By Katrina Firlik.

Neurosurgeons are quirky people. I’ve yet to meet one who’s “normal”; mind you, my observation-count of this rare species is still only three, so perhaps my sample-size is just too small. In her book ‘Another Day in the Frontal Lobe’ Katrina Firlik describes the habitat, behaviours, and temperament of the neurosurgeon. Here are some of the findings (corroborated with my personal experience):

• Quirk 1: Neurosurgeons are your superior. It doesn’t matter who you are, or what you do, brain surgery tops everything. I suppose that’s the attitude that naturally comes after 11 years of speciality training in an isolated culture. Firlik notes the stereotype, confirms its accuracy, and then exemplifies it with an out-right haughty tone throughout her book.

• Quirk 2: Neurosurgeons do only a few things very well. You’d think that the neurosurgeon would be the ultimate expert on function of that mysterious organ, the brain. They’re not. In fact, neurosurgeons handle only a small subset of brain disease. This includes trauma, tumours, and seizures. Comprehensive brain/mind function is left to be studied by the psychiatrists, psychologists, and neurologists, with each one contributing a unique piece. In fact, most neurosurgeons spend most of their time operating on the spine (that’s where the most money is to be made).

• Quirk 3: Neurosurgeons are mechanics. Brain surgery is not, well, brain surgery! If there’s too much fluid in the brain causing a build-up of pressure, you drain some to restore normal pressure. If there’s a tumour compressing on brain structures, you remove it to decompress the brain. Obviously I’m vastly simplifying, but most neurosurgical work is founded upon basic mechanical principles.

• Quirk 4: Neurosurgeons are emotionally tough. This is a necessary attribute. Chances are, that once you’re willing to let someone cut into  your brain, things are looking pretty bad. The outcomes of neurosurgical patients are usually not happy stories.

You may accuse me of speciality profiling; of drawing on superficial stereotypes. I protest that, in medicine, the stereotypes are usually objectively true. Each speciality has a unique personality of doctor associated with it. And it makes sense. When you train for many years with a small, isolated, community day-in, and day-out, you tend to form an identifiable culture. When medical students choose their future directions, a large factor is often the culture with whom they get-along the best.

Oliver Sacks is the Jane Goodall of neurology. He has spent his entire  professional career observing patients, dutifully recording in his notebooks, and publishing reports of his findings that illuminate how the mind works. Most of his published work tells personal stories of patient experiences. Most notably there is ‘The Man Who Mistook his Wife for a Hat’ (a man with visual agnosia) and ‘An Anthropologist on Mars’ (perceptions of people with autism).

In this TED Talk, Oliver Sacks explains Charles-Bonnet Syndrome –  a hallucination syndrome experienced by people who lose their vision. I was surprised to learn that up to 10% of people with vision loss experience Charles-Bonnet hallucinations, but only 1% of them report it because they are afraid of people assuming they  are going insane (which they are not).

Check it out, it’s fascinating:

Ever wondered why Dr. House and his staff suspect Lupus so frequently? Until this week, I always considered that to be very odd, and probably a quirk of the script-writers. Until we learned about Lupus!

Systemic lupus erythematosus (SLE) is an autoimmune disease of the connective tissue. ‘Autoimmune’ means that it occurs when a dysfunction in your immune system causes your immune cells to start reacting against your own body. Essentially, your body starts fighting itself. There are many different autoimmune disorders, but in SLE, the attack is mounted against components of connective tissue. Unfortunately, connective tissue is found virtually everywhere in your body. This means that SLE can affect virtually any organ system.

Seriously – you should see my textbook, and all of the hundred presentations of lupus that are listed there. It is understandable then, that given a systemic disease involving multiple organ systems, you might reasonably suspect lupus.

As you saw in the clip, there’s a sensitive blood test available for lupus: ANA. The clip explains how 95% of people with lupus are positive for ANA, which means that a negative ANA is a sufficiently good indication that you don’t have lupus. The problem occurs when your ANA is positive! Because although the test is sensitive, it’s not very specific and so a few different conditions may present with a postive ANA. So when the ANA is positive, you still have some sleuthing to do… or should I say Dr-House-ing.

Periodically, I like to review an album. Amongst mercurial mood-swings of taste, I occasionally latch onto a unique album making it my temporary obsession. It’s these that I tend to review. Accordingly, my musical fling this week is Jason Mraz’s “We Sing. We Dance. We Steal Things.”

