iiinova — where your digital self keeps evolving

AJ Lees @ajlees.bsky.social · 04/09/2026

I am pleased to report that the premature vested interest drive to introduce a biological definition of Parkinson’s disease a la Alzheimer has sunk like a lead balloon in the UK

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AJ Lees @ajlees.bsky.social · 04/09/2026

‘As scientific explanation becomes more comprehensive, the contribution which may be claimed by an individual approaches zero. Man’s creative powers,achievements in art,science & morals & capacity to choose is inconspicuous in the new scientific self portrait’ B.F Skinner 1948

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AJ Lees @ajlees.bsky.social · 16/08/2026

Listen to this salutary story that has so many lessons. if a normal DAT scan doesn’t absolutely exclude early Parkinson’s disease why do it in the first place. Second if there is no sequence effect on 20s of tapping - hold your horses @Ed_Jabbari podcasts.apple.com/gb/podcast/2...

podcasts.apple.com

2 Parkies in a Pod: a Parkinson's Podcast

Health & Fitness Podcast · Updated fortnightly · If you want to know more about Parkinson's, or how to cope with chronic illness, then this is the Podcast for you. Between them Clarky and Kuhan have b...

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AJ Lees @ajlees.bsky.social · 09/08/2026

As H L Mencken said ' for every complicated problem there is an answer that is simple, plausible and wrong. An example in my field is the notion of removing Lewy bodies from the brain and stopping disease progression in its tracks.

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AJ Lees @ajlees.bsky.social · 09/08/2026

Everyone in the NHS knows that there is not enough capacity in the system and not enough physicians to go round It is in the interest of all of us to pay more and to get rid of pony health insurance schemes that bail out when you get really sick No more elastoplasts

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AJ Lees @ajlees.bsky.social · 02/08/2026

Genetics is all very well but it is not the new Genesis. It cannot decide my destiny or the future of mankind

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AJ Lees @ajlees.bsky.social · 02/08/2026

Bring back the Cocoa Tree, White’s and Ozindas the London chocolate houses and serve that dark deep molten cacao that only Andalucians and Madrilenos now know how to serve I miss too the Cocoa forests of Ilheus #TheChocolatePort @dubreviewbooks

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AJ Lees @ajlees.bsky.social · 26/07/2026

An intelligent man feels what others only know Montesquieu #SoulfulNeutology #BrainspottingAdventuresinNeurology

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AJ Lees @ajlees.bsky.social · 24/07/2026

Are we losing medicine's soul to AI? In his review of @ajlees' "Murmuration", Rhys Davies explores "Soulful Neurology" - where neuropathology meets a humane appreciation of the patient. Warmly recommended for clinicians. Read: acnr.co.uk/book-review/mu… #Neurology #MedEd

acnr.co.uk

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AJ Lees @ajlees.bsky.social · 23/07/2026

I am weary of hearing well nurtured cultivated persons saying all is lost and clever young men and women saying they would have rather lived in the sixties Move on and embrace progress but try to know yourself better and avoid rogue machinery

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AJ Lees @ajlees.bsky.social · 18/07/2026

When all the years of hard work is over, the book is published and the reviews are in the only pleasurable bit starts. Sitting with a group of close friends to discuss the cast for the film that will hopefully follow is a delight like a crumb of gold

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AJ Lees @ajlees.bsky.social · 11/07/2026

“The trouble with quacks is that they cure people”. William Osler Can you be a quack without being a grifter or a privateer? If a quack uses placebos, avoids nocebos is good mannered and intuitive tells no lies and is a sound generalist. What is not to like?

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AJ Lees @ajlees.bsky.social · 11/07/2026

I have always loved being recognised and greeted by baristas, porters and waiters. It has contributed to me being a person of habit. The delight is brief snd low voltage but always makes my day

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AJ Lees @ajlees.bsky.social · 06/07/2026

Clare on Ragwort ( Mare’s Fart) ‘Thy waste of shining blossoms richly shields The sun tanned sward in splendid hues that burn So bright & glaring that the very light Of the rich sunshine doth to paleness turn And seems but very shadows in thy sight’ @JohnClareSoc #JohnClare

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AJ Lees @ajlees.bsky.social · 03/07/2026

