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The Quest For Wonder Special Features – Episode 3

After hard day’s questing for Wonder with his puppet pal Professor Brian Cox, puppet Robin is left with a few questions.  So after each episode he’s taking time to video chat with one of our Cosmic Genome scientists.

The Quest For Wonder Episode 3 Subscriber Exclusive

Medicine with Dr Kevin Fong

Robin: Hello Kevin Fong, X-rays seem like a pretty big deal in medicine, how important were they?

Kevin: Well, X-rays are a huge deal because they kind of suddenly turned doctors into superheroes; they gave them…they literally gave them X-ray vision, they gave them the ability to see inside the human body for the first time.  Up until then doctors had just had to kind of work out what was going on inside your body just from the way it felt from the outside and the way it sounded from the outside and what they could see, so it was really like guesswork.  But when X-rays first came in, this whole new world opened up and new ways of finding illness and finding injury opened up and that just made us better doctors, just that technology.

At the start when we first used X-rays, they were best for looking at what we call the hard tissues and hard tissues are exactly as they sound, stuff that is hard, so, like bones.  And that’s because the bones are very good at stopping the X-rays: when you look at an X-ray of your arm, or your skull, what you're seeing is the shadow, really, the shadow cast by the bones on the plate of film behind it as the X-rays pass through soft tissues, they don't really pass so easily through your bones and hard tissues.

Actually, though, we’ve come up with better and better ways of using X-rays, and nowadays we are very clever at using computers to reorganise the pictures, to take the X-ray pictures and to sort of build them up into a more complete picture so that actually these days you can take an X-ray picture of the heart, and of other softer tissues, but you have to use a computer to add up lots of different pictures from around the body to give you those pictures.  So, you're right, X-rays are best at looking at hard tissues, but using computers now we can even see softer tissues, so like the heart, like the liver, like the kidneys, all those other structures.

Robin: But aren't they dangerous? 

Kevin: Well, do you know what, X-rays in the way that we use them as doctors are extraordinarily safe, and the reason that they're safe is because doctors specialising in the use of X-rays and the use of other radiation and scientists have carefully, carefully worked out what dose of X-rays you can receive without it doing you any harm and letting you get all that benefit without any real risks.  But X-rays, like everything, and I mean everything else in life, are a thing that…too much of it can be bad for you and so we have to get the doses right, but that’s the job of the scientists and the engineers and the doctors who are using them, so it’s a tiny, tiny risk but we get rid of that risk by having specialists who know exactly how to use them so that you can get all the benefit from them.

Robin: See, Brian is very scared of scissors, I have to do all his scissoring for him.  So, how far has surgery come in the last hundred years, because no-one’s scared of scissors anymore, apart from Brian.

Kevin: Well, puppet Robin, I think Brian’s right to be scared of you and your scissors, scissors can be dangerous, but surgery isn't anywhere near as dangerous as it used to be, it’s come on in leaps and bounds in the last hundred or so years and that’s not actually really because of the surgeons so much, it’s actually because of other things that have to happen to allow you to do surgery.  So if you want to have big surgery, you've got to have an anaesthetic, and in the last century or so anaesthetics have got much, much safer, so that’s what I do, I’m an anaesthetist, and what I do as part of my job is give people some medicines to send them to sleep so that whilst the surgeons do their surgery, they're completely asleep, unaware, comfortable and they don't feel anything.

Now that used to be a very dangerous thing to do at the start of the 20th century, so about a hundred years ago, but again scientists were able to design better medicines, safer medicines, to send you to sleep and remove a lot of that risk and so today it’s really, really really safe to have an anaesthetic in a hospital  and so that risk of surgery has kind of gone away.   That’s probably the most important thing that made surgery safer. There are other things as well, of course, there are things like antibiotics that prevent infection after the surgery, and surgeons themselves have got a bit better, but most of it is the stuff that happens around surgery rather than the surgery itself.

Robin: In the olden days, no-one was very old, why have we got more old people now?

Kevin: Ah, now, this is one of the great myths: that people didn't really get old in the olden days.  Actually, it is true that the average life expectancy - so the average age people could expect to get to - was quite low at the start of the 20th century, it was as low as your 30s or 40s, but that was only the average: there were still old people around but it was just [that] an awful lot of people would die early in their lives.  Now the thing that killed them early in their lives was infection, so it was things like…things that you take for granted today, so like measles, mumps, rubella and other infections like that, and that’s because there was no defence against these very serious infections that children were particularly vulnerable to, and what science did for us there was create two things really, it discovered antibiotics - so a set of medicines that could fight infection - and also very, very importantly, vaccination. 

Now vaccination is a way of giving you a substance that boosts your body’s immunity to these infections; so if you have a vaccination for measles then that means that you are protected from that infection and therefore you can’t die from that infection, and that invention, innovation, transformed medicine forever, it meant that no longer did we have thousands and thousands of children who had received these vaccinations die from these preventable diseases, and it’s one of the great miracles of medicine in the last hundred years or so.

Robin: What are your favourite medical inventions?

Kevin: One of my favourite developments in medicine comes back to the X-rays, actually, and that’s because the thing that makes the modern world feel so special and so advanced is computer technology, and one of the places in medicine where we can make computers really work for us is in improving the quality of the pictures that we take of human bodies with X-rays and other methods and so…a long time ago all we had were these flat images, the sorts of images you will have seen of broken bones, but now we can build these very beautiful colour pictures of the whole human body, and not just flat two dimensional pictures but 3D pictures that you can rotate, we can navigate our way around the body and it makes all of medicine look much more like a really, really advanced computer game.  And indeed today that means that the way that doctors can help you, help get you better, becomes much more like those really advanced video games that you play at home.  A lot of our doctors, when they help people, are using these advanced graphics that are built on top of these X-ray images to find their way around the body, find the bit that they need to either remove or repair, and so for me I love that because computers coupled with what was X-ray technology make medicine feel like the stuff of science fiction today, and it makes us much better at making you better.

Robin: Is there any sort of medical advancement that could give me legs? I just want to run.

Kevin: Well that’s a good question; in fact, even there, science, technology and engineering are helping us.  There are some very clever people who've taken what they understand in the world of robotics and managed to make that work alongside the human body so that people who have very sadly lost their legs because of injury or illness can now be given the chance to have legs that they can control and get to work.  All this stuff’s quite early on in its development but its really getting there and, you know, we hope as we go forwards, this stuff, which again when I was growing up, we used to watch science fiction programmes about people with robotic limbs, hopefully in the future what was science fiction will become science fact, I’m very sure it will.

You can get Kevin’s book Extremes: Life, Death and the Limits of the Human Body here or rematch his Christmas Lecture series How to Survive in Space here.

Watch all episodes of The Quest For Wonder here.