On immortality

From the “Making dreams come true” department, we recently had a sauna installed at the new gaff.

Warming up
Warming up

It’s very nice, and you should know that South Eastern trains have a special, hidden, weekend fare that lets you use the High Speed service for the same price as the slow train, and that I can pick you up from the station.

In related news, Reuters reports that saunas “might” be good for one’s health. Reading on, this headline seems to undersell things a bit.

I’ve always thought that mortality was more or less 100%. Everybody dies, sooner or later. Now, Elijah skewed the stats a little, but his non-death was compensated for by Tabitha, Lazarus, and two or three others; but on average (and certainly within experimental error), we’re good.

But according to Reuters, that absolute statistic is looking somewhat shaky.

screenshot from Reuters release claiming less death

Reducing mortality

So you might want to take me up on that offer from Gravesend station.

Sadly, I can’t tell you how sound are the data linking saunas and immortality, because I don’t have access to the paper.

“Further studies,” write the authors, “are warranted to establish the potential mechanism that links sauna bathing and cardiovascular health.”

Indeed.

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On meetings

Six years ago I found to relatively easy to tell my mother what I did for a living, if not exactly explain it. I could wibble on about actin polymerization and spaghetti, or messenger RNA export, or why I’d spent a year of my life trying to repeat an experiment that our collaborators had published only to discover that the buggers had effectively made it up. She’d nod wisely and assume I was super smart, which suited us both, really.

Nowadays the conversation is more along the lines of,

“So what is it you do?”

“Uh, I write stuff. And edit stuff.”

“Like what?”

“Slides. And brochures. And 3D animations. And stuff for meetings. And iPad apps. Oh, look at this book we made!”

“Did you write it?”

“No. But then again…”

Blogging about the day job is just as difficult, but for different reasons. The things that make blog posts interesting happen all the time, but I can’t really write about most of them in anything other than vague generalities (unless I wanted to be run out of town by a horde of angry—and suddenly unemployed—pharmaceutical executives).

But there are some things that I do that I can talk about, and one of these is running a reasonably large meeting for healthcare professionals to learn about the evidence for, and responsible use of, certain treatments in their everyday practice. Obviously it’s not something I do myself—there’s a good dozen of us in the company who will be eating, drinking and breathing this particular meeting from now until the last delegate is safely on their transfer back to the airport in the middle of June, and that’s not counting our Production and Creative departments who, while not involved in the organization and programme, will work their magic on the venue and the materials.

The way this all works is that we approach Major Pharmaceutical Company, Ltd, with a grant proposal for running an educational meeting for around 1400 delegates. With luck, Major Pharmaceutical Company, Ltd agree to the proposal and gives us a wodge of cash to appoint a chair, select a steering committee, and work with those people to recruit a faculty (that is, speakers) and design a programme. In the case of the project that’s just kicked off, later this year we will be running the fifth of what’s turned into an annual event. The first one was before I joined the company, but I have had a key role in each of the three since—and will again be involved this year.

Although the cash comes from Major Pharmaceutical Company, Ltd, it has no role in the development of the programme or selection of the faculty. We get the programme accredited, and delegates are eligible to receive continuing medical education credits. The pharma company selects and pays for delegates to attend (although it’s also open to anyone else who wants to pay the registration fee), and we work with their logistics supplier, but that’s about it. We could, theoretically, have a day and a half worth of speakers saying that everything Major Pharmaceutical Company, Ltd produces is crap and kills patients, but I suspect our chances of hosting the event again would be slim. Fortunately for us there are at least three other companies in the same drug space with competing products, not to mention the other treatments that have been around for years. This makes achieving educational fair balance relatively easy.

So we book a venue, we organize the speakers, we work with the steering committee to produce a thought-provoking, relevant and hopefully practical programme; we sort out the logistics and book hotels and whatnot; what else?

Well, before I have to dust off my suit and go on site, we actually have to brief the speakers as to the educational content of their presentations, whether lectures or workshops. What do the chair and steering committee want attendees to take away from the meeting? How do we help them achieve this goal?

