This Medical Life

Essentially every culture, modern or ancient, understood that health and faeces are inherently linked. The Ancient Chinese practiced ‘copromancy’ which was the assessment of health based upon the shape, size and texture of faeces. Today we have the Bristol Stool Chart that helps us to classify faeces/poo into seven different groups. As disconcerting as it may be, the state of our poo can tell us a lot about our own health and this is only going to increase as our knowledge about our faecal microbiome expands.

The faecal microbiome is the composition of all the microorganisms within our faeces. We are learning that the composition not only affects our health but can also be contributory to diseases we experience. In some circumstances, this has also become a treatment with faecal transplantation to manage treatment resistant clostridium-difficile colitis.

This is the story of the faecal microbiome.

Our special guests:

• Dr Piers Mitchell, who is a hospital specialist consultant in the NHS and co-editor of the International Journal of Osteoarchaeology. Dr Mitchell has trained in paleopathology, osteoarchaeology, parasitology, medical history, and orthopaedic surgery.
• Dr Vincent Ho, who is a Gastroenterologist practicing in NSW, is an Associate Professor at Western Sydney University and head of a research laboratory.

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In 1891, Guido Werdnig documented two cases of brothers who had global progressive muscular weakness. In 1935, Dr Dorothy Anderson conducted an autopsy on a young child who had died from malnutrition due to suspected coeliac disease despite being on the upon treatment. In 1943, in inherited form of intellectual disability in boys was described by Martin and Bell. The diseases are Spinal Muscular Atrophy, Cystic Fibrosis, and Fragile X syndrome respectively. The learning curve for genetics in the last 100 years has been a steep one.

Recessive genes circulate in the general community and for the most part, they are hidden and play no part in day-to-day life. Some may even have had a survival advantage in pre-modern times. However, if two parents each carry matching recessive genes, there is an increased chance that their children can have a severe or even life-threatening illness. Carrier screening provides a test for parents to assess this risk, however, it also requires an understanding of the testing paths, risks and cost from requesting doctors.

This is the story of carrier screening

Our special guest is Professor Graeme Suthers who is the Director of Sonic Genetics Australia.

Additional information:

Link to further information about reproductive carrier screening: https://www.sonicgenetics.com.au/patient/test-information/rcs/

Link to carrier screening online patient course: https://www.sonicgenetics.com.au/patient/test-information/rcs/carrier-screening-online-patient-course/

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Seasonal influenza causes significant morbidity and mortality every year but can often fall into the underestimated category. Between 10-30% of the general population are infected each year with influenza that leads to an increase in hospital and intensive care unit admissions, the onus for prevention and early intervention has never been more important.

Our special guest is Associate Professor Paul Griffin from the School of Medicine at the University of Queensland and is an Infectious Disease Specialist at Mater Health.

This is the story of influenza.

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In 1998, a 6 page report published in the Lancet that would later be described as one of history’s great science frauds. The article was titled “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive development disorder in children” but the news headlines ran with a much shorter version: the MMR vaccine causes autism.

The article was written by Andrew Wakefield, a British gastroenterologist turned researcher, who had taken it upon himself to deceive the medical community and general population at large. Fortunately, investigative journalist Brian Deer uncovered the truth behind this ‘study’ through hard work, significant obstacles and persistence.

Although Wakefield’s claims have been thoroughly discredited, we still feel the impact of this fraud to this day and he has become an icon of the anti-vax movement.

Our special guest is Brian Deer who is an award winning investigative journalist and bestselling author for The Doctor that Fooled the World, published in 2020.

This is the story of the MMR vaccine fraud.

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In 1834, Robert Graves gave a lecture series on the ‘Newly observed affection of the thyroid gland in females’. He presented three women who had violent palpitations, enlarged thyroids, and an apparent enlargement of the eyeballs (later it would be called ‘exophthalmos’).

In 1912, Hakaru Hashimoto reported a new disease in a German journal after examining microscopically the thyroid tissue from four middle-aged women. He noted the lymphocytic infiltration and likened it to other conditions containing lymphocytes (ie. Sjögren syndrome) and named it ‘Strum lymphomatosa’.

