What do you say to a new set of students? (1)

A new academic year is about to begin, and students will be bombarded with a plethora of information about all manner of things. Some of it may even be useful. A lot of it could have been left out and picked up as they went along. (Indeed, a lot of information gets given ‘just in case’ so as to avoid potential liability.) Much of this information will be unloaded upon them in Freshers' Week*. And it does not end there. The first week or two of teaching includes further sets of preliminary information. For example, a lecture plan giving what is to be covered, in what order and when, is often provided. I've never been concerned about knowing in advance what’s coming up, but some students have used it to their advantage. One chap a year above me at university only ever went to one biochemistry lecture in the entire two years the course ran. And that was the very first lecture. On that occasion, he was given a list of lecture topics to be covered each week and so decided to go away and study it for himself.

Not being concerned about knowing what is coming up in advance, I was more interested in hearing what might be called the ethos behind the subjects being studied. Each discipline has its own way of thinking about things. Thus, I wanted to know what that was. The chap I mentioned above went away and studied biochemistry in a rather mechanical way. As he described it to me, his approach was that of mere rote learning. Biochemistry was not something that he wanted to pursue. It was just a subject forming part of a much broader degree syllabus. There were other areas that were of greater interest to him.

When beginning a course with new students – especially 'freshers' – I often used to flash up on the screen some pithy statements. These were meant to grab the students' attention, raise a smile (if not a laugh – although these were rather rare) and be thought-provoking. The thought provocation was what was most important.

My favourite opening statement came in two parts. (PointPoint cleverly allowed fades from a simple, initial statement into a much fuller one.)

The statement began:

Believe nothing this man tells you

Then…

Check everything he says by reading about it for yourself

…faded in.

It was not that I was not believable or going to tell them anything false – although that might have been inferred from the opening statement if left on its own. It was that I wanted the students to engage with the subject outside of the lecture theatre by reading about it and thereby engaging in the subject on their terms.

* Many institutions now use the term 'Introductory Week' instead. It’s not a term I ever liked and never will.

Seven Ages of Woman?

In the famous ‘all the world’s stage’ speech in As You Like It, Shakespeare – through Jaques – speaks of the seven ages of Man. These seven ages may seem a little contrived, and others have suggested different ones. However, what if we apply the idea to Woman? What might the ‘seven ages of Woman’ be?

Here is a (very) tentative list of seven (st)ages in the female lifespan as "qui fait réfléchir”.

• Birth
• Childhood
• Menarche (attaining adulthood/reproductive capacity)
• Reproductively active
• Climacteric (transition from reproductive capacity)
• Menopause
• Postmenopause (post-reproductive phase) 

NB Please note how I deliberately refrained from using blank verse.

From 'The Origins of Totalitarianism' (Arendt)

We sometimes, rather strangely perhaps, talk of ‘my body’ or of ‘our bodies.’ I suggest that this is strange because we are bodies. We and our bodies are a unity. To talk in that way implies some sort of separation or distancing when there is none. In this way of speaking, the mind seems to be looking from a vantage point elsewhere, a place that is not part of its body or part of its physical self.

Hannah Arendt (1906-1975), in The Origins of Totalitarianism, spoke of how totalitarianism splits one’s name from one’s body. She suggests that once you are just a body, you become superfluous as a person. Your body is an object separated from yourself as a person. It is just another body without its unique personality or identity.

This was something also found addressed by Aristotle (384–322 BC) and by Arendt’s mentor/lover Martin Heidegger (1889-1976). These thinkers considered there to be two aspects to human life:

• the animal/physical or bios, and
• the social/political/legal life of the named (identified) person

Both coincide; present at the same time. This must be recognised. To address one without the other, even inadvertently, is to fall into a totalitarian sort of mindset. This may not be intentional, but the effects can nevertheless be stark. On one level it can lead to philosophical error and flawed reasoning. But there is another practical area for concern.

The medical profession used to be heavily criticised for its attitude to patients whom it was genuinely trying to help. Focused upon cure via the treatment of causal lesions, the person who had the lesion was often forgotten. I once even heard a nurse refer quite loudly, and in the hearing of other staff and patients, to the ‘torticolis in cubical three’. Thus, patients felt somewhat like objects. In those days they were reluctant to complain. They felt powerless. In the UK, things have changed. (I sometimes think that now people complain unduly.) Complaints are more likely to be about how ‘I’ was treated rather than how ‘my body’ was treated.

Considering our various faculties, we say ‘I see’, ‘I hear’, etc. It is always 'I'. It is not ‘my eye sees’, ‘my ear hears’, etc. We see as if through one 'cyclopean' (singular) eye situated between our two eyes and yet rely on binocular vision to help us locate things in space. We hear in stereo – especially through headphones, again helping us locate things in space. But this time there does not seem to be a single point of hearing midway between the two ears.

