The Best Australian Science Writing 2015

by Heidi Norman

  ‘But even though it is floating in a magnetic field it can shift along its axis of rotation. Whichever side it shifts to becomes more efficient. So it can balance systemic blood flow like no man-made device has ever done, and like your heart and my heart – the native mammalian heart – does brilliantly.’

  For the team, this is a moment 15 years in the making. They’ve been here since 6 am this morning and nobody is going home until they watch the sheep open its eyes and stand. ‘This will be the first practical, mechanical, long-term replacement for the human heart,’ says Cohn. ‘Daniel Timms and his team have come up with a mechanism that makes an artificial heart balance like a native heart, which nobody has ever been able to do.’

  Fraser’s mile-wide smile is fixed in time. ‘This isn’t research,’ he says. ‘It’s revolution. We just totally fucked over four billion years of evolution.’

  ‘A sheep without a heart being kept alive by a machine with one moving part,’ says Cohn. ‘No pulse at all. Kinda makes you question what it is to be alive, right?’

  * * * * *

  Timms exits the operating theatre. He sits down for a moment, near the change rooms where six takeaway pizzas are going cold. He removes his surgeon’s scrub hat, digests the past 15 hours, the past 15 years. ‘You wait ’til I tell my mum about this,’ he says. ‘The first thing she’ll say: “Imagine if your dad could see this.”’

  The thought brings a tear to Timms’ eye that he wipes away with his thumb, smiling. Truth is, the BiVACOR was born as much in his own heart as in his mind. It was built with things that science can’t so easily explain: human connection, affection, love. It was built for his father. While Daniel’s artificial heart was growing through the early and mid-2000s, his father Gary’s warm and voluminous natural heart was dying; failing like 17 million human hearts around the world fail each year.

  ‘Dad was getting sicker and sicker,’ Dan says. ‘I would think about him, Wouldn’t it be good if he had another five years? Another ten years? What if we could create something that gives somebody an extra ten years of life? You could tick off your bucket list in ten years.’

  Dan Timms went to work. He devoted every waking hour he had to making a machine that would give him ten more years on Earth with his best friend. ‘Dad ended up getting his heart valve replaced by surgeons up here at Prince Charles,’ he says. ‘The surgeons and clinicians that brought me out here were the ones who were looking after my dad. These guys who had been involved with this thing for so long, they all would be doing their best to improve my dad’s outcome.’ When Gary’s heart continued to fail and he was placed in intensive care, he was cared for by the very surgeons who had urged his son on through his medical quest because they’d seen so many people die before their eyes from heart failure.

  Dan doubled, tripled his efforts. Not eating, not sleeping, only building, working himself to the point of exhaustion. ‘I was here in the lab working and it’s literally two minutes’ walk to ICU where they were looking after Dad,’ he says. ‘When he was … aaahh …,’ he struggles to find the words, ‘looking like he wasn’t going that well … yeah … I spent two full months just working on this. It was a naive two months. Of course, there was no chance I could do it in that time. But there was a time in that period where I remember thinking, “It’s just motivation.”’

  Gary Timms never got the chance to see if his son’s artificial heart design worked. He died, aged 55, of heart disease in the Prince Charles Hospital almost eight years ago.

  Timms takes a deep breath, exhales. He’s tired. Because it’s nearing midnight and because he’s been working 16-hour days for 15 years; because he’s sacrificed everything – no wife, no kids, no definitive place to call home – to build the machine spinning 2000 revolutions per minute in the theatre next door.

  There’ll be more animal trials for the BiVACOR; human implants after that. He’s intensely wary about claims of miracle breakthroughs and medical holy grails. Only after 500 men and women and children are living well and long with the BiVACOR inside their chests will he claim any kind of victory over Mother Nature. It’s taken 15 years to get to the beginning. But there’s a secret he can’t contain anymore, a truth he can’t avoid.

  ‘It works,’ he says, nodding, full of heart, full of soul. ‘It works.’

  Timms puts his surgeon’s cap back on and enters the theatre, joins his team to stare at the sleeping sheep on the operating table. Forty minutes later, the sheep’s right eye blinks twice, fully opens. Its head looks around, left, then right. It sucks on a stick of gooey molasses. Then it stands up. And those two words lit up beside the long night road of Daniel’s endeavour explode into 17 million tiny flecks of gold.

  How I rescued my brain

  Will a statin a day really keep the doctor away?

  Germ war breakthrough

  Where’s the proof in science?There is none.

  Geraint Lewis

  As an astrophysicist, I live and breathe science. Much of what I read and hear is couched in language that to outsiders can seem little more than jargon and gibberish. But one word is rarely spoken or printed in science and that word is ‘proof ’. In fact, science has little to do with ‘proving’ anything.

  These words may have caused a worried expression to creep across your face, especially as we’re often told by the media that science proves things: serious things with potential consequences, such as ‘turmeric is a proven substitute for 14 common drugs’, or more frivolous things, like ‘science has proved that mozzarella is the optimal cheese for pizza’.

