Firstly I want to apologise. The majority of my week or even just a whole day was not based on mind control – it was only a small part. However what I did was as interesting as mind control. So at 8.20 Monday morning I arrive at the Royal London Hospital for Integrated Medicine to attend clinic with Dr. Sharma. What happens here is that patients are referred to the consultant neurologist – Dr. Sharma. He then begins to deduce through a number of different clues; mainly through the patients history and is able to draw on his vast knowledge to correctly diagnose the problem. Actually the most interesting case wasn’t a stunning work of intellectual ability. Rather it came from a patient who already had their diagnosis. They’ve been diagnosed with Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy, which is bit of a mouthful (understatement much?). To save everyone’s time and mouth its called CADASIL. This disorder is caused by a mutation to a gene on the nineteenth chromosome. The effect of this mutation is far worse than its name. It dramatically increases the risk of having a stroke and also gives you plenty of migraines. The problem wasn’t exactly the risk of stroke – statins and a healthy diet were all helping to reduce the cholesterol levels. Rather it was the moral dilemmas that are so often skirted over. As it’s a genetic disorder the question was now to worry about the younger generation. The patient’s siblings all ready had the ball rolling in getting them tested. But what about the children? Would any one of us want to know we had this condition and could potentially die from it? The real world implications are huge. They’ll never get any insurance, a mortgage or even a bank loan. They’ll never be allowed to live in America and now a whole plethora of activities have been crossed out of their lives. How would children react if they knew they had the condition? Would it make them live their lives differently? It’s times like these when you truly appreciate the role of a doctor. The doctor has just dropped a massive life-changing bomb on the patient’s shoulders – but his work isn’t confined to just diagnosing. He’s already arranged therapy and counseling for the family and wishes to help them in anyway possible. To be a good doctor, you’re always going to have to balance the science with the social aspects of life and disease.
Moving on from that – Dr. Sharma isn’t just a consultant neurologist; he is also a senior researcher at the MRC Unit for Lifelong Health and Ageing at UCL and that’s where I spent the rest of my days after the clinic. His research is focused on the neurodegeneration of the motor system which he investigates using MRI scans, transcranial magnetic stimulation and the 1946 birth cohort. The first two are pretty science related but the last bit – the birth cohort is pretty amazing. It is a study of 5000 people who were all born in one week during March in 1946; they’ve been followed up throughout their 70 odd years alive. It is the biggest and longest running birth cohort study in the world and so much data; correlation and conclusions have come out of it. For example one such paper that was published using the results showed that the earlier a child would start to walk the higher the IQ. In fact for every month earlier the child learns to stand – on average they gain one half of an IQ point. This has further been proven with the complex link in the brain between the motor cortex and the cognitive ability and thus function of the brain (just want to point out – I could walk pretty much instantaneously after being born).
I bet by now you’re wondering where the mind control comes in. In fact I’ve already mentioned it. Transcranial magnetic stimulation. The act of using magnetic fields to stimulate an electric field in the motor cortex of the brain, which then creates impulses that causes the body’s nervous system to pass on electrical signal, which cause the muscles to contract and move. Currently the motions the body can be made to do are limited but the potential is there. It’s amazing to look at the science behind it, I remember learning in my Physics GCSE about Fleming’s left hand rule – which is exactly what the researchers use to stimulate the brain.
Another great thing about my placement was that my supervisor and me were both similar in one important fact. We are both horrendous in a wet lab. From a chemistry lab to the kitchen you can be guaranteed that I will make mistakes with my hands. So for me; working with computers in dry labs was a great experience. I learnt how to do some coding and use programmes that would actually allow me to do computer modelling of the brain. Using diffusion weighted magnetic resonance imaging I produced stunning images of the brain on my laptop. It’s really interesting how this specific type of MRI scanning works. We all know about the amount of the water our brain holds, but using diffusion MRI we can track motion of water in the brain and produce stunning images of the brain. These images were used to track changes in someone’s brain and then analyse the patterns that come out of it. For Dr Sharma it was how the brain changes with neurodegeneration experienced with motor disease.
The whole week was interesting, educational, inspiring and a number of adjectives that I can’t begin to list. Perhaps the best part was everyone I met whether it was Jane who gave me a cool electronic key to get into a Victorian house or Sanjay who helped me with my medical school entry. But ultimately I have to thank Dr Sharma who opened my eye to the potential for research in medicine; and how a background in both allows a person to approach any scientific problem with a unique perspective that has only motivated me more to become a doctor and now a doctor who is involved in furthering the collective scientific knowledge of the entire human race.