“Reflections on motherhood and self-fulfillment”

Re-posting a touching article I just read on Medium. Find it here

What I have learnt in these last few years of emotional turmoil and deep reflection, is that, we cannot find meaning, with or without a child, if one does not first, become as complete a human being as possible. Perhaps being completely self-sufficient is not realistic, given that we humans are social creatures and somehow evolved to depend on one another. However, my observations suggest that we are, as a generation, extremely dependent on external validation, with motherhood being, among the easiest ways of being immediately validated as a woman (the other being postings on social media). Instead, we require society to direct us towards a choice that gives some meaning to our lives, such as careers and/or parenthood.

Which makes me wonder, why do we do what we do? Why do we share the things we write, images we take etc? Asking ourselves these questions constantly is a good practice to make sure that whatever we do is in line with what we truly want, and not out of the expectations external to ourselves.

 

The iceman forcing scientists to rethink human physiology

I just listened to an episode of the podcast ‘Grow Big Always’ where the discussion revolved around the concept of mind control over body. The eccentric Dutchman Wim Hof first caught my attention a few years ago in a BBC documentary about ‘superhumans’, and in that episode, Wim was able to dive in the Arctic underwater in shorts for a considerable period of time, defying physiology as we know it. He has defied many odds since then, and we are only now beginning to understand how his physical and spiritual practices have enabled him to control his autonomic nervous system as well as his immune system, which is short of revolutionary. What to me, is even more amazing is the fact that his breathing techniques (somewhat similar to certain yogic meditation practices) combined with specific physical exercises and cold exposure can be taught to normal people with success.

For scientists, check out this article in PNAS from 2013, where Wim trained a group of people with his practice. To the researcher’s surprise, the training managed to greatly reduce the immune response (in a good way) to bacterial endotoxin. The ability to consciously control the autonomic nervous system and the immune response is truly revolutionary.

It is interesting to note how mute the response has been from the mainstream scientific community. This is not a study that has been obscured to some unknown journal or confined to some new age spiritual community, but instead this is a sound scientific study published in a prestigious journal. Yet very little has been reported in mainstream news, where sites like the BBC would instead constantly publish some new study on this or that new drug to cure cancer. The effects of oxygenation of the blood via deep breathing and increased alkalinity of the tissues as a consequence of the oxygenation on the immune system has been scientifically studied and validated. If preventing illness is really this easy, I wonder what the future of the medical industry (and preventive medicine) would look like…

Reality is only true within the perspective we choose to explore

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Today I was looking out my window across the street at a bus stop and noticed a person standing there looking back towards me. Even though we are all aware that different viewpoints must exist, in that moment, it really struck me that the reality that this person was living in was distinct from the one I inhabited. As that person looked towards me, she was imparting meaning to the perspective of reality that she was encountering from across the street. That point of view was unique to her alone and will be different for the next person who may repeat the same act but interpret the viewpoint from his or her own unique set of mental lenses.

7 billion perspectives

In this one moment, there are therefore 7 billion realities coexisting simultaneously as 7 billion people assign their own unique meaning to reality as they see it in front of them in the here and now. In the next instance, another 7 billion perspectives emerge, having been created in that instance by all 7 billion people. Could it be that in one instance of time, ‘reality’ is just made out of 7 billion multiplied by an infinite choice of perspectives?

What on earth could this mean?

There is no one reality nor is there one truth. There are a multitude of truths and a multitude of perspectives all existing at the same time. Reality is only true within the perspective we choose to explore. All other perspectives are valid and equally true…

Is there truth to science?

Following through this line of thought:  when we carry out an experiment, the results that we obtain, on their own, are neutral or meaningless, until a human being interprets the observations in a specific way. Given that each scientist working in that particular field has their own unique perspective of the world in front of them, one would expect there to be multiple interpretations to that one particular experimental result. Imagine how much more fun science would actually be! Perhaps in such a situation, we would then have to invent tools to allow us to integrate these diverse perspectives and work together in order to augment our understanding of a particular phenomenon to a higher level.  Yet, what we see today is a general consensus of what can be considered to be one version of a specific scientific truth. This ‘fact’ then persists over long periods of time, to the point that alternative perspectives or interpretations are squashed and fail to see the light of day. A paradigm shift occurs when one scientific truth is replaced by another that may be radically different from the previous one.  From that point onwards, it becomes the general consensus reality, promoting that one new version of scientific truth that will become the new dogma without incorporating many other possible interpretations of that ‘truth’.

Surely, this way of working with one point of view at a time is far too slow to create advances that could confront the challenges that humanity faces today. Perhaps, out of pure necessity, the science of the future will one day be driven forward by this multiple perspective approach as a new generation of scientists wake up to the realization that all truths are valid in a neutral universe.

