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Tools combined in engineering, medicine and as a metaphor for integration between fields of knowledge

An engineer turned doctor meets a physicist. This is not the beginning of a joke, but the beginning of a creative and surprising research path, which may change beyond recognition one of the most common fields of medicine: the medicine of the urinary tract and the male reproductive system.

From the right: Dr. Yigal Gat and Prof. Moti Hayblom
From the right: Dr. Yigal Gat and Prof. Moti Hayblom

In the first chapter of the story, the engineer Yigal Gat was bored. The practice of engineering no longer did it for him. So he put everything behind him and went to study medicine. In the second chapter he learned, to his surprise, that the knowledge he gained in his previous profession helps him solve problems in the field in which he specialized in the field of medicine: fertility processes in men. "The penetration of the sperm cell through the egg membrane, for example, is a complex mechanical operation, which engineering knowledge may well help to understand."

In the third chapter, in which he expanded his field of practice also to the medicine of the spermatic and urinary tracts in men, he already made extensive and significant use of his engineering knowledge to create a solution to a known health problem; One of the most common phenomena in this medical field is the enlargement of the prostate gland in men who pass the age of 60. "This is a phenomenon that stems from only one factor," he says. "Too large amounts of the male sex hormone, testosterone, reaching the prostate. The size of this gland depends entirely on this supply. More testosterone causes the gland to grow. A reduction in the amount of testosterone that reaches her reduces the gland - even after it has already grown beyond what is desired."

In many cases, the amounts of testosterone that reach the prostate are greatly increased as a result of the destruction of one-way valves in the drainage system of the testicles.

Basically, it can be said that the problems in this area arise from the fact that humans walk upright on two legs, in contrast to animals that walk on all fours, which do not have such drainage problems. But a creature that insists on walking upright needs venous blood from the testicles to the heart. The problem is that such an increase of the venous blood fluid is done against the force of gravity. For this purpose, there are one-way valves in the veins that allow upward movement, and block downward movement (similar valves perform a similar action in the veins of the legs). Thus, in fact, all men who reach the ninth or tenth decade of their lives no longer have normal valves in the veins of the testicles."

The malfunction in the valves causes an increase in the pressure of the venous blood fluid in the drainage area of ​​the testicles, which overcomes the pressure of the arterial blood fluid which carries with it oxygen necessary for the testicles. "The result," says Dr. Gat, "is the deterioration of the 'factory' that produces sperm cells." This is the main cause of medical problems of infertility in men. Following these medical insights, Dr. Gat, together with his research partner, Dr. Menachem Goren, developed a catheterization method to solve the fertility problem that was documented in scientific and medical journals, as well as in the standard textbook in the field. This method was also recommended in a book on male fertility.

From an engineering point of view, it was clear to Dr. Gat that a disturbance in the pressures, which takes place in one system, also affects another system, due to the principle of interlocking tools. In this case, venous blood that came out of the testicles carrying testosterone, on its way to the heart, partly arrives - due to the disturbance of the pressures - in the unwanted direction to the prostate, through its venous drainage system.

The engineering understanding of the pressure system and the flow directions led to an understanding that helped solve a health mystery that has occupied doctors for many years: how does it happen that at older ages, precisely when the production of testosterone in the male body decreases, a larger amount of this hormone reaches the prostate gland and causes it to grow? The answer: the venous blood, which drains the testicles, carries with it a very high concentration of testosterone. In a healthy and normal system, this blood flows to the heart, and from there, in the "new round", through the arteries, it reaches the prostate. But in the meantime, during this journey, the testosterone is diluted, and its concentration reaching the prostate is very small compared to the original concentration leaving the testicles. Dr. Gat: "But as the man grows older, and the one-way valves in his body wear out, break down and stop working, the return flow of the venous blood coming out of the testicles directly to the prostate brings testosterone in a high concentration, 130 times greater compared to the concentration that was supposed to reach it after the journey to The heart and from it, back, through the arteries."

What is the solution? As an engineer, Gath, the way to solve the problem was clear: the pressure system of the venous blood vessels must be restored to normal, to prevent the return flow from the testicles to the prostate. Since the valves designed to monitor these pressures are out of action, the vertical venous blood vessels must be blocked, thus reducing the pressure in the testicular drainage system (in this situation, the venous blood will reach the heart in indirect ways). The venous drainage will continue to function with the help of replacement veins.

