9 Ocak 2017 Pazartesi
6 Ocak 2017 Cuma
The Guardian view on AI in the NHS: not the revolution you are looking for | Editorial
The news that two healthcare trusts in London are to experiment with a system to look up symptoms by text message, to triage the kind of non-urgent queries at present handled by the NHS 111 service, raises many questions. They may not seem urgent when people are dying in the corridors of an NHS hospital for want of money, but in the long term they are just as important. Some are purely medical: is this an area that requires the attention of a human being, or is it one where purely factual answers will suffice? When will this project start using artificial intelligence? Some have to do with the way that the NHS is being privatised around the edges in ways that disadvantage the central public parts of it. Widest of all is the general question of the automation of brainwork, which might have effects quite as gigantic as the replacement of manual labour by technology has had.
Two kinds of claims are made for AI in medicine. The weaker and more plausible is that it can automate the processes where no judgment is required, only the clear and consistent following of well-understood rules. This kind of thing is what the 111 service is supposed to do: the question that it answers is not “what’s wrong with you?” but “do you really need to see a doctor?” Some triage is necessary in any healthcare system, and the present system in the NHS is under huge and growing strain.
But the wider claim of healthcare automation is that there will be systems that can augment and eventually replace the judgment of trained human beings. The hope is that deep analysis of unimaginable quantities of data will yield reliable knowledge superior to anything that unaided humans can produce. The placebo effect is important in medicine, and people who believe they are being treated by doctors who have the help of almost omniscient computers will probably do better than those who feel they are getting the harassed attention of an overworked GP even when the diagnosis and the remedies prescribed are exactly the same, as in most cases they will be. But that is not the basis on which we are promised a revolution in the delivery of healthcare. The revolution may come anyway: we are living through an enormous expansion in the reach and variety of machine learning systems, but it will not be for some time. The great majority of diseases do not require heroic diagnosis and exceptional treatment so much as the humane application of well-understood treatments. Much of what’s wrong with the NHS is a lack of money rather than sophistication. Even urgent large-scale threats such as the emergence of antibiotic-resistant pathogens don’t need artificial intelligence to avert, only the consistent use of the intelligence we already have.
It is the apparently small-scale automation of clerical work that we need to think about, because that might happen as quickly as the spread of smartphones did. Vast areas of bureaucracy are about the reduction of complex problems to simple ones for which the correct answers can be written down in a flow chart. This is artificial stupidity rather than artificial intelligence, but the two can merge inside computer systems to produce huge social change. Once the work has been broken down into simple algorithms, these can much more easily and quickly be followed by machines. The 111 service in north London is only one example of a much wider phenomenon. A Japanese insurance company has just replaced 35 claims processors with IBM’s Watson expert system. The Japanese government is preparing to automate the responses to parliamentary questions in a similar way. These are the first signs of a process that may annihilate millions of white-collar jobs in the same way that blue-collar jobs have already disappeared across the developed world. That would be a development to make last year’s political upheavals look like the mere premonitory tremblings of a real earthquake to come.
The Guardian view on AI in the NHS: not the revolution you are looking for | Editorial
17 Ekim 2016 Pazartesi
Looking for non-invasive medical remedies; Try Naturopathic Medicines
Naturopathy is a holistic form of medicine that uses natural and non-toxic therapies to treat illnesses, prevent diseases and improve health. It presents a non-invasive and a complete form of treatment. Discovered in the 1800s naturopathic medicine borrows from a wide array of traditional healing practices; acupuncture, herbalism, botanical medicine and the use of nutritional supplements. Naturopathic medicine encourages the self-healing process of the body using modern and traditional, empirical and scientific techniques. The treatment works by first finding the cause of the problem, unlike modern medicine that aims at treating the symptoms.
Naturopathic Physicians conduct lengthy interviews with patients focusing on their physical wellbeing, diet, lifestyle and emotional health. As such, they base their treatments on some beliefs:
· The self-healing nature of the body: the body has an innate self-healing ability, and naturopathy only facilitates this process by eliminating any obstacles.
· Use of gentle and non-invasive therapies.
· A holistic approach to treating patients: physicians identify any imbalances in the body and tailor the treatment to rectify it (depending on the symptoms presented).