We also think as if we had one mind, and yet different parts of the brain perform different tasks. Our faculties are not equally distributed throughout the brain in which they appear to reside. The brain is not a homogeneous entity. It is an anatomical composite of numerous nuclei and neural pathways. There is no obvious place where ‘I’ reside.

In the past, other parts of the body were considered to be the seats of various emotions. The obvious is the association of the heart with love. This association lingers. But from a knowledge of Shakespeare, the liver, spleen, and gall bladder immediately spring to mind as having different human qualities associated with them.

Now, all these qualities have retreated into the multiplicity that is the brain. What are we to make of such a thing as the brain the first time we dissect, knowing that all aspects of a person were once located there?

A statement poo-poohed

I want to cast doubt on something I read some time ago in a textbook of physiology originally written for nurses. But it relates to faeces and its smell and the more I look into the spelling of poo and/or pooh the more confused it gets. Both spellings can be used as nouns and as verbs. Both have the same dictionary definitions. I was expecting ‘poo’ to relate to a piece of faeces and ‘pooh’ to an unpleasant smell - not least, the smell of poo! This careful placing of the ‘h’ would have been important, I assumed. In that way, one could talk about the pooh (smell) of poo (faeces). But things are not so simple.

Referring back to that textbook of physiology originally written for nurses - which I shall, of course, refrain from naming. When it came to reading about the liver and bile, I came across something that, at the time I merely accepted but now, much later on doubt very much.

Bile is a secretion from the liver that enters the duodenum via a system of bile ducts. Often people assume that bile is primarily a waste product since it gets mixed with the gut contents which, of course, go on to form the faeces. Although there are some waste products to be found in the bile, this assumption is incorrect. Indeed, a significant proportion of the bile is reabsorbed. The bile has a beneficial role in the digestive process. It acts as an emulsifier aiding fat absorption, and is important for the absorption of the fat soluble vitamins A, D, E, and K. It neutralises the acidity of the stomach contents as they are released into the duodenum, and it also acts as a bactericide.

What that old textbook also claimed was that it deodorised the faeces. I am not disputing whether it may have that effect. What I want to question is any suggestion that this is in any way purposive. Unfortunately, that was the suggestion that textbook gave.

That there should be a mechanism for making the human faeces less smelly seems odd. Interestingly, nobody finds the smell of their own faeces completely intolerable. But when it comes to the smell of other people’s that is a different matter. All faeces, even one’s own, are to be avoided and any signal - including olfactory - that aids in that avoidance has a survival advantage. That we find faeces repugnant has a biological basis. The bactericidal effect of bile is clearly in keeping with this whereas deliberate deodorisation is not. Indeed, it potentially runs contrary to this. Furthermore, as a species, we do not have a particularly highly developed sense of smell anyway. Surely, it would be to our species’ advantage to make our faeces more smelly not less so.

This is another warning about taking what we read simply at face-value. Students often assume that textbooks are definitive, having the last word on its subject matter. I once had a student who was very reluctant to question any textbook. She even described their contents as ‘written in stone.’ It was hard to convince her otherwise.

Another student, years latter, spent some time in the USA as a postdoctoral student in a prestigious academic department. At that time, an eminent colleague was preparing a new edition of one of the world’s most authoritative biology textbooks. Readers naturally assume that person to have written the book. But that is not the case. Instead, graduate students were pressed into writing different sections which were then stitched together. What the student used to do was to simply crib from other textbooks! So one of the world’s most authoritative biological textbooks is really a composite of other less well respected tomes - paraphrased.

Where do breasts belong? (2)

The ambiguity of the title of my previous post entitled ‘Where do breasts belong? (1)' reminded me of the ‘milk line’ – which I find may also be called the mammary ridge or mammary crest. (I did not previously known that.) This is a line along which, in humans, accessory nipples and breasts may form. Sometimes these may be fully developed and even functional. Re-reading my post title to mean ‘Where on the body do breasts belong?’ The answer is not necessarily on the front of the (female) chest.

The milk line is to be found in other mammals. Indeed, it is primarily a mammalian characteristic which in humans has largely become confined to the thoracic region. The milk line extends on both sides from the armpit to the thigh in an elongated S-shaped curve. Much the same can be seen in rats, for example. It is particularly clear when the dam is suckling numerous pups who have denuded the nipple of its surrounding fur.

There are stories of women who have breastfedfrom a nipple on their thigh. The only illustrations I have seen of this have been nineteenth-century engravings or images based on them. However, I do not believe them to have been drawn from life. The images I have seen show a child standing at its seated mother’s side drinking from the outside of her thigh. The milk line does run past the groin into the upper thigh but only the inner (medical) side of the upper thigh, not the outer (lateral) side. So although the idea of breastfeeding from a nipple on the thigh is plausible, the details as depicted in the engravings I have seen are wrong.

