Shocking

A couple of days ago I was getting snitty about the fact that John "Beautiful Mind" Nash was 'treated' for schizophrenia with insulin shock therapy.  In a different hospital or under the direct care of a different doctor at the time, he might have had a session or two or twenty of electro-convulsive therapy (ECT) where two electrodes are attached to the temples and a jolt of current (kaZANG!) is administered to the seat of reason.  I would have taken the high-moral 20/20 hindsight ground on that form of treatment as well  . . . until I heard the TED talk by Sherwin Nuland, about his experience with ECT.  He was extremely well qualified to give such a talk because he was an highly effective and well-connected Ivy League surgeon - who had been cured of crippling depression by a course of ECT.  What made his talk particularly affecting was that the treatment had saved his life and his sanity a long time ago and he had never before talked about in public.  But it was also important because it shook me out a complacent knowledge that ECT was a barbarism that was thankfully in the past and of which the medical profession should be ashamed.  Drugging (MAOIs, TCAs, SSRIs, SNRIs, Lithium) depression is now the norm and it's a HUGE $80billion market - very lucrative because the drugs deal with the symptoms and each sad, shuffling cash-cow keeps taking them for decades unless they top themselves first.  Investigating it all will take a blue chunk out of my Summer.

Nuland's depression was utterly debilitating, it seems to have been triggered by a collapsing and recriminatory marriage and not helped by an almost total lack of support or empathy from his medical colleagues.  Maybe mathematicians are kinder?  The general consensus among the senior medics was that the best treatment for his depression (and a good dash of obsessive compulsive disorder) was to give him a pre-frontal leucotomy which surgically severs connection to the part of the brain which deals with affect.  So you cure the madness but turn the patient in a sort of shambling oaf.  As Norbert "Cybernetics" Wiener famously noted "prefrontal lobotomy ... has recently been having a certain vogue, probably not unconnected with the fact that it makes the custodial care of many patients easier. Let me remark in passing that killing them makes their custodial care still easier."  The young intern who had been actually caring for Nuland persuaded his senior colleagues to try a course of ECT instead. That less invasive intervention gradually but permanently cured him and Nuland eventually went back to his successful and well-respected life as a surgeon and pillar of his community.

Our fear and loathing of mental illness is highly developed: almost as if it was contagious.  It was the redemptive power of tolerance that cured John Nash but it took decades to achieve.  Trinity College being a city-centre campus has its fair share of the wandering deranged who are let hang-out and attend lectures if they are quiet.  That used to be the case anyway.  The management is quite possibly insisting that these unfortunates pay fees nowadays.

Nuland is most famous as the author of a revelatory book called How We Die which lifts the bed-clothes to reveal that, to a close approximation, there is no such thing as a good death.  The great transition is usually painful, degrading, ugly and messy.  But acknowledging this to be true is the first step in dealing with it. I'll have more to say about this in due course. Sherwin Nuland died at the beginning of March this year, he'll be missed.

Trash: 2014 Organic: 2010

I wrote last year about walking the county road with Dau.II, her friend and three bin-bags. We were encouraged by An Taisce and our tree-hugging friends to pick other people's rubbish out of the local ditches, drains and roadside verges. Actually it was a couple of weeks later in April last year and that made the work a good bit harder because the grass and nettles were well up: both obscuring the rubbish and making it harder and wetter to pick up.  Yesterday was The Day Appointed but I was all for giving it a miss.  We're busy with the lambs and the attendant civil engineering works and I still wanted to tidy up a few sceacha (Crataegus monogyna).  But the */!@%$! chainsaw wouldn't start, so mid-morning I trekked off to visit Rene my favorite bricoleur down in St Mullins to see what he could do.  Under his attention, the saw came back to life and we sat awhile having a cup of tea talking round the houses about food-labelling and fish-farming.

We've all long been aware of the difference between Irish Smoked Salmon (sourced who knows where but smoked in Ireland) and Smoked Irish Salmon (grown in Ireland but smoked who knows where).  Rene showed me an empty package of  Smoked Irish Salmon : organically farmed mild oak smoked salmon. On the back, the product claims to be Smoked Irish Organic Salmon (Salmo salar) slices. He knows a lot about fish-farming having started the first eel (Anguilla anguilla) farm in the Netherlands a generation ago and he has an idea about what corners are necessary to cut if you want to supply one of the big UK margin-slashing supermarket chains.  He was also a bit bamboozled by the Euroleaf symbol (see right) which appeared under the bar code. But maybe that's because he hasn't got out much these last four years: "From 1 July 2010, the use of the EU organic logo is compulsory for organic pre-packaged food produced within the European Union."  He maintained that the only thing organic about the product was the saw-dust used to smoke it.  Which, if you read the brown text above, could well be true in the weasel-word tradition that makes a marketable distinction between Irish Smoked Salmon and Smoked Irish Salmon. But the documentation on places where the Euroleaf may be displayed suggest that this hypothesis cannot hold up - and I quote:
Can the logo be used on packaging material of the following products?

