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High-tech, low-tech, or no-tech?
DISSECTING ROOM
LIFELINE Sandeep Jauhar Sandeep Jauhar grew up in a family obsessed with news. Before going to medical school he was an AAAS Mass Media Fellow at Time Magazine in Washington. During medical school at Washington University he worked for the St Louis Post-Dispatch. He writes regularly about medicine for The New York Times. On Sept 11 and 12, 2001, he was among the physician volunteers at the World Trade Center. Who was your most influential teacher, and why? My father, because he taught me the therapeutic value of work. Which patient has had most effect on your work, and why? The psychotic ICU patient who invited me into her room “for a drink” at 0300 h when I was on call at the beginning of my internship. She inspired me to start writing about some of my hospital experiences. What would be your advice to a newly qualified doctor? Keep a diary—hospital will never be as interesting as it is during internship. How has your view of the USA changed since Sept 11? No-one could have imagined the attacks; like Sputnik, they forced all Americans to expand very rapidly their sense of what was possible. But like Sputnik, the attacks have created an environment in which people often seem to confuse possibility with probability. If you had not entered your current profession, what would you have liked to do? Acting or film direction, but as a child my biggest aspiration was to become the chief nuclear arms-control negotiator for the US government. What is the least enjoyable job you’ve ever had? Washing up at the local pizza joint at high school, the only job I was ever fired from, because I refused to clean the dishes with a hose. Where were you in your sibling order, and what did you gain or lose as a result? The middle child, which forced me to claw and manipulate for my parents’ favour. Do you believe in monogamy? Yes, but it’s a losing proposition for most species.
810
High-tech, low-tech, or no-tech? am interested in the latest airport security systems that are being developed in the wake of the attack on the World Trade Center. One new system uses a device that scans the area around the eyes to monitor the blood flow there. It seems that when we are telling lies there is a pronounced rise in blood flow in this region. Presumably, if it passes its trials we can all look forward to waiting in queues to be grilled by security staff while someone shines some sort of beam in our eyes. Not long after the events of Sept 11, 2001, I was flying to Vienna to speak at a meeting and found myself being interrogated at the check-in by a young woman about my case, its contents, and recent history. She seemed a bit more laid back than most, so I decided to ask a question that had intrigued me for some time. “Tell me”, I said leaning forward confidentially, “has anyone ever admitted that they were actually carrying a bomb in their case?” She gave me a tired smile, so perhaps my question was not as original as I had thought, and said, “I know it sound stupid, but it’s the way people answer that’s important. Not just what they say. We do get training.” I remember being given a hard time a couple of years ago when trying to leave Israel. I had two things against me. The first was that I had a British passport issued in Milan. I managed to explain this before being hit by the big one—“You were born in the Soviet Union”, accused the guy behind the desk. “That’s news to me!” I replied. Even at 0600h, a Glaswegian cannot be bullied. “Look” he said, flourishing my open passport, “it says you were born in Glasgow”. He pronounced it Glasgow to rhyme with cow. Eventually, I managed to convince him. This event set me thinking about different approaches to security. All branches of science have areas that
I
can be divided into either “high-tech” or “low-tech”, but I have always been interested in a third category, which I call “no-tech”. The scanner to measure blood flow in the eye is obviously high-tech, whereas radiography machines are low-tech, but I believe there is also a role in security for no-tech. My first experience of this approach took place many years ago in the Middle East. Even then the border between Iran and Afghanistan was a bit tricky, since some people were trying to smuggle drugs out of Afghanistan and get them to the west. At that time, Iranian customs used a beautifully simple technique. The customs officer asked the traveller a series of questions about his habits and, if he was suspicious or unhappy about the frankness of the answers, he smiled, then simply raised his right hand and placed it on the chest of the traveller right over the heart. If it was pounding, the guy was taken off for what we shall simply call “more detailed investigations”. Now, that’s low-tech at its best. I was also reminded of this approach shortly after my Vienna visit when I got an e-mail from a Russian I had met at the meeting. We had been talking about the differences between East and West and he told me a story that highlights their different philosophies, as well as underlining the very pragmatic nature of the Russian mind. It seems that during the space race in the 1960s and 1970s, the Americans found that the pens of their astronauts pens did not work in space because the ink did not flow properly in zero gravity. They invested several million dollars into developing a new form of pen that delivered the ink in gel form and worked well in space. When the Russians encountered this problem they simply switched to pencils! David Jack
THE LANCET • Vol 360 • September 7, 2002 • www.thelancet.com
For personal use. Only reproduce with permission from The Lancet Publishing Group.
