Medicor 2015 #2

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medicor

medicor medicinska fรถreningen i stockholm

38 Insight with Margaret Livingstone

2015 #2

20 SEK

30 Dreaming with Lucidity

WAITING IN LINE

The issue of organ donation in Sweden and how to tackle it.

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Prelude

The stories behind the stories?

Photo by Jingcheng Zhao for Medicor

“Oh, right. I forgot. Sorry I don’t think I’ll have the time.” Christer Fuglesang answered when Oskar and I met him for our interview in Aula Medica last August. There went our cover, we thought as he headed in to hold his lecture. Luckily for us the door to the lecture hall was locked. So we seized the opportunity and quickly asked him if we could do the interview as we waited. He agreed.

Now there was only one problem left: the photos. Martin was already on his way and what would we do without cover photos?

So we came up with a plan. Oskar stationed himself inside the lecture hall while Martin and I prepared a “studio” outside the entrance. We thought that maybe he has time to take a couple of quick ones before he leaves. But nothing went as planned this day.

While we were test shooting I suddenly get a text from Oskar: ”He left through the other door!”. This is not a good start as Editorin-chief, I thought while heading after him down the corridors.

When we finally caught up he was as calm as ever. Yeah sure, he said, I got time. Let’s take some photos.

This isn’t the only time we planned one thing and then had to rethink, however the results in some magical way always turn out for the best. Like the time when we arranged to interview and photograph Jesper Rönndahl and he sends us a text right before saying he can’t make it and will be in touch. At this point everything was set and we were ready to go. He did however have a legit reason. We later learned that he had just become a father.

That’s part of the charm of being a student magazine. We never know what will happen. No one is employed, we don’t have an office and we all work with our own equipment. Still we manage to create this magazine. The secret? All the amazing people in the Medicor Team who give their time.

Giving is also something we focus on in this issue, however a very special and important gift; the gift of life. We talked to Peter Carstedt and Martha Ehlin, the founders of the Swedish organization for more organ donation (MOD), about their stories and the challenges within the health care system. Read more on page 22.

Finally, this is the end of my journey as Editor-in-Chief, but it’s only the beginning of Medicor’s and I truly hope you want to join it. I told my story; now it’s time for you to tell yours.

Sincerely, Robert de Meijere Editor-in-Chief

Cover photo

by Martin Kjellberg for Medicor 2

Medicor Magasin Grundad 2006. Nionde årgången.

Utges av Medincinska Föreningen i Stockholm ISSN: 1653-9796 Ansvarig utgivare: Robert de Meijere Tryck och reproduktion: Åtta45, Solna Adress: Medicinska Föreningen i Stockholm Nobels Väg 10, Box 250, 171 77, Stockholm Utgivningsplan 2014: nr 1: mars, nr 2: maj, nr 3: oktober, nr 4: december.

Kontakta Medicor: chefredaktor@medicor.nu www.medicinskaforeningen.se Frilansmaterial: Medicor förbehåller sig rätten att redigera inkommet material och ansvarar inte för icke beställda texter eller bilder, samt tryckfel. Upphovsman svarar för, genom Medicor publicerat, signerat frilansmaterial; denna(e)s åsikter representerar nödvändigtvis inte Medicors eller Medicinska Föreningens.

Photo by Jingcheng Zhao for Medicor

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Overture COVER STORY

KAROLINSKA

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GLOBAL FOCUS

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DOES KI HAVE A DARK HISTORY?

How the socioenc.onoic status may affect our brain development

Iskra Pollak Dorocic on the history of Anders and Gustaf Retzius

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ON THE RIGHT PATH Caroline Olsson and Emelie Looft describes their month the IIMC.

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IS THERE LIGHT AT THE END OF THE TUNNEL?

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“I HAVE A NEW KIDNEY, BUT I AM NOT SICK.”

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Irina Pader interviews winners of the famous IgNobel prize.

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CULTURE

ANTHROPOCENE Humanity’s impact on Earth may have changed its course forever. Many questions surrounds the Anthropocene: the age of man.

DREAMING WITH LUCIDITY Sibel Ilter on lucid dreaming: what it is and how we can benefit from it.

THE EARTHQUAKE IN NEPAL The public health situation in the post-catastrophic country.

INSIGHT

“AT FIRST THERE WAS NOTHING FUNNY ABOUT IT...”

JUSTICE IS BLIND AND THE LAW IS JUST Crime and punishment in the modern world..

An interview with Martha Ehlin and Peter Carstedt on the issue of transplantation.

Jessica De Loma Olson on the mysteries behind near-death experiences.

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SYRIA: A PUBLIC HEALTH UPDATE Devy Elling follows up on the last four years of armed conflict.

WAITING IN LINE

SCIENCE

THE BRAIN AND POVERTY

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BEHIND THE FAMILIAR

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COMICS

Stories behind the sculptures and buildings around campus.

Some comic relief from Mikael Plymoth and Anny Truong

“IT BECAME CLEAR TO ME HOW POWERFUL TALKING ABOUT ART IS AT GETTING A MESSAGE ACROSS.” Medicor talked with Margaret Livingstone, Professor of Neurobiology at Harvard Medical School and author of “Vision and Art: Biology of Seeing”

medicor Robert de Meijere • Editor-in-Chief | Oskar Swartling • Associate Editor | Andrey Pyko • Creative Director Ibrahim Rayyes • Proofreader General | Yasmine Djoumi • Producer | Jessica De Loma Olson • Web Manager | Halima Hassan • Editor of Global Focus Sibel Ilter • Editor of Campus | Iskra Pollak Dorocic • Editor of Science | Poya Livälven • Editor of Culture Irina Pader, Anna Vidina, Sarah Wideman, Se whee Park • Reporters | Martin Kjellberg, Katarina Stojanovic • Photographers | Karolina Werynska, Devy Elling, Mimmi Mononen, Sayoni Chakraborty, Caroline Olsson, Emelie Looft, Teodora Andonova, Olivia Miossec • Writers Fergal Horgan, Parvin Kumar, Susanna Atrushi • Proofreaders | Mikael Plymoth, Anny Truong • Illustrators

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Aperture Photo by Medicor’s Katarina Stojanovic for the book A book about bullying. It will be published this summer and wants to inspire and give advice on how to prevent mistreatment. The author Amanda BergstrÜm Andersson wants the book to be a help in the everyday life at work, schools and organisations.

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Smörgåsbord

Jan de Doot JAN DE DOOT IS A 17TH CENTURY BLACKSMITH FROM

the Netherlands who is said to have performed a successful lithotomy. Not impressed? Maybe we should ad that it was on himself and with a kitchen knife. He later had the bladder stone, the size of an egg, set in gold. This is the subject of a painting from 1655 by Carel van Savoyen. However the accuracy of the story remains uncertain.

USA IT IS THE STORY OF WILLIAM E. HAAST, BORN

in New Jersey and with a special love for snakes.

Also known as the “Snakeman”, he was the director of the Miami Serpentarium Laboratories, in charge of producing snake venoms for research uses. After handling more than 3.000.000 poisonous snakes, Bill Haast was bitten at least 173 times by these poisonous animals.

To survive this he injected himself with a mix of venoms from 32 snake species every single day for more than 60 years.

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Snake bites

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Sir Ranulph Fiennes BRITISH ADVENTURER WHO WAS

the first to cross both poles by foot and the oldest person to ever climb Mount Everest has never been one to listen to doctors’ advice. After a failed attempt in 2000 to walk unsupported to the North Pole he sustained a severe frostbite to the fingers of his left hand. Upon returning home his surgeon

urged him to wait a couple of months before amputation to allow the healthy tissue to regrow. So he decided to do the job himself. “I purchased a set of fretsaw blades at the village shop, put the little finger in my Black & Decker folding table’s vice, and gently sawed through the dead skin and bone just above the live skin line,” A job well done he commented. It doesn’t stop there. In 2003 he suffered from a heart attack and underwent

a double bypass operation. Four months later he completed 7 marathons in 7 days in 7 continents. In his defense his cardiac surgeon had approved the marathons, providing his heart-rate did not exceed 130 beats per minute. So did it? Well Fiennes did not know since he forgot to pack the heart-rate monitor.

DIY Surgery THE SOVIET SURGEON, LEONID ROGOZOV,

auto-diagnosed himself with acute appendicitis in 1961. Stuck in the middle of the Antarctica in a Russian base with other 12 men, he was unlucky enough to be the only physician there. At the age of 27 and after considering all his possibilities, he had no choice. He had to remove his own appendix. After cutting, sewing some mistakes, cutting again and putting everything back in place, he did it. Those painful 105 minutes of surgery saved his life.

> 15.000 days THAI NGOC IS A VIETNAMESE FARMER

that states he has not slept since 1973. He recalls having a quite bad fever one day and never sleeping again after. Despite several other cases have been described around the world, this is the longest period without sleeping recognized at the moment. While some experts are still skeptical about the truth of these issues, could you imagine what would you do with all does extra hours?

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KAROLINSKA

Learning a new language was never this fun!

Language@KI

By Sayoni Chakraborty YOU HAVE MOVED TO A NEW CITY,

opened up to experiencing a new culture, customs, way of living and you are soaking it all in while you are there. Being an international student - whether you are on exchange, on a long term programme or working at KI - one very important part of visualizing the system is knowing the language.

And, Language@KI does exactly that; they provide language classes for every international individual at KI who wants to understand the Swedish language, language skills that range from basic phrases to more elaborate formulation. This project started a few years back under the International Committee of Medicinska Föreningen and has been highly successful with teaching over 300 students each semester, the concept being really simpleInternationalization. This is something the International Committee strongly believes in. And how is this implemented?

Native Swedish speakers teach everydayuse of the language to the international

students in small and concise classes every week.

So, very soon after a few classes you will be moving on from “Hej, kan du prata engelska?” to much more advance and fluent use of words. What else? Meeting people from other parts of the world, fellow class-mates and bonding with them over fika, which should always be fun! Wait, did someone mention fika?

Of course! After all, it is hard to imagine any sort of get-together in Sweden without fika. Half-way through the class you expect freshly brewed coffee, refreshing tea, cinnamon buns, sandwiches and fresh fruits which unsurprisingly awaits you. As a teacher, one earns much more than just credits for exchange studies – you earn the joy of imparting your valuable knowledge. The groups of students and teachers being widely diverse and coming from different walks of life is indeed a great opportunity to expand horizons and promote integration and internationalization.

The spring semester of 2015 is almost nearing its end. Language@KI will be preparing for the International Dinner, a gala event. This will be an evening filled with games, mingling, fun and delicious home-made food from all over the world.

But is also serves a symbolic purpose – which is the act of assembling people from different nationalities under a single roof, essentially becoming the most multicultural population in the world, even if just for one night.

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Language@KI An International Committee Initiative To know more about the project, like the Facebook Page and stay updated.

Twinning

By Kalle Garpvall (vice-chairperson of the Twinning project 2015) AFTER A VERY SUCCESSFUL EXCHANGE

project with Heidelberg, Germany, during 2014 – the Twinning Organization Committee in the International Committee (IN) at Medicinska Föreningen decided to aim a bit further away this year and it was decided to do the project with Dokuz Eulül University, Izmir, Turkey!

And so, during the Easter break, 12 Turkish students got to learn KI and Stockholm with the help of their 8 Swedish Twins! A lot of planning was put into making the program during the week as enjoyable as possible, and different social events was mixed with educational happenings. A dinner at Medicinska Föreningen and a visit to Skansen were some of the activities. There was also time for exploring the Stockholm nightlife (schlager gayclub? Check.), picnics and a two-night stay at Solvik including Sauna, an Easter

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Egg-hunt and a Swedish sittning, complete with singing (in Swedish)!

On the educational side, a lab visit with a lecture on Optiogenetics (thanks to Calvin Young at the department of Neuroscience) and a Global Health class (thanks to Helena Nordenstedt at the department of Public Health Sciences) was on the schedule. The group also paid a visit to KTC (Clinical Training Centre) at the Karolinska hospital and the New Karolinska Hospital Showroom.

The project goes on and in June the Swedish participants will go to Turkey for a hopefully equally enjoyable week under the Turkish sun!

Big thanks to Frida Hellström for coordinating the entire project as Chairperson; to Andréas Lillieroth Bricaud for taking care of everything concerning food during the week; to Amy Sjöström

for planning some awesome social activities: to Global Friends for sponsoring part of the week and of course, to myself for helping out here and there!

