How Science gives Nature a helping hand

Reproduced from the

Medicine can work wonders,but as Professor Robert Winston's latest series reveals,doctors still have a lot to learn from the human body.

E Jane Dixon

When Professor Robert Winston talks about the human body, something like reverence softens his professionally abrupt manner. Describing the intricacies of a pioneering hand transplant, he turns his own hand slowly in the air, as if displaying a rare and fabulous piece of kinetic sculpture.
"Our capacity for wonder," says Winston, regretfully pocketing the exhibit, "is the whole reason for science. When you stop wondering, you probably stop producing good science."

This sense of the marvellous is the driving force behind Superhuman, a major new series for BBC 1 that starts next week. Winston is our guide on a whistle-stop tour of the human body's extraordinary resources and its literally fatal flaws.
Within its six instalments the series explores many ground-breaking medical advances, from those that embrace new technology-driven solutions to those that harness the power of nature itself to seek, and sometimes effect, a cure. At its heart the series marvels at the body's capacity for self-repair and at how medical intervention can accelerate that process.

"The real argument of the series is that often the body knows better than the doctors, and that doctors would do well to understand the basic science and improve their knowledge of how to help the body to heal itself," says Winston.
Perhaps the most startling examples of this swing away from modern interventionist medicine are the case histories outlined in next Tuesday's opening programme about recent breakthroughs in trauma medicine - the treatment of serious injury. There is compelling new evidence that, left to its own complex devices, the body will deploy some remarkably effective defence strategies. It is now thought that even the simplest intervention - such as pumping fluids into the injured body to restore blood pressure - may upset the natural recovery process.

"In the Vietnam War, people actually died because the medical treatment was too quick," Winston points out. "Had doctors allowed some of the very seriously injured soldiers to recover on their own, lying on the battlefield, they might actually have got better. This is what happened in the Falklands War, where night battles and bad weather meant quick recovery of casualties was too dangerous. Because medical teams couldn't get to them, and because of the extreme cold, which slows down the effects of trauma, many terribly wounded soldiers did in fact survive.

While Superhuman will celebrate technological procedures that our parents never dreamed of- watch a child's face as he hears voices for the very first time following a cochlear implant - Winston warns that technology has also set our bodies at dangerous odds without environment. "Quite a lot of the time, we bring medical disasters upon ourselves," he explains. "In the programme dealing with infection [Killers into cures], we point out that by giving people antibiotics when they were children, we have probably increased asthma, which is now an epidemic. Again and again we come back to this mechanistic approach to medicine.Just today there was a report about an artificial heart - well, yes, that may work, but we could be doing much more to promote a harmony between ourselves and nature that would reduce the incidence of heart disease in the first place."

Many of the procedures described in Superhuman are likely to spark controversy. The technique of treating Parkinson's disease by transplanting the brain cells of pigs into humans, for example, and the world-famous mouse with the human ear grown on its back, are flashpoints for animal-rights activists. This is something Winston takes very seriously: "We scientists have tended to go very quiet about animal research, but I believe very firmly that if you don't engage in a debate, you lose it. I think there is a very serious threat in this country to bio-technology and bio-medical research from people who want to see all animal research banned. "Animal research is vital for human health.

Professor Robert Winston explores natural defences and scientific advances

[Animal testing is highly dangerous,results are spurious,the problem with Thalidomide happened in part because of animal testing.Animals bodies are not the same as ours, and react differently to different substances,it is therefore absouletly mad to use them as a testing ground for what will be used on ourselves -LB]
Without it we wouldn't have new cancer treatments, we wouldn't have modern surgical practice or the ability to fight bacteria, we wouldn't have transplants. By the same token, our humanity is diminished if we don't treat other species with respect. Scientists, like myself, who do animal research have a great respect for animals. But as long as we, as a society, are wearing leather shoes and eating meat, there is no excuse for giving way to people who feel that all animal research is immoral. It's not immoral. We must use animals wisely, we must use them humanely, but their use is essential for human wellbeing."

