Monday, October 22, 2012

Needlessly dissecting a good movie

I take my movies seriously. I look for a message in every movie, and I honestly don’t understand how to take that message lightly. That being said, a good movie experience usually leaves me deeply affected. A bad movie experience leaves me untouched.

It’s not that I only like happy endings. In fact I am terribly skeptical of happy endings. I usually fancy myself as a passioned realist (Yes, I am aware of how pompous that sounds), and I hate it especially in love stories, when everything turns out hunky-dory. Like that nincompoop (adjective?) movie of Karan Johar. What was it? That extra-marital affair one with SRK, Rani Mukherji, Abhishek Bachhan and Preity Zinta I think. Okay now when an effin’ extra marital affair plot ends with both scorned halves of the couple ultimately cool with the infidelity, that is ridiculous enough. Unless of course they are genuinely chilled out hippy people, which I assure you NOBODY in a Karan Johar movie ever is. As if mocking the audience, I distinctly remember the last scene of the movie insinuating a possible romantic angle between the scorned husband of one couple and the scorned wife of the other AT THE FREAKIN’ WEDDING RECEPTION OF THEIR EXES! (Google reminds me I'm talking about Kabhi Alvida Naa Kehna)Now I watched this movie I think some 6 years back so there might be technical glitches in my memory, but if I am mistaken I will be nothing but reassured that this wasn’t the case after all. The main reason I loathe the Karan Johar gang is because they make such fools of the audience. I doubt he’s stupid, but clearly he takes our stupidity for granted and it’s paying off for him, it seems like. Especially with such INANE movies like Student of the Year (which I have not seen, but I’m so livid I don’t care about fair chances anymore) being made. 

Anyway, this outburst wasn’t provoked by Karan Johar. Curiously, it was provoked by a brilliantly made Malayalam movie called ‘Diamond Necklace.’ I’d heard nice things about the movie, and though I am usually a little wary of Malayalam movies set in cities (I can’t stand the way the project ‘modern’ youth, women especially, there are more and more exceptions to this now – 22 Female Kottayam, for example), I decided to give this one a chance.

I wasn’t disappointed either. DN was engaging from the minute is started. Fast moving, excellent acting, brilliant characterizations, Fahad Fazil (or Fahadh Faasil as Wiki spells it) again flawlessly portrays the douchey character of a spendthrift doctor who is a compulsive spender and lets this weakness stoop himself into unimaginable lows. The three women in his life were also nicely played by Samvrutha Sunil, and two actresses who I think are new called Anusree and Gauthami Nair.

I was fast liking the movie more and more, because I couldn’t wait to see how the unscrupulous protagonist was gonna pay for his various misdeeds [SPOILER ALERT!!! which include stealing a diamond necklace from the terminally-ill woman he slept with without telling her he is already married, after making sure she’s asleep by double-dosing her with morphine and consequently getting the nurse in charge (who he also cheated on) fired.] So yeah, I was watching the movie thinking it should be fun to watch all of this bite him in the ass so hard at the end. Except it didn’t! With unimaginable luck, douchebag not only gets away BUT gets away with the goodwill of all the people he cheated.

The same thing happened in Woody Allen’s Matchpoint (the one with Jonathan Rhys-Meyers and Scarlett Johansson remember?) And I wouldn’t be surprised if that was the inspiration behind this movie. But at least in Matchpoint there is the satisfaction of at least some of the cheat-ees finally realizing that they’ve been cheated. Even if Scarlett Johansson was shot dead right after, at least for that one second Jonathan Rhys-Meyers was hated. Here there’s nothing! Everyone forgives him, and is even grateful to him for things he really had nothing to do with.

When the movie ended, my dad and mum understandably laughed at my outrage. It’s just a movie, he said. Why are you acting like it really happened?

Which is true.
So I should just chill out and go to sleep.

Thursday, May 31, 2012

Why the fuss, doc?

Satyamev Jayate's latest episode on medical malpractice has generated much debate as was, I expect, the producers' plan. The latest has been the uproar in the medical community alleging some sort of defamation. On what basis, I'm still confused about. But if the uproar has anything to do with one Facebook rant by a young doctor that is doing the rounds (see here), then I'm not convinced.

