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Robin Warren, pathologist who rewrote the science on ulcers, has died

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Re: Robin Warren, pathologist who rewrote the science on ulcers, has died

#51

Post by cbsmith »

tombert wrote: post #38
taeric wrote: post #36

Earlier quoted context omitted.

This is the poster example I use for how dramatically information can change within our lifetime. I still encounter people that are unaware that most of the "stress causes ulcers" was just wrong.

It certainly matters more in medicine, where you have very serious risk of causing people pain, but as I've gotten a bit older I've become a lot more sympathetic to people having trouble keeping up with the world sometimes. Like, it's not a good excuse, don't get me wrong, but as much as I try, I simply cannot keep up with the entire state of the art of computer science. I wish I could, and a younger me without a fam…

> Like, it's not a good excuse, don't get me wrong, but as much as I try, I simply cannot keep up with the entire state of the art of computer science. I wish I could, and a younger me without a family and responsibilities actually would mostly keep up with everything, but now it just feels like there's never quite enough time to learn everything I really should.

This is the part of this conversation that I don't get. Yes, it is impossible for one person to contain the entire body of knowledge, which means you're not going to know some of the time, and that might be embarrassing or otherwise troublesome.

However... it should be rare that you operate in complete isolation. You should be regularly interacting with other practitioners, including people whose entry into the field is newer, and therefore should be aware of the current state of the art. There should be interactions where that information is shared, both allowing projects you work on to take advantage of advances in the state of the art even if you don't know about it, and for you to become aware of advances in the state of the art.

Re: Robin Warren, pathologist who rewrote the science on ulcers, has died

#52

Post by melling »

trhway wrote: post #48
kevinmchugh wrote: post #31

Earlier quoted context omitted.

Science advances one funeral at a time

sometimes i think even funerals can't help. For example, several years ago significant cataract improvement was achieved by applying to eyes lanasterol (chemical in your body clearing cataract naturally) with DMSO (well known widely used solvent which is used in particular to deliver various medicine through the skin, etc., and some adventurous people are also using it to for example deliver dye into eyes to change t…

Sounds like they are still trying to use lanasterol:

https://pubmed.ncbi.nlm.nih.gov/36484206/

I see stories about this being used for cataracts going back almost a decade.

Medicine advances so slowly.

Re: Robin Warren, pathologist who rewrote the science on ulcers, has died

#53

Post by trhway »

melling wrote: post #52
trhway wrote: post #48

Earlier quoted context omitted.

sometimes i think even funerals can't help. For example, several years ago significant cataract improvement was achieved by applying to eyes lanasterol (chemical in your body clearing cataract naturally) with DMSO (well known widely used solvent which is used in particular to deliver various medicine through the skin, etc., and some adventurous people are also using it to for example deliver dye into eyes to change t…

Sounds like they are still trying to use lanasterol: https://pubmed.ncbi.nlm.nih.gov/36484206/ I see stories about this being used for cataracts going back almost a decade. Medicine advances so slowly.

Of course, as lanosterol is how your body does it when things work ok on their own. The issue is delivery, and for unknown reason they are doing it without DMSO or anything similar. Lanosterol with its large molecular weight have no chances of making it inside on its own. The other way of course is injecting it directly into the eye, and it probably would have to be done many times, and, once injections stop, the crystalline accumulation may happen to start again (as cataracts indicate that the body probably have some issue producing and delivering lanosterol naturally), ie. cataract returning, and in this case the cataract surgery starts to look like not that bad of an approach solving the issue once and for all.

>Medicine advances so slowly.

This is one on my deepest existential fears - not just in medicine - the Ancient Greeks could have had steam turbine based ships, yet it took more than 2000 years, and i'm wondering with a tint of fear what wonderful things we're missing on and what Dark Ages we have to pass through before getting to those things (and i'm not going to see them being long gone before it). The high-tech with AI, etc. is the only area where i feel that the progress has at least some minimally reasonable speed (or at least it is hardly reasonable to ask Nature for something faster than the Moore law), and if it were in high-tech there would be already 10 start-ups funded by at least $100M each perfecting and productizing the combinations of DMSO+lanosterol and exploring the similar approaches :) Unfortunately it seems there is no money here, and the Robin Warren's discovery didn't make him a billionaire.

Re: Robin Warren, pathologist who rewrote the science on ulcers, has died

#54

Post by codesnik »

dekhn wrote: post #47

This is one of those situations where the narrative is fairly simple: people believed X, it was wrong, a few iconoclasts demonstrated in a fairly convincing way that Y was indeed the case, and then over time, the story got rewritten in the literature. But in practice it turned out to be more complicated than the narrative; X is still somewhat true and ulcers and gastric disorders are both caused by, and affected by,…

Huh. Could you tell more on ways of sneaking up information to them? I personally am so undiplomatic I have hard time even to imagine, how to do it.

