Friday 10 April 2020

Cures by thinking

Thursday (yesterday) was a pretty good day - I sprang from bed at first light; downed two cups of tea and yomped up the mountain behind our house to fetch some building materials. On return I had two more cups of tea + two slices of toast and started to review the last First Draft of my project students. It was much better than I expected although absurdly beyond the submission deadline [sister sick, Dad in hospital] and missing whole sections. That took me till shortly after 10 am. At 1030 I tuned into a zoomaskype lock-down lab meeting hosted from her kitchen by my old boss the Professor of Comparative Immunology at TCD. It's more than 7 years since I was on the pay-roll so, apart from The Gaffer, the entire dramatis personnae has changed . . . but the Mississcience keeps on rolling, he keeps on rolling along.

I was fly-on-the-walling because several of the youngsters are moving into bioinformatics and molecular evolution . . . because the labs are all closed and there is only so much productivity can be squeezed out of reading the literature. I guess I was the same in my 20s, but it's wonderful to see how full on these youngsters are. What to do? - if your research agenda is abruptly shuttered with about a week's notice: barely enough time to preserve your irreplaceable tissue samples, clean down your lab bench, empty the trash, gather your notes, switch off the light and go home. Threatened with an indefinite postponement of the experiments and analyses vital for completing their PhD, these kids seem to regard it as an exciting opportunity to up-skill themselves. Two of them recently registered for an on-line two day work-shop in R, the statistics and graphics programming language. The first half of the lab meeting was their two-hander to explain what they had learned on the course and how it would be applied to their research programme. I taught myself a bit of R in the 00s, when I was helping Tony Blair and Bill Clinton analyse the human genome. My advice, from a life-time of acquiring programming languages, was a) that their learning would be at nothing unless they used R soon to analyse some of their own data b) it was a really smart move to have done the course with a wingman. I learned almost everything I know about R by ebbing and adapting fragments of working code from Avril who later went on to write The Book of R.

I was about to sign off because my part in the process was done, but I hung on for a few minutes to see what else was going down in Comparative Immunology. It turned out to be a couple real doctors who had just come off the Corona ward in one if the teaching hospitals - one of them was still in surgical scrubs. Swoon!, me. These people are the front line; the folks whom we all spontaneously applauded three weeks ago.  That applause was to acknowledge how hard they are working and at personal risk of contracting Covid-19 themselves or, worse, bringing it back to their families. Here's Dr Mike and 107 of his doctory pals telling how it feels on the front line.

What do I see when I think hard-working Corona-front-liners? Sputum and blood; intubation; alarms on the crash cart; no time for food; sleep deficit; consequent errors; guilt; worry; inadequate supplies; trolleys; too many patients; too many shifts; reluctance to leave; death; death; death.

But from yesterday's reports, the best of these workers are shattered at the end of the day because they have been thinking [like Feynman and the radios] which, as Daniel Kahneman has shown, is an exhausting, calorie-torching exercise even under optimum conditions. Dau.II flagged the Dr Mike and the 107 Samurai video for me. Her observation on it was how many of these doctors felt it was a privilege and an honour to be able to max out their Hippocratic oath in this time of need. But y'know, as well as being worked off their feet and cursing [themselves?] for the ones that got away the medicos I heard are stoked by the chance to  wrastle with the data they are accumulating to find a solution to the long list of things we don't know about Corona and the response of the human immune system. What drugs, what physical interventions work? When is the best time to administer them? Which of them are futile for this patient . . . but might work for that one? They can only do this effectively if driven by evidence, which mean gathering data, which takes time, and won't affect the outcome for this patient, so it's extra work. And, shift over, when they've decontaminated themselves, kissed the kids goodnight, found something to eat, fed the cat, skyped the parents, started a laundry wash . . . then they put in a couple of hours analysing that data and thinking, thinking, think-zzzzzzzzzz (if they are lucky enough to be blessed with sleepability). That's whom we are applauding.

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