Naked Christmas: Presents, plonk and a pliosaur

Plus, could cola clear the food stuck in your throat?
22 December 2023
Presented by Chris Smith
Production by James Tytko.

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In this festive magazine show, join Chris Smith as he samples the BMJ's Christmas offerings, enjoys a glass or two of sparkling wine (in the name of science, of course), and previews the pliosaur discovery set to make waves on TV over the Christmas period...

In this episode

A glass of Coke and ice

01:01 - Cola, coffee and chairs: BMJ Xmas edition

Could hospital coffee machines be spreading pathogens...

Cola, coffee and chairs: BMJ Xmas edition
Kamran Abbasi, BMJ

Each year, The British Medical Journal publishes a special Christmas and New Year edition that welcomes more light-hearted fare and satire from the world of science. It gives doctors the chance to let their research hair down. So what Christmas crackers have made it in? Kamran Abbasi is the editor in chief of The BMJ.

Kamran - So the first one is a study of the safety of cola in resolving what we call an oesophageal food bolus. That means, you've got something stuck in your throat, and whether or not drinking cola can relieve that. It's a question, interestingly, believe it or not, that has been studied before, though we think probably never before in a randomised control trial, which this was, done in Holland, and they evaluated 51 patients and they were either given cola to drink and they drank it in sips or they were just observed. What they discovered, possibly disappointingly, was that the cola had no effect on whether or not people's throats were unblocked and they no longer felt like choking. Although it wasn't shown to be beneficial, there was no statistically significant effect of cola drinking, in a larger sample, possibly, if they'd had a slightly different power calculation, there might be a benefit. It doesn't rule out the benefit of cola, but neither does it demonstrate it if I could encapsulate it like that.

Chris - I've heard people say that cola's a bit corrosive! But what's the mechanism of action then? Is it the caffeine that perhaps makes things constrict a bit better and pushes the stuck stuff, whatever's clogging up your oesophagus, out the way?

Kamran - Possibly long-term ingestion of cola inevitably has an effect in that way, but I think when we're talking about just having a sip to relieve something stuck in your throat, I think we're thinking that it possibly improves the motility of your oesophagus and pushes the bolus or whatever the food is that's impacted into your stomach. I'd say the mechanism is still to be determined. We don't even know that it's effective at this point.

Chris - You can try sipping some cola, but it's probably not going to make a difference. You're probably going to need to see someone who can help you out in a different sort of way. Now, the next story you've got for me is one very close to my heart because it concerns what I do for a job, where I work, but also a substance which I can't live without.

Kamran - There's quite a drinking theme here in this year's Christmas issue. So this is all about coffee. We all want coffee at work - we're the same at the BMJ. We're all crowded around the coffee machine.

Chris - We call it the medicine dispenser.

Kamran - Yeah, precisely. So what we are looking at is whether or not, by touching those machines, we might be spreading infection. And of course all that's very topical with everything that's just happened with the pandemic, whether it's being encouraged to wash our hands and sterilise surfaces. One of those surfaces we've probably forgotten about is the good old coffee machine. This study looks at whether there are pathogens on coffee machines from different bits of coffee machines and it finds that there are. So, the question then is, should we be concerned about that or not? What these researchers find is, they tend to be commensal or atypical pathogens, ones that aren't medically relevant. So the bottom line is there are pathogens there, still wash your hands and obviously clean the machines - that's good practice and to be encouraged - but what we don't want and we aren't supporting is a ban on coffee machines. So I think this is good news.

Chris - Phew, I'm relieved. And to round up, I would say to finish us off, but that's got the wrong sort of connotation, hasn't it? This one is all about patient satisfaction, very important, but where the physician is and sits and where you put chairs. I'm intrigued. Tell me more about this one.

Kamran - Yeah, exactly. We do want to publish papers with a serious message and there's something serious here, which is about better communication with patients. If you've been in hospital either as patients or visiting somebody, you often see the medical team or the surgical team wandering around the hospital, going from patient to patient, and the question these researchers are asking, by sitting next to the patient, by facing them, whether or not that means that there's better patient satisfaction in the encounter. What they found is that, first of all, by putting a chair there, inevitably it means that the consultant or the doctor sits down more often. That's no surprise. But secondly, the patients feel more satisfied by the conversation. And thirdly, it doesn't seem to take up more time than if they just stood.