Dr. Sheikh’s argument is based on a line of logic that is disturbing. Throughout the write-up he is arguing that it is not fair doctors are having to pay for their community’s flaws when many other professions are just as corrupt. While I’m no fan of Aamir Khan’s flamboyant righteousness, I do not understand why doctors have been offended by the theme of last week’s show. They have as much as a right to be offended as an honest politician has to be, by Anna Hazare’s movement. Suddenly I see too many similarities between Anna and Aamir. Both have, on paper, noble intentions, are highly adulated by the masses, but their techniques highly criticised by the intelligentsia.

Dr Azhar Sheikh is I’m sure an honest hardworking professional. But his arguments weaken his cause. The most bothersome of them I am quoting below.

“Private colleges charge a capitation fee of 40 – 50 Lacs for MBBS, you should have also produced some evidence of such practice. Like you call a victim in all your episodes, why not here? And do the same story Engineering, Architecture, Law and MBA colleges, do you think they are clean? Why target doctors alone?"
This point makes it sound as if Dr Sheikh is skeptical about the practice of capitation fees in medical institutions. But as that would be unrealistically naive of him, I will give him the benefit of the doubt and assume that he only took issue with the fact that Aamir Khan presented no proof of its existence. In a news channel or in a show that you would expect some journalistic standard, the absence of evidence to support capitation fee claims would be inexcusable and perhaps even illegal. But as the claims feature on a show that airs on Star World, which is essentially entertainment, there is some degree of impunity.

It is Dr. Sheikh’s “Engineering, Arch, law colleges etc are just as corrupt, hence don’t target us” attitude that is the most bothersome. Instead what he should have or maybe meant to say was that just as the bad guys in medicine have been caught, bad guys in the other fields must be held accountable as well.

“One of your guest (Dr. Gulhati) said that doctors ask for 30% commission from Pharma companies to write their drugs. That is baseless, over-the-roof and sensationalizin g the matter. That is as true as “Most Leading actors ask newcomers to sleep with them”

That is a flawed analogy. In the casting couch scenario the actor endangers nobody but her/himself. Which is totally not the case in the doctor-pharmacompany scenario. By unnecessarily prescribing a drug, the doctors at fault are putting their patients in a financial as well as a health risk. Who's sensationalising now?

“You compared the numbers of Licenses cancelled in England and in India. I must say your team is quite resourceful and please collect and compare following details also – a.Number of doctors beaten on duty by goons from various political outfits.”
Again, this point of Dr. Sheikh’s completely discredits his point of view. What does doctor bullying have to do with cancelling corrupt doctors’ licenses? That’s like saying though only only 1 in 10 corrupt politicians are penalised, it’s okay since many politicians are killed by terrorists. Wtf?

“You said that the most brilliant students who take up medicine, should take it only for service to mankind, they should go to other fields if they want to earn. Why? Are we living in imperialism? Are doctors not allowed to earn and spend a good life?
Agreed, there’s nothing wrong with doctor’s becoming rich. Why shouldn’t they. But again, at the risk of sounding corny, I think everybody should join a profession they care for. Not just doctors. Maybe there’s more emphasis on doctors and journalists to be ethical over money-hungry because they deal with human life on such a direct level, unlike engineers or accountants. Then again, considering the decades of study a doctor has to undergo to establish him/herself I always thought doctors must REALLY be better human beings than the rest of us. I wonder if Dr. Sheikh would agree.

Now and then within his outburst, I feel Dr. Sheikh has a point buried somewhere, but he seems to be taking his anger out on the wrong people. Shooting the messenger isn’t going to help. Medical malpractice is real. It’s okay to feel a tinge of indignation when your profession is under scrutiny because of a few wrongdoers (I know. I’m a journalist), but don’t go to the extent of attacking the whistleblower and sticking up for the ones who are maligning you in the first place.
Whatever point he was getting at, was completely destroyed for me by the absurdity of his final dramatic statement.

“For every 10 doctors who are doing wrong, there are more than 1000 healers. You owe us an apology!!! 

Tuesday, March 27, 2012

The phenomenon of the fleeing flu

Why is the common flu more deadly for some than it is for others? Everybody’s thought about it. How is it that some people can die from something that begins as a measly running nose, while others barely notice it come and go?

The vague answer would be ‘immunity’. At least that’s how I’ve always shut my brother up when he’s feeling inquisitive. But it’s always nice to understand ambiguities. Immunity is not a switch that can be at ‘good’ or ‘bad’ but a complex system governed by millions of pathways, enzymes, anatomical and external factors.

