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Hello Brain
In Context
A fine mess “Multiple sclerosis”, reflects Bob Worthington, “sounds less like a disease than the names of many present day sports stars. I can imagine Vitus Gerilitis versus multiple sclerosis in the men’s singles at Wimbledon.” His autobiography, In a Mess, written in the early 1980s but only published this year, is the tale of his experiences with the disease, as well as his misadventures with Spanish au pairs, cowardly alsatians, and public telephone vandals. The story begins in 1958 with a momentary loss of balance in the coal bunker of his north England home. His symptoms develop into tingling in the extremities and an inability to walk in a straight line. He is treated with synacthen depot (tetracosactide). However, over time this treatment causes osteoporosis and osteoarthritis, and as the story progresses, we learn about his whimsical approach to dealing with his back pain. His disease forces him to change careers, and he and his wife take over a small post office in Cheshire, UK. However, as his back problems progress, Bob is admitted to hospital because of the side-effects of the painkillers he was prescribed and is told that he will soon be permanently bedridden, a prediction Bob meets with typical disdain and humour. Bob states explicitly that he wanted to avoid dwelling on the details of the disease, and that his main goal
is to entertain and amuse, but the book does provide some insights into how health care and the treatment of multiple sclerosis has changed in the past 50 years. Particularly notable was the fact that his doctors kept his diagnosis from him for 10 years, a decision that Bob “totally agreed” with, but which would nowadays be considered highly unethical. Worthington maintains a healthy disrespect for the medical profession, skewering bureaucracy and condescension with good humour and grace. Worthington taps a rich vein of northern wit that delights in the absurdity of everyday life; much of its charm comes from the narrator’s self-effacing style and artful turns of phrase. However, ultimately, In a Mess is a collection of humorous anecdotes from the life of one patient with multiple sclerosis rather than a more systematic attempt to discuss the effects of the disease and his treatment, and the book could have been stronger if it focussed more directly on his disease. Nonetheless, In a Mess is a warm and funny book that helps place multiple sclerosis in the context of the life of one man and his family.
Published Online December 4, 2014 http://dx.doi.org/10.1016/ S1474-4422(14)70237-6 In a mess: an inspirational laugh out loud account of how MS affected one man and his family Roberts James Worthington, Freshlook Management, 2014. pp 142. £9·99. ISBN 978-1783014644
Robert Stirrups
Technology Hello Brain Launched on Sept 22, 2014, Hello Brain is a European health awareness web-based campaign led by Trinity College Dublin (Dublin, Ireland) and funded by the European Commission that provides easy-to-understand information and short films about the brain and brain health. It addresses a general audience with the intention to support people who wish to learn about brain health, mainly through promotion of healthy habits and healthy lifestyle. The initiative is available as a free App for smartphones (iPhone and Android), a web version for PC, and a hardcopy version. This app is quite simple. It is not an interactive strenuous video game. Rather it comprises short recommendations of mainly pleasant things to do during the day (strolling, reading, chatting, playing cards, etc), to establish good habits for brain health. It also provides extended additional information and scientific bibliography for the more advanced readers. When promoting brain fitness for adults, the video games’ industry has often been accused of focusing on repetitive
www.thelancet.com/neurology Vol 14 March 2015
tasks rather than tackling the brain health as a whole. Even though the brain can be stimulated and trained by practicing video games, it has been difficult to assess the benefits of this, if any, on broader cognitive and perceptual abilities. The Hello Brain initiative provides a different brain fitness platform and encourages social interaction and a healthy lifestyle as the best stimulus and environment for the brain. To change lifestyle is challenging, particularly for elderly people. So, a simple approach might be a good strategy to avoid rejection or rebuttal. This is indeed a well-aimed project for older generations, who can be less enthusiastic about new technologies. However, changes in lifestyle should ideally be an ongoing lifelong process. Accordingly, this laudable initiative might need to consider how to address such a broad audience (probably impossible with only one platform) to compel young, as well as older, adults and even children to participate.