It would not be until the 1950s that the underlying mechanism of these diseases would be known: autoimmunity. The former, now known as Graves’ disease, and the latter Hashimoto disease are the most common causes of hyperthyroidism and hypothyroidism respectively.

Our special guest is Dr Daman Langguth who is an immunology and Head of the Immunology Department at Sullivan Nicolaides Pathology.

This is the story of autoimmune thyroiditis.

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Since recorded history, heartburn has been a common complaint and the descriptions from ancient physicians are virtually indistinguishable from today’s accounts. However, one thing we do know that they did not is a small subset of patients whose long standing heartburn could predispose them to a precancerous condition known as Barrett oesophagitis.

Barrett oesophagitis is caused by chronic gastro-oesophageal reflux disease with a number of known risk factors for developing this. These patients require regular monitoring +/- intervention as they have an increased rate of developing oesophageal adenocarcinoma. For this episode we have called in some specialists to help us out.

Our guests include:

• Dr Tristan Rutland – Anatomical Pathologists who specialises in Gastrointestinal Pathology
• Dr Milan Bassan – Gastroenterologist who is Head of the endoscopic department at Liverpool Hospital

This is the story of Barrett Oesophagitis.

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Professor Ian Frazer pioneered the development of the first Human Papilloma Virus (HPV) vaccine which has seen a reduction of HPV infections in young women between 70-86% and the incidence of cervical cancer rates drop by 90%. Few doctors/scientists have had such a profound impact on the health of so many people. Today we talk to Professor Ian Frazer about his career, the events leading up to the HPV vaccine development, and the future of this life-saving medicine.

Some of Professor Ian Frazer awards include:

• Australian of the Year (2006)
• Prime Ministers Prize for Science (2008)
• The Balzan Prize (2008)
• Fellow of the Royal Society of London (2012)
• Companion of the Order of Australia on the Queen’s Birthday Honours list (2013)
• Immunology research department named the Frazer Institute at the University of Queensland

This is the Story of Professor Ian Frazer and the development of the cervical cancer vaccine.

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In 1964, a young woman was murdered as she walked to her apartment in Queens, New York. Her screams were left unanswered. No one came to her help. Within the space of thirty minutes, the assailant would return two more times to stab her again and again. The woman died. The number of witnesses to this crime who did not help was: 38. Two psychologists posed a question: how could this happen in such a heavily populated city?

Two other landmark studies occur around this time including the Milgram experiment and the Stanford prison experiment. Two experiments that range from insightful to controversial. However, all of these have captured the attention of psychologists and students, and helped us to learn more about ourselves. If nothing else, the latter certainly taught how one should not conduct a psychology study.

These are some of the stories of psychology from the 60s.

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In 1912, Merck Pharmaceuticals was searching for a blood clotting agent to compete with a competitor in the market. One of the agents, a chemical by-product (and not even named) was produced and patented without any significant testing. This was a drug that we would come to know as MDMA or Ecstasy.

In the 1960s, this drug found it’s way into use by a Chilean psychiatrist for psychotherapy, Dr Claudio Naranjo. He found that it helped patients to open up, it intensified emotions, gave access to suppressed memories, and provided insights.

In the 1970s and 1980s, the recreational use of MDMA became prevalent but also became a focus in the war on drugs with both political and scientific powers advocating strongly against its use. Today, the experimental studies confirm that MDMA is very useful in a controlled medical setting for the use of patients suffering from Post-Traumatic Stress Disorder (PTSD).

Our special guest is Dr Stephen Bright who is a clinically-trained psychologist, senior lecturer at Edith Cowan University, researcher into psychedelic science and co-founder of Psychedelic Research in Science & Medicine (PRISM), an Australian non-profit research association that supports formal research into psychedelics such as primarily MDMA.

There is additional information for GPs about MDMA posted.

This is the story of Ecstasy.

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The medicinal properties of aspirin (acetylsalicylic acid) have been well-documented for hundreds of years. It seems even our ancient ancestors thousands of years ago had some insight into its healing properties even if the usage was misguided. We are still learning about aspirin and the best ways to use it.

Our special guest is Professor Simon Dimmitt, a Physician in General and Cardiovascular Medicine. He has released a website providing evidence-based prescribing for Doctors.

This is the story of Aspirin.

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