Scientists Dissected the Brains of 79 NFL Players. What They Found Is Disturbing. | Mother Jones


Yesterday, the country’s leading investigators of sports-related brain injuries released what could be their most shocking finding yet: Of the 79 deceased NFL players examined, 76 showed evidence of chronic traumatic encephalopathy, or CTE. The researchers at the Boston University CTE Center have examined, in total, the brains of 128 people who played football at all levels—from high school to the pros—and 101 showed evidence of CTE. The numbers buttress a growing body of evidence that suggests that playing football at any level can lead to grave health consequences.

In case you haven’t been following the story, here’s how CTE works: When the brain is subjected to repeated trauma—from the severe (and rare) concussion-causing hits to the repetitive, smaller impacts a lineman might absorb thousands of times in his career—its tissue starts to deteriorate. That causes the buildup of abnormal tau proteins, which interfere with a whole host of critical brain functions. In the short term, it can lead to memory loss and impaired judgment; in the long term, it can lead to severe depression and dementia. Ex-players describe its symptoms as crushing, and in many cases, the pain, unpredictable outbursts of rage, and memory loss becomes too much to bear.

Three images of brain tissue, with tau protein in brown. The left sample is from a nonplayer subject, the middle comes from a football player, and the right belongs to a boxer. Courtesy of the Boston University Center for the Study of Traumatic Encephalopathy.

In the past few years, several former NFL players have committed suicide and were later found to have had CTE. On Monday, researchers found that Jovan Belcher—the Kansas City Chiefs linebacker who killed his girlfriend and himself in 2012—also had been suffering from CTE.

Two decades ago, when players began to link their health problems with their football careers, the NFL denied the prevalence and severity of brain injuries. In the 2000s, the league’s (now-defunct, and poorly named) Mild Traumatic Brain Injury Committee frequently stated that not one NFL player suffered from chronic brain damage. In 2009, years after the first player had been diagnosed with CTE, Dr. Ann McKee—a leading Boston University researcher—presented her findings before an NFL committee, which reportedly attacked the scientific rigor of her research. Meanwhile, right-wing media like Breitbart have been downplaying CTEand attacking doctors’ credibility for years, often referring to their work as “junk science.”

Currently, there’s no way to definitively know if a living player has CTE. (Traumatic brain injury, which may lead to CTE, can be identified in living people.) Leading researchers are the first to point out that their sample population is skewed: Brain bank donations come disproportionately from players who suspected they had CTE while alive. CTE sufferers who commit suicide have tended to shoot themselves in the chest; in some cases, they’ve left notes asking that their brains be used for research.

Still, the more CTE researchers study players’ brains, the grimmer the findings get. While they admit the shortcomings of their research, CTE experts overwhelmingly insist that football increases risk of traumatic brain injury. The outcry has pushed the NFL to backpedal on its previous position: It recently opted to settle in a massive class action suit filed by former players suffering from CTE-like symptoms. It will likely pay out hundreds of millions of dollars, if not more. An internal study commissioned by the NFL found that 30 percent of players will develop brain trauma complications sooner, and more frequently, than the general population. (The league didn’t dispute the findings.)

Just how the developing research will affect other levels of football remains to be seen. The hit sustained by University of Michigan quarterback Shane Morris last weekend—and coach Brady Hoke’s decision to let him keep playing—was shocking.

We know the NFL has a brain injury problem. Given the outcry over what happened to Morris—and the $70 million concussion settlement the NCAA reached in July—it’s obvious that college football does too.

How to Be Alone: An Antidote to One of the Central Anxieties and Greatest Paradoxes of Our Time | Brain Pickings


“We live in a society which sees high self-esteem as a proof of well-being, but we do not want to be intimate with this admirable and desirable person.”

If the odds of finding one’s soul mate are so dreadfully dismal and the secret of lasting love is largely a matter of concession, is it any wonder that a growing number of people choose to go solo? The choice of solitude, of active aloneness, has relevance not only to romance but to all human bonds — even Emerson, perhaps the most eloquent champion of friendship in the English language, lived a significant portion of his life in active solitude, the very state that enabled him to produce his enduring essays and journals. And yet that choice is one our culture treats with equal parts apprehension and contempt, particularly in our age of fetishistic connectivity. Hemingway’s famous assertion that solitude is essential for creative work is perhaps so oft-cited precisely because it is so radical and unnerving in its proposition.

A friend recently relayed an illustrative anecdote: One evening during a short retreat in Mexico by herself, she entered the local restaurant and asked to be seated. Upon realizing she was to dine alone, the waitstaff escorted her to the back with a blend of puzzlement and pity, so as not to dilute the resort’s carefully engineered illusory landscape of coupled bliss. (It’s worth noting that this unsettling incident, which is as much about the stigma of being single as about the profound failure to honor the art of being alone, is one women are still far more likely to confront than men; some live to tell about it.)