(Twinning is a project under the International Committee at Medicinska Föreningen)

Would you be interested in working with coordinating the Twinning project for 2016? The current Organization Committee is stepping down, meaning a new Chairperson and –vice will have to be found. Twinning is a concept mostly aimed towards medical students, but everyone is welcome to apply. Contact us at Twinning.KI@gmail.com or intcom@ medicinskaforeningen.se!

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medicor

KAROLINSKA

Hej där!

Vi ses på nästa InnovatiOnsdag!

Välkommen till en inspirerande föreläsningsserie om allt från banbrytande medicinska innovationer till hur man ska använda crowdfunding för att finansiera sin idé!

Lyssna på erfarna talare som är ledande inom sitt område och utbyt idéer med andra deltagare. Dessutom ingår lunchmacka!

Läs mer på ki.se/innovationoffice

Innovation Office 9

KAROLINSKA

Does KI have a dark history?

Taking a closer look at the legacy of Anders and Gustaf Retzius at the Karolinska Institutet

By Iskra Pollak Dorocic Photo by Anna Vidina

KAROLINSKA

INSTITUTET

RECENTLY

found itself in the spotlight of the Swedish media - and not in a particularly flattering light. The unwelcome attention began with the publication of a lengthy Dagens Nyheter article detailing an old skull collection at KI, which was assembled by late 19th-century anatomists and fatherson duo Anders and Gustaf Retzius.

CONTROVERSY AT KI

The article, titled Mörk historia fram i ljuset [Dark history brought into the light], described the almost 800 human skulls, many of which were obtained by questionable and, by today’s standard, unethical means such as looting indigenous burial sites around the world. The skulls were used by Anders and Gustaf Retzius to build a classification system of races based on skull shapes.

The collection has been stored away and mostly forgotten since the 1960’s, but in 2008 the Museum of New Zealand requested the return of several Maori remains. It took KI four years just to reply, and until 2014 to decide to return the re-

mains. The university was criticized for not handling this issue appropriately and quickly enough.

A further discussion sprung up around the legacy of the Retzius researchers. In the center of the debate lies the Department of Neuroscience, also called the Retzius laboratory, to whom the skull collection was officially left.

Some members of the department have been actively discussing the legacy of the Retziuses: an open letter to the ViceChancellor signed by over 40 members and a subsequent symposium to discuss the matter. Someone has even been turning the statue of Gustaf Retzius sideways in an anonymous protest.

The open letter addressed to the Vice-Chancellor, Anders Hamsten, raised the question of whether the various naming’s around campus (Retzius Laboratory, Retzius väg and the lecture hall Gustaf Retzius) are suitable given the scientist’s problematic connection to race research.

Nicolas Guyon, the PhD student who penned the letter explains his reasoning, “My intention was to bring KI’s attention to what I felt was a lack of openness and discussion regarding a certain part of Gustaf Retzius’ legacy, in spite of the fact that his name and face are plastered all over the department. My aim was not to diminish his positive contributions, but to start a conversation about what we can learn from his mistakes.”

WHO WERE ANDERS AND GUSTAF RETZIUS?

Despite the fact that their names are so associated with KI, many people are not really aware of the scientific contribution of the Retziuses. Both men have prominent places in KI’s history: Anders Retzius (1796-1860) was professor of anatomy and served as KI’s Vice-Chancellor for 30 years, while Gustaf Retzius (1842-1919) is remembered for his seminal publication describing the anatomy of the inner ear of a large number of vertebrates. Both had a considerable international reputa-

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tion in their own time, aside from their work in physical anthropology.

The Retziuses were prolific researchers and adamant anatomists. They believed that with careful study of anatomic details of organisms, the basis of the natural system of biology would ultimately reveal itself. This led them to study all kinds of species in great detail and produce meticulous anatomical drawings and they did not stop at just animals.

Anders Retzius pioneered the use of craniometry, the measurement of skulls, and was the first to use the cephalic index in physical anthropology to classify ancient European human skulls. He classified brains into three main categories, based on their shapes: “dolichocephalic” (long and thin), “brachycephalic” (short and broad) and “mesocephalic” (intermediate length and width). Gustaf discussed his father’s and his own work at the Huxley Memorial Medal and Lecture (the highest honour awarded by the Royal Anthropological Institute) in London, where he expressed his worry of a dissipation of the ‘Nordic’ race and the need to institutionally protect it from other races.

According to historian Olof Ljungström from the Unit for Medical History and Heritage at KI, the Retzius craniological collection was “specifically intended as a means to try to work out the origin and relationships of the nations and ‘races’ of man, as understood in 19th century terms”. This field of physical anthropology served as a theoretical framework for what would come later, in the early and mid-20th century - the misuse of science for race biology, scientific racism and eugenics.

The Retziuses were far from alone in this endeavor of trying to divide races based on some anatomical definitions.

They lived in an era where craniometry was hailed as the tool of objective and true science. Many great scientific thinkers of the day, many written about in textbooks and honored today, began proving their theories about mankind using craniometry.

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Sadly, the “objectivity” of craniometry instead began being used to perpetuate many of the stereotypes of the times.

The evolutionary biologist Stephen Jay Gould writes in The Mismeasure of Man, “The leaders of craniometry were not conscious political ideologues. They regarded themselves as servants of their numbers, apostles of objectivity. And they confirmed all the common prejudices of comfortable white males —that blacks, women, and poor people occupy their subordinate roles by the harsh dictates of nature.”

“remembering is not the same thing as honoring” One of those “apostles of objectivity” was Paul Broca, a late 19th century French surgeon and anatomist, celebrated today for his discovery of the part of the brain responsible for speech generation (now known as Broca’s area). Broca was also convinced that the size of one’s brain is inextricably linked to one’s intelligence, and tried to prove that human races could be ranked linearly on a scale of mental capacity - with white males on top, of course. Broca was convinced he was right, but, as Gould describes, “his facts were reliable, but they were gathered selectively and then manipulated unconsciously in the service of prior conclusions”. Many of his scientific contemporaries bought into the big brain theory, and signed up to have their own brains weighed after death – a posthumous brag-

ging contest of sorts.

This example of Broca illustrates one of the problems with “objectivity” of science. Scientists are humans after all, influenced and biased by their own world views and the time they live in. A human body can be measured in many ways, and data can be cherry-picked in order to prove one’s theories, albeit unconsciously.

Though racist ideas were dominant in the time of the Retziuses, Broca and their contemporaries, opposing voices did exist. The Haitian scholar Antenor Firmin, in his 1885 book titled Equality of the Human Races, argued that the equality of the races could be demonstrated through rational and scientific analysis. The text was sidelined as a ‘radical’ view and ignored by the mainstream European dialogues of race.

THE ISSUE TODAY

KI is far from the only university to be confronted by questions of legacy. University College London renamed the Francis Galton Laboratory for the Study of National Eugenics to the Galton Laboratory of the Department of Human Genetics and Biometry - though the university still honors Galton by keeping his name, regardless of the fact that he is considered the father of eugenics. An article in Times Higher Education asks, “justice demands a public discussion about why we have (and about why, for so long, we have kept) those names.”

More recently, James Watson, one of the recipients of arguably the greatest Nobel Prize ever for the discovery of the

DNA helix, was suspended from his position as chancellor of the prestigious Cold Spring Harbor Laboratory, after making comments suggesting that people of African descent are not as intelligent as people of European descent.

In terms of the Retizus legacy at KI, Eva Åhrén who is head of the Unit for Medical History and Heritage, says “it’s important to discuss the meanings and consequences of ethically compromising actions, and not to shy away from the difficult and dark aspects of scientific work in the past (or in the present)”, she goes on, “remembering is not the same thing as honoring”.

“Discussing this topic might also help students and researchers today reflect on what they themselves are doing that might be (or become) an ethically contested type of research.” Indeed, we should take this discussion as opportunity to reflect not only on who we choose to honor, but also on the science we are pursuing today. With the advent of new technologies, it is now possible to attempt to find the genetic underpinnings of intelligence, race and sexuality, for instance. These findings may, once again, be misinterpreted or misused to support ideologies of our times. How will our research be viewed in 100 years?

In March, following the aftermath of the publicity, the Swedish Society for Anthropology and Geography decided to change the name of the annual ‘Retzius’ medal it gives out. How the debate will play out at KI remains to be seen.

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KAROLINSKA

On The Right Path

One month with Institute for Indian Mother and Child

By Caroline Olsson and Emelie Looft WE ARE IN AN EXTREMELY HOT AND

green suburb of Kolkata, India. I’m sitting on a bed next to a fifteen-year-old girl.

We talk about singing and dancing. And about nice smiles, especially the smile of the Japanese volunteer; she likes his smile. So do I. We talk about pain. I have a small bandage on my arm after a scratch.

She shakes her head; “Not good.” I should be more carful. I promise I will.

We are sitting in her hospital bed at the IIMC´s indoor clinic. This fifteenyear-old girl wears a cervical collar that inhibits the formation of scar tissue on her neck. She stays at the clinic in order to get rehabilitation after a skin- transplantation from her thighs to her neck.

The scar from the kerosene burn stretches from her cheeks over the chest, shoulders and arms down to her stomach.

Women at the campus talk about unhappy marriages. Sometimes, the husband or the husband’s parents do not approve of the young wife or of the dowry her family paid for her wedding, and the bride will suffer accordingly. The problem with “burning brides” – where a bride is put on fire with intentions to either harm or kill her – is a widespread public health problem in India and resides from the patriarchal structures of the Indian society and the subjugated role of women. Over 8000 women are killed each year and only about 15 % of these cases make it to court.

The girl in the hospital bed is a victim of unjust social norms that she cannot control. She doesn’t want to talk about what happened to her. But yes, she knows pain. She agrees that my pain under the bandage is small in comparison.

I have been at the IIMC- centre for three weeks. In total, we are 20 volunteers from different countries. The majority of my time is spent at the indoor or outdoor clinics; tending to wounds, administrating injections and taking blood pressure, but there is so much more going on here. We have celebrated birthdays for the children at the orphanage. We have

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visited schools and have been giving English lessons. One day we went out to play football on a muddy field with the teenagers in the soccer team of the villages.

Another day I had paint all over my body after painting Minions at the walls of the nursing school.

Covered in colors everyone looks the same, everybody is equal and strangers readily become friends.

One morning, I am alone tending to the patients at the indoor clinic and I have twenty women and children to visit before lunchtime. By my side is Masudur, a ten-year-old boy who stays at the clinic while receiving treatment for a candida infection. He is a great help as he translates when the patient’s English or my Bengali and body language is not enough. He holds a pen and paper and writes down the temperature and heart rate of a 2-year-old who has a big abscess on his scalp. He keeps track on the time on his mobile while I’m counting the slow breaths of an older woman. I tell Masudur that he is like a mini doctor, but he just shakes his head. He knows that no matter how hard he works in school he might not even have an opportunity to attend those kinds of studies.

The main focus for IIMC, apart from healthcare, is education. The IIMC sponsorship program gives the children the opportunity to go to school, something that can be life changing for not only the child, but for his or her whole family.

The other major focus for IIMC is women empowerment through projects like microcredit banks, Women´s peace council and handicraft production. One early morning, during the last days of my stay here in Kolkata, I’m on my way to a

micro credit meeting on a motorbike driven by one of the incredible Indian volunteers Alim. He runs the five IIMC- banks that give over 25 000 women the opportunity to take loans for their own business.

The surroundings are lush and rice fields, fishponds and brick houses with straw roofs surround the roads. I see a women walking down the road with an umbrella protecting her from the sun, and I take out my camera to take a photo. Alim tells me that she is one of the mothers on her way to the meeting. There is something in her way of walking that makes me feel that we are on the right path.

Institute for Indian Mother and Child (IIMC) is a non-governmental organization, founded in in 1989 by Indian physician Dr. Sujit Kumar Brahmochary, with the mission to provide health care to the poorest people of the region. The organization operates in West Bengal and in the rural areas of Kolkata, India. IIMC works through many different projects to enhance society in rural areas, including programs within education, sponsorship, economy, female empowerment, agriculture and production. The Swedish branch of IIMC, IIMC-Sweden, has a close collaboration with IFMSA and works primarily with the sponsorship program and by sending volunteers to Kolkata.

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IIMC

Are you interested in sponsoring the education of a child in the rural parts of West Bengal? Or do you want to know more about volunteering in Kolkata? Send a mail to iimc@ifmsa.se. Read more about IIMC at www.iimcmissioncal.org and join the Facebook page IIMCSweden.

