Reviews of Everyday Things – A Conference

Part of the academic education is supposed to be about developing a critical eye for things. You should finish a PhD able to wrap your brain’s sulci around an experience or some sort of argument and arrive at a reasoned assessment of its many elements. Or at least an ability to drop sulci into a sentence I guess.

This faculty could just be employed while actively pursuing academic work or engaging in a mental wrestle with a Rob Schneider anti-vaccination rant. Job done you could sink in to the other experiences of life, relieved of the need to exercise your brain in any way.  A bit like when you watch a Rob Schneider movie.

[OK, we can both spot the flaws there. Obviously you don’t require any more brain flexing to demolish a Rob Schneider anti-vax rant than to watch one of his movies. And no one is watching one of his movies. Let’s leave the multiple fails behind and move on.]

Developing a critical eye shouldn’t be confined to desk time. Following a principle I’m sure someone on an infomercial has already turned into a wodge of money-making glibness, why not train that brain during the experiences of every day? What can you learn from examining every experience in disorienting detail?

So to a review of a conference, because academic life will be full of them, and I might as well learn from them.

The Conference Location

This conference was a gathering of anaesthetists. What’s the collective noun for a group of anaesthetists? A slumber, maybe? It’s a generalist audience run by the Australian Society of Anaesthetists. This time around it was run up at Darwin which has a lot of things going for it. Not least of those was a bit of bonus summer.

That said the Top End is supposed to have a reputation for fringe-dwelling extremes of experience. Scheduling the welcome event at a place called “Crocosaurus Cove” certainly had potential. So to end the night without a crocodile being led through the crowd on a lead was, honestly, a bit of a let down. I bet they wouldn’t let you down like that in Vegas.

In fact there wasn’t really anything particularly ‘out there’. It was just a place with an excellent vibe. Disappointing.

The Content

If a week or so later you can’t really suggest if it was a good conference for the academics bit, what does that say? Some of that is a result of the fact that my particular bit of anaesthetics is a niche, so it doesn’t get so much space on a program. In fact all of the things actually related to kids’ anaesthesia pretty much fell at the end of the conference.

There were a couple of standout sessions though. Some of those related to the quality of the keynote speaker (a bit more on that below). The reason they were standouts though is that a lot of the sessions felt pretty ‘standard’. The thing is I don’t quite understand why medical types don’t seem to make the link that if you made your standouts pretty much what all of the talks were like, everyone would benefit.

None of it is rocket surgery either. Most of it is reflected in things I’ve put elsewhere. But for an updated version, there were a few things that stood out:

1. Do Less

It’s never clear to me if the problem with those talks where people try to summarise all of time, space and the spirit world in their talk ended up there all by themselves or felt compelled because of a topic they were handed. Those talks that stood out generally did less though. They had a single point to get across and they made it stick.

2. Don’t Bury the Big Bit

One of the talks I went to from a really clever and excellent person was a review of all of a topic. They stuck to a structure. That structure was something like “Here is the landscape of this topic. Here is the stuff we were always told. Now I will walk through why that is all almost exactly unchanged. This will take some time. Oh, and in the last 90 seconds I will mention a genuinely new bit of something that didn’t use to be ranked as highly as those old things but will actually change your practice.”

The thing that will change everyone’s practice isn’t the afterthought. That’s a highlight.

3. Don’t Apologise

In one talk, a speaker actually said “I’m sorry you can’t actually read this slide because of all the details on it.” Don’t apologise for that slide. Ditch it.

It seems like there’s only a couple of explanations for leaving a slide like that in. One is that the speaker feels they need it as some form of support. Putting up something I can’t read doesn’t support my positive impression of the speaker. The other is that rather than digest it themselves and turn it into something useful the audience can take away, they took the shortcut.

Don’t say sorry thanks.  Just fix it.

4. The Extras

This might seem a really small point but some of the little traditions should be allowed to slowly wheeze out their existence in the corner. Like the conference bag. Most people who make their way to a conference probably have access to a bag they could use. They are unlikely to need a bag of dubious quality extensively branded with the logo of a meeting that was anything but the planning and simultaneous launch of the first manned Mars mission.