We call each of the speakers—and we’re talking at least 20 internationally recognized doctors and researchers—and talk them through the programme, suggest a topic, get their feedback, refine the programme, and then spend 6 weeks chasing them for their slides or at the very least an abstract so we can give our Production and Creative departments the content they need to produce a programme book in time for the print (or this year, digital device) deadline.

Endgame

The end is in sight…

And we—that is, my Editorial team and I—have to edit the faculty abstracts and biographies (and in some cases write the damn things to start with), as well as check the presentations against the educational objectives of the meeting. There’s a whole heap of slide editing work in there too: has the speaker included their disclosures? Is every slide with data on it fully, correctly referenced? Is there fair balance? Are there annoying little formatting inconsistencies that make consecutive slides appear to jump around? Are there random slides from another talk in this presentation? Has the speaker included all relevant information (and omitted irrelevancies)? Are case presentations sufficiently anonymized? Can we suggest anything—content-wise or structurally—that might improve the educational value of the talk?

That last might seem a bit odd: after all, they are the world leaders in their field and we’re ‘just’ a medical communications agency. But 3 years spent looking at presentations and papers gives one quite an insight into a field, and we’ll often be able to draw a speaker’s attention to a paper only recently published, and they have learned to trust and respect our knowledge. This is particularly valuable when it’s 2 in the morning, the speaker arrived in the country just in time for dinner and has only just now got to the dingy hotel room we’re using for slide previews, with slides we’ve never seen before, and is giving the first talk in just six and a half hours’ time.

There’s the content and design of the Save the Date, the Invitation, the programme book itself, the signage at the meeting… all of which at some point involve an argument between Editorial and Production, or Creative and Production, or Account Management and Creative, or (more likely) all four, usually terminated by the phrase “The print deadline is at 12, TODAY!”

And on top of all that there’s that book I didn’t write.

Or did I? Next post, perhaps.

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On remembrance

Thirty years ago—plus or minus a week—I visited Berlin for the first time.

It was a school trip, organized by our physics teacher. We rode a train from Braunschweig to Helmstedt, where we picked up an East German engine and crew. The doors were chained so they couldn’t be opened by anyone trying to get in. We clanked our way along the dreary transit line, stopping to change engines again at Potsdam, before terminating at Charlottenburg—our gateway to the bustling, decadent shrine to capitalism that was West Berlin.

We rode on the U-bahn; visited the Olympic Park; played video games on the fifth floor of KaDeWe; had liqueur-soaked crepes in a an alcove on the Ku’damm.

We saw the Tiergarten, the Geisterbahnhöfe.

Battle damage.

The Wall, and the Pope’s Revenge.

Popes-revenge
Pope’s Revenge by tölvakonu, on Flickr

We took a coach through Checkpoint Charlie, negotiating the Soviet guards and the concrete roadblocks. We visited the Tomb of the Unknown Soldier, and his goose-stepping guards.

My clearest memory is of how grey everything seemed—the roads, the buildings: even the state-run apotheken. We came back and visited the Checkpoint Charlie museum: shocked, stilled, and dumbstruck—but not totally uncomprehending—at the desperation that led so many people to risk death to escape the East.

Neu Wache
Changing of the guard

And because we were who we were, we figured out how high our hotel room was by dropping stones off the window and timing how long they took to hit the ground.

At Easter the next year I went back with my parents and sister. We drove to Helmstedt on a warm and sunny morning, to Checkpoint Alpha. Dad had to leave the car and march into the Soviet checkpoint. Outside stood a young Soviet guard in full winter furs, sweating in the unseasonal April weather. Summer uniform was a month away.

When dad got back to the car we had two hours to get to Checkpoint Bravo at Dreilinden: any faster and we’d have been done for speeding. Too slow and we would have been under suspicion of stopping and picking up passengers. In case we were stopped by the Vopos we had flashcards with two simple phrases on them, in Russian, German and English. The cards read, “I wish to proceed without further delay” and, “I demand to see a Soviet officer”. The second card was the biggie—if ever we played it we would have to wait until one turned up.

I don’t remember much of that trip—except we once again saw the Wall, perhaps the zoo too, and my sister was delighted that we had chocolate bunnies at breakfast on Easter Sunday in the B&B.

