'Eindhoven', 'Krefeld', 'Dusseldorf Gerresheim', 'Dulag Luft at Hohemark','Stadtroda','Egendorf','Obermassfeld',
Background to story:
Royal Air Force
Article ID:
A4072330
Contributed on:
15 May 2005
I was flying a Whitley when I was shot down. On July 4th, at 2am, I made a parachute descent at Eindhoven, Holland. There were 5 of us on our plane : Dickie Davis (rear gunner), Ken Bowden (a good actor), Ron Lakin and myself who all survived (the other three weren’t injured) and Gibson who died. I subsequently met Ken Bowden at Heydekrug, he was in the bed next to Roy Dotrice.
I was found by a dog, shot in both legs, in an irrigation ditch. A German orderly helped cut me out of my flying suit, he was very gentle and kindly. He wouldn’t let me walk but got an ambulance, which was driven across the field to pick me up. I was put on to a stretcher and was taken to Krefeld to a hospital run by nuns.
My legs were in a mess, I was shot in the right thigh, my head was hit too, my left foot had been stuck. The nuns at the hospital treated people very badly. They used to put food by my bed but I wasn’t strong enough to eat it. When they came back and found the uneaten food they swore at me.
My left leg went gangrenous. They took me to a hospital (Res Laz) in Dusseldorf Gerresheim, which was run by the French and had about 1000 French patients, I was the only Brit. This was in 1941 on July 8th, when France was under German rule and French workers were taken into Germany to work. They were used to handling minor injuries, hernias etc. A doctor there called Galving came to look at me. I was on a stretcher and when he saw my left leg he recoiled. I stayed in this hospital for about 8 months.
I’d already learnt German and French at school — at Dusseldorf I got a big compliment from a Frenchman. He said ‘You speak very good English for a Frenchman’. I had done 7 years of French at school and was better at it than German. I learned the correct version but you pick up the patois from French men. Of course I picked up a lot, I was stuck in a hospital with only French people. My greatest friend was a Frenchman whom I met at Dusseldorf, he gave me some of his ration and a lighter. I saw him a couple of times after the war, once in Lille, another time in Leicester in 1957 when Muriel was expecting Fran.
We used to have very good concerts at Dusseldorf, Paul Boissier ran an excellent orchestra and he arranged a jazz gala on 26th September 1941; I was the only English man there.
I had two operations on my legs at Dusseldorf, both by Galving.
On March 2nd 1942 I was moved to Dulag Luft at Hohemark (which means ‘High Point’), near Oberursel, Frankfurt where RAF prisoners were taken for distribution to POW camps. This was up in the mountains, on the Rhine, a beautiful setting, lots of snow. Around this time I spent time in solitary confinement. They took my clothes away and interrogated me for information and turned the heat up. I was warned ‘ No one will know you are here’, but I told him I’d already been here for 12 months and had received parcels, which took the wind out of his sails. Another German, Lieutenant Erihart, came in to see me, he spoke perfect English and said he’d been to Queens College Oxford, but I wouldn’t tell him anything. I heard after the war he got four years for ill-treatment of POWs. This happened over two days, by then they knew I was no good to them.
I was next taken on April 2nd 1942 to Stadtroda hospital, where I was in bed next to an Army man, Taffie (he was Welsh) — he looked after me for weeks, used to sort out food for us both as I couldn’t do anything. The hospital was in a nice village.
The hospital was under German control but with British doctors, the patients were English plus some from Crete and New Zealand. They did two operations on my left leg, which straightened it and put it in plaster, after which I could walk, more or less. The surgeons there were Leslie Lauste and butcher Martin (I met Martin at Wimbledon years later, he was very tall). The senior sergeant made the patients clean the hospital.