I have spent years and hours trying to make my writing clear and simple but still can’t resist throwing in a new word occasionally or using two adjectives when one would do

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AJ Lees @ajlees.bsky.social · 03/07/2026

I have spent years and hours trying to make my writing clear and simple but still can’t resist throwing in a new word occasionally or using two adjectives when one would do

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AJ Lees @ajlees.bsky.social · 03/07/2026

What I love about detective fiction is the mystery and the puzzle element especially when observation and abduction are at the fore. There is no need for violence or even a murder to send me asleep. A missing person or a poison pen letter is sufficient

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AJ Lees @ajlees.bsky.social · 30/06/2026

I learned as a young man that girls did not like grumblers and I have done my best to restrict my curmudgeonry to male company. I remember once being told by my future wife that I had better go home rather than spoil her pleasure through my incessant grousing

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AJ Lees @ajlees.bsky.social · 27/06/2026

If at 80 you're not a cripple or an invalid, if you have your health & still enjoy a walk a good meal & can sleep without a pill, if birds and sea inspire you, you are most fortunate & should get down on your knees & thank the Lord for his savin' & keepin' power. #HenryMiller

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AJ Lees @ajlees.bsky.social · 25/06/2026

Mirabeau Diptych Beach reading while you dance the shag to the Tams, Larry Williams and Chairman of the Board Makes a good present for your doctor and royalties to Parkinson's disease

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AJ Lees @ajlees.bsky.social · 17/06/2026

Another ‘renegade’ who had an enormous early influence on me through his writing was Richard Asher “if the cause of an illness is not known it is necessary to invent one’ Asher believed medical overinvestigation was a form of cruelty as well as profiteering

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AJ Lees @ajlees.bsky.social · 10/06/2026

We need more neurologists who are competent to diagnose and treat all patients with neurological symptoms presenting for the first time in clinic and the emergency department. The growth in subspecialists has become a sort of lifestyle choice

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AJ Lees @ajlees.bsky.social · 02/06/2026

Neurologists are attracted to microscopes and psychiatrists to wide angled lenses Neurologists are noticers psychiatrists are listeners Soulful neurologists and sensitive psychiatrists combine both approaches to explore the pathology of self

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AJ Lees @ajlees.bsky.social · 16/05/2026

The AI developer should be accountable and responsible for rigorous pre and post market efficacy and safety evaluation not the ‘doctor in the loop’ If i dont trust its validity then it is of no value

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AJ Lees @ajlees.bsky.social · 16/05/2026

Proponents for the new anti-amyloid drugs make a comparison with the multiple sclerosis scene 20 years ago believing their introduction will lead to a momentum swing in dementia care and more efficacious immunotherapy All the same i am pleased they are not available on the NHS

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AJ Lees @ajlees.bsky.social · 09/05/2026

A Russian-Chilean-English effusion first presented as a poster at the Bicentenary in Paris last year and now published in the excellent Archivos History of Medicine section #CharcotShower @Marcelo65708093 @mselikho1 @teiveads doi.org/10.1055/s-0046…

doi.org

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AJ Lees @ajlees.bsky.social · 01/05/2026

Clinical researchers are now counterculture. What was once mainstream is now the province of mavericks and the avant-garde They are adrift between university and public health system, derided by the customer friendly in the emporia

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AJ Lees @ajlees.bsky.social · 27/04/2026

Murmuration by @ajlees The sequel to Neurological Birdsong, in which one of our most celebrated neurologists transforms his favorite tweets into poetry. Available worldwide @Amazon from Mirabeau Press amzn.to/3Y0f5VS

amzn.to

Murmuration

Murmuration [Lees, A.J.] on Amazon.com. *FREE* shipping on qualifying offers. Murmuration

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AJ Lees @ajlees.bsky.social · 26/04/2026

In the NHS control tower devoid from patient care it is the government machinery not the manifesto or the Hippocratic oath that counts- Kafkaesque

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AJ Lees @ajlees.bsky.social · 20/04/2026

Leave your e-silo . Get out into the hospital, walk the walk linger on the wards talking to your patients. Pop down stairs and search out a neuroradiologist Never buzz patients into your clinic. Have a post clinic debrief with the juniors. Skip the hot air meetings

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AJ Lees @ajlees.bsky.social · 20/04/2026

More specialists fair reimbursement of the neurological consultation (should be costed at at least twice an MR scan) Removal of profligate wasteful imaging and unnecessary gadgets Is anyone listening in the bunker?