Enough with the shoddy extras that don’t need to be extras. Ditch the bags. Human people can probably adapt. And didn’t Darwin teach us that those predisposed not to adapt will just become extinct? No? That’s a complete misrepresentation? Let’s move on anyway.

Here's that amazing little text - couldn't be better.

Here’s the amazing little text by John West – couldn’t be better.

5. The Legend

I wrote once before about all the things ways John West impresses me.  All too often you shouldn’t meet a hero. Not this time.

He is 86. He needed some questions repeated. He doesn’t walk so fast. And he was endlessly patient and engaging. People would come up and mention a topic and he’d latch on and ask them to e-mail more information. There’s more than a few people in the game that could learn from that example.

Then there were his talks. In a time where everyone with a TED fetish thinks that’s where the history of presentations started could have done with seeing this. He told stories. He showed the personal within the science. He didn’t rely on dot points. He surprised.

All those other people didn’t invent the rules of presenting. There were good people already doing it.

Oh wait. Yes it can.

Oh wait. Yes it can.

The critique? Some bits were good. Even the talking to people bits. Some bits were just as ‘meh’ as other conferences. There’s at least a few of those items that could be fixed by clearer direction and support from organisers. But it’s clear that changing the template for conferences is a bit like turning an ocean liner with a kayaker’s paddle.

Which coincidentally is in the plot of the next very unfunny Schneider flick.




Lessons from ‘Not the John West who Rejects’

Everyone loves new stuff. Superhero movies have clearly found new ways to spawn. There are teams all over the world working on new ways to restore vision. Of course there’s new Coke I guess. Maybe not all new things are great.

There’s sometimes focus from people in the online space about the great examples of new medicos and researchers out there doing things in what seems like new ways. Communicating in new ways. Open access. Taking up new opportunities.

The thing is sometimes I’m not sure any of this is new. It’s just clever people using the means available to them that weren’t available to generations of particular clever people before. There are plenty of examples of people who have been around a long time who already showed the way in a manner that looks very familiar.

Which gives me the chance to mention a personal favourite of mine that most people don’t know: John B West.

Not the Fish Guy

This particular John West is probably pretty much known to medical types and not many others. That’s because he is responsible for a tiny little book which pretty much covers all of the physiology of breathing. But more on that later.

To understand why John West provides so many inspiration points for a lowly researcher slogging away at a PhD, it’s worth knowing a little of his CV.

He started out in Adelaide way back in 1928. Obviously I wasn’t around but I’ve been to Adelaide and I am pretty confident it wasn’t a huge city back then. It’s certainly pretty low key now.

While in Adelaide he picked up his undergraduate medical degree (back in 1952). He headed across to London to work and casually picked up a PhD in 1960 (he’d already picked up his MD in 1959).

The 1960’s led him to find a new height to climb – a bit literally actually. He joined an expedition to the Himalayas with some Hillary guy to be one of the trip physiologists. Posts in Buffalo and back in London followed then he spent 1968 with the NASA Ames Research Centre in California. One year later, in 1969 he joined the faculty at the University of California at San Diego as professor of medicine and physiology.

He headed up a trip to Everest in 1981 and was chairman of the Science Verification Committee for Spacelab 4 in 1983 for NASA.

And along the way he knocked out a classic of the medical literature: his respiratory textbook.

I’ve actually left out huge slabs of his achievements, posts and awards.

As a novice researcher, I take a glance at this guy who wrote one of my favourite physiology nerd books and pretty quickly think ‘well that can’t be done’.

And it might not be possible to match him as a researcher because a) he’s obviously very good at it; and b) he hasn’t been doing so much of the clinical work near as I can tell.

There’s still a bunch of things to inspire a young researcher though and plenty of them pretty much mirror things I’ve learned from people who impress me from slightly more contemporary times.

So here follows a list of lessons not to reject from John B West:

1) There’s more than one way forward

It can be easy to think there’s only one path to a research career. And while the landscape might have changed, John B West describes his research training as “extremely haphazard”, further adding “in terms of formal research training I grew like Topsy”. This is reassuring if say, you end up trying to learn how to do research in prehospital helicopter work.