Naturally, the medical community is in no hurry to adopt the scientific explanation and the new treatment method. Doctors don't really like to delve into scientific principles, and innovations, especially when they are so simple, arouse doubts. The doctor with a scientific background found himself trying to explain, to convince, but with only partial success. Sometimes he is required to present the results of experiments on animals (for example, mice), but animals that walk on four limbs do not suffer from a phenomenon that results from walking upright on two legs.

In the first processes of formulating the idea about the effect of the drainage system of the testicles on the function of the prostate, Dr. Gat Al joined Professor Motty Highblom from the Department of Condensed Matter Physics at the Weizmann Institute of Science. Professor Highblom understood the physical-engineering logic underlying Dr. Gat's proposal, examined a number of questions with him, and encouraged him to turn to the research path, which involves writing scientific articles, publishing them in appropriate journals, and presenting them at professional conferences in the fields of medicine and health. All these, at the same time as his work as an attending physician. The result: the doctor now applies his method, albeit on a small scale, and performs catheterizations on men who come to him on the recommendation of their doctors, or in other ways. The success rate of these catheters is very high (medical success in this case is the significant reduction of the prostate).

In fact, initial medical treatments using the new method, carried out in patients with non-diffuse prostate cancer, led to promising results, and in some cases even led to a significant reduction, to the point of disappearance of the tumor.

36 תגובות

  1. I happened to read the article and the comments on it and I regretted it very much.
    If this is the level of the "doctors" in Israel, then woe to the country.
    I hope that the commenters here, who boast of various degrees, do not represent the level of academia in Israel.

  2. ravine,

    Certainly there are areas in which cooperation is beneficial and promotes science, there is no debate about that. On the other hand, there are areas that are fundamentally different and ask different questions. This point brings us back to the previous debate on whether it is possible to build a science that will quantitatively describe human societies. I believe, as I argued in the same debate, that different fields require different methods and completely different models. The scientific method is only a framework for many methods and forms of thinking. Just as the word religion contains many options for different religions. In my opinion, there is no room for the claim that all sciences work in the same way, but of course it is possible to occasionally use methods taken from another discipline. In conclusion, I believe that the debate between us is more quantitative than qualitative.

  3. sympathetic:

    Of course, biology as a whole studies different phenomena than physics, which as a rule studies different phenomena from chemistry. But this is not the separation you talked about and about which I responded (you described lines which, in your opinion, distinguish physics from the other sciences and distinguish these are wrong in my opinion).
    In my opinion, the main engine for sharing knowledge between fields is the ability and desire to explore new phenomena that require these collaborations. For example, a neuroscientist cannot be only a physicist, not only a biologist, not only a chemist, and not only a computer scientist. Brain research requires knowledge sharing between scientists from all these fields

  4. ravine,

    You write "separation you are talking about may be a sociological matter but certainly not a matter of substance". The separation between different types of research in different fields of science is certainly not a sociological matter but a matter of essence. Over time, fields separated from each other: science from philosophy, physics from chemistry (or alchemy) and biology. The trend of separation has only grown over time, it has a basis on which it relies. Now the question that must be asked is the opposite: what in the modern world makes it possible to reverse this trend? Does the accessible knowledge revolution allow people to quickly learn about different fields or create collaborations? Does the use of the computer allow a bridge between different fields of knowledge. The fact that the fields of knowledge differed only shows progress in science and different understanding in different fields.

  5. sympathetic:
    I agree with Guy.
    The whole idea of ​​natural selection, for example, is a very successful abstraction.
    Around him and around the further abstraction of genetics, extensive mathematics also developed.
    Science, as a principle, deals a lot with taking the common "outside the parentheses" and this is what biology also does.
    It is true that the subject is more complex, but still progress is being made and research in the fields of EVO DEVO is pushing the envelope further.

  6. sympathetic:

    I believe that the distinction you speak of between physics and the other sciences is inaccurate.
    All science is based on abstraction. The basic tool of any science is creating a model and examining the empirical basis for that model. The separation of scales is an integral part of any science. When a biologist talks about a cell, he makes an abstraction, makes a separation of scales and talks about a model.
    The separation you are talking about may be a sociological matter but certainly not a matter of substance.
    The most prominent example I can think of is Ronald Fisher who was a great biologist and an equally great mathematician who founded the branch of statistics and uses the tools he developed in physics, biology and computer science.
    In addition to this, there is an entire branch of computational biology in which mathematical and computational models are used to analyze genetic information and build models of biological processes.

