The Provocateurs is The Stand’s new series of debates, featuring academics who have to tell us about their research while making it fun – and provocative – all in the space of twenty minutes.
And if that sounds familiar, it is. Last year these events were part of the Cabaret of Dangerous Ideas sessions but, as our host Susan Morrison tells us,
‘The Young People said we needed a rebrand.’
Fortunately, even if (by her own admission), Morrison find ‘provocateurs’ a tricky word to get her Glaswegian tongue around, nothing else has really changed. We’re still promised an interesting, entertaining and thought-provoking hour (with time for questions) from two researchers at the top of their game.
On Thursday, our first speaker is Lucy Remnant (University of Edinburgh), a scientist studying DNA and chromosomes. But before she gets onto those, Remnant wants to tell us about scientific mistakes, of which it seems there are rather a lot. Is that a bad thing?
‘NO!’
Students are taught, says Lucy, to learn from their mistakes but not to repeat them – when in fact, looking at them and repeating them can sometimes lead to massive breakthroughs.
Lucy cites Alexander Fleming. He discovered penicillin, right? What a genius! But if Fleming hadn’t left a plate of bacteria out when he went on holiday, he’d never have found a fungus growing on that bacteria when he came back. That fungus was preventing the bacteria from growing. It was promptly named penicillin, and went on to have a stellar career of its own, saving the lives of many soldiers in World War One.
In 1895, Wilhelm Conrad Rontgen, a German physicist, was busy shooting cathode rays through chemicals. On a whim, he decided to shoot some through his own pelvis. He wasn’t supposed to be doing this (who knew?) but ta-dah! He discovered X-Rays and they’ve been used to take photos of bones ever since.
In her own field, Lucy tells us about Linus Pauling. He published what he thought was the chemical structure of DNA; a year later James Watson and Francis Crick found out he’d got it wrong – and by looking at where he’d gone wrong, they got it right.
To illustrate her research, Lucy produces some knitted socks. Except they’re not socks – they’re tubes of chromosomes. Possibly… Each sock has a pair, except one sad one that gets left behind and feels uncomfortable. It’s likely that 1% of the population has a different number of chromosomes from the standard 46. These are mistakes made by cells, and it’s those mistakes – which may cause anything from Down’s Syndrome to cancer and fertility problems – that Lucy’s investigating. And a human mistake – or rather a failure to follow a protocol – has led to her lab’s discovery of a new and simpler way to isolate chromosomes, and so to the writing of a new, simpler, protocol.
Lucy is all for students being taught not to fear mistakes, but how can this happen when, as Morrison points out, scientists may well be penalised for making them? Pressures of funding, the need to publish authoritative papers – even, as Lucy reminds us, the hyper sterile environments now demanded in labs, all conspire against the idea that short term failure can bring long term benefits. Lucy is part of a new network that plans to change things,
‘It’s the messy edges where breakthroughs can come through. It would be better to teach young people to fail often.’
A tricky idea when the pressure to be perfect in all things has perhaps never been greater, but as Morrison suggest, all we need to do is be more cat. When something goes wrong, just walk away with the classic ‘I meant to do that ‘look. Because if anyone knows how to do nonchalance, it’s definitely our feline friends.
Our second speaker appears in an oversized hospital gown. Yvonne Kuipers is Professor of Midwifery at Edinburgh Napier University, an honorary professor at the University of Antwerp and an NMC Registered Midwife. Her research looks at women’s experiences of birth and how these might be improved.
Yvonne’s presentation begins with voiceovers of comments passed on to interviewers by the women who were on the receiving end of them. Women are told to ‘stop moaning’ to ‘be a good girl.’ They are regularly told that they should be grateful they have a healthy baby, regardless of whether they’ve been ignored, mocked, cut, stitched, given medication without consent and totally traumatised.
A pilot lands a plane safely; he gets a round of applause. Beyonce performs Crazy and gets a standing ovation,
‘Childbirth is special, sacred…the women doing it should be honoured, applauded, given flowers, diamonds.’
What happens to most women? They’re left flailing on their backs under bright lights, with no privacy and a constant stream of medical staff coming in and out of the room. In ‘normal’ life, says Yvonne, the things done to women in childbirth would be classed as assault. In the labour ward, they’re just ‘routine procedure.’
Women do not forget childbirth. Even if it all happened years ago, when Yvonne talks with them they remember it as if it were yesterday, and few of them see it as a positive experience. A 2004 report showed that there had been no improvement in birth outcomes in high income countries; this led to efforts being focused entirely on the reduction of neo-natal deaths, and blame for poor outcomes being directed at women. Mothers are labelled too fat, too thin, too old, too everything.
If a woman in labour disagrees with a medical professional, what Yvonne calls ‘the dead baby card’ is swiftly played; you’d better accept what we say, you don’t want to risk your baby’s life, do you? Again and again, women are told to be ‘grateful.’
And it doesn’t end at birth, says Yvonne. Women who feel traumatised by this lack of compassion can suffer post-natal depression; their relationship with their partner may deteriorate. They will be reluctant to go to their doctor with their problems because they have lost any hope of being listened to. The lack of compassion and dignity in birth silences women, and yet again they are told just to be ‘glad your baby’s healthy’ – which of course makes them feel guilty for having any negative feelings at all.
A traumatic birth full of intervention teaches a woman that her body is not her own, and leads to a wider, societal fear of childbirth. My own mother told me not to let my daughters watch Call the Midwife as ‘it will put them off forever’ – and that was the early series, when the same midwife visited the woman in her home and delivered her baby there too. Long gone are those halcyon days.
Yvonne wants to change things. Compassion and dignity should not, she says, be optional; consent should never be non-negotiable. Childbirth has become over-medicalised and rife with protocols; it’s very difficult for a midwife, no matter how empathetic, to do anything differently. There’s a well-documented shortage of midwives, and an even better-documented lack of cash in the NHS coffers. Is change even feasible? Midwives work on an inflexible shift system which means they can rarely stay with a woman throughout labour. Hospitals want women in and out of beds as soon as possible – will there ever be space for a woman to take longer than her allocated time to deliver? The only people likely to be allowed that luxury are surely those who can afford to pay for it?
Yvonne believes we have to try. Communication, or rather lack of it, is, she says, a big part of the problem in all medical care. Whilst there may not be time to get consent in an emergency, it would normally be perfectly possible to ask a woman if she agrees with the proposed course of action.
Is there a way to build compassion into midwifery training? And even if there is, can it be put into practice given the constraints under which midwives work?
This was an interesting talk and one that raised more questions than it answered. I’m sure most mothers, or women planning a pregnancy, would like to hear more about Yvonne’s work in future, but much as I would like to see her views in action, I fear that nothing will change in our underfunded, overloaded, system for many years to come.
The Provocateurs series continues throughout the Fringe at The Stand, York Place (venue numbers vary.) Please note many events, including these ones, take place in buildings other than The Stand’s main venue, though still on York Place.
On Monday 18 August at 11.25am Chris Purcell will speak on Learn with Your Body and Michael Leavitt on Knocks to the Head, followed at 5.40pm by Chris Elsden on Children’s Money and Berengere Digard on Minds Eyes. Further talks include Urban Camping, Sleep Myths, Robot Romance, Brain Health Roulette, Gender Fears, Women in Iranian Cinema, and many more. For details visit The Stand’s website and click on the Fringe tab.
