Woman's Hour - Actor Romola Garai, AI research and breast cancer, Rebecca Watson

Episode Date: August 13, 2024

Annie Ernaux’s Booker-nominated book, Les Années, traces her journey from childhood in post-war France to old age in the post-9/11 era. Now adapted for the stage, Gina Mckee, Deborah Findlay and Romola Garai, alongside Anjli Mohindra and Harmony Rose-Bremner, are the five actors portraying different stages in the life of an ‘unnamed’ French woman. Romola Garai joins Nuala McGovern in the Woman’s Hour studio. We talk to Regina Barzilay, a Professor of AI & Health in the Department of Computer Science at MIT, about how her own breast cancer diagnosis shifted her research to predicting cancer. Regina and her team have built an Artificial Intelligence system that can predict almost half of all incidences of breast cancer up to five years before they happen. And author Rebecca Watson on her latest novel I Will Crash - a unique take on sibling torment. Presenter: Nuala McGovern Producer: Lisa Jenkinson

This BBC podcast is supported by ads outside the UK. I'm Natalia Melman-Petrozzella, and from the BBC, this is Extreme Peak Danger. The most beautiful mountain in the world. If you die on the mountain, you stay on the mountain. This is the story of what happened when 11 climbers died on one of the world's deadliest mountains, K2. And of the risks we'll take to feel truly alive. If I tell all the details, you won't believe it anymore. Extreme. Peak danger. Listen wherever you get your podcasts.

BBC Sounds. Music, radio, podcasts. Hello, this is Nuala McGovern and you're listening to the Woman's Hour podcast. Indeed it is. Good morning and welcome to Woman's Hour. Well, I was stopped in my tracks by a play called The Years. It is currently playing at the Almeida Theatre in London and it tells the story of a one woman through five actors.

Romola Garai is one of those women and she will be here with me. Also today, the woman who helped create the revolutionary AI system that can predict almost half of all incidences of breast cancer up to five years before they happen. That discussion coming up.

And for those of you with brothers, what was your relationship like? Was it good with a bit of teasing or something more difficult altogether? Well, today we're going to look at the much darker side of sibling relationships with Rebecca Watson. She has a new book, I Will Crash, and it explores an abusive

brother told through an inner monologue. Rebecca will also be in the Woman's Hour studio. I want to tell you about this story I saw out of Guernsey this morning. Two 12-year-old girls, Juliet and Lilia, swam to a woman called Sue, who was knocked unconscious while swimming. Juliet said, I dived in and swam maybe three or four metres out and I flipped Sue over and then because it was so choppy, you needed to make sure her head was held up above the sea. Lilia was at her body, I was at her head and we were holding her up, shouting for people to come and get her because it was quite difficult for us to bring her back on her own. It was incredible work, really quick thinking by them.

And Sue, after a hospital stay, is now doing fine. But I was wondering, have you ever been shocked by a youngster's ability to do something remarkable and surprising? Now, this could be your kid or somebody else's.

Did they do something that you were just wowed by how they managed? And of course, it doesn't have to be saving lives. You can get in touch with the programme by texting, the number is 84844.

On social media, we're at BBC Woman's Hour or you can email us through our website or you can send a WhatsApp message or a voice note using the number 03700 100 444. So all those conversations that will be coming up. But let me begin with Afghanistan,

because it's almost three years since the Taliban took power in that country. And life since then has been incredibly restrictive for women and girls. Girls have been banned from going to school. And judges are now overturning tens of thousands of court cases from the past, including divorces. Tomorrow, we've just seen, has been declared a national holiday by the Taliban to mark their three years in power. Let me bring in Mariam Aman, who's an assistant editor

for the BBC's Afghan service here in London. Welcome to the programme. How would you describe daily life for women in Afghanistan now? Good morning, good morning. Well, we just, tomorrow, the third anniversary, we spoke to at least three highly educated

Afghan women whose lives have been directly impacted by the rulings and by the changes in policies put in place by the Taliban regime.

And one of them describes her day that she spends all her day either on on her mobile if she has electricity, or she cooks a meal a day. And the rest of the day she just wonders and thinks about all her unfulfilled dreams and, and the things that she can't do anymore. So we have two sets of women in Afghanistan, one probably rural whose lives with the change of government has not been impacted so much. But then you have one whole set of women in cities who had thriving careers, who were working,

and the girls who were going to school, who were hopes and dreams. We are talking about this set of women whose lives have been changed completely since the return of Taliban. And I suppose many fled, but of course there are many that could not for whatever reasons. You know, I was looking at some photographs out of Kabul. It was a clothes seller and they had mannequins that were wearing various dresses. But the heads were covered. The faces were covered, apparently because the Taliban had asked, you know, no human faces or human seeming faces to be visible in public.

I'm just wondering what that must be like for women as they walk around. So Taliban have said that there needs to be a rule of head to toe coverage when the girls are outside or when women are outside. And the mannequin kind of a symbol of Kabul, where a lot of beauty parlors or shops selling women clothes were always with these mannequins. And apparently Taliban feel that they are provocative and enticing. So the faces needs to be covered. But the head-to-toe ruling that came about two years ago is adhered to, but they do still roam around the city, mainly Kabul, mainly big cities in northern and eastern Afghanistan. Not so much in eastern, but northern and Kabul in particular.