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KAROLINSKA

Image credit: Christian Papatziamos Hjelle, Cajsa Schalling

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SCIENCE

Science Snippets

By Iskra Pollak Dorocic and Irina Pader IMPLANTING HAPPY MEMORIES A bit reminiscent of the movie Inception, scientists have managed to enter the brain of a mouse while it is sleeping and implant new memories. The extraordinary feat was accomplished by recording the animal’s brain activity during sleep and associating a specific activation pattern with a pleasant feeling. The scientists linked a particular place cell activation in the hippocampus with a stimulation of the pleasure center of the brain. Once the mice woke up, they headed straight to the location which was coded for by the stimulated place cells – suggesting that the implanted memory was a conscious one. (de Lavilléon et al., Nature Neuroscience, 2015)

PROMISING ANTIBODY AGAINST HIV For the first time, a broadly neutralizing antibody against HIV-1 infection (3BNC117) has successfully been tested in a phase 1 clinical trial in humans. In contrast to earlier developed antibodies, this new type can neutralize multiple HIV strains and has now shown to be effective in human immunotherapy. Intravenous administration to 29 individuals, of which 17 were HIV positive, resulted in a significant reduction of the virus levels for 28 days. The study gives hope for combinatory antibody-drug treatments in the future.

(Caskey et al., Nature, 2015)

Image credit: Eric May (Flickr)

PAINKILLERS ALSO KILL PLEASURE Paracetamol is one of the most popular over-the-counter painkillers in the world.

Recent research found a new surprising side-effect: the drug not only dulls physical pain, buy might also dull pleasure and other emotional reactions. Participants in the study took either paracetamol or a placebo, and were then exposed to emotionally-charged images, either very disturbing or pleasant. The participants who took paracetamol had less intense reactions to the images, both happy and sad. The research suggests that the painkiller may have effects on more than just relieving pain, but can also more broadly dull our emotional responses.

(Durso et al., Psychological Science, 2015) FIRST HUMAN EMBRYO ENGINEERING For the first time ever, scientists claim to have edited the genomes of human embryos. The experiment took place in China, and used ‘non-viable’ embryos from fertility clinics, which were at the single cell stage. The researchers used a technique called CRISPR/Cas9 to attempt to modify the gene responsible for beta-thalassemia, a severe and often fatal blood disorder. 86 embryos were injected, out of which 54 were then genetically tested. Only 28 showed successfully editing, and only a fraction of those had the replacement genetic material. These early experiments raise huge ethical issues and calls for restrictions on this type of research.

(Liang et al., Protein & Cell, 2015)

Image credit: latteda (Flickr)

Image credit: lunar caustic (Flickr)

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MAN’S BEST FRIEND As anyone with a pet dog can attest, there is a special bond between an owner and their dog. New research suggest that it’s all in the gaze. A Japanese team has shown that when dogs spend a lot of time making eye contact with their owner, their levels of oxytocin increase.

The owner’s levels also increased. Oxytocin is a brain hormone involved in the parent-child bond, as well as other types of social behavior. The researchers also artificially increased oxytocin levels in the dogs with a nasal spray, resulting in longer eye-contact in females dogs (but not males). This is the first study to show oxytocin can facilitate social gaze interaction between two different species, and suggests dogs evolved this during domestication. (Nagasawa et al., Science, 2015) HUNTER-GATHERER MICROBIOME A recent study has analyzed the gut microbiota of a modern hunter-gatherer community, the Hadza of Tanzania, and gives a snapshot of how the pre-industrial gut microbiome must have looked like. Compared to Italian urban controls, the Hadza microbiome has a surprisingly unique microbial profile and higher biodiversity, which is well adapted to break down the fibrous plant-based food of the Hadza. Interestingly, females and males differed significantly in their microbiota depending on their lifestyle, as women collect plant foods while men mostly hunt.

(Schnorr et al., Nature Communications, 2015)

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SCIENCE

Is there light at the end of the tunnel?

Image credit: Eli Bishop Urbex Photgraphy (Flickr)

The mysteries behind near-death experiences

By Jessica de Loma Olson SURE YOU HAVE ALL HEARD ABOUT THE

“light at the end of the tunnel”. That moment, almost at the doors of death, when you can see your life pass in front of you.

In the blink of an eye, you can apparently see all your loved ones. Some even say that they - who knows if this means their mind or their soul - feel detached from the body and are able to see everything happening around them. Others sense security and warmth. All these are just some of the personal experiences that can seemingly be grasped on the way towards death. And let me stress on the way, but without actually getting there.

These are known as near-death experiences or NDEs. No matter whether for religious, cultural, scientific matters or just plain curiosity, humans at least at some point of their lives always wonder if there is something beyond death. If so, what is it like? Such questions, for which we will probably never get an answer, are closely related to what happens when people resuscitate and NDEs might lead us a bit closer to that eagerly-awaited answer.

Many people who have suffered an accident or have temporarily ‘died’ on the operating table recall having these NDEs. But do we know exactly what they consist of and why they occur?

Already in 1982, Daniel Carr published in the journal Anabiosis: The Journal of Near-Death studies his findings regarding how NDEs could be linked with the release of endorphins and enkephalins in the brain. These two opioid peptides,

which participate in the response to painful stimuli and in generating happy feeling respectively, were suggested to participate in the secure and warm feeling experienced during NDEs. Multiple studies also propose that other drugs, such as ketamine and DMT (N,N-Dimethyltryptamine, a psychedelic chemical), can induce a similar state comparable to NDEs.

...humans at least at some point of their lives always wonder if there is something beyond death.

This resemblance between NDEs and drug abuse-related delusions could increase the skepticism about the veracity of these testimonies. Are NDEs just hallucinations? Hundreds, if not thousands, of testimonies flood the Internet describing personal experiences. Books, TV and all sorts of media are an excellent way to share these and leave us doubting whether they are actually true or if it’s just the human brain playing tricks on us.

To demystify this topic, more research is still ongoing. In 2010, a study led by S. Grmec at the University of Maribor (Slovenia) showed that higher levels of CO2 in blood are associated with NDEs in the case of cardiac arrest survivors. These levels of CO2 could alter the chemical balance in the brain, affecting the vision

and maybe causing that “light at the end of the tunnel”.

But being realistic, scientists are now focused on understanding if NDEs actually occur, instead of searching for explanations as to what appear to be “NDEs”.

This was done in the study published in 2014 by S. Parnia encompassing 4 years of study, 15 hospitals and 3 countries. Cardiac arrest survivors who were temporarily clinically dead and with no signs of consciousness were asked if they remembered anything from the time during their unconsciousness. 39% (55 out of 140) answered yes, making it one of the biggest studies ever conducted in this field, but leaving still much unsolved.

However, no matter what the causes underlying these phenomena are or if they are actually a glimpse of death or not, everybody that presumably experiences them describes it as life-changing.

A new opportunity to live their lives.

But while NDEs are still a mystery and the fright - or curiosity - towards the unknown of death still haunts us, embrace this uncertainty. Consider it as an opportunity to live life with all its light before we actually see it at the end of the tunnel – or not.

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“At first there was nothing funny about it…”

Image credit: Vero Villa (flickr)

Science that makes people laugh and then think

By Irina Pader

IGNOBEL PRIZE (A WORDPLAY OF THE

word “ignoble”, meaning dishonorable or unworthy): the “cousin” of the real Nobel prize, the “satirical counterpart”, the “parody”... Inaugurated 1992 by Marc Abrahams, it honors scientific achievements that first make people laugh, and then think: mostly unusual, imaginative science, with a humorous touch. But where do you draw the line between a serious and seemingly not so serious research question? How do you decide if you pursue a research question that might sound a bit funny from the beginning? Medicor got the opportunity to talk to four IgNobel laureates while they were on a stopover in Stockholm during the 2015 IgNobel Europe tour.

Dr. Jaroslav Flegr from Czech Republic, IgNobel winner of 2014 in the category “public health” with the project: Changes in personality profile of young women with latent toxoplasmosis – effects on mental health by owning a cat Can it really be “mentally hazardous” to own a cat? This question was going around in my head before I met Dr. Flegr, who is an evolutionary biologist and parasitologist. One of his research interests is toxoplasmosis, a parasitic disease mainly found in cats, but which can also be transmitted to humans. Dr. Flegr is particularly interested in understanding if and how the parasite can

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manipulate the behavior of its host. He started with this research about 25 years ago and explains that, at the time, only a very small amount of funding was avail-

But where do you draw the line between a serious and seemingly not so serious research question? able. Since the researchers could not rely on expensive animal models, they simply started to use humans instead: “They are much cheaper, a lot of fresh students are coming all the time!” says Dr. Flegr with laughter. More seriously he adds that it is very easy to test if people are affected by toxoplasma and to compare behavior and the personality profile of infected versus non-infected subjects.

Nonetheless he has been criticized for this research approach for not “involving enough molecules”, and other researchers consider it “ancient science” to give questionnaires to people. “But they were not awarded the IgNobel prize!” says Dr. Flegr happily. So what are the mental effects? “People who are infected with toxoplasma have a 2.7 times higher probability of traffic accidents and a similar increase of schizophrenia”, says Dr. Flegr, and points out that with one

third of all people infected, this becomes a very serious issue. “Of course I also have a lot of normal papers and I think some side-products of my research are very important.” Dr. Flegr refers to his finding that Rhesus factor positive and Rhesus factor negative people have a different susceptibility to several diseases, including toxoplasmosis. Thus, the IgNobel prize was nothing he was really aiming for, but he felt very happy about the opportunity to promote some of his “more serious research”. Dr. Flegr admits he feels that more of his research deserves the IgNobel prize: “I always do something interesting and some of these interesting things are also funny!”, he says with a smile. Which is also what he recommends to any other scientists: “My strongest recommendation is to do always something interesting, it is not important whether it is considered serious or modern or something. Do always something which is interesting. and serious discoveries will follow!”

Dr. Sabine Begall and Dr. Pascal Malkemper from Germany, IgNobel winners of 2014 in the category “biology” for showing that when dogs defecate and urinate, they prefer to align their body axis with Earth’s north-south geomagnetic field lines “At first there wasn’t anything funny about it!”, replies Dr. Begall when I asked about the motivation behind the

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Dr Nakamats claims to hold more than 3300 patents, compared to Thomas Edison’s ‘only’ 1093 inventions. project. Both Dr. Begall and Dr. Malkemper are investigating magnetic reception in mammals and are trying to find out how the Earth’s magnetic field is perceived. They are mainly working with African mole rats, which were the first mammals to be shown to have a magnetic sense. The knowledge about other mammals is still very limited because it is rather difficult to study migration routes in, for example, whales. In order to find a more accessible model system, they instead came up with dogs to study magnetic alignment. “The focus was not the dog behavior itself, they were in fact a tool to show that they can sense the magnetic field, too”, says Dr. Malkemper. At first they got a lot of negative feedback and criticism. Friends asked if they are completely out of their minds to study urine and feces of dogs. In addition, many dog owners said that this study is totally silly and they were convinced that their dogs would just align however they want. Other critics argued that they were wasting tax money. But Dr. Malkemper points out that the whole study was done in their spare-time. “It was not only a ‘just for fun’ study, we had a real scientific interest, but did it as a ‘bonus’ to our normal work with African mole rats”, he says. Dr. Begall adds: “We did not have to go out with the dogs ourselves, we just gave a compass and pen and paper to 50 dog owners.” All along they were very curious whether they

would find anything or not. Finally the scientists were really surprised when the work finally paid off. Also the critics changed, all of a sudden people found it exciting and many dog owners said: “My dog can do it, too!” Both scientists were overwhelmed when they won the IgNobel Prize. Dr. Begalls advice for students is to be totally open-minded: “Always think in different directions, don’t focus on one narrow direction. Also consider the ‘impossible!’” For Dr. Malkemper it was important to realize what really inspired and fascinated him. “Do not be afraid to follow up on it even if you might encounter some head wind. Just check where you can do what you want to do and then really work towards your goal!”

Dr. Nakamats from Japan, IgNobel winner of 2005 in the category “nutrition” for his project to photograph every meal he has consumed over a period of 43 years It was a true pleasure to meet 86-yearold inventor Sir Dr. Yoshiro Nakamats: Apart from being awarded the IgNobel prize in nutrition for documenting every meal he has ever eaten, he was selected by the U.S. Scientific Academy as one of the greatest scientists in history and claims to hold more than 3300 patents (compared to Thomas Edison’s ‘only’ 1093 inventions). Examples of his inventions are the floppy disc, digital displays,

jumping shoes with leaf springs on their soles and a kerosene pump. He showed me a book about all his inventions and impressed as I was, I asked which of his inventions was his favorite. He replied: “Do you have children? This is the answer to your question, I’ll hope you understand”. So how did he come up with all these ideas? “My main motivation is always looking for unknown things. To invent something is very difficult and for that you need to have a strong spirit!” says Dr. Nakamats. He did not know about the IgNoble prize before, but was very happy when he was awarded. “It is very important to reach higher than any other student and to be ambitious!” he recommends to students and researchers. For his inventions, he says that he did not face any sort of criticism in the past. “I am doing new things that nobody is doing. So no criticism.” Also he emphasizes that the whole point of the prize is to make people think and usually people appreciate that. While talking about future inventions, Dr. Nakamats replied that he has cancer and is going to die at the end of this year. So his present project, he explained, is to devise a cancer therapy. “I am planning to make ten inventions, ten therapies. These therapies will beat cancer”, he says. Twenty percent of the project he has done, “the rest eighty percent I must do until the end of the year.”