What I appreciate about Jason Mraz’s music is it’s freshness, variability, and skilful instrumentation. Since I’ve never listened to Jason Mraz before, I can’t compare it to his previous work. But the album shows a mature musicality, and influence from a few different musical styles.

A definite highlight track for me, is “Butterfly”. I love the punchy brass, and funky rhythm! The vocals include unmistakable Michael Jackson imitations, playfully suggestive lyrics that never fail to make me smile, and later in the track – yes, it really is – scat singing!!!

Another supreme track is “The Dynamo of Volition”. Such a catchy chorus! ”Live High” has some wonderful lyrics urging the listener to “live high, live mighty, and live righteously”, with fitting backing from a gospel choir. The radio-overplayed “I’m Yours” reminds me a lot of Jack Johnson’s beach-appropriate, leisurely style, but with improved backing vocals and instrumentation (i.e. more than just a guy with a guitar). “Lucky” features a nicely-balanced duet with Colbie Caillat, and sweetly romantic lyrics.

Highly recommended. Check it out; let me know what you think!

WordPress tells me that when people come to my blog via Google, the search term that they most often use to get here is…. “squid”.

I’m not sure just how I feel about that ! Don’t get me wrong, I love squid – to watch, to swim with, to study, to eat, to dissect. But I’m just not sure if when people type “squid” into a google search, that what they are really looking for is the blog of a first-year medical student. Hmm…

It was a momentous week for television. After years of anxious watching and waiting, with the expectancy building unbelievably high, NBC’s ‘The Office’ did not disappoint its viewers last week:

The scene is in the rain at an unattractive gas station, with cars moving through the foreground and obstructing the camera’s view. The dialogue is hard to make out, and very few words are spoken. But wow ! As the culmination of a beautiful story of two ordinary people falling in love, I feel that this has got to be one of the most romantic scenes on television.

If you ever need some uplifting, check out www.Despair.com :) ! I know that sounds counter-intuitive, but their “Demotivators” work so much better than those phony, cheesy motivating ones! You’re sure to get a laugh anyway. Go have a look!

I find human ancestry fascinating. How are we all related? What did my ancestors look like, and where did they live? What are the stories of our forbearers as they struggled for survival, made discoveries, and lived together?

Adam and Eve were African. That’s not a new discovery, but many people have never heard it. The immediate consequence is that you yourself, regardless of where you come from or where you live now, have African ancestors. The reason that we can be sure of that comes from population genetics.

Here’s a TED Talk that took place in my home-country, Tanzania, that explains in simple terms how you can be sure that you have an African heritage. The speaker is Spencer Wells, who is the director of the Genographic Project. They analyze DNA from indigenous people around the world, building a family tree for the human races. If you want to purchase the kit, you can actually participate in the project yourself by sending in your own DNA for analysis.

Here’s what I found interesting about this talk:

Adam and Eve never met each other. That’s because, by ‘Adam’, I mean the most recent common ancestor of all the men that are alive today (according to the biblical account, ‘Noah’ would have been a better name since all men are said to descend from him more recently than Adam). Correspondingly ‘Eve’ refers to the most recent common ancestor of all the women that are alive today (Noah’s wife).

Now men generally have more disproportionate reproductive success. That is, some men father many children while others father none. For example, Ghengis Khan had so many concubines that it is believed he is an ancestor to more than half the men on the planet (does that explain a lot to you ?). Women, on the other hand, are generally more evenly reproductively successful. The consequence of this difference between men and women, is that ‘Adam’ appears in our history far more recently than ‘Eve’. So much so, that they lived in completely different time periods and could never have met.

Another interesting realization about Adam and Eve, is that they weren’t the first “humans”. Far from it. The origin of our species dates much earlier, but we defined Adam and Eve as the most recent common ancestors. To find the actual first “humans” is an impossible task, given that evolution works along gradients making only gradual changes. It would be like trying to find the first moment that a child is “grown-up”.

Finally, Adam and Eve lived side-by-side with other non-human bipedal apes. Actually it’s been that way throughout our history. There has almost always been other walking, thinking hominids living with us. It’s a fair question to ask why there’s just our species left now. Did we kill-off, or out-compete the others?