2) Get out and try stuff

West went to London as a doctor partly to see the world. Being in London bumped against the Postgraduate Medical School doing respiratory research. There happened to be the first cyclotron designed for medical research just opening. Getting out there got him somewhere he didn’t necessarily plan.

3) Find teams

The breathing guy further describes the team around London as providing “a very stimulating intellectual atmosphere with chemists, physicists, and engineers all working in the same unit”. Maybe it’s the team around you and the stimulation they offer that can really drive you. No man is an island of heaving lung tissue etc. etc.

He really isn't the fish guy. But hear is a majestic bear anyway.

He really isn’t the fish guy. But here is a majestic bear running with a salmon anyway.

4) Take up chances

It’s hard to know when they might strike and it’s probably easier to say ‘yeah … nah’ than ‘sure’ but serendipity can work out sometimes. West: “I happened to be sitting next to someone at a meeting of the Physiological Society in England who told me of plans for the Himalayan Scientific and Mountaineering Expedition, which was to take place in 1960 and 1961. At that time I had no special interest in high altitude but was selected by Sir Edmund Hillary to go as one of the physiologists, and the expedition was a great success… I helped make the first measurements of maximal oxygen uptake at an altitude of 7,440 m on Mount Makalu.” He would later end up leading a team to Everest in the early ’80s and describing the first measurements of oxygen uptake at the summit. That was a pretty good chance to take way back in 1960.

5) Be generous

John West could probably sit on his laurels and relax a little now. Played hard. Done good. That sort of stuff. He could probably spend his time turning a buck from his accumulated knowledge and expertise too. Yet back in 2011 he posted a series of lectures covering his accumulated wisdom on respiratory physiology online. Look, you can go and watch right here.

This is actually a pretty generous thing to do. Sharing his knowledge as much as possible probably gives it more of a chance to get out and help more people too. It’s enough to make me forgive the awful title music. And even the bow tie.

6) Don’t waste a word

Well, this one is aspirational rather than something I can claim I do. I fling words around like a toddler with confetti at a wedding. A long time ago the good Prof. West condensed his encyclopaedic knowledge of all things breathing into a text. It’s still the best text out there on matters respiratory. And it’s small. Not much over 150 pages.

If you actually sit down and read it though, every page is packed with profound stuff. When I finished my anaesthesia training my copy was so chewed up I replaced it. It’s shiny.

Really shiny.

Really shiny.

The Rest

Actually I don’t know the rest. I’m still getting things from this guy. And I’ll still be getting things from him for a while yet. Even in person. Because John B West, who must be around 87 years old is keynote speaker at a conference in Australia this year. He’ll be telling the crowd about research up on Everest. And maybe wearing an awful bow tie even though it’s Darwin.

Still getting out there at 87. I may not take his example on work-life balance.



A lot of the stuff about John B West’s career came from this profile at the American Physiological Society site. Oh, yeah. He was President of that group too.

The image of the bear with the salmon is from flickr’s Creative Commons area under CC 2.0. It was posted by Lake Clark National Park and is here in an unaltered form.



Avoiding First Impressions

When you write stuff to put out in the broader world of the net everyone knows you don’t read the comments. For that way madness lies.

The same rules don’t entirely apply to the rest of life. If your doctor has constructive feedback on your health, you might want to listen. When your lawyer has timely comments, you should probably take it on board. Presenting at work? You probably shouldn’t finish by putting on the headphones and listening to sick beats.

Researchers get the same reality dealt out every time a grant comes around. Don’t read the comments? What a shining dream.

The one thing you can do is not go with your first impressions. The thing with first impressions is that they are frequently unkind. And if you’ve decided to go down the grant route (and with local success rates heading to 10% or so, some have given up) you have to get past that.

Still, there’s at least a little bit of you that needs to take a few minutes to vent the things you’d really say, before you do the editing. Because the comments always seem the same on first impression.

Sample Comment 1: “Why did you not choose to do your methodology in all of the following ways that if I had read your proposal in any detail I would have realised you have already included in your methodology?”

Really? You read it? [By Orzel and via]

Really? You read it, right? [By Orzel and via]

First response:

“Do you like that Escher guy? You know that genius who made all those artworks specially designed for the front of fridges where things go around and around in circles and you don’t know where it begins and ends or where the fish become birds? I don’t know why but your comment made my brain hurt just like that.”