And that was it. A few years later the Wall came down (Jenny has a piece of it somewhere) but until last week I’d never had chance to visit Berlin again.

Last week was a work trip—we were running a day and a half conference at a hotel a few hundred yards from where the wall once stood. I got there on Wednesday, but we didn’t stop working until it was time to catch the flight home on Saturday. I saw a fair bit of Berlin from the window of the taxi, but had little chance to look around on foot. We did manage to walk to Potsdamer Platz, where, instead of nail beds and barbed wire and anti-vehicle trenches, we drank weissbier under the purple roof of the Sony Center.

On the way to the conference dinner I managed to catch a glimpse of the illuminated balloons that marked where the Wall once stood. Sadly, we had to fly back the day before the celebrations marking the 25th anniversary of its fall.

And when I got back told the girls about the meeting, and then about Berlin and the end of the Second World War and the Wall going up and how it came down again, they were amazed that any system of government could be so oppressive as to prefer to shoot its own citizens rather than let them leave. All they hear about is how some want to make it more difficult to get into their country, not escape it. I haven’t yet had chance to tell them the story of one of our meeting’s Steering Committee; how she and her family had to flee Berlin in 1950 when her grandfather, a local politician, was rounded up and murdered by the Stasi; how she couldn’t visit the town of her birth for 40 years.

Remembrance isn’t just about those who fought—in whatever capacity—and died for our freedoms. We must also work to ensure that those freedoms—to live and work and love without fear of oppression—are not again lost. And before we do that, we have to tell people these stories, to show them what they are unable to remember because they weren’t there.

In Flanders Fields the poppies blow (3/3)
“In Flanders Fields the poppies blow” by Tijl Vercaemer, on Flickr

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On a hill

Jenny and I took some friends around the Rotherhithe peninsula yesterday, cutting through Russia Dock Woodlands and finally climbing Stave Hill.

From the top of Stave Hill you can appreciate just how flat London geography really is. The Hill’s not very high—30 feet, according to Wikipedia (and the base is barely above sea level)—but you can easily see the lipstick tower at Elephant and Castle, the London Eye peeking around the glistening slops of Mount Doom (I think you mean the Shard—Ed), the Orbit at the Olympic Park, and even, on a clear day—again according to Wikipedia—Wembley Park ten miles away. The Isle of Dogs, that ever-expanding monument to Mammon, dominates the eastern skyline.

But yesterday, for a brief moment, I caught a glimpse of what London might have been were the Square Mile a mediaeval hill fort, or built on the slopes of a cliff leading to warmer seas.

Two-way radio

In the glass of 20 Fenchurch Street, better known as the Walkie Talkie, I could see the City reflected. And because of the sloping sides of the skyscraper, the illusion is that Fenchurch and Aldgate are climbing up towards the impenetrable heights of Wapping Fortress.

There might be a movie in there, somewhere.

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We strapped this baby into a chair. You won’t believe what happened next!

Tired and hungry

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On biological modelling

You can take the rat out of the lab…

mRNA in search of a ribosome

… but you can’t complete translation without a ribosome.

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She blinded me with science

Jenny is putting the finishing touches to a revised manuscript. I’m reading about a very interesting paper in my old field—and telling her about it.

Joshua is doomed, isn’t he?

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A momentary lapse of reason—Chapter Fifteen

Chapter Fourteen


The Police

It was always trying, visiting Mary’s mother. Most Saturdays Slater would rise early and sit in the box room he liked to call his study with a pile of academic papers, perhaps a lab notebook or two or a student’s thesis, and catch up with everything he hadn’t been able to do during the week. He’d emerge briefly around 11 for fresh coffee, then take a late lunch. Towards late afternoon, if Mary wasn’t visiting friends they’d go for a walk out towards Fulbourn or over the Gogs, afterwards often heading into town for dinner. They never booked ahead, but rather looked around until they found somewhere not too busy, hang the cost.