Chris - So this was the mere fact that if you put a chair with a patient in the right sort of position in relation to the patient, then the person who's talking to the patient comes and sits in it so you get a sort of more eye level conversation rather than somebody looking down on top of you, as it were?

Kamran - Yeah, exactly. And I think one of the criticisms of traditional medicine is that it's very patriarchal: somebody very senior comes to see you in hospital, they tower above you, they talk down to you, don't listen very much to what you've got to say as the patient. This is changing that power dynamic in that you're sitting down, you're the same eye level and that enables a conversation and should encourage you as the doctor to listen more to the patient, should encourage the patient to feel that they're speaking more directly, on the same level with their clinician. So clearly, again, we need to see whether something as simple as this could lead to any clinical benefit. We may never be able to demonstrate that, but surely this has to be one of those situations where anything that encourages a better conversation has to be a good thing.

Chris - The people in charge in the hospital, of course, are the infection control team. So what do they say about this? Are they happy with the doctors sitting on the chairs spreading diseases?

Kamran - Haha. Yeah, I'm not sure a doctor sitting on the chair is the most problematic mode of transmitting diseases. We've already banned ties from hospitals because they might be a vector of transmission - there wasn't much strong evidence around that. I don't think sitting on a chair is going to cause problems. If anything becomes widely adopted, there'll always be people who try to stop you doing it, but I can't see that mechanism personally.

A bottle of Champagne and a glass

Champagne showcase: let's get fizz-ical
Clare Bryant, University of Cambridge

Now, many of us will have the opportunity over the coming days to sit down with a nice glass of wine or two. And, arguably, one of the best ways to get dinner off to a flying start is to pop open a bottle of bubbly. But which one, and why does the fizz do the bizz, or is it all just in our heads? As well as being an internationally regarded immunologist, Cambridge University’s Clare Bryant is also a wine buff, and she took me to her local eatery in Saffron Walden, Chaters, which also doubles as a distillery!

Clare - It's that time of year, Chris. And one of the things that I think is particularly interesting about champagne is the whole history and science behind it. And what does a bubble do? So there's two elements to this - there's the methode traditionnelle, which is a way in which champagne is made, but it's also a way in which many sparkling wines across the world are made, including England, which produces particularly fine sparkling wine. So today we'll compare champagne with an English sparkling wine.

Chris - I'm looking forward to that bit. How far back in history does it go?

Clare - In the 1600s, the champenoise, the people in Champagne, decided to make wine to try and compete with people in Burgundy. They were making wine with one particular grape, pinot noir. And along the way, one of the things they found was, because they were farther North than Burgundy, it was colder during the fermentation process. They were getting a stopping point when the wine was too cold. And then, when the temperature warmed up again, they were getting fermentation occurring again. What they found is that sometimes their wines were fizzy. Now, initially, this caused total horror because this was a wine fault. And then after a while they tried marketing it, in particular to us Brits and the Brits decided they really liked fizzy wine. By around the mid 17, 1800s, sparkling wine was something they were working hard to produce. The challenge was, though, to get nice sparkling wine, you need to have the fermentation in the bottle, which means the bottles need to be very strong. So it wasn't really until about the early 1900s manufacturing processes started to produce bottles that were strong enough. After that production kicked off the champenoise were in business.

Chris - What's involved in actually making it, though?

Clare - So there's two phases of fermentation which is absolutely key. So you harvest the grapes, of which there are three usually, pinot noir, pinot Meunier, and Chardonnay, and they make what's called a base wine. Then they put this wine into bottles with some more yeast, a little bit of sugar, and then the wine undergoes a secondary fermentation in the bottle and that's what generates the gas. After a while, they take the old yeast out and then they dose it up with a little bit more sugar sometimes to alter the sweetness of the wine, and that's it.

Chris - How did the bubbles contribute to the wine, though? Is it just that it's fizzy and frothy and it looks exciting? Or do they actually affect the chemistry?

