http://www.hektoeninternational.org/index.php?option=com_content&view=article&id=1327

Winter 2015

The art of medicine cannot be inherited, nor can it be copied from books. – Paracelsus

 

 
Photography by Michael

My youngest daughter has a lizard called Limmy living on her bedside table. Each time I kiss my girl goodnight, stroke her long, blonde curls and turn off the light, Limmy’s reptilian outline glows with a reassuring phosphorescent greenness. We bought him when my daughter was four years old, around the time she started getting scared of the dark and the Mickey Mouse night-light, the lullabies and bedtime stories all failed to calm her down. I used to hold Limmy’s little plastic body under the lamp for a few minutes, flipping him over as though he were a sunbather working on an even tan. As soon as I turned off the light, the lit-up lizard would glow like a beacon in the dark. I sat beside my tiny girl, listening to her breathing in the stillness of night, weaving it with the day’s events into the tapestry of her dreams, as she gradually fell into a deep sleep.

Limmy the lizard’s soul was crafted out of zinc sulfide which would have been mixed into his plastic body as he lay in the molded womb of the Chinese factory production line that bore him and his thousands of glow-in-the-dark siblings into the world. I owe a huge debt of gratitude to these phosphors that, after being energized, continue to radiate visible light – they have played a crucial role in staving off the night horrors for all my children. My firstborn used to lie in bed at night staring at a glowing galaxy of planets, suns and comets on his ceiling. My middle child lined her walls with sparkling bananas in pajamas chasing teddy bears across the nighttime glow of her room. And when my darlings were all safely tucked in, sleeping soundly under the watchful glow of their luminous companions, I would tiptoe downstairs hurriedly and turn on my fluorescent computer screen to smash a deadline for some medical article due in by midnight.

Fluorescence has been used in diverse fields of biomedical research since the 1920s. A glowing green fluorescent protein, GFP, first observed in the jellyfishAequorea victoria back in the 1960s, has become an important contemporary tool in medicine. It won Osamu Shimomura, Martin Chalfie, and Roger Y. Tsien the Nobel Prize in Chemistry in 2008. The discovery of GFP allowed scientists to see processes that had previously been invisible. A fluorescent gene threw light on understanding important areas such as how cancer cells spread, the development of nerve cells in the brain, and tagging brain cancer cells prior to surgery. The GFP, dropped into the DNA material of an animal as a kind of luminous genetic tag, acts as a marker, lighting up the particular tissue or cell type of interest so scientists can follow its movements. The animal, or targeted parts of its anatomy, shine like a neon sign in the dark. GFP has helped scientists map the role of various proteins in the body and how their malfunctioning can lead to disease. In one impressive experiment, researchers tagged several different nerve cells in the brain of a mouse resulting in a kaleidoscope of colors. Nowadays there are heaps of glowing lab animals out there – fish, mice, pigs, rabbits, dogs, kittens – you name it.

My first encounter with the magic of fluorescence was on my sixth birthday, when my father gave me a Seiko wristwatch. Hiding under my sheets at night, mesmerized by its glowing hands, I taught myself to tell the time. Many years later, I found out that the phosphor in these watches used to be mixed with a radioactive element such as radium, which has a half-life of 1,600 years. My father died a long time ago, but I still keep that watch in my desk drawer. Even now, it still glows in the dark and the radiation it holds, beyond the radium, is that of my father’s love. Many years later, while I was living in the Middle East, the magic of balmy evenings lit up by fluorescent fireflies, darting around like tiny fairies in the dark, lent a wonderful contrast to the fiery missiles that hurtled overhead from time to time.

I think the alchemy of the act of writing uses the enchantment of fluorescence too. Anne Lamott writes in her book Bird by Bird: Some Instructions on Writing and Life“Becoming a writer is about becoming conscious. When you’re conscious and writing from a place of insight and simplicity and real caring about the truth, you have the ability to throw the lights on for your reader.”

When I was a young doctor, well before the age of computers and the internet, I felt frustrated at how difficult it was to find accurate, readable medical information to hand my patients. Without understanding just what it was they were suffering from and their options for treatment, people were so often left in the dark. I was determined to “throw the lights on,” to find the language which would translate the unknown for them. With so little available at the time, I started by writing my own patient information leaflets. From there it was a small step to enrolling in a Diploma of Professional Writing and Editing at RMIT, after which I landed a gig writing medically-themed feature articles for The Age newspaper. Soon I was launching out into profile pieces, book reviews, short stories, and poetry. Like a true general practitioner, I took on anything that came my way. In a literary version of Medécines Sans Frontières, no form of writing was off-limits. I was prepared to shine a torch down any genre’s throat and examine it.

If I had to choose which form of illumination I love most though, it would be fiction. Novelist David Grossman writes: “I imagine, and the act of imagination revives me…I invent characters. Sometimes I feel as if I am digging people out of the ice in which reality has encased them…I write, and I feel that the correct and accurate use of words acts like a medicine.”