· Symptoms denote an underlying internal imbalance caused by emotional, physical or mental problems.
· Focus is on proactive prevention: naturopathic physicians believe in preventing rather than treating diseases through an evaluation of subjective and objective information. As such, doctors can quickly decipher any future vulnerability in patients.
Naturopathic medicine is known to deal with all kinds of medical ailments the most common being; chronic pain, cancer, allergies, hormonal imbalances, fibromyalgia, fertility problems, menopause, respiratory conditions among others. In our discussion, we will look at 4-5 cures of using Naturopathic Medicine
1. Naturopathy to treat heart disease
Heart disease is also referred to as cardiovascular or coronary artery disease. Different medicines have been developed to treat the disease but most effective remedy requires diet changes. Naturopathic doctors recommend various natural ways of addressing the problem:
Mediterranean diet: it is a plant-based diet that is rich in fiber, fruits, whole grains and vegetables. It also emphasizes on monosaturated fats like olive oil and foods rich in Omega 3.
Supplements and herbs: they help fight atherosclerosis (the major cause of heart disease). Herbs like Coenzyme Q10 (an antioxidant that aids in energy production), Hawthorn (helps in the relaxation of blood vessels) and Taurine (protects and improves symptoms related to heart failure).
Meditation: it reduces physical, mental and emotional stress correlated with cardiac problems. Naturopathic doctors also recommend adding other forms of relaxation like listening to music, walking, dancing to your daily routine to reduce stress.
2. Naturopathy to treat fibromyalgia
Fibromyalgia is a health condition that causes chronic fatigue, chronic pain, depression, memory problems, irritable bowel syndrome, and headaches. It is a multi-casual health condition that requires a deep understanding of the body organs to treat the multiple factors that initiate the problem. If the multiple stressors occur over an extended period, they cause fibromyalgia, destroying the body’s natural healing ability. The condition requires an integrative approach of treatment i.e. through the use of conventional and alternative diagnostic techniques like naturopathy. Naturopathy physicians recommend the following therapies for patients suffering from fibromyalgia:
· Gentle exercises like yoga, dancing, Tai Chi, and walking.
· Eating foods rich in minerals like potassium citrate and magnesium maltase.
· Eating foods rich in anti-inflammatory and digestive enzymes.
· Foods that contain anti-oxidant vitamins like Beta-carotene, B-complex, C and E.
· Adding foods rich in fatty acids to your diet; fish oils, flaxseed oil, and primrose oil.
· Detoxification program that includes liver cleansing, mercury detoxification and amalgam removal.
3. Naturopathy to treat chronic pain
Chronic pain is pain that lasts longer than six months. The pain can be mild, excruciating or in the form of sporadic episodes. The most common causes of chronic pain include headaches, backaches, joint pain, and pain from an injury. Other kinds of chronic pain include pain affecting certain parts of the body such as the leg, neck, arm, shoulders, and the pelvis. It may also originate with an infection or initial trauma. Physicians recommend various medicines to treat/relieve chronic pain but most of them offer modest results and cause a host of side effects.
Naturopathy provides a more holistic alternative of treating chronic pain with or without cause by identifying imbalances in the body that irritate tissues, or nerves causing pain. For example if the pain occurs on both sides of the body, it indicates an underlying disorder; if it occurs on one location it is more likely to be caused by an injury. Naturopathic medicine provides various solutions for treating pain:
Acupuncture: it relieves pain by helping the body to release endorphins, reduce pain signals to the brain and stimulate the body’s healing ability.
An anti-inflammation diet: naturopathic physicians prescribe herbal medicines that reduce inflammation.
Hydrotherapy: here water is used to increase circulation, reduce inflammation and promote detoxification thus managing chronic pain.
Supplementation: natural supplements like curcumin, and fish oils reduce inflammation, muscle tension without causing adverse side effects.
4. Naturopathy to treat fertility problems
Infertility is a health problem affecting both men and women. Studies show 30% of infertility problems are caused by female factors, 30% due to male factors and 40% due to unknown causes. Modern medical diagnosis and remedies involve lots of invasive tests, surgery, drug therapy and now artificial conception technology.
