Tag: medicine

Posted in Psychology & Medicine

Psychopath

Posted on by Jinavie

A common character found in psychological thrillers are those who seem to have no regard for the well-being of others, disobey social rules and act violently for seemingly no reason. They show no remorse or empathy and can be very intelligent, charming and high-functioning (although not typically). We describe these people as psychopaths, or sometimes sociopaths. To over-simplify it, a psychopath essentially has no moral conscience and do not believe in the social contract.

The terms psychopath and sociopath are often used interchangeably, but in modern psychiatry, they both fall under the diagnosis of antisocial personality disorder (ASPD). ASPD patients tend to have a long history of criminal charges, often relating to violence, chronic lying and fraud, drug use and other law-breaking actions. These characteristics may show from early childhood, with the typical psychopathic child being described as one murdering animals and being violent towards other kids. These children are often diagnosed with another disorder called conduct disorder.

Psychopaths are very popular in movies and TV shows due to their unpredictable nature, wanton violence and maniacal behaviour inflicting terror into the audience’s hearts. After all, who wouldn’t be afraid of a remorseless killer who finds enjoyment from others’ suffering? Unfortunately, many movies distort the image of the psychopath and blend in various other mental health disorders such as psychosis into the character. Sometimes psychopaths are even sensationalised, being described as an antihero.

It is true that many serial killers turn out to be psychopaths, but physical violence is not necessarily a feature of all psychopaths. A subset of “successful” psychopaths differentiate themselves by being less physically violent, appear to follow the social norm and succeed in challenging fields such as business, finances, law or even medicine. However, they will also have a pervasive disregard for others and will only care about having their way. Their lack of empathy allows them to act immorally, stabbing people in the back and lying, cheating and manipulating their way to the top. It is not some sick sexual perversion or power trips that motivate psychopaths, but impulsivity, egocentricity and gratification. To psychopaths, the aim of the game is to win, no matter the cost.

This makes you wonder. How many people around you are secretly a psychopath – one who would take advantage of you without a shred of guilt? How many people around you hide behind the mask of sanity?

(NB: Just putting it out there, Sherlock Holmes is neither a psychopath nor a sociopath. If anything he probably has an autism spectrum disorder like Asperger’s syndrome.)

Posted in Psychology & Medicine

Mithridatism

Posted on by Jinavie

Mithridates VI, the King of Pontus (ancient Greek/Persian state located in modern day Turkey), had a paranoia that there were people who wanted to assassinate him through poison. This likely stemmed from his father being poisoned by his mother (reportedly), who favoured his brother over Mithridates as the heir to the throne. He noticed in his youth that the meals brought to him induced stomach pains. He connected the dots and deduced that his mother was trying to poison him slowly so that his brother would become the next king. He fled to the wilderness and devised a plan to protect himself. It is said that he began taking a concoction of various poisons in non-lethal doses every day, to develop an immunity to the most common poisons available during his time. This led to the idea of mithridatism – the gradual self-administration of non-lethal doses of poison to develop immunity. Ironically, Mithridates’ plan backfired eventually when he attempted suicide by poison after a massive defeat against Rome. He found that the poison had no effect on him and had to request his bodyguard to kill him by sword.

Mithridatism has been recorded or suspected in various times of history. Indian epics tell the story of the king Chandragupta Maurya – the first king to unite India – who selected a group of beautiful girls and raised them in the palace. He gave the order to administer small amounts of poison to these girls as they grew up, making them invulnerable to toxins. He called these girls vishakanyas (poison maiden) and believed that they could be used as assassins who could kill men through the act of sex.
There are suggestions that Rasputin was also a practitioner of mithridatism and that this was why he survived an assassination attempt involving poison, but there is not much evidence for this.
The practice of mithridatism is also mentioned in various fictions, such as The Count of Monte Cristo and The Princess Bride.

