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Meet the Doctors of Antarctica

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When physician Dale Mole stepped off the C-130 turboprop plane that had landed at the South Pole in January 2012, he felt a twinge of disappointment. It was only minus 25 degrees Fahrenheit. Granted, it was summer—but he had expected worse.

“The average winter temperature is minus 85,” he says. As the weeks and months passed, however, the thermostat dropped as low as minus 107. Mole’s exhaled breath would freeze in mid-air; no one dared leave bare flesh exposed more than 10 or 15 seconds; teeth would ache for hours after exposure.

Once, as Mole was cresting a snow bank, his face mask froze. “I had to remove my mask to breathe and the super-cooled air felt like ice daggers in my throat,” he says. “I was afraid my windpipe was going to freeze, which could prove fatal.”

The Amundsen-Scott South Pole Station at twilight. Courtesy Dale Mole.

In Antarctica, the coldest and most isolated place on the planet, even the simple act of breathing becomes an endurance test. Home to three permanent U.S. expedition outposts—McMurdo Station, Amundsen-Scott South Pole Station, and Palmer Station—it’s inaccessible eight months out of the year due to oppressive weather conditions. Researchers from a variety of countries fly in with the knowledge they’re about to be effectively cut off from the world.

But what happens when a medical situation arises? More than 2800 miles from the nearest hospital in New Zealand, Antarctic crews must rely on the expertise of a single physician responsible for upwards of 150 people. (The number varies by season.) Working autonomously, the doctor is charged with analyzing x-rays and blood work, providing aftercare, overseeing pharmaceutical duties and even performing dentistry. Serious conditions that could be managed in a major facility become radical emergencies. Surgery is a major undertaking, and intensive care can’t be sustained.

Such adversity is not for the claustrophobic or easily shaken. But for Mole, volunteering was academic. “I signed up,” he says, “because I wanted the challenge of providing medical care in the most remote and austere environment on Earth.”

The Right Stuff

The view from the observation deck. Courtesy Dale Mole.

Scott Parazynski, M.D., had spent 16 years in NASA's astronaut corps and was an experienced mountaineer when the offer came to become Chief Medical Officer overseeing healthcare for the National Science Foundation’s U.S. Antarctic Program (USAP). Having tended to climbers all the way to the summit of Mount Everest, he was familiar with the psychological and physical demands of practicing medicine without a net.

“It takes a really broad skill set,” he says. “I call it MacGyver medicine. What can you do to diagnose and treat conditions in a really remote environment when the chips are down? You have to invent solutions on the fly.”

Physicians who volunteer typically have backgrounds as surgeons or emergency room veterans. When Parazynski selected former submarine medical officer Mole to go to the South Pole, the 63-year-old underwent a rigorous screening: an EKG to assess cardiovascular health, an ultrasound of the gallbladder to rule out any simmering problems, and a psychological test.

Once approved, Mole left Denver for New Zealand, which connected him to McMurdo Station. There, a dentist gave him a crash course on fillings and root canals. After a week, he boarded a flight to the South Pole, where his patient base of 49 scientists and researchers studied everything from geophysics to astronomy in a fuel-powered compound; the dry air (the area averages seven percent humidity) forces residents to guzzle four to six liters of water a day. Mole was careful not to touch any metal with his bare hands—it can take the skin right off—and investigated his professional tools, a mixture of modern and museum-worthy.

“Some of the items I remember from visiting the doctor in the 1950s,” he says. There was a World War II embalming kit, a straitjacket, and glass syringes with reusable needles. “Some of our lab equipment was also designed for use on animals, but was perfectly suitable for humans. The x-ray unit was the portable kind used by veterinarians, but it worked.”

Ventilators, ultrasound, and critical life support devices are also present, though luxuries like an MRI device would be cost-prohibitive owing to the small population. “You’re relying upon clinical judgment and your resourcefulness,” Parazynski says.

Because the Antarctic workers are carefully screened for any major conditions, Mole and other physicians frequently find themselves treating conditions common to any industrial environment: slips, common colds, and lacerations. The plummeting temperatures and non-existent humidity also give rise to dry skin conditions and respiratory ailments. One, “the McMurdo crud,” is a hacking cough that tends to nag at patients.

Dawn at the American base. Courtesy Dale Mole.

Despite the cold, frostbite is not as common as one might expect. Mole saw only a few cases, albeit one that resulted in a patient losing part of an ear. Most injuries, he says, “were sports related, as many played basketball, volleyball and dodge ball on their off-duty time.”