  But has science truly proved these things? Well, no.

  The way of the mathematician

  Mathematicians prove things, and this means something quite specific. Mathematicians lay out a particular set of ground rules, known as axioms, and determine which statements are true within the framework.

  One of the best known of these is the ancient geometry of Euclid. Over the last few millennia countless children have sweated to prove Pythagoras’s relation for right-angled triangles, or that a straight line will cross a circle at two locations at most, or myriad other statements that are true within Euclid’s rules.

  Whereas the world of Euclid is perfect, defined by its straight lines and circles, the universe we inhabit is not. Geometrical figures drawn with paper and pencil are only an approximation of the world of Euclid where statements of truth are absolute.

  Over the last few centuries we’ve come to realise that geometry is more complicated than Euclid allowed for, with mathematical greats such as Gauss, Lobachevsky and Riemann giving us the geometry of curved and warped surfaces.

  In this non-Euclidean geometry, we have a new set of axioms and ground rules, and a new set of statements of absolute truth we can prove.

  These rules are extremely useful for navigating around this (almost) round planet. One of Einstein’s many great achievements was to show that curving and warping spacetime itself could explain gravity.

  The mathematical world of non-Euclidean geometry is pure and perfect, and can therefore only ever be an approximation of our otherwise messy world.

  What about science?

  But there is mathematics in science, you cry. I just lectured on magnetic fields, line integrals and vector calculus, and I am sure my students would readily agree that there is plenty of maths in science.

  And the approach is the same as other mathematics: define the axioms, examine the consequences.

  Einstein’s famous E=mc2, drawn from the postulates of how the laws of electromagnetism are seen by differing observers, his special theory of relativity, is a prime example of this.

  But such mathematical proofs are only a part of the story of science.

  The important bit, the bit that defines science, is whether such mathematical laws are an accurate description of the universe we see around us.

  To do this we must collect data through observations and experiments of natural phenomena, and then compare them to the mathematical pred
ictions and laws. The word central to this endeavour is ‘evidence’.

  The scientific detective

  The mathematical side is pure and clean, whereas the observations and experiments are limited by technologies and uncertainties. Comparing the two is wrapped up in the mathematical fields of statistics and inference.

  Many, but not all, rely on a particular approach to this known as ‘Bayesian reasoning’ to incorporate observational and experimental evidence into what we know and to update our belief in a particular description of the universe.

  Here, belief means how confident you are in a particular model being an accurate description of nature, based upon what you know. Think of it as being like the betting odds on a particular outcome.

  Our description of gravity appears to be pretty good, so it might be an odds-on favourite that an apple will fall from a branch to the ground.

  But I have less confidence in super-string theory, which proposes that electrons are tiny loops of rotating and gyrating string, and the odds that this theory will provide accurate descriptions of future phenomena might be thousand-to-one.

  So, perhaps science is like an ongoing courtroom drama, with a continual stream of evidence being presented to the jury. But there is no single suspect and new suspects are regularly wheeled in. In light of the growing evidence, the jury is constantly updating its view of who is responsible for the data.

  But while evidence is continually gathered and more suspects are paraded in front of the court, no verdict of absolute guilt or innocence is ever returned. All the jury can do is decide that one suspect is more guilty than another.

  What has science proved?

  In the mathematical sense, despite all the years of researching the way the universe works, science has proved nothing.

  Many theoretical models have given us a good description of the universe around us. But at the same time exploring new territories reveals further gaps in our knowledge, lowering our belief in the accuracy of our existing experiments.

  Will we ultimately know the truth and hold the laws that truly govern the workings of the cosmos within our hands?

  We can believe that our mathematical models are providing ever more accurate descriptions of nature, but we’ll never know if we’ve found reality. In the words of one of the greatest physicists, Richard Feynman, on what being a scientist is all about:

  ‘I have approximate answers and possible beliefs in different degrees of certainty about different things, but I’m not absolutely sure of anything.’

  What shall we teach the children

  Imagine there’s new metrics (it’s easy if you try)

  Germ war breakthrough

  John Ross

  It was the first full week of the year, when sport and holiday weather dominate the headlines. For medical researchers, it held the promise of lab time uninterrupted by the usual meetings and grant applications.

  Then something happened to marshal researchers around water coolers in excited conversation. A Boston-led team reported the discovery of a completely new class of antibiotics – the first in a quarter of a century.

  The breakthrough, reported in the journal Nature, was one of the best pieces of news since the 1960s emergence of antibiotic resistance sparked alarm across the medical world. Health authorities feared the antibiotic era spawned by the 1928 discovery of penicillin could be a fleeting thing, with the world once more at the mercy of microbes that kill millions in infancy and make simple surgery a hazardous undertaking.

