Thursday, 14 March 2013

What's Up Doc?

Can you fix something without truly understanding it?
If you ask a brainy engineer, the type that designs jet engines or nuclear reactors, can you solve a problem without understanding it; the answer is likely to be negative.  If you ask the guy that fixes your car, he might say “dunno, but let’s have a go”.  I have never met a white coated medical researcher, so I cannot tell you how they would reply.
A long time ago I gave up on expecting experts to fix types of unusual problems.  Like the illuminated “engine malfunction” light that sometimes appears in my car, like why did the radiators in my house bang and clank as they warmed up and later as they cooled down (it's not air in the system).  Why did my environmentally friendly solar panels make a noise like they were about to explode? The list grows longer.  Having solved all these problems and some others, I moved on to healthcare.  Why did my chest hurt when I sneezed? very funny to watch, instead of my reflex being to cover my mouth, I would hold my chest.  Then I even started giving medical advice to my Mother, a doctor herself.  But I digress.
If somebody had asked me, prior to Christmas 2012, "so Peter can you fix Monty?" then the best I could have said would have been something dull like:-
Autism is an incurable condition that you can manage, but you cannot reverse or cure it pharmacologically. Maybe one day there will be a cure, but too late for us.  Using behavioural techniques Monty has made great strides forward.  He can walk, run, ski, swim, read, write, do basic addition and subtraction.  He has emerging understanding of Wh- questions.  When asked a specific question he may make a short verbal reply, or he might totally ignore the questioner and the question.  A lot depends on who asks the question.  He sometimes suffers from stereotpy (aka stimming) particularly at school and this can makes it hard to complete simple academic work.  He may sometimes disrupt the class, even though he has a 1:1 assistant.  When his brother, Ted, asked if Monty will ever learn to drive I answered “maybe, maybe not, let’s hope for the best”
Three months later, and two months after everybody now knows about the Bumetanide Epiphany, my wife says to me out of the blue “Do you think you can really fix Monty” and even “What’s up, Doc”. Well, I never said I could or would fix him, but at least I am going to have a dam good try. Ted’s odds of getting Dad’s old Triumph Spitfire all to himself are slipping daily from odds-on favourite. If they slip to 50% my job will be complete.
So, can I fix something without truly understanding it?

Well, quite possibly, but the more I understand the problem, the better are my chances.

In neurobiology nobody fully understands the subject.  It is a work in progress. By the time Monty and Ted draw their pensions, it will still be a work in progress.



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