Your New Head of the Undergraduate Medical School - An Introduction from Prof. Malcolm Shepherd

Abstract

A long time ago….. and by a long time Imean before new Dr Who, before iPhonesand around the first appearance of StarWars Lego …… truly a very long time ago,things were simpler. Not necessarilybetter, different, much simpler….notclearly better, but definitely better!Conversations never ended, lasting longinto the night without conclusion; no onewas blessed with facts, just opinions andpassion. ‘Britain will remain at the centre ofEurope….’‘no way William Shatner (original CaptainKirk for non-geeks) will ever get intospace …’‘Glasgow could never host the biggestcycling event of all time…..’‘no, you could not possibly be allergic tored meat, you are made of red meat…’Of course now smartphones and theinternet have relegated the art ofconversation to a list of facts and dates,and no one speaks to each other without aseries of emojis and hand gestures. Or Imight have got that wrong you tell me…….‘But surely. Old man’ you say, carefullypicking the most contentious topic fromthe list above, Surely you cannot beallergic to red meat, we are all mammals,and the rules of Immunology say youcannot be immune to self.’‘Ah’ says the wise old man (In this scenariobizarrely that is me), ‘a long time ago youwould be correct, but in 2002 strangereports emerged that people with ahistory of tick bites, experiencedanaphylaxis after eating red meat’. Now across the world from Australia toNorth East USA the phenomenon of redmeat allergy causing strange delayedonset anaphylaxis, often as much as 4 hours after eating has been recognised.Breaking many rules of allergy fromrapid onset to variable presentation thestrangest aspect of this allergy is thatsensitisation seems to follow the bite ofparticular species of ticks. One of thoseticks is the indigenous Deer tick in theUK and so yes this allergy is found inrelatively high numbers in Scotland.Don’t worry, it is very very rare, but wehave identified around 40 patients whohave this allergy after being bitten byticks in Scotland.‘So what?’ you may say ‘its so rare whyshould we worry’. Well the truth is thattick populations are growing in the UK.There are a number of reasons, butglobal climate change with warmermoister winters probably play a part.Increased use of rural environmentswith Scotland’s amazing right to roamlegislation and wonderful landscapeincreases the exposure of urban andrural populations to ticks and we areseeing sufferers from all regions of thecountry. Climate change is an engine of change inhealth science and while self-allergymay seem a trivial example, it is a verypowerful concept; our immune systemsturning on ourselves in the face of awarming climate. Allergy medicine is fullof the human consequences of awarming climate from self-allergy topan-allergens crossing botanical speciesand we see new patterns of disease emerging from theenvironmental catastrophe we arefacing. Learning about the engines of change inmedicine and discovering what healthscience can do to limit our global impactwill become an increasingly importantaspect of Medicine as you becomeleaders and innovators of the future. Ihope we can inspire you to think aboutthe ways we can all work to limit this andavoid potential catastrophe.