The edited response:

“Assessor 1 has some suggestions for methodology suitable to address the key aims. We agree that many of these are highly suitable and point to our similar methodology on proposal pages …”

Sample Comment 2: This project addresses an entirely novel and innovative concept. Do the researchers have preliminary data establishing the role of this technique?

You know my ears used to stand up before I started reading this. [via]

You know my ears used to stand up before I started reading this question. [via]

First response:

“To be honest you’ve hit on the real project we’re working on in the shed out the back. What we’re actually working on is the DeLorean from Back to the Future. That way, once we sort the flux capacitor, it would make sense to suggest that it would be easier to get this grant money to develop preliminary data if we had already procured the preliminary data for which we’re seeking the grant money.”

Edited response:

“This project will deliver the initial data to enable future high value research as outlined in the proposal on page 9, paragraph 4.”

Sample Comment 3: This technology is unproven in the clinical context as it is unknown if it correlates with underlying pathology in a reliable manner. The proposal is for prospective blinded research. Wouldn’t it be better to just let clinicians treat using this technology?

Imagine this is a photo of me in a vast wasteland representing your insight. I am exactly this impressed. [via]

Imagine this is a photo of me in a vast wasteland representing your insight. I am exactly this impressed. [via]

First response:

“You had me at ‘the technology isn’t proven yet’. But then you suggested we should send this device out as some sort of random number generator out to clinicians and just let them have a swing at treating patients in the absence of any guidance as to what those numbers might actually mean or what changing them might do. And at that point I was distracted by the sound of an ethics fairy sawing off its own wings with piano wire and now I don’t know what to say.”

Edited response:

“This project will establish reliable associations between the information provided by this technology and the clinical condition of patients. While this will facilitate future research to directly influence treatments, it is too early to take this step.”

Sample Comment 4: This team has a range of clinicians mixed in with the team which is valuable to the project. It is noted that those members of the team do not have significant publication profiles.

Don't underestimate how much I want to use this flipper claws on you. [via]

Don’t underestimate how much I want to use these flipper claws on you. [via]

First response:

“I have this dream where I’m riding a magnificent uni-turtle (I call it a uni-turtle because it’s sort of like a turtle but it has a single horn) and the weird bit is that I’ve never seen the uni-turtle before but it has my Mum’s name tattooed on its little tail. Do you have dreams? Wait, I know you have dreams because you’re obviously thinking of a magical land where people can work full-time looking after patients to get to the point where they usefully contribute practical knowledge to stuff like this, while also churning out the same number of publications as a full-time researcher.”

Edited response:

“Each member of the team contributes unique skills to ensure this project can be completed.”


Time and Reality

The thing is you don’t want to say any of these for another reason. Once you get past the first impression, the assessors usually have a point. My (very) limited experience is that the quality of the comments usually reflects the proposal. The assessors mostly seem to take their work pretty seriously. There’s a point to the review and they have to report.

And at times when we put more and more time in with less hope of success, you do your best to answer the comments in the 2 pages you get.

But at least for one day you can enjoy the idea of all the things you wish you could say.


Back to Africa

So we’re off again. To deepest darkest Africa (of course not, that’s not really a thing) to work on little kids’ hearts. Except this one is the same, same but different version. Tanzania, not Rwanda. Less of us, more of the local team. Via Doha, not Jo’burg.

And so it starts with the glamour. The airline food.


Stop. It's too much.

Stop. It’s too much.

I have this memory of an interview with Sir David Attenborough, the man whose voice must accompany all nature documentaries. (That is a serious statement. All future documentaries should come with an Attenborough special voiceover feature.)

I’m pretty sure it was with an Australian interviewer, and he asked the great speaker of breathy wonderments for a top travel tip. His number one? “Treat food as fuel.”

And so it is.

He then demonstrated the value of this motto. With a tale of a dish of honour prepared in a village utilising fish innards, grandmother’s spit and the encouragement of three days of high, hot sun.

Maybe airline food is easy.

So while I digest, what are the preparation steps this time around?


