- Email: [email protected]
Of mice and men
Media Watch
Books Of mice and men “There are myriad ways to fail. You could fail to get a job; you could experience equipment failure, a failure of communication, a failure of nerves; you could fail to get funding. Your advisor could be stolen by another university and you could be orphaned, displaced, and dispossessed. Your lab could move and your animals die, or refuse to breed, or suffer post-traumatic stress. You could pick the wrong project in the wrong place, or the right project at the wrong time.” Welcome to the world of biological research, (outlook seems a little cloudy). The excerpt is taken from Allegra Goodman’s Intuition, an elegantly written and uplifting tale set in the laboratories of an impoverished cancer research unit. The story begins in the wintry depths of 1985. At the Philpott Institute, fictional neighbour to Harvard University (Boston, MA, USA), Cliff Bannaker is investigating whether a variant of respiratory syncytial virus (RSV) could target cancer cells and revert them back to healthy ones. Intoxicated by dreams of success he ignores his supervisors’ instructions to put an end to the project. “The point is, RSV does not work”, jabs laboratory director Sandy Glass, before once again demanding that the stubborn scientist fall into line. But when the experimental mice are next examined, a handful show up with vastly diminished tumours. Cliff’s star has risen, and the exultant Sandy, sniffing a muchneeded fundraising opportunity, turns over the entire laboratory to follow up his research. Cliff thinks of his sudden good fortune as his due. After all, had he not nurtured the virus, defied his superiors, and resisted attempts to pressgang him into other, muddleheaded experiments? He ecstatically beholds a lifeless but gloriously cancer-free mouse: “all his hours in the lab…all the care and ambiguity and blood involved with tumour models in live mice—all that seemed like nothing now as he looked at the normal, healthy corpse before him. Here was the way forward. Here was the human body writ small”. Of course, such lofty perspective is the preserve of the blessed. Co-opted into Cliff’s research, his colleagues, including girlfriend Robin Decker, must put aside their studies and content themselves with serving the greater good. “Please be happy for me”, Cliff whispers to Robin. There is little chance of that. Unwillingly but inevitably enveloped by envy, balking at the injustice of it all, and feeling marginalised and undervalued, Robin becomes increasingly resentful of her younger boyfriend—“this was like being drafted to join a war effort” she sourly reflects—and eventually ends their relationship. But she has spotted something at the laboratory, an inconsistency with Cliff’s notes, a flouting of certain procedures. http://oncology.thelancet.com Vol 7 November 2006
Could he be manipulating his results? How tempting it must be to exchange the uncinematic drudgery of research, the painstaking accretion of knowledge, the dogged narrowing down of data, for the no less timeconsuming pursuit of effortless glory. Co-director Marion Mendelssohn dismisses Robin’s concerns, sharply aware of her questionable motives. Obstinately convinced of her righteousness, Robin leaves the institute and commences a lengthy struggle to uncover the truth. The endeavour rapidly gathers momentum. Soon enough Sandy’s moral crusade is appropriated by carpet-bagging politicians and grudge-bearing former scientists, overshadowing her grandstanding efforts to publicise Cliff’s findings. Meanwhile Cliff himself slips quietly off stage; Goodman doesn’t want him revealing his hand until the story has played out. A highlight of Intuition is biologist Xiang Feng’s idiosyncratic phrasing. His amused colleagues compile a lexicon entitled Fungi: “analyse: to flounder; hypothesis: highly flawed thinking; breakthrough: artefact”. But most apposite is the definition for experiment: “a series of humiliations”. Goodman acutely explores the tension between normal human reactions and the work of science: “a scientist was, by definition, impassive. He cut his losses and moved onto something else…a scientist did not allow emotion to govern his experiments.” But Sandy, Robin, and Cliff are driven entirely by emotion, each propelled to their fate by their irresistible nature. Marion, the true scientist, finds herself swept along by the tidal flow of Sandy’s impassioned designs, blindsided by the machinations of all those around her. Then there’s the wider picture. Sandy is subpoenaed to appear before a government committee. ”Let me ask you this”, the chairman sneers “if your research project is private, then why do you accept public funding for it?” Society entrusts scientists with answering vital and urgent questions and, of course, the scientist must remain accountable. But accountable to whom? His fellows, both competitors and allies, or agenda-driven politicians? (The hearing is the novel’s weakest section, the narrative’s smooth contours jarringly interrupted by a bizarre confrontation between Sandy and the chairman. Goodman’s descriptive energy rarely flags but her dialogue can be hit and miss.) Also in the offing is an understated debate on the complicated interplay between art and science. Sandy’s teenage daughter Kate reads a Francis Bacon essay to a bemused Cliff: “slow down”, he interrupts “so truth is a pearl—and what was the diamond again?” Often, Cliff does not seem to be a scientist at all, if anything, he seeks
Intuition Allegra Goodman Dial Press, 2006 £13·30 (US$25·00, €20·00) pp 344 ISBN 0 385 33612 8
899
Media Watch
the transcendence of great art (that Bacon’s first attempts at essay writing ended life crumpled up and tossed on the fire is a fact that would undoubtedly escape the impatient young man). Intuition on Marion and Sandy: “best of colleagues, they remained best of friends, creators of a rare world unto themselves, a peaceable kingdom where the lion might lie down with the leopard (Marion was no lamb)”. Here,
surely, is a passage to sum up the novel: the witty and uncomplicated prose style, the compassionately rendered characters, and the pleasing literary allusion. In literature too, there are myriad ways to fail. Ms Goodman has sidestepped all of them.