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Anthropocene The questionable age of man

By Oskar Swartling

THE STUDY OF EARTH, ROCKS AND HOW

they change and are created is an old, although still important scientific field.

Geology does not only provide information of historical importance, but also helps us understand the world we live in and the world we will live in. Like the field of medical sciences, the advancement of geology has widespread impact on our society. By studying the continental drift, the layers of the Earth and past climates, geology delivers useful and necessary information about natural hazards and climate change, to name a few. The impact of humanity on the Earth is one of our time’s major topics, but is not limited to climate change, the rise of the sea levels or the deforestation of rainforests.

The idea of a geological time that recognizes our impact on the planet is gaining ground and more voices are being raised

Geology delivers useful and necessary information about natural hazards and climate change to let the present epoch Holocene give room for the Anthropocene: the age of man.

Geology uses periods, epochs and ages as units of time to make sense of all the rocks, fossils and sediments that are found around the world. By doing this, it is possible to give all these materials an absolute age and to determine the geologic history of the Earth. This discipline is called geochronology and uses radioactive isotopes and other techniques to date the material. It is therefore possible to divide the geologic history in the units of time named earlier. The body controlling this is the Internation18

al Commission on Stratigraphy (ICS) by defining strata criteria. In short, they are responsible for the geological time scale, making the sciences of geology, palaeontology and geobiology working on a global scale. We are right now living in the Quaternary period and the Holocene epoch, starting 11,700 years ago after the last ice age. Although that might change, the ICS has started the Anthropocene Working Group, evaluating the proposed new epoch. It is, however, necessary to understand just how important the geological time scale is. Some describe it as so fundamental for geology that it can be compared to the periodic table for chemists. With this in mind, it is not hard to understand that although popular, the Anthropocene is not warmly accepted in all corners of the scientific field.

The proposed epoch Anthropocene is becoming widely popular, not just within geology. The epoch is thought to have started when human activities started to have an impact on the ecosystems of the Earth. The next question is, however, when did this happen? The early start of the Anthropocene is when humans first started changing the land by farming and herding. To be an adequate unit of time, the start has to be clearly defined. For example the start of the current epoch, the Holocene, is a chemical reflection of the end of the last ice age in an ice core found 1,492.45 metres down in Greenland. Due to this need of specificity, just the start of the Anthropocene is a big debate. The early start of the Anthropocene could be seen in the rise of methane in the atmosphere, indicating a higher frequency of farming and herding activities. Another possible start of the epoch is what is known as the Great Acceleration, a time starting in the beginning of the twentieth century. During this time, the marks of humanity on the environment increased exponential-

ly. A third proposed start is the records we can find all over the world after the nuclear bomb tests in the 1950s. Another, somewhat terrifying start of the epoch is a drop in carbon dioxide levels in the atmosphere between 1570 and 1620. A paper published in Nature linked this drop to the death of 50 million indigenous people after the ‘discovery’ of America.

According to the paper, millions and

The epoch is thought to have started when human activities started to have an impact on the ecosystems of the Earth millions of hectares of agricultural land became overgrown by forest, thus the drop of the carbon dioxide concentration. Despite the different candidates for the start of the Anthropocene, there are other reasons besides pure scientific reasons that the proposed epoch is so popular.

Usability is the main reason the Anthropocene has become so popular. A geological time defined by a starting point from when humanity started to destroy the ecosystems of the Earth is a useful tool. What started as a geological concern became something many disciplines can use as a way of getting heard. It is beyond doubt that humanity has a major impact on the Earth and that this is recorded in material all over the world, but since the geological time scale is immensely large, many question the significance of this impact on the rocks and sediments that are studied today. Many environmental researches, media and politicians embrace the proposed epoch to push for legislations and

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Image credit: Doc Searls (flickr)

to get the public’s attention. The Anthropocene is no longer just a name for a unit of time, a new element in the periodic table of geology; it is a way of changing the route we have embarked on. The geologists concerned with the idea of an age of man do certainly not question the evidence for climate change. They are, however, sceptical of letting politics and public opinions affect their science.

The dividing line seems to be the question of whether it is too premature or due to non-geological reasons the new epoch would be introduced. Humanity is affecting our planet and we are leaving well-defined marks suitable for a definition of a new epoch. But from a pure scientific point of view, it is not totally clear if it is necessary. If the start of the Anthropocene would be the beginning of the twentieth century, e.g. the Great Acceleration, the sedimentation on the bottom of the sea from this period would be thinner than one millimetre. Given this, some geologists recommend that the evaluation of the new epoch should happen in some thousand years.

The Anthropocene has become a political statement. The need to formalise the age of humanity’s impact on Earth is more than geology. The new epoch could be used as a, albeit good, argument in many relevant and important decisions. With this epoch and its definition, it might be easier to raise the question

of climate change even more, to really reach out to the public. One can imagine the incitement and strive to globally end the Anthropocene, the modern equivalent of the Dark Ages. But the Anthropocene is a formal geological time scale; the Dark Ages is not. The word Anthropocene is already in use in the geological society, although informally. Still, the message is clear even from an informal definition.

What started as a geological concern became something many disciplines can use as a way of getting heard For an outsider it is difficult to recognize the importance and status of the geological time scale, but it has undoubtedly a high place in geology and other sciences. Like in many other disciplines, there is a debate on scientific grounds whether the Anthropocene should be honoured with a formalisation. It is clear, however, that other aspects are influencing the pure scientific debate. Keeping in mind that an age of man could be used as a good weapon in the tiring and slow debate on climate change, maybe a formalisation is a good thing. Or do we

want science to be independent, a place where one can extract information and use it for the advancement of our society? The questionable age of man raises important questions for all the scientific disciplines and it is hardly the last time these hard questions have to be asked.

We have on one hand a geological time scale used to date and relate geological materials and to describe our world. But on the other hand, climate change debates are crumbling and new inputs and arguments are certainly needed. The Anthropocene Working Group will publish its recommendations by 2016. After that follows discussions and a decent time of voting before the epoch finally could be formalised. The importance of this can be argued. The real problem is not whether the Anthropocene should join Cambrian, Jurassic and the Holocene as a unit of time. The real problem is that we can actually define the geological history of our planet by the impact we are having on it.

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Image credit: David Appleyard for iGEM (flickr)

Not Afraid to Start from Scratch

By Anna Vidina and Sarah Wideman

WOULD YOU BE READY TO CARRY OUT

an ambitious project from basically nothing to begin with? It takes enthusiasm, courage and lots of work. That is exactly what iGEM teams sign up for every year.

Why? Let us see. iGEM stands for international Genetically Engineered Machine and it is an international science competition for students. It started as a small course at Massachusetts Institute of Technology over ten years ago. In the first competition only 5 teams participated, but since then it has grown immensely! In 2014 almost 250 teams from 32 different countries participated, including teams from Harvard, Oxford, Uppsala and Gothenburg. iGEM teams compete in synthetic biology, which is a mix between biology and engineering. Synthetic biologists use genetic engineering and standard parts to create cell systems that perform useful tasks. Previous iGEM teams have developed systems to detect arsenic in drink-

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ing water, turn non-recyclable waste into plastic and to detect and treat tuberculosis.

This year students from Karolinska Institutet are participating in iGEM for the first time, together with students from Kungliga Tekniska Högskolan and Stockholm University. The Stockholm iGEM team are developing a biosensor for early detection of lung cancer. The team consists of 19 students with diverse backgrounds. They are a mix of Master’s and Bachelor’s students studying Biomedicine, Biotechnology, Toxicology, Bioentrepreneurship and Chemistry. Although all of them study in Stockholm they come from 13 different countries!

It was a sunny Sunday afternoon

when I met the iGEM Stockholm team.

While they were having a break from their weekly meeting, we went outside to take pictures and I got the opportunity to talk to three team members from KI.

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Back row left to right: Pontus Höjer, Denise Strand, Mona Hassan, Karl Annusver, Karol Kugiejko, Sarah Wideman, Alison Shea Baxley, Maximilian Karlander Front row: Carmen Gallo Álvarez, Utsa Karmakar, Manon Ricard, Felix Richter, Hugi Ásgeirsson, Axel Bergenstråle

Manon (Biomedicine Bachelor, France) Utsa (Toxicology Master, India) Karol (Biomedicine Master, Poland)

What made you join the team?

K: I was inspired by Felix, our team leader, when he held the first info event. I thought it would be a great opportunity to gain experience and learn how to work together in a team.

M: I had already heard about iGEM and when I arrived at KI, I was surprised to realise that KI had never participated. Later, I was motivated to join the team because it seemed exciting to join a new project and it also seemed like a lot of fun.

U: I was looking for something to do in the summer and iGEM seemed like a challenging and fun student project.

What are you looking forward to the most?

K: Group-work! It’s hard to work in a big group, have productive meetings, come to a productive conclusion and thoughtful ideas. I also look forward to getting experience in the lab since no-one will be there to give us instructions or tell us what to do. This means you have no limits, you get to start from scratch and create something amazing.

M: For me as a bachelor student I think that the most interesting thing is to see how the project evolves. Everything is going very quickly right now. I also love that we get to do everything - not only the scientific part but also communicating with the public and getting in touch with other iGEM teams from all over the

world. We can drive the project ourselves from scratch till the end.

U: As I have a background in medicine I look forward to learn many new things, including lab techniques and methods.

The project itself is a challenge and if we succeed we get to present the project in the US. M: Yes! There’s the Jamboree in September. A bunch of our team will go to Boston to present our project, meet the other competing teams and hear about their projects. I can’t wait to meet so many people that share the same interests and that have worked through the same challenges as us.

come from different backgrounds, we get to teach each other. I would say that the most challenging thing is to communicate and arrange meetings as we’re so many.

Also finding funding is really difficult for a big team.

U: The best is definitely the team! It’s really challenging to have both the iGEM project and course-work simultaneously but this should get better in the summer.

K: For me the best thing about iGEM is that it connects many different disciplines. I have a background in biology but in this project I also get to do new things like engineering and chemistry. That’s really extremely exciting!

How did you decide on your project idea within the team?

What do you think the future holds for iGEM Stockholm?

M: We knew we wanted to detect biomarkers at low concentrations. So we started by developing ideas in smaller groups of 4-5 people. We went completely crazy and tried to be really creative by thinking that everything was possible. Then we presented our ideas to the whole team, got feedback and worked more in our small groups. In the end, we had a final meet-up all together and voted for the best project.

M: It’s the first time that Stockholm has an iGEM team so I hope to create a good image of this project and inspire people to follow our example. Also we’re setting the foundations for future teams.

U: It was also really good to get feedback from our supervisors, who all come from different fields.

What have been the best and the most challenging experiences so far?

M: As we haven’t started the lab work yet, the best thing so far has been to get to know the whole team. As all of us

K: I’d also like our work to inspire students next year and I hope we can find someone to lead the team who works as hard as Felix does. I want the project to become big so that professors and students know what iGEM is. I think both students and professors could benefit from that.

U: I like that we are not bound to any university, it’s a collaboration. I hope it stays that way and that the Stockholm team flourishes in coming years.

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WAITING IN LINE Story by Oskar Swartling Photo by Martin Kjellberg och Helena Wahlman

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“ “

I have never seen myself as sick. I have never done that and I never will. I have a new kidney, but I am not sick.

It is very hard to describe the waiting”, Martha Ehlin says. “It is so incredibly difficult to be on the waiting list. I usually describe it as a living nightmare. There is so much uncertainty. Someone else’s decision will decide whether I can stay alive or not.”

Martha was thirty years old when the unexplained back pain and exhaustion did not give away. The symptoms became more severe and after visiting a doctor she did an x-ray. The radiological examination revealed round, cyst-like formations in and on the liver, but no further explanation. Martha had to endure even more testing and examinations before she got the answer to her problems. The answer, however, was a bolt from the blue.