The concept of taking small doses of something to build up an immunity is still used in modern medicine. Desensitisation therapy is used to treat certain allergies, by exposing the body to small doses of the allergen. It is well-known that alcoholics and drug addicts required more substance to achieve the same effect as most people because they develop tolerance to it. There is some evidence that mithridatism is an effective way to build immunity to venomous snake bites.
However, not all poisonings can be avoided with mithridatism. Poisons such as cyanide pass through the system too quickly to create any tolerance, while heavy metals simply build up in the body to create a toxic effect after a history of exposure.

Posted in Psychology & Medicine

Silphium

Posted on by Jinavie

Although sex was devised by Mother Nature to promote procreation, humans have been trying to separate the baby-making aspect of sex from the pure carnal pleasure it gives for a very long time. The Romans are known to have used a fennel-like herb called the silphium as a form of birth control. They discovered that the leaves of this plant could be ground up and made into a resin pill, which seemed to reduce the likelihood of women becoming pregnant. The Roman scholar Pliny the Elder recorded that one could use the resin as a pill or pessary to promote menstrual discharge, suggesting pregnancy has not occurred.

News of this medicine spread throughout the empire and there was massive demand for it. The plant grew exclusively on a narrow coastal area in present-day Libya and was impossible to cultivate. This meant settlements in this area could trade the plant at a very high price. It is said silphium was “worth its weight in denarii (silver coins)”. Its economic importance is signified in coins from Cyrene (an ancient North African city where silphium was produced) depict the silphium plant or seed. In fact, one theory of the origin of the heart symbol is the shape of the silphium seed pod. Overharvesting of the plant, the fact that it could not be cultivated and other factors such as changing environments and overgrazing ultimately led to the extinction of this plant and scholars still debate the exact identity of the plant.

Although there are records that indicate silphium was used as a contraceptive and abortifacent (substance that induces abortion), it is unclear as to how effective it was. Related plants such as wild carrots have shown to have abortifacent properties in some studies and there certainly are a vast list of plants that could potentially harm or terminate a pregnancy. Regardless of the potency, the heavy trade of the plant and its intended use points towards the fact that the concept of contraception is not new to human civilisations. It is interesting to think that we are the only species to actively want to reduce the risk of making a baby during sex, which is the original purpose of sex.

Posted in Science & Nature

HeLa

Posted on by Jinavie

In February 1951, a woman named Henrietta Lacks was diagnosed with cervical cancer. The cancer was aggressive and her health quickly deteriorated, until her ultimate demise in October 1951. Although Henrietta Lacks passed away on that day, not all of her was dead. A scientist named George Otto Gey succeeded in culturing (growing on a petri dish) the biopsied cervical cancer cells, provided by Lacks’ physician. He discovered that this lineage of cells could keep dividing and growing without stopping. In the human body, cells will eventually reach a limit of dividing and be destroyed. The cells from Henrietta Lacks, however, were immortal. Gey named this cell line HeLa, taking the first two letters of Lacks’ first and last names.

The HeLa cell line (and all other immortal cell lines since) have proven very useful in research as they give an infinite supply of identical cells, giving scientists a model template they can experiment on. The immortality of the HeLa cells is such that 60 years later, scientists are still using cells from that lineage – cells virtually identical to the cells taken from Henrietta Lacks (save for random mutations that happen in any cells). The cells are so well-adapted to unlimited growth that they are sometimes considered a laboratory “weed”, because it can easily invade another cell culture and completely take it over. One biologist even went as far as claiming that HeLa cells were no longer human, but instead a new species. He supported his claim with the fact that HeLa cells are self-sufficient and can reproduce on its own, and that it has a different genome (even chromosome numbers) to human cells due to the nature of cervical cancer.

The main issue with HeLa cells is the ethics behind it. At no point did Lacks or her family give permission to the doctor for him to donate her cells for research. Since her death, the cells were not only used for the purpose of pure research, but also commercialised. Unfortunately, medical ethics was not well-established at the time and asking the patient’s consent for such things was not common. The two major sides in this debate would be the unethical act of taking human tissue and using it without consent, versus the potential benefit it brings. For example, HeLa cells were used by Jonas Salk for his research that led to the development of the polio vaccine. It may be a stretch, but if those cells were not taken from Lacks, the development of the polio vaccine may have been delayed and countless more people would have suffered from a lifelong crippling illness. This is the great question in medical ethics: how much of an individual’s human rights can we afford to sacrifice for the needs of the many? Do the needs of the many really outweigh the needs of the few, or the one?