Talha Burki [email protected]
Management of lung cancer
Lung cancer therapy annual 5 Heine H Hansen (Ed) Informa Healthcare, 2006 £55·00 (US$13·55, €81·70) pp 224 ISBN 0 415 38024 3
This book offers a well-coordinated, self-contained update on developments in recent published work, and how this information affects the day-to-day management of patients with lung cancer. The text is easy to read and accessible to anyone interested in this subject, from respiratory nurse specialists to doctors in training, and knowledge of the previous annuals is not needed. The introduction by Heine Hansen sets the scene, with emphasis on the dominant role of cigarette smoking in lung cancer. Here, he reinforces the health warnings against smoking and provides evidence that “it is never too late to stop smoking as there is always a health gain by quitting”. The book then goes on to cover epidemiology, biology, early detection and screening, staging and prognostic factors, and the treatment of non-small-cell lung cancer, small-cell lung cancer, and mesothelioma. Every chapter contains key references, which help further in-depth study. Highlights of the Lung Cancer Therapy Annual 5 are the chapters on screening, staging, staging procedures and prognostic factors, and the treatment of non-small-cell lung cancer, which summarise well the recent work and interest in these areas. Results of completed and ongoing lungcancer screening trials are discussed and the American Cancer Society (Atlanta, GA, USA) recommendations on informed decision making for lung cancer screening are given. The difficulty in the discrimination between benign
and malignant processes, and the use of PET are reviewed, as are prognostic factors, which are nicely subdivided into anatomical and non-anatomical factors. The chapters on treatment emphasise the need for disease-specific specialists and discuss the increasing multimodality approach used in the treatment of lung cancer. This book also reviews the use of surgery, radiotherapy, and chemotherapy, either sequentially or concomitantly, in selected groups of patients. Additionally, new and more targeted agents are discussed. However, patients in clinical trials are not representative of the general patient population—those in North America could differ substantially from those in the UK, for example. The main problems with this book are because of space constraints, such that some sections are slightly indigestible, and some controversial themes are not fully developed— eg, the role of adjuvant chemotherapy. However, these sections are referenced sufficiently for the interested reader. In summary, this book is a useful and informative read on lung cancer, and can be read on its own without reference to previous annuals, updating the reader on advances in lung cancer and providing background epidemiological data on incidence and survival.