• Sardines in organic olive oil: NO
• Organic salmon: YES
• Wine made with organic grapes: NO
• Soup made of organic vegetables: YES
• Wool from organic sheep: NO
• Milk from a dairy farm in conversion period: NO 
• Other organic animal products, where only national rules exist (rabbits, snails, deers, etc.): NO
• Pet food: NO 

Clear? As organic mud! But do we really care whether the farmed salmon or the fish-meal they ate or the lice that they shed into the surrounding water or indeed mild oak sawdust is organic if the stuff has accumulated serious and unnecessary planet-sapping shipping miles between being gaffed in Ireland and smoked in Scotland? Local trumps organic.

By the time I returned, The Beloved and O'Manch had been out for an hour and picked the road clean well into the neighbouring county.  All I was able to contribute was an old tire that I'd picked out of the verge the previous afternoon on the way home and the wing of my own car which I had retrieved from a ditch in another part of the county a few days after my argument with that same ditch. TB & O'M had found another two tires and a couple of bagfuls of miscellaneous jetsam.  After a bowl of soup we went to the village hall to compare notes with the other trash-pickers and have a community cup of tea and some buns.  This annual ritual is worth doing, not only to meet the neighbours, scarf down some free food and clean up our own back-yard but also to discourage the next person who wants to fire something out of the car-window.  If the hedges are already festooned with detritus, it is marginally easier to do the wrong thing.

bleh bleh

News from the creche is that we acquired another (ram) lamb yesterday morning, more or less 3 weeks after our freebie.  As I enumerated earlier after the ultra-sound scanning, we are expecting another 16.  One of the ewes having had a heart-attack and died a couple of weeks ago, we are already two lambs down on our tally.  Yesterday arvo I left work early intending to do a little light chainsaw work. Instead I found myself dragooned into clearing out one end of the poly-tunnel to receive the maternity ward.  We are due a brutal enough storm tomorrow afternoon and it seemed a little unfair to subject the newborns to a soaking wet cold night if it may be avoided.  Handling sheep is always a little more complex than "let's keep them in the poly-tunnel for a couple of weeks".  You have to get them in the door first and that involves running some temporary sheep wire out in a funnel pointed at the entrance.  Meanwhile the doors had thrashed themselves to fritters in the Darwinday storm, so a gate had to be found to close the gap  . . . and some fence-posts and a couple of rolls of sheep fence, and some staples, screws, a hammer, the cordless drill (which inevitably was low on juice), the post-driving short-handled sledge-hammer.  And it all had to be done now as light was failing and a fine drizzle set in from the West.  For once it all went forward as planned, the sheep followed the bucket of feed and O'Manch and I were able to hoosh the stragglers into the tunnel with the gate. I knew there was a reason I'd kept 6 honeycomb-cardboard interior doors - they can be re-purposed as corral.

When we had finished tinkering about shifting this and making-do with that, O'Manch asked what we call people who fix things up (apart from goll-darned genius).  I was delighted to hear that in Spain the skill is called bricolaje just as French has bricolage.  Bricolage has a particular place in the hearts of evolutionary biologists because of the pivotal essay by Francois Jacob which introduced us to the word.  I asked O'Manch what they call the fellow who does bricolaje and, after denying that there was such a word, he offered manitas which is the same as our handyman, and isn't quite the same.  He also denied that there was anyone in his home-town who fitted the description bricoleur and claimed that if something went wrong you called in a particular specialist.  But I know, if I were to ask either of his grand-fathers, they will be able to identify the Mr. Fixit, el Fijador, in their neighbourhood even if that chap is now long dead.

Exercise is medicine

I am the least likely person to espouse the belief that 'exercise is medicine' except in the sense that an adult lifetime of doing no exercise has been associated with virtually no medicine. Eeeee, when I were a nipper, The Man made me do exercise on a regular basis and I was continually sick:  asthma, boils, constipation, depression . . . I could go on.  Indeed me and my  much loved sofa have been exchanging atoms like Myles na gCopaleen's policemen and bicycles for so long that it is often hard to determine who is supporting whom.  It would be infinitely hard for me to run a half-mile because I'd have to drag the ould sofa along with me like a monstrous handicap.