Posted in Psychology & Medicine

Belladonna

Posted on by Jinavie

The belladonna flower has a name that means “beautiful lady” in Italian. However, its other common name has a completely different meaning – the deadly nightshade. Both names can be explained by the uses of the flower throughout history. The deadly nightshade (Atropa belladonna) is a small shrub with purple bell-shaped flowers and shiny black berries. All parts of the plant contain various toxins such as atropine, scopolamine and hyoscyamine. These alkaloid toxins are included in a group of chemicals called anticholinergics, because they act on cholinergic receptors on neurons, which are involved in activating the parasympathetic nervous system. As cholinergic receptors are widely utilised throughout the body, anticholinergic toxicity causes a wide range of symptoms.

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The main symptoms of anticholinergic toxicity are best remembered using the following mnemonic:

  • Hot as a hare (increased temperature – reduced temperature regulation)
  • Blind as a bat (blurred vision – dilated pupils)
  • Dry as a bone (dry skin, eyes and mouth – decreased secretions)
  • Red as a beet (flushing – dilation of blood vessels)
  • Mad as a hatter (hallucinations and agitation – neurological interaction)

The name deadly nightshade is obvious as severe toxicity leads to seizures, coma and death. The reason why the deadly nightshade is also called belladonna is that the diluted extract from the plant was used as an eye drop to dilate women’s pupils – a look considered beautiful then (nowadays the effect is used to examine the eye). The toxins extracted are used in other fields of medicine too. Although not used now, anticholinergics were used as an anaesthetic for surgery due to its neuropsychiatric effects. However, atropine is still used in the emergency setting to reverse bradycardia (excessively slow heart rate), as anticholinergics speed up the heart rate. This highlights the fundamental principle of medicine that “the dose makes the poison”. For the only difference between medicine and poison is the dose… and intent (Oscar G. Hernandez, MD).

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Posted in Psychology & Medicine

Food Coma

Posted on by Jinavie

Why do we feel sleepy after we eat? There are two components to the so-called “food coma”: neurological and hormonal. When we eat, the food mashed up by your teeth is swallowed down the oesophagus and into the stomach, where it is churned in a vat of very strong hydrochloric acid. The acid dissolves the food into liquid form, which is then sent to the small intestines. Here, the chemical components of the food such as carbohydrates is broken into simpler blocks, such as glucose. This is then absorbed into the bloodstream.

The body can actually sense when you have swallowed food, as your stomach stretches and sends signals to the brain. This triggers the activation of the parasympathetic nervous system (opposite of the sympathetic nervous system, which is the “fight or flight” system). The parasympathetic nervous system is involved in digesting and rest. It stimulates stomach acid production, gut movement and even reduces your energy level so that digestion can happen smoothly. In old people, it can even decrease blood pressure enough to a point that they feel dizzy (much like head rush). This is the neurological component.

The hormonal component is linked with the absorption phase of digestion. To deal with the increasing level of glucose in your blood, the pancreas secretes insulin. Insulin rounds up the glucose in the blood and stores it away in cells to normalise the blood glucose level. In this process, it also stimulates the uptake of certain amino acids (building blocks of protein) into cells. However, it leaves out one type of amino acids called tryptophan. Because there is more tryptophan in the blood compared to the other amino acids, your brain decides to use this to build more proteins. Tryptophan is converted in the brain into a very important neurotransmitter called serotonin, which is then converted into melatonin. Melatonin is a neurotransmitter involved in triggering sleep. Therefore, through this extremely complicated pathway, food causes sleepiness.

At face value, this makes it look like increasing intake of tryptophan may help induce sleep. It is commonly said that turkey meat and bananas help you sleep because of tryptophan. But this is an urban myth as neither of these foods are particularly high in tryptophan and there is no evidence to suggest that tryptophan itself helps you sleep. Then again, melatonin supplements have some evidence supporting it as a sleep aide. This shows just how complicated the human body can be.