On August 21st 1942 I was moved to the hospital at Egendorf, near Stadtroda, in the central part of Germany. The countryside reminds me now of Wiltshire, it was beautiful. The hospital was previously used as a college for the Hitler Youth; it was on a hill and like being in a holiday camp. It was more like a convalescent home than a hospital; they didn’t do any operations there. My left leg was affected by the move. I made sure that I got a bed near the kitchens, so I could watch the girls at work there and hear the radio playing every night. The summer of ’43 had beautiful weather and I had a girlfriend in the kitchen, Anna Maria Blankenfuland, she was very blond and had a sister Lottie — there were about 5 girls working there in all. We got Red Cross parcels and took them to the kitchen and they’d heat them up for us. The parcels had tinned meat, prunes, little things of cheese, dried egg, tins of fish. We received German rations too, but they weren’t anything special.
They didn’t mind people who were wounded going outside the hospital and I used to go to Blankenhein village.
There were Russians, Poles, Belgians and French in Egendorf, it was run by mainly English doctors plus a couple of French doctors. In winter they would ask for say 6 men to get the coal and I always volunteered because I could talk to them. Known there as Schwartze ie black because I had black hair. We used to travel by oxen cart and sled. The doctors there were doing a fiddle to get the coal. I was kitted out in striped Polish trousers and a blouson. We found out after the war that we were very near one of the concentration camps. I remember one day the sky was blue, but then a great black cloud came across. We thought it was just a rain cloud, or perhaps from a bombing but now I wonder if it was from that camp.
We had a good band at Egendorf, we used to put on shows for the English and French, I used to be the compere. I played a bit of table tennis there. I bought myself an accordion and with a Yugoslavian who played the trumpet and another chap on drums we set up a band called the Cosmopolitans.
I met George Friedlander, a German Jew, at Egendorf, he had joined the British Army and was a POW. I was friendly with Walter Kretchmer, the guard commander, German. He had lost an eye and finger and had been shot in the thigh, he was part of Rommel's army that had marched across France. He was a sensible man, not vicious in the slightest. His brother was a famous submarine commander, who ended up as a POW in Canada.
Whilst at Egendorf Cooper, the doctor there, sent me to Obermassfeld on May 22 1943 for a couple of weeks. Here the Geneva Commission, who checked injured POWs in case any were eligible to be repatriated, saw me. One chap who lost an arm was lucky, he was sent home. Tiger Fulton was another doctor at Egendorf, he was an international bridge player and later an umpire at Wimbledon. I am not sure how these English doctors ended up in the German hospitals, perhaps they were captured during Dunkirk?
Shortly after returning to Egendorf I was sent back to Stadtroda on June 13th 1943, where I stayed for about 5 weeks and started to learn chess, taught by a Russian, before being put on a train to Mohlsdorf on August 21st. I was there about a week and contracted jaundice, so was sent back to Obermassfeld hospital on August 30th where I spent 4 weeks in bed, not at all well. At Stadtroda the cooking was based on a liquid fat which may have caused the jaundice. When I was mobile again they sent me to Mühlhausen Army Camp on November 9th. This was not very nice but I wasn’t there for long, setting off for Heydekrug later that month.
As a doctor, I thought I knew how to treat my patients. Then my wife ended up in the hospital.
Here's what her illness taught me about successful medical care.
By Joseph LadapoJanuary 25
Joseph Ladapo is a physician and health policy researcher. He is an assistant professor at NYU School of Medicine.
I’ve spent all my professional life as a doctor. But when my wife suffered a chronic, debilitating illness, I realized that medicine looks totally different through the eyes of a patient. Our experience — through seven hospitalizations, countless more emergency department visits and endless doctors’ appointments — taught me lessons about surviving the American health-care system that I could never have learned in a classroom or in my professional role. The things I learned continue to shape how I now care for my patients.