I was prepared to give Prof Niall Moyna's talk on the subject a miss.  Indeed, I felt I was obliged to skip it because I was scheduled to teach the Immunology part of my Human Physiology course at the same time.  But when I got to work yesterday morning I was more or less ordered by my HoD to bring my class to hear the visiting speaker. We so rarely get to hear people from outside, that I should have had the courage of my convictions and cancelled class to go: you can quickly have enough of Immunology lectures.  Anyway, like The State Pathologist, the Gardai and the Governor of Mountjoy gaol, the lunchtime talk was worth crossing the atrium for.  It was, however, a bit of a gallop and I'd neglected to bring my note-book so I'll not be able to recall half of what was said. He started with a polemic saying effectively that the Health Service Executive HSE should be renamed the Illness SE, because preventive medicine and health promotion forms a vanishing small part of the HSE's ambit. There were further interesting snippets of arresting information.

70% of the Irish health care budget is spent on cardio-vascular disease (CVD), diabetes, some cancers and of course obesity which could be all but eliminated if the plain people of Ireland engaged in a modest regime of muscular activity.  Cost to exchequer = nil; savings = ?$4bn? each year. (the government allocates €13bn a year to health - about a quarter of what's available). Moyna pointed out that you don't have to pour yoyrself into shorts and a coloured shirt to exercise.  Digging the garden, painting the bedroom, even ironing the old man's shirts will all serve to burn some calories. The deal seems to be that if you keep the shear-force of the blood coursing through your veins slightly above baseline, then the linings of the vessels maintain their sleek structural integrity.  If the blood gets sluggish for as little as 3 days, then these vascular epithelial cells crinkle up and start to allow plaque to form.  So doing a marathon walk through Spain once a decade is not what is called for.

One of the best things about Moyna's talk was to hear him exhorting our students to critically evaluate whatever the current dogma is. Fashions in medicine and in sport come and go and despite some passionate advocacy the current truth universally acknowledged is sure to be replaced with some other certainty within their own lifetimes. He also spent a small amount of time asking them to follow the evidence rather than their instincts. Nevertheless, his analysis of two alternative protocols for increasing the fitness of GAA athletes, was insightful.  Since the foundation of the state, Fianna GAA have increased their stamina and fitness (ie beefing up the concentration of mitochondria in their cells) by a regime of Endurance Training ET which seems to amount to doing laps round the pitch every training session for 90 minutes. Moyna's research group has been evaluating a High Intensity HI alternative and comparing its effects to those of trad ET. HI training requires the athletes to run like buggery for a few minutes; pause to recover; repeat.  The elapsed time for equivalent cardio-vascular results is much less under HI than with ET.  But get this, the actual exercise time is still less (maybe 10% of jogging round and round), so I had this image of school-going sporty-types running like buggery; doing their geography home-work; repeat.  They'd soon knock off all the capital cities in South America.  I like very much that application of evidence-based research.

Here's another really useful concept to get across.  There is a diminishing return on your investment of time and energy in exercise.  It's easy to obtain some cardiovascular health benefit merely from getting off the couch and scything some nettles.  But spending twice as much time, doesn't get you twice the VO₂max. You have to work insanely long hours (10,000 according to Malcolm Gladwell) to get to achieve hyper-fit mastery of your sport.  Never mind The Elite; I take from Moyna's talk the idea that if every boy and every girl in the country could be encouraged to run and jump and hew wood and fetch water a little, then we'd all be much richer even as multi-national Big Pharma got poorer.  It's really important recruit youngsters, because once you start accumulating flab, it is effectively impossible to permanently shed it.

Rehabilitation

A Beautiful Mind is the film of the book by Sylvia Nasar about John Nash, a brilliant young mathematician at Princeton in the 1950s who won the Nobel prize for economics in 1994.  At Princeton his brilliance was tinged  eccentricity which eventually blossomed into decades of paranoid schizophrenia.  This tragic development certainly wasn’t discouraged by the weirdly widespread sense of paranoia in Cold War America.  The film hints at the horror of being mad, and the double horror of seeing your beloved go that way.  Internal horror was matched by dreadful “treatments” meted out in those days on the certified insane, including in this case insulin shock therapy, which gives the recipient convulsions and coma but has no scientifically demonstrable benefit.  The part of the psychiatrist in charge of Nash (played by “Gladiator” Russell Crowe) is taken by Christopher “Captain von Trapp”  Plummer, so one is primed to ask which of the two is really bonkers. Plummer narrated the wolf & water parable cited at the end of the Jean Giono trib. Jennifer “Labyrinth” Connelly plays Nash’s long-suffering, loyal and courageous wife.  I guess serious actresses can’t play teens in a cartoon world forever. Paul Bettany takes the part of Nash's invisible friend: the Crowe-Bettany partnership was developed in Master and Commander.