She had cancer, a rare endocrine tumour in her pancreas with metastases in the liver. The cancer was neither possible to remove by surgery nor curable. Martha faced two options: lifelong cytostatic treatment or five-organ transplantation.

The five-organ transplantation included a new pancreas, liver and, due to surgical reasons, also a new ventricle, duodenum and small intestines. Martha chose the latter and was put on the waiting list. And she waited.

Peter Carstedt was twenty-one years old and had studied business manage24

ment for two years when he decided to study in Japan the following year. He was in the middle of his studies and wanted a change of environment, common for people of his age. He applied and got accepted, but needed a medical certificate before he could leave. “Wait a second, this doesn’t seem right”, he says, recalling what the doctors told him. He had proteinuria and high blood pressure and

Martha faced two options: lifelong cytostatic treatment or five-organ transplantation. was sent to the hospital for a kidney biopsy, where the worry was confirmed.

Peter had IgA-nephropathy, a disease associated with an abnormal production of IgA and depositions of the antibodies in the glomeruli, but the cause is not totally clear. Peter stayed positive, despite the diagnosis: “I thought: ‘how lucky I was to find it’, rather than focusing on the negative aspects”. At the time of the diagnosis Peter had a renal function at 70 % and was given medicine and had regular controls. The progression of the disease var-

ies; some have a rapidly progressive nephropathy, others stay at their decreased renal function for decades. “The doctors told me that if I was lucky the renal function would stay steady and I could live a normal life until I was fifty or sixty.” After the unexpected news, Peter went to Japan.

Martha tried to live in the present, although it was hard not to keep the cell phone close at all times, waiting for that phone call that would change everything.

At the same time, she was treated with chemotherapy that broke her down everyday. Paradoxically, she could not become sicker since the surgery was complex and only could be done on fairly healthy persons, this despite the treatment and the fact that she had a growing and spreading cancer. “But I tried to stay positive and take one day at a time. I made goals for myself in the future. One of these was to help others that was in the same situation as I was.” The surgery itself was a subject for worrying: “I was given strong medication and had trouble sleeping. I could feel how I was being broken down, since everyday I got worse and worse. I also thought a lot on the possible transplantation. It was a big operation. Would I wake up again? And if I would, would everything work or was I going to continue

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with this suffering?” Martha also thought about her living donor. That someone else would be willing to donate his or her organs felt unreal. During that time, she had not herself registered as an organ donator. She was going to receive an organ but had not expressed her will to donate herself. Martha felt ashamed, it was wrong. What she didn’t know was the situation of organ donation in Sweden, still today: “I understood that persons had to wait for a while on a waiting list, but that we in Sweden had such an organ shortage I understood first when I started to work with the question. Maybe I was ‘happily’ unknowing during my wait.”

“...that we in Sweden had such an organ shortage I understood first when I started to work with the question.”

After his diagnosis, Peter kept going.

He was, as he describes it, “living life”. He went to Japan to study abroad, travelled to Haiti and worked with HIV and Aids issues and ended up in Shanghai where he worked as a consultant. “I have never

seen myself as sick”, Peter says, “I have never done that and I never will. I have a new kidney, but I am not sick.” In his late twenties and living in Shanghai, Peter’s renal function plummeted to 30 %. He developed gout that was mistakenly considered an injury he acquired after skiing. Only later, when the gout spread to both his feet, did Peter become aware of his decreased renal function. “The doctors in Sweden wanted me to come home, but I wanted to go home with flying colours, so I took the Trans-Siberian railway home. I couldn’t just go home because of a disease I didn’t even have”, he says and laughs. “The trip took a week and when I came home I had a renal function of about 9 % I was so tired; it felt like having influenza for three months. The disease went the wrong way.”

“Are you kidding with me?” was the only thing Martha could say when the call finally came, informing her that the hospital had organs ready for her. She underwent the surgery the same evening and was given a new liver, pancreas, ventricle, duodenum and small intestines. The operation took seventeen hours. But the wait for new organs and the chemotherapy before were not the only challenges Martha faced. “The way back was not a dance on roses. There were a number of

complications and I was at the intensive care unit for four months. I had to learn everything again. Walk, eat, and tie my shoes. And I was kept at the hospital another four months before I could leave.”

During this time, she heard that there was something called the World Transplant Games, a sporting event for transplant athletes. The next event was in two years and was going to be held in Gothenburg.

Martha was happy if she could just be in the audience and cheer at the other transplant recipients. It turns out, she went on to achieve something much more than that. During the World Transplant Games she won five gold medals in five different disciplines, or as she once said: one gold for every organ she had received. During the games, one of her teammates was Peter Carstedt.

“Are you kidding with me?”

“One thing I clearly remember is when the senior physician came in and told me that I needed acute dialysis. That wasn’t so fun, it was one of the few times I cried”, Peter says. However, he soon regained some of his renal function, which is very rare. But during this time, he had 25

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already begun with the transplantation investigation. A lot of persons close to Peter offered to donate a kidney. “That was also a strange situation. What do you do when an ex-girlfriend or a friend from school offers to donate a kidney? Do you say: ‘Good, I’ll tell the doctor, just give me your number and he will call you’?”

In the end, Peter’s mother was the best match for a donation. Due to his partly regained kidney function, the investigation for transplantation was already finished before he actually needed the organ. He describes this as a very odd situation: “I was waiting to become more sick so I could become healthy. At least that’s how I saw it. I kind of wanted to be done with it.” It is indeed a difficult situation and Peter raises some important questions: “How do you do if you are applying for a job? Do you tell them? Or if you are on a date, do you tell it on the first, the second or the third date?” Peter’s renal function became progressively worse and he eventually received his mother’s kidney. The procedure went well and Peter, like Martha, participated in the World Transplant Games 2011 in Gothenburg. Also he won five medals, among them one gold.

The World Transplant Games were an epiphany for Peter: “It was a game with ‘only winners’, where you celebrated life.

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MER ORGANDONATION (MORE ORGAN DONATION) is an independent organisation working with the issue of transplantation in Sweden. They work for the people on the waiting list where no one should die waiting for a tranplantation.

NUMBERS OF REGISTRATIONS TO THE ORGAN DONATION REGISTER

When we had the opening ceremony there was a silent minute. A silent minute honouring all the persons that have died on a waiting list and we were honouring all the donors that made it possible for us to be alive. Today, this still touches me very much.” He started to think about the situation for people needing transplantation in Sweden. Just like Martha, whose goal was to help others who are in the situation she was in before the operation.

At the time, there wasn’t any independent organisation working with the question of organ donation and transplantation and Sweden had few organs transplanted each year compared to other countries in the European Union. “We felt that no one in Sweden was working for the people on the waiting list.” Martha and Peter, two people with different histories; one with an aggressive disease and recipient from a deceased donor; the other with a progressively decreased renal function and recipient from a living donor, united with the ambition take on the issues and created the organisation MOD - Mer organdonation (More Organ Donation). In the beginning, Peter and Martha travelled around Sweden, talking to Socialstyrelsen (National Board of Health and Welfare), the Donation Council, Transplantation units and experts from the

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“

I usually describe it as a living nightmare. There is so much uncertainty. Someone else’s decision will decide whether I can stay alive or not.

healthcare system. They wanted to learn more about the issue of organ donation and transplantation in Sweden to better understand the problem with the Swedish system. In their eyes, the big issue was that no one talked about it, the debate was non-existing.

Martha and Peter identified three main problems in Sweden. The first one is the public. Sweden ranks among the best in the attitude towards organ donation, where 85 % of the population is positive towards donating their organs.

However, only 15 % have sign up to the national donor registry and 40 % have expressed their will in some way, e.g talked to relatives or carrying a donation card.

The second issue is the laws and regulations. The transplantation legislation is old and vague, making the legal aspects of transplantation problematic. The third issue are the intensive care units and their praxis and routines. With better and better medicine and equipment we can keep people alive for a longer period of time, making more people eligible for donation. Healthcare professionals are not allowed, in today’s praxis, to treat someone for another person’s benefit or in order to respect the patients will to become an organ donor. Here is where it gets problematic. Unfortunately transplantation

NUMBERS OF PERSONS ON THE WAITING LIST 2015

falls into this category, making it hard for the staff at the intensive care unit to know the extent of their authority. To put it simply, the law, praxis and routines are not up to date. The uncertainty leads to that the number of transplantations per million persons varies between different regions in Sweden, meaning that different regions interpret the law in dissimilar ways. Additionally, many comparable countries, like Norway and Spain surpass Sweden in the

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COVER STORY

“

In 20 years, I hope MOD doesn’t have to exist.

amount of transplantations per million persons. Norway, for example, is almost twice as good as Sweden. Peter is quick to add that the transplantation side is very good in Sweden. Many sophisticated surgeries are done, like the five-organ transplantation Martha got, and the mortality after transplantation is low. It is on the donation side that MOD is trying to make a change. MOD is working with all three areas that are problematic: to increase the number of people who has actively said yes to organ donation, to renew and update the existing laws in regard to organ donation and to change the routines and praxis of the healthcare system. MOD is today the biggest information channel/ source for organ donation in Sweden and the organization gives lectures in schools throughout the country and has the biggest social media platform with over 57,000 followers on Facebook. MOD has developed informative pamphlets and

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smart phone apps to make it easier for the public to make their decision to donate.

The list goes on and on, but the ambition is to raise the public’s awareness. They want people to pick a side and then make their will heard, thus helping all the people on the long waiting list. Every year about fifty persons die while on the waiting list in Sweden and MOD is trying to push that down to zero.

Paradoxically, a long waiting list is better than a short one, given the turnover is higher. This allows the match between donor and recipient to be better. MOD’s goal is therefore not to shrink the waiting list, but to make it possible for more people to have a proper match in time and that no one should die while on the waiting list. MOD is evidently on the right path. Two years after the organisation was founded by Martha and Peter, 67.000 listed themselves in the donation register, twice the number the years before.

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Three years after, more people signed up during the first six months than in 2011 and 2012 combined. In 2014 a movie made

by MOD had one million views in just a month. The movie featured three persons on the waiting list recording their farewell to their loved ones if they wouldn’t make it. Thanks to Peter, Martha and the 400 volunteers that are helping them, the issue of organ donation has been raised.

However, the issue is complex. The public’s attention is not the only thing needed to decrease the mortality on the waiting list; the politicians and the health care also has to do what they can to change the situation to the better. Socialstyrelsen recently published a report stating that the number of donors every year could be almost doubled, if only the health care had worked with the issue of transplantation more structured and been better at talking to the families that are faced with the very difficult discussion that follows a death of a person eligible for donation.

According to Peter, the response to MOD from the health care has been mainly good: “We received a fantastic welcoming at the first meeting we attended for all persons responsible for organ donation in Sweden, where we got a standing ovation.

At the same time, we have met healthcare professionals pointing out that we are not physicians and that this is not our area of expertise. But we don’t agree with this and since nothing is being done, we do it.” Martha agrees that it is a question that always has to be present. “The issue of organ donation and transplantation has to be taken further. Among the public, the health care and the politicians that make the decisions. It is about knowledge and attitudes. And I want to think that we are on the right track.”

“There are going to be large changes in the Swedish system.”, Peter says. MOD is involved in a national investigation led

by Anders Milton (Regeringskansliet), proposing law changes and new rou-

DIGITAL PRESENCE MOD works continually with their digital platform for donation, therefore raising the public’s awareness.

tines in the health care that will make the transplantation situation better in Sweden. This is desperately needed in a country with the highest incidence of people positive to donate their organs, but with few transplantations per year.

People waiting for new organs should not have to die when we have the potential to help them. It is essential that everyone ask themselves where they stand on the question, for there are many reasons one may not want to donate their organs.

Once the stand is taken, make it heard.

Even though everyone by law has agreed to donate their organs if not stated otherwise, this is not followed by the health care. If you want to be sure your organs can help someone in need, join the donor registry or express your will to your family and friends. But we, as part of the future health care, have an even bigger responsibility. It is time to change how the organ donation system works in the health care, because there is an enormous discrepancy between the number of potential donators and the actual donators, therefore saving people that are today dying in vain. It is just not acceptable that errors of the donation systems allow people to die prematurely, and the health care system has to take its responsibility in this complex issue. Maybe then can we help Peter pursue his ambition: “In 20 years, I hope MOD doesn’t have to exist.”

