This Medical Life

Seasonal influenza causes significant morbidity and mortality every year but can often fall into the underestimated category. Between 10-30% of the general population are infected each year with influenza that leads to an increase in hospital and intensive care unit admissions, the onus for prevention and early intervention has never been more important. Our special guest is Associate Professor Paul Griffin from the School of Medicine at the University of Queensland and is an Infectious Disease Specialist at Mater Health. This is the story of influenza.See omnystudio.com/listener for privacy information.

In 1998, a 6 page report published in the Lancet that would later be described as one of history’s great science frauds. The article was titled “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive development disorder in children” but the news headlines ran with a much shorter version: the MMR vaccine causes autism. The article was written by Andrew Wakefield, a British gastroenterologist turned researcher, who had taken it upon himself to deceive the medical community and general population at large. Fortunately, investigative journalist Brian Deer uncovered the truth behind this ‘study’ through hard work, significant obstacles and persistence. Although Wakefield’s claims have been thoroughly discredited, we still feel the impact of this fraud to this day and he has become an icon of the anti-vax movement. Our special guest is Brian Deer who is an award winning investigative journalist and bestselling author for The Doctor that Fooled the World, published in 2020. This is the story of the MMR vaccine fraud.See omnystudio.com/listener for privacy information.

In 1834, Robert Graves gave a lecture series on the ‘Newly observed affection of the thyroid gland in females’. He presented three women who had violent palpitations, enlarged thyroids, and an apparent enlargement of the eyeballs (later it would be called ‘exophthalmos’). In 1912, Hakaru Hashimoto reported a new disease in a German journal after examining microscopically the thyroid tissue from four middle-aged women. He noted the lymphocytic infiltration and likened it to other conditions containing lymphocytes (ie. Sjögren syndrome) and named it ‘Strum lymphomatosa’. It would not be until the 1950s that the underlying mechanism of these diseases would be known: autoimmunity. The former, now known as Graves’ disease, and the latter Hashimoto disease are the most common causes of hyperthyroidism and hypothyroidism respectively. Our special guest is Dr Daman Langguth who is an immunology and Head of the Immunology Department at Sullivan Nicolaides Pathology. This is the story of autoimmune thyroiditis.See omnystudio.com/listener for privacy information.

Since recorded history, heartburn has been a common complaint and the descriptions from ancient physicians are virtually indistinguishable from today’s accounts. However, one thing we do know that they did not is a small subset of patients whose long standing heartburn could predispose them to a precancerous condition known as Barrett oesophagitis. Barrett oesophagitis is caused by chronic gastro-oesophageal reflux disease with a number of known risk factors for developing this. These patients require regular monitoring +/- intervention as they have an increased rate of developing oesophageal adenocarcinoma. For this episode we have called in some specialists to help us out. Our guests include: Dr Tristan Rutland – Anatomical Pathologists who specialises in Gastrointestinal Pathology Dr Milan Bassan – Gastroenterologist who is Head of the endoscopic department at Liverpool Hospital This is the story of Barrett Oesophagitis.See omnystudio.com/listener for privacy information.

Professor Ian Frazer pioneered the development of the first Human Papilloma Virus (HPV) vaccine which has seen a reduction of HPV infections in young women between 70-86% and the incidence of cervical cancer rates drop by 90%. Few doctors/scientists have had such a profound impact on the health of so many people. Today we talk to Professor Ian Frazer about his career, the events leading up to the HPV vaccine development, and the future of this life-saving medicine. Some of Professor Ian Frazer awards include: Australian of the Year (2006) Prime Ministers Prize for Science (2008) The Balzan Prize (2008) Fellow of the Royal Society of London (2012) Companion of the Order of Australia on the Queen’s Birthday Honours list (2013) Immunology research department named the Frazer Institute at the University of Queensland This is the Story of Professor Ian Frazer and the development of the cervical cancer vaccine.See omnystudio.com/listener for privacy information.

