The Happy Pod: Turning my toddler's tales into tunes

12:54Ginny:all their extended family all my cousins in the UK and whatnot are amazing I love them to bits

13:03Anita:and so now I feel like I have like a bonus family and it's it's been a phenomenal experience.

13:11Stephen Spencer:Christopher ending that report by Frankie McCamley. Has a stranger ever changed your life? We'd love to hear from you if so. The address is globalpodcast at bbc.co.uk. Next to an extraordinary operation that could improve access to life-saving surgeries for people around the world. A surgeon carried out a prostate removal on a cancer patient from nearly 2 ,500 kilometres away using a robot. Professor Prokar Dasgupta was in London remotely controlling the machine operating on Paul Buxton in Gibraltar. My colleague Johnny Diamond spoke to them both about the procedure.

13:50Ginny:The robot has tiny little wrists and a 3D HD camera, which magnifies the vision inside the tummy. So the prostate gland, which was removed, actually looks like a football. I know Paul is a football fanatic. And I can see all this from a computer console or a robotic console in 3D HD and move the instruments with my hands and feet. The difference is 20 years ago, I would be in the same room with a robot doing this for a patient, removing his cancer and curing him of it. On this occasion, the difference was that I was 2 ,400 kilometers away using a different robot, but having the same view of Paul's prostate and the inside of his tummy and guiding that robot, literally moving the arms of the robot on a high-speed dedicated fiber line.

14:48Ginny:and I'm really excited and glad that it went well. Procar knows me inside out, really, doesn't he? But we've never actually met face to face. And Paul, I mean, did you care that no one was there? The two consultations I had with Procar at the beginning, it really explained it well, which obviously helped me make my final decision. I had a week to think about it, discuss it with my family, and I found it rather interesting, to be honest with you. And when I put it to a couple of my friends and a couple of the family, they go, you're not going to do that, are you? And that's it, I am, yeah. I'd made my mind up from the first consultation, and nothing was going to sway me.

15:27Ginny:Prokart, was there anything that you missed by not being there? I didn't miss anything, and this is the beauty of it. The connection delay between the London Clinic and Gibraltar was only a fraction of a second. So it felt like I was in Gibraltar. And of course, although this has taken a year of planning, in the end, the only thing that matters to me is patient safety and the doctor-patient relationship. So I reassured him that there would be my team in the operating room in Gibraltar with a surgeon being present who would be able to finish the operation just in case the line or the connection went down.

16:14Ginny:But in reality, that didn't happen. People in Gibraltar, the excellent Gibraltar team have told me it felt like I was in the room myself. To be honest with you, I don't think I realise the gravity of it. When you speak to people like Prokhar and his nurses, they're so calm that it puts your mind at risk as well. Prokot, I mean, things like this have been done before. Is there anything we should take from this specific operation? Yes, absolutely. This is Telesurgery 2.0. We did the first trial in the world between Guy's Hospital and Johns Hopkins putting a needle in the kidney in 2002. But then the technology did not have telesurgical capabilities.

17:00Ginny:The current technology does. So I think this is good for patients as new robots are coming to the market because it brings equity of access. There is a humanitarian role. For example, it has been done between USA and Angola, for example. In China, a vast country, they have even done a trial. And we hope now that with the connections being much faster, the robots being much more intelligent, with such a lot of AI in play, which you can't see, I think this could bring in a new era for patients. It takes so much stress out of, obviously, having a cancer diagnosis is serious. and it's shocking when you first hear it.

17:40Ginny:This option, I recovered in my own home. I have the people around me. It's a game changer for having surgery. And thank you all for putting your faith in us and our team. Thank you. It was well worth it. Thank you.

17:54Stephen Spencer:Paul Buxton and Professor Prokar Dasgupta speaking to Johnny Diamond.

18:05Stephen Spencer:Coming up on this podcast, how learning to appreciate poetry can improve the way trainee doctors interact with patients. You need to be present and you need to be able to give your full attention and you need to be able to hear what the patient is saying but also what they're not saying and read between the lines.

18:31Ginny:We focus on the part of the internet that most people don't know about. It's called the dark web. Undercover in the furthest corners of the dark web, US special agents are on a mission to locate and rescue children from abuse.