LIFELINE Sandeep Jauhar Sandeep Jauhar grew up in a family obsessed with news. Before going to medical school he was an AAAS Mass Media Fellow at Time Magazine in Washington. During medical school at Washington University he worked for the St Louis Post-Dispatch. He writes regularly about medicine for The New York Times. On Sept 11 and 12, 2001, he was among the physician volunteers at the World Trade Center. Who was your most influential teacher, and why? My father, because he taught me the therapeutic value of work. Which patient has had most effect on your work, and why? The psychotic ICU patient who invited me into her room “for a drink” at 0300 h when I was on call at the beginning of my internship. She inspired me to start writing about some of my hospital experiences. What would be your advice to a newly qualified doctor? Keep a diary—hospital will never be as interesting as it is during internship. How has your view of the USA changed since Sept 11? No-one could have imagined the attacks; like Sputnik, they forced all Americans to expand very rapidly their sense of what was possible. But like Sputnik, the attacks have created an environment in which people often seem to confuse possibility with probability. If you had not entered your current profession, what would you have liked to do? Acting or film direction, but as a child my biggest aspiration was to become the chief nuclear arms-control negotiator for the US government. What is the least enjoyable job you’ve ever had? Washing up at the local pizza joint at high school, the only job I was ever fired from, because I refused to clean the dishes with a hose. Where were you in your sibling order, and what did you gain or lose as a result? The middle child, which forced me to claw and manipulate for my parents’ favour. Do you believe in monogamy? Yes, but it’s a losing proposition for most species.
810
High-tech, low-tech, or no-tech? am interested in the latest airport security systems that are being developed in the wake of the attack on the World Trade Center. One new system uses a device that scans the area around the eyes to monitor the blood flow there. It seems that when we are telling lies there is a pronounced rise in blood flow in this region. Presumably, if it passes its trials we can all look forward to waiting in queues to be grilled by security staff while someone shines some sort of beam in our eyes. Not long after the events of Sept 11, 2001, I was flying to Vienna to speak at a meeting and found myself being interrogated at the check-in by a young woman about my case, its contents, and recent history. She seemed a bit more laid back than most, so I decided to ask a question that had intrigued me for some time. “Tell me”, I said leaning forward confidentially, “has anyone ever admitted that they were actually carrying a bomb in their case?” She gave me a tired smile, so perhaps my question was not as original as I had thought, and said, “I know it sound stupid, but it’s the way people answer that’s important. Not just what they say. We do get training.” I remember being given a hard time a couple of years ago when trying to leave Israel. I had two things against me. The first was that I had a British passport issued in Milan. I managed to explain this before being hit by the big one—“You were born in the Soviet Union”, accused the guy behind the desk. “That’s news to me!” I replied. Even at 0600h, a Glaswegian cannot be bullied. “Look” he said, flourishing my open passport, “it says you were born in Glasgow”. He pronounced it Glasgow to rhyme with cow. Eventually, I managed to convince him. This event set me thinking about different approaches to security. All branches of science have areas that
I
can be divided into either “high-tech” or “low-tech”, but I have always been interested in a third category, which I call “no-tech”. The scanner to measure blood flow in the eye is obviously high-tech, whereas radiography machines are low-tech, but I believe there is also a role in security for no-tech. My first experience of this approach took place many years ago in the Middle East. Even then the border between Iran and Afghanistan was a bit tricky, since some people were trying to smuggle drugs out of Afghanistan and get them to the west. At that time, Iranian customs used a beautifully simple technique. The customs officer asked the traveller a series of questions about his habits and, if he was suspicious or unhappy about the frankness of the answers, he smiled, then simply raised his right hand and placed it on the chest of the traveller right over the heart. If it was pounding, the guy was taken off for what we shall simply call “more detailed investigations”. Now, that’s low-tech at its best. I was also reminded of this approach shortly after my Vienna visit when I got an e-mail from a Russian I had met at the meeting. We had been talking about the differences between East and West and he told me a story that highlights their different philosophies, as well as underlining the very pragmatic nature of the Russian mind. It seems that during the space race in the 1960s and 1970s, the Americans found that the pens of their astronauts pens did not work in space because the ink did not flow properly in zero gravity. They invested several million dollars into developing a new form of pen that delivered the ink in gel form and worked well in space. When the Russians encountered this problem they simply switched to pencils! David Jack
THE LANCET • Vol 360 • September 7, 2002 • www.thelancet.com
For personal use. Only reproduce with permission from The Lancet Publishing Group.