Posted in Life & Happiness

Time And Healing

Posted on by Jinavie

A tiny wound like a paper cut or pin prick takes about one week to heal. A cut from a sharp object like a knife takes 2~4 weeks to heal. Broken bones take 6 weeks to heal. Even after a heart attack (myocardial infarction), with proper medical care and rehabilitation you will return to living a relatively normal life 3~4 months later (assuming you survive). But there is no concrete figure of how long it takes to heal the aches of a broken heart.

The time it takes to get over a broken heart is extremely variable from person to person, case by case. Even so, ultimately the wound will heal and you will be able to move on with your life. Sure, the healing process will leave a scar that may cause you to wince every now and then, but you will come to accept and become okay with things. People do all sorts of things to hasten this process, from harmless things such as demolishing a tub of ice cream to acts such as rebounding or walking down a self-destructive path. But there is nothing that will heal a broken heart like the best medicine – time.

Time has an incredible effect on the body, mind and heart. It is like fertiliser for good memories, letting it bloom and flourish over time, while acting as pesticide for bad memories, slowly weeding them out until it is out of sight. So if you are in pain from a wound – physical or emotional – let time do its job and work its healing magic. And remember that just like a cut, poking at the wound in your heart will only delay the healing process. While time does all that, all you have to do is survive.

Posted in Simple Pleasures of Life

Simple Pleasures of Life #30

Posted on by Jinavie

Meeting people, hearing their stories, sharing a moment and leaving a positive mark on their lives.

There’s a branch of philosophy that believes that the world only exists within our minds. That the people around us are merely figments of our imagination. As crazy as this thought is, to some degrees, we human beings all live at least a little selfishly, absorbed in our own worlds. For example, thanks to a psychological phenomenon known as special pleading, we are prone to judging others by how their actions affect us while we only judge our own intentions.

Because of this human nature, we often forget one simple fact: each and every person that you see around you has a life of their own. That person that you accidentally bumped into has a name, a job, a family (maybe). He or she will have hobbies and interests, goals and dreams, experiences and memories.

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Of course, it’s understandable that your brain tends to ignore this simple fact on a routine basis. The poor bugger has to process an overload of sensory and cognitive information every nanosecond, and if it was to consider every little details of everything, your head might just explode. But that’s no excuse to not think about it every now and then. You know, just ponder the implications.

If there’s one thing I’ve learnt about the world, it’s that each person has a very unique story to tell. They are walking books that are in the process of being written into a grander, more epic tale by the day. You’d be surprised what kind of stories you hear from complete strangers. One of the reasons I wanted to go into medicine was to hear all the stories every patient had to tell. I am reminded of this fact every day in the hospital. I’ve met old men who survived wars, kids who’ve suffered more diseases than you would in three lifetimes and even an old lady who gave the best tips on how to cook fish (which I’ve sadly forgotten…). Point is, if you take the time to stop and have a chat, you might hear some amazing stories that put movies and books to shame.

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I think one of the greatest joys we can experience as human beings is really opening up to someone, getting to know who they are and showing them who you are to them. Memories, stories, values, dreams, opinions, humour, all that jazz. It might be crazy to think that the world only exists in our heads, but it’s not at all crazy to think that everyone’s perspective of the world is very different. When you share a bond with another person, it’s like connecting those two different worlds. Yup, getting to know a person is like opening a wormhole between dimensions. What that’s pretty cool right. The best part is that this could happen between two lovers who’ve known each other for ten years, or even between two people that happened to meet by chance an hour ago. That’s human interaction I guess. It’s not about the amount of time you’ve spent with them. It’s about the quality of the time you shared with them. Opening wormholes and stuff.

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My last point is to do with leaving a mark. It’s one thing to be aware that the person that’s in front of you is a unique life of their own, it’s another to be conscious of the role you play in their story. For example, a compliment you paid in passing might completely change the person’s day. A simple act of kindness you thought nothing of could be recorded in someone’s life book as a life-changing event.
I said at the start that we judge others by their actions and ourselves by our intentions. Well then, by that logic, once you pass away the only thing that will be left to affirm your existence will be recordings of you in other people’s life books. So consider the mark you leave. Even a smile can make a difference.