Here are the points that stick with me still:
1. Speak up. During one hospitalization, my wife complained of pain in her arm at the site of an intravenous catheter that had been placed for hydration. The nurse reassured us that all was fine, but her pain persisted and gradually worsened. We could have insisted that the IV be re-checked or removed, but not wanting to be perceived as “too demanding,” I decided to back down. The next day, she developed thrombophlebitis — painful inflammation of blood vessels — at the IV site. She was too sick to advocate for herself at the time. My choice to acquiesce contributed to her avoidable suffering.
These types of situations happen often in my experience: the man who is hospitalized with a heart attack but wants to discuss his foot pain, or the woman treated for pneumonia whose primary concern is her anxiety. Earlier in my career, I paid less attention to these issues when they didn’t seem related to my patients’ major medical problems, but I rarely make that mistake now. Even if I don’t immediately have an answer to my patient’s problem, I try and file the issue away and revisit it the next time I see the patient. As the physician and scholar Sir William Osler famously said, “Listen to your patient, he is telling you the diagnosis.”
2.Don’t be afraid to ask for a specialist.My wife was, at times, in excruciating pain. In fact, memories of her lying in misery while her doctors tried in vain to relieve her suffering are some of the saddest of my life. It was only the unconventional treatment choices of two specialists in distinct disciplines — one a neurologist, the other a pain specialist — that helped loosen the suffocating grip of her pain.
This experience reiterated how important it is to bring in specialists. And it reminded me how valuable pain management is. As an internist, most of my training in pain management happened on the job while caring for patients with cancer. Though I picked up strategies from more experienced nurse practitioners and physicians, I don’t have nearly the expertise of specialists, who receive formal training in a range of interventions and therapies. They also spend more time with patients suffering from chronic, painful conditions and learn through these interactions how to better aid their suffering.
The perspective of pain-management specialists is particularly important, because many physicians don’t treat pain seriously enough. In my experience, private conversations among doctors about patients with pain are often dominated by terms like “drug-seeking” and “addicts.” The stigma surrounding pain treatment is so powerful that doctors frequently bring these biases with them into meetings with patients, quickly turning a conversation’s tone from friendly to adversarial. This can leave patients feeling neglected, ignored or ashamed. Now, when I take care of patients for whom pain is a major component of their medical presentation, I am more diligent about explicitly addressing whether my pain management plan is likely to be effective. If I have doubts, I almost invariably consult a pain specialist.
3. Don’t feel bad about asking to speak with a patient advocate. Patient advocates — sometimes called patient representatives — listen and respond to patients concerns’ about their care, and often address concerns about quality or communication breakdowns. Discussing your concerns with them tends to focus the attention of doctors and hospital leaders in a way that might otherwise not be possible.
We used a patient advocate once during my wife’s care. A change in hospital leadership created an administrative roadblock that prevented one of her primary doctors from caring for her. We felt that the urgency of her needs were being cast aside, and I contacted a patient advocate and wrote a letter to the hospital’s president and executives. The issue was subsequently resolved.
I’ve also seen patient advocates work as a doctor. Recently, the family of a critically ill patient I cared for contacted a patient advocate because they were upset that more aggressive treatments had not been initiated by one of the specialists involved in her care — a concern I had picked up on in my conversations with them but had not fully appreciated. Managing her treatment alongside the specialists who were also involved was my top priority, but the advocate sharpened my attention, and I became more engaged in the specialist’s decision-making. Ultimately, she did receive more aggressive therapy, which speeded her recovery.
4. Share your health challenges with others and don’t stop searching for help. Of the many lessons I learned while my wife was sick, this might be the most important one. I searched endlessly for help from my physician colleagues, books, medical journals and websites, seeking ways to relieve my loved one’s suffering. Though many of these efforts led to dead ends, salvation finally came in the form of a senior neurologist in Texas who was kind enough to respond to an email I sent him. He had suggestions about how to manage her care and ideas about treatments to try, most of which we pursued. Additionally, he connected us to a preeminent neurologist in New York whose new, unconventional ideas finally began helping her and gave her relief.