But the coverage, yes, that's part of what Taliban have, from the beginning, have said that this needs to be taken care of. And that is definitely something that we've heard, along with the lack of education for girls. There are also the court cases that I alluded to there that are currently being overturned, including divorce cases. Can you tell us more about that? So the system in its entirety, the Taliban regime,

believed that the previous republic was corrupt. And the rulings that were happening during republic were part of that whole big corruption and things could change. But they are not just opening the cases as they like. They are opening the cases based on the demand of plaintiffs or people who were not happy with the previous ruling. They would come to Taliban, put a case and say, for this reason, this reason, I'm not happy. And I want this case to be or sort of appeal the decision of the previous government. That has kind of opened a Pandora box, if you like, and a whole set of cases that plaintiffs before, they were not really happy with the rulings. They are now coming back

to open the cases. We particularly studied one case. Our correspondent went into Kabul and looked into a teenage bride who was married to a man, married off to a man without her will. And the previous government's court system said that no, they declared the marriage void and she was set free. But the husband of that person, the ex-husband has now come back and has reopened the case. And this time, the case has ruled in favor of that gentleman. So what we could what we see is a republic that was Western back and had slightly leniency towards women. And they had we had this whole big, what you call it, violence against women elimination set of policies in place that has been replaced with a new, more male friendly set of government, set of policies that kind of are now coming into place and affecting the people, the group of women that were protected in republic.

So a woman leniency republic policy is replaced with a harsher, more strict sense of Sharia the Taliban are bringing in. And does it look like there is any movement at all when it comes to girls' and young women's education? No, I'm afraid. And from the first year that they promised that they will let girls go in to the second year that they kept on saying, well, we are looking into policies, we are looking into curriculum, we are looking into segregation of gender. Now, to the third year that there is a complete silence over secondary education and higher education of women. issued his festive messaging, there were completely no sign of any hint about reopening of schools. So we are here with three years gone by

with no secondary education, no higher education, and no prospect of these ever being opened again. So that's where we are. The UN has described the situation as gender apartheid, really creating that division within society that wasn't there, at least in the big cities. Are you expecting any new edicts from the Taliban?

Well, in the last three years, we had some 50 different rulings that kind of impacted social, political and personal lives of women. We kept saying that all has been covered, and then there will be new ones coming in. We don't know. We don't see any vacuum in the edicts in previous policies to um for for any edict to come and fill some sort of vacuum because women's political presence is um erased woman has been erased from social uh life their education is impacted there they can't go to gym they can't go to parks they can't travel alone they can't be you know they there are certain jobs that they could do they could only be in primary teaching they could be in health and there are some really small number of them working in place as as female

police the the opportunities are are scarce so I don't see where else there is room left for any new ruling. You feel all the freedoms have been taken away. I do wonder psychologically what that means for the mental health of the women that are there. Well, because of this anniversary, we have spoken to a few of them.

And there's one thing that mental health comes when your basic necessities are covered. But most of the people that we spoke are fighting for survival, fighting for their next meal, fighting for being able to feed their children, feed their family or have a shelter or be able to turn around and say, of course, I'm depressed. the country based on UN data is going through the worst malnutrition, the worst food poverty that this country has ever gone through. And we have drought, however that pronunciation is. Mm-hmm. And so there are a lot of factors that are impacting their daily survival and their mental health, however bad it is. They don't really think or have time to think because they have grave concerns to address first. But UN has said that the Afghan women are going through worst mental health crisis. to the years next. This is Annie Arnault's 2008 Booker-nominated book Les Années that traces her journey

from childhood in post-war France to old age describing not just her tumultuous life but also her dreams, her perceptions and significant chunks

of history between the 1940s and the beginning of the 21st century. It has been adapted, translated and it's also directed by Aline Arbeau for the stage. It's on at the Almeida Theatre in London. There is Gina McKee, Deborah Findlay, Romola

Gary, alongside Anjali Mahindra and Harmony Rose Bremer, who are the five actors portraying the different stage of Annie Arnau's life. And Romola joins me in the Woman's Hour studio now. Welcome. Thank you. So good to have you with us. This is an incredible production. Your performance is also brilliant. Just to give people an idea of the scope, this

60 year journey through France, the West, women's liberation and then the five of you, these amazing actors, reenacting the life of this woman through various scenes and going through the various ages, I suppose, of that century as well. What was it like for a full two hours sharing the stage with the other four? And I should say it's kind of a small

stage as well with these amazingly big presences including yours yes it's a it's a very intense experience doing the show it's so incredibly fast um and it's two hours and there's five of us and you don't really remember any specific thing that happens on the stage because you're working at such a pace. And as you say, we're telling these two narratives that kind of interact. One is the story of this one individual woman, but also the collective story of the entire sort of Western 20th century. So it's a bit like, yeah, it's a bit like going through an accident or something. You don't really remember anything when it's happening. It's so interesting that you say that, though, because I saw the play about a week ago and was blown away by it, as I think I've alluded to.