I’ll end my 30 day challenge with a quote I particularly like regarding human interactions, by a certain Mr. Rogers:

“If you could only sense how important you are to the lives of those you meet; how important you can be to the people you may never even dream of. There is something of yourself that you leave at every meeting with another person.” ~ Mr. Rogers

May your life be full of little, simple pleasures 🙂

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Posted in Psychology & Medicine

Pain

Posted on by Jinavie

Perspective is everything. By changing your perspective, you may discover an innovative solution to a problem, or understand the actions of someone else. But more importantly, your perspectives have direct implications in your life and health.

For example, let us consider pain. Pain is a sensation – an electrical signal in response to a noxious stimuli that is causing damage to your body. It is a warning system that screams to the brain that something is wrong. To boil down the complex physiology of neurotransmission, essentially imagine the system as an electrical circuit. If something damages tissue, like a knife slicing through flesh or a clot blocking off oxygen supply to the heart, the pain “switch” is activated, a signal is sent to the brain, and it is interpreted and “felt” by the brain as pain. Because your brain needs to interpret the signal, pain is essentially subjective. If you are distracted or in a good mood, you will feel less pain compared to when you are distressed and focussing on it. The same stimuli can be handled completely different by every person, making pain extremely complicated and difficult to assess in a medical setting. Pain scales may be used to try objectify the level of pain, but this is still very crude.

UCEM Pain Scale

One way or another, pain is technically all in your head. That is not to say that pain is not real – that would be an insult to sufferers of chronic pain. But your perspective, way of thinking and frame of mind can make a significant difference to the amount of suffering the pain causes. This is not just an overly-optimistic view of the world that everything can be fixed with optimism. There are real physiological systems in place to alleviate pain when you are happy. These chemicals are called endorphins – so named because they are so potent that they match the effect of morphine (endo(inside) + morphine). This natural painkiller is released in response to pain, but can also be stimulated by having fun and being happy. Laughter is literally medicine.

Not only that, but by being in a good mood, you become more resilient and “distracted from the pain”, allowing you to bear the pain more easily. A woman going through childbirth suffers quite possibly the most extreme level of pain a human being can experience, but the prospect of seeing their newborn child (and probably finally ending their pregnancy) and the loving support of their spouse, family and friends keep them pushing onwards. Even though the noxious stimuli of stretching is real, the brain can choose to downplay how much pain it thinks it should feel with these positive factors.

Although it may not be able to make your pain magically disappear, never underestimate the power of positivity, laughter and happiness. Perhaps that is why the emotion of happiness was evolved – to alleviate the misery and pains of living in this world. To survive.

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Posted in History & Literature

Halitosis

Posted on by Jinavie

There is a technical word for everything in medicine. A great example is halitosis. In the late 19th century, Dr. Joseph Lawrence and Jordan Wheat Lambert developed a new surgical antiseptic. Finding that the target market was too small, they distilled the new product and advertised it as a floor cleaner and also a cure for gonorrhoea. But sales were still not great and they came up with a brilliant marketing scheme. Their company Listerine began advertising the dangers of “chronic halitosis” as a serious health problem in the 1920s. People were unfamiliar with this condition and instantly associated it with some form of major illness. They were desperate to prevent themselves from getting it, or to treat it if they already had it. Lucky for them, Listerine came to the rescue with their product that treated chronic halitosis.

Of course, halitosis is simply the medical term for bad breath. Although bad breath is not an actual disease, Listerine was extremely successful in convincing the population that it was a problem and was able to market their product this way. Listerine’s campaign was so successful that bad breath is still considered extremely offensive and socially unacceptable, making mouthwash almost a “necessity”. To quote advertising scholar James B. Twitchell, “Listerine did not make mouthwash as much as it made halitosis”. They had successfully invented a problem that their product could solve – creating not only supply for the product, but also the demand. This strategy has since been employed by countless advertising schemes to help sell products.