Published Online December 4, 2014 http://dx.doi.org/10.1016/ S1474-4422(14)70235-2 For more on the Hello Brain campaign see http://www. hellobrain.eu
Alonso Pardal Bermejo
251
A fine mess “Multiple sclerosis”, reflects Bob Worthington, “sounds less like a disease than the names of many present day sports stars. I can imagine Vitus Gerilitis versus multiple sclerosis in the men’s singles at Wimbledon.” His autobiography, In a Mess, written in the early 1980s but only published this year, is the tale of his experiences with the disease, as well as his misadventures with Spanish au pairs, cowardly alsatians, and public telephone vandals. The story begins in 1958 with a momentary loss of balance in the coal bunker of his north England home. His symptoms develop into tingling in the extremities and an inability to walk in a straight line. He is treated with synacthen depot (tetracosactide). However, over time this treatment causes osteoporosis and osteoarthritis, and as the story progresses, we learn about his whimsical approach to dealing with his back pain. His disease forces him to change careers, and he and his wife take over a small post office in Cheshire, UK. However, as his back problems progress, Bob is admitted to hospital because of the side-effects of the painkillers he was prescribed and is told that he will soon be permanently bedridden, a prediction Bob meets with typical disdain and humour. Bob states explicitly that he wanted to avoid dwelling on the details of the disease, and that his main goal
is to entertain and amuse, but the book does provide some insights into how health care and the treatment of multiple sclerosis has changed in the past 50 years. Particularly notable was the fact that his doctors kept his diagnosis from him for 10 years, a decision that Bob “totally agreed” with, but which would nowadays be considered highly unethical. Worthington maintains a healthy disrespect for the medical profession, skewering bureaucracy and condescension with good humour and grace. Worthington taps a rich vein of northern wit that delights in the absurdity of everyday life; much of its charm comes from the narrator’s self-effacing style and artful turns of phrase. However, ultimately, In a Mess is a collection of humorous anecdotes from the life of one patient with multiple sclerosis rather than a more systematic attempt to discuss the effects of the disease and his treatment, and the book could have been stronger if it focussed more directly on his disease. Nonetheless, In a Mess is a warm and funny book that helps place multiple sclerosis in the context of the life of one man and his family.
Published Online December 4, 2014 http://dx.doi.org/10.1016/ S1474-4422(14)70237-6 In a mess: an inspirational laugh out loud account of how MS affected one man and his family Roberts James Worthington, Freshlook Management, 2014. pp 142. £9·99. ISBN 978-1783014644
Robert Stirrups
Technology Hello Brain Launched on Sept 22, 2014, Hello Brain is a European health awareness web-based campaign led by Trinity College Dublin (Dublin, Ireland) and funded by the European Commission that provides easy-to-understand information and short films about the brain and brain health. It addresses a general audience with the intention to support people who wish to learn about brain health, mainly through promotion of healthy habits and healthy lifestyle. The initiative is available as a free App for smartphones (iPhone and Android), a web version for PC, and a hardcopy version. This app is quite simple. It is not an interactive strenuous video game. Rather it comprises short recommendations of mainly pleasant things to do during the day (strolling, reading, chatting, playing cards, etc), to establish good habits for brain health. It also provides extended additional information and scientific bibliography for the more advanced readers. When promoting brain fitness for adults, the video games’ industry has often been accused of focusing on repetitive
www.thelancet.com/neurology Vol 14 March 2015
tasks rather than tackling the brain health as a whole. Even though the brain can be stimulated and trained by practicing video games, it has been difficult to assess the benefits of this, if any, on broader cognitive and perceptual abilities. The Hello Brain initiative provides a different brain fitness platform and encourages social interaction and a healthy lifestyle as the best stimulus and environment for the brain. To change lifestyle is challenging, particularly for elderly people. So, a simple approach might be a good strategy to avoid rejection or rebuttal. This is indeed a well-aimed project for older generations, who can be less enthusiastic about new technologies. However, changes in lifestyle should ideally be an ongoing lifelong process. Accordingly, this laudable initiative might need to consider how to address such a broad audience (probably impossible with only one platform) to compel young, as well as older, adults and even children to participate.
Published Online December 4, 2014 http://dx.doi.org/10.1016/ S1474-4422(14)70235-2 For more on the Hello Brain campaign see http://www. hellobrain.eu
Alonso Pardal Bermejo
251