Testing Times

Editorial Testing Times As I write, the inquests have begun. Two natural phenomena, one very large and one very small, have exercised our minds, and our economies, recently. The larger, a volcano under Iceland's Eyjafjallajoekull glacier, comprehensively grounded Europe's commercial airlines, causing chaos and stranding registered voters everywhere. The second was a microscopic villain. The influenza virus H1N1 (Swine Flu) surfaced in the United States, twirled its pantomime moustache menacingly, and ignited the 2009 pandemic. Governments immediately raced to stockpile supplies of vaccine and Tamiflu. In both cases, the question now being asked is whether the official response was over zealous. Many lives were lost to that influenza virus, but none to volcanic ash in jet engines. So far. For both events, however, the outcome might have been very different. Begging Wordsworth's indulgence, our retrospection is, I would contend, drama, recollected in tranquility. Conall McCaughey's superb and timely review considers the biology of that influenza virus. Using it as a template, he expounds on viral structure, its ubiquity and abundance, mechanisms of replication and dissemination, and how anti viral therapies work. Mature readers will recall diligently writing serial essays, confident in the knowledge that each would be marked with forensic fairness, by dedicated, selfless examiners who, with luck, would overlook minor obfuscations, and score hosanna's to their worthy prose. In the tick of a cosmic clock, those same readers would find themselves marking interminable essays; wading though cryptographic handwriting to unearth the morass of random half-learned facts that lay concealed, or perhaps, congealed, beneath. As an assessment tool, the essay is now a thing of the past, in medicine at least, and the multiple-choice question is looking like an endangered species too. In the second of this edition's reviews, Paul McCoubrie considers the assessment process, why it remains essential, and in an encyclopedic exposition, demonstrates just how far we have moved away from foolscap and writer's cramp. Professor Brew Atkinson's presidential Ulster Medical Society address is also within these pages. Professor Atkinson's masterly article details our understanding of the pituitary gland, from Ancient Egypt, via David and Goliath, to our current genetic understanding of pituitary-related diseases. My thanks, as ever, for all your papers. Please keep them coming. May I finally take this opportunity to wish you and yours a wonderful summer.