Archive for June 3rd, 2008

Novocaine for the soul

For various reasons, mostly not having the internet yet in the new house, [NB I now have the internet, hence the post] I haven’t been writing much of late. Well in reality I’ve been writing lots just not online and not of the the most positive or cheery nature.

A couple of book recommendations:

– Rise and fall of modern medicine:
First recommended by on of my dear old ICU bosses in NZ. Covers 12 of the major medical discoveries that have genuinely transformed how medicine is done.

They almost all happened between 1930 and 1970. This may surprise you. One of the few things in medicine that continues to amaze me is how in the dark we are about almost everything that happens. We still can’t even cure the common cold. We can see that some of the drugs we give appear to make people betterĀ  though often we haven’t a clue why (we have plausible theories that often sound good but that’s different), and we certainly have a very limited idea of what actually causes many of the diseases we see.

We are flying somewhat blind. I hope this does not scare you. We certainly do the best we can, the best on the information we have, just that the information we have mightn’t be great. I’d still trust a pilot flying blind more than joe bloggs flying blind.

The other thing that struck me was how completely random and fortuitous all the great discoveries have been. For example we have been so lucky to be provided (never mind how it was even discovered) with a fungus that just happens to be lethal to many of the common bacteria that uses to kill so many in infancy and old age. It also happens to be almost entirely non-toxic to humans. And the funny thing is we haven’t a notion why this fungus happens to make this most fortuitous of discoveries. There is not the slightest evolutionary advantage for a fungus to produce an antibiotic, and indeed of the countless species of microorganisms only a tiny fraction happen to produce such useful chemicals. I find this distinctly odd. But comfortingly grateful none the less.

Back to TW in NZ. He was 67 when I worked with him. He started anesthetizing his first patients with drops of ether on gauze (though are you keeping up with Lost) and his only monitoring was watching the chest rise and fall and his finger on the superficial temporal artery. TW has seen a few things. Often I got the impression that the only drugs worth giving (at least to the ICU patients) were morphine, antibiotics and oxygen (though I have my suspicions about the oxy). The longer I do the job the less I disagree.

Things the grandchildren should know:
Read in just over a day listening to my collection of Eels on shuffle. I find Mark everett a truly fascinating individual, between this book, his songs and the recent TV documentary about his father. Above all else there is honesty and comprehension of “the inevitable pain of being alive” (as David Bazan puts it). He also appears to have grasped something of the sweetness of life in “how I was thinking about how everyone is dying but maybe it’s time to live”.

Plus he has a cool beard, cool dog and smokes cigars. What more can I say. He makes nice tunes too if that helps.

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