Tariq Sethi [email protected]
Web Medical school on demand Before Aazaz Haq jumps into the shower each morning, he connects his video iPod to his computer to download the previous day’s lectures at the University of Michigan Medical School, Ann Arbor, MI, USA. Recently, the topic was lung cancer histology, and the second-year medical student memorised the differences between squamouscell carcinomas and adenocarcinomas while making himself a smoothie and walking to class. For Haq and his classmates, lectures on podcast—a digital audio or video file that can be downloaded 900
automatically onto a computer or MP3 player—are turning medical school into an on-demand and on-thego pursuit. About 10% of medical schools in the USA and Canada use some form of podcasting to distribute lectures, and up to a quarter will adopt the technology within the next year, predicts Morgan Passiment, director of Information Resources Outreach and Liaison at the Association of American Medical Colleges, Washington, DC, USA. The trend is spreading outside North America as well. http://oncology.thelancet.com Vol 7 November 2006
Books Of mice and men “There are myriad ways to fail. You could fail to get a job; you could experience equipment failure, a failure of communication, a failure of nerves; you could fail to get funding. Your advisor could be stolen by another university and you could be orphaned, displaced, and dispossessed. Your lab could move and your animals die, or refuse to breed, or suffer post-traumatic stress. You could pick the wrong project in the wrong place, or the right project at the wrong time.” Welcome to the world of biological research, (outlook seems a little cloudy). The excerpt is taken from Allegra Goodman’s Intuition, an elegantly written and uplifting tale set in the laboratories of an impoverished cancer research unit. The story begins in the wintry depths of 1985. At the Philpott Institute, fictional neighbour to Harvard University (Boston, MA, USA), Cliff Bannaker is investigating whether a variant of respiratory syncytial virus (RSV) could target cancer cells and revert them back to healthy ones. Intoxicated by dreams of success he ignores his supervisors’ instructions to put an end to the project. “The point is, RSV does not work”, jabs laboratory director Sandy Glass, before once again demanding that the stubborn scientist fall into line. But when the experimental mice are next examined, a handful show up with vastly diminished tumours. Cliff’s star has risen, and the exultant Sandy, sniffing a muchneeded fundraising opportunity, turns over the entire laboratory to follow up his research. Cliff thinks of his sudden good fortune as his due. After all, had he not nurtured the virus, defied his superiors, and resisted attempts to pressgang him into other, muddleheaded experiments? He ecstatically beholds a lifeless but gloriously cancer-free mouse: “all his hours in the lab…all the care and ambiguity and blood involved with tumour models in live mice—all that seemed like nothing now as he looked at the normal, healthy corpse before him. Here was the way forward. Here was the human body writ small”. Of course, such lofty perspective is the preserve of the blessed. Co-opted into Cliff’s research, his colleagues, including girlfriend Robin Decker, must put aside their studies and content themselves with serving the greater good. “Please be happy for me”, Cliff whispers to Robin. There is little chance of that. Unwillingly but inevitably enveloped by envy, balking at the injustice of it all, and feeling marginalised and undervalued, Robin becomes increasingly resentful of her younger boyfriend—“this was like being drafted to join a war effort” she sourly reflects—and eventually ends their relationship. But she has spotted something at the laboratory, an inconsistency with Cliff’s notes, a flouting of certain procedures. http://oncology.thelancet.com Vol 7 November 2006
Could he be manipulating his results? How tempting it must be to exchange the uncinematic drudgery of research, the painstaking accretion of knowledge, the dogged narrowing down of data, for the no less timeconsuming pursuit of effortless glory. Co-director Marion Mendelssohn dismisses Robin’s concerns, sharply aware of her questionable motives. Obstinately convinced of her righteousness, Robin leaves the institute and commences a lengthy struggle to uncover the truth. The endeavour rapidly gathers momentum. Soon enough Sandy’s moral crusade is appropriated by carpet-bagging politicians and grudge-bearing former scientists, overshadowing her grandstanding efforts to publicise Cliff’s findings. Meanwhile Cliff himself slips quietly off stage; Goodman doesn’t want him revealing his hand until the story has played out. A highlight of Intuition is biologist Xiang Feng’s idiosyncratic phrasing. His amused colleagues compile a lexicon entitled Fungi: “analyse: to flounder; hypothesis: highly flawed thinking; breakthrough: artefact”. But most apposite is the definition for experiment: “a series of humiliations”. Goodman acutely explores the tension between normal human reactions and the work of science: “a scientist was, by definition, impassive. He cut his losses and moved onto something else…a scientist did not allow emotion to govern his experiments.” But Sandy, Robin, and Cliff are driven entirely by emotion, each propelled to their fate by their irresistible nature. Marion, the true scientist, finds herself swept along by the tidal flow of Sandy’s impassioned designs, blindsided by the machinations of all those around her. Then there’s the wider picture. Sandy is subpoenaed to appear before a government committee. ”Let me ask you this”, the chairman sneers “if your research project is private, then why do you accept public funding for it?” Society entrusts scientists with answering vital and urgent questions and, of course, the scientist must remain accountable. But accountable to whom? His fellows, both competitors and allies, or agenda-driven politicians? (The hearing is the novel’s weakest section, the narrative’s smooth contours jarringly interrupted by a bizarre confrontation between Sandy and the chairman. Goodman’s descriptive energy rarely flags but her dialogue can be hit and miss.) Also in the offing is an understated debate on the complicated interplay between art and science. Sandy’s teenage daughter Kate reads a Francis Bacon essay to a bemused Cliff: “slow down”, he interrupts “so truth is a pearl—and what was the diamond again?” Often, Cliff does not seem to be a scientist at all, if anything, he seeks
Intuition Allegra Goodman Dial Press, 2006 £13·30 (US$25·00, €20·00) pp 344 ISBN 0 385 33612 8
899
Media Watch
the transcendence of great art (that Bacon’s first attempts at essay writing ended life crumpled up and tossed on the fire is a fact that would undoubtedly escape the impatient young man). Intuition on Marion and Sandy: “best of colleagues, they remained best of friends, creators of a rare world unto themselves, a peaceable kingdom where the lion might lie down with the leopard (Marion was no lamb)”. Here,
surely, is a passage to sum up the novel: the witty and uncomplicated prose style, the compassionately rendered characters, and the pleasing literary allusion. In literature too, there are myriad ways to fail. Ms Goodman has sidestepped all of them.