Clare - It actually contributes to the taste and the flavour because the bubbles act as a carrier. They carry volatile molecules all wrapped up in these little parcels of carbon dioxide and then, as the bubbles burst, they release the smell and the aromas and everything that's associated with the wine in a very concentrated way across the top of your glass. So whereby when you normally taste a glass of wine you might swirl the glass to try and get the aromas out, you don't need to do that with champagne. That's what the bubbles do and that's what makes the wine so exciting.

Chris - I think we should try some. What have you brought along for us to consider?

Clare - So I've bought two half bottles of wine, today.

Chris - Where's the other half? Have you already drunk it?

Clare - Chris, don't be so churlish. It's lunchtime. So what I've bought is a half bottle of rose champagne because rose champagne is very interesting. That's pink champagne. What they do to make rose champagne is they add a little bit of still red wine to the bottle to give it a pink colour. So that's a traditional champagne from France, and then I've also bought a half bottle of white sparkling wine from Nyetimber, which is one of the oldest English champagne makers in the UK.

Chris - I think we should pop some corks, but we've got to be careful how we do this, Clare, because there's a paper in the British Medical Journal for Christmas that cautions us how to safely open champagne bottles because apparently a very high proportion of eye injuries are caused by escaping champagne corks.

Clare - Yeah, I saw that. That's from our colleagues in ophthalmology. You can totally understand that because a cork comes out at quite a rate. But actually their advice on how to uncork a bottle of champagne is very relevant to maintaining the flavour as well because if you fire that cork out at a great rate of knots, you are firing out lots and lots of CO2 and you're reducing the flavour. So the best way to do it is to take the wire off, pop a tea towel over the top, gradually ease out the cork, and then gently pour your wine, preferably down the side of the glass because if you fire it into the middle of the grass you're losing your bubbles. There's about a million bubbles in a hundred mils of champagne, so you want to keep those as much as possible.

Chris - It sounds like the guy who counted the perforations in a Tetley tea bag, but which one are we going to start with?

Clare - Would you like to start with the rose? That's how you open a bottle of champagne, Chris.

Chris - I'm impressed. None wasted.

Clare - None wasted.

Chris - Right, so I've got a couple of glasses. That's one. Beautiful.

Clare - As you can see Chris, in your glass, there's little bubbles just coming up to the top and they'll be bringing all the aromas up to the surface. Take a deep sniff.

Chris - It's a very fruity number, there.

Clare - Should be fruits, cherries, cranberries, that kind of flavour actually in there. Tell me what you taste.

Chris - It's beautiful. Cherries. I can see why they're saying cranberries and cherries. Didn't get the smell so much, but the flavour: big hit. Beautiful.

Clare - And I can taste little toastiness on the back as well. And it's that combination of fruit toast and the bubbles and you can feel the bubbles on your tongue as well. That, coupled to the texture, that's what really helps carry the wine. So yeah, it is delicious, I have to say.

Chris - I probably wouldn't have considered something like that a rose, and I didn't realise that they made it by adding red wine to the mixture, and it's delightful.

Clare - Yeah, it'll work really well with smoked salmon. Any of the usual, traditional starters.

Chris - Let's try the English one. I'm really keen to get stuck into that and see how it compares. The people having lunch in here are going think we've got a lot to celebrate, Clare

Clare - We survived another year, Chris - there's a lot to celebrate! So you can see something else interesting here as well, Chris, which is you can see a sort of mousse-y stuff that comes out on the top. So that froth is due to the protein in the wine, actually. Have a sniff.

Chris - This doesn't have the same fruitiness. This is more of just what a white wine would smell like. To me, it doesn't have that same fruity sparkle.

Clare - Yeah, I agree. There's no cherries there, right?

Chris - It's nice, though. It's fruity, but I couldn't put my finger on exactly what fruit. Apples maybe. It's certainly fruity, but it doesn't have the intrigue that the other one did. That tantalised my taste buds.

Clare - I would agree. This is more of a chardonnay flavour through it. It's a different beast, but it's a beautiful beast. They're two different things. That's one of the reasons why I bought them, because I knew the flavour profile would be different.