Step 1: Get the Aim Right

Rwanda is a trip to provide a whole service. Tanzania is a trip to support a new service. We return to support a team aiming to develop their own paediatric cardiac surgery service. However long that takes.


So less pace. More time making sure the local guys who don’t get to do this regularly run the show as much as possible. The aim, even more than the last trip, is maximum support and education where we can help.


Step 2: Get the Gear

The team travelling to Tanzania last time left some gear. We still need gear. So those of us setting out from Sydney are carrying stuff. It is quite important not to forget the stuff. It also means I have a limit on packing for myself. Particularly if you like to take at least two torches, a bit of medical kit and drum sticks. Because you never know when drumming will be necessary.

Probably a different type of peanut

Probably a different type of peanut


Step 3: Go to the Dentist

Seriously. I didn’t want to be stuck in Tanzania with a dental annoyance. So I went on this day of the flight. I am very pleased. I also included a haircut in essential preparation steps. It’s in the “beggars can’t be choosers” style book, but still.


Step 4: Learn About the Place

I have a whole lot of flight time and I don’t know that much about the destination apart from the nasty burrowing bugs in the still waters (no schistosomiasis thanks), how to name the thing mauling you in Swahili if it’s a lion and that the mainland bit used to go by Tanganyika before hitching up with Zanzibar.


I actually travelled there in 1998 so I remember a few things. Mostly the bit where the guy on the boat told my then girlfriend (now wife) he’d be an open door if my portal became less appealing. Not cool dhow guy.


Step 5: Fly like a Researcher

That’s right I’m supposed to be doing a PhD and stuff. Every time I see a researcher online talking about plane travel they mention the many hours of uninterrupted work that stretches across the ocean in front of them.


I will endeavour to copy them. Until I check the movies then all bets are off.


And so onward. It’s only 30 hours of travel before I get to fall asleep in the team meeting.

Rabbit season, duck season, grant season

There are some things that can’t be explained in just a few words. The influence of burn injuries on postjunctional nicotinic acetylcholine receptors. Parthenogenesis. Adam Sandler’s continuing movie career.

Then of course there’s the unremitting slog of seeking grant money as a researcher. In the last little bit of time, Australian researchers have been immersed in big competitive grants season. I guess it’s something like the big football season but with slightly less need for ice baths.

I’ve been here before and had help from several monkeys (unfortunately not the requisite 1000 genetically manipulated ones) too. The nature of a relatively stand alone project is that you need to look for money to support it wherever you can. That means lots of grant applications. For one success. So now that I’ve had a few weeks to recover, is there anything different about the experience this year? And are there animals other than monkeys to learn from?

1. Focus on First Impressions

The first time around I spent an awful lot of time on the 9 pages of the grant proposal. I spent less time on the opening synopsis and selecting the particular subgroups for labelling the project. This was probably a bit to do with being overwhelmed by trying to learn the game.

What I hadn’t appreciated is how important that synopsis is in framing how the rest of the project will be considered. Or that from early in the piece the groups that will vet the project are decided on the basis of the groupings you choose. So the opening impressions got a lot more work this time around.

You want to inspire respect, right?

You want to inspire respect, right?

2. Coherence

This was actually something that had featured before but was a really significant bit of the feedback I got again on external review. Every bit of the application has to support key themes. For this project, we don’t struggle to show it’s a new idea. What we do need is to show the aims we’ve got will get us to the bigger goal of the project and how the individuals in the team are vital to delivering those aims so we can get back to that overall goal. Every bit of the application feeds back into the rest of the application. It’s a bit like one of those mind-bending Escher drawings.

It all needs to line up in a way that makes sense.

It all needs to line up in a way that makes sense.

3. Show What You Can Do

One big difference this time around is that we have actually done stuff. We can do it. We can actually take a monitor to accident scenes and get data. So the biggest change in the application this year was to actually show this off. Because now it doesn’t look quite as much as a project based on “we have this crazy idea that we can do new monitoring on people after accidents with a computer and a helicopter”. It’s more like “we DO this crazy thing where we take a computer in a helicopter and monitor people at accidents.” Preliminary data feels like a big addition. It also proves we can work together as a team.

If you've proven you can do stuff, show you can do stuff.