As a doctor, it was undoubtedly easier for me to reach out to physician colleagues and make sense of the scientific literature than it will probably be for those not in the medical field. I encourage those without a medical background to speak with acquaintances who are doctors or nurses, or nonmedical friends who have experienced the health-care system firsthand as either a caregiver or patient. The Hippocratic Oath obliges us to help when we can, and you never know who may have had a similar experience or what another physician might be willing to do to help you.
Every day in June, the most popular wedding month of the year, about 13,000 American couples will say “I do,” committing to a lifelong relationship that will be full of friendship, joy, and love that will carry them forward to their final days on this earth.
Except, of course, it doesn’t work out that way for most people. The majority of marriages fail, either ending in divorce and separation or devolving into bitterness and dysfunction. Of all the people who get married, only three in ten remain in healthy, happy marriages, as psychologist Ty Tashiro points out in his book The Science of Happily Ever After, which was published earlier this year.
Social scientists first started studying marriages by observing them in action in the 1970s in response to a crisis: Married couples were divorcing at unprecedented rates. Worried about the impact these divorces would have on the children of the broken marriages, psychologists decided to cast their scientific net on couples, bringing them into the lab to observe them and determine what the ingredients of a healthy, lasting relationship were. Was each unhappy family unhappy in its own way, as Tolstoy claimed, or did the miserable marriages all share something toxic in common?
Psychologist John Gottman was one of those researchers. For the past four decades, he has studied thousands of couples in a quest to figure out what makes relationships work. I recently had the chance to interview Gottman and his wife Julie, also a psychologist, in New York City. Together, the renowned experts on marital stability run The Gottman Institute, which is devoted to helping couples build and maintain loving, healthy relationships based on scientific studies.
John Gottman began gathering his most critical findings in 1986, when he set up “The Love Lab” with his colleague Robert Levenson at the University of Washington. Gottman and Levenson brought newlyweds into the lab and watched them interact with each other. With a team of researchers, they hooked the couples up to electrodes and asked the couples to speak about their relationship, like how they met, a major conflict they were facing together, and a positive memory they had. As they spoke, the electrodes measured the subjects' blood flow, heart rates, and how much they sweat they produced. Then the researchers sent the couples home and followed up with them six years later to see if they were still together.
From the data they gathered, Gottman separated the couples into two major groups: the masters and the disasters. The masters were still happily together after six years. The disasters had either broken up or were chronically unhappy in their marriages. When the researchers analyzed the data they gathered on the couples, they saw clear differences between the masters and disasters. The disasters looked calm during the interviews, but their physiology, measured by the electrodes, told a different story. Their heart rates were quick, their sweat glands were active, and their blood flow was fast. Following thousands of couples longitudinally, Gottman found that the more physiologically active the couples were in the lab, the quicker their relationships deteriorated over time.
But what does physiology have to do with anything? The problem was that the disasters showed all the signs of arousal—of being in fight-or-flight mode—in their relationships. Having a conversation sitting next to their spouse was, to their bodies, like facing off with a saber-toothed tiger. Even when they were talking about pleasant or mundane facets of their relationships, they were prepared to attack and be attacked. This sent their heart rates soaring and made them more aggressive toward each other. For example, each member of a couple could be talking about how their days had gone, and a highly aroused husband might say to his wife, “Why don’t you start talking about your day. It won’t take you very long.” The masters, by contrast, showed low physiological arousal. They felt calm and connected together, which translated into warm and affectionate behavior, even when they fought. It’s not that the masters had, by default, a better physiological make-up than the disasters; it’s that masters had created a climate of trust and intimacy that made both of them more emotionally and thus physically comfortable.
Gottman wanted to know more about how the masters created that culture of love and intimacy, and how the disasters squashed it. In a follow-up study in 1990, he designed a lab on the University of Washington campus to look like a beautiful bed and breakfast retreat. He invited 130 newlywed couples to spend the day at this retreat and watched them as they did what couples normally do on vacation: cook, clean, listen to music, eat, chat, and hang out. And Gottman made a critical discovery in this study—one that gets at the heart of why some relationships thrive while others languish.