‘There’s no space for today’s young Einsteins’

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I entered science full of optimism and left a top ivy league university lab feeling disillusioned with lack of meaning in my work. My advisor encouraged each of us graduate students that a scientific career was reserved for only the fittest…in a Darwinian sense of the term. In fact, today’s scientific career leaves very little space for neurodiversity. Introverts (like Einstein) just cannot flourish in an environment where people are encouraged to publish or perish. The science of today is filled with errors and irreproducibility because all the truth-seeking/meaning-driven people have been weeded out by the system and those that remain are of certain personality types that drive a certain type of science. Perhaps this is particularly true of the biological sciences although such attitudes in academic theoretical physics are increasingly commonplace.This article at the Guardian sums it up clearly here :

If Einstein’s project had relied on a grant application today, it would surely be rejected; probably no young scientist could afford the luxury of contemplating it in the first place. It’s not clear there is a space for Einsteins in modern science any longer.

When doctors stopped listening to their patients

I was once attached to a gastroenterology clinic, when an immaculately dressed but apprehensive looking elderly lady in her 70s walked in for her appointment. The lady, C, was referred by her family doctor due to some unspecific bowel problems. The attending physician looked at her notes, mumbled some things to her in jargon-filled language, one of which was the word ‘Crohn’s’. C became alarmed, and asked the physician if it was something serious. He mumbled some more, and told her to forget about it until she’s had further tests. Within 10 minutes, the consultation was over, and C, was ushered out the door.

An hour later, I walked out to make my way to another part of the hospital when I spotted C sitting in the corner of the patients’ waiting area. She saw me and I walked towards her. She seemed deeply troubled and so I decided to stop and talk to her. It turned out that her husband had recently died and she was very lonely. They had met during the war in Italy; he was an Allied soldier who was not well-off and she was a Napolitan girl from a respected background. She described that it was ‘true love’ till the end, and how she turned her back on her home and her culture to be with him. She also revealed how she had waited for a long time for this consultation with anticipation, and that she had been worried about her own mortality since seeing her husband die. The mention of Crohn’s disease mortified her and became a further source of anxiety. The speed and tone of the consultation left her with even more emptiness than before.

What I learnt from this experience was that doctors often, by focusing on the symptoms and not the underlying cause of illness completely miss the mark on how to truly heal another human being. The gut-brain axis is a well-known connection, where stress results in worsening or even the appearance of symptoms. The symptoms are real, in that they are physiological and not ‘in the mind’. However, by zooming in on the physiological manifestation alone such as the case of C, will probably result in worsening of her symptoms due to more stress and anxiety. What this lady needed, besides being investigated further, is a referral to social services and psychological counseling. Perhaps her symptoms may even be cured without medications. She did not get what she needed, because no one was there to listen.

Yet, I cannot blame the doctor alone for his actions. The medical system is broken and the doctor is simply part of this broken system. It is a system that works well as long as we narrow its usefulness for treating specific physical symptoms but restrain our expectations on making us feel better. It is not a system that is focused on achieving optimal health, as defined by the World Health Organization to be ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity‘. Medical students, prior to being unleashed into the healthcare system should be made aware of the shortcomings of the current system. Medicine is not the magic pill to solving people’s health problems. They should be prepared for a world where unsatisfied patients will question them and ultimately leave their care for that conferred by homeopaths or acupuncturists who are better listeners with more time on their hands. Why would this be so surprising anyway?

There is an unfortunate tendency to portray patients who are doubtful or distrustful of the conventional healthcare system in a patronizing light. In paediatrics, I remember being taught that no one knows the child better than the parents. Yet today, medical professionals seem to be completely shocked by the ‘irrational’ behaviour of parents who claim that their child has had an adverse reaction from vaccination. Rather than listening to the parents’ concern (pre or post-vaccination), doctors are quick to judge parents as being irrational and quickly dismiss their fears or observations, which is paradoxically an emotional, rather than a rational approach to dissecting a problem. Shouldn’t we at least try to understand why these parents are concerned? Have they all suddenly gone ‘irrational’ for no apparent reason? This is when, in my opinion, the medical system has turned into some sort of a religious sect with a belief system that masquerades as ‘evidence-based medicine’, and anyone who even attempts to question the prevailing assumptions is quickly being labelled as a medical heretic. For parents, there is nothing more demeaning than earning the title ‘anti-vaxxer’ by the medical establishment.

 Are we entering the dark ages of medicine?

The End of the Antibiotic Era?