  7. Two British physicists recently found the solution to the ellipsoidal horse problem using techniques from quantum theory!

  8. I don't want to be a puppy either, but if it's a puppy then it's a puppy by Camila whose claims I agree with: the importance is in what a person says not in their titles and no one is doing humanity a favor by commenting here on the site.
    I'm serious. At the level of principle, there is no problem with different fields of science violating each other and helping one develop the other, but I have a number of misunderstandings:
    The first achievement is a psychological achievement, but the character of scientists and their emotions also have an impact in science. Many scientists for example from physics come with an arrogant approach to other fields. They see biologists, for example, as fools, who do not understand mathematics enough and start from the assumption that the only truth is in physics. Such an arrogant approach, which is taken by those who also refuse to learn about the subject they are entering into with the attitude that they can reconstruct everything correctly, is problematic. This is not a contribution to another field, but rather the creation of antagonism.

    The second achievement stems from the state of knowledge today. The specialization in specific fields is due to the fact that over time the knowledge accumulated in certain fields is enormous and difficult for one person to master. We wouldn't expect, for example, a philosopher to contribute to knowledge in physics or biology, since the tools he learned would probably not help quantitative scientists. Several hundred years ago there was no dichotomous separation between philosophy and the quantitative sciences (Leibnitz is an example of this). The different fields have evolved to such an extent that they ask different questions and their methods of finding solutions are different. I will try to clarify this point:

    Physics is based on abstraction, removing all unnecessary details and finding a reason for a phenomenon, therefore mathematics is a very effective tool in physical research.
    In physics there is usually a separation of scales: spatial, energetic and temporal. You can talk about a body moving in space and write laws for it without knowing that it is made up of atoms.
    In physics, a body or system can be isolated from its environment without impairing its function, and the components of the body can be studied to learn about the whole.
    In physics, there will often be a single cause or factor for a phenomenon, or as someone put it, "the biologist is looking for selection, the physicist is looking for causality".
    In biology, due to the difficulty of separating scales due to the system's dependence on its constituents due to the fact that systems have properties from selection (a type of randomness), the field was clearly more descriptive. The biologist is interested in details and not in abstraction. On the basis of this separation, the joke is told about the physicist who solved the spherical horse problem.

    In conclusion, due to the different nature of the disciplines, it is difficult for me to imagine many fruitful collaborations between the two. Despite all this, areas of biology related to processing large amounts of information do help physicists as they also helped analyze economic systems on Wall Street.

  9. Reform Dos:
    I think that this example you referred to dismisses the argument of the commenter in question quite clearly.
    I never studied economics, but I still read Tversky and Kahneman's article in science about people's cognitive biases in making decisions under conditions of uncertainty:
    http://psiexp.ss.uci.edu/research/teaching/Tversky_Kahneman_1974.pdf

    This publication indicates the novelty of their research and does not refer directly to prospect theory. I confess that I have never heard of the arbitrage problem, but I have a feeling (surely as an economist you know more than I do) that it is the entirety of their work that earned them the prestige they have earned.
    In our case, even if the arbitrage problem was an insurmountable obstacle, this would not necessarily impair either the quality of the researchers or the quality of their research. There are many 'pure' economists who do not reach even lesser achievements than those mentioned.
    Many times the source of innovation in science is bringing insights from one field and combining them in another field.
    Stefan Benach is quoted as saying: A good mathematician is one who finds analogies between sentences, an excellent mathematician is one who finds analogies between theories and the ultimate mathematician is one who finds analogies between analogies.
    And by analogy to the subject in question: a good scientist is one who uses physical tools to solve problems in physics or biological tools to solve problems in biology. The excellent scientist is one who uses tools from one field and solves problems from another field with them. (And who is the ultimate scientist?)