But when I went then to read, to prepare, to speak to you, I realised it was almost a blur for me. And it was only when I went back and looked at the individual scenes and the things that were said that it came back into sharp focus. It's like you kind of digest it all in one large piece. And I'm just thinking what it must be like to be caught up in the eye of that storm. What were the rehearsals like? They were extraordinary because the text of the play is very, very spare. So there are these, you know, it's an adaptation from a piece of her work is stream of consciousness. So you have these,

you know, specific lines that relate to her sort of internal journey. And then you have people stepping forward and narrating events from 20th century history. But there was absolutely no indication in the page of how incredibly physical the play is and we make all the scenes with props that are on the stage and you know it's a very very fast piece of work so when we sort of you know we're in rehearsals and Alina would come over and say you know now we're going to describe the twin towers falling over with these boxes we were like oh okay um is that going to work it did yeah when the piece of work is performed it goes such incredible lick and with such kind of power going through it that i think like the audience the performers kind of get swept up in that sense of the kind of weight of history and

the speed of history and how much has happened in the last 60 years in Western or in the whole of Europe. And yeah, it can feel sometimes you step off the stage at the end and go, wait, what just happened? I went to see a matinee and I was like, she has to do that again tonight, which is a whole other thing. There's also a white sheet, which is one of the props. Sometimes we see photographs from the various eras as well, which I think is very poignant because I think we've all got those old photographs of ourselves or of parents that sometimes is how we remember times. Yeah. And I think we reenact these photos, obviously with five actresses at different ages and we look very different. There was never any

attempt to kind of make us into the same person because I think the piece has a real understanding of how deeply people change through their life. And there was a real, you know, Alina, the director, really embraced that sense of the kind of wild variety that can exist within a person. So, you know, we reenact these photos from different periods of history that, as you say, everyone has in their drawers at home, you know, photos from the 50s, photos from the 70s, you know, but, you know, we all do it with the sort of knowing sense that although these are sort of faded faces from history, they're people that live inside us and that are the same as us. And so there's that sort of duality as well. And memory as well, which made me think about,

sometimes I only, I think I only remember the past through those photographs, you know what I mean, instead of the whole experience of the time. But that role of memory in our lives is also throughout the play as a theme. And there was a line that spoke to me about the memory never stopping. I want to listen to you and Deborah Findlay,

who plays Annie in her later years, talking about it just to give our listener a feel for the play's atmosphere. The images that follow us all the way into sleep, the real or the imaginary ones, they will all vanish

at the same time, like the millions of images that lay behind the foreheads of our grandparents, dead for half a century, and of our parents also dead. And one day we'll appear in our children's memories, among their grandchildren and people not yet born. Memory pairs the dead with the living, real with imaginary beings, dreams with history. Memory pairs the dead with the living. It really does. I think that theme of time, I suppose, passing and how a person changes throughout it is a big part of it. The audience is gripped throughout it, as I'm sure you've seen as well.

And there are some graphic scenes, one that is very funny about masturbation of the younger woman discovering masturbation for the first time. You also have another scene that I think stays in the memory where you reenact a dangerous backstreet abortion. This was like early 60s that you are in at that point. It's a very difficult watch, however one

might feel about abortion. And although you are told in advance about what to expect when booking the tickets and outside, both labelled and also by ushers. I think it's hard to be fully prepared for it. You're an actor, it's your job, but is it a difficult scene to develop? Yeah. To be prepared, whether audience or actor? It is a difficult scene. I thought it was a very important piece of writing when I read it.

It was the piece I auditioned with, actually. Really? Yeah, and so I was very you know aware from a very early stage what it's a very very graphic piece of writing I thought it was very important I think it's something that so many women went through and still go through to me it felt like a very important thing to put it on the stage to talk in acute kind of gynecological detail about what happens to a woman when she tries to abort her own pregnancy because her society does not support her to make that choice. It is distressing.

There's no two ways about it. And it is impossible, I think, no matter how much the theatre and we all try to prepare the people in our lives for what it entails, to really know what it's going to feel like to watch it. And I find it difficult to perform sometimes. So I was wondering that as I was watching you. Yeah. Sometimes people have to leave and we have to stop the show. But I've never felt anything other than total sympathy for those people, because I do sometimes I find it hard to perform. But I think the thing that keeps me going and keeps the audience watching, and I've spoken to many people about that piece of writing, is the sense that, you know,

although it's graphic, it's specific, it doesn't feel in any way exploitative. And I think that, you know, because of the, you know, the fact that this is a sort of a continuing issue in the world, I think it is something that is important to depict in accuracy. As some of our listeners might have seen, you mentioned it there as well, that some audience members have left during that scene. But I was wondering then for you as an actor, how do you, because it's so intense, if somebody leaves in the middle of that, how do you gather yourself again and begin again? I think sometimes it helps me connect with the audience actually because you know when people have to leave the audience and the performer and the person who has to leave go through a sort of strange contract where