Sean Roden, M.D., who stayed during the comparatively warmer summer months prior to Mole’s arrival, recalls that altitude sickness was a problem for many: Antarctic stations are 9500 feet above sea level. Staff and crew take Diamox, a drug that helps adjust the body’s chemistry to the environment, but it isn’t always effective. “I had a headache for over two months,” Roden says. “Everyone was just constantly short of breath, had a headache, had a hard time sleeping. You get winded just brushing your teeth.”

Summer also invites a scourge of insomniacs, with the sun refusing to go away and inhabitants putting up blackout shutters to try and cope with the irregular seasons. “People were walking up and down hallways, not really awake, not asleep,” Roden says, like zombies.”

When Doctors Get Sick

The modest inpatient ward. Courtesy Dale Mole.

It’s a hypochondriac’s worst nightmare: alone in the Antarctic, with the lone physician too ill to care for anyone else. Modern screenings have reduced that possibility, but the area has been home to a series of legendary crises.

Some countries require their doctors undergo an appendectomy to ward off the potential for appendicitis. If that seems excessive, consider the case of Leonid Rogozov, a Russian physician who diagnosed himself with a swollen appendix during a 1961 expedition. Trapped in the Austral winter with no flights in or out—the harsh weather can prevent aircraft from functioning properly—he deputized a few researchers to be his surgical assistants and cut out his own organ using only local anesthesia. He recovered in just two weeks.

In 1999, Jerri Nielsen discovered a lump in her breast. She performed a biopsy using only an ice cube to numb the area; upon discovering a cancerous growth, she had drugs air-dropped to her until she was able fly out for treatment.

If anything similar were to occur today, physicians would have the benefit of teleconferencing with colleagues. “We can look remotely in someone’s ear, eyes, listen to their heart, share views of ultrasound or EKG tracing,” Parazynski says. “We can look over their shoulder and be part of the decision making process.”

That assumes, however, communications are working. Mole says Internet access was available only a few hours at a stretch. Without it, “You rely upon textbooks you either brought with you or were available in the small South Pole medical library.”

Dental concerns are treated here. Note the armrests for ease of gripping and writhing. Courtesy Dale Mole.

Much of a physician’s time is spent in preventative preparation, training staff in the event of an emergency. During his stay, Roden orchestrated the medical evacuation of a crew member who had fallen ill with a neurological issue more than 400 kilometers from base. “We had rehearsed it in a drill, so we were prepped for it.” (The patient recovered and returned to work.)

Off-duty, Roden says numerous groups were devoted to salsa dancing, knitting, or Doctor Who viewing parties; Mole read, ran four to six miles a day on the treadmill, and ventured outside sporting at least six layers of insulation—anything to stretch out from his cramped 6 x 10-foot living quarters. He says he experienced none of the depression that can result from a lack of sunlight for months at a time.

“Being at the South Pole was like living on another planet, one with only one day and one night per year,” he says. “There was always something unique to experience, so I was never bored or felt an overwhelming desire to leave.”

Breaking the Ice

The remains of the cables used to power the station, stacked up by workers and dubbed "Spoolhenge." Courtesy Dale Mole.

After 10 months, Mole saw his first plane, thought of his wife, and breathed a sigh of relief. With winter over, he was able to return to the States in November 2012. During his tenure, he had attended lectures on art history, cared for a group requiring everything from dentistry to physical therapy, and trained non-medical staff to provide critical care in the event of an emergency.

Roden’s four-month stay was a kind of sensory deprivation. Back home, life had gone from being a blinding sea of white to glowing Technicolor. “Coming off the ice, seeing a sunset, the colors were just, wow,” he says. “Getting back to sea level was amazing. I felt great.”

Such experiences are more than an endurance test: they help inform future remote care in environments as varied as rural America, third world nations, and even Mars. Advanced handheld diagnostic tools, Parazynski says, are already on the way. “The notion is to develop a device that would have the diagnostic capabilities of a full lab in a major hospital. Not overly prescriptive, just basic physiological parameters, blood chemistries. It will help revolutionize healthcare in remote and in regular health care.”

While the efforts of Mole and other physicians are a valuable learning tool for future explorers, it’s the physician who may benefit the most. “The months of profound darkness, the majestic starry skies, the shimmering auroras, the icy desolation, going to bed at night a few feet from where all the lines of longitude converge …” Mole trails off. “These are the memories I will carry with me to my grave.”

This story originally appeared in 2015.

