The Weekly Dose - Episode 24

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.**

High-tech Boobs...

Human breasts are ultra high bioreceptors. Breast milk actually changes its composition depending on the individual nutritional requirements of the child drinking it by taking information from the saliva of the child to determine nutritional deficiencies or even the presence of pathogens. In fact each breast is independent, so if a mother is nursing a different child on each breast, the milk from each side may look different in colour and even have a different chemical composition.If the child is sick, the milk might even change colour to a yellow-ish antibody rich milk. 

   The Latest AI Craze... 

No, not the trend of everyone generating artistic self-portrait renderings from their selfies BUT ChatGPT.It's basically a super-powered chatbot. A prototype artificial intelligence chatbot developed by OpenAI that specializes in dialogue and reinforcement learning techniques. In simple terms - you ask it a question and it gives you a pretty convincing human sounding answer.So much so that people have used it create games, websites, music and even stories!Here is one "I" made earlier. I asked it this: "tell me a dystopian origin story of a once peaceful killer monkey"Here was it's story:

Once upon a time, in a world not so different from our own, there lived a tribe of peaceful monkeys in a lush and verdant rainforest. These monkeys were known for their intelligence and kindness, and they lived in harmony with the other animals in the forest.

One day, a group of humans entered the rainforest with the intention of cutting down trees and making way for a new development. The monkeys tried to warn the humans that their actions would destroy the delicate balance of the forest, but the humans paid no heed.

As the humans continued their destruction, the once peaceful monkeys grew angry and resentful. They formed a group and began to fight back against the humans, using their intelligence and cunning to outsmart them at every turn.

Over time, the monkeys became more and more ruthless in their resistance, and their once peaceful nature was replaced with a burning desire for revenge. They began to attack the humans without mercy, striking fear into their hearts and causing them to flee in terror.

The once peaceful killer monkeys had become a force to be reckoned with, and their actions had plunged the once lush and beautiful rainforest into a dystopian wasteland. Despite their initial noble intentions, their thirst for revenge had turned them into the very thing they had once fought against: violent and dangerous predators.----Not bad, considering it took all of 5 seconds to render this piece. The limits seem endless with this burgeoning technology but I wonder if this can be repurposed by children writing school essays, university students during coursework and so on. Will the deprivation of free thinking and reduce burden of having to need inspiration make us "dumber" and less creative? This newsletter would probably have been far quicker to write if AI generated but then do you not lose some incalculable human element, your "voice"?These thoughts made me think of the move idiocracy. If you haven't seen it, it's a hidden gem.

Why Healthcare Workers Should Have Counselling...

Grief and trauma is a spectrum. Throughout our lives we will be exposed to micro-stresses like the sound of your shrill early morning alarm or a work email from your boss as well as macro-stresses like the loss of a loved one, seeing a traumatic event.People start in healthcare roles as young as 18 years old and are exposed to the grim reality of hospital life. Cardiac arrests, cancer diagnoses and tide of very unwell patients. A lot to handle for anyone, day in, day out.When I saw my first cardiac arrest and also my first death on my second shift as a doctor at the age of 24, I was in shock. I didn't ever want that feeling of breaking ribs during CPR or frantically feeling useless while a patient was dying ever again. Unfortunately my first four months on a geriatric ward during winter involved several deaths and cardiac arrests. Understandably, seeing death in the workplace is a macro-stress. Often it is seen as part of the job and we bottle these emotions inside us whilst they have insidious effects on our mental health without even realising. If a pilot is involved in an incident, they have a debrief session and counselling. Should healthcare workers not be offered counselling or some form of debrief/therapy session on a regular basis to cope with the daily horrors faced?Quis Custodiet Ipsos Custodes - Who Guards the Guards? Whilst healthcare workers watch over society, who watches over them?

Patients Have No Patience...

It seems nowadays hospital life is in such a frenzy that patient's are too often viewed as their pathology rather than people. Patient in Bed 3, not Mr Smith. Patient with diverticulitis, not Tom the Ski instructor. I still enjoy getting to know a bit about the patient's background and personal story and not just their medical history. In an age of numbers, fast turnarounds and busy staff it helps to humanise things once again.I was recently on call and was about to perform an emergency appendix removal on a teenage boy. He asked me if I could finish the operation before the England football game kicked off. I failed him and finished the operation 14 minutes after kick off.Last year I spent 20 minutes on a ward round debating the best England Test Match openers of the last 20 years with one of my patients, much to the annoyance of my juniors...On the flip side I've also made some comical errors of speech and judgement when interacting with patients. I once put out my hand to shake a blind man's hand. There was 20 seconds of awkward silence until it dawned upon me he was blind.I once referred to a patient's wife as his daughter to the joy of his wife but wrath of the patient himself. All was well in the end and I survived.During a telephone clinic consult with an elderly patient, I ended the conversation with "ok, bye, I love you.." Which was reciprocated with a delightful, "I love you too doctor".

Big Poops And Hearts...

There is a peculiar connection between a heaving great dump and your heart. Your heart rate can slow down by releasing a large trouser biscuit. Your autonomic nervous system is controlled by your vagus nerve; you know this as the "fight or flight" - the gas and the brakes. You can stimulate these brakes when you get frightened, jump in cold water or even having a full satiated belly can stimulate it, which is one reason why you feel tired after a huge meal (post prandial slump). The vagus nerve is also stimulated when you bear down like when you're struggling to eke out an enormous poop. As Elvis unfortunately found out, it is possible to die on the toilet particularly if you have a dodgy heart. Surprisingly death due to faecal syncope (fainting during defecation) is pretty common.

Bruce Lee's Death, 50 years on...

in 1973, Kung Fu legend Bruce Lee's autopsy revealed that he had died from a brain swelling which was thought to be due to an excess of painkiller he was taking. However, doctors have recently published a hypothesis suggesting his death may be explained by hyponatraemia (a low sodium) caused by his kidney's inability to excrete excess water. If you're particularly interested you can read the full paper here. Your body needs a fine regulation of sodium in the blood for fluid balance. An imbalance can cause tissues to swell including those in the brain. The study hypothesised that Lee had lots of risk factors for hyponatraemia including consuming high amounts of liquid in his diet, cannabis use (which promotes thirst) and even the use of prescription drugs and alcohol which decreases the kidney function.

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