Chris - And lastly, what should I eat with this? Because there's a lot made of horses for courses, wines for different dishes. So what's a really good compliment for these sorts of beverages?

Clare - So one of the things that's very interesting about champagne is that actually it balances out with quite a lot of different foods, but in particular it works well with the umami food profiles. So things like smoked salmon, which has been an obvious pairing as you know, but it's the kind of complex flavour, the umami flavour, that you get with smoked salmon, but also with ham and various other savouries. And in fact, in front of us, we have a little bit of ham and we shall shortly try it with the sparkling wines and see what we think.

Chris - So there you go. We've sorted out at least the start to our Christmas dinner this year. Cheers Clare, thank you very much for doing this for us, and now I know a bit more about champagne. I'm really grateful.

Clare - Happy Christmas, Chris.

Light shines on sea floor

15:36 - 2 metre pliosaur skull retrieved from Jurassic coast

The specimen will feature in a David Attenborough festive special...

2 metre pliosaur skull retrieved from Jurassic coast
Steve Etches

The skull of an enormous sea monster called a pliosaur has been extracted from the cliffs of the Jurassic Coast in Southern England. The marine reptile would have ruled the waves 150 million years ago and its 2 metre skull is one of the most complete specimens of its type ever discovered. It’s so special that it will feature in a David Attenborough programme on BBC One on New Year's Day...

Steve - This would look very similar to a crocodile skull, but it's much, much larger. And of course the rest of it was up in the cliff and that's where it fell from. So we got a drone and droned the whole cliff to find out where it'd fallen from. We located it after looking at the film footage. Basically, we had to get a climbing frame in to help us to get down to it because it was in the middle of a very steep, sheer cliff. When I finally got down to it we realised the animal, when it finally settled on the seafloor, it was upside down. From that, the next stage was to actually work out a plan to excavate in the cliff, form a big cave, a massive great cave above it, down on it, and then clear it off and strengthen it and really extract it. We did that with a very well designed cage in the skid system. Then, laterally, it then came to my workshop for me to clean it and put it all back together.

Chris - Did it come out, as they say in the trade, 'on block?' It was still encased in big lumps of stone and you had to chip that away to reveal what was the real fossil inside the extraneous rock?

Steve - So it came out naturally. It was still covered in what we call mudstone and you could see part of the bone, but a lot of the bones had broken and it was in a huge block that weighed we think just over a ton. There's lots and lots of cavities in the skull where the eyes were, where the muscles were, so that had to be cleaned right out. Philip found the initial discovery in April, it took from April to August to get it out of the cliff and back into safety. It came into the museum a couple of months later and it probably took another six or nine months to get it back ready for display.

Chris - The clean specimen, how big is that skull?

Steve - It's nearly two metres long. On the side of it, the back of the skull, you could extend your arms and it would be about that wide.

Chris - Goodness, that's a big head, isn't it? If you extrapolate from that head to the whole creature, what would the rest of it have looked like and how big would the rest of it have been?

Steve - We think it would be 9 to 10 metres, have four big flippers exactly like you see a turtle's got, and those would probably be about two metres long each, four of those, very short neck, and a barrel shaped body. So it's rather like, if anyone knows what the Loch Ness monster looks like, on that basis, it's very similar to that big fat body. It's a top of the food chain predator. In other words, this was the apex predator in the Kimmeridgian seas. There's nothing bigger. When it took food, it took anything. It ate its own kind, and they would've fed on Ichthyosaurs and anything that smaller than themselves, they would've fed on.

Chris - So, in answer to the question, 'What did it eat,' you would say, 'Anything it wanted to?'

Steve - Anything it wanted to. Now a lot of people think they're just scavengers but we've got evidence, in some of the bones, where they've got big bite marks. One side of the bone, we deduce it's still attached to the body, otherwise the teeth would bite both sides or you get bite marks over the side of the bone - that indicates it was still on the body while it was being ripped apart. They would probably be down in the dark depths of the water and come up and just take prey in a very quick movement.

Chris - Is the rest of it still in the cliff, then?