Solitude, the kind we elect ourselves, is met with judgement and enslaved by stigma. It is also a capacity absolutely essential for a full life.

That paradox is what British author Sara Maitland explores in How to Be Alone(public library) — the latest installment in The School of Life’s thoughtful crusade to reclaim the traditional self-help genre in a series of intelligent, non-self-helpy yet immeasurably helpful guides to such aspects of modern living as finding fulfilling work, cultivating a healthier relationship with sex, worrying less about money, and staying sane.

While Maitland lives in a region of Scotland with one of the lowest population densities in Europe, where the nearest supermarket is more than twenty miles away and there is no cell service (pause on that for a moment), she wasn’t always a loner — she grew up in a big, close-knit family as one of six children. It was only when she became transfixed by the notion of silence, the subject of herprevious book, that she arrived, obliquely, at solitude. She writes:

I got fascinated by silence; by what happens to the human spirit, to identity and personality when the talking stops, when you press the off button, when you venture out into that enormous emptiness. I was interested in silence as a lost cultural phenomenon, as a thing of beauty and as a space that had been explored and used over and over again by different individuals, for different reasons and with wildly differing results. I began to use my own life as a sort of laboratory to test some ideas and to find out what it felt like. Almost to my surprise, I found I loved silence. It suited me. I got greedy for more. In my hunt for more silence, I found this valley and built a house here, on the ruins of an old shepherd’s cottage.

Illustration by Alessandro Sanna from ‘The River.’ Click image for more.

Maitland’s interest in solitude, however, is somewhat different from that in silence — while private in its origin, it springs from a public-facing concern about the need to address “a serious social and psychological problem around solitude,” a desire to “allay people’s fears and then help them actively enjoy time spent in solitude.” And so she does, posing the central, “slippery” question of this predicament:

Being alone in our present society raises an important question about identity and well-being.

[…]

How have we arrived, in the relatively prosperous developed world, at least, at a cultural moment which values autonomy, personal freedom, fulfillment and human rights, and above all individualism, more highly than they have ever been valued before in human history, but at the same time these autonomous, free, self-fulfilling individuals are terrified of being alone with themselves?

[…]

We live in a society which sees high self-esteem as a proof of well-being, but we do not want to be intimate with this admirable and desirable person.

We see moral and social conventions as inhibitions on our personal freedoms, and yet we are frightened of anyone who goes away from the crowd and develops “eccentric” habits.

We believe that everyone has a singular personal “voice” and is, moreover, unquestionably creative, but we treat with dark suspicion (at best) anyone who uses one of the most clearly established methods of developing that creativity — solitude.

We think we are unique, special and deserving of happiness, but we are terrified of being alone.

[…]

We are supposed now to seek our own fulfillment, to act on our feelings, to achieve authenticity and personal happiness — but mysteriously not do it on our own.

Today, more than ever, the charge carries both moral judgement and weak logic.

Illustration by Maurice Sendak from ‘Open House for Butterflies’ by Ruth Krauss. Click image for more.

Curiously, and importantly, mastering the art of solitude doesn’t make us more antisocial but, to the contrary, better able to connect. By being intimate with our own inner life — that frightening and often foreign landscape that philosopher Martha Nussbaum so eloquently urged us to explore despite our fear — frees us to reach greater, more dimensional intimacy with others. Maitland writes:

Nothing is more destructive of warm relations than the person who endlessly “doesn’t mind.” They do not seem to be a full individual if they have nothing of their own to “bring to the table,” so to speak. This suggests that even those who know that they are best and most fully themselves in relationships (of whatever kind) need a capacity to be alone, and probably at least some occasions to use that ability. If you know who you are and know that you are relating to others because you want to, rather than because you are trapped (unfree), in desperate need and greed, because you fear you will not exist without someone to affirm that fact, then you are free. Some solitude can in fact create better relationships, because they will be freer ones.

And yet the value of aloneness has descended into a downward spiral of social judgment over the course of humanity. Citing the rise of “male spinsters” in the U.S. census — men over forty who never married, up from 6% in 1980 to 16% today — Maitland traces the odd cultural distortion of the concept itself:

In the Middle Ages the word “spinster” was a compliment. A spinster was someone, usually a woman, who could spin well: a woman who could spin well was financially self-sufficient — it was one of the very few ways that mediaeval women could achieve economic independence. The word was generously applied to all women at the point of marriage as a way of saying they came into the relationship freely, from personal choice, not financial desperation. Now it is an insult, because we fear “for” such women — and now men as well — who are probably “sociopaths.”