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iStock // Ekaterina Minaeva
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Man Buys Two Metric Tons of LEGO Bricks; Sorts Them Via Machine Learning
May 21, 2017
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iStock // Ekaterina Minaeva

Jacques Mattheij made a small, but awesome, mistake. He went on eBay one evening and bid on a bunch of bulk LEGO brick auctions, then went to sleep. Upon waking, he discovered that he was the high bidder on many, and was now the proud owner of two tons of LEGO bricks. (This is about 4400 pounds.) He wrote, "[L]esson 1: if you win almost all bids you are bidding too high."

Mattheij had noticed that bulk, unsorted bricks sell for something like €10/kilogram, whereas sets are roughly €40/kg and rare parts go for up to €100/kg. Much of the value of the bricks is in their sorting. If he could reduce the entropy of these bins of unsorted bricks, he could make a tidy profit. While many people do this work by hand, the problem is enormous—just the kind of challenge for a computer. Mattheij writes:

There are 38000+ shapes and there are 100+ possible shades of color (you can roughly tell how old someone is by asking them what lego colors they remember from their youth).

In the following months, Mattheij built a proof-of-concept sorting system using, of course, LEGO. He broke the problem down into a series of sub-problems (including "feeding LEGO reliably from a hopper is surprisingly hard," one of those facts of nature that will stymie even the best system design). After tinkering with the prototype at length, he expanded the system to a surprisingly complex system of conveyer belts (powered by a home treadmill), various pieces of cabinetry, and "copious quantities of crazy glue."

Here's a video showing the current system running at low speed:

The key part of the system was running the bricks past a camera paired with a computer running a neural net-based image classifier. That allows the computer (when sufficiently trained on brick images) to recognize bricks and thus categorize them by color, shape, or other parameters. Remember that as bricks pass by, they can be in any orientation, can be dirty, can even be stuck to other pieces. So having a flexible software system is key to recognizing—in a fraction of a second—what a given brick is, in order to sort it out. When a match is found, a jet of compressed air pops the piece off the conveyer belt and into a waiting bin.

After much experimentation, Mattheij rewrote the software (several times in fact) to accomplish a variety of basic tasks. At its core, the system takes images from a webcam and feeds them to a neural network to do the classification. Of course, the neural net needs to be "trained" by showing it lots of images, and telling it what those images represent. Mattheij's breakthrough was allowing the machine to effectively train itself, with guidance: Running pieces through allows the system to take its own photos, make a guess, and build on that guess. As long as Mattheij corrects the incorrect guesses, he ends up with a decent (and self-reinforcing) corpus of training data. As the machine continues running, it can rack up more training, allowing it to recognize a broad variety of pieces on the fly.

Here's another video, focusing on how the pieces move on conveyer belts (running at slow speed so puny humans can follow). You can also see the air jets in action:

In an email interview, Mattheij told Mental Floss that the system currently sorts LEGO bricks into more than 50 categories. It can also be run in a color-sorting mode to bin the parts across 12 color groups. (Thus at present you'd likely do a two-pass sort on the bricks: once for shape, then a separate pass for color.) He continues to refine the system, with a focus on making its recognition abilities faster. At some point down the line, he plans to make the software portion open source. You're on your own as far as building conveyer belts, bins, and so forth.

Check out Mattheij's writeup in two parts for more information. It starts with an overview of the story, followed up with a deep dive on the software. He's also tweeting about the project (among other things). And if you look around a bit, you'll find bulk LEGO brick auctions online—it's definitely a thing!

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Nick Briggs/Comic Relief
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What Happened to Jamie and Aurelia From Love Actually?
May 26, 2017
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Nick Briggs/Comic Relief

Fans of the romantic-comedy Love Actually recently got a bonus reunion in the form of Red Nose Day Actually, a short charity special that gave audiences a peek at where their favorite characters ended up almost 15 years later.

One of the most improbable pairings from the original film was between Jamie (Colin Firth) and Aurelia (Lúcia Moniz), who fell in love despite almost no shared vocabulary. Jamie is English, and Aurelia is Portuguese, and they know just enough of each other’s native tongues for Jamie to propose and Aurelia to accept.

A decade and a half on, they have both improved their knowledge of each other’s languages—if not perfectly, in Jamie’s case. But apparently, their love is much stronger than his grasp on Portuguese grammar, because they’ve got three bilingual kids and another on the way. (And still enjoy having important romantic moments in the car.)

In 2015, Love Actually script editor Emma Freud revealed via Twitter what happened between Karen and Harry (Emma Thompson and Alan Rickman, who passed away last year). Most of the other couples get happy endings in the short—even if Hugh Grant's character hasn't gotten any better at dancing.

[h/t TV Guide]

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