Send in the clown

But what lies ahead for Johnson in those uncharted waters? His best joke was not meant to be one. In November 2016 he claimed that “Brexit means Brexit and we are going to make a titanic success of it.” In this weirdly akratic moment of British history, most of those who support Johnson actually know very well that Brexit is the Titanic and that his evasive actions will be of no avail. But if the ship is going down anyway, why not have some fun with Boris on the upper deck? There is a fatalistic end-of-days pleasure in the idea of Boris doing his Churchill impressions while the iceberg looms ever closer. When things are too serious to be contemplated in sobriety, send in the clown.

The Ham of Fate | by Fintan O’Toole | The New York Review of Books

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A relative of Nye Bevan, the founder of the NHS, died after serious mistakes by two hospital trusts meant his lung cancer went from treatable to incurable… 

Link

(Image courtesy of Alun of Penglas).

Not so much a jet plane, but I don’t know  exactly when I will be back either.

Smombies everywhere

My youngest daughter lived in South Korea for a while and I visited on a couple of occasions. It was a lot of fun in all sorts of ways. The following rings(!) true

The government initially tried to fight the “smombie” (a portmanteau of “smartphone” and “zombie”) epidemic by distributing hundreds of stickers around cities imploring people to “be safe” and look up. This seems to have had little effect even though, in Seoul at least, it recently replaced the stickers with sturdier plastic boards.

Instead of appealing to people’s good sense, the authorities have therefore resorted to trying to save them from being run over. Early last year, they began to trial floor-level traffic lights in smombie hotspots in central Seoul. Since then, the experiment has been extended around and beyond the capital. For the moment, the government is retaining old-fashioned eye-level pedestrian lights as well. But in future, the way to look at a South Korean crossroads may be down.

A dangerous creature is haunting South Korean crossroads – Smombie apocalypse

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Software is eating..

Comparison of the accuracy of human readers versus machine-learning algorithms for pigmented skin lesion classification: an open, web-based, international, diagnostic study.

You can dice the results in various ways, but software is indeed eating the world — and the clinic. The (slow) transition to this new world will be interesting and eventful. A good spectator sport for some of us. (Interesting to note that this study in Lancet Oncology received no specific funding. Hmmm).

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What is science for: dangerous thoughts.

The quote below was from a piece in the Lancet by Richard Horton.

Reading [Bertrand]Russell today is a resonant experience. Existential fears surround us. Yet today seems a long way from the dream of Enlightenment. Modern science is a brutally competitive affair. It is driven by incentives to acquire money (research funding), priority (journal publication), and glory (prizes and honours). Science’s metrics of success embed these motivations deep in transnational scientific cultures. At The Lancet, while we resist the idea that Impact Factors measure our achievements, we are not naive enough to believe that authors do not judge us by those same numbers. It is hard not to capitulate to a narrow range of indicators that has come to define success and failure. Science, once a powerful force to overturn orthodoxy, has created its own orthodoxies that diminish the possibility of creative thought and experiment. At this moment of planetary jeopardy, perhaps it is time to rethink and restate the purpose of science.

Offline: What is science for? – The Lancet

I am just musing on this. We like to think that ‘freedom’ was necessary for a modern wealthy state. We are not so certain, now. We used to think that certain freedoms of expression underpinned the scientific revolution. We are having doubts about this, too. Maybe it is possible to have atom bombs and live in a cesspool of immorality. Oops…

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Living in Scot itchland

Genital scabies was, to the English, “Scotch itch,” and Scotland was “Itch-land.” The pox was the Spanish or Neapolitan Disease to the French; the French Disease to the Spanish, English, and Germans; the Polish Disease to the Russians; the Portuguese Disease to the Japanese. Captain Cook was chagrined to learn that it was called the British Disease in Tahiti as, in so many words, it was in Ireland: in Ulysses the Citizen, a rabid Irish nationalist, mocks Leopold Bloom’s reference to British civilization: “Their syphilisation you mean.”

Vile Bodies | by Fintan O’Toole | The New York Review of Books

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Wigged out!

“There is no urgent need to go discarding something which has been out of date for at least a century.”

The Economist | Wigged out

This quote refers to the wigs judges in the UK wear. But it seems apposite for much of the way we think about medical education.

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Mental Health Services for Medical Students

Medical students have higher rates of depression, suicidal ideation, and burnout than the general population and greater concerns about the stigma of mental illness. The nature of medical education seems to contribute to this disparity, since students entering medical school score better on indicators of mental health than similarly aged college graduates. Roughly half of students experience burnout, and 10% report suicidal ideation during medical school

NEJM

This is from the US, and I do not know the comparable figures for the UK. Nor as I really certain what is going on in a way that sheds light on causation or what has changed. By way of comparison, for early postgraduate training in the UK, I am staggered by how many doctors come through it unscathed. I don’t blame those who want to bail out.

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Statistics and empathy

An economist may have strong views on the benefits of vaccination, for example, but is still no expert on the subject. And I often cringe when I hear a doctor trying to prove a point by using statistics.

Age of the expert as policymaker is coming to an end | Financial Times

There were some critical comments about this phrase used by Wolfgang Münchau in a FT article. The article is about how ‘experts’ lose their power as they lose their independence. This is rightly a big story, one that is not going away, and one the universities with their love of mammon and ‘impact’ seem to wish was otherwise. But there is a more specific point too.

Various commentators argued that because medicine took advantage of statistical ideas that doctors talked sense about statistics. The literature is fairly decisive on this point: most doctors tend to be lousy at statistics, whereas the medical literature may or (frequently) may not be sound on various statistical issues.

Whenever I hear people talk up the need for better ‘communication skills’ or ‘communication training’ for our medical students, I question what level of advanced statistical training they are referring to. Blank stares, result. Statistics is hard, communicating statistics even harder. Our students tend to be great at communicating or signalling empathy, but those with an empathy for numbers often end up elsewhere in the university.

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