This fairly modern attitude, which casts voluntary aloneness as a toxic trifecta of “sad, mad, and bad” — is reinforced via rather dogmatic circular logic that doesn’t afford those who choose solitude the basic dignity of their own choice. Reflecting on the prevalent response of pity — triggered by the “sad” portion of the dogma — Maitland plays out the exasperating impossibility of refuting such social assumptions:

If you say, “Well, no actually; I am very happy,” the denial is held to prove the case. Recently someone trying to condole with me in my misery said, when I assured them I was in fact happy, “You may think you are.” But happiness is a feeling. I do not think it — I feel it. I may, of course, be living in a fool’s paradise and the whole edifice of joy and contentment is going to crash around my ears sometime soon, but at the moment I am either lying or reporting the truth. My happiness cannot, by the very nature of happiness, be something I think I feel but don’t really feel. There is no possible response that does not descend almost immediately to the school-playground level of “Did, didn’t; did, didn’t.”

Underlying these attitudes, Maitland argues, is the central driver of fear — fear of those radically different from us, who make choices we don’t necessarily understand. This drives us, in turn, to project our fright onto others, often in the form of anger — a manifestation, at once sad, mad, and bad, of Anaïs Nin’s memorable observation that “it is a sign of great inner insecurity to be hostile to the unfamiliar.”

Illustration by Marianne Dubuc from ‘The Lion and the Bird.’ Click image for more.

These persistently reinforced social fears, she notes, have chilling consequences:

If you tell people enough times that they are unhappy, incomplete, possibly insane and definitely selfish there is bound to come a grey morning when they wake up with the beginning of a nasty cold and wonder if they are lonely rather than simply “alone.”

(This crucial difference between aloneness and loneliness, in fact, is not only central to our psychological unease but also enacted even in our bodies — while solitude may be essential for creativity and key to the mythology of genius, loneliness, scientists have found, has deadly physical consequences on our risk for everything from heart disease to dementia.)

Paradoxically, Maitland points out, many of our most celebrated cultural icons had solitude embedded in their lifestyle and spirit, from great explorers and adventurers to famous “geniuses.” She cites the great silent film actor Greta Garbo, a famous loner, as a particularly poignant example:

Garbo introduced a subtlety of expression to the art of silent acting and that its effect on audiences cannot be exaggerated… In retirement she adopted a lifestyle of both simplicity and leisure, sometimes just ‘drifting’. But she always had close friends with whom she socialized and travelled. She did not marry but did have serious love affairs with both men and women. She collected art. She walked, alone and with companions, especially in New York. She was a skillful paparazzi-avoider. Since she chose to retire, and for the rest of her life consistently declined opportunities to make further films, it is reasonable to suppose that she was content with that choice.

It is in fact evident that a great many people, for many different reasons, throughout history and across cultures, have sought out solitude to the extent that Garbo did, and after experiencing that lifestyle for a while continue to uphold their choices, even when they have perfectly good opportunities to live more social lives.

So how did our present attitudes toward solitude emerge? Maitland argues that our lamentable refusal to afford those who choose aloneness “the normal tolerance of difference on which we pride ourselves elsewhere” is the result of a “very deep cultural confusion”:

For two millennia, at least, we have been trying to live with two radically contrasting and opposed models of what the good life would or should be. Culturally, there is a slightly slick tendency to blame all our woes, and especially our social difficulties, either on a crude social Darwinism or on an ill-defined package called the “Judaeo-Christian paradigm” or “tradition.” Apparently this is why, among other things, we have so much difficulty with sex (both other people’s and our own); why women remain unequal; why we are committed to world domination and ecological destruction; and why we are not as perfectly happy as we deserve. I, for one, do not believe this — but I do believe that we suffer from trying to hold together the values of Judaeo-Christianity (inasmuch as we understand them) and the values of classical civilization, and they really do not fit.

She traces the evolution of that confusion all the way back to the Roman Empire, with its ideals of public and social life. Even the word “civilization” bespeaks these values — it comes from civis, Latin for “citizen.” (Though it warrants noting that one of the greatest and most enduring Roman exports issued the memorable admonition that “all those who call you to themselves draw you away from yourself.”) Still, the Romans were notorious for their lust for power, honor, and glory — ideals invariably social in nature and crucial to the political cohesion of society when confronted with the barbarians at the gate. Maitland writes:

In these circumstances solitude is threatening — without a common and embedded religious faith to give shared meaning to the choice, being alone is a challenge to the security of those clinging desperately to a sinking raft. People who pull out and “go solo” are exposing the danger while apparently escaping the engagement.

Maitland fast-forwards to our present predicament, the product of millennia of cultural baggage:

No wonder we are frightened of those who desire and aspire to be alone, if only a little more than has been acceptable in recent social forms. No wonder we want to establish solitude as “sad, mad and bad” — consciously or unconsciously, those of us who want to do something so markedly countercultural are exposing, and even widening, the rift lines.

But the truth is, the present paradigm is not really working. Despite the intense care and attention lavished on the individual ego; despite over a century of trying to “raise self-esteem” in the peculiar belief that it will simultaneously enhance individuality and create good citizens; despite valiant attempts to consolidate relationships and lower inhibitions; despite intimidating efforts to dragoon the more independent-minded and creative to become “team players”; despite the promises of personal freedom made to us by neoliberalism and the cult of individualism and rights — despite all this, the well seems to be running dry. We are living in a society marked by unhappy children, alienated youth, politically disengaged adults, stultifying consumerism, escalating inequality, deeply scary wobbles in the whole economic system, soaring rates of mental ill-health and a planet so damaged that we may well end up destroying the whole enterprise.