  10. Guy, (23)
    Gali's main argument was that when scientists move from their main field of work to other fields (for example from physics to biology) they do not have the knowledge required in the science they are moving to in order to understand all the implications of their research. In other words, while they are able to solve the problem in the micro field, they do not know the macro field sufficiently in order to understand all the implications of their research. Gali took the argument "one bridge too far" and claimed that the problem rules out a transition between areas. While I agree with most of the commenters that this claim is too inclusive and does not stand the test of reality, it still does not rule out the argument completely (which is why I stated that I partially agree with Gali).
    The first article by Kahneman and Tversky is an example of an article whose authors solved one problem but did not understand its implications for other areas of science. In the context of this article, this is likened to a researcher who manages to solve the problem of the heart valves but in the process cuts off the air supply to the lungs.
    The fact that you learned about Kahneman and Tversky's article at university is primarily due to the fact that both continued to work in the field until they eventually managed to arrive at a similar theory without the arbitrage problem.

  11. To the lion, move one of them, please listen to my way, a mountain stood before him, I placed my hand on it, the mountain collapsed.
    Akiva Nof, water for King David, in the mouth of the pale tracker.

  12. You don't have to give anything in your head. Both Sinai and Oker Harim are you.

    The Talmud chooses Sinai, but the sciences advance thanks to 'mountaineers'.

  13. R.H.:
    As far as I know, a mountaineer is not synonymous with a person with knowledge in a narrow field, but with a sharp person.
    In modern terms, the question the Talmud discusses is "Which is better: knowledge or intelligence?" And he chooses knowledge.

    "Uprooting mountains - sharp and peppery in the Torah, even though there is no Mishna and barita arranged for him so much"
    Rashi's treatise on parenting, handbook, page XNUMX

  14. Dos Reformi (16):
    Your story supports exactly the opposite position to Gali's.
    Prospect theory is still taught in behavioral economics courses. Every model ended up being wrong (you can also say that Newton was just as wrong, but this has nothing to do with him being or not being a physicist, but with the fact that when doing research, you naturally come up with theories and try to disprove them when the need arises).
    The contribution was precisely in introducing considerations from the field of psychology into the field of economics (they were preceded by Herbert Simon who led to a perceptual change in which man in economics is not seen as a rational agent but as one who operates under the limitations of uncertainty)

  15. Thank you R.H.

    I don't intend to hitch a ride, so I won't expand on my model here. On occasion, if you give me a stage or if an article is published here on a close topic, I will do as you advise.

    I feel the need to apologize for the condescension I showed earlier. For more than eight years now I have been wearing the benches of the University of Glasgow (physics, computer science, philosophy, theology and a few other trifles) and I have probably been infected with the British mentality.

  16. jubilee,
    Regarding my response to your suggestion about the photons. You raised the issue when you stated that you were being ignored for chauvinistic reasons and you got what you asked for when you wrote "get off me". But perhaps clarification is still needed for my response there. What I meant, and I admit that I phrased it a bit bluntly, is that apparently there is a disciplinary difference between us in seeing things.
    Your proposal is beautiful for science fiction (which I cherish and appreciate very much). What would have happened? Or what would the world look like if...?

    On the other hand, in the field of natural sciences, from which the last Kamila, Ehud, and others here come, and I have no such hypotheses. Every sentence and every hypothesis in the article must rely on one of the following parameters:
    1) Based on published results, then you are obliged to quote from where.
    2) Based on your results and then you must present them
    3) Based on mathematical analysis in light of past results - this is for example the case of string theory which, although not yet based on experiments, is based entirely on previous results and models.

    That's why you might understand that your words "maybe the photons and particles form a macro system" as interesting and innovative as it may be is not based on anything and its place for now in science fiction stories. The situation would be different if you could propose an experiment (even thought) or any way or model, or you would base your hypothesis on previous results.

    Hope I made myself a little clearer.

  17. Dos Reform,
    This discussion reminds me of the debate in the Gemara about what is better than a Sinai (with broad knowledge) which is a sort of Talmudic equivalent of a multidisciplinary researcher or a mountain clearer (deep) which is the equivalent of an expert in a narrow field. And also the Talmud to the best of my memory tends to say that Chinese is better. Not exactly the same as the current discussion but similar.

  18. Hello R.H

    Indeed, I really remember a number of beautiful and to-the-point discussions, in a good spirit, without condescension and without a market atmosphere.
    This is how it should be and how it is appropriate on the only scientific web site in the Hebrew language.