Well, if you find ancestry like this interesting, I highly recommend Richard Dawkin’s book “The Ancestor’s Tale”. It takes you on a journey back to the most recent common ancestors of humans, apes, mammals, vertebrates, and eventually all of life.  It’s a beautiful book.

[WARNING: SPOILERS WITHIN] [WARNING 2: THIS POST JUST FOR FUN]

Welcome to Gotham City. You know it well. It’s the city that you sometimes imagine you live in. Especially on those nights when it’s dark and cold outside, and you’ve got a long walk home. Alone. The scummy hell of a place where everyone is either a crook or a victim. You’re not a crook, right? Which makes you the victim. Keep a tight grip on your wallet. Don’t go down any dark alleys. Don’t even glance. Look tough, and walk on by.

Shh!! What’s that sound? Like laughing… no, cackling! There!! Beneath the fire escape! A twisted soul; scarred, and discoloured. The Joker – his hair an unsightly mess, wearing a contorted wicked grin, and with madness dripping from that leering, sickening laugh. One silently wonders whether the Joker’s insanity betrays the emotional state of an underlying actor who would later overdose on prescribed insomnia medicine. How much is performance? Regardless, an eerily convincing performance it is. Scared yet? You should be – he’s looking right at you. No point in running. This villain moves on animalistic impulse. He claims to never plan; he “just does”. But somehow bombs keep getting planted, and creepy clown-thugs placed in convenient watches. Actually, whole hospitals and ferry-boats get rigged. Impressive for a guy that never plans. Oh ya, and once things are going his way, he’ll exclaim maniacally that it was all according to plan! Hmm, now there’s a true anarchist.

Enter Rachel Dawes. More than a pretty face, this independently thinking woman has an important decision to make. That’s right, just one. Which man to pick. Gosh, that’s a tough one. Wouldn’t want the wrong decision made, maybe it’s best to blow her up before she has the chance! Now, that leaves zero independent actions for this female character. Which begs the question: would it have been cheaper just to hire a life-size woman doll? But then there’d be less companionship for the other female cast members. Which ones? Well, the nameless wife and mother of two, and that masculinized butch of a female cop. Here’s an easy solution to the gender imbalance: cast Rachel as a lawyer. Instantly, that adds so much breadth to her character. Phew!

But you and the mindless Ms. Dawes are saved!! Swoosh! POW, POW!!! Explosions all round! Oh, and of course, an absolutely thrilling car-chase that demolishes most of the vehicles on the road (Gotham City’s unique solution to curbing greenhouse gases). Now the Joker makes our hero choose between saving only one of two hapless innocents. But our guy’s a pro at indecision – somehow he always manages to save them both (well, except where it really mattered with Rachel). Batman is your penultimate superhero. He flies; all superheroes must fly, even if aided by webs or wings. He’s got brawn, sweet gadgets for when brawn is insufficient, a gruff sexy voice, and a mild-mannered alter-ego. Best of all, he’s a total loner. That’s a job requirement. All heroes must be tragically misunderstood.

Great movie! Absolutely loved it!

For months now, I’ve stubbornly resisted buying this album. During that time, it has been topping the iTunes charts and is played incessantly across the radio. Everyone has heard it, and most listeners have a strong opinion about it one way or the other. So finally, I can ignore it no more – I caved and bought it.

A paradoxical album, some of its tracks have an addictive, driving beat that has me turning up the volume and moving to the pulse. Others, like ‘Umbrella’, are so unbearably annoying and unmusical that I can hardly bear to listen to them. 

No one can deny that the album has variety. There are club-style dance tracks in ‘Don’t Stop the Music’ and ‘Push Up On Me’. The vocals of ‘Lemme Get That’ are mostly rapped, while ‘Good Girl Gone Bad’ sounds more like pop of the generic “soft-rock” radio variety. ‘Shut Up and Drive’ (great track!), has rock guitars and drums. All of this from an artist whose previous albums were criticized for lacking versatility. No more!

It’s true – there’s some lack of musicality here. The melodies aren’t impressive for their own sake, and the tracks are driven mostly by a strong rhythm section. But, credit must be given for certainly showing much improvement over Rihanna’s previous albums. 

My conclusion: it’s a worthwhile album! If you can avoid those few tracks that will drive you insane, the rest is a really good listen.