Of course we also live in a world of great beauty, sacrificial and passionate love, tenderness, prosperity, courage and joy. But quite a lot of all that seems to happen regardless of the paradigm and the high thoughts of philosophy. It has always happened. It is precisely because it has always happened that we go on wrestling with these issues in the hope that it can happen more often and for more people.

And wrestle we do, often trying to grasp and cling our way out of solitude — a state we don’t fully understand and can’t fully inhabit to reap its rewards. Our two most common tactics for shielding against solitude, Maitland notes, are the offensive fear-and-projection strategy, where we criticize those capable of finding joy in solitude and condemn them to the sad-mad-bad paradigm, and the defensive approach, where we attempt to insulate ourselves from the risk of aloneness by obsessively accumulating a vast network of social ties as a kind of “insurance policy.” In one of her most quietly poignant asides, Maitland whispers:

There is no number of friends on Facebook, contacts, connections or financial provision that can guarantee to protect us.

One of Antoine de Saint-Exupéry’s original watercolors for The Little Prince. Click image for more.

Our cultural ambivalence is also manifested in our chronic bias for extraversion despite growing evidence for the power of introverts. Maitland writes:

At the same time as pursuing this “extrovert ideal,” society gives out an opposite — though more subterranean — message. Most people would still rather be described as sensitive, spiritual, reflective, having rich inner lives and being good listeners than the more extroverted opposites. I think we still admire the life of the intellectual over that of the salesman; of the composer over the performer (which is why pop stars constantly stress that they write their own songs); of the craftsman over the politician; of the solo adventurer over the package tourist… But the kind of unexamined but mixed messages that society offers us in relation to being alone add to the confusion; and confusion strengthens fear.

Among Maitland’s toolkit of “ideas for overturning negative views of solitude and developing a positive sense of aloneness and a true capacity to enjoy it” are the exploration of reverie and the practice of facing the fear. She enumerates the five basic categories of rewards to be reaped from unlearning our culturally conditioned fear of aloneness and learning how to “do” solitude well:

  1. A deeper consciousness of oneself
  2. A deeper attunement to nature
  3. A deeper relationship with the transcendent (the numinous, the divine, the spiritual)
  4. Increased creativity
  5. An increased sense of freedom

In the remainder of How to Be Alone, Maitland goes on to offer a series of “exercises” along each of these five directions of aspiration — psychological strategies for retuning our relationship with solitude.

High alcohol intake linked to heightened HPV infection risk in men


A high alcohol intake is linked to a heightened risk of human papillomavirus infection among men, suggests research in the journal Sexually Transmitted Infections. The findings seem to be independent of other risk factors for the infection, such as number of sexual partners and smoking.

There is some evidence to suggest that alcohol impairs the workings of the immune system, both in terms of the initial protective inflammatory response to infection and the development of subsequent immunity.

And habitual drinking is known to increase susceptibility to , septicaemia, tuberculosis and . The researchers therefore wanted to find out if there was any association between drinking patterns and susceptibility to HPV infection.

They included 1313 men who were already taking part in the US arm of the HPV in Men (HIM) study, an international study that is tracking the natural history of HPV infection in men.

Participants filled in extensive and validated questionnaires on their long term sexual history and diet in the preceding 12 months. The food frequency questionnaire also asked about alcohol, including serving size, frequency, and type.

The men underwent a medical examination two weeks before the start of the study, and then every six months afterwards. Samples were taken from three genital areas to test for the presence of HPV.

Alcohol intake was grouped according to daily consumption of less than 0.10 g/day in the bottom 25% (quartile) of consumption up to 9.91 g* or more a day for those in the top 25%.

Men who habitually drank more tended to be younger, smokers, of white ethnicity, to have had more sexual partners, and they were more likely to be circumcised—which may protect against infection—than those who drank less.

Average daily alcohol intake among those who tested positive for HPV was significantly higher than among the 514 men who tested negative. It was 4.52 g for those testing positive, compared with 3.13 g for those testing negative.

For those testing positive for the HPV types associated with increased cancer risk, average daily alcohol intake was 5.23 g; while for those testing positive for types not associated with cancer, it was 5.29 g; and for the four types against which the HPV vaccine is active, it was 6.31 g.

When further analysis was done of HPV prevalence, this was significantly higher among men in the top 25% of alcohol consumption compared with the bottom 25%: 68.9% versus 56.7% for any HPV type and 35.2% versus 22.8% for those types associated with increased cancer risk.

The data were also further analysed across categories of two potentially important : whether the men were smokers; and the number of sexual partners they said they had had.