300,000 Visitors on merorgandonation.se

55,000 Friends on Facebook /merorgandonation

40,000 Downloads of the digital donation card

app.merorgandonation.se

1,500 Friends on Instagram @merorgandonation

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SCIENCE

Dreaming with Lucidity “Lucid dreaming has considerable potential for promoting personal growth and self-development, enhancing self-confidence, improving mental and physical health, facilitating creative problem solving and helping you to progress on the path to self-mastery.” – Stephen LaBerge Image credit: Gingerimagebox(flickr)

By Sibel Ilter WHAT DOES IT MEAN TO BE AWARE OF

your dreamful state in a dream? A dream you experience in your sleep is known to bring out mental visions, emotions and sensations to your body, making you encounter certain situations that are out of your control. More concretely, it is seeing yourself meet up with an old friend, going to a nearby boutique to buy yourself your favorite fruit, and traveling to a different continent with one step out of the door of your house. During a majority of these dreams, we have a hard time coordinating our route; we can not sense any innerdirected will of where we would like to go, and so our dreams take spontaneous turns, giving us the show in which we willingly participate in. We can also partake in a dream unwillingly, which usually happens when our dream unexpectedly turns into a nightmare. We will struggle to reverse the effect, which will lead to a night of problematic sensations and a morning of sweaty clothes. In the conceptual meaning of lucid dreams, however, we overcome the state of dreamful unknowing and lull into an active consciousness – from there, we are free to terminate the nightmare. Lucid dreams, also known as vivid dreams, were explained by the Dutch psychiatrist Frederik Willem van Eeden in 1993 as “the re-integration of psychic functions so complete [in ludic dreams], that the sleeper reaches a state of perfect awareness and is able to direct his attention, and attempt different acts of free volition. Yet the sleep, as I am able confidently to state, is undisturbed, deep and refreshing.”

The quotation of the previous statement suggested the presence of consciousness during sleep, a claim that was denied by many for years. Like most dreams, modern studies now suggest that lucid dreams are known to take place during the REM (rapid eye-movement) state of our sleep. Scientific research has found that during REM sleep, the eyes of the

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dreamer shift in the direction of their gaze during the dream, enabling researchers to communicate with lucid dreamers using eye-movement signals. So what happens during a lucid dream? How is it initiated and where in our dreams does it start?

Lucid dreams are known for their variety and can start in different ways. The D.I.L.D. (dream-initiated lucid dream) begins as a normal dream in which the dreamer later on recognizes as a dream.

It usually happens when encountering a ludicrous scenario, such as waking up to an elephant in your room or participating in witchcraft with your friends. Being faced with such situations usually sparks a small portion the dreamer’s consciousness which in turn questions the reasonability of the event, eventually concluding it as a dream. For some, such awareness initially wakes up the person from their dream. Although not trained lucid dreamers, these people still experience a small fraction of lucidity in their dreams which induces a signal to wake them up. For others, however, especially those who are more familiar with lucid dreams, the dreams are allowed to go on, even after the dreamer has claimed the dream as a dream. A W.I.L.D. (wake-initiated lucid dream) occurs when the dreamer goes from a normal wakeful state directly into a dream state. This occurs when the person enters REM sleep from a completely self-aware wakeful state. A wake-initiated lucid dream is usually commenced with sleep paralysis. The body is normally paralyzed during sleep so that the movements done in dreams don’t induce reflecting movements in real life. Sleep paralysis can also, however, occur before sleep. This can lead to a state where the person lays awake, and yet is paralyzed all over the body. The wakeful person may then experience an inability to move, pulsating noises and hypnagogic hallucinations (all associated with sleep paralysis) before moving into W.I.L.D. state.

Once the sleeper has moved away from the wakeful sleep, the sleeper carries on to experiencing the different natures of a lucid dream. Although the most logical way of thinking is perceiving dreams and reality as two separates, some experiments concluded that there is no abstract dividing line between a dream and real life. In fact, they suggest that it is a line so indefinite that dreamers usually penetrate the boundary between dreams and real life without really knowing which side they are on, as in whether they are awake or still dreaming. This type of interference between dreams and reality could expose the dreamer’s body to stressful and confusing sensations, one of them being false awakenings. In false awakenings, the dreamer wakes up, usually in the room they fell asleep in, but are in fact still dreaming. In a lucid dream, the dreamer recognizes it as normal awakening and begins with their morning routines like any other day. Sometimes, a cold shower could then wake them up, only to have them realize that they have been dreaming all the while. This is a repetitive sequence that can go on four or five more times (in some profound cases, even more) before they actually wake up, entirely removed from their dream. Van Eeden described these false awakenings as “demoniacal, uncanny, and very vivid and bright, with... a strong diabolical light.”

For most lucid dreamers, the most intriguing thing they go through is waking up. Some argue saying that they can never tell when they are fully awake because of the continuous feel after the dream. They claim being so conscious in their dreams that it almost “feels real”, a feeling that continues all the way through waking up.

The only thing that confirms their full state of awakening, is their sudden lack of control, something they fully possessed in their dream.

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Image credit: Sean MacEntee (flickr)

The Brain and Poverty Family income linked to differences in children’s cognitive development

By Mimmi Mononen EXPERIENCES OF EARLY CHILDHOOD ARE

critical for brain development. A new study suggests that childhood socioeconomic status is essential for the shaping of cognitive development, along with nurture, love and education. Childhood socioeconomic status is a concept that stands for parental education, occupation and income, and it was shown in the study to correlate with brain surface area, as well as size of brain regions crucial for the development of language, memory and reasoning skills in children.

Our brain is the product of both our genes and experiences. According to the study published in Nature Neuroscience this March, the experience of growing in a poor family has an apparent effect on brain and cognition giving life-long disadvantage in terms of academic achievement. A research group from Columbia University in New York City imaged the brains of 1099 American children, adolescents and young adults, and correlated the brain surface area with the income class of the children’s families. After taking genetic factors into account, the group found that children from the families belonging to the lowest income classes tend to have up to 6% smaller brain surface area compared to their peers from high income families. Even though the authors do not speak of what might specifically cause the brain changes, they believe the growth environment to play a significant

role in directing the cognitive development early on in life.

The message of the study is not that children from wealthy families in terms of income get a head start, turning into life-long advantage; or “if you are poor, your brain will be smaller, and there is nothing that can be done about it”, says Elizabeth Sowell, the senior author on the study. Instead, aim is to shed light on the link between childhood poverty and brain development, and thereby improve access of the poorest families to resources to enrich the growth environment of their youngsters. Also education of the adults at home, school and free time activities can help fighting the disparities between children by simply increasing awareness in the society.

...is a national as well as global challenge.

As getting rid of poverty is a hard thing to do, narrowing down the most influential factors among aspects such as parental income, stress levels, nutrition and cognitive stimulation may be the key to intervene the effects of poverty. Furthermore, to expand the definition of childhood poverty beyond low income and consumption of the family is crucial for understanding the different

dimensions of the problem. For example, material poverty may imply that a child’s day starts without nutritious breakfast and that instead of school, the child has to engage into hazardous labour. In the long run, both of them lead to decreased cognition, emotional capacity and bodily growth. On the other hand, environment lacking stimulation and emotional support may have similar effects as material poverty for children in families with relatively high income.

Protecting children from experiencing poverty in terms of low income and disempowerment is a national as well as global challenge. Proposed improvements to fight childhood poverty include better targeting of education, health and social assistance services towards the very poor, implying changes to the public finances and implementation of national plans. To convince governments to spend more on poor households, the group behind the childhood poverty study plan a major trial to investigate whether providing the poorest families with monthly payments can help to boost the brain development of their children. According to the group, results of the study can directly inform decision makers on benefits of investment to low income families with children.

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GLOBAL FOCUS

Syria: a Public Health Update “More than 200,000 lives have been lost in the four years of armed conflict” – BBC report

By Devy Elling THE SYRIAN UPRISING BEGAN IN EARLY

2011 as an anti-government protest. It erupted in response to the arrest and torture of teenagers, who were found painting revolutionary slogans on a school wall, in the southern city of Deraa. The unrest led the nation to begin a demonstration, and resulted in a rise in the demand for the resignation of President Bashar AlAssad. Shortly after this, the government began to take action against those opposing the president, which resulted in the opposition supporters to take up arms, mainly to defend themselves, but afterwards, used was used to expel government forces from local areas.

Violence escalated in the cities and towns of the country, and eventually reached the capital, Damascus, and Syria’s largest city, Aleppo in 2012. By mid2013, the United Nations reported that approximately 90,000 lives have been taken.

Projections have shown that the number of casualties is growing exponentially.

The Syrian Uprising has therefore, been noted as the worst humanitarian disaster at present.

The Syrian Ministry of Health has reported an improvement in the nation’s health index, with life expectancy at 56 years in the 1970s to approximately 73 years in 2009. In addition, children’s mortality under the age of five has decreased significantly. Although this improvement has been significantly impacted as a result of the ongoing conflict. The health system that was once known as probably one of the best in the Middle East has

The health system that was once known as probably one of the best in the Middle East has become the worst. become the worst. The unprecedented conflict has distressed the population, of which more than half are children under the age of 18.

The vast majority of casualties and injuries have resulted from the use of firearms by the government and opposition

forces. Even though injuries are seen as a direct consequence of the war, injuries from accidents due to damaged homes, or even fleeing from the conflict, can be seen as an indirect effect of the conflict. In addition to injuries, toxic waste from the used parts of firearms may have immediate, as well as long-term environmental and public safety concerns.

Residues from used firearms, and other weapons may result in a significant increase of different respiratory diseases, and skin-related disorders.

The World Health Organisation (WHO) has warned Syria and its neighbouring countries about disease outbreak possibilities in relation to an increase of movement between borders. According to different reports, individuals on the move usually lack adequate health system, as a result of the demolition of infrastructure due to the civil war. With an increase of movement and crowded places, diseases, such as typhoid, cholera, and dysentery, are considered inevitable.

Other diseases, for instance measles was estimated to have shown a significant increase.

The Save the Children organisation has noted the impact of inadequate living conditions on children’s health. There has been an increase in the number of children suffering from diarrhoea, hepatitis A, and upper respiratory tract infections. The fatality of the infections should

Approximately half of Syria, shown in red, is controlled by the Syrian government forces, while the other half is mainly controlled by the Islamic State of Iraq and the Levant. Some parts in the north of Syria, illustrated in yellow, fall under the Kurdish forces jurisdiction.

Areas shown under Syrian opposition forces, and al-Nusra front are shown in green and white on the map, respectively.

Photo credit: Wikimedia

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Hospital after explosion in Aleppo.

Photo credit: Wikimedia

be taken into consideration, as untreated infections can lead to death.

Many of the aforementioned diseases are preventable with vaccines; however, due to the inadequate health system, rapid movement between borders, and overcrowded refugee camps in Syria’s neighbouring countries, it is difficult to assess possible vaccination programmes. Thus, the situation may lead to further deterioration of preventive and control measures, if efficient vaccination programmes are not prioritised.

For the older population, chronic diseases, such as diabetes, cardiovascular diseases, and pulmonary diseases, also contribute to the burden of diseases in Syria, in addition to communicable diseases. According to Médecins Sans Frontières (MSF), commonly known as Doctors without Borders, it is important for health care systems to be able to provide with adequate care for those who are affected. Since the conflict started, management of non-communicable diseases have been more difficult, due lack of access to good health care and medication.

Many of the elderly flee the nation to be able to seek treatments in neighbouring countries, namely Jordan, Lebanon and

Iraq. With this migration, many issues arise, as medical costs in the neighbouring countries are considerably higher than what most can afford.

...individuals on the move usually lack adequate health system...

Organisations like WHO, United Nations Population Fund (UNFPA), and United Nations High Commissioners for Refugees (UNHCR) have made estimates of the number of refugees, and their location. These organisations collaborate amongst themselves, and with other non-governmental organisations (NGO) to help in different locations surrounding Syria. Aid from the collaborations includes provision of clean water, food, and shelter. It is, however, difficult to assess because of the possibilities of underreported individuals.

Together with several organisations, health care practitioners are reported to have worked in secret by moving to different locations, such as underground facilities, in order to escape the ongoing

barrel bombing in the area. The circumstances they are exposed to forced them to work in inadequate facilities with lack of electricity, and limited medical supplies.

The current situation in Syria has influenced health in many different ways.

A lot of the issues have arisen as a result of the conflict and are directly affecting the population, and some have indirect impacts. It is important to have active surveillance of infectious diseases, and improvement of chronic disease management, if the conflict continues to escalate.

Moreover, assessment and preparations for different interventions should be developed in conflict settings, taking different aspects of the conflict in to account.

