Morgellon's, Messiahs and Mass Hysteria.

Over the course of the last 14 months, 15 people (mostly teen-aged girls) in the town of LeRoy in New York State developed Tourette's-like twitches and vocalizations. After an exhaustive series of diagnosis, it was concluded that these occurrences were most likely the result of conversion disorder.

Conversion disorder, formally known as hysteria, is a psychiatric disorder that causes sufferers to display neurological-like symptoms of twitching, fits and spams

An example of Jerusalem syndrome ©Wikimedia Commons; Image Credit: Ja

This is looked into in the Channel 4 documentary "The Town That Caught Tourette's". Many of the girls felt let down by the diagnosis, thinking "this can't all be in my head" and sort out other, even less probable answers.

There are many cases throughout history and the modern world of similar occurrences and there are many more diseases and disorders that we are yet to understand. Here I am going to have a look at some of the odder cases:

Morgellon's Disease

First reported in the 17th century by the physician Thomas Browne, Morgellon's exhibits as aches, faitigue, skin lesion and the sensation that insects or fungal roots are growing beneath the skin. Fibers are "seen" to be growing beneath the skin surface.

The disease has shown a sudden boom, thought to be due to the internet - a meme sickness as it were. However, in recent months, researchers and doctors have begun to report strange findings within the skin of sufferers, possible markers of an actual fungal infection. Cases have also now begun to be reported in infant children who are not normally susceptible to psychosomatic disease.

Whether or not Morgellon's is an actual disease or a "delusional parasitosis" - a case of the brain becoming convinced of an infection - is still up in the air.

Alice in Wonderland Syndrome

Also known as the less catchy Todd's Syndrome, this is a disorder that affects the mind's concept of perception. The visual cortex stops being able to process scale, thus larger things seem small and vice versa. Sufferers report feeling taller than a tree or too small to reach up and sit on a chair.

Normally temporary (an episode can last anywhere from one minute to a whole day), and presenting mostly in migraine sufferers and young children, this syndrome could give us interesting insights into how the brain deals with self-perception and scale.

"Strawberries With Sugar virus"

Back in 2006, in an episode of the popular Portuguese teen show "Strawberries With Sugar", the characters and their school were struck by a life threatening virus. Shortly after, over 300 pupils at 14 separate schools came down with dizziness, rashes and shortness of breath, all symptoms of the fictional disease.

Many of the schools were forced to temporarily shut down and, coincidentally, reschedule some state exams that were meant to be occurring.

After much investigation, the Portuguese National Institute for Medical Emergency concluded that the cases were simply doe to mass hysteria.

Jerusalem Syndrome

An odd phenomenon has been seen in tourists visiting the city of Jerusalem; people, normally middle-aged men, who have lived their lives otherwise perfectly normally spend time in the city and suddenly begin to dress in old bed sheets and declare that they are John the Baptist.

That is a vast over simplification, but Jerusalem Syndrome is a well-studied occurrence with vast numbers of tourists every year suffering from religious psychosis and delusions that evaporate as soon as they are removed from the city.

The syndrome even got a mention in The Simpsons; in The Greatest Story Ever D'ohed, the family visit Jerusalem and Homer becomes convinced that he is the Messiah.

Dancing Plague of 1518

An oldie but a goodie. the Dancing Plague began in Strasbourg as a woman named Frau Troffea began to dance in the street. She didn't stop moving until she died of exhaustion and dehydration four days later. By that point, 30 or so people had joined her and by a month later over 400 dancers were out in the street. Many of the afflicted died from heart failure or strokes.

Records documenting the dancing deaths make it very clear that this was not twitching, or convulsing, but "although they were entranced, their arms and legs were moving as if they were purposefully dancing".

Over the last 490 years, many explanations have been offered. Everything from divine inspiration to ergot poisoning (think the organic version of LSD) has been blamed.

Most likely though, this is another case of mass hysteria and stress-induced psychosis. These people had been living in famine conditions for at least 7 months and in an area riddled with disease and horrific living conditions, it is possible that something just snapped in the population as a whole.

Published in The Yorker November 17th, 2012

The Shot-Gun Approach to Applying for a PhD or Masters

About to start the final year of my university degree, I am beginning to panic. It is not the massive increase in work load or the dreadful prospect of finals that is getting to me, but it is the huge and terrible decision that I now have to make.