The results showed significant associations between the highest levels of alcohol intake and HPV prevalence among those who had never smoked, for any type of HPV and for those types associated with an increased risk of cancer.

There was an association between the highest levels of , HPV prevalence and lifetime sexual partners, but it was not significant, and furthermore, it applied to any number of .

This is an observational study, so no definitive conclusions can be drawn about cause and effect, and further research will be needed to confirm the findings. But the researchers point out that because neither smoking nor sexual activity seemed to influence HPV prevalence, some other factor is likely to have been involved, and that could be alcohol.

“Although these results cannot be considered causal and should be interpreted with caution, our findings do provide additional support to current public health messaging regarding the importance of moderate alcohol consumption, smoking cessation, and safe sex practices,” they write.

Governments seize colloidal silver being used to treat Ebola patients, says advocate.


Efforts to bring natural Ebola treatments to suffering West Africans have been squelched by the World Health Organization (WHO), which recently blocked multiple shipments of nanosilver solution measuring at 10 parts per million (ppm) from entering the region, leaving thousands to suffer needlessly.

health

WHO officials also reportedly called off a trial at an Ebola isolation ward where local health authorities were set to begin administering the silver, which the U.S. government previously demonstrated is highly effective against Ebola. WHO ordered the trial not to proceed despite the fact that it had earlier voiced support for experimental treatments.

Both WHO and the U.S. Centers for Disease Control and Prevention (CDC) have given their blessing to experimental therapies for Ebola, citing a lack of proven treatment options. But when it comes to using therapeutic silver, all bets are off, it seems.

Authorities block small shipment of nanosilver three times

According to the Natural Solutions Foundation (NSF), efforts to ship nanosilver into Sierra Leone have thus far failed. The organization has been trying to deliver a shipment of 200 bottles of nanosilver 10 ppm, and 100 tubes of nanosilver gel, to no avail. At this point, the shipment has been returned to the U.S. for the third time.

“That parcel, shipped Air Express at a cost of $3400 to Sierra Leone on August 20, never made it out of Paris,” reads an NSF action alert. “Air France has yet to find a reason for that. But it made its way back to the US again, apparently for the 3rd time without being delivered to Africa.”

People are dying, and bureaucrats are still playing politics with silver

Formerly classified documents obtained from the U.S. Department of Defense (DOD) reveal that antimicrobial silver solutions like the kind NSF is trying to deliver to Africa have proven benefits in fighting Ebola and other forms of hemorrhagic fever. Research conducted by the DOD and several other federal agencies back in 2008 confirmed this, though health regulators largely ignored it.

A presentation entitled “Silver Nanoparticles Neutralize Hemorrhagic Fever Viruses,” which revealed exactly what its name suggests, was buried and kept secret for years. In essence, investigators determined that simple silver solutions neutralize viruses like Arenavirus and Filovirus, both of which are related to Ebola.

Interestingly, the research was conducted with the backing of the DOD’s Defense Threat Reduction Agency (DTRA) and the U.S. Strategic Command Center for Combating Weapons of Mass Destruction. The presentation was given by researchers from the Applied Biotechnology Branch, 711th Human Performance Wing of the Air Force Research Laboratory.

But not a single mainstream media outlet reported on the presentation, and to this day its findings have been largely ignored by establishment health authorities. Sadly, this political quagmire — nanosilver is an obvious threat to pharmaceutical interests, and thus is being marginalized — is resulting in thousands of needless deaths in West Africa with no end in sight.

Contact your representatives and demand that nanosilver be used in Africa

NSF is calling on 10 million people to write their representatives and demand that clinical trials be conducted on nanosilver in Africa. The group says doctors and nurses need nanosilver to protect themselves, and patients need it to overcome the disease. Recommended dosages for each application are available at the following link; at the bottom of this page, you can also contact your representatives by inputting your zip code:
SalsaLabs.com.

Learn all these details and more at the FREE online Pandemic Preparedness course at www.BioDefense.com

Sources:

http://org.salsalabs.com

http://thesilveredge.com

http://www.npr.org

http://science.naturalnews.com

 

An electronic revolution in the doctor’s bag


Boy and stethoscope

The stethoscope revolutionised the way doctors interacted with their patients and became a symbol of the profession. Now that electronic alternatives are becoming a common sight on the wards, maybe it’s time to update our idea of what a doctor is for?

“Every medical student remembers the day when they bought their first stethoscope,” says Professor of Cardiology Petros Nihoyannopoulos. “They remember the name of the stethoscope, they remember the colour of the stethoscope – and possibly the day when their first stethoscope was stolen and replaced by another one.”

But in Hammersmith Hospital in London, where Dr Nihoyannopoulos works, the noble instrument is under threat from a little white box. Looking like a smartphone circa 2005, the handheld ultrasound scanner is connected by wire to a probe which is laid against a patient’s chest. Flip the lid of the scanner and a black and white image appears on the scanner of the patient’s heart. At the push of a button the patient’s blood flow is highlighted, if all is well, in red and blue. An abnormal flow is painted in lurid yellows and greens.