Naturopathic therapy, on the other hand, provides a more holistic view of treating infertility problems. The couple is treated individually while addressing their emotional, spiritual and psychological aspects. Some naturopathic remedies used include herbalism, making nutritional adjustments, flower essences (helps relax the mind), osteopathy and homeopathy. The treatments enhance the body’s natural processes without the use of invasive surgical methods, artificial conception technologies or toxic drugs.
5. Naturopathy to treat allergies
An allergy is an aggressive immune response triggered by inhaling irritants like pollen or ingesting certain kinds of foods. People suffering from allergies are sensitive to mold, dust, spores, and pollen. Naturopathic medicine associates allergies with weak immune and digestive functions thus naturopathic remedies help improve their function and eliminate the symptoms. Patients suffering from seasonal allergies should start the natural therapies a month or two before the season commences to minimize the severity of the symptoms. Other naturopathic remedies include:
· Herbal medicines like Dong Quai (has anti-inflammatory properties), eyebright (ideal for sneezing and itchy eyes), and the red clover (enhances the body’s resistance to allergies). Patients may make a tea of one or more herbs.
· Nutrition: include dark green, leafy veggies, deep yellow veggies, carrots, yams cabbage, ginger, onions and garlic.
· Hydrotherapy; hot foot baths, castor oil packs and placing a cold cloth on the forehead.
Sources
www.cancercenter.com
www.naturopathic.org
activebacktohealth.com
www.thehealthsite.com
Looking for non-invasive medical remedies; Try Naturopathic Medicines
Looking for non-invasive medical remedies; Try Naturopathic Medicines
Naturopathy is a holistic form of medicine that uses natural and non-toxic therapies to treat illnesses, prevent diseases and improve health. It presents a non-invasive and a complete form of treatment. Discovered in the 1800s naturopathic medicine borrows from a wide array of traditional healing practices; acupuncture, herbalism, botanical medicine and the use of nutritional supplements. Naturopathic medicine encourages the self-healing process of the body using modern and traditional, empirical and scientific techniques. The treatment works by first finding the cause of the problem, unlike modern medicine that aims at treating the symptoms.
Naturopathic Physicians conduct lengthy interviews with patients focusing on their physical wellbeing, diet, lifestyle and emotional health. As such, they base their treatments on some beliefs:
· The self-healing nature of the body: the body has an innate self-healing ability, and naturopathy only facilitates this process by eliminating any obstacles.
· Use of gentle and non-invasive therapies.
· A holistic approach to treating patients: physicians identify any imbalances in the body and tailor the treatment to rectify it (depending on the symptoms presented).
· Symptoms denote an underlying internal imbalance caused by emotional, physical or mental problems.
· Focus is on proactive prevention: naturopathic physicians believe in preventing rather than treating diseases through an evaluation of subjective and objective information. As such, doctors can quickly decipher any future vulnerability in patients.
Naturopathic medicine is known to deal with all kinds of medical ailments the most common being; chronic pain, cancer, allergies, hormonal imbalances, fibromyalgia, fertility problems, menopause, respiratory conditions among others. In our discussion, we will look at 4-5 cures of using Naturopathic Medicine
1. Naturopathy to treat heart disease
Heart disease is also referred to as cardiovascular or coronary artery disease. Different medicines have been developed to treat the disease but most effective remedy requires diet changes. Naturopathic doctors recommend various natural ways of addressing the problem:
Mediterranean diet: it is a plant-based diet that is rich in fiber, fruits, whole grains and vegetables. It also emphasizes on monosaturated fats like olive oil and foods rich in Omega 3.
Supplements and herbs: they help fight atherosclerosis (the major cause of heart disease). Herbs like Coenzyme Q10 (an antioxidant that aids in energy production), Hawthorn (helps in the relaxation of blood vessels) and Taurine (protects and improves symptoms related to heart failure).
Meditation: it reduces physical, mental and emotional stress correlated with cardiac problems. Naturopathic doctors also recommend adding other forms of relaxation like listening to music, walking, dancing to your daily routine to reduce stress.
