- Email: [email protected]
Misled by moonshine
DISSECTING ROOM
JABS & JIBES
LIFELINE Arturo Morillo
Who was your most influential teacher? Cosimo Ajmone-Marsan introduced me into research and was to me a living example of intellectual honesty. Which research paper has had most effect on your work? My paper with Dennis Baylor on spinal input to the midbrain reticular formation. The findings showed how a hypothesis had become accepted as fact without experimental support. How do you relax? Listening to music, watching people’s behaviour, not looking at myself in the mirror. What is your greatest regret? Not having been able to pursue a full-time research career. What alternative therapies have you tried? I have never tried such therapies. I’m scared! What is your favourite book? My favourite book is my own life. It teaches me a lot about myself and everybody around me throughout my stay on this planet. I’m working on writing about it. What is your favourite journey? A journey along the Sinu river in Colombia, when I was a 5th year medical student. It was on the December vacation period and I practised medicine among the campesinos. I was shocked by the lack of a sense of future for their lives, the way they were exploited, and the overwhelming frustration of not seeing a solution. What is your greatest fear? Not being afraid of anything. What is your worst habit? I have the feeling that the way I look at people makes them uncomfortable. I can’t help it.
1218
Misled by moonshine he moonless nights are noisy. Under the stars Lake Malawi has brighter floating lights. Tilley lamps today; in the past they burnt brushwood on the dugouts. The light attracts shoals of “usipa”, small sardine-like fish. The fishermen’s powerful voices then call other canoes to cast their large fine mesh nets. Standing in these unstable craft they haul huge catches to the surface and empty them into the canoes. The next day, the bamboo drying racks and the rocks around the bay are covered with silver. The technique does not work when the fish are misled by moonlight, and then we sleep peacefully. The owl calls, the insects strum, and the waves lap the sand. Once in a while the headlights of the hospital LandRover light up the trees. Soon after, a voice will call and a message will be handed through the reed fence. One such occasion announced the arrival of Shem, 28 years old. He had fallen from his bicycle Usipa drying and was taken, semiconscious, to a mission hospital 60 miles away. That was 8 days previously, and he had been recovering well until the day before, when he developed weakness of his left arm and leg and almost continuous fits. He was then transferred to the government district hospital beside the lake, where I work for part of the year. The operating theatre was soon set up by the clinical officers. They do most of the basic medicine in the country, including anaesthesia and routine surgery such as caesarean sections and hernia repairs. Working long hours for modest pay, they do a good job in poor circumstances. There are only nine trained surgeons for a population of 11 million. They work in the three central hospitals, the nearest being over 250 miles away. A hammer and chisel had to be used to make a small opening in the right side of the skull. A large intravenous cannula was passed under the dura,
T
and old blood was aspirated. The next day he was talking and moving his arm. A week later he alarmingly demonstrated his recovery by doing press ups. In a few days he was home, returning to hawking, among other things, dried usipa. His village water borehole no longer works. Lack of spare parts or maintenance, or a lowered water table, are the usual reasons. However, the stream is half an hour away, or rather it used to be there for the women and girls with buckets on their heads. Nowadays, it only runs for part of the year. Essential tree cutting by the increasing population has decreased the flow, and the village higher up is taking more than it used to. For many, food is short, and stunting of the increasing number of children is common. Perhaps stunting is an advantage in times of scarcity, less food and water being required. Urgent efforts to promote free primary schooling are hampered by the shortage of books and classrooms. Blackboards under trees, with 70 children around the teacher, are a common sight. Where do they go in the rains and would a British class of that size be as attentive and quiet? One in ten, if they are lucky, will go on to secondary school, but with slim prospects of a suitable job. The beautiful land is overused and the lovely lake is overfished. Trees are being cut increasingly to burn the bricks for aided development projects such as building primary schools. One local politician wisely said “as long as our birth rate grossly exceeds our death rate, poverty alleviation is a non-starter”—a rarely heard view. International donor campaigns promote child survival, safer motherhood, and clean water, without realistic emphasis on population restraint. Must we be misled by moonshine? Michael King
Arturo Morillo studied at the Universidad Javeriana Medical School, Bogotá, Colombia. He headed the department of physiology and was dean of medicine at Javeriana. From 1991 to 1996 he was executive director for INCLEN. He is currently at Javeriana as an assistant for research management and promotion to the academic Vice-Rector.