they're suddenly connected very intensely with the material the sadness of it, the difficulty of it. And I think sometimes it can feel like after that person's had to be carried out, the audience and myself are like, okay, let's carry on and tell the rest of this story. And it can feel more communal because of that. The female body is a part of this play very explicitly. There's a lot about love, about sex, about abortion we've mentioned, masturbation we've mentioned, also ageing, all those things that a woman goes through. And I was interested, I was reading a previous interview you did

that you said as a young woman you definitely did not understand about the body in the sense that you thought your body was the property of the society that that you lived in and that you didn't really understand that it belonged to you that you could dictate about it and And I wondered for you, that evolution from being that younger person, I know you've spoken out about sex scenes, for example, and I think got a hard time about it sometimes from directors. To be in this place now,

I was just curious for your reflections on it. Well, I think, you know, it's been an incredible experience for me working on this play and, you know, working with a director who I think really understood from Annie and O's writing and in her adaptation that the history of the later part of the 20th century is written on the bodies of women you know and the experiences that they have gone through is intertwined imperceptibly with the history of our country and and and women carry the scars um the effects on their on their skin and and that although society is often dictating to women like

you know what what happens to their bodies there is also a kind of radical point of realization where you can push back against that and kind of take radical ownership of your body I think I it was working with creatives like Alina and the adaptation of Annie Eno's work I think for me working with with female writers and who who understood that like taking a narrative control it can extend into your own sort of physical control of your body and you know working with creators where it was just not at all interesting to them on any level what I look like on the stage like that was never any part of the conversation you know and and really because that's so interesting because I'm just thinking was it Dirty Dancing 2 that you worked on that I think

what you ate was monitored yeah I had I had some really, really bad, shocking experiences when I was very young in the industry where, you know, the line between you as a performer and you as a sort of body that is controlled by a corporation was not, that line was not, there wasn't a line. Yeah. So yeah, so, yeah, I've been very lucky, I think, in my career to have had the sort of absolute opposite experience of that where you work with creatives who want your body and all of its kind of multiplicity to tell a story that is a true story and not hold up some kind of ludicrous ideal

that is just used to punish and harm other women anyway. It's also, you might have thought it from our conversation so far, but it's a very funny play. I laughed throughout it. It's maybe even all the more funny because some of the stuff is so real. It's important, I imagine, for this audience to keep them in their seats as well, to try and get that across. Yeah, it's very funny. There's lots of music in it. We sing, dance. I should say that you're playing instruments and singing. We have a crazy aerobics routine when we do the 80s. I mean, there is so much humour in it. And I think that feels very much part of the femaleness of the storytelling and

that I think there's this sense of history happening constantly but it but it's sort of happening to you in a way that feels sometimes quite unfortunate like you know suddenly we're all expected to do aerobics and at that stage in the play the actors us the actors are exhausted so you know there's other sex scenes still to come after that. Sex scenes, you know, we have to, you know, we play all the male characters in it as well. So we play her lovers. She had a lot of lovers later in her life. So we play all those parts.

And, you know, as the play goes on and on, I think the audience can see like the kind of, the effect of doing the play on us as performers. And it becomes almost kind of funny that we're sort of having to sort of do these kind of crazy things. Phrenetic, energetic activity. I can't recommend it highly enough. Tough to get a ticket, I noticed this morning when I was just having a look, which is no surprise.

Maybe it'll go to the West End. That would be wonderful. Yeah, we would love to have more of a life and allow more people to see it. Before I let you go, you know, I had the son of the director of The Wicker Man here yesterday on the programme. Because I know you're a horror film fan. Yes. And you wrote and directed Amulet. Is that something you'd like to do more of?

Is it horror films where you're... Yeah, I mean, I... Love lies? Right. And, well, have tried to direct lots of different films in lots of different genres. But yes, I do particularly like horror and my first film was a horror film and yeah I would love to make more. Well

come back when you do. The years continues at the Almeida Theatre until the 31st of August with another couple of weeks still to go and I should say actually if you've been affected by anything we've been speaking about some serious topics here as well in this discussion there are links to support on the BBC

Action website. Thank you, Romola Currie. Some of you getting in touch about remarkable young people. Some years ago my son aged 18 responded to cries for help and along with two others apprehended

a man with a knife and saved the life of a pregnant woman who was being stabbed on the street. i felt so proud of his demonstration of courage and bravery from an unassuming young man wow that's amazing i'm saying they don't have to be saving lives but but there is a listener who got in touch i was just talking about a story out of guernsey where two young girls swam in and saved a woman who was drowning um I also want to let you know about what's coming up next week. There is Listener Week. I've talked about it

a number of times on the programme. If you have an idea you want to get on, next week is the week that it will be on air. 84844 is the number to get in touch if there's somebody

you want to hear from or a discussion you want to hear. That is what you need to do. But also, I want to let you know, if you have a look at our Instagram page now, there is a face on there that you might recognise,

a face for radio. It's me, aged 11, an awkward age, let's be honest, red-haired, mono-browed, in a plum velvet dress with a cream lace collar.