2. Naturopathy to treat fibromyalgia
Fibromyalgia is a health condition that causes chronic fatigue, chronic pain, depression, memory problems, irritable bowel syndrome, and headaches. It is a multi-casual health condition that requires a deep understanding of the body organs to treat the multiple factors that initiate the problem. If the multiple stressors occur over an extended period, they cause fibromyalgia, destroying the body’s natural healing ability. The condition requires an integrative approach of treatment i.e. through the use of conventional and alternative diagnostic techniques like naturopathy. Naturopathy physicians recommend the following therapies for patients suffering from fibromyalgia:
· Gentle exercises like yoga, dancing, Tai Chi, and walking.
· Eating foods rich in minerals like potassium citrate and magnesium maltase.
· Eating foods rich in anti-inflammatory and digestive enzymes.
· Foods that contain anti-oxidant vitamins like Beta-carotene, B-complex, C and E.
· Adding foods rich in fatty acids to your diet; fish oils, flaxseed oil, and primrose oil.
· Detoxification program that includes liver cleansing, mercury detoxification and amalgam removal.
3. Naturopathy to treat chronic pain
Chronic pain is pain that lasts longer than six months. The pain can be mild, excruciating or in the form of sporadic episodes. The most common causes of chronic pain include headaches, backaches, joint pain, and pain from an injury. Other kinds of chronic pain include pain affecting certain parts of the body such as the leg, neck, arm, shoulders, and the pelvis. It may also originate with an infection or initial trauma. Physicians recommend various medicines to treat/relieve chronic pain but most of them offer modest results and cause a host of side effects.
Naturopathy provides a more holistic alternative of treating chronic pain with or without cause by identifying imbalances in the body that irritate tissues, or nerves causing pain. For example if the pain occurs on both sides of the body, it indicates an underlying disorder; if it occurs on one location it is more likely to be caused by an injury. Naturopathic medicine provides various solutions for treating pain:
Acupuncture: it relieves pain by helping the body to release endorphins, reduce pain signals to the brain and stimulate the body’s healing ability.
An anti-inflammation diet: naturopathic physicians prescribe herbal medicines that reduce inflammation.
Hydrotherapy: here water is used to increase circulation, reduce inflammation and promote detoxification thus managing chronic pain.
Supplementation: natural supplements like curcumin, and fish oils reduce inflammation, muscle tension without causing adverse side effects.
4. Naturopathy to treat fertility problems
Infertility is a health problem affecting both men and women. Studies show 30% of infertility problems are caused by female factors, 30% due to male factors and 40% due to unknown causes. Modern medical diagnosis and remedies involve lots of invasive tests, surgery, drug therapy and now artificial conception technology.
Naturopathic therapy, on the other hand, provides a more holistic view of treating infertility problems. The couple is treated individually while addressing their emotional, spiritual and psychological aspects. Some naturopathic remedies used include herbalism, making nutritional adjustments, flower essences (helps relax the mind), osteopathy and homeopathy. The treatments enhance the body’s natural processes without the use of invasive surgical methods, artificial conception technologies or toxic drugs.
5. Naturopathy to treat allergies
An allergy is an aggressive immune response triggered by inhaling irritants like pollen or ingesting certain kinds of foods. People suffering from allergies are sensitive to mold, dust, spores, and pollen. Naturopathic medicine associates allergies with weak immune and digestive functions thus naturopathic remedies help improve their function and eliminate the symptoms. Patients suffering from seasonal allergies should start the natural therapies a month or two before the season commences to minimize the severity of the symptoms. Other naturopathic remedies include:
· Herbal medicines like Dong Quai (has anti-inflammatory properties), eyebright (ideal for sneezing and itchy eyes), and the red clover (enhances the body’s resistance to allergies). Patients may make a tea of one or more herbs.
· Nutrition: include dark green, leafy veggies, deep yellow veggies, carrots, yams cabbage, ginger, onions and garlic.
· Hydrotherapy; hot foot baths, castor oil packs and placing a cold cloth on the forehead.
Sources
www.cancercenter.com
www.naturopathic.org
activebacktohealth.com
www.thehealthsite.com
Looking for non-invasive medical remedies; Try Naturopathic Medicines
8 Eylül 2016 Perşembe
Situs inversus and my "through the looking glass" body
What links Catherine O’Hara, Enrique Iglesias, Donny Osmond, and me? At face value, at least, not a lot. Look beneath the skin, however, and you would see a striking similarity: our hearts beat on the right, not the left. In fact it goes beyond mere dextrocardia, which would mean only the heart is transposed; instead, all our organs are placed in mirror image to the norm. We are linked by abnormality: we all have situs inversus.