Michael King
THE LANCET • Vol 351 • April 18, 1998
JABS & JIBES
LIFELINE Arturo Morillo
Who was your most influential teacher? Cosimo Ajmone-Marsan introduced me into research and was to me a living example of intellectual honesty. Which research paper has had most effect on your work? My paper with Dennis Baylor on spinal input to the midbrain reticular formation. The findings showed how a hypothesis had become accepted as fact without experimental support. How do you relax? Listening to music, watching people’s behaviour, not looking at myself in the mirror. What is your greatest regret? Not having been able to pursue a full-time research career. What alternative therapies have you tried? I have never tried such therapies. I’m scared! What is your favourite book? My favourite book is my own life. It teaches me a lot about myself and everybody around me throughout my stay on this planet. I’m working on writing about it. What is your favourite journey? A journey along the Sinu river in Colombia, when I was a 5th year medical student. It was on the December vacation period and I practised medicine among the campesinos. I was shocked by the lack of a sense of future for their lives, the way they were exploited, and the overwhelming frustration of not seeing a solution. What is your greatest fear? Not being afraid of anything. What is your worst habit? I have the feeling that the way I look at people makes them uncomfortable. I can’t help it.
1218
Misled by moonshine he moonless nights are noisy. Under the stars Lake Malawi has brighter floating lights. Tilley lamps today; in the past they burnt brushwood on the dugouts. The light attracts shoals of “usipa”, small sardine-like fish. The fishermen’s powerful voices then call other canoes to cast their large fine mesh nets. Standing in these unstable craft they haul huge catches to the surface and empty them into the canoes. The next day, the bamboo drying racks and the rocks around the bay are covered with silver. The technique does not work when the fish are misled by moonlight, and then we sleep peacefully. The owl calls, the insects strum, and the waves lap the sand. Once in a while the headlights of the hospital LandRover light up the trees. Soon after, a voice will call and a message will be handed through the reed fence. One such occasion announced the arrival of Shem, 28 years old. He had fallen from his bicycle Usipa drying and was taken, semiconscious, to a mission hospital 60 miles away. That was 8 days previously, and he had been recovering well until the day before, when he developed weakness of his left arm and leg and almost continuous fits. He was then transferred to the government district hospital beside the lake, where I work for part of the year. The operating theatre was soon set up by the clinical officers. They do most of the basic medicine in the country, including anaesthesia and routine surgery such as caesarean sections and hernia repairs. Working long hours for modest pay, they do a good job in poor circumstances. There are only nine trained surgeons for a population of 11 million. They work in the three central hospitals, the nearest being over 250 miles away. A hammer and chisel had to be used to make a small opening in the right side of the skull. A large intravenous cannula was passed under the dura,
T
and old blood was aspirated. The next day he was talking and moving his arm. A week later he alarmingly demonstrated his recovery by doing press ups. In a few days he was home, returning to hawking, among other things, dried usipa. His village water borehole no longer works. Lack of spare parts or maintenance, or a lowered water table, are the usual reasons. However, the stream is half an hour away, or rather it used to be there for the women and girls with buckets on their heads. Nowadays, it only runs for part of the year. Essential tree cutting by the increasing population has decreased the flow, and the village higher up is taking more than it used to. For many, food is short, and stunting of the increasing number of children is common. Perhaps stunting is an advantage in times of scarcity, less food and water being required. Urgent efforts to promote free primary schooling are hampered by the shortage of books and classrooms. Blackboards under trees, with 70 children around the teacher, are a common sight. Where do they go in the rains and would a British class of that size be as attentive and quiet? One in ten, if they are lucky, will go on to secondary school, but with slim prospects of a suitable job. The beautiful land is overused and the lovely lake is overfished. Trees are being cut increasingly to burn the bricks for aided development projects such as building primary schools. One local politician wisely said “as long as our birth rate grossly exceeds our death rate, poverty alleviation is a non-starter”—a rarely heard view. International donor campaigns promote child survival, safer motherhood, and clean water, without realistic emphasis on population restraint. Must we be misled by moonshine? Michael King
Arturo Morillo studied at the Universidad Javeriana Medical School, Bogotá, Colombia. He headed the department of physiology and was dean of medicine at Javeriana. From 1991 to 1996 he was executive director for INCLEN. He is currently at Javeriana as an assistant for research management and promotion to the academic Vice-Rector.
Michael King
THE LANCET • Vol 351 • April 18, 1998