Researchers from a whole bunch of Universities and labs in the US and UK published an article in Nature on the 25th of March that might just have made a breakthrough of sorts in bringing some certainty into the hugely murky world of personalized medicine. Scientists from the Sanger Institute in Britain claim to have discovered the “crucial first line of defense” against the flu.

What they had to work with
In 2009 the journal Cell published a paper that established a protein called IFITM3 as having a crucial role in restricting viral replication, proving to be particularly hindrant to influenza, dengue and the West Nile virus. IFITM3 does this by inducing an immune agent called Interferon to prevent viruses from emptying their poison into cells, and consequently barring replication of the viral DNA in their host. See this for details.

However the study published in Cell was only demonstrated in-vitro, meaning in lab conditions. Usually an observed result only gains enough credibility to be applied once it is sufficiently replicated within a living system, or in-vivo.

It pays to play mice
The recent study from Nature have taken the IFITM3 study to the next level and proved that the IFITM3 does indeed play a highly significant role in determining how severely a flu virus affects its host. They did this by using one of the most efficient strategies to determine the functions of a gene/protein in a body. This involves deducing the role of substance ‘X’ in subject ‘Y’, for example, simply by observing the effect of Y in the absence of X. Since human subjects are not an option, the most commonly used animal model is Mus musculus or the house mouse(The mouse DNA is almost 85% similar to ours). Usually when the function of a gene, or its product -- a protein is to be determined, scientists genetically engineer mice with that particular gene absent or inactive so as to observe the effects. These mice are called knockout mice.

So these researchers used knockout mice which had an inactive IFITM3 gene and infected them with a low-pathogenicity (relatively mild) flu virus. They did the same for wild-type mice (normal variety) as well to compare the effects. They found out that the knockout mice suffered a great deal more than it’s wild cousins. The wild-type mice was tested and found to have increasing levels of the IFITM3 protein following infection, compared to the knockout mice which were unable to produce the protein. Similar results were seen when these two groups of mice were infected with the H1N1 virus which was recently responsible for the swine-flu pandemic.

The lungs of the mice without the protein (-/-) and with the protein (+/+) Image from Nature

From mouse to man
After collecting sufficient evidence of the protective role of IFITM3 in mice, the scientists proceeded to test their theory on human beings. How they did this is by examining influenza-ridden patients who have had to be hospitalized.

Now all human beings have the IFITM3 gene; the main differences lie within the gene itself. We’re all different from each other despite being more than 99% genetically similar. A large chunk of that variation is due to something called SNP’s or Single Nucleotide Polymorphisms.
SNP into it

Picture two chains of colour beads, each about 1200 beads long. The two chains are almost exactly identical except for example the 500th bead which is red in one chain but blue in the other. This would now be called rs500 (rs stands for reference SNP). And snp500 has two variants or alleles ie. R (red) and B (blue). In this analogy, the chain = IFITM3 gene, a bead = a nucleotide. Our cells are diploid, meaning we have two sets of each gene. So a person can either be RR (both red), BB (both blue) or RB (one of each). Of course in reality, our DNA is made of not color beads but nucleotides named A (adenine), G(guanine), C(cytosine) and T(thymine).

Example of an SNP. Image from Riken research.

Sometimes the type of SNP, or the variant that you have on a particular gene will markedly affect the kind of protein that gene produces. One particular variant (‘CC’) of an SNP called rs12252 on the IFITM3 gene, results in the formation of a shortened version of the usual IFITM3 protein. This ‘CC’ variant of this SNP is much less prevalent than the more popular ‘TT’ and ‘TC’. Now if the IFITM3-flu virus hypothesis is true, the shorter protein produced in people with ‘CC’ in their IFITM3 gene will not be enough to resist the flu virus, and such a person would be more likely to have a severe attack than a person who is able to produce the usual protein.

They tested the hypothesis by selecting patients from various hospitals who were struck with severe influenza and testing their DNA to detect whether they were TT, TC, or the rogue CC. Then they compared this distribution to the normal frequency of these alleles in the population and concluded that the faulty variant CC is indeed more prevalent in severe flu patients than it is in normal circumstances.

A pie chart representing how the rogue allele CC is more likely to occur in hospitalised flu patients than in the general European population Image from Nature.

Frankly my dear, should I give a damn?

This not only favours the hypothesis that the IFITM3 protein does indeed play a role in the progress of the flu, but also gives us a potentially useful way to predict a person’s susceptibility to a killer flu.

