Medicine and Science from The BMJ

This episode is available in video form on YouTube: https://youtu.be/1cGrD47eZSk  American science fiction author Kim Stanley Robinson joins Kamran Abbasi to discuss climate disaster, the need for political imagination, and science fiction's vision for health. Kim Stanley Robinson is the acclaimed author of a trilogy of novels, exploring the terraforming and settlement of Mars. His most recent novel, 'Ministry for the Future', was published in 2020. 'Ministry for the Future' sets out a vision for real solutions to our climate crisis, covering global finance, the animal kingdom, rising sea levels, energy production and much more. The book imagines a Ministry that begins its work in 2025. Five years after publication, with 2025 past and gone, The BMJ spoke to Robinson to explore how closely the novel's vision for the future has reflected reality. 01:00 BMJ's New Climate Change Initiative 01:21 Kim Stanley Robinson's Ministry for the Future 04:02 The Role of Political Violence in Climate Action 10:50 The Concept of the Carbon Coin 12:51 The Importance of Global Collaboration 27:32 The Role of Medicine in Climate Change 32:33 Youth and Climate Activism 37:53 Hope and Despair in Climate Action 41:29 Conclusion and Future Works Read more about The BMJ's climate coverage in the latest issue: https://www.bmj.com/content/392/8479

It’s time for 2025’s festive fun! Practicing medicine can be a very visceral experience - and the English language can’t always adequately capture the sights, sounds, smells. So Matt Morgan, intensivist and BMJ columnist, is creating medical neologisms, and joins us to share a few. Madhvi Joshi, a GP in London, has written about longevity science, and we hear how the “biohacking” of internet influencers like Bryan Johnson is making its way into the consultation. Navjoyt Ladher and Tim Feeny take us though this year’s festive research, and are joined by Anupam Bapu Jena from Harvard, who has been looking at self censorship in the time of Trump, and Melanie de Lange, from the university of Bristol, who has been investigating the impact of daylight savings time. Reading list: A dictionary for medicine’s unnamed moments https://www.bmj.com/content/391/bmj.r2476 Science of longevity medicine  https://www.bmj.com/content/391/bmj.r2536  Changes in diversity language in National Institutes of Health grant awards https://www.bmj.com/content/391/bmj-2025-087222  Acute effects of daylight saving time clock changes on mental and physical health in England https://www.bmj.com/content/391/bmj-2025-085962 

In this episode, we hear how Generative AI is making it into the consultation room - but not through NHS endorsed routes - surveys suggest that ⅔ of doctors are using AI, for backoffice tasks - but also increasingly for information and diagnosis.   David Navarro, a research fellow in generative AI at the Australian Institute of Health Innovation, Charlotte Blease, associate professor at the Participatory eHealth and Health Data Research Group at Uppsala University, and Marcus Lewis, GP in London, reflect on what we know about the real way in gen AI is being used - and what “triadic care” (doctor, patient and AI) will mean for the future of the therapeutic relationship.   We also hear from Teppo Järvinen, professor of orthopaedic surgery at Helsinki University, about surgical subacromial decompression - a 10 year follow up of a double blinded placebo controlled trial, confirms that surgery is no more effective than standard care. Yet surgical interventions continue - we hear why.   Finally, we go to a Cholera clinic in Nigeria, where Médecins Sans Frontières are running cholera treatment centres, which you can help by donating to our Christmas appeal.   Links Generative AI and the clinical encounter   The BMJ appeal 2025-26: Inside MSF’s response to cholera in Nigeria: a day in the life of an emergency doctor   Arthroscopic subacromial decompression versus placebo surgery for subacromial pain syndrome

There is an enormous amount of research on treatment for ADHD - pharmaceutical and otherwise. But not all of those trials, or meta-analyses, are of high quality; and not many compare the whole literature.  Now a new umbrella review - a review of reviews - tries to give a broad overview of the whole evidence base. Corentin Gosling, associate professor at the Université Paris Nanterre, joins us to set out the benefits and harms of ADHD therapies.   Also, the BMJ’s been investigating the employment of doctors on “local” contracts in the NHS - and our latest look at this exposes what some have described as a “gig economy”, with doctors plugging rota gaps but missing out on training, development, and salary progression. Rebecca Coombes, head of journalism at The BMJ explains more.   Finally, Tom Frieden is former head of the US Centers for Disease Control, and current CEO of Resolve to Save Lives - he’s written a new book on public health. He joins us to talk about what actually improves health at a population level, and why the current US administration’s approach to staffing the CDC is leaving the country open to danger.   Reading list Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making Revealed: Thousands of NHS doctors are trapped in insecure “gig economy” contracts  

  "Damning” and “unforgivable failures” is how some papers headlines reacted to criticism of former UK prime minister Boris Johnson in the second of 10 reports from the UK Covid Inquiry. Under pressure, in 2001 Boris Johnson announced a covid inquiry led by a former judge, Baroness Hallett. Each report is examining a different area of the pandemic's impact, and module 2 is about decision making and political governance. The report describes inertia, toxic cultures, and an inability to learn lessons - disfunction that contributed to many extra deaths.  To dissect the report and discuss what needs to change, we're joined by; Rebecca Coombes - The BMJ’s head of journalism Kevin Fong - anaesthetist and lead for major incident planning at University College Hospital Matthew Flinders - Professor of Politics and Public Policy at the University of Sheffield