Handheld ultrasound scanner (2007)

“Every single consultant and junior doctor is hooked on these devices,” says Nihoyannopoulos. “When one breaks down or goes missing, it’s a disaster – everyone is panicking. It’s like when you lose your stethoscope as a medical student.”

Hammersmith hospital was the first in the UK to try the now-widespread gadgets, and Nihoyannopoulos says they have revolutionised examinations and ward rounds. But he adds that stethoscopes still have their uses, specifically for listening to the lungs.

“I’m listening to children with asthma all the time,” agrees London family doctor Graham Easton. “Well, you can’t hear wheezes with an ultrasound scan, you can’t hear chest infections with an ultrasound scan. It’s also very useful for listening to bowel sounds and gastroenterology problems.”

Stethoscopes are unlikely to disappear, but it seems possible that hospital doctors will stop carrying them around. Mark Hochberg, a surgeon at New York University, suggests they may go the way of the ophthalmoscope – the light-emitting tool for looking in patients’ eyes. Doctors used to carry their own, he says, but now they just use a communal one usually fixed to the wall in the examination room.

But the stethoscope is far more central to our image of the medical profession than the ophthalmoscope ever was.

Child having check-up

“We have a real emotional attachment, not just doctors, but also patients, to this icon of medicine and healing,” says Graham Easton. “Symbolically it’s a kind of link between doctors and patients – a kind of umbilical cord going from one to the other. It’s often the only time we lay hands on a patient during an examination, and that demonstrates thoughtful caring, which is very powerful, we know, in healing.”

Until the stethoscope first appeared, in the first half of the 19th Century, doctors rarely touched patients – and they were identified with a very different object, the cane.

“They carried canes for a reason which was as important to their philosophy of medicine as the stethoscope is to ours,” says Berwyn Kinsey, a historian who gives tours around the Royal College of Physicians and other medical buildings. These were no ordinary canes. They had a well at the top to hold scented oil, and perforations for releasing a scent that would supposedly keep away disease. Cartoons at the college show doctors holding their canes to their noses to keep themselves safe from the miasmas, or bad smells, of their patients.

Engraving of physicians holding canes

These early European physicians were often graduates of divinity, and wore the black of the clergy. They listened, they examined stool samples, they prescribed foul-tasting liquids or regimens of fasting, but they did not touch their patients.

Medicine was still in thrall to the ancient theory of the four humours, which held that individuals were composed of a balance of bile, blood and phlegm. Understanding a patient’s personal circumstances was therefore more important than looking at their bodies. Remote diagnosis, by correspondence with a physician in London or Paris, was perfectly feasible. Even when doctors and their wealthy patients met face to face,Dr Jan Henderson writes, “in making a diagnosis, the physician gave priority to the patient’s account of his or her symptoms, even if it contradicted what the physician observed with his own eyes”.

“Start Quote

The potential for people to take medical selfies is quite interesting”

Bjorn Hofmann

As understanding grew, from the 17th Century onwards, that patients died because of problems with particular organs – a fact often revealed in autopsies – physicians began to conduct “in vivo” autopsies on their patients. The Austrian doctor, Leopold Auenbrugger, developed the diagnostic technique of tapping on patients’ chests and listening to the quality of the echoes.

For physicians interested in the new scientific medicine, touching patients became a necessity – but for a long time it remained socially unacceptable.

“The sense of touch really has two strikes against it,” says Constance Classen, author of The Deepest Sense: A Cultural History of Touch. “One, it’s very much associated with manual labour, and therefore it’s a coarse, lower-class kind of sense, traditionally. And that’s why for a long time surgeons were thought to be much lower status than physicians because obviously they were very much hands-on. But the other strike against touch of course, was the association with sensuality – that made it very hard for physical examinations to be acceptable.”

Propriety meant that Victorian physicians sometimes asked women to indicate where they felt pain on a porcelain modesty doll.

Diagnostic model (19th C)

It was in these circumstances that in 1816, the French physician Rene Laennec rolled up a sheet of paper and placed one end against a female patient’s heart. According to his friend Lejumeau de Kergaradec , he was inspired by children playing in the courtyard of the Louvre, “with their ears glued to the two ends of some long pieces of wood which transmitted the sound of the little blows of the pins, struck at the opposite end”.

It wasn’t long before Laennec started to experiment with wood, eventually refining his design to a candlestick-like object he called the stethoscope, from the Greek words meaning “to explore the chest”. It was 45cm long, 4cm wide and had a removable drum for listening to a patient’s heart and another drum to amplify the noise next to the physician’s ear.