And yes, I did love that dress. And I'm in that picture with my little sister, Eileen. It's her communion photo. And my big sister's there, Vera. And the reason I'm in that picture with my little sister, Eileen. It's her communion photo. And my big sister's there, Fira. And the reason I'm telling you this is because both my sisters will be joining me for a special programme that we're recording on Woman's Hour all about sisters. And I want your stories. There's a recent paper suggesting that relationships between sisters can be more rewarding and more positive than any other bond between siblings. Does that

ring true for you? Or maybe do you struggle to get on with your sister? And if you don't have sisters, what does the sisterhood mean to you? Maybe you've found a sister of another kind. We'll also have a psychotherapist giving advice throughout the programme. Please send in your questions for her. Perhaps you want to know how to be a better sister or want to understand sisterly dynamics and patterns. It's the same way to get in touch. 84844. Email us through our website or on social media. It is at BBC Women's Hour.

So that's going to be an interesting programme. Coming up next week right here. Or that one is actually the week after. Listener week next week and is actually the week after. Listener week next week. And then Sisters the week after. I'm Sarah Trelevan. And for over a year, I've been working on one of the most complex stories I've ever covered. There was somebody out there who's faking pregnancies. I started like warning everybody.

Every doula that I know. It was fake. No pregnancy. And the deeper I dig, the more questions I unearth. How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's Baby. It's a long story. Settle in.

Available now. Lots to look forward to. I want to turn to AI next. And breast cancer. We know that turn to AI next and breast cancer. We know that breast cancer is the most common cancer in the UK. There is one woman diagnosed every 10 minutes. That's according to the charity Breast Cancer Now. But it's still every three years that women from the age of 50 to 70 are invited by the NHS for a breast screening.

So that means some people may not have their first screening mammogram until they're 52 or perhaps 53 years of age. For Regina Barzillet, she's a professor of AI and health in the Department of Computer Science at MIT. It was her own breast cancer diagnosis that shifted her research to predicting cancer. Regina and her team have built an AI system that can predict almost half of all incidences of breast cancer up to five years before they happen. Regina, join me in the studio to tell me more about the AI model. So when I came to MIT, I was working full time on developing machine learning methods for natural language processing, for understanding text. And in 2014, when I was just a few months before I was 44, I was diagnosed with breast cancer. And it came as a huge surprise because nobody in my family ever had breast

cancer. And I didn't consider myself as being a high-risk patient. So it was really a huge surprise when I got it. And luckily, you know, the screening in the US allows to be screened since age 40. So I was diagnosed. And when I went through my treatment, I was really surprised to see that none of the stages of the treatment are really affected by information technology. And this was really a stark contrast between what was going on in all other areas of our life. Even in 2014, you know, Amazon was there, Netflix, many other kind of product recommendation services, but none of it impacted breast cancer care, you know, in one of the top American hospitals, which was MGH. So when I came back, it was time to kind of revisit my life. And I decided

that I would really like to do something to change it. And so you decided to try and get into information technology, because up to that point, and in many places, it's mammograms that kind of led the way, shall we say, for detection? Yeah. So the way I was thinking when I came out, I felt I need to do something. And I was going to multiple doctors and trying to ask what is it that I can do. But despite the fact that I was already a professor at MIT,

none of them really kind of thought about the obvious way to do it. And again, remember 2014 was not 2024 when everybody are familiar with AI. But finally, we found a problem with one of the doctors from MGH who saw that it can be a good idea to apply AI to analyze mammograms. And the reason the mammograms, because this is the most common way of screening, you can do something more exotic, but every woman gets a mammogram. So we said, if we want to have something high impact,

you need to be able to make predictions of mammogram. And from the beginning, the question that I was interested in was not necessarily do detection because, you know, human can do detection. Maybe there is a place to improve there. But really to be able to tell women like me who are not suspecting that they're at risk to tell them what is their risk profile. And MGH is Massachusetts General Hospital.

Massachusetts General Hospital. So tell me a little how the AI model works that you have been working on. So the AI model, the same way that we're using the technology to look, you know, at our iPhone, if you're using iPhone or some other phones, it can unlock it based on your face. It is trained to recognize your face from many other faces. In a similar way, you can train the system when you give to it an image, and you give to it the outcome of that woman for the next five years. And going back to our analogy with a phone, it's not like you need to tell you should recognize me because I have these eyes. So these years, it's kind of learns to identify the features, low-level features on the image that correlate with you. The same way if you have a mammogram and you know what happened to this woman in five years.

And today, if we take a mammogram from 2019, we would know what happened to her in five years. It learns to connect these kind of low-level features with an outcome. And maybe some women would never get cancer, so the model learns. And some women are going to get it within three years, or somebody is going to get it next year. So the model tries to translate these low-level features into the distribution over the outcomes. So what you're doing with your AI model is using old data from women who did or did not go on to have breast cancer to try and teach the AI model what to look for, what represents cancer, what does not. Absolutely. That's exactly what AI is good at, because in contrast to the eyes of us as humans, even if it is an experienced radiologist, it can pick up a very low level patterns, which are too subtle for human eye to see.

