The Weekly Dose - Episode 23

The Weekly Dose...

... the latest from Dr Karan

  Here is your weekly dose...  

Hi all!Here is your weekly dose of the Sunday Six! A few things I found interesting this week. If you enjoy this please feel free to forward this to friends. families and enemies alike!**You'll find more in depth analysis of some of these subjects on my social platforms in the links just below, including Dr Karan Investigates! for deep dives into interesting topics on my YouTube channel.**

Why Do Surgeons Wear Green or Blue Scrubs...

In the 19th and even early 20th century surgeons used to wear white aprons during operations. The more blood on their smock, the more experience under their belt!

One of the reasons Surgeons Switched colours to blues and greens was because an intense focus on the colour red (blood/innards) can lead to distracting green illusions on white surfaces. This is known as the “after effect” illusion similar to the floating spots we see after a camera flash. Not what you want your surgeon to have!

Why I Have Hope For Alzheimer's...

We barely understand the brain. It’s no surprise however that the last few decades of Alzheimer’s research has been plagued by duds, failures and false promises.

Alzheimer’s disease is a terrifying condition. It’s insidious, it’s progressive and we can’t keep it at bay once it sets in. Right now the state of play is we have medications which help *symptomatically* to treat symptoms, e.g donepezil. The issue is we still don’t have medication which can reverse or even slow down the progressive brain destruction seen in Alzheimer’s.

BUT..there may be hope.

A recently published trial showed that a Monoclonal antibody called lercanemab can train the immune system to clear “amyloid plaques” which can build up and destroy the brain tissue. It’s a small effect and only helpful in trials for early Alzheimer’s and is not without side effects. However this is the first time we have seen something to help change the course of the disease and not just paper over symptoms.

A small step in the trial world but a huge stride forward in Alzheimer’s research.

The Truth About Surgical Complications...

My old boss told me this aphorism: A good surgeon knows how to operate. An even better surgeon knows when to operate. The best surgeons know when NOT to operate.

Contrary to popular opinion, surgeons as a species try not to operate if we can avoid it. If you’re seeing a surgeon for an operation it’s likely because it is needed for a live saving or life prolonging operation or at the very least to improve your quality of life.

Every surgery carries risk - whether it’s removing violent bum grapes aka haemorrhoids or chopping out a bowel cancer.

Whenever we embark on an intervention or procedure on a patient we weigh up the benefit of the procedure against the risks it may carry. If the equation is favourable, we will proceed. Occasionally a surgeon may proceed with unfavourable odds in extreme scenarios, major trauma being on such case.

Unfortunately surgeons make mistakes. The rarity, the exception rather than the norm. However if we look at the trend over the last 50 years, worldwide - surgery has become safer, with more algorithms, pathways and checklists to make sure things like wrong site surgery, wrong patient surgery (!) does not happen.

The advent of AI integrating into surgery with robots will usher us into an age where we might hope to reduce complications even more.

For now, to err is the unfortunate plague of the human condition.

Fun Fact...

The cremasteric reflex. A strange test and I wonder who was the first doctor to try this on a willing patient/victim.

The cremaster muscle is involved in elevating the testicle. The muscle is stimulated by stroking the inner thigh which then causes the testicles to reflexively contract upwards. If a person has testicular torsion, this reflex is absent - a pretty good diagnostic sign! (P.S this paragraph likely causes thousands of people to stroke their inner thigh...) 

The Weird Future Of Cancer Therapy...

Why don’t we have a cure for cancer? The age old question. The truth is cancer is NOT a single disease. It’s a disease process and an umbrella term which encompasses hundreds of different, unique pathologies across various organ systems and tissues.

What’s worse is that even within a specific type of cancer, for example breast cancer - there are genetic variations meaning that no two cancers will ever be alike.

The holy grail of oncology and medicine as a whole is precision medicine where we can identify the “precise” medicine for each individual person by determining that persons genetic make up to see how they respond to specific medications to create a bespoke cocktail of treatments for them.We are not quite there yet however.

The future does look promising - for example we can grow “cancer organoides” which are derived from the patient’s cancer tissues and grown in a lab as a simulated cancer to throw various treatments at to see what works best!

What I'm Watching...

I’ll admit. I love sci-fi. Everything from marvel to Star Wars to mind bending features like inception and tenet. The more brain melting the better. If you’re anything like me you’ll enjoy this one; Dark.

It’s a German sci-fi series that takes an alternative take on the time travel genre and really explores the ethical, philosophical and literal impacts of what altering time can do to our lives.

I’m also watching it to brush up on my German which has collected some rust over the years!

I’m addicted to this series and it’s very rare I can binge watch several seasons in a week. 

As always, please give me feedback on Twitter. Which of this weeks Sunday six is your favourite? Is there something you want more, or less of? I'm open to any suggestions so please let me know! Just send a  tweet to @drkaranrajan and use the hashtag #theweeklydose at the end so I can find it!

Have a wonderful week, all.

Much love,

Karan