Recently the BBC published a story about a bacterial strain resistant to a last-resort antibiotic found in China, raising fears that we are close to a post-antibiotic era where common, treatable infections will become untreatable and life-threatening. How did we get to this stage despite the advances of 21st century medicine? Much talk has been made recently regarding the possibility of sending humans to Mars, yet could it really be that humanity may not even get there if we are threatened by the humble terrestrial bacteria?

For most of human existence (around 200,000 years since modern humans appeared), humans have had to rely on their own immune response, as well as the help of some ‘natural remedies’ to help them cure infections. Unbeknown to ancient humans, the natural remedies used such as frog bile with sour milk (Babylonia), warm soil (South American Indians) and mouldy bread (Greece and Serbia) contained the precursors of modern antibiotics. Traditionally, antibiotics are natural chemicals produced by bacteria or fungi to inhibit the growth of other bacteria. Therefore it may not be too surprising if these seemingly strange practices miraculously worked to treat bacterial infections. It was only in 1928, that the modern era of mass-scale production of antibiotics came into being with the discovery of penicillin produced by a contaminating fungus in Alexander Fleming’s laboratory. Since then, many other antibiotics were discovered from the environment and were successfully used to cure many dreaded illnesses such as tuberculosis, scarlet fever and septicaemia. Molecular biology also enabled the screening and tweaking of large numbers of synthetic chemicals that could mimic the action of natural antibiotics. The usage of antibiotics was life-saving and contributed to the rapid decrease in infectious disease burden in the world. We enjoy the increased longevity we now have, in part, due to the ‘re-discovery’ of antibiotics and its subsequent widespread use.

From that stage onwards, one might expect the saying ‘and humanity lived healthily ever after‘ to be emblematic of the state of the human species.

So what happened?

The forces accelerating the rise of resistant bacteria

We all have heard of places where doctors and pharmacists over-prescribe antibiotics, or places (physical or online) where antibiotics could be bought without prescription. As an example, one of the major factors leading to the rise of multi-drug resistant tuberculosis is the abandonment of antibiotic treatment prior to the completion of therapy, leading to the overgrowth of a small population of resistant bacteria, which then gets transmitted to others. In India, the illegal selling of drugs resulted in unregulated usage of antibiotics which subsequently gave rise to resistant strains. Thus, human culture and practice is one major factor that contributes to this problem.

There is, however, another important factor that is discussed less frequently; that of economics. Specifically, the issue lies in the subtle link between the usage and manufacturing of antibiotics to that of monetary profit. By monetary profit, I mean both to increase profit as exemplified by the use of antibiotics to heighten yields in animal agriculture and at the other end of the spectrum, the lack of profitability as viewed from the perspective of the pharmaceutical industry.

The discovery that low doses of antimicrobials had a growth-promoting effect in the late 40s coincided conveniently with the onset of intensive farming practices in the UK with the passing of a new Agriculture Act in 1947. Since then, antibiotics have been used in animal agriculture to counter suboptimum animal growth due to unsanitary conditions and overcrowding, allowing for increased animal densities in farms. Antibiotics were also used preventively during specific periods such as weaning (to separate calves from their mothers) and after transportation, both of which are situations that occur when animals are highly stressed. Stress weakens the immune system making animals more susceptible to infections. Preventively feeding them antibiotics will not do anything to their stress levels but will quickly cure any subsequent infections that develop, thus minimizing loss of profit.

Widespread use of antibiotics in animals creates pressure on bacteria to evolve genes that can resist and survive the onslaught of these antimicrobials. That is exactly the situation that was discovered in China, as reported by the BBC, where the drug of last resort used widely in livestock, colicin, was rendered ineffective by resistant bacteria. Eventually, these resistant bacteria (and residues of antibiotics) will wind up in humans, directly via the consumption of contaminated meat, or via the usage of animal manure in agriculture, finally ending up on your plate. The repercussions of this practice go beyond solely the introduction of resistant bacteria into our bodies, but also towards the perturbation of the human microbiome by antibiotic residues which have been implicated in the rise of obesity as well as allergic diseases.

Whilst antibiotics are used to increase profits in animal agriculture, pharmaceutical industries shy away from the research and production of new antibiotics due to the perceived lack of return from investment. Why invest in the development of an antibiotic that has a net present value of less than $50 million when one can gain more profit in the sales of a new musculoskeletal drug worth more than $1 billion? Almost all the classes of antibiotic used today were discovered between the 1920s and 1970s. Since then, only two new classes have been developed and very few are in the pipeline.