What should I do after I graduate?

I have always – perhaps there has been an occasional lapse when the idea of being a journalist flittered by – wanted to go on to postgraduate education. Partially because of the fear of entering the world of work but mostly because I really do enjoy research and I find the lab work side of things suits me well.

So that brings me to the next step. Applying to the PhDs and Masters that I want to take.

The logical step for a biochemist on a 2:1 from a reasonably decent institution would be to do a Masters degree, taught or research based, before applying for a PhD. This plan, however, makes the assumption that I either have the money or am willing to take out a (real actual) bank loan to cover one year of education that’ll cost anywhere from £5000 to over £11000 in fees alone. All that for something that may not even be necessary for me to proceed in the direction I want.

Well then, how about applying straight to PhD?

In fact, that is the approach I am taking. But there are so many PhD placements and so many of them look so good. The entry requirements do seem to vary somewhat but most are pretty similar. Here, money is less of a problem, your studies will be funded by various research councils and funding bodies.

At around £50 a pop, with CVs, personal statements and all sorts of transcripts to send off, applying for a PhD isn’t a quick job. This isn’t the sort of thing that “they” recommend doing in an offhand way. Focus on one or two and do them well, don’t just fire out CVs all over the place.

And yet, I am going to apply for all the ones I like. And at least one Masters course, almost as a backup.

Better safe than sorry.

What Is The Point Of Acupuncture?

A recently released data meta-analysis, published online at www.archinternmed.com, has studied the effects of acupuncture on 17, 922 patients suffering from chronic pain conditions such as osteoarthritis and chronic headaches.

The randomised control trials (RCT) compared the effectiveness of acupuncture against no treatment and "sham" acupuncture. Only studies that were perceived to be unbiased and followed the patients for at least four weeks post-treatment were considered.

A acupuncture practitioner in action ©public domain; Image Credit: Kyle Hunter

Across all the pain conditions, patients who received acupuncture reported significantly reduced pain after four weeks compared to those who received no treatment. Patients who received a sham version of acupuncture (for example, using needles that retracted rather than pierce the skin) also reported reduction in pain, but to a lesser extent although a statistically significant difference was seen.

This difference in effectiveness could well be due to the difficulties in conducting a true double blind trail that involves sticking needles into people. In all likelihood, many patients will have observed that their skin was not actually being pierced; and obviously the therapists would be aware that the needles were false. Or at least, one would hope that they would have noticed.

Smaller differences in acupuncture benefits were seen in trials where the patient’s received ancillary treatments such as physiotherapy and gentle exercise programs lead by physical therapists.

These results show that, whilst acupuncture is effective as a treatment against chronic pain, there are many additional factors to be taken into consideration; for example, the relationship between the acupuncture therapist and the patient likely has an impact on the well-being of the patient. Most people feel improved after spending an hour or so getting one on one treatment of any sort.

This is good news for sufferers in the UK as acupuncture treatments on the NHS are being offered as a viable alternative to strong painkillers which are often addictive with many side effects from long-term use. Unfortunately the NHS offers acupuncture as a treatment for many things, and the placebo effect will only take you so far.

In comparison to this, is an investigation conducted by the National Patient Safety Agency, which reported adverse effects following 10% of acupuncture treatments. Whilst most of these cases are reports of nausea and fainting, some patients reported having needles left in them for hours (long after the therapist had left) with some needles having to be surgically removed.

A few reactions have been more severe. Edzard Ernst of the University of Exeter reports that studies of acupuncture in other countries and outside of the NHS in the UK have shown 86 deaths in the last 45 years due to lung collapse after acupuncture. Whilst these cases are extremely rare, it does suggest that the NHS should refrain from offering acupuncture as a treatment for everything from anxiety to nicotine addiction (as it currently does) until a very large scale RCT can be conducted that shows any benefit at all that will outweigh even the slightest of risk.

Published in The Yorker October 5th 2012

Mathematical Inquiry

In July, the House of Lords science and technology committee published an inquiry into higher education in STEM subjects (science, technology, engineering and mathematics) looking at, among many other things, the falling rates of uptake in the subjects regarded traditionally as “hard” sciences in the UK in comparison to many other countries.