Situs inversus is a rare congenital condition in which all of an individual’s internal organs in the thorax and abdomen are positioned on the opposite side to where they should be. The liver, for instance, is now on the left, the spleen on the right. Flipped, for want of a better word.
In some cases a person can live most of their life without realising they have situs inversus. Indeed, it has been reported that Donny Osmond was only aware of his condition after his case of appendicitis was overlooked because his appendix wasn’t where the doctor expected it to be. As such, and with an estimated occurrence of one in every 10,000 births, situs inversus totalis – the full term for complete anatomical reversal – has intrigued scientists for centuries. Many believe the condition holds clues to understanding how our bodies differentiate right from left, and the significance behind such a preference.
I was diagnosed with situs inversus totalis at six months old. Often, recorded signs of a reversed anatomy are dismissed as an error of the x-ray technician, the left and right labels supposedly mixed-up. It was only when I was taken to hospital with unrelated breathing problems that doctors began to consider the possibility that I had situs inversus. “Sit down and listen to everything I tell you”, the doctor told my parents, who, even after listening intently, were left in a state of disbelief. Several medical staff hurried into the room, excited. Medics may only come across one case of situs inversus in their careers, and I was later invited to take part in a Guess What’s Wrong With The Baby trainee doctor event.
For the last twelve years I have worn a MedicAlert bracelet on my left wrist to notify people of my rare condition. Turn it over and emergency medical staff are informed that I have “Complete Situs Inversus Normal Ciliary”. Rather than being simply an accessory or conversation piece, it serves the valuable purpose of preventing the somewhat unfortunate-sounding possibility of having an operation on the wrong side in an emergency.
Since all my organs have assumed the exact opposite location, situs inversus does not affect my overall health. I was very lucky; had only a few of my organs moved, or had they grown in random positions – as is the case with situs ambiguus – the condition would have been very serious. Of those born with situs inversus, 25% have Kartagener Syndrome (also referred to as primary ciliary dyskinesia), a defect in the cilia that line important organs and tracts, such as the respiratory tract, causing bronchitis, and reducing male fertility.
In other circumstances, the failure of one of the organs to move to the other side can further complicate the individual’s health, by causing entanglement. This often proves fatal.
There is also a strong probability that people born with situs inversus have heart problems. Speaking with adult congenital cardiologist Dr Dan Halpern at New York University’s Langone Medical Centre in July, I began to fully understand the condition’s implications. “You are the rarity,” he said, before delving into an animated description of the cardiovascular impact a reversed anatomy can have.
The most common heart problem, Halpern told me, is the transposition of the great arteries: instead of the great vessels arising from the heart criss-crossing over each other as they should, they lie in parallel. Alongside this, the main ventricles of the heart are inverted, or the great vessels arise from the wrong chamber. In the event of heart surgery, situs inversus can involve complications, since organs such as the heart are chiral – ie. they can be distinguished from their mirror image. Just think what would happen if you tried, for example, to attach a left hand to a right wrist. A similar geometric problem occurs if a donated heart from a non-situs inversus donor is transplanted into someone with situs inversus. The donor’s heart must be placed into the reversed position, and the surgeon needs to consider aspects such as the different weighting and the need to ensure the reattachment of the asymmetric blood vessels. It is almost like trying to complete a jigsaw puzzle with the wrong pieces.
Thankfully, twenty years on from my surprise diagnosis I have been able to lead a perfectly normal life – albeit one with a growing curiosity for what situs inversus entails; the history of its discovery, its wider cultural implications and why it occurs.
Although Aristotle cited two cases of transposed organs in animals,situs inversus was first discovered in Naples by the anatomist and surgeon Marco Severino, in 1643. A century later the Scottish physician Matthew Baillie recorded the reversal as situs inversus, from the Latin situs, as in “location”, and inversus for “opposite”. Situs solitus is the normal structure, while isolated levocardia refers to when the heart alone remains on the left – an even rarer condition.