Was the spontaneity of their Saturday evenings was an attempt to recover some lost romanticism? Or maybe one or other of them was trying to apologize for something—or even simply reminding themselves that perhaps not having children was not without its benefits. All his friends had grown up, had children, and although they seemed to work as hard as he did he could occasionally feel their envy, disguised though it was as pity.

Whatever the reason, he looked forward to Saturdays—except when once a month when they’d make the tedious drive to Leicester, to the drab Fifties vision that was the Eyres Monsell estate, to the semi smelling of stale cigarettes, Camp coffee and cat piss.

In another life, perhaps, he could have got on with Mary’s mother. She had been, by all accounts, quite a looker in her youth. But while some women age gracefully, maintaining an air of elegance, even desirability, well into their greying years, she had fared no better than her council estate environment. Neither was she immune to the more medical slings and arrows of age: the signs of creeping dementia and incipient angina were clear.

She’d also taken an immediate and deep-seated dislike to her only son-in-law. When they arrived at her door, Mary had to tell her Tom’s name repeatedly. When at last she did appear to remember him, she would ask why he’d dropped out of med school, or what kind of career was journalism for the husband of her daughter. He had almost convinced himself that the old bat wasn’t at all senile, but rather was deliberately needling him.

As usual, they had driven home in silence. Slater let Mary through the door first, then threw his keys with slightly more force than intended onto the table. Mary frowned without saying anything, and Slater hated himself just a little bit more.

The decanter was rattling on the edge of the whisky tumbler when the doorbell rang.


Unsubtle.

That was the single thought that occupied his mind. The blue lights reflecting off the windows in the quiet Cherry Hinton street, the two uniformed officers hammering on the door, the shrillness of Mary’s voice, audible even out here in the allotments.

Unsubtle.

When, two hours after they’d arrived, the police went back to their car and drove off, Michel wasn’t totally surprised that Tom wasn’t with them. Even the Cambridge police must have realized there wasn’t a shred of evidence. No; what was surprising was that they had got involved at all at this stage. There was but one hypothesis that fit his observations, but he couldn’t yet be sure he was right. He needed the fox to come out of its hole.

He’d waited all afternoon; a little longer wouldn’t hurt.

And there it was. The white Ford with the Sheffield licence plates turning into the cul-de-sac, reaching the end, and reversing into the Slaters’ driveway. And the platinum blonde—and someone else he didn’t recognize—crunching up to the front door and ringing the bell.

When the door opened, he pinched out the joint and walked slowly up to the house.


When the police had gone, Slater stood with his forehead pressed against the wood of the front door, the tumbler still in his hand but the whisky untouched. Behind him there was silence, but it was the silence before an earthquake.

I will be calm, he thought. Whatever happens, I will be calm.

A chair creaked; footsteps across the hall to the kitchen. A clink of glassware and the sound of running water.

Be calm.

The footsteps returned, and he heard Mary gulp down the water.

“What,” she said, just a hint of a quiver in her voice , “was that all about?”

Slater moved his head away from the door and looked up at the architrave. Hmm. Mould. That’s going to be have to seen to this summer.

“Well?”

Calm.

He turned around to face her, dispassionately noting the water dripping from the corner of her mouth; the wide, unblinking eyes; her hand, still holding a glass, hanging limply at her side.

“There’s some mould up there above the door. We should get the wood treated,” he said.

He barely flinched as the glass exploded against the doorframe, inches from his face.

I am so fucking calm, he observed, a bomb could go off and I wouldn’t notice it.

He looked down, and poked a piece of broken glass with the toe of his shoe. “For some reason,” he said, “the Cambridgeshire Constabulary think I had something to do with the death of Charlotte Stowell. They’re not the sharpest tools in the shed, as you know.” He looked up, and smiled brightly. “Good job that was one of the cheap Tesco glasses and not your mother’s crystal.”

 

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I fought the law

Jury service
Nobody commit any crimes any time soon, mkay?

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My iron lung (redux)

The is a modified version of a couple of posts that originally appeared in December 2006 on ‘Life of a lab rat’, my blog at the University of Sydney. Which is now sadly defunct.