In 1964, a young woman was murdered as she walked to her apartment in Queens, New York. Her screams were left unanswered. No one came to her help. Within the space of thirty minutes, the assailant would return two more times to stab her again and again. The woman died. The number of witnesses to this crime who did not help was: 38. Two psychologists posed a question: how could this happen in such a heavily populated city? Two other landmark studies occur around this time including the Milgram experiment and the Stanford prison experiment. Two experiments that range from insightful to controversial. However, all of these have captured the attention of psychologists and students, and helped us to learn more about ourselves. If nothing else, the latter certainly taught how one should not conduct a psychology study. These are some of the stories of psychology from the 60s.See omnystudio.com/listener for privacy information.

In 1912, Merck Pharmaceuticals was searching for a blood clotting agent to compete with a competitor in the market. One of the agents, a chemical by-product (and not even named) was produced and patented without any significant testing. This was a drug that we would come to know as MDMA or Ecstasy. In the 1960s, this drug found it’s way into use by a Chilean psychiatrist for psychotherapy, Dr Claudio Naranjo. He found that it helped patients to open up, it intensified emotions, gave access to suppressed memories, and provided insights. In the 1970s and 1980s, the recreational use of MDMA became prevalent but also became a focus in the war on drugs with both political and scientific powers advocating strongly against its use. Today, the experimental studies confirm that MDMA is very useful in a controlled medical setting for the use of patients suffering from Post-Traumatic Stress Disorder (PTSD). Our special guest is Dr Stephen Bright who is a clinically-trained psychologist, senior lecturer at Edith Cowan University, researcher into psychedelic science and co-founder of Psychedelic Research in Science & Medicine (PRISM), an Australian non-profit research association that supports formal research into psychedelics such as primarily MDMA. There is additional information for GPs about MDMA posted. This is the story of Ecstasy.See omnystudio.com/listener for privacy information.

The medicinal properties of aspirin (acetylsalicylic acid) have been well-documented for hundreds of years. It seems even our ancient ancestors thousands of years ago had some insight into its healing properties even if the usage was misguided. We are still learning about aspirin and the best ways to use it. Our special guest is Professor Simon Dimmitt, a Physician in General and Cardiovascular Medicine. He has released a website providing evidence-based prescribing for Doctors. This is the story of Aspirin.See omnystudio.com/listener for privacy information.

A continuation of Episode 30. In this episode, we discuss the continued management of patients with Breast Cancer and the BRCA pathological variant. Our special guests: Associate Professor Nick Murray who is a Medical Oncologist and Director of the Medical Oncology Unit at the Royal Adelaide Hospital Cancer Services Dr Eryn Dow – Medical Oncologist and Clinical Cancer Geneticist It is important to note that while Breast Cancer is the most common cancer in women, the discussion of BRCA and familial breast cancer accounts for ~10% of cases. This is a complex disease that we are learning about every day and with the remainder of Breast Cancers accounting for 90%, it is a topic we will be revisiting in the future. This is the continued story of BRCA.See omnystudio.com/listener for privacy information.

In 1866, a French physician by the name of Pierre Paul Broca recognised a terrifying disease running through the women of his wife’s family: breast cancer. He wrote that they could be well and have perfect health before this ‘germ’ of an illness would go off like an ‘explosion’ and could kill within 1 to 2 years. Broca studied his family for the next 30 years where he noted that 15 close relatives including his wife’s mother, his wife, and his daughter were all affected. It would not be until the late 20th century that our knowledge and scientific techniques would lead us to understand this phenomenon. Professor Mary-Claire King in the late 1980s helped to identify the genetics of the BReast CAncer gene and continued research identified another. Today we know these as the BRCA1 and BRCA2 genes. Unfortunately, women who have these BRCA gene mutations have an increased risk of breast and ovarian cancer (plus some others). The nature of this disease spans multiple specialities and, as such, we have some special guests for this episode to help us understand this disease, the treatment, and the management of this illness. This is the story of BRCA (Part 1). Our special guests for Part 1: Professor Graeme Suthers – National Director of Genetics for Sonic Pathology Australia Doctor Melissa Bochner – Breast and Endocrine Surgeon and member of BreastSurgANZ and current chair of the Breast Cancer Quality AuditSee omnystudio.com/listener for privacy information.