Because bacteria are constantly evolving, resistance genes exist both in the environment where bacteria undergo friendly exchanges as well as due to mutations that occur when the pressure is high for survival, such as with widespread antibiotic usage. Therefore, in order to keep up with the evolving bacteria, research on antimicrobials cannot stall for decades, as has happened, or we will end up in a post-antibiotic world where even simple surgeries may lead to life-threatening consequences. That is where we are heading now, if new efforts to revive antibacterial discovery and re-evaluate the usage of antibiotics are not put in place.

How do we move forward?

Imagine a world where essential drugs such as antimicrobials were made by non-profit organizations that are financed by all governments of the world in a collective action for the good of human health, instead of a world where the health of humans depended on whether or not curing us signifies a good return on investment. Something has clearly gone wrong somewhere in the path of history to have led us to this point of our development as a society.

In 1846, William Morton conducted the first successful surgery using an anaesthetic at the Massachusetts General Hospital in Boston. Following his success, he promptly patented the anaesthetic. His actions at the time generated widespread outrage among the medical establishment who found his actions to control and profit from a life-saving substance to be immoral. No such condemnation exists today as we have gotten used to a new normal where exclusive patents and blockbuster drugs are absolutely acceptable from a capitalistic societal point of view. For most, if not all of us, this model is all that we have ever known.

The prediction and fear of an imminent ‘antibiotic apocalypse’ may just be what is needed to radically change the way businesses are run when it comes to antibiotics and healthcare; similar to the case of climate change, where desperate times require drastic actions. Most countries in the European Union have banned the use of antibiotics in animal feeds though the practice is still widespread worldwide, including the United States. Alternative non-profit drug discovery consortiums have been established though many have turned to collaborating with industry in order to obtain funding. The cost of developing a new drug (at least $300 million) is prohibitively expensive for any non-profit organization to bear, which is why a whole new way of funding such treatments should come into being, such as by pooling together funds from various countries into a common fund for research and drug development for human health. We may also need to look into nature to discover new antibiotics that bacteria have evolved over millennia; though with the unchecked destruction of our ecosystem, these potential therapies may be lost forever before we ever come close to discovering them.

Perhaps it is also time to rethink how we view the fight against infectious diseases by focusing on non-pharmaceutical prevention strategies. Vaccines do not come to mind since it will be impossible and even harmful to our microbiome to create vaccines for every organism on earth that could potentially cause us harm. We need to look into why infections occur in the first place by understanding the dynamics between our environment and our bodies and what we can do to minimize the risk of infections, thus obliterating the need for antibiotics in the first place. This is, in itself, a whole other topic for discussion, so stay tuned!

Towards health 4.0

Obesity, Alzheimers, multi-drug resistant bacteria, allergies, autoimmunity, Ebola and pandemic flu; these are among the health challenges that our society face in the 21st century. The question is: how ready is our healthcare industry in meeting these emerging challenges effectively?

I went into the biological sciences because I believed that scientific progress could make life better for billions of people, especially the ones that are the most vulnerable. After more than a decade in academia and industry, I am sceptical that with the current setup, we will ever be able to come up with meaningful solutions to the current and upcoming health challenges of our time. It is astonishing that around 270 billion dollars per year is being spent on medical research, yet emerging diseases like diabetes keep increasing relentlessly in developed countries and preventable infectious diseases like tuberculosis continue to kill millions in the developing world. It is hard not to wonder if we, as researchers, are looking in the right direction to solve the world’s health problems.

If this trend continues, our healthcare industry will be crippled from the increasing burden of illness that threatens to swallow up resources that are getting scarcer. To face these complex health challenges, I believe that there is an urgent need to explore radical new directions for scientific discovery that are innovative and unconventional yet relevant for the health problems that we face today.

To do this, we need to abandon the safety of scientific silos, go beyond the existing scientific paradigms and reach out across different knowledge domains to make new connections that bring us to the next level of understanding the human body in the context of modern society and the environment that we live in. Equally important, we should treat negative results with the same reverence as positive results, even if this means that these results are not as appealing to prestigious scientific journals and for our scientific careers. At present, large areas of investigation are being neglected simply out of fear of going against the prevailing scientific establishment (which includes grant-funding bodies and university tenure committees) or perhaps out of perception that the topic is not fashionable enough for the community. This aspect of research culture, I feel, hinders our ability to truly discover solutions that make a real difference to people’s health and to society.

With this blog, I plan to look at issues in healthcare with different sets of lenses. I want to ask questions that are not usually asked and pick up on things that are not usually noticed. I will attempt to put healthcare issues in perspective by incorporating viewpoints from beyond the world of biological science and medicine. Stay tuned for more updates and I look forward to your comments!