If he were a dog…

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‘D’ had terrible teeth. Not only were they broken, but they were also worn down in such a way that they looked like an aged rodent’s teeth.

He had worked for many years in a place where there were high levels of atomic radiation. Naturally, he was concerned about how much radiation he had been exposed to over the years.  On one of his many visits, he asked me somewhat irritably: “How many more x-ray pictures do you need to take?”

I replied: “I have enough pictures to take out your bad teeth, but not enough to save them.”

D seemed reasonably satisfied with my answer. At least, he never raised the subject again.

Some weeks later, D’s wife, who was also one of my patients, asked me why her husband had to make such an enormous number of visits to my surgery. I explained that the repair work was extensive and complicated, each tooth requiring several appointments. She replied quickly:

“If he were a dog with so many problems, I’d have had him put down ages ago.”

Gift of a Parsi gentleman

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There is a decorative drinking fountain on the Broadwalk in London’s Regent’s Park. The fountain looks like a typical Victorian gothic structure, which it is. Closer examination reveals bas-relief panels that depict: a bull standing by a palm tree; a lion next to a palm tree; and the head of a man wearing an oriental hat. This fountain would not look out of place in Bombay, which is full of structural souvenirs of the Victorian era. This should not surprise you when you learn that the fountain was a gift of Sir Cowasjee Jehangir Readymoney (1812-78) from Bombay.

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Cowasjee, who was born in Bombay, received little education before becoming a warehouse clerk in Duncan, Gibb & Co. in that city. In 1837, he moved into a more lucrative job. Nine years later, he opened his own business. In 1866, he became a Commissioner of Income Tax in Bombay. Later he became a Justice of the Peace.

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Readymoney lived up to his name, becoming very wealthy. He invested huge amounts of money into a wide variety of good causes including social housing (similar to that erected by Peabody in the UK) in Bombay, The University of Bombay and an Indian Institute in London. A year after being made a member of the Order of the Star of India in 1871, he was made a Knight Bachelor of the UK. These honours were awarded to recognise his great philanthropic contributions.

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The fountain in Regent’s Park, which no longer issues water, was erected in 1869, nine years before Readymoney’s death. His main residence was in Bombay’s Malabar Hill district.

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Teach yourself anatomy

Dr Thomas A Quilliam, who died in 2008, taught me general human anatomy during my first year as a dental student at University College London (‘UCL’). His teaching method was quite unlike anything I had encountered before.

Quilliam

At our first meeting with him, Quilliam told us that as he was lazy, he preferred the students to give the lectures whilst he sat and listened at the back of the lecture theatre. He was not kidding, because this is exactly what happened.

We had anatomy ‘lectures’ five days a week and did dissections of a human cadaver on several afternoons. Each week, several students were assigned particular topics chosen from the syllabus. Each student was required to compose a twenty-minute talk on his or her topic, as well as designing simple diagrams, which could be drawn quickly on examination scripts, to illustrate it. For example, I can remember being asked to talk about the lymphatic drainage of the mammary glands. You might well wonder whether this was ever any use during my 35 years in dental practice. I am not sure that it was.

At each class in the lecture theatre, three students gave their presentations. Before that, Quilliam would treat us to short extracts from (usually) American medical education films. I can remember one with the thrilling title “The surgical anatomy of the kidney”. We would watch the first few minutes, before Quilliam switched off the projector. Then, each of the three students who had prepared for that day, gave their presentations. Most students, even the shyest in the class, did a good job, and made useful drawings and diagrams. Some enterprising students even prepared informative models of the anatomical structure they were describing. Every now and then, Quilliam, who sat at the back of the banked seats in the lecture theatre, used to ask a question to clarify what the speaker was saying. If the student answered “maybe” or “perhaps”, Quilliam would say: “That’s a typical University College answer.” Actually, it was. When I was studying physiology at UCL, we were taught to question everything and be reserved about stating that something was a certain fact.