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GLOBAL FOCUS

Justice is blind and the law is just Crime and Punishment in Modern World

By Karolina Weryńska LET

ME

INTRODUCE

YOU

TO

Vyacheslav. At the end of the Soviet Union, in his late twenties Vyacheslav was a well-respected prosecutor in Smolensk, Russia. His was a normal life, until one day he decides to stab to death his two female coworkers. Apparently it was boredom that made him want to find out how it felt to kill. In his own words: “I wanted to feel again, I was bored. You read Dostoyevsky maybe you understand”. Here I feel I must mention that Fyodor Dostoyevsky is one of the most important Russian writers. His works exploring human psyche, often tangled and twisted, inspired also Anton Chekhov, Ernest Hemingway and Frederick Nietzsche.

Apparently it was boredom that made him want to find out how it felt to kill Vyacheslav was sentenced to death, though that was not the end to his story.

While preparing for his execution, the Russian government established a moratorium on death penalty. Thus his punishment was changed to a life incarceration in Petak Island Prison, also known as Russian Alcatraz.

Surrounded by one of the finest lakes on Russian soil is a lone island. Crystal blue waters and beautifully preserved woods around make quite a contrast for one of the world’s worst prison. Petak Island Prison, a former monastery, is located on the White Lake, only the most dangerous criminals are sentenced for this miserable fate.

The island has two ways of access – a rocking wooden bridge or a prison boat.

Rumor has it no one has ever escaped, which is proof how tight the security was. There is no chaos inside, no budding guard-prisoner relationship, just order, “a soul-crushing order” that breaks even the toughest inmates. For misbehaving pris34

oners are held for 15 days a small, dark room with nothing but a metal bucket and a fold-down bed. During daytime the bed is hidden leaving the inmate to stand or sit on the floor.

Two people kept in one cell for approximately 22.5 h per day, the rest is spent inside barb wired cages. There is no library, no books allowed. Bathrooms are an unattainable luxury. Moreover, only two visitors are allowed every year.

After long negotiations The Daily Telegraph was allowed access inside. Presented report shows that half of the inmates are positive for tuberculosis (TB).

As you can easily imagine, a place with no proper washing facility won’t provide health care, especially not an incredibly expensive treatment for TB. Therefore, it should surprise no one that many prisoners go insane. In some cases maybe we should rather say – from bad to worse. Indeed, specialists agree that after 4-5 years of living in such conditions personality deteriorates, leaving a wreck with a human skin.

Now let us travel a bit north-east.

Whilst the Gulag labor camps were shut down 60 years ago, prisons there are still no walk in the park and people can be imprisoned for most inadequate offenses. A fifteen year old boy was sentenced for 3.5 years of prison for stealing 2 hamsters. A mother of 4 small children was convicted and incarcerated for 4 years for stealing 12 cabbages. Meanwhile in the EU, rapists (with good lawyers) often serve less time than that.

Another place worth mentioning here is North Korea with its Camp 22. Despite satellite photos, North Korea denies it exists at all. It holds political prisoners and enemies of the republic. Data shows evidence of medical experimentation on humans, torture and gas chambers. All used before in the Nazi concentration camp during WWII. Interestingly, the most intriguing prison is somewhere in Czech Republic.

While, neither its location nor name is known, CIA calls it 0WK. (NOTE! Not OWK, but 0WK. It is an easy mistake and leads to a rather unexpected mix-up. If you google OWK you learn it stands for “other world kingdom” and is a BDSM femdom society providing a true “prison experience”. Just to clear any possible confusion.) Nobody made it out alive, so there is nothing solid, but speculation exists about it being situated underground.

Prisoners locked in 1.2 x 1.8m2 cells, shackled to chain on the walls with a single bucket inside.

Why do we kill people who killed people to show that killing is wrong Finally, I give you Norway – a country with the world’s most humane prisons.

The cells are comfortable and modern, with an in-suite bathroom, mini-fridge and flat-screen TVs. Each 12 cells share a kitchen and a living room, furthermore the prison offers many possibilities of creative outlets (physical activates, instrumental workshops, etc.). A variety of 18 different colors was used to stimulate moods of prisoners. It goes without saying that standard there is higher than in most student accommodations.

Andreas Brevik, a mass murderer, convicted for a massacre of 77 people, is serving there a 21-year sentence (maximum prison time in Norway). He spends 23 hours a day in isolation, in a cell with sections to sleep, study and exercise. And yet it was not satisfactory enough for Andreas Brevik. In his letter of complaint, he mentions for example: his room is too cold, a rush during his morning shaving, no view from his window and the absolute need for the newest version of Playstation (together with games for adults not “for 3-year-olds”). “You have put me

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Photo credit: Markus Daams (flickr)

through hell. (…) I won’t be able to survive much longer” – he sums up his current conditions of life. What hardships he must face there without any exciting video games and inconvenient schedule of the day!

Living in European Union capital punishment is mostly a part of scary stories of the past. We forget that sanctioned by law, killing people is still very much present in our world. Indeed, death penalty is legal in 32 states in the US (out of 50). Accepted methods of execution vary between the states. Lethal injection is most common, also used by U.S. military.

Furthermore in 8 states electrocution is considered a secondary method, 5 states have gas chambers and 3 use hanging.

In 2015, Utah joined Oklahoma in utilizing firing squads in case of no drugs for lethal injection are available (or found constitutional). Isn’t quite shocking that one of the most respectable countries in western world provides death row inmates with a gruesome ending, more appropriate for the terrors of WWII? Having said that surveys suggest, in case of referendum, UK citizens would vote for restoration of death penalty. How does it fit in with our civilized society?

Hanna Arendt, a great German philosopher, said “man produces evil as a bee produces honey”. Crime and violence will always be part of our world. The need to protect ourselves is a perfectly sound instinct, in line with evolution even. Nevertheless, experience and science can often provide us with better solutions.

In 2010, Jeremy Irons on behalf of Amnesty International said the most incred-

ible thing: “Why do we kill people who kill people to show that killing is wrong?”

Such a simple thought, and yet a shocking breakthrough. Evil can’t be overcome with evil. To punish a crime, demonstrate that it isn’t an acceptable behavior you can’t simply commit the same deed in the name of law. An ancient Code of Hammurabbi “an eye for an eye, a tooth for a tooth” should not be a basis for any modern legal system.

Therefore, Norwegian legal system is not a fluke or a sign of weakness, they prove that the great massacre, committed on their soil by their citizen, didn’t change them. They remain steady in their beliefs, do not bow to violence. Rather use it to demonstrate their law is stronger that a murderer. They uphold human right and no criminal will affect the purity of their system. Justice above all.

A food for thought: if Brevik was born in Texas he might have been sentenced to death, however since he is Norwegian he plays on his Playstation. We need to remember to differentiate between justice and vengeance. Justice was served, he is locked inside his cell paying for his crimes.

The Universal Declaration on Human Rights states the right to live shall never be derogated, even in the times of national emergency. It means that no matter what happens our right to live is always valid and no one can take it away.

Thus, capital punishment stands in opposition to every international treaty ever signed. Albeit, one can postulate that big, wealthy countries don’t need to sign or uphold anything being their own security.

Besides USA, also Japan, China, Iran, Afghanistan, Egypt to list a few, consider death penalty a legal punishment. 18% of UN countries actively use it, while 26% retain, but don’t use. Hopefully one day all people would be protected by their basic right to live, no matter the nationality.

In 2007 Pakistan was reported to have 7,436 prisoners waiting for an execution, followed by USA – 3,263 convicts. China prefers to perform the execution swiftly without the unnecessary delay. Typically in USA a death row inmate spends about ten years waiting for the noose. The long process is supposed to ensure that no falsely accused innocent would be killed.

Despite the best efforts of legal system, miscarriage of justice can happen. Evidence can come to light too late. Unfortunately, a wrongful conviction after execution cannot be retracted. Consequently, the law, instead of protecting, actually killed an innocent person.

Life is not black and white, it’s a hundred shades of grey. In terms of relevant right and wrong, some issues need to remain constant, unchangeable. The right to live is a primary value we possess throughout the whole life, nothing can change that. Death penalty stands against that basic human right. However, as mentioned above, prisons can also be flawed, brutal even. I can’t pretend to know the solution, but the problem is quite clear.

The only thing we can do ourselves is to pay attention to the matters of both global and local importance. Don’t be comfortably numb when others are suffering!

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GLOBAL FOCUS

The Earthquake in Nepal Focusing on Help

By Teodora Andonova On the 26th of July, 1963, an earthquake hit Skopje, the capital of Macedonia, measuring a magnitude of 6.1 for 20 seconds. This ruined 80% of the city buildings, killed over 1000 people, hurt more than 3000 individuals, and made more than 200,000 people homeless. One of the individuals who became homeless was my grandmother and her family. Her brother was one of the hurt; their house broke down onto him, he just about survived the earthquake, however, with permanent physical and psychological damage.

Skopje as a city has still not succeeded to rebuild itself, even though the city received impressive international help.

In fact, the house that my grandmother is living in today, was supposed to be a temporary home for individuals who had been affected by the catastrophe, built with help from Sweden. When I visit my grandmother during the summer, I visit this house. I visit the help that she received from Sweden, and it is still standing today, even though it was only meant to be temporary.

On Saturday the 25th of April this year, as is most probably already known to you, an immense earthquake hit Nepal, measuring 7.8 on the moment magnitude scale, followed by several aftershocks. 7000 people have died and the death toll is still rising a week later and expected to reach 10,000, and more than 14,000 are hurt.

Over 2 million people are said to have been affected by the earthquake severely, according to a UN report.

It is the worst earthquake since the earthquake in Bihar 1934. The loss of many lives and casualties were accompanied by the destruction of buildings, leaving many homeless. World heritage monuments have also been destroyed. Due to the fear of even further aftershocks, people live and sleep outside in the middle of the streets even though there has been heavy raining in Nepal. The rainy season poses another post-disaster threat, there is a great risk of cholera outbreak.

Hospitals cannot handle the amount of people in need of medical help after the earthquake. “We urge foreign countries to give us special relief materials and medical teams. We are really desperate

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for more foreign expertise to pull through this crisis,” said Chief Secretary Leela Mani Paudel.

Nepal is a country lying on the boundary of two massive tectonic plates – the Indo-Australian and Asian plates. The Himalaya Mountains have been created by the collision of these plates, and with these collisions, earthquakes are expected. In fact, the Nepal earthquake triggered an avalanche on Mount Everest, making it the deadliest day in history for the mountain peak, killing at least 19, including Google executive Dan Fredinburg.

Help to Nepal is arriving in different forms from different countries. The Swedish Red Cross, together with the Swedish newspaper Expressen, collected 1,5 million SEK by Wednesday night, the 29th of April, just three days after the disaster. Other help organisations in Sweden are also collecting money, such as UNHCR. On the Swedish UNHCR campaign website it is said that 11,000 tarpaulins and 4000 solar lamps have been sent away to Nepal.

Zubin Zaman, Oxfam India Deputy Director, spoke out about the Nepal earthquake and how Oxfam tries to help: ‘Our priority is to ensure that people affected have adequate humanitarian assistance and we are able to prevent secondary disasters, including outbreak of disease by providing safe water and critical sanitation support.” Medecins Sans Frontieres (Doctors Without Borders) are also present in Nepal as of May 1st. 43 Swedes have also been placed in Nepal for help from the Myndigheten för samhällsskydd och beredskap, MSB. It is thought that they will stay there for numerous weeks to help out.

Locally, people are said to be very helpful in volunteering and helping out their fellow citizens in need. 90% of the Nepalese Army were also sent to the stricken area in the aftermath of the earthquake under the Operation Sankat Mochan.

India has been the first to respond from an international point of view as Nepal’s immediate neighbour, which provided relief and rescue with the help of its armed forces within hours after the earthquake. Other countries and unions

have also donated money or are promising to donate. As of the 30th of April, 16 countries have provided support to Nepal with EU coordination including Spain, Belgium, Czech Republic, Denmark, Estonia, Norway, Poland, the United Kingdom and Sweden.

Another type of help that can be seen locally, from Karolinska Institutet, is from Rubin Joshi, a PhD student at Karolinska Institutet from Nepal. He has posted on the Facebook page “KI Students” and many other pages on Facebook about the earthquake, informing and urging people on how to donate to the disaster in Nepal.

Help is still needed, and he is working on collecting help as much as he can for his motherland.

Nepal is one of the world’s poorest countries, this earthquake has damaged the country even more. Help is required, in all forms. Your donation may help someone in Nepal today to the point that their grandchildren visit yet another Swedish house in Kathmandu, just as I have visited my grandmothers’ Swedish house in Skopje.

There are different organisations to donate to as mentioned previously, however, if you wish to support Rubin Joshi and his support to Nepal, please send money to the Help Nepal Network – Sweden. You may also contact him if you wish to know in which other ways you may help.