This also can explain why during the swine flu pandemic for example the virus was deadly for some and barely perturbed others.

With more confirmation, perhaps there could be a day when people can take informed decisions on whether or not he/she should take extra precautions like vaccines against the disease.

Even more in the future is the possibility of developing a drug that is similar to the IFITM3 protein so that it can curb the flu virus the same way.

But hold your horses…
There’s still a lot more to be done. The number of patients studied was only fifty three, hardly a large enough sample. The researchers themselves emphasise on the need for these results to be replicated in larger studies to hold good.

Another fact to keep in mind is that a living body is too complex for simple cause-effect relationships. Though the role of IFITM3 stands out, it is not the only gene that plays a role in our overall susceptibility to the disease. Other genetic and environment factors too interfere.

Other references

Wednesday, March 21, 2012

How is a painkiller curing cancer?

Cancer has been one area of science that the Indian media is willing to spend space on. Sadly, I couldn’t come across too many reports -- forget Indian reports -- that would lure a lay-reader to go beyond the ‘Aspirin a Cancer killer’ headline and bother to find out what was actually done here.

What is Aspirin?

Aspirin belongs to a class of drugs called nonsteroidal anti-inflammatory drugs or NSAIDs which is usally called ‘Dispirin’ in India. The main use of Aspirin is as a pain-killer, though more recently it has shown to prevent cardiovascular (heart) problems and now cancer.
How does it work?

Aspirin blocks the activity of an enzyme in our body called cyclo-oxygenase. Cyclo-oxygenase is needed to produce various chemicals in our body like prostaglandins, prostacyclins and thromboxane.

Pain: Prostaglandins are chemicals produced during injuries because of which we get swellings, inflammation and thereby pain. A high dose of aspirin (300mg and over) prevents the enzyme cyclo-oxygenase from producing these prostaglandins. And Voila! No pain.

Cardiovascular diseases: A lower dose of aspirin blocks cyclo-oxygenase too, but not enough to prevent prostaglandin production. At lower doses, aspirin prevents cyclo-oxygenase’s role in the production of another chemical called thromboxane. Thromboxane is usually produced by blood cells called platelets (with the help of cyclo-oxygenage) to help clot our blood and prevent too much bleeding, when you hurt your knee for example. But clotting of blood within your blood stream can obstruct free flow of blood and result in a stroke or a heart attack. So by preventing the production of thromboxane, blood is less likely to clump together in your blood vessels and cause complications.

Cancer: While the above two uses of Aspirin are relatively well established, it’s role in cancer prevention/cure has been debated since the 70’s by Bennett and Del Tacca. But three recent studies on the topic conducted by Peter Rothwell of the Oxford University however have silenced some skeptics. They conducted a randomized, controlled trials and concluded that a daily low dose of Aspirin for just 3 to 5 years is enough to lower risk of certain cancers, particularly bowel cancer in people who are at risk.

However, it must be noted that all these studies have been epidemiological studies. Though statistics have been proved to be immensely useful to establish correlation between two factors, is it enough? From what I have explored, not many biological reasons for this phenomenon have emerged. If they have then, nobody seems to be talking about them enough.

How is Aspirin doing this?
The biological processes involved in this correlation have still not been established. However there have been some explanations proposed.

As mentioned, Aspirins thins blood, makes it less likely to clot by its effect on blood clotting platelets. Now platelets, save us from bleeding to death no doubt, but they have been show to play a sinister role as well. They prime cancer cells for metastasis ie. They help cancer cells spread from its site of origin. How it does this is detailed in this easy-to-understand article .
So since Aspirin is anti-platelet, and platelets are pro-cancer, this could be one of the mechanisms by which Aspirin cures cancer.
Last month Australian scientists made another explanation.
Co-lead author Tara Karnezis said tumors secret proteins and compounds called growth factors, attracting blood and lymphatic vessels to their vicinity and allowing the cancer to flourish and spread. These growth factors also encourage lymphatic vessels -- or "supply lines" -- to widen, which enables the spread of cancer, she added. "But a group of drugs reverse the widening of the supply line and make it hard for the tumor to spread -- at the end of the day that's what kills people," Karnezis said. "This discovery unlocks a range of potentially powerful new therapies to target this pathway in lymphatic vessels, effectively tightening a tumor's supply lines and restricting the transport of cancer cells to the rest of the body."