Steve - When we excavated around it, there were more and more bones going back into the cliff and we've got a scap, in other words, a breastbone of it as well. We know there's a lot more there and with the preservation that we've got on the skull, there's no reason to suppose the whole body's not there. Logistically, it's a very difficult thing to get out because it's about 15 metres down. That would indicate we couldn't tunnel in anymore, we would have to remove the whole of that 15 metres cliff and then expose it and then collect it and put the rock back and reinstate the cliff.

Chris - There's going to be hundreds of tons of rock, isn't there? Is there not a danger that, nature being what it is on that coastline, there could be a fall and this could be lost?

Steve - No, the erosion is quite rapid, but we don't get big land slips or anything like that here. It's more by wet/dry desiccation: there's bits falling off all the time, but it's not massive great slips. It will take a number of years, probably about 20 years, to go way back. The erosion is quite quick, but not that quick.

Chris - Can you get inside the skull and see what the brain structure would have been and that kind of thing in those cavities?

Steve - That's the really good thing about this. The whole skull, every element's there and where you excavate the back of it, you can see the brain case, you can see where everything that you need to see is. The only thing is you can't see the underside or the palate, the roof of the mouth, because that's on the base if you get what I mean.

Chris - It's absolutely extraordinary isn't it? So what did Sir David Attenborough make of it when he had a glimpse?

Steve - I think he was very impressed when he looked at it. We looked initially at the snout, because we CT scanned that to look inside it where you've got all these pits in there that indicate it's sensing pressure, and it's one of those things that you see - crocodiles have got the same things but they're really well developed in this pliosaur, they're all over the front of the snake, all these pits that are joined by a channel that go back into the brain. When something swims through, they leave an electrical discharge. It may be that that they could pick up on but, again, that's still quite new. People are still arguing over what these represent and what they really do. The thing is with this skull, it's so good that because it's very large, we would like to have CT scanned it, the whole thing, but there's no CT scanner in Britain that's big enough to do this.

Chris - And of course anyone who's intrigued by what you've been saying can catch you prime time on the BBC on New Year's Day.

Steve - Yep, that's right. Eight o'clock BBC One I think it is. The film shows the extraction which is quite a difficult thing to do. I don't think anyone in their right mind would probably look at doing it, but we didn't want to lose this because we realise its significance and its scientific importance.

Santa's sack

20:57 - Psychologist gives the gift of Xmas shopping advice

The pitfalls to avoid during your last minute present buying...

Psychologist gives the gift of Xmas shopping advice
David Robson

Now, those of us that have spent the past few weeks buying presents for loved ones will know that it can feel like one of the most stressful parts of Christmas. So, is there anything we can do to make it a bit easier on ourselves? I’ve been speaking to David Robson, author of The Expectation Effect: How Your Mindset Can Transform Your Life...

David - I think the most important thing to remember, and it can actually be a source of great comfort to us, is that we don't have to worry too much about the expense of the present. This is one of our key biases is that we think the value is all important, especially if we're giving a present to a wealthy person, for example, or if we think that it's going to be compared to all of the other presents that someone is receiving. But a ton of research shows expense just really isn't a big priority for the person receiving the gift. They care much more about how personal it is, what it means to them and the other person, than the price tag. It really isn't all about the price tag at Christmas.

Chris - So what sorts of things should I weigh up then? If I want to go and buy a gift for, say, my wife or my brother?

David - One of the things that we pay far too much attention to, apart from expense, is the surprise factor. We really want to see that huge smile or that little bit of shock on the day as someone opens their present. What the research shows is that might delight someone in the moment but, in general, they're going to be far less satisfied with those kinds of surprising gifts than something that would be really useful, that would really contribute to their happiness in the long term. A simple example of this is that you we might buy a showy bunch of flowers that's already in bloom, but people are generally much more satisfied and feel closer to the gift giver if you buy them something that's going to bring happiness day after day over a longer period of time. So rather than that bouquet of flowers, you might buy them a house plant, for example.

Chris - Someone wrote to one of the newspapers the other day and said that her husband got her a chainsaw for Christmas. This can backfire, can't it? Because you end up with the gift that the person wants themselves and they give you saying, "This'll be really useful in the garden," thinking, "Actually that's quite what I want." And it's also kind of saying, "You don't do enough in the garden" if you're not careful.