Post Scriptum – After this text was already submitted, just before print, another big earthquake hit Nepal the 12th of May, not even three weeks after the last earthquake. It measured 7.3 on the moment magnitude scale with at least 40 deaths in Nepal and more than a thousand hurt. This time the earthquake was also felt in the neighbouring countries; so far 17 have died in India and one in Tibet.

Charles Haviland, former Nepal correspondent, spoke out about the recent earthquake: “That sense of returning normality with aid being delivered to villages and people finding reasons for a bit of optimism, a bit of cheer in their lives, suddenly that sense of security I think will be knocked quite badly.”

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Photo credit:Earthquake BS 2072 (2015) in Nepal 02” by Punya

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Contact: Rubin Joshi 0729195207 rubin.joshi@ki.se www.katastrofhjalpnepal.se 37

INSIGHT Insight is Medicor’s feature with the aim to shine light on some of the different occupations and branches within the medical field. Each edition features an interview with a selected person and a presentation of his or her area of specialization. The intent is to inspire and to give students insight into some lesser known career paths.

Margaret Livingstone

Professor of Neurobiology at Harvard Medical School, author of “Vision and Art: Biology of Seeing”, head scientist at Livingstone Lab

By Se whee Park ”WHY DO WE WANT TO STUDY THE

brain? I cant imagine studying anything more interesting!”, are the words of Dr. Margaret Livingstone when asked why she chose to specialize in neurophysiology. Margaret Livingstone is a professor and scientist heading the Livingstone Lab at the Harvard Medical School and works in the field of visual neurophysiology.

Today she goes around the globe giving lectures on “The Brain’s Perceptions of Visual Arts” where she explains to us how much art - throughout the times, from da Vinci to Monet - could illustrate as well as enhance the theories of the brain.

Livingstone is also the author of the book “Vision and Art: Biology of Seeing” where she goes more in-depth into how our eyes and brains coordinate to perceive artwork.

Neurophysiology is a branch within medicine that incorporates physiology and neuroscience in order to study the functioning of the nervous system, including the brain, the peripheral nerves, the spinal cord and sensory organs. The topic 38

of the brain has been of interest to mankind since as early as 1600 BC when the Ancient Egyptians drafted the oldest documented writing about the brain. However it was not until the 1900s when the technique of using electroencephalogram (EEG) was first introduced and the field developed immensely. Today this field of study has expanded both clinically and within basic research. Clinically, health authorities study neurophysiology in order to identify and treat several neurological diseases such as epilepsy, strokes, dementia and other nerve dysfunctions.

Within basic research, neurophysiologists are continuously expanding and improving methods of investigating the brain.

One of the most studied, and also best-defined, brain regions is the visual system.

The field is called visual neurophysiology and is based on trying to figure out how the brain works by recording from neurons in the visual system. When Livingstone was asked why vision in particular is used to study the brain, she answered, “because the visual system is an attrac-

tive part of the brain to study. First of all, a quarter of our brain is visual. We are very visual animals and you can present the stimuli easily, and you understand what they mean, and it’s so clear how we do it.

So by studying, for example, how one part of our brain reacts to a visual stimuli we could explain the functions of that part of the brain”.

Livingstone however has not always worked with neurophysiology, “I started in engineering and then switched to pre-Med because I thought doctors did science, but it turns out there is kind of this prescribed right answer in medicine which I didn’t find that interesting”.

During her time in pre-Med she decided to take a rotation into psychiatry, which she found very interesting. This encouraged her to get a PhD in pharmacology, where she tried to manipulate the monoamine system. However, she came to realize that, at that time, the monoamine theory of schizophrenia was just too new and unknown for her to begin manipulating it pharmacologically. This is why she

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INSIGHT

Photo: Rose Lincoln/Harvard Staff Photographer

decided to change her path of PhD and investigate the affect of monoamines on behavioral patterns of lobsters. During that period Livingstone began her collaboration with the neurophysiologist David H Hubel. The two worked together to investigate the earliest part of vision and how the monoamines would affect information processing in the visual cortex, and this is when Livingstone “got hooked on vision”.

Although art and visual perception are two topics that seem to be far apart from each other, Livingstone quickly came to realize how much art could be used to validate her theories on how our brain perceive our vision. In her early lectures she used examples of optical art to convince the audience of their ability

“It became clear to me how powerful talking about art is at getting a message across.”

to see motion. “It turned out that [the optical art examples] were the only part of my talk that people remembered. So it became clear to me how powerful talking about art is at getting a message across.

So then I just started talking more and more bout art and came to realize that a lot of what I was doing in science could be illustrated or even enhanced by asking what artists were doing.”

Livingstone believes that the future for neurophysiology is going to be huge.

Currently there are projects in the United States like the “Brain Initiative” which are pushing people to invent new techniques for recording from lots of neurons at once. She believes that this is going to be the next big breakthrough to the big

question of how we code information in our brain.

As for an advice to the students at Karolinska Institute, Livingstone strongly encourages “to do something that you are really interested in. I am still doing experiments that I have no idea what the answer is going to be, and I really, really want to know. And I think that’s important because unless you really care, you’re not going to use your imagination and think and think and think until you come up of a way to figure it out”.

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’02 Publication of ”Vision and Art: Biology of Seeing” ’88, ’93 Had two sons ’80 PhD from Harvard University ’75 Post-doc research with David H. Hubel

’88 Received tenure and promotion as Professor of Neurobiology ’72 Bachelor of Science

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Behind the Familiar

The things you did not know yet about the campus

By Anna Vidina and Olivia Miossec

I LOVE THE STARK CONTRAST THESE HISTORICAL red old buildings form against the large, imposing and ultramodern Aula Medica. The two houses named Stenbrottet (probably named after a quarry pit in the nearby woods) and Tithe Barn have both been declared as listed buildings in 1947 (protection is given to buildings of special architectural or historic interest). It is why they were integrated rather than destroyed when KI set up its campus site in the 1940s. Whilst they date back from the 18th century, they were restored in 1999 and are today used as office space and conference rooms.

They have housed many a character throughout history. It all started with a baker by the name of Joakim Sasse who acquired the small cottage depicted in the picture above (or at least, the ancestor of that cottage) in 1771. He also had a bakery built, grew tobacco and ran an illicit distillery. A man to satisfy all your vices. Then there was Giovanni Battista Ambrosiani who sounds like

JÖNS JACOB BERZELIUS MY FIRST THOUGHT WHEN I HEAR

the name Jöns Jacob is nachos.

However, behind any cafeteria building name, there is always a great man.

And this man is Jöns Jacob Berzelius (1779-1848), one of the founders of modern chemistry and the father of Swedish chemistry. He discovered silicon, determined atomical weights of elements as well as selected names and symbols for them. Maybe more importantly for us, he convinced King Carl XIII to set up an ‘academy for the training of skilled army surgeons’ which evolved into KI. This makes us the modern day ‘skilled army surgeons’, still somewhat skilled but not to be trusted with a scalpel. The bust you see in the picture is actually a bronze replica of the actual sculpture which was made by the French artist Pierre-Jean David whose name sounds like a ‘French for beginners’ textbook character. It is located in a lecture hall at KI with Jacob Berzelius name.

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the picture of class. I mean – an Italian ballet master comes to dance at the Stockholm Opera Company and teaches at the war academy in Karlberg. This was followed by a new tenant in 1822, Anders Lorens Hendall.

His deep fascination for animals translated into two main hobbies: hunting animals and breeding foxes. Indeed, it was in this building that the Swedish Association for Hunting and Wildlife Management was established in 1830. As for the breeding, he managed to raise a black fox variety which was sought out by the royal court of Saint Petersburg. (I choose to naively believe they were used as pets, not coats.) The quarry pit’s black foxes can be seen at the Natural History Museum in Stockholm. After Hendall died, the Ambrosiani family returned and managed a tobacco plantation there, of which the last shears were only removed in the 1960s. It is in fact very impressive how widespread growing tobacco became in Sweden during the 18th century.

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THIS BRONZE SCULPTURE IS TITLED

‘Entomological raping’ (entomology = science of insects). And yes, the title is as self-explanatory as it is strange. And yes, there is a back story. On the right we see a man with insect-like antennas protruding from his jaw. On the left, a woman figure. They are abducting a a woman with a flower-like hat. It was created by Eric Grate (1896-1983) and it is inspired from his time in Paris in the 20s with the surrealists. Spending a lot of time at circuses and fairgrounds there, Grate became fascinated with an armless and legless singer named Violeta. Due to her condition, it is believed that she was abducted many times by men and that her lady companion, Duena, may have been an accessory in these excursions.

In 1957, Grate was commissioned by Sweden’s National Public Art Council to create a sculpture to stand outside the entrance of KI and he came up with this. It led to a protest from the staff who felt it inappropriate to have a work of art depicting the destructive powers of disability in front of a medical school, whose focus should be on the healing powers of science. The students, on the other hand, wholeheartedly supported this sculpture. This led to an inflamed debate which went all the way up to Sweden’s Supreme Administrative Court.

Whilst suggestions to remove it altogether or at least to give the woman arms and legs were proposed, the issue was finally settled a year later and the sculpture has remained since for all to admire.

THIS SCULPTURE, APTLY NAMED

Broken Clock, was brought to KI in 1979 from some other location in Stockholm. And unfortunately quite ironically, the sculpture in itself is ‘broken’ as it does not move as it used to (check out that rust). Indeed, its creator Per Olof Ultved, a Finnish sculptor, was a leading figure in the quite niche-like genre of moving sculptures. This may have originated from a skiing incident in which he was left immobile for a long period of time, with both legs in a plaster thus leading to his desire to communicate

movement through his art (if all skiing incidents led to that much creativity – we would all be artists by now). A ‘side effect’ of many of Ultved’s ‘mobile’ creations was the loud noises the belts and pulleys made. We should therefore all be grateful this sculpture has forever ‘gone to sleep’. It would make KI sunbathing (which is usually a two week window) a much less pleasant experience. The artist is also known for his murals on the walls of the blue line which you can admire next time you fancy journeying to the center of the earth.

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CULTURE

This Changes Everything:

Naomi Klein tackles climate change and capitalism

By Iskra Pollak Dorocic

IN A REMOTE PART OF THE SOUTH

Pacific exists a tiny, isolated island most people have never heard of. It is called Nauru and at one point not too long ago, during the 1970’s and 80’s, it boasted the world’s highest per capita GDP and was touted as a model for the world in terms of economic development. The reason was its unique geology – the island is made up of phosphate rock, a valuable agricultural fertilizer. As Naomi Klein writes in her powerful new book This Changes Everything: Capitalism vs. The Climate, “Nauru started developing at a record speed – the catch was that it was, simultaneously, committing suicide.” Foreign multinational companies moved in and mined the center of the island for phosphate until it became an almost uninhabitable empty shell. Very quickly the island went from a beautiful,

palm-covered, white sandy beach paradise, to a strip-mined, ghostly, infertile piece of rock. Today the island is in deep debt , the government lacks money to perform many of its basic functions and the unemployment rate is 90%. Nauru is just one of the examples Klein uses to show how short-sighted, large-scale human activity fueled by capitalism and the pursuit of never-ending economic growth is profoundly changing the planet.

This Changes Everything goes to great lengths to describe how this inevitable environmental downfall is not happening by accident. The book provides an eye-opening exposé of powerful and well-financed organizations and lobby groups that lie behind indecisive government action and the lack of stricter environmental regulation. In addition to receiving almost $1trillion in annual global subsidies from

the public, major fossil fuel companies receive a much greater public subsidy: “to treat our shared atmosphere as a waste dump.” Thus follows, argues Klein, that climate change is not a problem that can be solved by markets or industry, rather it will need a great restructuring of our political, economic, and social systems.

Instead of global trade agreements, Klein appeals for local action, communities which are sustainable and self-sufficient, and more worker rights. Klein calls the present “decade zero”, the last decade to take decisive action against climate change. If we don’t, global temperature will likely increase by more than 2 °C causing disastrous effects on the environment, ultimately leading the whole planet down Nauru’s path.

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Sommarerbjudande -ll studenter på KI

“Jag är svag för “läkardeckare”. En rik-g sträckläsningsbok. Betyg 5” –Ingela Molly, bloggare Tre skäl -ll varför du bör köpa Kongospår:

• Kanonuppföljare -ll Turkanarapporten som hiKlls lästs av 24,000 •

SuperrabaO -ll studenter: 119 kr

Allt överskoO -ll Läkare Utan Gränser

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Beställ böcker på: www.chris-anunge.com RabaOkod: student

Trevlig läsning! /Chris-an Unge Läkare och skapare av Ronden

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