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AJ Lees @ajlees.bsky.social · 20/04/2026

For evaluating the course of treated Parkinsons disease there is nothing better than the medical interview comparing it with the written previous consultations ( takes 30 minutes) . The examination is a momentary snapshot.Scales are for trials, wearables a waste of time.

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AJ Lees @ajlees.bsky.social · 12/04/2026

I carried out my best research at a time when it was still possible & acceptable to talk with & observe patients over hours in hospital & serially over months. In this way I garnered much more clinically relevant information than could ever be obtained by a battery of wearables

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AJ Lees @ajlees.bsky.social · 09/04/2026

This is the best available evidence comparing efficacy, safety and cost of apomorphine and foslevodopa-foscarbidopa pump therapy in Parkinson's disease. Unlikely to ever be a head to head comparison rdcu.be/fcv5J

rdcu.be

Licensed Subcutaneous Infusion Therapies in Advanced Parkinson’s Disease: An Indirect Treatment Comparison and Cost-Minimisation Analysis

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AJ Lees @ajlees.bsky.social · 03/04/2026

If you want to find a good neurologist never consider a name that pops up when you google 'top neurologists' It is an even more perilous method of inquiry if you replace 'neurologist' with 'Parkinson's disease specialist' More data below amazon.co.uk/Murmuration-J-… @Mirabeau_Press

amazon.co.uk

Murmuration

Murmuration : Lees, A.J.: Amazon.co.uk: Books

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AJ Lees @ajlees.bsky.social · 02/04/2026

I have been struck how something closely resembling the methods of the Spanish Inquisition has been set up in many universities for the fun of the institutional inquisitors

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AJ Lees @ajlees.bsky.social · 30/03/2026

Who wants to be a fossil before his or her time? - a powerful incentive to discard my old textbooks and continue to attend Grand rounds. But in so doing I have learned that new is not always better and that much important & hard gained knowledge is in danger of being lost

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AJ Lees @ajlees.bsky.social · 19/02/2026

Before ward rounds we convened as a firm over bourbons or croissants to discuss the ward patients and their diagnoses for 1 hour, then do the business round requestioning and reexamining and then communicating the planned management. The nursing sister was always present

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AJ Lees @ajlees.bsky.social · 15/02/2026

I remain fascinated by my ‘lizard brain’ with its prehistoric fears, intuitions, elations and soulfulness. I have always preferred cellars to attics #Basalganglia #amygdala #nucleusaccumbens

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AJ Lees @ajlees.bsky.social · 31/01/2026

I'm talking about emergent grass-roots dancing of the brain that is far greater than its component parts. Cheaper than a Big Mac royalties go to Parkinson's research Press your Amazon button now. A great gift for neurologists psychiatrists and neurophiles. www.amazon.co.uk/Murmuration-...

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AJ Lees @ajlees.bsky.social · 16/01/2026

Old age is a planet to itself where all those minor psychic and physical bumps and scratches are suddenly disinhibited taking on new and suddenly robust lives of their own. Anything that has been ignored or closeted is now lit like a Noir film, shadows looming over the everyday.

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AJ Lees @ajlees.bsky.social · 15/01/2026

A great present for all life scientists but especially those with an interest in the brain. Cheaper than a box of chocolates and better for you. Any royalties go to Parkinson’s research #Neurologicalbirdsong Murmuration amzn.eu/d/9zbsdOh

amzn.eu

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AJ Lees @ajlees.bsky.social · 15/01/2026

Belatedly it dawned on me that many of Kennedy and Trump’s notions of health and illness stem from the orgone boxes, golden dawns, trepanning, psychedelics, macrobiotics of the Swinging Sixties. I found it all a pile of baloney

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AJ Lees @ajlees.bsky.social · 15/01/2026

Finding new ways to provide hope is an important part of neurological practice but you wont find enlightenment in our journals or our textbooks.

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AJ Lees @ajlees.bsky.social · 31/12/2025

I found seeing patients, avoiding functions and committees, walking & listening to music & reading about important developments a way of reducing angst and creating flux. I didn’t have electronic health records which allowed me time to think and carry out clinical research

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