If you’ve proven you can do stuff, show you can do stuff.

4. It’s Still for the Old Timers

I worked at this grant. I worked quite hard at it. And I learned things. But that is probably where the benefit of it will end. The simple truth is that our number 1 investigator (not me, naturally) is considered a newbie under NHMRC rules. That’s got a lot to do with the fact he also does clinical work, and that whole looking after patients bit doesn’t put enough wins in the positive column to make up for less publications.

The estimate emerging from the NHMRC is that the overall success rate will fall to 12% this year. The further projection is that by 2017 there’ll be less than 480 project grants awarded (down from 731 in 2012). The age of the investigators given the grants keeps going up. The number of applicants is also rising.

Our chances weren’t helped by rules limiting applications from one of the members of the team who is truly world class as a researcher. And I might understand the logic in limiting, but it’ll probably kill our submission.

The system still rewards those with ancient research DNA in them.

They lurk, waiting. With their scale-encased eye of Sauron surveying the scene. (OK, that's a little unfair.)

They lurk, waiting. With their scale-encased eye of Sauron surveying the scene. (OK, that’s a little unfair.)

5. Find Someone Who Thinks a Bit Like You, But Better

Deep inside a project it can be pretty easy to see many glorious details of the trees but not the forest. Or the hills surrounding the forest. Or the roads to get there.

This time I had the benefit of a pro reader and checker who kept helping all the way to the deadline. Having someone (in my case the excellent @gillianscott07) with an understanding of research professionally reviewing what you’ve done and spotting all the structural issues obscured by the bloodshot red of your eyes is invaluable.

That anyone would spend their time sharing the pain of an application that isn’t their own is baffling and amazing. Really.

Someone who can look at things a bit like you, but who is not you.

Someone who can look at things a bit like you, but who is not you.


So 3 weeks later I am almost free of facial tics and I’ve stopped turning door handles 5 times before I walk through a door. The application is better this time. I even made it to the list of real investigators in the paperwork.

But it probably won’t get up.

And next week I’ll start my next application. Because there’s no order in “Rabbit season, duck season, grant season”. It’s just always grant season. And the researchers are mostly in the firing line.


A note about the images in this post:

It occurred to me I let this post out before I’d sorted the attributions for the images. All of these images were available on flickr via their creative commons section and are covered under variants CC 2.0. None of the images have been altered in any way.

The original sharers were:

The Lion with a Bad Hair Day – Dawn Ellner

Zebra Up Close – svenwerk

The Panther Chameleon – ponte1112

Crocodile Eye – Dennis

Mirror Squirrels – Marko Kivelä

Doing Research That Might Not Work

When I was a little guy I thought research science type people were pretty much all about power. Big hair, white coat, potions that bubble and a maniacal laugh. That was the cardboard cutout version of a science person I would have pinned on my wall.

Then I got a tiny bit older and got a tiny bit more of a clue and I realised that mostly these science people who do research were on a mission to discover massive things that would change everything about everything. Or at least everything about one thing. It seemed like something as cool as magic that wasn’t actually magic. Well, I did say it was a tiny bit more of a clue.

Decades later and I find myself trying to do research and I finally understand more that researchers are generally just people trying to answer questions. In a way that involves a bit of method to get you there. And that also involves all the magic of repeatedly walking into a rake.

And that occasionally means researching stuff that might not work.


Simple Questions

Just in case you haven’t read all the background on this research project (I’m guessing that’s everyone) it’s about brains and lights.

It started with an observation. Whether I’m doing work in prehospital medicine or helping kids snooze at the hospital I am very interested in the brain. When we go to accidents in particular we see our fair share of people who have injuries to the brain. This is a big deal.

With minor injuries to the brain, it might well be that you are briefly unwell and then you recover. Some brain injuries leave you with permanent problems in just about any function you can name. Speech, thought, movement, sensation, anything.

What might be less obvious is that the injury doesn’t just happen when your head gets rattled. The injury triggers off evolving processes that can be worsened significantly by further insults over the following period. Things like low oxygen or not enough blood flow to tissues or too much pressure in the head.