Throughout the day, partners would make requests for connection, what Gottman calls “bids.” For example, say that the husband is a bird enthusiast and notices a goldfinch fly across the yard. He might say to his wife, “Look at that beautiful bird outside!” He’s not just commenting on the bird here: he’s requesting a response from his wife—a sign of interest or support—hoping they’ll connect, however momentarily, over the bird.
The wife now has a choice. She can respond by either “turning toward” or “turning away” from her husband, as Gottman puts it. Though the bird-bid might seem minor and silly, it can actually reveal a lot about the health of the relationship. The husband thought the bird was important enough to bring it up in conversation and the question is whether his wife recognizes and respects that.
People who turned toward their partners in the study responded by engaging the bidder, showing interest and support in the bid. Those who didn’t—those who turned away—would not respond or respond minimally and continue doing whatever they were doing, like watching TV or reading the paper. Sometimes they would respond with overt hostility, saying something like, “Stop interrupting me, I’m reading.”
These bidding interactions had profound effects on marital well-being. Couples who had divorced after a six-year follow up had “turn-toward bids” 33 percent of the time. Only three in ten of their bids for emotional connection were met with intimacy. The couples who were still together after six years had “turn-toward bids” 87 percent of the time. Nine times out of ten, they were meeting their partner’s emotional needs.
* * *
By observing these types of interactions, Gottman can predict with up to 94 percent certainty whether couples—straight or gay, rich or poor, childless or not—will be broken up, together and unhappy, or together and happy several years later. Much of it comes down to the spirit couples bring to the relationship. Do they bring kindness and generosity; or contempt, criticism, and hostility?
“There’s a habit of mind that the masters have,” Gottman explained in an interview, “which is this: they are scanning social environment for things they can appreciate and say thank you for. They are building this culture of respect and appreciation very purposefully. Disasters are scanning the social environment for partners’ mistakes.”
“It’s not just scanning environment,” chimed in Julie Gottman. “It’s scanning the partner for what the partner is doing right or scanning him for what he’s doing wrong and criticizing versus respecting him and expressing appreciation.”
Contempt, they have found, is the number one factor that tears couples apart. People who are focused on criticizing their partners miss a whopping 50 percent of positive things their partners are doing and they see negativity when it’s not there. People who give their partner the cold shoulder—deliberately ignoring the partner or responding minimally—damage the relationship by making their partner feel worthless and invisible, as if they’re not there, not valued. And people who treat their partners with contempt and criticize them not only kill the love in the relationship, but they also kill their partner's ability to fight off viruses and cancers. Being mean is the death knell of relationships.
Kindness, on the other hand, glues couples together. Research independent from theirs has shown that kindness (along with emotional stability) is the most important predictor of satisfaction and stability in a marriage. Kindness makes each partner feel cared for, understood, and validated—feel loved. “My bounty is as boundless as the sea,” says Shakespeare’s Juliet. “My love as deep; the more I give to thee, / The more I have, for both are infinite.” That’s how kindness works too: there’s a great deal of evidence showing the more someone receives or witnesses kindness, the more they will be kind themselves, which leads to upward spirals of love and generosity in a relationship.
There are two ways to think about kindness. You can think about it as a fixed trait: either you have it or you don’t. Or you could think of kindness as a muscle. In some people, that muscle is naturally stronger than in others, but it can grow stronger in everyone with exercise. Masters tend to think about kindness as a muscle. They know that they have to exercise it to keep it in shape. They know, in other words, that a good relationship requires sustained hard work.
“If your partner expresses a need,” explained Julie Gottman, “and you are tired, stressed, or distracted, then the generous spirit comes in when a partner makes a bid, and you still turn toward your partner.”