Often a rudimentary (or supernumerary) nipple may be seen along the milk line. This takes various forms but may show up as a small area of darker skin pigmentation on the milk line. This may be found in males as well as females. The fictional Bond villain Francisco Scaramanga (from The Man with the Golden Gun (1965)) had a third (i.e., supernumerary) nipple. Unfortunately, as depicted in the film (1974), it did not fall on the milk line. For many anatomists and zoologists, their enjoyment of the film may have been compromised as a result – everything else in the James Bond films being entirely credible, of course.

Human Biology - Medawar's view

My undergraduate degree was in human biology. Several years after graduation and looking for lecturer jobs, I saw an advertisement for a human biologist. At last! I applied and got it. When I arrived, I said how glad I was to finally have a job as a human biologist. “Oh”, the head of department replied, “that was just a term we used as a catch-all.” (Sadly, she was not somebody known to inspire her staff.)

That story is not isolated. Once when I said to somebody that I was a human biologist, they said, “We did that at school. It’s to do with sewage, isn’t it?” The label human biology can be used very loosely. Anything biological that happens to involve humans in some way can find itself labeled ‘Human Biology’.

So I include here something that was more carefully considered.

Of human biology, Sir Peter Medawar (1915-1987) wrote that “it is not so much a discipline as a certain attitude of mind towards the most interesting and important of animals. Human Biology portrays mankind on the canvas that serves also for other living things. It is about men rather than man: about their origin, evolution, and geographical deployment; about the growth of human populations and their structure in space and time; about human development and all that it entails of change in size and shape. Human Biology deals with human heredity, the human genetical system, and the nature and import of the inborn differences between individuals; with human ecology and physiology, and with the devices by which men have met the challenges of enemies and of hostile environments. Human Biology deals also with human behaviour - not with its wayward variations from one individual to another, but rather with the history and significance of, for example, family life; of love, play, showing off, and real or sham aggression. Finally, and most important - because most distinctively human - it must expound and explain the nature, origin and development of communication between human beings and the non-genetical system of heredity founded upon it.”

This Medawar wrote in the Foreword to Human Biology edited by Harrison GA, Weiner JS, Tanner JM, & Barnicot NA. 1964. Oxford: Clarendon Press.

This book may be viewed at the Internet Archive (login required for the whole book, but the full version of Medawar’s Foreword can be viewed without needing to do so).

What stands out for me is how Medawar considers human biology to be ‘a certain attitude of mind’. It is something much more than simply lumping certain things together and giving a catch-all name because humans are involved in some way. It is not so much about the type of data collected but its meaning and relevance to the understanding of humankind. That makes a considerably broad sweep of data of potential value.

There is another, much shorter quotation, perhaps in a similar vein, that I found. This time it is about physiology.

    "Physiology is not a science or a profession but a point of view."

Ralph W. Gerard, Mirror to Physiology: A Self-Survey of Physiological Science Washington, D.C.: American Physiology Society. 1958.

Lungs and Living Forever

There is a general assumption that if only we could make the cells of our bodies live forever, then so would we. Only cancerous cells are known to divide indefinitely, but groups of such cells do not form structures that are architecturally as sophisticated as the organs ordinarily found in the body. The architecture of the organs is important to the processes these organs perform. So is the behaviour of cells forming these structures. Some cells exhibit quite innocent behaviours that mean that even if cells were immortal, the innate mortality of the organism cannot be avoided.

I am thinking particularly of the lungs.

Even though the lungs are enclosed within the thorax, they are on the front line when it comes to intimate contact with the outside world. We cough out dust, but not all of it. Although they have what might be described as ‘dust-catching’ mechanisms, it is impossible for all dust to be out. It is inevitable that some dust particles will enter deep into the airways.

(Indeed, I remember a cadaver that we were dissecting many years ago. It must have been that of a South Wales miner who, judging from his age, may well have been down the pit in the 1960s or 1970s. His lungs were of the purest, shiniest black that one could imagine. It was as if they had been sculpted from a block of pure anthracite, except that they were soft (even allowing for the embalming process).

The lungs have a mechanism for dealing with those particles that are not coughed out or caught. This mechanism is to wrap them up and form a fibrous barrier around them. Sometimes these packages may even be seen on a chest radiograph – especially if they calcify.

This mechanism has a downside. The process of fibrosis leads to a local reduction in the elasticity of the lungs. This, in turn, makes it more difficult for other particles to be removed and fibrosis progresses. It is conceivable that if we lived long enough, eventually the whole lung would become fibrosed. Certainly, breathing would become increasingly less efficient. If living forever were merely a matter of cells becoming immortal, this (normal) behaviour of lung cells would eventually lead to them becoming unable to sustain life. To prolong life, a lung transplant would be necessary.

The following illustration may add further insight.

From: Roberts, F., & MacDuff, (Eds.). (2018). Pathology Illustrated (8th ed.). Edinburgh. Elsevier.