It’s not what you know, it is who you know, especially when it comes to medical matters. And if you know someone who can prescribe antibiotics and get you into A&E’s X-ray unit on a Sunday morning then you must be doing pretty well. The good news is that it does not appear to be a fractured rib.

The bad news is that even if it was, you wouldn’t be able to see it because of the consolidated pneumonia and pulmonary effusion (“50% of hemithorax”). My specialist’s comment was “People with chest X-rays like that are usually already in hospital”. Oh, and “It’s getting better, but you’re taking a week off”.

So I went to the quack’s a week later, and fortunately did not get to see the muppet who managed to miss the pneumal party when I crawled into his office the previous Thursday, barely able to breathe and unable to stand. Instead I saw a nice lady doctor who continued my roxithromycin prescription and also prescribed a cephalosporin. That is because I said I did not want a penicillin, as we use β-lactamases in the lab all the time and I did not want to take the risk that anything pathological in me had managed to acquire resistance. Unlikely I know, but always a worry.

I don’t actually think she knew what I was talking about, but tried her best. She had never prescribed cephalosporins before, and knew nothing about them, but spent a good few minutes looking in various books before deciding what to do. She didn’t even know who Ed Abraham was, which is a shame, because I did my DPhil in The Sir William Dunn School of Pathology, where the whole antibiotic story took off.

Roxithromycin is a bit of a wonder drug, really. lt works by binding to the large ribosomal subunit and prevents nascent peptide from translocating (look, just STFW, OK?). This means that the bacterium stops growing because it can not make any protein, and becomes a sitting duck for any big, angry macrophages that are in the area. Interestingly, roxithromycin concentrates in phagocytes, which are of course recruited to sites of infection. So if you’re a streptococcus in my pleural tissue, this big, angry macrophage bearing down on you is not just going to eat you up, it’s going to lay down an artillery barrage of antibiotic that will keep your mates busy until it can get around to them. Pretty clever, huh?

The other thing that’s really nice about this drug, compared with the β-lactamase family (penicillin, etc.) and derivatives (cephalosporins) is that it just stops the bugs from growing. The β-lactamase family kill growing bacteria: They are incorporated into the growing cell wall of the bacterium, weakening it. Normally, the bug’s cell wall maintains the cell’s shape and size. But if that cell wall is weakened, the bug will eventually go POP! and spew all that icky bacterial goo everywhere. So there’s a bit of a mess to clean up. With roxithromycin and other macrolides, the bug just waits to be disposed of tidily.

The cephalosporins are still pretty remarkable. You know about Howard Florey and Ernst Chain, but it was Edward Abraham who proposed the correct structure for penicillin. He then went on to develop the cephalosporins, and was allowed to patent them which was a major boon for British science, especially in Oxford. I did my Part II project in a lab opposite his office, and finished my DPhil on the same floor, and used to bump into him quite a bit. If I’d known then what I know now, perhaps I could have asked him why cefuroxime tastes of bacon-flavour crisps. On the way down and on the way up (i.e. when coughing five hours later), if you see what I mean.

Another forgotten character in the antibiotic story is Norman Heatley. I met Norman a few times while at the SWDSOP – I remember a gentle, kindly man who always carried a penknife. This was a veritable sonic screwdriver that he used to fix any recalcitrant equipment around the place. He also seemed to be the only person who knew how to operate the School’s flagpole.

Finally, one of my close college friends and the Queen’s bridesmaids was the great-niece of Lady Margaret Florey. Margaret Jennings was on Florey’s original team, looking at the effect of penicillin on animals. His wife at the time, Ethel, organized and carried out the clinical trials. By all accounts, it was not a happy marriage, but they stayed together until her death. After a suitably brief period of mourning, Howard married Margaret (after a 27 year affair), and they were happy for a tragically brief time, Howard dying suddenly eight months later.

I saw Lady Florey just the once, in the lecture theatre at the SWDSOP. Old age had sadly affected her by then and she died soon after. I was fortunate enough to be able to go to her memorial service. I seem to remember it being a lovely sunny day in summer at the Marston parish church, but the WWW seems not to think her important enough to give me any clues as to the date. Somewhere, in a box of old papers and memorabilia, I might have a service card.

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