In that moment, the easy response may be to turn away from your partner and focus on your iPad or your book or the television, to mumble “Uh huh” and move on with your life, but neglecting small moments of emotional connection will slowly wear away at your relationship. Neglect creates distance between partners and breeds resentment in the one who is being ignored.
The hardest time to practice kindness is, of course, during a fight—but this is also the most important time to be kind. Letting contempt and aggression spiral out of control during a conflict can inflict irrevocable damage on a relationship.
“Kindness doesn’t mean that we don’t express our anger,” Julie Gottman explained, “but the kindness informs how we choose to express the anger. You can throw spears at your partner. Or you can explain why you’re hurt and angry, and that’s the kinder path.”
John Gottman elaborated on those spears: “Disasters will say things differently in a fight. Disasters will say ‘You’re late. What’s wrong with you? You’re just like your mom.’ Masters will say ‘I feel bad for picking on you about your lateness, and I know it’s not your fault, but it’s really annoying that you’re late again.’”
* * *
For the hundreds of thousands of couples getting married this month—and for the millions of couples currently together, married or not—the lesson from the research is clear: If you want to have a stable, healthy relationship, exercise kindness early and often.
When people think about practicing kindness, they often think about small acts of generosity, like buying each other little gifts or giving one another back rubs every now and then. While those are great examples of generosity, kindness can also be built into the very backbone of a relationship through the way partners interact with each other on a day-to-day basis, whether or not there are back rubs and chocolates involved.
One way to practice kindness is by being generous about your partner’s intentions. From the research of the Gottmans, we know that disasters see negativity in their relationship even when it is not there. An angry wife may assume, for example, that when her husband left the toilet seat up, he was deliberately trying to annoy her. But he may have just absent-mindedly forgotten to put the seat down.
Or say a wife is running late to dinner (again), and the husband assumes that she doesn’t value him enough to show up to their date on time after he took the trouble to make a reservation and leave work early so that they could spend a romantic evening together. But it turns out that the wife was running late because she stopped by a store to pick him up a gift for their special night out. Imagine her joining him for dinner, excited to deliver her gift, only to realize that he’s in a sour mood because he misinterpreted what was motivating her behavior. The ability to interpret your partner’s actions and intentions charitably can soften the sharp edge of conflict.
“Even in relationships where people are frustrated, it’s almost always the case that there are positive things going on and people trying to do the right thing,” psychologist Ty Tashiro told me. “A lot of times, a partner is trying to do the right thing even if it’s executed poorly. So appreciate the intent.”
Another powerful kindness strategy revolves around shared joy. One of the telltale signs of the disaster couples Gottman studied was their inability to connect over each other’s good news. When one person in the relationship shared the good news of, say, a promotion at work with excitement, the other would respond with wooden disinterest by checking his watch or shutting the conversation down with a comment like, “That’s nice.”
We’ve all heard that partners should be there for each other when the going gets rough. But research shows that being there for each other when things go right is actually more important for relationship quality. How someone responds to a partner’s good news can have dramatic consequences for the relationship.
In one study from 2006, psychological researcher Shelly Gable and her colleagues brought young adult couples into the lab to discuss recent positive events from their lives. They psychologists wanted to know how partners would respond to each other’s good news. They found that, in general, couples responded to each other’s good news in four different ways that they called: passive destructive, active destructive, passive constructive, and active constructive.
Let’s say that one partner had recently received the excellent news that she got into medical school. She would say something like “I got into my top choice med school!”
If her partner responded in a passive destructive manner, he would ignore the event. For example, he might say something like: “You wouldn’t believe the great news I got yesterday! I won a free t-shirt!”
If her partner responded in a passive constructive way, he would acknowledge the good news, but in a half-hearted, understated way. A typical passive constructive response is saying “That’s great, babe” as he texts his buddy on his phone.