As a Labour peer who rose to prominence for his pioneering work in the field of fertility treatment - the walls of his office are covered with photos of infants he has helped into the world - Winston is intimately connected with the ethical debate over how far doctors should go in pushing the boundaries of human biology.
To critics, issues such as altering the sperm of newborn babies to prevent genetic disorders being passed down the family line, and therapeutic cloning, have dangerous echoes of the eugenics experiments practised in Nazi death camps. It's an idea that Winston, who is Jewish, energetically refutes. "That notion of genetics, which comes into the last programme only slightly, does have those echoes, if only to discard them," he explains. "We're in the 21st century, and I think what happened half way through the 20th century doesn't have the same resonance. I didn't feel there was a need to be sensitive about that."

The frequently heard assertion that medical scientists are "playing God" with human life has him practically stamping with irritation: "It's just nonsensical," he says. "If you believe, as I do, that human intelligence is God-given, then not to use that intelligence, actually, is unethical. We're not trying to change creation, what we're trying to do is use what God has created to enhance, prove and protect human life."
There is no doubt that Superhuman will raise as many questions as it answers. "That," says Winston, "is the nature of science."

Appliance of science Over six episodes, Superhuman examines doctors' efforts to help the human body to help itself COLD COMFORT Kate Close was thrown from her horse on a freezing day, and lay for almost two hours in the cold before paramedics could reach her. In hospital, trauma doctor Alistair Wilson went against medical precedent and decided not to warm her up. As Trauma, the series opener, reveals, surgeons are increasingly acknowledging the body's instinct for survival, and how the natural cooling process prevents widespread damage in badly injured patients. ANIMAL AID Animals are seen as an important future source of donor organs. Genetically modified pigs are being bred for this purpose, and Spare Parts tells how cells from pig foetuses were used to treat Jim Finn, who suffers from Parkinson's disease and whose condition has since dramatically improved. HEAL THYSELF When Penny Roberts, a keen skydiver, fell from 2,000 feet after her parachute failed to open, her spinal column was so badly damaged she was told she would never walk again. Yet four years later, she has begun to notice feelings in her legs. Self Repair shows the body's resilient qualities. GERM WARFARE Not all bacteria are bad, and some diseases can even help to defeat others. Killers into Cures meets Robert Swan, who volunteered to have the herpes virus injected into his brain in a bold bid to halt the growth of an inoperable tumour. Four years on, the results have been remarkable. THERE'S ALWAYS HOPE The Enemy Within examines some radical new approaches to fighting cancer, including the use of a drug made from the poisonous African bush willow plant, and prospective cancer vaccines. SCIENCE OF LIFE For couples like the Paget Dunthornes, who lost a child to cystic fibrosis, embryo screening techniques offer a chance to begin again, but this is a highly controversial area. The final programme, The Baby Makers, shows how science is striving to combat inherited diseases, such as genetically altering the sperm of male carriers, and therapeutic cloning, which utilises embryonic stem cells.

Date: 26/06/98 16:30
Dear Editor, With the end of Professor Robert Winston's excellent series The Human Body also came the end of a human life,that of Herbie,who bravely decided to show his death on TV.
With this programme Professor Winston sought to show that we are dying from the moment we are born,and that we should face death with less moroseness since via a scientific view,we live on,at least in a physical sense,as he correctly stated via the re-use of our atomic components, but the person may only live on in memory.
But previously in the series he had alluded to a religious sense of soul,and in Herbie's programme,people alluded to being nearer to God when close to death.As a scientist Professor Winston gives us valuable information about what we are as physical beings,but by allowing Religion to creep into the picture,this mars an otherwise edifying view of death as less than a complete loss.
Personal beliefs are nothing to do with science,and the nature of the thing alluded to as "soul" can be explained by he emergent behaviour of the brain,in very much the way that Professor Winston explained the tunnelling effect near death.Thus Religion has no place in a programme about "The Human Body".
Even if the programme had been called The Human Spirit it's role would still have been dubious.More to the point,for a scientist to show that he has a Jewish faith on national television helps to undermine the very interesting information that Professor Winston has shown as a scientist.
Religion and Science as Professor Lois Wolpert and Professor Richard Dawkins rightly say,are antitheses of one another, and should not appear as if they are in any way connected.Religion is belief by faith,Science is knowledge by experiment,and for Robert Winston to blur the boundary is unhelpful,especially in a series that seems to have been lauded for it's engaging commentary,light humour, intelligence,and technical capability.
Yours sincerely,

