Bad Science, Ben Goldacre

In my opinion, this book can be described as nothing other than brilliantly eye opening. Ben Goldacre discusses serious issues faced by the public, including medical professionals with a fantastic sense of humour and flair. I seriously enjoyed reading his book.
I enjoyed his chapter about Gillian McKeith, but that was mostly due to his whit as opposed to the science based knowledge he wrote about, which was definitely not lacking in other areas of the book. To start with, he debunked techniques that are widely used in schools, called 'brain gym', which I myself have been subjected to and wasn't overly enamoured by. These techniques include things such as creating 'brain buttons' which can be used to stimulate your carotid arteries from outside your ribcage by simply rubbing your chest. Obviously impossible. He then goes on to discuss the fact that the cosmetics industry are using long words which the general public are unlikely to understand in order to sell more products on the basis that if people do not understand the sciencey words they are likely to think that the product will be beneficial to their health. For example, the use of the names of specific compounds that are ingredients in the cream, when in fact, if you look closely enough at the packaging, or any of the advertising for the product, there are no claims that those specific chemicals will actually make you look better. As the author states, the claim is made for the cream on the whole, because as we are all aware, moisturising the skin will make it look nicer, but that could be done using a cheap cream as opposed to the expensive one with the magic, fancy chemical. This is an interesting point, which basically encompasses the message Ben Goldacre is trying to get across for the rest of the book, and that is the fact that we are too quick to believe the things we are told, particularly when it comes to scientific fact.
A fantastic example of this is the famous case with the MMR vaccines being linked to autism. The case which was eventually disproven, but only after thousands of children didn't receive the safe vaccination they needed to protect them from extremely dangerous diseases. This book addresses the idea that we are so easily misled in a clever and humorous way that keeps the reader engaged in even the most potentially tedious areas of deeply confusing statistical methods.
One thing I'm really glad I've been able to take from this book was knowledge of the Cochrane Collaboration, an organisation who carry out reviews of clinical trials and review them systematically, which has provided us with a database of information about how well the trials were conducted and the results found over a collection of trials as opposed to just one.
Overall, I loved reading Bad Science and feel that it educated me on the pharmaceutical industry as well as opening my eyes to some of the money making scams and how the media mislead us on scientific topics every day. I would definitely recommend it.

How much of our brain do we actually need?

I attended a gifted and talented conference a few months ago where we were told about a man who had walked into a hospital with enlarged ventricles meaning that his actual brain tissue was reduced massively. I was so fascinated by this because I could not get my head around the fact that the brain can be so significantly damaged and for someone to be able to function with almost no real problems. I read further into this and found that this man had an IQ of 75, which is of course below average but by no means unusual, and definitely does not indicate the level of damage to his brain tissue which was seen. To me this shows just how much our brains can adapt to certain circumstances. This is especially impressive considering that the man had suffered from hydrocephalus as a child, which can often kill. The man must have had immensely increased intracranial pressure which, in his severe case should have caused some sort of mental disability. 

Another interesting case of brain injury (that I read about in Impulse) was the case of Phineus Gage, who had a metal rod driven through his brain, but managed to survive reasonably unchanged, given the circumstances. This is due to the fact that the rod penetrated his left frontal lobe, the area of the brain associated with recognising consequences and knowing the difference between right and wrong (among other things of course), which would explain why Gage's injury only resulted in a change in his voluntary behaviour. This was, of course, famously recognised by his peers, and the reason he was fired from his job as a foreman. 

I find it incredibly interesting that the brain is such a complex and vital organ, but can take serious damage without fatal consequences. When even the smallest thing goes wrong, for example in 'silent strokes', it can have significant effects, such as the onset of vascular dementia, but others can have a huge steel rod pushed through and remain mentally competent. It is definitely fair to say that the human body is a well oiled machine and something I often wonder if I will ever truly get my head around. 

Paediatric A&E

A&E has always been an area of medicine I have wanted to look into purely because it always seems so exciting and diverse. One of the reasons I love the idea of becoming a doctor is that I know I will never be bored and A&E has always appealed to me because of the need for quick and efficient problem solving and the ability to work under pressure. Some people might view this as scary or unpleasant but I love situations like that. So, when I was offered some time with a consultant in paediatric A&E at my local hospital, I jumped at the opportunity. I arrived and was sent straight to the staff room area which was full of doctors at computers typing away, with a big TV screen on the wall with names and DOBs and injuries on. I was introduced to a few doctors and told to just shadow anyone I liked. Great.

As soon as someone picked up a card to leave the room, I jumped up too and followed. A finger injury on a young boy following an incident with a folding chair… Oh dear! It was definitely difficult seeing the child so upset but it was nice to watch the way the doctor interacted with both the child and the parent. Reassurance, support and professionalism with the parent, and care, patience and compassion with the young child. 

After seeing the patient, I followed the doc to go and fill out a multitude of online forms to allow the boy to be discharged. That area of medicine is something which is definitely not well known among wannabe doctors, but it didn't bother me too much. I saw it as a pleasant break from patient contact to consolidate the things I'd seen and reset myself to go back to see more patients. 

I saw lots of chest infections but one which stands out was a young boy who was covered in a rash. I went into this consultation with a medical student who was doing a placement and after taking the history and conducting the physical examination, she suspected scarlet fever, but was unsure, and so didn't mention anything to anyone before relaying her findings to the consultant. By doing so, she avoided panic and ensured that no unnecessary concern was caused. The consultant then went to do her own exam and ruled this possibility out and diagnosed a chest infection. However, the medical student was still applauded for her efforts, despite her initial diagnosis being incorrect, because she was able to seek help and reassurance. This highlighted another, less obvious quality of a good doctor, and that is being able to check your work and recognise areas of weakness, asking for help where necessary, especially when the welfare of others is in question. 

Because I quickly got on really well with the medical student, she taught me how to take patient histories and taught me a method she had recently learnt called BINDS used when taking the histories of young children. B stands for birth, as in was the birth normal? Natural or Csection? I- Immunisations, are they up to date? N- nutrition, are they eating normally, enough, still have an appetite, drinking enough, less/more than usual? D- development, are they developing the way you would expect, do they act in similar ways to other children their age? S- social background, who do they live with? Do they live with any pets? 

Overall, I loved A&E experience :)