In the third kind of response, active destructive, the partner would diminish the good news his partner just got: “Are you sure you can handle all the studying? And what about the cost? Med school is so expensive!”
Finally, there’s active constructive responding. If her partner responded in this way, he stopped what he was doing and engaged wholeheartedly with her: “That’s great! Congratulations! When did you find out? Did they call you? What classes will you take first semester?”
Among the four response styles, active constructive responding is the kindest. While the other response styles are joy-killers, active constructive responding allows the partner to savor her joy and gives the couple an opportunity to bond over the good news. In the parlance of the Gottmans, active constructive responding is a way of “turning toward” your partners bid (sharing the good news) rather than “turning away” from it.
Active constructive responding is critical for healthy relationships. In the 2006 study, Gable and her colleagues followed up with the couples two months later to see if they were still together. The psychologists found that the only difference between the couples who were together and those who broke up was active constructive responding. Those who showed genuine interest in their partner’s joys were more likely to be together. In an earlier study, Gable found that active constructive responding was also associated with higher relationship quality and more intimacy between partners.
There are many reasons why relationships fail, but if you look at what drives the deterioration of many relationships, it’s often a breakdown of kindness. As the normal stresses of a life together pile up—with children, career, friend, in-laws, and other distractions crowding out the time for romance and intimacy—couples may put less effort into their relationship and let the petty grievances they hold against one another tear them apart. In most marriages, levels of satisfaction drop dramatically within the first few years together. But among couples who not only endure, but live happily together for years and years, the spirit of kindness and generosity guides them forward.
Friday, November 25, 2016
"Much medical training is about information and knowledge and less about traveling the more difficult path of feeling…it’s crucial for doctors to stay with the feeling, listen feelingly, and not turn away from the pain and suffering in patients and themselves. There is one shining difference between knowledge and understanding: We doctors may forget knowledge, but we never forget what we understand. We understand through feeling."
TODAY I DO NOT WANT TO BE A DOCTOR - Glenn Colquhoun. Today I do not want to be a doctor. Nobody is getting any better. Those who were well are sick again and those who were sick are sicker. The dying think they will live. The healthy think they are dying. Someone has taken too many pills. Someone has not taken enough. A woman is losing her husband. A husband is losing his wife. The lame want to walk. The blind want to drive. The deaf are making too much noise. The depressed are not making enough. The asthmatics are smoking. The alcoholics are drinking. The diabetics are eating chocolate. The mad are beginning to make sense. Everyone’s cholesterol is high. Disease will not listen to me Even when I shake my fist. TODAY I WANT TO BE A DOCTOR - Glenn Colquhoun. Today I am happy to be a doctor. Everyone seems to be getting better. Those who were sick are not so sick and those who were well are thriving. The healthy are grateful to be alive. And the dying are at peace with their dying. No one has taken too many pills. No one has taken too few. A woman is returning to her husband. A husband is returning to his wife. The lame accept chairs. The blind ask for dogs. The deaf are listening to music. The depressed are tapping their feet. The asthmatics have stopped smoking. The alcoholics have stopped drinking. The diabetics are eating apples. The mad are beginning to make sense. Nobody’s cholesterol is high. Disease has gone weak at the knees I expect him to make an appointment. http://lifeinthefastlane.com/today-i-do-not-want-to-be-a-doctor/
When it was revealed that Google’s London-based company DeepMind would be able to access the NHS records of 1.6 million patients who use three London hospitals run by the Royal Free NHS trust – Barnet, Chase Farm and the Royal Free – it rang alarm bells.
Not just because the British fiercely guard their intimate medical histories. Not just because Google, a sprawling octopus of a company with tentacles in all our lives, wishes to “organise the world’s information”. Not just because patients are unlikely to have consented to Google having this information.
The issue for many is the intertwining of these concerns with the idea of artificial intelligence (AI). DeepMind is no ordinary company. It specialises in AI, developing technology to exhibit something like intelligent reasoning.