David - Lots of gifts can be backhanded compliments. They can really carry these mixed messages. I think our egotistical tendencies can play a big role in other ways as well. So, for example, there's research showing that we're really reluctant to buy someone a better version of a product than the one that we own ourselves. In fact, we might just not buy them that product at all. So it might be that you're buying someone in your family a new food mixer and you'll get the version that's slightly worse than the one that you own because you don't want to feel in competition with them - you don't want to be jealous of the gift you're giving.

Chris - Someone said to me once that other gifts that tend to go down very well are experiences. When you send someone off to a spa, or to do that jump out of an aeroplane they've always wanted to do, or that hot air balloon ride?

David - Yeah, that's exactly right. People really value personal growth and that's one of the most important things within any relationship: giving people the opportunity for personal growth. We call that self expansion. Buying these experiences is one way that we can contribute to that. There's lots of research showing that when people do create opportunities for self expansion, it brings people closer together. That trip to the spa, or tickets to a concert, you've got all the anticipation before that event happens - so that's bringing a lot of happiness to the person - and then it's sticking in their memories for months and years afterwards.

Chris - Any tips for, if we flip this round for a moment and say, we are the recipient, not the giver, and we get something that really does leave us a bit lukewarm, any tips on to how to handle that?

David - So I think this comes down again to our egocentric thinking. We are thinking so much about our own disappointment that we actually forget that the person buying the gift, it might be mistaken, but they probably did put a lot of thought into it. Just trying to consider what options they might have been looking at and how much time they might have spent thinking about this that soon shifts those feelings of disappointment into a feeling of gratitude that at least they bothered, at least they had you in their mind when they were going about their Christmas shopping.

Chris - So think about that as you unwrap what you know is a bit of a naff present. You must have an example yourself of a particularly fantastic present you've had and a particularly awful present you've had. Care to share?

David - I will do. First, the awful present, and I think this is a really good demonstration of that last point. It was my birthday actually, and one of my friends sent me in the post a secondhand cassette tape of Belinda Carlisle. I wasn't a Belinda Carlisle fan, really. This was in the 2000's when cassettes weren't really listened too much. I really struggled to think why she had chosen that. But I think reading this research, I'm sure that she felt there was some personal connection there, that maybe in the past I've mentioned that one particular song or that we'd heard it at a party together and it brought back lots of memories to her that it just didn't bring back to me. But actually, I think she really made an effort there and I should have been more grateful at the time rather than expressing my disappointment. In terms of the kind of best present I've received, that was my electric piano from my parents when I turned 18 and now, 20 years later, and it's still something that brings me great pleasure and it's something that, every time I use it, I remember my parents, I remember in that event how exciting it was to open it, and it really does bring me closer to them even when they're far away.

Reindeer

25:54 - How many reindeer would Santa need?

God forbid anything were to happen to the current lineup...

How many reindeer would Santa need?

To get to the bottom of your Christmas conundrum, James Tytko called on mathematician Ems Lord to crunch the numbers...

Ems  - Thanks James. What a fun question. After a bit of Googling, I’m going to assume that each reindeer can tug a hefty 136 kilograms. And there are approximately 2.4 billion kids under 18 eagerly awaiting their presents.

James - And I suppose we’ll also need the weight of the average present.
Ems: Exactly right. Based on a thorough investigation of the top ten gifts from the John Lewis website, let’s go for the average gift weighing in at 1kg.

James - Sounds like we’re all set for some maths magic.
Ems - Drumroll, please! Dividing the total weight of the presents by the load each reindeer can carry leads us to the conclusion that it will take 17,647,059 reindeer to haul that sleigh of joy around the world!

James - Woof. Or whatever sound it is a reindeer makes. Are there even enough reindeer to pull this off?
Ems - Some more Googling tells me Earth's reindeer population sits at a mere 7 million. Should the usual suspects, led by Rudolph, lose their magical powers, Father Christmas might need to start thinking about a reindeer breeding project.

James - along with one hell of a poop scoop! Thanks Ems - and merry christmas.

Ems - Merry Christmas, James.

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