    And please allow me, R. H. and Gali, to express a hypothesis regarding difficult statements. If Gali called someone a word taken from the street, maybe it was because he unintentionally angered her. I would love to see you make amends and get back on track without getting down to personal levels

  19. Reform Dos:
    In my opinion, there is nothing in your words that would justify the nickname "puppy".
    Anyone can make a mistake and certainly when dealing with a field in which he is not an expert, but that is not the point.
    The scientific method, which is based on rare experiments, reliable observations and (objective) peer review, is good enough to face the risk that such mistakes will be made and discovered, and scientific research as a whole only benefits from the mixing of fields.
    It should also be remembered that specialization in a narrow field has never been a declared doctrine of science. All in all, this is a sad phenomenon that is the result of the necessity of reality dictated by the limitations of our brains and the brevity of our lives.

  20. At the risk that I too will be called a puppy, I will try to partially defend the position presented by Gali Weinstein.

    Kahneman (a Nobel laureate in economics) and Tversky (who died before the prize was awarded) were psychologists with no formal training in economics (Kahneman once remarked that he had never taken a single class in economics). One of their important breakthroughs was the Prospect Theory of value, which was first published in 1979. Although the article was published in a leading journal, it was not accepted by the mainstream in economics because it allowed the creation of arbitrage (profit without risk).
    It wasn't until Kahneman and Tversky published another paper in 1992 that solved the arbitrage problem that their theory gained recognition.

    The lesson from the example is twofold. First, as mentioned by commenters before me, mixing fields in science can lead to a positive contribution. At the same time, the concern Gali raised (albeit in an extreme form) is also real. When scientists from one field try to advance knowledge in another field there is a risk that the fact that they do not know the field will lead them to wrong conclusions.

  21. Yuval, I don't know what you want. We had some very interesting discussions with you about the Bible and I don't remember being cynical or "not nice". When the discussion is scientific and matter-of-fact there is nothing to be nice or not nice and in my opinion I adhere to the rules of etiquette a little more than some others here, for example, I have never called my friends "stupid" and I have not descended into personal lines. I responded to the quality of what was said and not to its origin or the education of the author of the message or article.

  22. Maybe you're right, and that's still debatable, but you're just not nice. It's really not fun to read your stuff, even though sometimes they actually have the potential to be interesting. is not that a loss?

  23. jelly,
    When you called the legitimate respondents to your claims "idiots" the discussion between us ended.

    I suggest you learn some discussion culture. Apparently your PhD title (and not just a PhD with academic publications, you know) doesn't give you the truth or even elementary politeness. And apparently even "doctors" are not prevented from writing nonsense, such as for example that Carmel is a remote region that no one knows, remember?

    "With us at the academy".

  24. wavy (10)
    The fact that you hold a doctor's degree does not justify preferential treatment for your claims. Which degrees are what do this to you? So I also hold a doctor's degree and I also publish and participate in international scientific conferences and I would still like my arguments to be considered for their merits and not for my degree. And to the point of the matter, you expressed a position that is quite nonsensical (in light of the many examples that testify to this) and from this point of view publishing nonsense on a popular website actually harms you and me too because people see that even doctors can talk nonsense. Especially what you did when you wrote: "I actually originally come from the academic world and I'm doing myself a favor by writing in the media." What an arrogant attitude is reflected in your words. I respect the actions and way of thinking of the person in front of me and not his title. There is no lack of degree holders whom I do not particularly appreciate for their opinions and their way of thinking which is clearly not scientific.

    Unlike you, I don't think you're stupid, but only that you expressed a position that clearly doesn't line up with reality and reflects a narrow, closed-minded and unhelpful view of scientific practice. Apart from waving your hands and bragging unnecessarily about your degree and your work, you did not answer the arguments and examples that were given in the comments in that article or here. Stop whining and start responding as female scientists and PhDs like us are supposed to do, and that is to defend our position rationally while referring to the facts that are placed before us or examine our position and change it if that is what those facts require of us. What do we care if the person making a factual claim about facts that are available to everyone is a professor or a beautician? If the claim is stupid it will be quite easy to show it. If the claim is valid, it will be possible to examine it and treat it with respect and seriousness.