While grotesquely invasive therapies didn’t help bring Nash back to Stockholm, Planet Earth in 1994, three factors worked together to bring about the rehabilitation of his Beautiful Mind.
a) Although his schizophrenia was manifestly a problem with his mind, Nash was able to mobilise other rational parts of his brain to face up to his delusions and help bootstrap them under control.  Not unlike the famous story of the autistic university professor who was told that students preferred it if lecturers faced the audience rather than the equations on the blackboard.  She was smart enough (professor after all) to be able to modify her lecturing style (scribble scribble turn scribble scribble) appropriately without really having a clue why folks would prefer things that way.  So Nash’s achievement is a triumph for the power of rational thought.

b) Alicia Nash, no intellectual slouch herself, fell in love with John when they were both young and brilliant and stuck in there for more than forty years holding down a job, or two, to keep her family together and whenever possible to de-institutionalise her husband.  Someone with fewer inner resources and less courage would have bowed to pressure from family, friends, neighbours and the medical profession and abandoned her husband in hospital.  Unconditional love was thus a very significant factor in the miraculous redemption.

c) Finally, the Nashes moved back to Princeton and the University was sufficiently tolerant to allow Nash the run of the campus where he regularly hung out in a corner of the library and at a particular table in the canteen when he wasn’t talking to invisible people.  This gave him a reason to get up in the morning and a familiar place to operate in.   Eventually he started to talk maths again to students and faculty.

Now, we’re all of us exceptional because Blobbies are a teeny minority of the population.  Let’s hope that, like Nash in Princeton, we can be allowed to pursue our own path without being compelled to conform.  We chose the minority sport of  home educating our two daughters. Like Nash’s cure, this option must be treated as a long-haul, strategic choice. It turned out that we the parents did very little of the education.  We cleared some space for Dau.I and Dau.II to educate themselves. The benefits were rarely obvious as measured by demonstrable short-term “achievements” like being able to read at age six or knowing the capitals of all South and Central American countries. But several of our home-ed friends, when they are troubled by the consequences of their choice, look to our girls and say "if my kids turn out like that, I won't be ashamed".

The world of economics would be more deeply flawed than it is without John Nash: he brought light and insight to the dismal science.  His eccentricity was the well-spring of his creative contributions, but he needed space and time to pursue his original ideas without being nagged by the normal median world.

It's not helping your kids

A home educating pal-o-mine had an educational philosophy which was for the relevant parents to "Shut up and get out of the way".  I've elaborated mine a little here, although what I actually did for the girls was close enough to shut up and stand aside - SUASA. This is not to say we did nothing for them. No, they spend hours of the early lives in the car being shipped to ballet, drama, library, music, play-dates, the river, the arboretum, home-ed gatherings.  During those journeys conversation occurred over and around whatever talking book was on the car tape-deck - far too much Harry Potter in my opinion. Later, our pal Lulu, organised the HEN transition year mid-teen marathon which shipped her girl and ours and a dozen others all over the island to cultural, historical, scientific and political venues once a month for a year (and a half).  Then there were/are 3000 books in the house and Dau.I certainly read more than half of them before she left home. But most of the adult input was The Conversation meandering up hill and down dale wherever the questions drove it and always taking in a little of what could be seen from the vantage points of that developing and emerging landscape of ideas. The great thing is that there was never home-work - which might be defined as a dreary assignment required by someone else to be completed to that someone's schedule.

This was in sharp contrast, and largely in (over-)reaction to, what happened with The Boy who went to almost as many schools as I had homes as we schlepped back and forth across the Atlantic and North Sea.  When we finally came home to Ireland for good when he was 14, the Head of his Nth school said that, to thrive in the Irish system, 3 hours of home-work would be required.  Consultation with teens in other schools suggested that this was 'normal'.  I'm afraid that I did try to 'help' The Boy with his ekkers which meant that I tried to impose my idea of self-discipline on him in exactly the way that had riled me up when my own father had applied that treatment to me.  The Boy wasn't having any of that, and by way of civil disobedience and a few rows, encouraged me to back off.  It is not surprising that, with a professional biologist in the house, he achieved his lowest grade in that subject in his Leaving certificate.  Me attempting to change that was perhaps the lowest point in our relationship. My bad, but I did learn.  With home-education there is no sensible way to incorporate homework - and good riddance.