Baillie’s 1788 account of the discovery during a seminar at the Hunterian School of Medicine conveys the shock the room of young doctors felt as they were faced with the mirror image. His text explains that from the outside the deceased man appeared to be of normal disposition, but that “upon opening the cavity of the thorax and abdomen, the different situation of the viscera was so striking as immediately to excite the attention of the pupils”. While the right lung is usually divided into three lobes, the pupils discovered “‘exactly contrary to what is found in ordinary cases”. He goes on to explain that “the apex of the heart was found to point to the right-side nearly opposite to the sixth rib, and its cavities as well as large vessels were completely transposed.”
The account also tells of the “considerable pains” Baillie took to establish how the condition had affected the man while he was alive. In researching the life of the deceased it was established that “the person, while alive, was not conscious of any uncommon situation of his heart.” It seems probable that if such a finding had been made in medieval times, a person with situs inversus would most certainly have been branded a witch or demon posthumously.
Artists and writers have explored the implications of situs inversus. Understandably so: it makes for a cracking plot twist. The titular character in Ian Fleming’s 1958 James Bond novel Dr No is saved from a bullet because of his dextrocardia. In Her Fearful Symmetry, Audrey Niffenegger introduces situs inversus during the postmortem of a twin. During the period 1452-1519, Leonardo Da Vinci is alleged to have been one of the first to depict the situs inversus anatomy – but then again, he did write back to front.
We consciously seek to attribute symbolism to structures that are formed in nature, investing our belief in the left-right asymmetry norm. Most notably, the heart and its position has always held an important cultural significance. America’s pledge of allegiance relies on the belief that the heart veers to the left of the thorax. In the Middle East, placing a hand over one’s heart after shaking hands with someone conveys respect, but also forges trust. The playground promise “cross my heart and hope to die”, started life as a religious oath, Christian in origin. “Hand on heart” suggests a sense of truth. Are these pledges and customs compromised if the right hand covers flesh and nothing more?
Of course, bodies come in many forms. Beneath the skin the illusion of regularity can be overturned, the body’s complexity brought to the light.
Situs inversus and my "through the looking glass" body
12 Ağustos 2016 Cuma
Think loneliness is about single people looking for love? Think again | Gaby Hinsliff
It’s hard to feel alone inside a long and happy marriage. But it’s easier than it looks, perhaps, to feel lonely. Last week, Italian police officers responding to reports of screaming and crying inside an apartment in Rome found something unexpected behind the door. Jole and Michele were a devoted elderly couple who had ostensibly got themselves worked up over a sad story on the TV news, but some gentle questioning elicited the fact that both were struggling with terrible loneliness. After 70 years of apparently loving marriage they still had each other, and yet that clearly was not enough.
Related: 10 reasons people are lonely? It’s more complicated than that | Sue Bourne
This being Italy, the officers rather charmingly cooked them a meal of spaghetti with butter and parmesan and stayed to chat, before doing the washing up and posting a flowery account on Facebook of how loneliness can suddenly sweep over you “like a summer storm”. The story went viral because it’s so heartwarming, and yet on second reading it’s also rather unsettling. The lonely are not quite the people we think they are.
It will be 20 years ago this summer that the first Bridget Jones novel was published, a timely reminder to ignore the spectacularly awful sequels and remember just how neatly the original skewered some of the myths about lonely singleton life.
Bridget was famously terrified of dying alone and forgotten, but ironically the one thing she wasn’t was lonely: she was riotously surrounded by friends and family, even if they did all keep harping on about her getting a proper boyfriend. It’s smug marrieds who can all too easily collapse in on themselves, severing old friendships they will come to regret in the process. (Anyone who thinks that having a baby means you’ll never feel alone again, meanwhile, has yet to find out how it feels to be home with a howling infant, desperately trying to engage the postman in conversation because he’s the only sentient adult you’ll see for hours.)
It’s all too easy to become consumed by family life and then wake up in middle age, ostensibly at the centre of a rich and busy life, struggling to remember your last meaningful conversation. That feeling may not be loneliness yet, but it’s a first step on the road.