Monaural stethoscopes from 1820 and 1840

According to Dr H Kenneth Walker, it’s thought that for the next 10 years every stethoscope in existence was turned on the lathe by Laennec himself, and they were given out free with his book on the technique of listening to the body, known as auscultation. “Public acceptance of the stethoscope was such that within a decade physicians felt they must use the stethoscope or else jeopardise their reputation,” writes Walker.

The flexible stethoscope appeared in the 1830s, with a binaural version appearing a few decades later. Doctors – who also adopted white coats to signify their status as scientists – started using more tools as their understanding of the body increased. When medicine became available to the masses, and physicians needed to take their kit on house visits, they needed a bag to carry it around. They chose the Gladstone bag, and the final signifier of the medical profession was in place.

Doctor's bag
A doctor’s bag (English, 1890-1930) used by Prof John Hill Abram

The stethoscope and other diagnostic tools were partly responsible for the acceptance of physical examinations as “a special kind of touching”, says Constance Classen, because they were a way of mediating between the doctor’s hand and the patient’s body. It was the start of a century and a half of patients sticking their tongues out and having lights shone in their eyes and ears, and of being asked to hop up on the couch for a minute.

“Laennec’s solving a moral problem with a technological solution, but there’s another thing that’s going on,” says Bjorn Hofmann, a philosopher of medicine at the Dartmouth Center for Health Care and Delivery Science. “Before the stethoscope, the access to the disease was a story told by the patient, but afterwards the doctor trusted much more the technology or the apparatus.”

1870 stethoscope
An 1870 stethoscope is still recognisable today

Ironically, while stethoscopes helped doctors become physically intimate with patients, they represented an intellectual distancing. Laennec’s descriptions of the sounds that can be heard through his instrument – he described one of the symptoms of fibrosis, for example, as “the nasal intonations of the juggler speaking in the character of Punch” – describe a sound world filled with meaning closed off to the layman.

Unlike the stethoscope, the portable ultrasound monitor has a screen that can be turned round to show patients their own bodies in a way that they can understand, bringing them into the conversation.

“I think traditional devices and traditional interaction with doctors have been kind of mysterious for most patients – they don’t really understand what the doctor’s listening to or screening,” says Shiv Gaglani, a medical student and an editor of the online magazine MedGadget.

“One of the objections I get when I show people stuff, is: ‘My professional identity means I carry a stethoscope on my neck. So how can I use this little thing – people won’t know I’m a doctor?'” says Shiv Gaglani.

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Man with stethoscope

“The stereotypical image of the (male) doctor doing his rounds in a shirt and tie, topped by a starched white coat, possibly trailing a retinue of nurses and students, became obsolete in the UK six years ago when the government issued dress code guidelines prohibiting dangling ties, long sleeves (including the white coat) and wristwatches.”

To help customers cross this psychological barrier Gaglani decided to make a new doctors’ bag. It’s designed, Gaglani says, “to bring back that vintage feel, but to say, ‘Hey look, now we’re in the 21st Century and there’s a lot better ways of collecting and storing information.'”

In fact, it won’t just be doctors collecting and storing that information. Phones, watches, toothbrushes and other seemingly innocuous objects are coming on to the market that will collect our health data over time. One way to see this development is as a partial undoing of the revolution brought about by Laennec’s stethoscope. Not only will these gadgets mean medical staff will need to touch patients less, they will also put a mass of data about a person’s body into his or her own hands.

“The potential for people to take medical selfies is quite interesting,” says Bjorn Hofmann. “Medicine is moving back to the patient’s narration of his or her disease, a narration given by various types of gadgets. And it raises the question: What does this do to the professional – does the doctor become a coach, a servant or an adviser – what will the new role be?”

Mark Hochberg at New York University says medical training is once again emphasising talking and listening to patients, rather than treating them as “objects to be prodded, poked and made to suffer”.

“The role of the doctor, ironically, must be to go back to the bedside,” he says. “To be an interpreter of symptoms – so we can learn every possible aspect of what the patient is feeling and experiencing – then input the information into an iPad and come out with a list of all potential diagnoses.”

Antibiotic ‘link to child obesity’


picture of pills

Antibiotics targeted at specific bugs did not lead to weight gain
Young children who are given repeated courses of antibiotics are at greater risk than those who use fewer drugs of becoming obese, US researchers say.

The JAMA Pediatrics report found children who had had four or more courses by the age of two were at a 10% higher risk of being obese.

But scientists warn this does not show antibiotics cause obesity directly and recommend children continue using them.

Many more studies are needed to explain the reasons behind the link, they say.

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It would be a concern if parents took from this that they ought to be reluctant to allow antibiotic use in their children”

Dr Graham BrudgeUniversity of Southampton

Targeted therapy

US researchers from the University of Pennsylvania and Bloomberg School of Public Health reviewed the health records of more than 64,500 American children between 2001 and 2013.

The children were followed up until they reached five years of age.

Almost 70% of them had been prescribed two courses of antibiotics by the time they were 24 months old.

But those who had four or more courses in this time were at a 10% higher risk of being obese at the age of five than children who had been given fewer drugs.