Lord Willis of Knaresborough (who chaired the inquiry) suggested that the biggest problem lies not with a lack of interest but with a lack of mathematical skill. The UK now lies 28^th in the world in school leavers maths skills, and we are falling further every year. Students who do not take maths at A level cannot apply for many STEM courses and find study of most sciences a much larger leap to degree level.

I did do maths at A level, though it was not my strongest subject, because I wanted to go on to study Biological sciences. Armed with this A level I was able to apply to all the universities of my choice although now many STEM courses at good universities do not require an A level grade in mathematics, not because it is unnecessary, but because there are not enough students applying with this qualification to fill the universities' courses.

And where A level maths is necessary to apply for the course some universities are forced to offer remedial maths to all STEM students. Friends studying medicine at top universities report being alarmed by the complete lack of maths skills in their fellow undergrads. This simply tells us that, for everything that A* at A level is worth, the current school maths curriculum is not doing what it is meant to do and forcing more, disinterested pupils onto it will not solve anything. I for one can vouch that no one should ever be made to slog through Statistics 3 against their will.

Instead of a compulsory boosting of numbers, the teaching itself must be changed. Last year Government statistics published on 140,000 secondary school teachers showed nearly a quarter of maths teachers lacked degree level maths. I spoke once to a woman who taught maths at a local secondary school, her qualifications in the subject began and ended with a B at O level. She confided in me that she hated maths but that no one else at the small school was willing to teach it either. No student is going to learn from a teacher who is uncomfortable teaching the subject.

The curriculum at GCSE needs an overhaul first. I can't remember much from my year eleven maths lessons except for playing games, eating sour skittles and being incredibly bored by the entire thing. Barely anything we learnt had real world applications and most had been taught by rote year on year since the start of secondary school. Maths post-GSCE was seen as intimidating, a massive leap up from what we had done so far.

And, in a way, it was. Yet still the lessons were based around memorizing equations and mechanical rules; very little real-world problem solving was done. Days when we tried old Oxbridge entrance papers, or the 6^th form maths challenge were rare because these are not a test of how many geometry equations you could memorize, but instead a challenge of logic, understanding and comfort with numbers, something that wasn't necessary to have to pass the course.

This is were the problem lies, not in the numbers of pupils, but in the core of the curriculum - students are leaving school with no skills to apply their maths. Base the A level around maths you require, give the pupils something to think about, to apply to situations that they come across and more people will begin to feel comfortable with the subject and will take that with them into higher education.

Musings of a lab rat

I am trying to be grateful for what I've got...

Over 24 weeks of lab work experience outside of University is a great thing to have on your CV, but frankly. I'd like to have my last three Augusts back. See, life as an undergraduate (and even pre-university) lab rat is very rewarding, good experience and all that rot, yet I can't help but feel somewhat fed up with the whole business.

Perhaps a career in science is not for me, or, more likely, weeks of sitting about, staying out of the way and reading the BBC news website is not an accurate experience of the world of a research lab. My summers of 2010 and 2011 are a hazy blur of protein preps, DNA gels and crystal try after crystal tray. At no point could I honestly say I fully understood what I was doing and why. I did enjoy it though, the procedures and visible results.]

An eppendorf centrifuge is one of the many machines that will try and kill you. Just make sure that you close the lid ©Wikimedia Commons; Image Credit: Rockpocket

Admittedly this summer has been an improvement. Currently I am in week six (of eight) and, whilst all my projects are crashing down around my ears, I have been able to stretch my scientific wings a tad more, as it were.I have my own projects, am left to my own devices and can make my own decisions as how best to proceed. The subsequent lack of success so far is possibly a result of this.

In all honesty, this new-found laboratory freedom is more likely a consequence of the assumption that I, having now completed the second year of a Biochemistry degree, must know what I am doing, rather than any display of competence on my part, however it is best not to think too hard about such things, rather stick to doing what I do best (muddle on regardless of all else around me).

Yes, I still follow the post-grads around with my notebook out begging the answers to questions such as “Why is my cloning not working?” “What have I grown on this plate?” and most importantly “Why is that machine beeping at me in such an angry way?”*, but now some problems I can finally tackle for myself. Key among these being what to next to keep my slowly sinking projects above the water line slightly longer, and when it is acceptable to suggest a tea break to your colleagues (any time but lunchtime, it seems). So for the next couple of weeks, I shall proceed as best I can, googling my way through experimental protocols and depending alarmingly on Wikipedia.