The blunt truth is that not all lonely people are lovable old grannies who tug at your heartstrings
For while the cavernously empty feeling endured by the bereaved or unwillingly single can indeed be a terrible thing, and life-shortening to boot, it’s not the only kind of loneliness. A recent University of California study found that while almost half of its elderly subjects confessed to feeling lonely at times, only 18% of them actually lived alone.
Unhappy marriages, atrophying into long silences and separate lives, might have something to do with that, but the story of Jole and Michele suggests something else: a distinct kind of loneliness stemming not from the absence of significant others but from a feeling of disconnection with the wider world, a sense that you’re no longer part of something shared and human. Is it just a coincidence that the Italian couple’s crisis seems to have been provoked by a run of news stories – violent attacks, abuse at a kindergarten – revealing human nature at its coldest?
Fleeting loneliness comes to all of us occasionally, but it solidifies into something deeper and darker for those who start to perceive the world as a harsh and hostile place, one that wouldn’t welcome efforts to connect even if you try. It’s that nagging feeling of rejection, of not belonging or standing somehow apart from others, that is the true hallmark of feeling lonely in a crowd, and it’s by no means the preserve of the old.
Interestingly, a recent Brunel University study of over-50s found more than half of those identifying themselves as lonely had been that way for over 10 years, suggesting the feeling had become part of the fabric of their lives. (The same study, by the way, found levels of loneliness had barely changed since the second world war; so much for the idea of a modern epidemic, caused by fragmenting and hectic modern family lives.)
Related: The future of loneliness | Olivia Laing
So perhaps it’s not so surprising that this week’s obituaries of the fabulously wealthy Duke of Westminster, a father of four, should describe him as “lonely”. Immense wealth can of course be isolating – although the money clearly didn’t make the duke unhappy enough to get rid of it, or indeed to eschew the family tradition of minimising inheritance tax liabilities – but in Gerald Grosvenor’s case something else seems to be going on. What emerges is a picture of a man struggling all his life with feelings of inadequacy and anxiety, worried that he had done nothing to live up to the reputation of those ancestors who built his unearned fortune. Bullied at school, he reportedly left Harrow without one proper friend.
And if you can’t bring yourself to feel sorry for a billionaire, the blunt truth is that not all lonely people are lovable old grannies who tug at your heartstrings. An unhappy few have pushed others away with their self-destructive behaviour and are now paying a high price for it; some have struggled bitterly all their lives with the art of making friends, never quite mastering social norms. How much of the late-night bile spewed on social media simply reflects the envy and frustration of those who see other people happily connecting all around them and just don’t quite know how to join in? Loneliness has its dark side, one not so easily solved by more visits from the grandchildren or well-meaning volunteer “befrienders” popping in for chats over coffee.
For Jole and Michele, at least, perhaps there will be a happy ending. Now their story has been made public, perhaps surviving relatives or old friends will rally round, and if nothing else the knowledge that strangers worldwide are now asking how they can send letters or visit must do something to restore their faith in human nature.
Yet while a little kindness goes a very long way, it’s too easy to pretend loneliness can all be solved by a few more companionable plates of spaghetti. It makes for a less heartwarming story but the truth is that, like the poor, the lonely may to some degree always be with us – even, perhaps, when they’re ostensibly with someone else.
Think loneliness is about single people looking for love? Think again | Gaby Hinsliff
24 Temmuz 2016 Pazar
Double hand transplant: "It"s a small miracle, looking at what nature has allowed us to do"
It was a moment that mingled triumph with relief as the UK’s first double hand transplant patient awoke from a painstaking 12-hour operation with two new sets of fingers.
“It’s better than a lottery win because you feel whole again,” said Chris King as he recuperated at the Leeds General Infirmary. “They look absolutely tremendous,” he added. “They’re my hands. They really are my hands.”
But despite his joy at the successful surgery, the real test for King may just be beginning. Experience from previous such transplants suggests that the psychological challenges of bearing another person’s hands can be hard to cope with.
Clint Hallam, the patient who received the world’s first hand transplant 1998, claimed that he felt “mentally detached” from the new limb and had it removed three years later in a secret operation.
Nadey Hakim, a surgeon at Imperial College London who was involved in that operation, agrees that for some the psychological impact can be considerable.