For me, writing fiction is often about finding and embracing my ghosts; the voices of the unseen hovering around us – the forgotten, frozen in ice. They whisper in my ear, imploring me to listen and bear witness to their existence. Often, I cannot face them and have to leave my desk to make a cup of tea instead, or hang out washing, walk the dog, answer emails, look at cat memes on Facebook. This may sound odd, to admit publically that I am talking to ghosts, but I am referring here to metaphorical spirits only. Ghosts have appeared in fiction throughout the ages, embodying a diversity of roles and haunting a variety of characters. Some take on the form of bold and terrifying poltergeists, corybantic cadavers who rattle around demanding moral justice and vindication, others appear as mere wisps of foggy miasma, canvassing subsequent generations to bear witness to past events with little more than a whisper. I would think most of them glow in the dark. There are a long line of literary spectres, from the biblical Samuel’s ghost, conjured up by the Witch of Endor, which appears before Saul to predict his demise, to Charles Dickens’ entourage of ghostly apparitions. Who can forget Ebenezer Scrooge, transformed by a series of visitations from other-worldly spirits, and David Copperfield, born at midnight, privileged to see ghosts and spirits and haunted by memories of people and places he has visited in the past?

But I digress – or do I? What possible relevance do ghosts have for medical writers in the 21st Century? Surely we are writing about cutting-edge science and there is not a scrap of proof that ghosts exist beyond our imagination? Avery F. Gordon writes in Ghostly Matters: Haunting and the sociological imagination: “The willingness to follow ghosts, neither to memorialize nor to slay, but to follow where they lead, in the present, head turned backwards and forwards at the same time…(is) to be haunted in the name of a will to heal…to allow the ghost to help you imagine what was lost.”

In my chase of ghosts, I turned to literature and enrolled in a Bachelor of Arts, devouring books like a starving woman at a banquet. And recently, I completed a Master of Fine Arts in Fiction Writing, writing a thesis entitled: Talking to the Dead – Can Haunting Lead us Home. Dictionary definitions of the word haunt include “come to the mind continually; obsess” and “to be continually present in; pervade, disturb or distress” (The Free Dictionary).   It is derived from the Old Norse wordheimta, to lead home. The word home has various definitions too, including both “a place of origin, a starting position” and “a goal or destination.” One dictionary refers to “the source, or place where something is discovered, founded, developed or promoted” (The Free Dictionary). Both ‘haunt’ and ‘home’ indicate place.

So, maybe the ghosts haunt the haunted in order to lead them back home. Those who have blazed a trail before us, may actually light up the path ahead of us too. And if we have lost the ghosts of our scientific past, if they have ceased to shine like beacons inside our laboratories, our clinics and within the pages of our professional journals and popular science and health articles, then I believe we have lost our way. If we forget that Thomas Edison, the inventor of the light bulb, profoundly changed our existence when he lit up the night and made it hospitable for human beings, then we also forget that twenty-nine years before him Joseph Swan began working on a light bulb using carbonized paper filaments. And if we forget the ghost of Joseph Swan we forget the Polish inventor of the kerosene lamp in the 1800s, and the Chinese inventor of the humble candle 2,300 years earlier, all the way back to the first caveman who figured out how to rub two sticks together to make fire. We need to keep the fluorescent ghosts of these visionary giants seated beside us as we write about contemporary advances, in both science and medicine. They are part of an ongoing narrative about the beautiful and miraculous events that play themselves out on our tiny planet, and in our boundless universe.

Years ago, I was scrabbling about in the dark by myself, trying to bridge the gap between the language of two separate countries – the Gobbledegook of Medical Science and the Language of the Laity – that were divided by a vast ocean of misinformation and misunderstanding. Nowadays, the highway of medical advances is littered with huge billboards of information screaming facts and counter-facts at us as we travel down new and often unmarked roads. The fluorescence of the internet, and its overabundance of information, does not mean we are out of the darkness yet; in fact, this plethora of knowledge can often serve only to blind us with its glare. It is our job as writers to shed light on the facts, highlighting the data that shines brightly amongst the dross.

Ernest Hemingway wrote in a letter to his fourth wife Mary Welsh in 1945: “All my life I’ve looked at words as though I was seeing them for the first time.”

As writers we all need to do this – keep our language fresh, avoiding both jargon and cliché. This goes double for medical writers. My advice to you is BE your reader – look upon the word fluorescence as if you haven’t a clue what it means, then turn it over, examine it, read up about it, interview experts in the field – become fluorescence’s best friend. When you finally come to write about it, write the work as though you are seeing it for the very first time. Then, illuminate it; make it glow in the dark, like my daughter’s lizard, Limmy, so that in turn, you may light up your reader’s inner child.