Reality checks
So whatever the reason, this doesn’t mean we can simply start gobbling up pills and expect to be Cancer free. There are several concerns that haven’t been addressed.

Aspirin has been known to have side-effects, one of the more serious though rare one is stomach bleeding.

Some critics have noted that some of the doses given in the study were much higher than the 75mg dose typically given in the UK, said a BBC report (Since the article is Lancet, read Elsevier, stuck up folks aren’t letting me read it for free and verify this myself).

The benefit of Aspirin for healthy people is yet to be quantified. The lead author Prof Rothwell himself has said that for most fit and healthy people, the most important things they can do to reduce their lifetime cancer risk is to give up smoking, take exercise and have a healthy diet. Aspirin does seem to reduce the risk further – but only by a small amount if there is no risk factor.


Tuesday, March 20, 2012

My First Rage Comic

It's not enough to live in Anugraha apartments or Brihadeeswar Flats anymore. Even Sunflower apartments and Fern Hill just don't cut it. THIS is the new status symbol

Fancy Flat names in India

Saturday, March 3, 2012


As of now (03-Mar-2012, 17:48 IST), #100WaysToDieInIndia is trending on Twitter. Globally that is. So I thought it would be amusing to see what people outside of India know about India.. In fact, so enamoured did I get with this notion that I abandoned my dissertation work in this noble pursuit.

What I found out:-
1) Indian food is deadly spicy.

2) Indians hate Pakistanis

3) It is unheard of to not love SRK

4) Indian elders regularly beat kids with chappals

5) Cows, goats and elephants trample on us frequently. Cobras also.

6) Indian parents have no tolerance for their wayward (read non-engineering/medically inclined) offspring.

7) Indians are all vegetarians

8) Indians all have long names

9) Indians often sell body parts to buy cricket tickets

10) Indian men don't cheat

11) Abusing a Sardar is frowned upon.

12) We all marry our cousins. And Sanji is a real name.

13) If not that then at least we must do arranged marriage

As if all of this wasn't enough, we've got these to worry about -
whatever they are..

Sunday, February 19, 2012

Would you stop to listen to the music?

Back in 2007, Gene Weingarten, a journalist from the Washington Post thought of an interesting experiment to study human behaviour. He managed to convince a world class musician to exhibit his violin expertise dressed as a homeless person in busy Washington DC metro. The idea was to observe how differently people would accept the same product outside its society-assigned place of belonging - the concert hall.
Joshua Bell, the musician, had just played for a fancy audience - each of whom had paid around $100 for a ticket - a few days ago.

This is what happened.

Bell managed to earn about $32 (excluding the $20 bill he got from a fan who eventually recognised him) from more than a thousand commuters who passed by during that 45 minutes.

How screwed up is that? Imagine how differently we would look at the world if we had no set notions.

There's 2 ways to interpret this.
1. It's possible to wonder if the talent in question is overrated. Maybe Bell is just a mediocre violinist who got a series of lucky breaks. If the crowd didn't listen, does that mean the music wasn't really good?
This is a very valid point, especially in this age where a video of a dog twitching in it's sleep can go viral.
There are so many chance happenings that serendipity has lost its charm today. How do you know if Justin Bieber would be where he is today even if Scooter Braun hadn't 'discovered' him? What is Braun had not updated his flash player or chose this guy instead?
I could go on...
It's all arguable i suppose, but maybe I'm being naive in saying that talents like Joshua Bell, AR Rahman and others are the few for whom luck might not have played as much a role as their gift and their hardwork did.
For them not to have been noticed would have taken life full of lousy luck and bad decision-making.
Which brings us to the second point of view.

2. Let's say these famous guys are really talented (Okay, excepting Snooki, the Kardashians, anybody in Bigggg Boss and Zayed Khan), so there's nothing wrong with a little bit of luck helping them out right?
But imagine if the same amount of luck was given to everyone. How many potential superstars are lurking in the world with no chance of recognition? The supremely overdone example ofcourse is 'How many Sachin Tendulkars might exist among the millions of galli cricket players'.


this was not even a point with which I began this blog entry. I meant to write about how shackled we are by our responsibilities and by perceptions of the society as a whole. How without realizing it, most of us form most of our opinions based on already formed ones.

Sounded really deep in my head, but like wannabe trash on paper. Will publish this still because I'm self destructive that way.