The worried luddite

Living in a post google search world means that the answer to every question is not only within reach of a 10 second computer search but also the answer can be a multitude of different things.

Take this question for example: ‘what is the use of Gabapentin?

This question produced 5,800,000 results in 0.92 seconds. That’s crazy. It would take me a life time to read through each one of these entries. So obviously I don’t. In fact I already knew the answer vaguely and just needed reconfirmation. But what happened is that on 5 different webpages, I was given a slightly different answer. Not only was I confused but also frustrated. Was the question I was trying to answer worth the twenty minutes of trawling around? Wouldn’t an old-fashioned look up in some book been easier (Yes: this is why the BNF exists).

Technology offers us so much. Hi-tech equipment to do routine surgeries. The concept of e-consultations where the need for doctor and patient to be in the same location is gone. The robotics used in complex surgeries. Even the blood pressure machine is no longer manually used. Let’s face it, technology has revolutionised medicine forever. And we don’t want to go back! We’re far connected, stable and stronger as an industry than we have ever been before. We are saving more people, treating more families and overall achieving higher feats on a day by day basis.

However a talk with my brother (and then subsequent many chats with many engineers) had me wondering what direction our beautifully expanding technological field will take us. We are already in the era of driver-less cars and 3D printing. ┬áSurely it is not too incredulous to imagine a near future where routine check-ups are done by artificial intelligence? Or coughs and colds be automatically diagnosed through a system of exclusion criteria. I used to work for a service which used algorithms to come up with a likely diagnosis. Effectively using the knowledge of many doctors and compiling it into a workable computer program. How long until our machines start doing what we already do. This already has a name: machine learning. Recently a machine beat a human at the game ‘go’. A game far more complex than chess and undefeated by a non-human since its conception centuries before. And when our machines are as good as we are, how long until they get better? What will be the role of doctors then? Will we be there to provide moral support and talking therapies? Won’t that be a good thing? Doctors are always saying how over-worked they are!

But surely humanity cannot be replaced? Can it? What makes us humans so? What makes us tick? Why do we emote and feel? No one has completely figured this out. The more I study the more I feel that medicine is absolutely not just a science. It’s an art. Ask any doctor and they will give you examples of where they’ve not relied on computer algorithms and text-book learning. They’ve relied on compassion, empathy, communication and most importantly experience. Nothing in medicine is cut-clear. There are areas of grey, scales and degrees to diagnoses and disease. The reasons is because the human brain and body is complex. Far more complex than any machine ever built. We, the flawed, egoistic, narcissistic humans are the perfect example of the epitome of creation. We are also the creators of machines. We created machine learning and artificial intelligence and it is here to stay.

There may be a day many many years in the future when instead of seeing your doctor, you’d be seeing a machine. We are racing and advancing ahead in the field of medical-technology at a rate greater than ever before. Making leaps and bounds but is the future where humans are no longer needed really a future we want to jump towards? As the creator of the TV show ‘Black Mirror’ said: ‘I’m not scared about the future of technology but I am worried about it.’




The Power of food

What do you know about the nutritional content of the last meal you ate? Maybe you were having a cheeky Nandos. Maybe you opted for a healthy salad today. Maybe you’re trying a new diet. I had a barbecued, marinated lunch of lamb.

Now think about this: when was the last time you had actual, formal teaching on nutrition and food? I think the last time someone sat down and taught me about food was back in Year 6. We learnt about the food pyramid and the next day had to make ‘healthy sandwiches’. That’s also when I learnt that tomato in bread makes it soggy…

Increasingly over the last year I’ve become fascinated with the abundance of food around us. Over the past year I’ve tried so many different, alternative diets. To name a few I’ve tried to have a plant only based diet. But I missed meat too much so then I tried only a ‘white meat’ diet. Then I tried to do a ‘no carbohydrate’ diet. Recently I’ve been trying to eat smaller but more frequent meals. The truth is I know very little about the food I am eating and also what’s actually beneficial.

  • Does red meat actually cause colon cancer?
  • Do cereals contain more sugar than grain?
  • Is the acid in fruits causing our teeth to rot?
  • Does peeling a vegetable mean we are loosing the vitamins and minerals from that food?
  • Do onions actually cause hormonal disturbances?
  • Does milk cause inflammation?
  • Does cheese contain pus!?
  • Is the food I am eating, killing me?

I’ve always been told that breakfast is the most important meal of the day and that we must never skip it. But for centuries our ancestors were hunter-gatherers. They ate seeds and fruits. They ate when they could. They didn’t have the luxury of an egg and and toast every morning. But cereal, eggs, bagels and bread need a consumer market. They need to be sold. So next time don’t fast-forward the advertisements. Notice how brands like Kelloggs and Burton promote their items? Now look at the packaging of the cereal or yoghurt pot you have at home. It hasn’t been clearer to me that the food industry, like the tobacco industry cares more about money and its business than it does the health of its consumers. After all consumers are replaceable with healthier and younger ones.

Incidentally it was only last month that BMJ released a study that finally proved that alcohol has absolutely ZERO health benefits to us. Remember the days when people would give you a cheeky smile and say ‘red wine is good for the heart’ My mind then went to the tobacco industry. It took researchers 80 years to show the correlation between smoking and lung cancer. For 80 years the media and the government actively ignored medical and health experts and made money off people in exchange for a hospital bed when they got ill. So could the same be happening to food now?

After spending so much time looking at food labels, trying to eat better, trying to feel healthier I’ve only become more confused and a little disillusioned. Recently I picked up a pot of a very famous branded fruity yoghurt. It was something my brother ate after lunch on a daily basis. Yoghurt is good, right? Certainly better than those processed juices and definitely better than a slice of cake. In this 125g pot of mango yoghurt, 13 grams was pure added sugar. I was so disgusted because this very same brand has advertised its yoghurt as a ‘healthy alternative’. Well yes, its healthier than the juice and the cake. But that’s like saying smoke cigarettes instead of a pipe. Whilst one might be healthier than the other, both are still not actually healthy for you.

I could give example after example of similar hypocrisies with different food items but I guess the point I’m trying to make is that as a society we are blissfully unaware of the damage food can do. And it’s unfortunate because food shouldn’t be the reason we are getting ill. And I think half the reason chronic diseases are on the rise is because no one knows what we should be eating.

I’m a medical student and so far in my training I have had one lecture on nutrition. Is this adequate knowledge for a medical professional? Short answer: no. And I’m going to be a practicing doctor in less than two years. If our professionals (barring our dieticians and gastroenterologists) don’t even know what we should be eating how on earth can the society even begin to eat well?