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Strange medical term in Casualty

In the last episode of 'Casualty' the surgeon Connie Beauchamp described a patient as suffering from cor pulmonale. She pronounced this in such an odd way, with the stress on the final 'e', that for a moment I didn't understand what she had said. The stress is normally on the 'a' (third syllable).

It isn't the first time that Connie has come up with odd things in this show. Some time ago, as I noted here, she told a patient to complain about her to the BMA - she should have said the GMC.

Andrew Marr traduces Thucydides

In 'Start the Week' today Andrew Marr referred to Thucydides, the Athenian historian, as 'the father of history' and also 'the father of lies'. This is incorrect; both these epithets have been applied to Herodotus, not Thucydides, who is regarded as a serious and reliable historian, still studied by academics today. But even Herodotus is now thought to be generally reliable and is our only source of knowledge for many features of the ancient world.

Dr Giles Fraser's Latin tag

Giles Fraser's 'Thought for the Day' has figured here before. Today he mentioned the demise of the old one-pound coin and its inclusion of the motto 'fid. def.', which he said was an abbreviation of 'fides defensor'. It isn't: it should be the genitive form, 'fidei defensor'. Quoting Latin and getting it wrong is a regular trap for speakers on 'Thought for the Day' - see this entry.

Book review: Living with a Wild God, by Barbara Ehrenreich

Barbara Ehrenreich, two of whose previous books I have already reviewed here, has many talents. She trained as a scientist and obtained a Ph.D in cellular immunology from Rockefeller University. But she then changed course and has been active in numerous other areas, especially feminism and left-wing politics. Throughout her career she has been a freelance writer, producing a wide variety of books and journalism, for which she has won many awards.

The present book is quite different from anything she has written previously. It is based on a journal which she started at the age of fourteen in 1956 and continued intermittently until 1966. The main reason for returning to it now is that it included the account of an ecstatic or mystical experience that happened to her when she was seventeen. As a rationalist and atheist she had not been able to come to terms with this and kept it to herself for many years, but now she feels it is time to try to understand it. [Read more]

Book review: Improbable Destinies, by Jonathan B. Losos

An important controversy in evolutionary biology concerns the inevitability or otherwise of the appearance of humans. According to Steven J. Gould, if the tape of life could be rerun from the beginning it is very unlikely that anything resembling humans would appear. But Simon Conway Morris disagrees. He and those who think like him hold that something very similar to us was pretty well bound to arise, and similar organisms would evolve on any other planets that support complex life (though these are likely to be rare). So who is right? This is the question that Losos tackles in his new book. [Read more]

Book review: Strange Bodies, by Marcel Theroux

This is a complex book. It could be described as science fiction or fantasy, but also as a philosophical or metaphysical novel—perhaps a fictional extension of the kind of thought experiments that Derek Parfit makes use of in Reasons and Persons; a meditation on the nature of human personality and its uniqueness or otherwise. And, finally, it is a thriller. [Read more]

New study confirms the Big Fat Surprise

Nina Teicholz's book The Big Fat Surprise (2014) challenged the conventional view that you should reduce your intake of fat, and especially saturated fat, to reduce your risk of a heart attack or stroke. A similar conclusion was reached by Gary Taubes a few years earlier in The Diet Delusion. Both these writers are science journalists, not clinicians, but their books were based on an impressive amount of literature research and, in Teicholz's case, interviews with leading experts in the field.

In spite of these and other heretics, the conventional doctrine that Fat is Bad continues to be widely taught and believed. But the result of the new PURE observational study seems to show pretty convincingly that the heretics are right.

This intercontinental study examined the role of diet in relation to cardiovascular disease in nearly 150,000 people in five regions. The report appears in The Lancet and is reviewed by Richard Lehman in his blog, an extract from which appears in the current BMJ (9 September 2017) in its From the Journals column.

Lehman thinks that observational studies are generally "bunk", but that PURE is an exception and probably takes us "the closest we are likely to get to the 'truth' about diet and cardiovascular disease." He quotes the conclusion of the paper as follows.

High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke.

So "we can abandon the saturated fat-cardiovascular disease hypothesis with some certainty."

Book review: A Voyage to Arcturus, by David Lindsay

I first tried to read this book many years ago but gave up baffled, probably expecting it to be science fiction of the kind I was used to. Yet it continued to stick in my mind, and recently I decided it was time to give it another go.

Science fiction it certainly isn't, at least as that genre is generally understood. It could be described as fantasy, but that isn't really right either. It has elements of both of these but could also be classed as philosophical allegory (it has been compared to Pilgrim's Progress). It evidently was written out of its author's deep religious and metaphysical preoccupations, not to say obsessions. In other words, it is a very unusual book that defies conventional categorisation. Read more

Book review: The Cradle of Humanity, by Mark Maslin

We are by now familiar with the idea that East Africa had a central role in human evolution, but probably few non-specialists realise how complex the story really is. This is what Professor Maslin writes about in his new book.