Last year its engineers produced a research paper showing it had created a program that could replicate the work of a “professional human video games tester”. In March, Google’s DeepMind made history by creating a program that mastered the 3,000-year-old Chinese board game Go, thought to be beyond current technology because of the number of possible moves. In what was considered a computing milestone, the company’s AlphaGo program beat the world Go champion 4-1.
Now such a company has a database containing detailed, private, albeit anonymised, records of all these people’s medical history, including HIV status, past drug overdoses and abortions. DeepMind says it needs the data to produce medical alerts for hospitals attempting to prevent acute kidney injuries.
The fear for some is that DeepMind’s database could allow for much more than the original stated purpose. The public is no stranger to the fact that NHS patient privacy has not been safeguarded – in 2014 the government was forced to halt and then scale back its proposals to produce a single English medical database over concerns that medical confidentiality could be put at risk.
DeepMind has not hidden its work with the NHS, announcing in February it was working with the health service to build an app called Streams to help doctors and nurses monitor kidney patients. What it did not reveal was the extent of its data haul, which encompasses historical patient records. Instead of the few thousand patients with kidney injuries, DeepMind got all the patient records of all three hospitals. That’s millions of confidential documents.
It says it needs the entire patient database to make Streams work. Backers of such databases claim that with such data powerful software packages can be created to diagnose diseases sooner.
The New Scientist magazine obtained the data-sharing agreement between DeepMind and the NHS, which revealed just how much information was being made available. The Google company’s skill is to discern complex patterns in huge quantities of data – and the NHS is a goldmine for such “deep learning”.
In this treasure trove of data are logs of day-to-day hospital activity, such as records of the location and status of patients – as well as who visits them and when. DeepMind will also obtain pathology and radiology test patient records.
As well as real-time data, DeepMind has access to the historical records from critical care and accident and emergency departments. Crunching this information, so the theory goes, allows DeepMind to develop predictions based on data that is too broad in scope for any one person to assimilate and analyse.
By comparing patient data, DeepMind might be able to predict that someone is in the early stages of a disease that has not yet become apparent. This is the medical holy grail: not treating a patient when they are ill, but treating them before they become ill.
Utopian? Perhaps. Behind the promise of these technologies lies the crux of the dilemma in the age we live. Google, Facebook and others feed on the fact we suspend our privacy rights in return for new technology built with our data.
Like Apple, Google is building a reputation in medical apps. It is also true that the use of machine learning in medicine by academics is nothing new. However this data is being passed to and controlled by one of the world’s biggest and most powerful companies. It raises questions over whether it might quickly become the biggest player, a de facto monopoly, over NHS health analytics.
AI also represents something new, a promise that a program could improve itself – and very quickly surpass human intellect. This is the so-called “intelligence explosion” – a point where humanity courts its own destruction. We are some way off this. No one has built a machine that respects social and ethical norms, even at the expense of its goals. It’s difficult enough to get humans to do that.
Some may say such extrapolation is ridiculous. After all Tay – the “intelligent” Twitter chatbot from Microsoft – lasted a few hours until she “learned” to become a racist, genocidal tweeter and was killed off. However as Elon Musk, the inventor who originally invested in DeepMind, said, it was worries over “Terminator” technology that drove him to warn about its dangers.
For perhaps sound commercial reasons, DeepMind operates under the radar. But this often raises more questions than answers. Google’s AI ethics board, established when Google acquired DeepMind in 2014 for £400m, remains one of the biggest mysteries in technology, with both companies refusing to reveal who sits on it.
Artificial intelligence needs data to learn. Hence the sucking up of all those patient records by Google’s DeepMind. So why the secrecy? If patients had been told what was going on and why, they could make informed choices. If they think the potential risks of Google dominance over a new critical technology for the NHS are outweighed by the benefits, then let’s have that debate. But if the company does not explain and carries on in secret, the public will rightly not go along with such plans.