18:47Stephen Spencer:Moving in now. Police!

18:49Ginny:From the BBC World Service, World of Secrets, The Darkest Web follows their shocking investigations. Listen on bbc.com or wherever you get your BBC podcasts.

19:05Stephen Spencer:Welcome back to The Happy Pod. Have a listen to this.

19:21Stephen Spencer:that's a dog shifting pitch in response to a song it's not uncommon to see a dog howling along to music but are they just making a noise or actually singing the recording is part of a study by tufts and Harvard universities in the US into whether dogs can actually demonstrate any musicality. My colleague James Menendez spoke to Professor Arnie Patel from Tufts, who led the study. So what are dogs trying to do when they sing?

19:48Ginny:We wanted to test an experiment, if they were shifting pitch, as a way of coordinating what they're doing with another singing voice, which is what we think is one of the fundamentals of human music. We see people doing it all over the world. But was it uniquely human? And does it depend on our sophisticated abilities to imitate complex sounds and speak? And so we were fascinated by the idea that other animals, like wolves, for example, were claimed to shift pitch when they listened to each other howl for functional reasons to make them sound like a larger pack, for example, by detuning their pitches.

20:20Ginny:So we took advantage of that to test dogs who are related to wolves, ancient breed dogs, to see if they would shift a pitch when they were howling along to something that set them off, in this case, popular music, to see if they would shift their pitch up or down when we shifted the music up or down. And they did. And this was a clue that an animal with largely instinctive vocalizations could do this. Right. And just to be clear, so they're not trying to match the pitch of the music, but they are moving it around. And you say, what, that could be that response to try to give others the idea that this is a big pack and not to be messed with.

20:55Ginny:Yeah, that's one way they could do it is actually try and detune their pitches from what they're hearing. Another way, they could come into convergence if they're using it for pro-social reasons, like try to reunite their pack. So these were all speculations, but this was an actual experiment to see if they had this capacity. And if this in principle could say that our own ancestors could have this capacity to sing and coordinate pitch for social reasons, even before we had the ability to speak and imitate complicated sounds. Right. So as you sort of hinted, this may well predate speech. This was another way of learning to communicate and what reinforced those bonds.

21:31Ginny:Yes, to have important social communication in ways that use musical elements before there's even linguistic elements in an animal's communication system. This isn't all dogs, is it? Not all dogs can do that? Well, we've only tested this ancient breeds that are more closely related to wolves genetically that share this genetic similarity. But it would be interesting to test modern breeds as well. There's plenty of videos on the internet of dogs howling along to music. But without doing an experiment, it's hard to know if they're in control or if they're just being instinctive and doing something inflexible.

22:05Stephen Spencer:Professor Arnie Patel from Tufts University. Poetry can mean different things to different people, from a powerful way to communicate emotions to something they were forced to study at school. but at the Likong Chang School of Medicine in Singapore it's being used to train doctors. It's hoped reading and understanding poems will teach students to recognise the nuance in what patients might say to doctors and to have greater empathy and compassion. The BBC's Rita Rahman went along to a class. Doctor, you say there are no halos around the streetlights in Paris and what I see is an aberration caused by old age and affliction.

22:46Stephen Spencer:I tell you it has taken me all my life to arrive at the vision of gas lamps as angels. Dr Tanya Turney listens as second-year student Marcia reads a poem about the French Impressionist artist Claude Monet refusing an operation to correct his eyesight. The poet Lizelle Mueller describes Monet arguing with his doctor, saying that the way he sees the world, blurred edges and all, is what defines him and his art. So if we shift this into a clinical space, when we're explaining procedures to patients and asking for consent, is there a message that you're seeing from this poem? Even though subjectively you might think it might help the patient, but objectively it might be the patient's own choice to not have this operation, which should be respected.

23:36Stephen Spencer:it. Poetry forms part of the school's medical humanities course, which is aimed at producing more compassionate doctors. It's compulsory and has recently been extended into all five years of study. Students come into medical school with a very science background and often want things to have one right answer, things to be black and white. But medicine's not like that. Medicine, and there's uncertainty from all sorts of different directions, and they need to navigate that uncertainty. I found that it was a very enlightening experience,

24:10Ginny:because not only are you sort of forced to slow down and understand the nuance behind every word that you read, you also get to hear the perspectives of everyone else around you.