He identifies five stages in human evolution based on the fossil record, marked by the successive appearance of (1) the earliest hominins; (2) the australopithecines; (3) Homo and Paranthropus; (4) Homo erectus; (5) the journey towards Homo sapiens. This scheme can be simplified into three phases. First there was the evolution of bipedalism, which led to the spread of Australopithecus species across Africa. Next came the evolution of Homo erectus, and finally we get the evolution of Homo sapiens. [Read more]

Book review: The Story of English in 100 Words, by David Crystal

Crystal finds that there are two main ways of telling the story of English. The usual approach is to present a historical overview, starting with Old English and tracing the development of the language through Middle English, Early Modern English, to Modern English. This provides relatively little information about vocabulary. The alternative is to concentrate on words—their origins and uses.

In this book he combines these approaches, to give a series of snapshots of the development of English. History is central to the discussion, but Crystal is flexible and doesn't hesitate to digress from the principal word that is being discussed to include other material related to it. The tone throughout is chatty and informal. [Read more]

Book review: Consciousness: Confessions of a Romantic Reductionist

As readers of Francis Crick's book The Astonishing Hypothesis will know, Koch collaborated with Crick in the research on consciousness that occupied the latter years of Crick's life. In this book Koch talks about this work and what it tells him about consciousness, and he also considers the philosophical and religious implications of his research. The book is a mixture of science, philosophy, and autobiography. These are not always clearly demarcated from one another and this makes it difficult to discern a sustained line of argument in the book.

Koch was brought up a Roman Catholic and although he has lost his formal religious faith he is not free of the need to search for transcendence that his upbringing inculcated. He tells us that he started studying consciousness to justify his "instinctual belief that life is meaningful". This explains his choice of subtitle.

[I am] reductionist because I seek quantitative explanations for consciousness in the ceaseless and ever-varied activity of billions of tiny nerve cells, each with their tens of thousands of synapses; romantic because of my insistence that the universe has contrails of meaning that can be deciphered in the sky above us and deep within us.
Read more

Book review: Who Wrote the Bible?, by Richard Elliott Friedman

The long-running BBC radio programme 'Desert Island Discs' provides its castaways with two books by default, the Bible and Shakespeare, to which they can add one further book of their choice. They are allowed to substitute a different book for the Bible, but hardly anyone ever does. This is evidence for the continuing importance of this book in modern life, even if fewer people actually read it than previously.

For Friedman, 'Bible' refers to the Hebrew Bible (Tanakh), which corresponds to what Christians call the Old Testament, although there are some differences. The question of who wrote the text is probably not one that has occurred to many secularists or Christians, and one might think it would be of interest only to biblical scholars. But Friedman has managed to produce a book that reads like a detective story and will hold the interest of anyone who recognises the central importance of this book in the history of Western culture. Read more

Book review: Admissions, by Henry Marsh

As readers of his previous book, Do No Harm, will know, Marsh is a neurosurgeon who has written with profound insight about his work. At the end of that book he was at the point of retiring from his post as a NHS surgeon. The present book is mostly about his life after retirement, although he was still teaching and carrying out surgery in Ukraine and Nepal.

Like the previous book, this one is cast as a memoir, with some descriptions of surgery but much else besides: travelogue, reminiscence, philosophical reflections. Although Marsh was only in his sixties when he wrote — he was born in 1950 — he is very conscious of age, mortality and the possibility of a descent into physical or mental incapacity. Read more

Book review: The Other World, by Janet Oppenheim

This a detailed scholarly account of spiritualism and psychical research in England in the Victorian and Edwardian periods. Oppenheim chose to restrict her study geographically to keep it in manageable bounds and she ended it at the outbreak of World War I because the context of spiritualism changed after that time.

The Victorian era was marked by sometimes agonised questioning of traditional religious beliefs, caused partly but not wholly by science. This is the broad framework in which Oppenheim examines her subject. The book has three parts. Part I, "The setting", looks at mediumship and the growth of spiritualism since 1850. Part II, "A surrogate faith", covers a lot of territory, including spiritualism and Christianity, psychical research in relation to agnosticism, and the influence of the Theosophical movement. Part III, "A pseudoscience", describes attempts to evaluate spiritualism scientifically, most notably by the founding of the Society for Psychical Research (SPR); there are also chapters on evolution in relation to spiritualism and the ideas of physicists concerning psychic phenomena. Read more

Book review: Thinking, Fast and Slow, by Daniel Kahnemann

The ideas in this book originated in large part from a collaboration lasting many years between Kahnemann and his colleague and friend, Amos Tversky. The central insight on which the book is based is that our minds can function in two ways, which Kahnemann refers to as System 1 and System 2. System 1 gives a quick appraisal of things that is often biased emotionally or in other ways. System 2 is slower and analytical; its operation is effortful, so the default approach to a problem is usually System 1. This is not always wrong, but it often is. Read more