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There were 50 students in my year. In all, we must have had at least 150 hours of ‘lecture’ sessions. As three students gave talks each session, this meant that everyone on the course had to prepare about nine topics from the syllabus. This ensured that everyone was likely to encounter at least one of his or her own topics in the final written or viva-voce examination.

You might be thinking that Quilliam really was a bit lazy, but you would be wrong. What his method achieved was very clever, and an important preparation for the clinical environment. Not only did his method avoid hours of having to listen to the same person giving the same lectures that he might have given year after year, but it also taught us to communicate ideas. Quilliam’s method of making us, the students, give presentations was a good training in the art of presenting unfamiliar topics clearly and comprehensibly. In dentistry, especially nowadays (and even when I entered practice), patients like to be kept informed about the nature of their problems and how they can be resolved.

An Albanian outpost

In about 1480, Albanians fleeing from the Ottoman army that was invading Albaia were given land in Sicily, just South of Palermo.

They built the town of Piana degli Albanesi on this land, and it is still thriving. Most if the inhabitants speak an archaic form of Albanian as well as Italian and preserve many Albanian traditions.

This picture shows a bust of Skanderbeg in Piana degli Albanesi. George Kastrioti Skanderbeg, national hero of the Albanians, resisted the Ottoman army for about 25 years, saving western Europe from becoming part of the Ottoman Empire.

Learning by teaching

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‘Doc’ mending a toaster in a friend’s home near Paris in 1978

Although my PhD supervisor was a full university professor of physiology, most people called him ‘Doc’. He was the pre-clinical tutor of the dental students, who undertook courses in academic rather than clinical departments of University College London (‘UCL’) during their first year of study. Doc’s PhD students were asked to volunteer to help teaching the basics of mammalian physiology to the dental students. I did this willingly. Once a week, I conducted tutorials for a group of six to eight dental students. Although I learnt a lot – teaching is the best was to learn, it was a case of the blind leading the blind. It was while doing this teaching that I met two of the people, who were to become owners of practices where I worked. They remembered me, but I did not remember them.

Once a week, the dental students carried out experiments in the physiology teaching lab. I assisted in the supervision of these classes. One of the experiments that the students undertook was pedalling on a bicycle rigged up to an electrical generator, which in turn was wired to a domestic lamp. The youngsters had to pedal furiously to get the lamp to glow, and while they did this their pulse rate and blood pressure was monitored.

Another experiment was connected with taste. The students had to prepare different dilutions of a chemical and used this to determine taste thresholds. The chemical used was phenylthiourea.  Some of the students could not taste this at any dilution. These people were lacking a certain dominant gene that allows people to taste this substance. The point of the experiment was to teach the students both about taste and, also, about genetic variation. Doc was keen for the future practitioners to learn that we are not all ‘built’ the same way.

Another experiment was examining the effects of various chemicals on the strength and frequency of contractions of short lengths of rodent gut in oxygenated tissue media. When we did this experiment and ones like it during our BSc physiology course, we attached the contracting gut too electronic force transducers which sent electric signals to an electronic graph drawing machine.

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A kymograph attached to a pressure-measuring tube

Doc did not use this simple method when his dental students performed the experiment. The contractile tissue was tied to a long delicate metal lever which had a sharp point at the end of it furthest away from the fulcrum to which it was attached. Movements of the tissue caused the lever to move up and down. These movements were recorded on the smoked paper tightly attached to the cylinder (or drum) of an old-fashioned kymograph. As the lever moved in response to the contractions, the fine point at its end moved up and down and displaced the charcoal attached to the smoked paper producing a white tracing where the carbon had been removed.

Handling the kymograph drum was a tricky business. First the special plain white paper had to be tightly attached to the metal drum. Next, the drum was rotated above burning paraffin so that it became completely coated with the black particles in the smoke coming from the paraffin. When blackened, the drum and paper had to be removed from the smoking area and placed carefully on the spindle of the kymograph without touching the blackened paper so as to avoid removing the carbon coating. Attaching the gut to the kymograph lever was also tricky.

