The heartiest day of the heartiest month

Cardiology continues its spectacular run as the only medical specialty with its own dedicated day (don't fact-check this claim)

This newsletter may be spectacularly infrequent and unpredictable, but I am contractually obliged, as a heart doctor, to send at least some cardiac-based content into the ether today: Anatomically-Inaccurate Anatomy Day ❤️

A chocolate heart I bought my wife on Valentine’s a few years ago #luckygal

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In my heady early days making educational content on social media, back when I actually had something useful to say, I used to practically carpet bomb people with the dorkiest, cheesiest cardiac puns on Valentine’s. But alas my heart is no longer in it, and I cannot bring myself to tweet all that nonsense again. So instead, I’ll include some of my greatest hits (loose definition) right now. However good or bad your Valentine’s has been, allow me to make it worse.

Bellend fast

Northern Irish friends! If you are looking for some entertainment this Friday evening, come see me spend an hour just wailing on the human body for being such unmitigated shite. I’ll be taking part in the huge NI Science Festival and am on Friday night at 8pm at the Black Box in Belfast.

As part of the publicity, I went on BBC Radio Ulster’s Sunday morning show, which, tbf, I should’ve realised would be fairly religious. The preceding segment to my interview were people choosing their favourite pop songs based on which biblical parable they reminded them of, and then discussing whether god could be gender neutral. I felt like the conversation could be summarised thusly: “To attempt to assign a gender to God is to fundamentally misunderstand the whole concept of God and by trying, you are only revealing yourself to be a small minded person projecting your tiny worldview onto the Supreme Being. But the bible says he’s a dude so shut the fuck up, he’s a dude. And then after this spiritual Sunday morning, on comes some random doctor from godless England to shit on God’s divine creation. I am sure that went down like a Chinese weather balloon.

Bloatware

If you missed my two most recent videos, first there was ‘Why do people keep falling for things that don’t work’ [ad-free link], just before Christmas.

This is, of course, an enormous question. And I was not seeking to give a comprehensive answer, which would have to include all number of cognitive biases and could easily flesh out a university module. Instead, I wanted to focus on something I call ‘mechanistic bias’. I have been spotting it everywhere I look recently, and admittedly I do have a morbid fascination with broscience influencers, who exhibit it extravagantly, but so do scientifically trained doctors. It’s an interesting one, as the more you learn about a subject, the more easily you get fooled by some sexy sounding mechanism or pathway.

I’ve been using more interviews in my videos over the last year or two, and last week I published the second full length interview with a guest (after David Nutt’s in 2021). This one was entitled ‘How to prevent almost all disease’ [ad-free link], with Andrew Steele – a friend and an expert in the field of longevity, which is about as rich a hunting ground for mechanistic bias as you could hope for.

And it’s a shame that longevity has as an image as a playground for Silicon Valley billionaires and tech-driven mechanistic bias, because there is so much fascinating science going on within the field. I put this mild accusation to Andrew and, in a complete failure to engineer an edgy, confrontational interview, he agreed. But what he also did is explain why he believes defeating ageing is the most important thing we can be doing as a species right now. Indeed, he switched careers from a physicist wanting to work in climate science, to a longevity researcher. And I think it is a very powerful argument, which informed my dramatic-sounding title. Ageing is the biggest risk factor for most of the world’s major killers, so tackling it might yield better results than focusing on specific diseases. We went into some deep detail, discussing the science, where research is right now and what looks promising, whether we can ever cut through the hype and broscience, whether ageing itself should be thought of as a disease, and even into health policy and economics. I am really proud of this interview and Andrew even said he thought it was the best he’d done (and he’s one of the most prolific interviewees I have seen!)

Podcast

Both of these videos are rather long. And while I generally make a habit of ignoring…well, almost everyone, I actually took heed of quite a few people who asked if I could make these longer videos available as podcasts. I realised that really the only thing you’d be missing out on is my face, so by all accounts this would be a marked improvement in people’s experience. Plus some of you crazy cats have been asking me to start a podcast, clearly aware how I desperate I am for something to do with my copious free time.

All of which is to say, the Medlife Crisis Podcast is live! For now, it will simply be the audio from my longer videos, but hopefully one day it’ll divergently evolve into its own phylum and years from now, archaeologists will scrape around in the dirt attempting to piece together the chronology as the bold claim is made that the Medlife Crisis Global Conglomerate Paramilitary Strikeforce and the Medlife Crisis Holistic Functional Lifestyle Wellness Ashram actually share a common ancestor. I have called it Still Practicing, as I do have some slightly lofty ambitions for what my podcast might become. The name is supposed to reflect the fact that I am lucky enough to work in a job where almost everything I learn can make me a better doctor. And each day I do try to get a little bit better. A while ago I realised that so much of what I learn can be relevant to anyone. The youtube channel was the first manifestation of that, focused on medical science, but the podcast might go in a slightly more philosophical or leadership-based direction. Don’t worry, I ain’t becoming a productivity life coach. Plus, the name also refers to the fact that in spite of all my nonsense online, I still have a medical licence and work full time – I am, remarkably, still practicing.