Re: Robin Warren, pathologist who rewrote the science on ulcers, has died

#55

Post by dekhn »

codesnik wrote: post #54
dekhn wrote: post #47

This is one of those situations where the narrative is fairly simple: people believed X, it was wrong, a few iconoclasts demonstrated in a fairly convincing way that Y was indeed the case, and then over time, the story got rewritten in the literature. But in practice it turned out to be more complicated than the narrative; X is still somewhat true and ulcers and gastric disorders are both caused by, and affected by,…

Huh. Could you tell more on ways of sneaking up information to them? I personally am so undiplomatic I have hard time even to imagine, how to do it.

I typically made a dumb reference to something I saw in the literature (JAMA, BMJ, etc) while also saying "but I guess that's just a controversial new opinion".

Basically you want to avoid directly confronting them by implying they are dumb or wrong. Instead, appeal to authority, but in a soft way, and downplay the confidence of the new result.

I had many years of being undiplomatic until I saw a video of Kevin mitnick. His normal nature was quite undiplomatic and fairly autistic, but when he did social engineering, he did an amazing job of telling people what they wanted to hear. Now, when I think something, instead of stating it in a clear and undiplomatic way, I rewrite it in a way that my mental model suggests increases the probability the listeners will change their minds and agree with me. This took a great deal of practice to be able to do in real time.

Re: Robin Warren, pathologist who rewrote the science on ulcers, has died

#56

Post by jorblumesea »

redhed wrote: post #22
tombert wrote: post #13

I got an ulcer about ten years ago, well after Warren's research, I went to a doctor and he told me that the ulcer was caused by stress. I said something like "didn't someone get a Nobel prize proving that ulcers were bacterial?" and the doctor hadn't heard that and "prescribed" me to get more rest and try and be less concerned about work. I got a different doctor after that. Robin Warren is someone who I respected t…

Same thing happened to me about 6 years ago. Told me to relax and not eat spicy foods. Makes me wonder how long medical advancements like this take to really spread to most doctors.

Continuing education in medicine is a big problem. Once someone graduates med school, their knowledge mostly freezes. The good ones keep up on latest developments but some don't.

Re: Robin Warren, pathologist who rewrote the science on ulcers, has died

#57

Post by jcynix »

kevinmchugh wrote: post #31
redhed wrote: post #22

Earlier quoted context omitted.

Same thing happened to me about 6 years ago. Told me to relax and not eat spicy foods. Makes me wonder how long medical advancements like this take to really spread to most doctors.

Science advances one funeral at a time

More specifically Max Planck wrote: "A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die and a new generation grows up that is familiar with it ..."

https://en.wikipedia.org/wiki/Planck%27s_principle

Re: Robin Warren, pathologist who rewrote the science on ulcers, has died

#58

Post by yongjik »

redhed wrote: post #22
tombert wrote: post #13

I got an ulcer about ten years ago, well after Warren's research, I went to a doctor and he told me that the ulcer was caused by stress. I said something like "didn't someone get a Nobel prize proving that ulcers were bacterial?" and the doctor hadn't heard that and "prescribed" me to get more rest and try and be less concerned about work. I got a different doctor after that. Robin Warren is someone who I respected t…

Same thing happened to me about 6 years ago. Told me to relax and not eat spicy foods. Makes me wonder how long medical advancements like this take to really spread to most doctors.

I went to an ear doctor recently, who was so old that I think he graduated when I was a toddler. But when I describe my symptom he says "Well, let's also see what ChatGPT says."

So some part of new medical information might spread faster than I had thought.

* My ear problem turned out to be that my ear canal was full of wax. I guess we didn't really need ChatGPT that day.. ¯\_(ツ)_/¯

Re: Robin Warren, pathologist who rewrote the science on ulcers, has died

#59

Post by bookofjoe »

yongjik wrote: post #58
redhed wrote: post #22

Earlier quoted context omitted.

Same thing happened to me about 6 years ago. Told me to relax and not eat spicy foods. Makes me wonder how long medical advancements like this take to really spread to most doctors.

I went to an ear doctor recently, who was so old that I think he graduated when I was a toddler. But when I describe my symptom he says "Well, let's also see what ChatGPT says." So some part of new medical information might spread faster than I had thought. * My ear problem turned out to be that my ear canal was full of wax. I guess we didn't really need ChatGPT that day.. ¯\_(ツ)_/¯

Unless things have changed fundamentally since I was in medical school (UCLA Class of 1974), a doctor's visit should start with taking a history and move on to a physical examination. I would think ChatGPT wouldn't even have been mentioned once your PE revealed a wax-filled external ear canal.

Re: Robin Warren, pathologist who rewrote the science on ulcers, has died

#60

Post by te »

apwell23 wrote: post #46
vjk800 wrote: post #23

I'm still waiting for a similar discovery to treat GERD. Having the condition, I've become a bit of a couch expert on GERD literature and it seems that everyone and their dog have a completely different opinion on what, in the end, causes it.

Same. It has been bane of my existence for last 3 years.

https://my.clevelandclinic.org/health/diseases/8098-hiatal-h...
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