And the type of antibiotics they were prescribed appeared to make a difference too – those given drugs targeted at a particular bug were less likely to put on weight.

But those given a broad-spectrum antibiotic – that can kill several types of bacteria indiscriminately – were more likely to have a higher body mass.

Prof Charles Bailey at the University of Pennsylvania, said: “We think after antibiotics some of the normal bacteria in our gut that are more efficient at nudging our weight in the right direction may be killed off and bacteria that nudge the metabolism in the wrong direction may be more active.”

And researchers say the study highlights that over prescribing inappropriate antibiotics could have a negative impact on child growth.

picture of a boy
Children who were given antibiotics in the first few months of life were also at greater risk

Prof Nigel Brown, president of the Society for General Microbiology in the UK, said: “This study adds further evidence that the use of antibiotics early in life has a role to play in obesity.

“While antibiotic use is only one factor that may predispose children to be obese, the study emphasises the importance of rapid diagnostic tests that allow precise targeting of antibiotics, which will kill the disease-causing bacteria and cause minimum disruption to the normal gut flora.”

And Prof Bailey acknowledged his study had limitations as they were not able to look at the children’s weight or exercise regimes.

He says the team will now start to explore what influence lifestyle factors has on these findings.

But Dr Graham Brudge, at the University of Southampton, said: “The design of the study did not allow testing as to whether antibiotic use during infancy causes obesity in childhood, only that there may be an association.

“It would be a concern if parents took from this that they ought to be reluctant to allow antibiotic use in their children.

“The key risk factors for childhood obesity are over-consumption of high energy, nutrient-poor foods and lack of exercise.”

Mice trials

Meanwhile in a separate study, scientists reporting in the journal of the American Society for Microbiology found that a species of gut bacteria – called Clostridium ramosum – could promote weight gain in mice.

Mice with these bacteria present in their guts became obese when fed a high-fat diet, while those that did not have the bacteria put on less weight despite being given high-calorie meals.

The scientists, from the German Institute of Human Nutrition, in Nuthetal, are now trying to understand how the bacteria interact with digestion.

Hope for blind as scientists find stem cell reservoir in human eye .


Scientists at the University of Southampton have discovered stem cells in the human eye which can be transformed into light sensitive cells and potentially reverse blindness

Scientists have discovered stem cells in the human eye which can be turned into photoreceptor cells and potentially reverse blindness

Scientists have discovered stem cells in the human eye which can be turned into photoreceptor cells and potentially reverse blindness

Hundreds of thousands of people who are registered blind have been offered new hope after scientists discovered special stem cells in the human eye which can be altered to pick up light.

Researchers at the University of Southampton have discovered a reservoir of stem cells in an area of the eye called the corneal limbus.

And they have proven that, in the right environment, they can be transformed into photo-receptor cells which react to light.

Scientists are hopeful that implanting the cultured stem cells in a damaged eye could reverse blindness.

It could offer a potential cure for the hundreds of thousands of people suffering macular degeneration or retinitis pigmentosa, which are both caused by the loss of photo-receptor cells in the eye.

“These cells are readily accessible, and they have surprising plasticity, which makes them an attractive cell resource for future therapies,” said Professor Andrew Lotery, of the University of Southampton and a Consultant Ophthalmologist at Southampton General Hospital led the study.

“This would help avoid complications with rejection or contamination because the cells taken from the eye would be returned to the same patient.

“More research is now needed to develop this approach before these cells are used in patients.”

The loss of photoreceptors cells causes irreversible blindness.

Age related macular degeneration (AMD), the leading cause of blindness in the developed world which affects around one in three people in the UK by age 75.

Around 513,000 people are in the late stage of AMD and that figure is set to rise by one-third over the next decade, totalling nearly 700,000 cases by 2020.

Almost two million people in the UK are living with sight loss, approximately one person in 30.

It is predicted that by 2020 the number of people with sight loss will rise to over 2,250,000. By 2050, the number of people with sight loss in the UK will double to nearly four million.

There is currently no treatment for blindness caused by the loss of photo-receptors.

So far scientists have only shown that the concept works in the lab and are yet to implant them in a human patient. But they are hopeful that the cells could be taken from a patient, grown in the lab and transplanted back into the eye. Clinical trials should begin within five years.

Charities are optimistic that it could herald a brighter future for people with sight loss.

Clara Eaglen, RNIB Eye Health Campaigns Manager, said: “At RNIB we talk to people everyday who tell us about the huge impact that losing their sight has on daily life, so this is very interesting research.

“The study shows that you can grow stem cells and make them act like light sensitive cells, a big step forward in helping patients with conditions such as age-related macular degeneration where damage has occurred to the light sensitive cells.

“These cells can then be taken from a patient, changed, and replaced – reducing the risk of rejection which is exciting.

“We are hopeful that stem cell technology will significantly change the way in which people with sight loss are treated over the next decade.”