*answers, in no particular order, are : “Because you've screwed up”, “Because you've screwed up” and “I don't know, but kill it now”.

Published in The Yorker September 19th 2012

What kind of quackery is this?

Jeremy hunt, believer in homeopathy and the integrity of Rupert Murdoch, is the new health secretary. This has worried a lot of people.

Back in 2007, Hunt signed a parliamentary Early Day Motion which supported the spending of NHS money on homeopathic “medicines “. The idea that the NHS could ever possibly phase out any clinically tested drugs for overpriced sugar pills took an alarming shuffle towards reality.

Arguably, the concept of the Health Secretary supporting homeopathy is just as ridiculous as the Environmental Secretary Owen Paterson being a climate change “sceptic”. Oh wait…

Tory cabinet reshuffling aside, homeopathy is one of the largest fields of alternative medicine. It is also the subject of ridicule amongst scientists, and angry defensive statements from its supporters.

Homeopathic remedies involve dissolving a substance (anything from snake venom to charcoal) in ethanol, then diluting this into water many, many times before tapping the contained solution against a hard object, such as a Bible or a leather covered paddle. The hypothesis is that the water molecules “remember” the initial potent substance; so the pill is apparently effective no matter how dilute it becomes. This flies in the face of all known laws of chemistry and physics.

The limited effect that homeopathic pills have is based around the placebo effect. In a case of mind over matter, the brain tells itself that the injection (though in fact saline) was a painkiller so that some of the pain felt is ignored.

Homeopathic remedies have never been shown to be effective in any large, placebo-controlled randomised clinical trial (a test all medicines must go through). One placebo is as good as another.

There is an anomaly though, one brought up in by many supporters of homeopathy whenever their particular beliefs are challenged. Known as the Belfast Study and published in 2004 in Inflammation Research, a group at Queen’s University looked into the reaction of basophiles (human white blood cells involved in inflammation) to ultra-dilute concentrations of histamine.

A dilution at 10^-38M (such as that used in homeopathy) in all likelihood will not contain a single molecule of histamine. And yet the claim was made that the cells reacted as if histamine was present. 

The placebo effect could not be at play here, individual cells are not sentient beings with an unquestioning faith in a particular treatment.

The anomalous paper makes for interesting reading and makes a good case for “weirdest scientific phenomenon outside of physics” but is certainly not any reason for people to get over-excited and start putting their health in the hands of a little bottle of over-priced sugar pills.

In fact, many further studies and attempts to recreate the workings of the initial Belfast study have found no such behaviour. The most notable of these follow up investigations involving BBC Horizon and James Randi, the famous skeptic. Until they do, it’s just a curious anomaly worthy of some further study.

Furthermore, until a homeopathic treatment can be shown in a full, unbiased clinical trial to be as effective as any current medical treatment, the idea that the NHS should fund such a therapy is utterly ridiculous.

I want to be a writer…

More specifically, I want to be a science writer.

Neither of those two sentence s come across well in front of a careers advisor. They conjure up awkward questions like “what have you written?” and “how much work experience have you got?”

Unfortunately my answers are the same as everyone else’s: a few things if the student papers and little, bordering on none. This does nothing to help me stand out from the crowd.

And so I am now trying to write for anything that’ll take me. Blogs, mini-articles, really long articles. Anything and everything. My portfolio is, gradually, expanding; although the veiw count on my blog remains embarrassingly low.

It is that coveted journalism work placement that I am after. And now it is crunch time. In just over six months, I will no longer be an undergraduate.  A terrifying thought. By CV is remarkably bare, and I haven’t updated it for over a year.

But all is not lost. The internet, as always, has come up trumps. I read an aarticle written by a man named Ed Young, in which he told how he and his coworkers  became science writers. Their routes were widely varied and, in many cases, circuitous. Some took formal training, others had had no previous experience  writing. Many took years to get a steady job, others landed one straight from university. Very few of the writers managed to live perfectly to the life plans that they made aged 18.

This is the point I’m trying to make. It doesn’t matter where you are now, as long as you are focused on where you want to be. Don’t make a set and steady plan for yourself, having a few goals and targets is good, but life is not predictable.

And, most importanly, keep updating  that CV, you never know when you’ll next get a chance to send it off.

Published grads.co.uk September 2012