  25. In the academic world, it is customary to say that it is better not to write in the media because it does us doctors a huge harm. My colleagues told me clearly: stop writing in the media and concentrate on your research. And they say that to all the professors and doctors. And it really hurts us and I don't get anything out of it financially.
    And what do I need all the stupid commenters above (R.H., the last Camilla and the like). When writers in the media descend to the level of the stupid commenters and start arguing with them and they begin to despise the writer, belittle him and insult him and also damage his good name. As if I were Bibi Netanyahu or Ehud Barak or some other famous person from the Knesset who is usually despised. But I'm not famous at all and I don't want to be a born star either. I actually come originally from the academic world and I do myself a favor by writing in the media. And they told me plainly: stop it. It's literally giving yourself a contradiction in life. And our doctors don't do that at all.
    Maximum write an article in Odyssey. And the commenters here only prove that the doctors really don't need to reach the media and don't need to write in the media. Because otherwise they are simply lynched by the media and it really hurts their good name. It's not enough that I don't get any financial profit from it, even that my good name is damaged. I am imparting the extensive knowledge I have accumulated over the years after post doctorates and many publications and international conferences I have attended and I am getting lynched in the square. And if this site happens to be linked to educational institutions, then this is what they study.

  26. jelly,
    First of all I apologize if you were offended by the use of your full name. I used your full name because that's what signed your comments and you answer according to the commenter's name, I have no problem calling you Gali.
    Second thing, unfortunately (or not) I am not a physicist but only a "pure" biologist as Camila calls it.

    I have nothing personal against you and I even came to your defense in the past when there were those who killed your articles on irrelevant grounds. However, in the above case, I strongly disagreed with your responses regarding the mixing of fields in science that reached the point of absurdity with the publication in Haaretz newspaper (about the researchers from MIT) and with the current article that showed how wrong you are, hence the sarcasm. I have a feeling that sometimes you argue and climb tall trees and don't know how to get down from them. Sometimes it is also allowed to admit mistakes.

    Yuval, there is no trickery here and stop looking for chauvinistic motives. The response is completely factual, we had a debate about the mixing of fields in science in another article and the current article greatly strengthens my claims and other claims and this is what I wanted to say in response 1 and Gali understood this very well. What's the deal here?

  27. Instead of "his response here is inappropriate in any way" it should be "his response here is not inappropriate in any way". Sorry, glitch.

  28. To the lady and the puppy (5, 6):

    Everyone who read your comments and the exchange in the article:
    https://www.hayadan.org.il/quantom_mechanics-use-in-vacceen-0401115/
    Knows how to put R.H.'s response. Here (1) is in the right context. His sarcastic response is a direct result of your responses there and the context is certainly appropriate because the article presents an example (another one of many brought up by different people) of mixing fields in science that leads to fruitful results. As you remember, you came out against the mixing of scientific fields for an unclear reason, therefore publishing his response here is in no way inappropriate. If you find his response offensive, you should think again about the firm statement you presented and act in one of the following two ways: a) Continue to insist that as a general rule mixing fields in science is wrong and justify it well and refer to all the many examples that this mixing has been and continues to be successful. b) Try to qualify and define under what conditions mixing of fields is considered and when mixing of fields might be problematic and then you can suggest ways for a more rigorous examination. Of course you can also simply write that you were wrong, but that requires a lot of mental fortitude and not all people have that kind of fortitude.
    Yuval, a commenter who writes that "freedom of speech creates an ugly reality" is not only a problematic commenter for me, but a downright dangerous commenter. Censorship should only be used as a last resort and in extreme cases. Censoring a comment that is very relevant to that lady's words just because the comment was addressed directly to that lady or because sarcasm was used is a clearly illegitimate act.

    I would like to make it clear that I am a "pure" biologist, but I greatly respect physics (and even some physicists) and in general I respect any honest attempt that meets scientific criteria to contribute to knowledge, even if the contributor did not "grow" his whole life in the framework or field in which he makes his contribution.

  29. Freedom of speech creates an ugly reality. Things sometimes come to the need to use the scissors. I suggest allowing "problematic" commenters (according to the system's considerations) to refine their keyboard bursts before they are approved for presentation here on the site.

  30. It is impudent to approve the publication of R.H.'s response. Above that contains my full name and is written in a mocking and disparaging tone. R.H. He is a physicist from the academy and he speaks rudely, mockingly and in poor language.

  31. Gali Weinstein,
    Oh my, an engineer who became a doctor??? That's a lot worse than a physicist turned biologist, isn't it?

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