble profession. or at least that’s what it is supposed to be. Right?

Wrong! This contradiction is in fact one of the reasons for this blog’s existence. If you are still reading this, there’s a slight chance that you are also interested in medicine in a weird kind of way. Right??

Wrong again !!! There are no rights and wrongs on this planet. At least that’s what the Americans would want us to believe. (Read more about it Here) Turns out, being right and being politically correct are kinda different things.

What has politics got to do with it? I tell you what, that’s the contradiction! Let me conclude this post by endorsing the most crassest of contradictions of Medicine.

“Politics is the art of the possible and Medicine is nothing but politics at a large scale”

Big deal ?   Not really.

That brings me back to the ‘noble profession’. Its hard to imagine but actually true. Medicine was a derided profession until as recently as late nineteenth century. Treating maladies was a menial job for most of history. It was the preserve of the cobbler, the carpenter was the intern and the barber might well be the house surgeon. In the absence of any scientific basis, the harrowing treatments did way more harm than good. Little could the doctor do other than blood letting, purging or leeches. It wasn’t until the start of industrial revolution in Europe that systematic enquiry took root in physical sciences. That’s when the science of human body, along with all its misgivings, gradually began to unravel. For the next one century it was the era of experiments.

Speaking of Medicine
Speaking of medicine

Doctor heal thyself 

Before closing, my parting thoughts: This post is not just about being weird. Nor is it about criticizing ‘all things medicine’. Rather, this is a space where I reflect on our own aberrations along side Medicine’s splendid achievements. In some ways its a reality check to help stay grounded, every time somebody gloats over the Medicine’s invincibility.

“Whither medicine?” The eminent physician Lord Horder asked this question back in 1949, in his British Medical Journal article. He had no way of knowing then, that his question would turn into a prophecy, just half a century later. “Why, whither else but straight ahead”. He answered his own question – But as Porter puts it, “today we are not even sure where straight is.” In the past, medicine as a profession had little to offer by way of treatment. Still nobody complained about the good old doctor. Ironically, as the medicine acquired its new found capability and power, so did grew the disillusionment with it.

Have we strayed from our path? Are there any limits to medical intervention? How do we decide when to stop intervening and allow nature to run its course? Do life support systems prolong life or are we merely prolonging the death? Why the most powerful nation in the world is struggling to pay its medical bills ? Why alongside the spectacular achievements, is there a culture of litigation? Why and how did we end up with managed care.? (More about Obamacare here) Are we somehow getting into medicalization of normal life events? How do we put a number value on health state? Should we really use a number to decide where we spend our one dollar on? And lastly, are the medical institutions today creating scientists instead of doctors?

The Managed Care paradox
Doctor’s dilemma: Manage the manager

Food for thought. All questions debatable. But it is not just about being cynical. Either way, these are questions that should prompt introspection, if only to refute their logic. Thanks for staying with me till the end.and hope to see you around. Its just a start but I will be posting new content regularly. Thanks again.

ciau for now.


Coming up: The number’s game: What they didn’t tell me in medical school!”  My next post is inspired by Gerd Gigerenzer and his amazing work – ‘Reckoning with risk: Learning to live with uncertainty’ 

Read more : About me 

A massive response is countering Ebola in West Africa – The #EbolaReport, January 25th, 2015

The Ebola end game? Not quite! Still a long haul…

#EbolaReport

A picture of the massive Ebola response that’s now in place in West Africa, and how it is making great strides in the fight to contain the year-long outbreak: http://www.who.int/csr/disease/ebola/situation-reports/en/.

Example: in Sierra Leone, 100% of districts have access to lab services within 24hours and have key religious and community leaders who promote safe burials; 1150 ebola treatment center beds available (that’s 8.7 beds per reported case currently); 96% of registered contacts to be traced are reached daily; 102 trained burial teams are available. 117 new cases were confirmed in the week of Jan 18th, but that was down from 184 in the week before.

Thank you to everyone who is working to turn the crisis around.

-Culled by Arthur Musah.

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