  In July 2014, British Prime Minister David Cameron warned that the world could be ‘cast back into the dark ages of medicine’, with people dying from routine infections. In 2012, World Health Organisation chief Margaret Chan said rampant antimicrobial resistance was propelling the world into a ‘post-antibiotic’ era. ‘In terms of new replacement antibiotics, the pipeline is virtually dry,’ she warned. ‘The cupboard is nearly bare.’

  Chan said ‘first-line’ antibiotics were already increasingly ineffective, forcing doctors to resort to more expensive drugs which required longer courses, caused nasty side effects and carried 50 per cent higher mortality rates.

  A major concern is the ancient scourge of tuberculosis (TB), with resistance threatening to reverse a long-term decline in deaths from the disease. About 5 per cent of an estimated 12 million TB cases a year involve strains that are resistant to the two major first-line drugs – isoniazid and rifampicin – and sometimes others. Treatment can take years and only about half of affected people are cured.

  Chan also highlighted the highly resistant pathogens turning hospitals into killing grounds. They include drug-resistant golden staph, also known as MRSA, and bacteria resistant to carbapenems, the antibiotics of last resort for infections such as E. coli.

  The new class of antibiotics, dubbed teixobactin, has only been tested on mice. But it appears to work against both MRSA and TB. And it will take at least two decades for bacteria to evolve defences against it, according to Grant Hill-Cawthorne of Sydney University.

  Hill-Cawthorne, of the Marie Bashir Institute for Infectious Diseases and Biosecurity, says bacteria typically have two ways of protecting themselves from antibiotics that attacked their surfaces. They either mutate the ‘target’ that the antibiotic attaches itself to on the bacteria cell wall, or they produce enzymes that disable the antibiotics.

  ‘In this case, the part of the cell wall that it’s acting upon is so vital to the bacteria that they can’t afford to mutate it. That means it’s harder for the bacteria to become resistant. The only way is to generate enzymes to attack the antibiotic. That’s a slower process in their evolution, and it typically takes about 20 to 30 years.’

  Monash University microbiologist Julian Rood says the buzz around teixobactin is justified, not only because of the drug’s potential but also because of the ‘elegant’ way it was discovered.

  He says the team at Boston’s Northeastern University developed a variation on the technique which yielded the first two antibiotics – penicillin and streptomycin, the first effective TB treatment – when researchers harnessed the organisms that yeast and bacteria produce naturally to protect themselves against other microbes.

  ‘You go into a natural environmental sample, like soil, and try and grow organisms on artificial media (such as) an agar plate,’ Rood says. ‘(But) only a very small percentage of the organisms are capable of being grown under those conditions. They just don’t make it.’

  The Northeastern team took a one-gram soil sample from a grassy field in Maine, removed the solid material, diluted the solution and placed it in a tiny multi-channel gadget known as an iChip. The device was shielded with two semipermeable membranes and reburied in the soil.

  ‘The idea was to say to the organisms that this is not artificial growth media at all,’ Rood says. ‘You’re in the soil; do your normal thing. They left it there for a month, and looked at what had grown. When you consider the method you think gee, that’s nice, I should have thought of that. Elegant experiments are always conceptually simple.’

  Teixobactin was merely the most promising of 25 new organisms discovered in the study, with the others also showing potential as drugs. But Rood says they could be the tip of the iceberg. ‘We all know from our gardening experience that every soil is different – it’s different in its biological and chemical make-up, its nutrient content, its water content.

  ‘My assumption would be, if you took their apparatus and did the same experiment in different soils, you’d come up with very different organisms. A lot would be the same, but a lot would be different. People are probably out there right now replicating this approach.’

  The Northeastern team says just 1 per cent of cells from soil can be grown on agar plates. But close to 50 per cent can survive the team’s quasi-natural technique. ‘Once a colony is produced, a substantial number of uncultured isolates are able to grow in (the laboratory),’ the paper says.

  It says synthetic approaches to producing new antibiotics
have been unable to replace the techniques that delivered the original examples. ‘Most antibiotics introduced into the clinic were discovered by screening cultivable soil microorganisms,’ it says. ‘Overmining of this limited resource by the 1960s brought an end to the initial era of antibiotic discovery.’

  Flinders University research associate Ramiz Boulos says the Northeastern approach shows there are still ‘mines’ to be discovered. ‘The discovery of teixobactin is very exciting,’ he says.

  Boulos heads a South Australian biotech company which is developing its own new antibiotics, with clinical trials planned next year. ‘We are in urgent need of a constant supply of new and effective antibiotics that work in new ways to slow down antibiotic resistance.’

  But enthusiasts stress it will be years before teixobactin appears in hospitals or pharmacies, if ever. ‘They’ve shown that it’s not toxic and works in mice,’ Hill-Cawthorne says. ‘Normally the (US) Food and Drug Administration and other regulatory authorities require that to be shown in two animal models.’

  He says the drug needs to be tested on another animal before human trials can begin. The aim then would be to demonstrate its safety in healthy people before trying it out on the sick, in small and then larger groups. ‘You’re looking at about five years at least to go through all those processes. The key is attracting funding – it’s very expensive.’