So when we are looking after these patients you can probably imagine we’d like to make sure we give the brain all the things it wants to start healing (or at least not keep getting worse) as quickly as possible. We put as many monitors as we can on to do this. Strangely, this doesn’t include anything to look at the bit we care so much about – the brain.


Before My Time

Back in 1977, a researcher by the name of Franz Jöbsis described a technique where you could shine a light through brain tissue, look at the light that made it out the other side and figure out stuff about the levels of oxygen and metabolism happening deep in that brain tissue. This was the start of tissue spectroscopy.

Sounds like the perfect fit for the problem, right? So why isn’t this standard 38 years later? Well actually there’s all sorts of challenges that held it up.

For starters, Jöbsis first tried it out on cats. Cat lovers might tell you many things about the miraculous brilliance of those brains but it is fair to say they are smaller than humans. So in humans what we tend to do is shine light into the brain tissue and pick up what bounces back. But it doesn’t all bounce back.

Picture it like this. You give a big group of squirrels a whole lot of speed (well this analogy is struggling already). Then you release them into the woods and tell them to come back and tell you what they saw. Some will just head in and come pretty much straight back and tell you their story. But some of them run and never stop running (well just imagine how twitchy a squirrel on speed would be). And some bounce off 10, 20 or 30 trees in all directions before they finally stumble back with their own unique story about the woods. Now you have to put all the stories together and say something sensible about the bit between the trees. Messy.

Is he pre or post stimulants? Who can tell? [Photo by Corey Seeman via flickr and shared unchanged under CC 2.0]

Is he pre or post stimulants? Who can tell? [Photo by Corey Seeman via flickr and shared unchanged under CC 2.0]

And that’s part of the reason it has taken so long to figure out what to do with that technique from Jöbsis. To get to here we’ve ended up using devices that use particular different wavelengths of light in the near-infrared range which have been tested under different conditions so we hopefully know a bit about how the light is absorbed and reflected in the tissues (how many squirrels come back and how many run). Most systems then display a number between 0% and 100% which is supposed to tell you a bit about the oxygen delivery and use under the sensor.

But even that isn’t that simple. There are different manufacturers, and each one tries to figure out how best to do it slightly differently so you can’t really directly compare any of them. And they won’t tell you exactly how they do it.

And the number between 0 and 100%? Well it’s not really measured against a gold standard. They make some assumptions there too. Plus you’re only sampling a small area so what about the rest of the brain?



Trying Things

So why bother? Well we’re going to try something slightly different and see how we go. For starters, we won’t be using the sensors on a single site, but a couple of sites on the head and a comparison sensor checking circulation in the body to try and put more information together.

More importantly we’re not just going with the number. Part of the analysis will look at the number that’s all about oxygen stuff, as well as another one that’s about how much blood is in the area. But it will look at the patterns in how these change in all 3 spots over time and compare them to the other observations we already take. Because if there’s hope for this monitoring to show something new, it would seem like the best bet is to think that it might pick up a change as it is happening, rather than relying on a single number not tested against any real gold standard.

And that might work. Or it might not and that would be absolutely fine. There are already companies out there telling people these monitors add vast amounts of knowledge to managing a brain injury. That’s not really true. But they have to sell units and saved brains sound like a pretty good story.

Of course it might just work and tell us new things about what is happening in the brain in real time. Which would be fairly sensational since we could then start figuring out how to treat patients using that information to hopefully stop all those evolving injuries. And less brain injuries would mean more people getting back to the lives they planned.

Or we might find something cool that’s unexpected and that would be a bonus. It’s just as likely though that the story from the speed-addled squirrels will be pretty confusing and we’ll find it’s not useful. Which would also be a great result since ruling something out of the calculations still brings us closer to finding things that work and not exposing patients to things that don’t.

So now there’s one more challenge if I’m to use this post to inspire me back into it. We don’t have squirrels in Australia.

Going Back to School for an Education

I have had some surprising invitations in my day. A traditional healer in Zimbabwe once invited me to try her herbal Viagra out. There have been invites to celebrations that required very specific dress codes that could probably only be satisfied by visiting dark corners of the internet. They were just about topped by an invite to hang out at Brooklyn Public School for their science fair.