Talha Burki [email protected]
Management of lung cancer
Lung cancer therapy annual 5 Heine H Hansen (Ed) Informa Healthcare, 2006 £55·00 (US$13·55, €81·70) pp 224 ISBN 0 415 38024 3
This book offers a well-coordinated, self-contained update on developments in recent published work, and how this information affects the day-to-day management of patients with lung cancer. The text is easy to read and accessible to anyone interested in this subject, from respiratory nurse specialists to doctors in training, and knowledge of the previous annuals is not needed. The introduction by Heine Hansen sets the scene, with emphasis on the dominant role of cigarette smoking in lung cancer. Here, he reinforces the health warnings against smoking and provides evidence that “it is never too late to stop smoking as there is always a health gain by quitting”. The book then goes on to cover epidemiology, biology, early detection and screening, staging and prognostic factors, and the treatment of non-small-cell lung cancer, small-cell lung cancer, and mesothelioma. Every chapter contains key references, which help further in-depth study. Highlights of the Lung Cancer Therapy Annual 5 are the chapters on screening, staging, staging procedures and prognostic factors, and the treatment of non-small-cell lung cancer, which summarise well the recent work and interest in these areas. Results of completed and ongoing lungcancer screening trials are discussed and the American Cancer Society (Atlanta, GA, USA) recommendations on informed decision making for lung cancer screening are given. The difficulty in the discrimination between benign
and malignant processes, and the use of PET are reviewed, as are prognostic factors, which are nicely subdivided into anatomical and non-anatomical factors. The chapters on treatment emphasise the need for disease-specific specialists and discuss the increasing multimodality approach used in the treatment of lung cancer. This book also reviews the use of surgery, radiotherapy, and chemotherapy, either sequentially or concomitantly, in selected groups of patients. Additionally, new and more targeted agents are discussed. However, patients in clinical trials are not representative of the general patient population—those in North America could differ substantially from those in the UK, for example. The main problems with this book are because of space constraints, such that some sections are slightly indigestible, and some controversial themes are not fully developed— eg, the role of adjuvant chemotherapy. However, these sections are referenced sufficiently for the interested reader. In summary, this book is a useful and informative read on lung cancer, and can be read on its own without reference to previous annuals, updating the reader on advances in lung cancer and providing background epidemiological data on incidence and survival.
Tariq Sethi [email protected]
Web Medical school on demand Before Aazaz Haq jumps into the shower each morning, he connects his video iPod to his computer to download the previous day’s lectures at the University of Michigan Medical School, Ann Arbor, MI, USA. Recently, the topic was lung cancer histology, and the second-year medical student memorised the differences between squamouscell carcinomas and adenocarcinomas while making himself a smoothie and walking to class. For Haq and his classmates, lectures on podcast—a digital audio or video file that can be downloaded 900
automatically onto a computer or MP3 player—are turning medical school into an on-demand and on-thego pursuit. About 10% of medical schools in the USA and Canada use some form of podcasting to distribute lectures, and up to a quarter will adopt the technology within the next year, predicts Morgan Passiment, director of Information Resources Outreach and Liaison at the Association of American Medical Colleges, Washington, DC, USA. The trend is spreading outside North America as well. http://oncology.thelancet.com Vol 7 November 2006