And also you can train AI on like hundreds of thousands of images, which it will keep sort of in its memory during training, while, you know, every human radiologist would just see a small fraction of it during their lifetime. So with AI, it's always talked about in the sense that it's only as good as the data that is inputted. So for example, you need previous mammogram information to be fed into the system and you're dependent on other hospitals and women, I suppose, we used the data available in Massachusetts General Hospital. Of course, we follow all the procedures to make it appropriate. And patients that are treated there, in general, are allowed to use that data in an anonymized way for research. Okay. So that's what we used at first. And then the second question was if the data, as you've said, if this strain on women from Massachusetts, which may not be representative of the whole world, even though we have a very diverse collection, still not the whole world.

What we did the next step was to ensure that the model actually works in different women across the world. And then we took our model, which is publicly available, and we tested it in many other hospitals, you know, from Latin America, UK to Asia to Israel. And we get an increasing evidence that the model sustained performance across very different populations. And so where are we in the sense of with this model? Is it being used? How widespread? So at this point, we actually tested the model on over 1,000,000.7 images around the world.

And there are several ongoing clinical trials in the US, which what they're trying to do is to see if the woman is considered to be high risk, then she needs to be screened more frequently or screened with a different modality, such as MRI, which has higher detection rate, but more expensive. So these trials are ongoing. There are several places that are using it in practice. Like one example that I would like to highlight is, again, in Massachusetts General Hospital during pandemic, when the capacity to screen was greatly reduced, they needed to see what is a sub-portion of the population that has to be screened, if you can only screen 20% of population. So they use Mirai to... That's the name of it. It's Mirai. It means future in Japanese, that you can use it to identify these women.

It actually demonstrated that you can pick up the high-risk women. There are various other places that use it to prioritize patients, to call them for MRI and so on. What about breast density? Because that often comes up when we talk about mammograms. So breast density has a very interesting relation to the technology like Mirai. The breast density idea was developed before I was born. And the idea was good that you want to look at the image. The doctors who develop it look at the images of women who got diagnosed later with breast cancer. They look at their previous images and ask, what are the patterns on the mammogram that kind of predict

what's going to happen in the future? And they identify the amount of white tissues has some correlation. But the problem with this measurement that we are all informed, first of all, over 40% of women have high dense breasts. So we're saying to half of the population that you are at risk. And I remember the first time I did my mammogram at age 40, they told me that I have high density. But the second sentence that came was, don't worry, at MIT, half of the female patients have high density. Don't worry about it. So because it is such a precise marker, you know, the patient who gets this information doesn't know what to do with it. But moreover, there are lots of studies from radiologists that shows that doctors looking

at the same images highly differ in how they assess density because it's very imprecise kind of how much white do you see. What machine is trying to do is be much more precise. It can really look at the image and correlate what does it mean this amount of white and it can consistently identify who is at risk. So you are using information given by the mammogram to then interpret with AI. Do you see a time in the future with your expertise in technology when we don't have to use the uncomfortable mammogram as the tool?

Absolutely. First of all, besides being uncomfortable, which is indeed an issue, that is also an issue that even in the countries like the US, you know, you do it once a year and, you know, there are some aggressive cancers that can develop in between. You cannot be scanned every day

and there are also some negative effect of, you know, frequent screening. I firmly believe that, you know, in the near future, you know, blood tests are going to be playing much bigger role in detecting. Maybe at the first instance of this, you do the blood test and they would say, yeah, you should go and do the mammogram. But hopefully, as we continue moving forward, I think the kind of less invasive ways to collect information would be modalities of diagnosis. I want to ask you another question on AI,

because in February 2020, you were involved in research where AI was used to discover an antibiotic capable of killing E. coli. Do you think these success stories are changing attitudes towards AI? You know, you began by telling me what happened in 2014. We're 10 years on. So it's interesting. I think there is a difference between what happens in drug discovery and what happens in healthcare.

In drug discovery, now a majority of pharmaceutical companies are applying AI from very early stages of discovery, designing molecules, alpha, fault play a role. There are many other techniques that are developed now and they become standard and up to running clinical trials and identifying the best patients. In healthcare around the world, especially in developing countries, there is very little AI. And if you want to remember your last visit to the doctor, you know how many of us can say that they had AI when they visited the doctor. And the reason is not that the technology is not ready. I think all the surrounding of it is not ready. You know, the economics of it, the policy around it, the implementation of it.

That's where we are really stumbling and I'm not sure when it's going to change. And that's in developed countries? This is in developed countries. Actually, there were some number of papers that demonstrated that in developing countries,

when they don't have a choice, they're actually using AI. So they kind of do that leapfrog. Yes. So interesting. Thank you so much for joining us and congratulations on your work so far. Thank you. That for joining us and congratulations on your work so far.