After the experiment, the paper covered with tracings had to be removed from the drum, again taking great care not to smudge the delicate layer of carbon and thereby obliterate parts of the tracings. Finally, the tracings had to be immersed briefly in a liquid lacquer that later evaporated and fixed the tracings (i.e made them immune to smudging). Only then could the students begin to make measurements of the amplitudes and frequencies of the contractions of the experimental material.

Doc had an ulterior motive in making his dental students use this highly obsolete measuring device. It was, he decided, an excellent way for future dentists to develop their manual dexterity.

As part of the pre-clinical course, Doc required that each of his students carry out a practical research project. He preferred simple projects such as measuring the blink rates of people sitting on Underground trains or assessing the rates at which peoples’ jaws moved whilst they were chewing gum. One group of students tested the theory (which has been proven) that people’s height was shorter at the end of the day than at the beginning. The main thing that concerned Doc was that his students were learning how to observe scientifically and systematically. It is most important, he felt strongly, for a clinician to be observant. He hoped that these projects would help to make these future dentists into skilled observers and therefore better clinicians.

Another reason for this project was for the students’ more immediate benefit. In the end of year physiology examination paper that he set for the dental students, he always inserted a question, which asked the student to write an essay about any aspect of physiology that interested him or her. Thus, simply by writing about the project undertaken, the student was guaranteed up to 25% of the marks.

Doc and his wife were perfect guides and became great friends during the time I was working on my PhD. I saw them socially often  for many years afterwards until their deaths. It was meeting and getting to know the dental student whom I attempted to teach that was one of the reasons that I strayed into dentistry.

African Art Fair 2018

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“The Contemporary African Art Fair (1 – 54)” is held annually at London’s Somerset House. This year it was a very exciting show full of vibrant, creative artworks mainly, but not exclusively, created by Africans with little or no European ancestry.

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Many of the works use recycled waste materials such as bits of paper, engine parts, spent bullets and retired armaments, electronic components, and so on. Almost every art work is a fine aesthetic object when seen as a whole. Looking into any of these works in detail is like beginning to explore Africa, its troubled past and challenging present.

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Africa is beginning to emerge from its colonial past. Africans are taking control of their destinies. Yet, at this exhibition, which is where a series of galleries display thier wares, mot of the dealers, who earn considerable commissions are ‘White’ Europeans. Maybe colonialism is not quite dead yet!

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The tests of time and taste

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Is it fair to juxtapose works of modern or contemporary art with great masterpieces, which have stood the test of time?

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We were fortunate to have been given (by our daughter) complimentary tickets to the 2018 Frieze Masters exhibition held in Regents Park. It is part of a larger art fair, Frieze, held in London annually.

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The Frieze Masters show contains stalls set up by art dealers, displaying only works made no later than the year 2000 AD. I must admit that I was expecting to see works of art only made during the 19th and 20th centuries. To my great delight, the artworks on display were made anytime between ancient times (several centuries BC) and 2000 AD.

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Although the more recently made (i.e. 20th century) artworks are of the highest quality, they are often on display close to artworks made many centuries earlier. Some of the gallery stalls contain a mix of modern art and much older works. Placing some 20th century works (e.g. Calder) near to older classical works (e.g. Brueghel and Cranach) is not fair to the newer works.

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The older artworks, which have stood the test of time and satisfied the tastes of many generations of viewers, make the nearby contemporary works seem weak in comparison. This is not always the case. Some small sculptures by Barbara Hepworth seemed very comfortable next to their far more venerable neighbours. Also, to my surprise some ancient classical carvings stood harmoniously close to some abstract art works made in the second half of the 20th century.

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The older works of art on display have been treasured for many centuries. Probably, what we see today is the best of what was produced long ago. Even at the time when they were made, their excellence must have been obvious when seen beside other works, now lost and long-forgotten, which were created at the same time.

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I question how many of the more recent (19th and, especially, 20th century) works of art, which I saw at Frieze Masters, will still attract both interest and high prices in, say, fifty or a hundred years’ time. And, I also ask myself how many of the newer works will be able to evoke the feelings of aesthetic wonder that, say, a Brueghel or a Cycladic sculpture have been able to do for so many centuries.  

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