A drop too much of wine

Disclaimer: The patient and any identifiable information has purposely been left anonymised to protect the individual’s identity. If you feel that this has in any way been violated please do not hesitate to contact me. 

When I first met her, it was because I had been asked to put in a cannula into her arm. My hands shook like anything. Luckily the doctor supervising me was very patient and we cobbled together (the patient, the doctor and I) and it was a success story. When I met her a week later it was to take a history from her. She was as welcoming as it is possible to be in an unfamiliar, non-personal hospital bed. But I drew the curtains and took a seat, the ‘Hello I am a medical student’ flowing from my lips. Continue reading


Mirror Mirror

Reflection. It is the dreaded word in healthcare. Why? Because it is uncomfortable and tedious. Imagine selecting the most boring film you know and watching every excruciating minute of it. Now imagine watching it with the most critical person you know. Does that sound fun? Reflection isn’t meant to be fun. But it is vital for creating a better health care service.  Continue reading

Tribute to surgery

As I sat in the world’s biggest car park, which is the M25, I wondered what was the cause of the delay this time? Another cyclist? Or was it an escaped dog on the motorway? Maybe someone’s car broke down. As the minutes ticked by, my passengers getting more and more bored, my head starting to hurt and finally google maps gave us an alternative route. Off we went down a different exit and my passengers reached the airport and managed to catch their flight. I chanced the motorway on the way back and the cause of the delay was suddenly quite apparent. It was a road traffic collision. Judging by the 3 ambulances, 2 police cars and too many people on the actual road, the situation was quite dire.  Continue reading

We need to talk (more)

We as humans are a social species. By that, I mean, we have the intrinsic need to meet and engage in conversation. Even people who call themselves ‘introverts’ have the innate requirement for social interaction. It is a physiological phenomenon, which eons of evolution has not gotten rid of. Or more precisely, eons of evolution has preserved our ability to connect to one another. Despite that, the modern human is not very good at engaging in conversation with another human, effectively. Continue reading

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.  Surely 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.’