Thank you. That was Regina Barcele. You can hear more about the research in a special recording of the Engineers Intelligent Machines Program. It's a live event in collaboration with the BBC World Service and the Royal Commission for the Exhibition of 1851. And it's available now on BBC Sounds. I was asking you earlier for your stories of remarkable young people and you've got in touch

84844. Here's one from Jo. She's in West Yorkshire. She said, I used to work with young carers that is under 18s looking after someone with an illness or disability.

Often they had a parent with an addiction or a mental health issue. They were incredible young people. Resilient, caring, ambitious. They juggled education with home life and part-time jobs. They were often from a single parent family, so had huge responsibility, which they'd just taken their stride, often along with siblings to look after too. And for the most part, nobody outside the home would know about any of this.

They'd just get on with amazing love to them all. 84844 if you would like to get in touch. Now to Rebecca Watson. Her first novel, you would like to get in touch. Now to Rebecca Watson. Her first novel, you might remember this, Little Scratch, was sold when she was only 22. Now she's the grand old age of 29. And her latest novel, I Will Crash, looks at a woman haunted by her abusive relationship with her brother. It's an experimental novel, this time looking at family trauma and memory. We talked about memory a little bit earlier as well on the programme. And it also looks at how we grieve the people who have hurt us.

It's written in the style of an inner monologue. The main narrative takes place over five days between a Wednesday and a Sunday in October. On Wednesday, Rosa, which is the narrator, the character, receives a phone call from her father announcing that her brother has died in a car crash. It's very unique, this voice, and it's a unique take as well on sibling torment, is the word. But it also examines how we love and whether we can forgive. Rebecca,

welcome to the Woman's Hour studio. Oh, thanks so much for having me. So this is compelling, also brutal at times. Rosa is the character and there's also her brother. We don't actually hear his name. No we don't he is unnamed throughout the book. You know I want you to read a few of the lines from the beginning of the book to give people a sense of it and then we'll chat a little bit more. Yeah, absolutely. I opened the door, and there he was, my brother, face carefully neutral. All right, he said. He was older, definitely. Of course he was.

Nobody escapes time. But he looked it, not in lines or where. Something about him was fuller, more real than my imagination would allow. It had been six years, enough had passed that I could notice. Otherwise it would have been only him, but instead there was difference. Everything a little changed, except that stubborn patch of skin above his left temple, just as I remembered, puckered yellow. It was a peace offering.

I knew that, as I tried to swallow the affront of him being there while he waited for my response. You don't appear on someone's doorstep, uninvited, saying, all right, unless you want to make amends. Even if it was a grunt of a word, all right, unless you want to make amends. Even if it was a grunt of a word, all right, leaving me really to be the first to speak. Thank you for that. And it immediately brings us in there. We're on that doorstep.

We're kind of understanding this person who has arrived, but Rosa does not want him there. And so we go back into an abusive relationship. And I think when I was reading it, I was trying to understand what was the level of torment that this brother had inflicted on the sister. I was left guessing though at times. Yes, well, the reader kind of has that mission alongside Rosa. She is trying to summon the memories that will make her understanding of her brother feel concrete enough to have sufficient evidence that he is a bad person. And so as a reader, you're grasping for those alongside her just to be able to, I guess, push him away sufficiently. We do learn that he was emotionally and physically abusive as they

were growing up. And he dies in a car crash. I'm not doing a spoiler that happens at the very beginning. But it's also this aspect of how much or in what way do you grieve somebody who has hurt you? Yeah, and I think what I was thinking about specifically was the fact that grief is such a big word, right? So as a writer, when you're tackling it, it's like, how do you do it? But actually, really, I wasn't thinking about the word grief at all. I was thinking about what are all the emotions within that? So you have the sense of disassociation,

you have the sense of expectation of how other people think that you'll react to something um you have this sense of suddenly all these alternatives of how your life might have played out alongside this person the sense of choice is just eradicated and so what i was really thinking about was what would all of those things how would they all uh interact with each other when the complication is that she doesn't even know how she feels about her brother, let alone how she feels about his death. Do you know when I was reading it, and I try when I'm reading something to read nothing beforehand, right? I don't read any reviews. I don't anything. I just dive straight in.

And when I was reading it, I wasn't sure whether this was autobiographical or not. I get that a lot. I think because I write... It's fiction, I should tell our listeners. Yeah, good clarification. I think because it's like really immersive first person and the whole idea, you know, with Little Scratch, my first novel as well, is that you immerse the reader in. So the reader's job is to inhabit the head of this person. And there's nothing in between you. And so I think because of that, your relationship to the book is far closer. You don't feel like you're reading something

as like a kind of observer. You are experiencing this. And so I do get, there's almost this kind of contract that you enter into where you've had this intimate relationship with the character and people suppose that's me. Well, yes. And my next thing when I did do my research afterwards

is like, does she have a brother and my understanding is you have three one twin brother and two other brothers exactly so it's a bit of dilution there it's like well you know I've got three of them you've got three of them but why did you decide to use that vehicle to explore these emotions I a brother? Yeah, of course. I think sibling relationships are so fascinating and so like underexplored as well. The complexity of a relationship that you either have from birth or soon after that's not out of choice.