Related: World-first skull and scalp transplant gives Texas man ‘new lease on life’
“For someone to use someone else’s hands to hold his wife, his kids – it is not easy,” he said. “I don’t think they will ever get used to it fully- they might claim they are used to it, but it is a very difficult task for anyone, even [for those which are] the strongest psychologically.”
King lost the four fingers of each hand in an accident three years ago. He received the double transplant in a lengthy operation conducted by a team of eight surgeons, led by Professor Simon Kay.
While around 80 hand transplants have taken place worldwide, King’s is the first double hand transplant to be carried out in the UK, and the first such procedure to be undertaken since the NHS launched its new hand transplant programme earlier this year.
Kay also carried out the UK’s first single hand transplant in 2012 when Mark Cahill, a former pub landlord, received a new right hand after his own became badly affected by gout and infection.
Cahill is enthusiastic about King’s operation. “I think it is fantastic, I am so happy for him,” he told the Guardian, adding that he hopes that the publicity will result in an increase in the number of donors to the hand transplant programme. “We have got plenty of people wanting hands, but not enough donors,” he said. That, he points out, could be down to the very visible nature of hands, which might make it especially hard for grieving families to give consent for donation. “I imagine it is heartbreaking,” he said.
Since his own operation, Cahill says that not only has he been able to carry out everyday tasks and drive again, but just six weeks ago used his new hands to give CPR to his wife after she suffered a heart attack. “I wouldn’t have been able to do it without my transplanted hand because my other hand was so deformed, I wouldn’t have been able to put any pressure on her,” he said.
As well as taking immunosuppressants, Cahill has been undergoing physiotherapy since the operation to improve the movement in his new hand. But, he says, he has not had any problems in accepting his new appendage.
“I think I was in a fortunate position,” he said. “I had [one] hand amputated and another one put on, so I was never without a hand. It is probably more difficult for people who lose a hand.”
Indeed, doctors stress that how patients feel about the operation is crucial. “The psychological point of view is very, very important,” said Professor Jean-Paul Meningaud of the University Hospital Henri Mondor in Paris. “Otherwise you can have a patient that [is] going to stop taking the treatment.”
For Hallam, the psychological implications post-transplant were apparently so overwhelming that he was unable to live with his new hand. In contrast to King and Cahill, Hallam had been without a hand for many years when he was selected for the operation. He lost it after an accident in prison – where he was serving a sentence for writing bad cheques. One minute he was climbing a ladder with a circular saw, the next he was sprawled on the flood minus his hand. Surgeons attempted to reattach it, but the limb lost sensation and dexterity and had to be removed.
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But Hakim rejects Hallam’s claim that he felt psychologically detached from the replacement limb after the later surgery .
“[The hand] was removed 2.5 years [after the transplant], requested by the patient, because he did not have the means to pay for his immunosuppressants,” he said. “The arm itself was in good condition until he stopped taking his anti-rejection medication.”
Other transplants have proved more successful. Another of Hakim’s patients, who underwent a double arm transplant in the US in 2000, is said to be doing extremely well. “He still has, after 16 years, an excellent function of both hands,” said Hakim.
But Meningaud, who has conducted a number of face transplants, as well as the world’s first face and double hand transplant, says the drugs used to prevent rejection are a cause for concern.
“You are going to suffer the side-effects of the immunosuppressant treatments your whole life,” he said, adding that such drugs put patients at increased risk of certain cancers as well as other health issues, while large doses to combat acute rejection can result in kidney damage.
Meningaud says his opinion on face transplants has changed over time, having seen problems with rejection, infection, and even a suicide attempt by a patient. “At the beginning I did not imagine the toll would be so important,” he said.
For King though, the operation has been life-changing. “I could shout from the rooftops and celebrate it big time, which is what I’m going to do,” he told reporters after the operation.
For the surgeons too, the procedure can bring feelings of awe. “You see a dead hand which is completely white, no blood supply to it, no viability, all of a sudden getting the colour of a normal hand. It is incredible,” said Hakim. “It is a small miracle which truly you are looking at in ecstasy, looking at what nature has allowed us to do thanks to modern surgery.”
Double hand transplant: "It"s a small miracle, looking at what nature has allowed us to do"