In the same issue of the Atlantic that had a piece on (not) protecting your child, there was another called "Don't help your kids with their home-work".  This reports research finding that helping with the homework can be counter-productive because you know less about trigonometry than they do; but also because the way you were taught a generation ago is different from how kids are taught today - so your attempts at 'help' only help to confuse.  They also report that helping your children choose academic options is worse than letting them alone for this task.  With 20:20 hindsight, I should surely have let The Boy choose his own courses rather than trying to make it easier for him by advising/telling/ordering him to choose a soft option like biology rather than, say, physics which he may have done well in.  After all he finished up becoming an engineer (which could be called practical physics) whereas I failed the only physics exam I ever took.  One of the few ways you can help your youngsters in school is by throwing shapes to get them into classes with high-reputation teachers - this is what middle class people do all the time: they network for their own advantage among other professional people.

So here's some advice.  Treat (your) children like real people: don't talk down to them. Have patience - eventually they will want to do something other than whatever it is you don't value. Don't foist your own failed ambitions on them. Don't assume that college is the best option. Kindness trumps credits.

NBT

I was born close to the Summer solstice in Dover, in the extreme SE corner of England.  That summer, maybe that month, an eighteen year old American cycled through Dover to the ferry-port from North Wales on the way to Germany for a vacation/adventure. The cyclist's father was serving in the USAF at one of the many air-force bases that littered the landscape of England in the 1950s. Se non è vero, è ben trovato because I too was a service-brat and our lives later became entwined. When we did meet I was 20, in my final inauspicious year in Trinity College Dublin, signed up to do a research project that required technical competence and enormous reserves of patience. Neither of which spring to mind when people think of me.  This sorry situation was saved by the timely appearance, as a Deus ex Machina, of the once-upon-a-cyclist, who was now installed as a visiting lecturer for a year in Dublin on a Fulbright Fellowship. He still had a bicycle but he'd also acquired a wife and two children, a PhD from Harvard and a house in the Boston suburbs. He gave a series of lectures about the interface between genetics and history which were poorly attended except by me. Such discipline-bridging ideas were meat-and-potatoes and fine champagne for me and I scarfed it all up.  After a few weeks I was able to switch projects and I spent the rest of the year in something close to nirvana: tooling round the island gathering genetic data and attempting to put it into a historical context.  With my new mentor's support I presented some preliminary analyses at the Spring meeting of the Irish Geneticists.  An under-graduate could do that sort of thing with credibility in the 1970s; it would be unthinkable nowadays. Again with his encouragement and support, I applied for and was awarded a scholarship from the Donegal Historical Society and the winter after I graduated, I spent a few weeks living in a freezing caravan near Killibegs augmenting the data I'd gathered for my student project.

We kept in touch, by letter, often sent to me poste restante because I didn't always have a sensible place to stay and somewhere along those months, he stopped being Professor Todd and became Neil. He suggested that I might like to do a PhD with/under him in Boston.  All I had to do was rustle up the first semester's fees and I could wing the rest with teaching fellowships. I worked long, wet hours, and not without hazard in Rotterdam Zoo until I had grubbed my stake for Boston University.  The fees were the absolute end of my money and so I was taken into the bosom of Neil's family and lived for the next couple of years in his cellar.  Joining a hall-of-fame of miscellaneous oddities who inhabited the space before and after me including a family of Chinese orphans discovered on the Want-Ads at the local supermarket, a sooty mangabey Cercocebus atys rescued from a Boston brothel, and a champion bench-presser found in the local library.

I learned a lot from Neil.  Insofar as I write clearly it is because of his  "Don't write run-on sentences".   I learned that you don't need to organise everything in advance: you can always fix things when you arrive - be that fees for college or hotels in a foreign country: we often travelled across the Atlantic on stand-by because it was far cheaper than being certain when and if you would travel on a given day.  He was, and I became, bi-polar with money: thrifty to often absurd levels and then open-handedly generous when the occasion demanded.  We were doing field work in Brattleboro VT and after an evening's work needed to find a place to eat.  We had developed the habit of seeking out traditional diners where you could fill up on meat-loaf and spuds for very little, so we headed out towards a tiny barrel-topped building on top of a small hill the other side of some waste-ground.  When we arrived it turned out to serve food but at gourmet prices and without meat-loaf on the menu.  I was for trying elsewhere but Neil insisted on taking what the Fates delivered and we ate famously well that night.

Neil was my mentor, supervisor, unstinting supporter and friend and he died this last Sunday after a long illness.  A great ragged hole has been torn in the fabric of my life.