Feed link –– Spotify link –– Acast link –– Other links hopefully coming soon

Second channel

A while ago I started a Shorts channel on YouTube but never really put any effort into it. As I’m sure you’re aware, YouTube Shorts continue to be a major talking point among creators and viewers, but I’ll save that discussion for another day. Long story…short, I decided to repurpose that channel into a more conventional ‘second channel’ where I can put any old garbage that doesn’t belong on the main channel. So go subscribe to Medlife Crisis 2.

I wasn’t successful applying to become an ESA astronaut, but this man was. Probably because he has cooler headwear. I had the pleasure of meeting the rather tall Pablo Álvarez Fernández last week, while I got up close to the actual European Service Modules which will take humans back to the Moon. Maybe Pablo will be one of them. We both started our careers working in Stevenage, and both applied to leave the planet. Sometimes correlation IS causation.

Nebula (a major change)

I was really lucky in my youtube career, to have met a bunch of brilliant educational creators quite early on, whose channels were already massive, and yet they invited me to join forces. Soon afterwards, as a group, we launched Nebula. Watching it grow and flourish has been such a source of pride for us. But apart from supporting efforts behind the scenes, I have simply not had the time to engage as a creator as much as I wanted. This year that’s going to change. Every video I post will go up as a Nebula First, ie you’ll be able to see all my vids at least a fortnight earlier than on YouTube, as well as ad-free, guaranteed. If I can really get my ass into gear (I think we all know the answer to that), then I want to be a full video rotation ahead, so when you see a video come out on YouTube, the next one will already be live on Nebula. I am going to be making more content designed to have a home on Nebula. I am going to be making content that will remain only on Nebula.

Until then, there are already hundreds of indie creators on there, making exclusive videos you can’t see anywhere else. And believe me, they’re great. Right now it’s 40% off the annual price.

This isn’t sponsored. This is just genuine passion for something we’ve built and that I care about. What’s more, this represents the first time I have felt comfortable asking for support from you. I want to keep this going as long as I can, and make better videos. I have always resisted asking for direct donation and if people have generously suggested it, I have tried to steer them towards supporting someone else. I also felt guilty that I can go months without posting, and wouldn’t want someone feeling short-changed. With Nebula I can tell you that signing up via any of the links in this email is the best way to directly support me as a creator, but also the development of Nebula. And of course to get access to everything. This newsletter might also move to Nebula if we can iron things out (don’t worry it will remain free).

Thank you for supporting me by signing up to this newsletter and reading this far. If you do check out Nebula, thank you for that too.

Apologies in advance, but really you brought this on yourself

All right, self-indulgent updates over. Time for the Valentine’s puns from yesteryear (and actually, more self-indulgence). I’ll start with a video, which was originally posted on Valentine’s in 2019 when I had about 30k subscribers. It’s a really interesting one that was quite fun to watch after several years, about the link between emotion and the heart, as well as asking the age-old question of whether you can actually die from a broken heart. It got a copyright strike (not just a claim, a strike on the channel) so I had to mute a part of it and re-upload. However, the little anime sequence remains on twitter for all the weebs out there.

Medlife Crisis (Rohin) @MedCrisis

This is the offending segment that led to my whole video being taken down, judge for yourself if it's parody. I was talking about 'broken heart syndrome' Takotsubo cardiomyopathy saying "it was 1st described in Japan, so we should describe it in a Japanese way" #anime #valentines

U R a QT

Medlife Crisis (Rohin) @MedCrisis

I'm not done making cardiology Valentine's yet #Medpickuplines #ValentinesDay #CardioEd #FOAMed #MedEd #medschool

Medlife Crisis (Rohin) @MedCrisis

Roses are yellow Violets are yellow Too much digoxin You silly old fellow #medicalvalentines

I am sure there were others, but I honestly don’t even know how to search for them, which could just be my brain’s cringe prevention crumple zones overriding my frontal cortex. I suspect that’s enough anyway, and I forgot how some of these are pretty…niche. Don’t worry, if you’re not a medic, you’re hardly missing out on some sparkling humour here.

Well, perfectly on brand for last minute me, it’s almost not-Valentine’s-anymore, so I better hit send before I’m yesterday’s news. Unless you’re significantly east of the UK, in which case, bookmark this to read next Feb 14th. Bye for now.

Rohin