24:20Stephen Spencer:When they're starting to interact with patients, you need to be present, and you need to be able to give your full attention, and you need to be able to hear what the patient is saying, but also what they're not saying and read between the lines. So the skills that you develop as you're exploring a poem encourage the reading between the lines that they can take into their patient interactions. Can we just look briefly at the first few lines? There's fire references all the way through, with this tongue of flame, the dry mouth, the thirst, when you look in the textbook and it says excessive thirst.

25:02Stephen Spencer:So how unbearable does it sound when you just see the words excessive thirst, whereas this description, it's so powerful. Marsha has even written her own poetry to help her manage the challenges of studying.

25:14Ginny:Medical professionals are often seen as saviours, and so we often have to present ourselves as the strong one. But I do think that we also need to carve out a space for ourselves where we can be open and vulnerable.

25:29Stephen Spencer:Because in order to treat our patients well, we have to be well ourselves. For those that it is a media that they connect with, and it does bring meaning to how they relate to patients, how they relate to themselves, how they understand their own identity as a medical student or a doctor or a human being, To see that, that's my hope and it's a real pleasure when that happens. And student Cheryl is noticeably moved when she tells me how poetry has helped her manage the doctor-patient relationship.

26:04Ginny:We kind of have to unclothe and clothe ourselves, the identity that we put on as a professional when we come to see patients. And the patients, they themselves have an identity that they present to us. But there was a time that I had the opportunity to speak with this very lovely old lady who shared with me the life that she had before she was sick. And I think that really made me see how actually we are not very different because we all have identities outside of our profession and outside of our personal lives as well.

26:38Stephen Spencer:Rita Rahman reporting. and for more on this story, just search for People Fixing the World wherever you get your BBC podcasts from. And we end this episode with the tale of a rather unusual stowaway who travelled from the UK to the US in the hold of a cargo ship. When the vessel carrying cars from Southampton arrived in New York, dock workers were surprised to find an extra passenger, a fox. The animal, a male thought to be around two years old, is being cared for at the Bronx Zoo while awaiting a permanent new home. Keith Lovett is the zoo's director of animal programmes.

27:15Ginny:Surprisingly, it's doing well. You would expect that this animal would be a lot more stressed, maybe thin in weight, but it appears pretty strong at this point. Our animal care teams are monitoring,

27:25Anita:our veterinary teams have looked at the animal and we have a few tests pending that we're waiting for.

27:31Ginny:But all in all, considering what this animal has gone through, it looks to be in pretty good condition. They are very opportunistic feeders. They will eat different types of produce. They will eat different types of protein. They will go after small rodents and stuff like that. So whatever it could get access to, I'm sure it was eating on that. But it's in pretty good body weight. You know, and down in New York, New Jersey, we do have one of the larger ports in the country, if not the world. So there is a lot of wildlife that comes through there. But this is a pretty unique story that this animal was, you know, in the cargo hold for that long doing this well.

28:08Ginny:So, you know, there's a personality involved with this animal as well. So, yeah, this is a pretty unique story. Am I surprised from a species standpoint? No, because they are so opportunistic and they can be a very hardy species. This is why they are so widespread in so many areas. So from a species standpoint, I wasn't terribly surprised. But again, for this animal to get himself locked into the cargo hold of a ship and do, you know, this long voyage and then come, you know, and really not show much wear and tear, if you will, from that voyage. Yeah, that is a little bit surprising. He's not as skittish as you expect this animal to be.

28:45Ginny:He's actually pretty receptive to the animal care staff that's taking care of him. He's not acting terribly shy. So one would assume he had some level of exposure to humans prior.

28:55Stephen Spencer:Keith Lovett.

29:01Stephen Spencer:And that's all from the Happy Pod for now. We'd love to hear from you. As ever, the address is globalpodcast at bbc.co.uk. This edition was produced by Rachel Bulkeley. The editor is Karen Martin. I'm Holly Gibbs. Until next time, goodbye. Bye.

29:47Ginny:Listen on BBC.com or wherever you get your BBC podcasts.