Robert Pirsig "Zen and the Art of Motorcycle Maintenance"[p421].Robert explains his son's death without referring to the supernatural...... I tend to become taken with philosophic question, going over them and over them and over them again in loops that go round and round and round until they either produce an answer or become so repetitively locked on they become psychiatrically dangerous, and now the question became obsessive: 'Where did he go?' Where did Chris go? He had bought an airplane ticket that morning. He had a bank account, drawers full of clothes, and shelves full of books. He was a real, live person, occupying time and space on this planet, and now suddenly where was he gone to? Did he go up the stack at the crematorium? Was he in the little box of bones they handed back? Was he strumming a harp of gold on some overhead cloud? None of these answers made any sense. It had to be asked: What was it I was so attached to? Is it just something in the imagination? When you have done time in a mental hospital, that is never a trivial question. If he wasn't just imaginary, then where did he go? Do real things just disappear like that? If they do, then the conservation laws of physics are in trouble. But if we stay with the laws of physics, then the Chris that disappeared was unreal. Round and round and round. He used to run off like that just to make me mad. Sooner or later he would always appear, but where would lie appear now? After all, really, where did he go? The loops eventually stopped at the realization that before it could be asked 'Where did he go?' it must be asked 'What is the "he" that is gone?' There is an old cultural habit of thinking of people as primarily something material, as flesh and blood. As long as this idea held, there was no solution. The oxides of Chris's flesh and blood did, of course, go up the stack at the crematorium. But they weren't Chris. What had to be seen was that the Chris I missed so badly was not an object but a pattern, and that although the pattern included the flesh and blood of Chris, that was not all there was to it. The pattern was larger than Chris and myself, and related us in ways that neither of us understood completely and neither of us was in complete control of. Now Chris's body, which was a part of that larger pattern, was gone. But the larger pattern remained. A huge hole had been torn out of the center of it, and that was what caused all the heartache. The pattern was looking for something to attach to and couldn't find anything. That's probably why grieving people feel such attachment to cemetery headstones and any material property or representation of the deceased. The pattern is trying to hang on to its own existence by finding some new material thing to center itself upon. Some time later it became clearer that these thoughts were something very close to statements found in many 'primitive' cultures. If you take that part of the pattern that is not the flesh and bones of Chris and call it the 'spirit' of Chris or the 'ghost' of Chris, then you can say without further translation that the spirit or ghost of Chris is looking for a new body to enter. When we hear accounts' of 'primitives' talking this way, we dismiss them as superstition because we interpret ghost or spirit as some sort of material ectoplasm, when in fact they may not mean any such thing at all. In any event, it was not many months later that my wife conceived, unexpectedly. After careful discussion, we decided it was not something that should continue. I'm in my fifties. I didn't want to go through any more child-raising experiences. I'd seen enough. So we came to our conclusion and made the necessary medical appointment. Then something very strange happened. I'll never forget it. As we went over the whole decision in detail one last time, there was a kind of dissociation, as though my wife started to recede while we sat there talking. We were looking at each other, talking normally, but it was like those photographs of a rocket just after launching where you see two stages start to separate from each other in space. You think you're together and then suddenly you see that you're not together anymore. I said, 'Wait. Stop. Something's wrong.' What it was, was unknown, but it was intense and I didn't want it to continue. It was a really frightening thing, which has since become clearer. It was the larger pattern of Chris, making itself known at last. We reversed our decision, and now realize what a catastrophe it would have been for us if we hadn't. So I guess you could say, in this primitive way of looking at things, that Chris got his airplane ticket after all. This time he's a little girl named Nell and our life is back in perspective again. The hole in the pattern is being mended. A thousand memories of Chris will always be at hand, of course, but not a destructive clinging to some material entity that can never be here again. We're in Sweden now, the home of my mother's ancestors, and I'm working on a second book which is a sequel to this one. Nell teaches aspects of parenthood never understood before. If she cries or makes a mess or decides to be contrary (and these are relatively rare), it doesn't bother. There is always Chris's silence to compare it to. What is seen now so much more clearly is that although the names keep changing and the bodies keep changing, the larger pattern that holds us all together goes on and on. In terms of this larger pattern the lines at the end of this book still stand. We have won it. Things are better now. You can sort of tell these things.

Further Reading

Superhuman, the accompanying book by Robert Winston and Lori Oliwenstein, is published on 12 October by BBC Worldwide, price £18.99