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28-minute Mini-Med lecture, 40 hours of preparation

Medical talks a hit with public, a challenge for physicians:
There's a public thirst for basic scientific knowledge, and audiences are willing to focus and work hard to follow along

October 23, 2005

By Tom Spears
The Ottawa Citizen

It is Opening Night at Mini-Medical School, and Dr. Mark Walker is on stage, lecturing on his usual topic of pregnancy and what can go wrong with it. But tonight's talk is rewritten -- heavily -- for an audience with no medical training.

Dr. Walker is a high-risk obstetrician, also a lab researcher, also a father. He knows pregnancy.

He lectures students often; he also speaks at highfalutin national and international medical conferences about his research.

He can often prepare a lecture the night before, he confides. Or even, if necessary, the morning of the event itself.

For his first Mini-Med gig he did 40 hours of writing, practising, and rewriting. Forty.

Mini-Med is an odd phenomenon that has spread all over North America: Hospitals and universities are picking their top teaching faculty to explain the human body to ordinary listeners.

It's watered down, certainly. But they're discovering what David Suzuki learned a generation ago: There's a public thirst for basic scientific knowledge, and audiences are willing to focus and work hard to follow along.

This week, the University of Ottawa started its second year of Mini-Med in parallel English and French series.

Dr. Walker and two other medical school profs kicked off with pregnancy and birth.

As always, it has given them a chance to revisit what they know in a new way, cutting through the immense complexity of detail to condense the essentials, and to explain these in non-technical terms, with a little humour.

For Dr. Walker, there's an extra obstacle.

"I'm an incredibly nervous public speaker," he says. "I love it. But, I don't know if you ever did competitive racing or swimming? It's those 10 seconds before the gun goes off and you think: 'What am I doing here? Can I just quietly walk away?'

"It's like that when you get up to the podium. You hear your pulse in your ears, you feel your chest beating underneath your clothes.
"I think it's what make you sharp -- the fight-or-flight reaction."

Of Mini-Med, he says: "This is the hardest lecture I've ever done. By far. Because it was like translating into a second language. You can't use jargon. As you know, we (doctors) have our own language of not only medical-ese but it's also acronyms. It's hard to get away from the PEs, the SVTs. So this last lecture was 28 minutes, I think. It took me 40 hours to prepare for it."

The veteran at Mini-Med is Dr. Akef Obeidat, who starts each lecture in the series with a half-hour of anatomy.

He cracks jokes (they're pretty corny but they go over well, perhaps because they're incongruous in this setting), and then he hits them with the solid stuff. As he shows the view inside a knee joint flexing, with the cartilage shifting back and forth to cushion the action, there's utter silence. You can hear the breathing as 250 pairs of eyes stare in fascination. This is a generation where knees are starting to matter.

Dr. Walker takes his turn, and wows them with images from inside the womb: Video of a fetal heart beating in minute detail. Also images of a spine defect that causes spina bifida. More silence.

"It's a big deal covering a whole year of medical school in an hour," he says.

His topic, as usual, is fetal life and development. He calls it "life's greatest miracle" -- how one cell grows into trillions of cells, and also what can go wrong along the way.

It is what drew this doctor into medicine.

His father was a Toronto pediatrician. ("I think if my father had been a shoemaker, I would have been a shoemaker," he notes.)

But first year at med school was a bust. He was the second-youngest in the class (the youngest was his future wife) and he never felt he got it. He wanted to drop out.

Then he spent a summer following an obstetrician around, and saw his first baby delivered. The young student was hooked. He had a goal, a focus, and an emotional tie to his studies. "The rest of med school was a breeze."

The Mini-Med style of explanation to an untrained public is a necessity for the doctor of 2005, who must often explain complicated scientific concepts to a patient. Want to do brain surgery? You'd better know how to tell the patient what it will do to his head, or the lawyers will get involved.

His current research at the Ottawa Health Research Institute involves a "cohort" of 8,000 mothers and their babies in an effort to answer a wide-ranging set of questions about how the things that happen in the womb will affect that baby's health in adulthood. Cancer, heart disease, stroke, diabetes -- all these may have origins in the womb, he argues.

"When you think about it, you go from one cell to 100 trillion cells in the womb. Any insults that happen in that period may have significant health impacts later in life," he tells the Mini-Med audience.

Yes, you can explain detailed cell biology and genetics to Mini-Med, to an audience that isn't totally sure how DNA works. And he found out how while bouncing a lecture off his 11-year-old son, a surrogate for the Mini-Med gang. With coloured Lego.

DNA is a long string of four kinds of molecules, usually expressed using their initials of A, C, G and T. These become blocks of red, yellow, green and blue plastic blocks. Bingo, a genetics lecture is born.

And so Mini-Med continues, bringing together this odd partnership of untrained but inquiring minds with the leading medical brains of our city. It is an odd thing to watch sometimes. But it is always remarkable.

Read Dark Matter, Tom Spears's blog of science quirks and snarks, at www.ottawacitizen.com

Note: Reprinted with permission from the Ottawa Citizen.