Why so surprising? Well, I don’t really have any link to Brooklyn (even the Sydney one) beyond an under 10s game of cricket that went pretty well and getting engaged on a nearby river a while ago. On top of that, I don’t really count myself as much of a scientist. I’d like to be able to develop some researching skills, but there’s something about failing to get grants, generate much data or publish life changing papers that makes me think I have a way to go. But then you bug someone who is quite an impressive scientist (who you can find as @DrBrocktagon on Twitter) and someone else falls through and before you know it you’re a fallback option.

The Welcome Mat

The Welcome Mat

Having said yes to doing a presentation, I had a few things to face up to. Anyone will tell you not to work with kids and animals. I assume it’s fear of unpredictability that drives that saying, though I would usually laugh at such balderdash when armed with a large array of controlled substances. The great thing about tackling a different audience is it gives you a chance to re-examine how you communicate ideas. There have been other posts where I’ve mentioned some thoughts on presentations (like here and here and here) but I can’t think of a time when I’ve been able to chat to a bunch of kids. So while some stuff was the same, there were a few lessons that I think will probably make me PhD better.

1. Re-examining What You Do

A new audience gives the chance to view what you do through the eyes of another. When wrestling with the reluctant vagaries of data collection or sinking in the latest grant rejection, it’s easy to feel like the project that once excited you might not be that great. Figuring out which bit to talk about when you can say “actually we’re flying on helicopters to see what shining light into people’s brains might tell us” is a great way to re-engage with the cool stuff that got it all rolling.


2. Less is More

One of the reasons kids can be confronting is they so often hit us with honesty more than we are used to. There’s no agenda, they’ll just make it painfully obvious as they suck the oxygen from the room with yawning mouths that you are boring. The aim here was to cover three things – what is science/who is a scientist, stuff we do at work and how that involves sciencey stuff. Even that was kind of a bit. Maybe 3 ideas was even too much.


3. Kids are Naturals

Spend a day chatting about science stuff with kids and it’s really obvious that for lots of kids science is a natural fit. They have a natural curiosity that seeks ways to understand the world around them. Even more impressive was the rigour of their application of a methodology to answer their questions. Here’s an example – one pair wanted to see if shoe size was related to height. So they sat at a ferry stop and got about 60 people to shed their shoes and get measured. They recorded all the data, and displayed it in all its glory, as well as dividing height by foot length to see if there was a consistent relationship. Then of course there was the guy who did multiple tests of different-sized paper ninja stars to check their flight characteristics. Or the youngster who pursued behavioural testing in dogs. More than 50 dogs on a beach.

Data is so much of the story. Seriously inspiring.

That's a lot of smelly feet to get near.

That’s a lot of smelly feet to get near.

4. There Are Uses for Laser Pointers

It is not for pointing at screens. Really great for demonstrating the interaction of light with interfaces though. Plus lasers.


5. Flexibility is an Expectation

Not because you’ll find yourself competing in long forgotten schoolyard games in a winner takes all fashion. I hope. Let’s say though that you plan to use a toy to demonstrate helicopter flight. Then you end up in a  room with multiple fans directly over the heads of the kids. Probably best not to be too committed to anything.


6. Audience Testing

Beyond the usual practice, for a chat to kids I highly recommend testing the material out on kids in advance if you have some handy amenable to spending a few minutes (or amenable to a bribe to do that). I had an easy option in three gents aged 7, 5 and 2. The 7 year old was right into it. The 5 year old gave up a decent number of laughs. The 2 year old went and hid in a box. You can’t please everyone I guess.


7. The Unplanned Bit is the Best Bit

The talk was fun but by far the best bit was the questions afterwards. Partly because it showed some kids listened to the stuff I said and they came up with questions. But we also covered anaesthesia, pilots, who I like best on the helicopter, helmets, brain injuries, how incredibly old I am and the worst injuries I’ve come across. It was particularly excellent.


How did it go? Somewhere between having the kids so excited they mobbed me and squeezed so hard an eye popped out like an old stuffed toy and throwing small paper projectiles from boredom (although there were ninja stars handy). It was not just the best talk I’ve had the chance to be a part of any time I can remember, it genuinely reinvigorated my enthusiasm for my own project. A few years in to this part time PhD, that was a lesson I needed to revisit.