It's there by default. That these are people that witness you while you yourself are still in a kind of formative time when you're not quite settled into the grooves of who you will become. They're your kind of earliest witnesses to your life who may compete or misremember, you know, how you yourself see your past. There's such a charged and sort of dark space there that the capacity for where that can go, I just found really, it hooked me. But we never really find out because I think if you ever get two siblings together, we're going to do a programme on sisters in a couple of weeks, there's often a different

memory of how something went down. We never really find out his side. No, we don't. And I thought that tension point, that was what really, really compelled me. The idea of we, in life, right, we assume that our past is something solid that we can hold on to, that our memories act as these kind of tent pegs to make an understanding of who we are. All of that past comes together to form an archive of ourselves. And siblings are a great example of how that can be kind of picked at, or indeed unpicked. So for me, when the kind of beginning of this novel, the kind of image I had in my head, I guess, was as she finds out about the death of her brother, who is the only witness for some of the things that went on between them.

Sure. All of these facts, ideas, things that she wants to believe are concrete to just kind of get chucked up into the air. And the kind of narrative of I Will Crash is her desperately trying to catch some of these pieces and still be able to refigure it back into what she understood. One that stayed with me just to give our listeners an idea of some of the treatment is that him spitting in her eye and holding the spit into her lids with his thumbs

pressed firmly and many other things as well but it's kind of I suppose the fear that she has as well as the actual actions that goes throughout her childhood but you say there's only the main witness suppose, the fear that she has as well as the actual actions that that goes throughout her childhood. But you say there's only the main witness is between the two of them or the two witnesses, brother and sister. But of course, the other two that are involved are the parents. But their take on it, and I'm sure there'll be parents out there and people who are brothers and sisters and whatnot,

that this will resonate with them, that the parents might have a completely different take or want to have, maybe denial, a completely different take on what that relationship is between a brother and a sister. Totally. And I think the parents were a really interesting way for me of exploring the idea of how we like reinforce roles. So much of our understanding of other people can actually be just what we choose to understand of them what we want to understand and so I think for her relationship with to her parents particularly her mother her mother is desperate for her brother for her son for Rosa's brother to be someone else and desperation, her determination for her son to remain what she wants him to be

acts as this kind of absolute blinders. She can't see past that. And that determines the relationship with Rosa. Because everything, I think it's particularly true to any kind of family dynamic, once you have these early understandings who someone else is, that changes. That's a lens by which you interact with them for perhaps the rest of your life. Yeah, it's interesting whether that changes or not.

Your brothers are reading the book, I understand. I think so. You haven't had any feedback from them yet? Not yet, but before it came out, they knew it was about a brother, so they were making lots of jokes that it would be about one of them but I think perhaps when they finish reading it they'll decide that actually it's about someone else. Is it difficult to write

as you do? You read a little bit for us there but I mentioned the word experimental as well which I think has often been used in regards to your fiction that kind of fragmented stop-start that we have as an inner monologue ourselves. You know, we stop-start, we pick up thoughts, go again. That's kind of the feeling I got while reading it. Is it difficult to write? To me, it's the most intuitive way to write. I'm not choosing to write in a kind of zany

or a kind of unexpected way. To me, it really came from the fact that what I wanted to be able to get down on the page was a genuine expression of how we think and how we see the world in the present moment and so the form acts really as a device for me to be able to evoke that to get the reader quickly into that moment and be able to inhabit it and feel that it's like genuine as well. It can all also be and i wonder what you think about this word claustrophobic yeah which again is that sense of like i'm taking i'm taking a layer out between the reader um and the book there's there's not that like reassuring sense

of distance that you might have where you can put it down and be like that's not me or that's not real I want it to be really close and uncomfortable but in that is I think kind of like the miracle of reading where you can associate yourself so closely with the character that you're reading that uh it's a form of empathy isn't it um did you speak to other people about their relationships with brothers or abusive? I'm just wondering where some of the detail came from. Now, that is the mystery of the imagination, I think. You know, obviously, everyone speaks to each other about their relationships with their family, with their friends. It's kind of the obsession we all have when we're having a drink with our mates. But I think a lot of it

just came from trying to work down, you know, the trick of specificity. If you can think of a particular moment, if you can have that, you know, that shard you mentioned of pushing thumbs against someone's eyelids. If you can make it visceral, it suddenly feels so, so much more real. It is visceral. I Will Crash is Rebecca Watson's new book. Thank you so much for joining us. Thanks for having me. Tomorrow, we turn the page on the next chapter of our genre fiction series. This time, we'll be talking about science fiction, a genre that has been accused of being written for and by men. But it does have a large and ever-increasing female fan base, not to mention increasingly high profile female authors.

They include Larissa Lai and Moira Buffini, who will be joining me to discuss feminist utopias and the crossover hits to convert any fiction fan that's coming up. Also, thank you for your messages on Remarkable Children. My daughter surprised us on Sunday. She's autistic and struggles with socialising and speaking to people. But she did an amazing day on Sunday. She took charge. She took the sails at a car boot sale

and we are just so proud of her. It sounds small, but her autism and anxiety holds her back in so many things she would like to achieve. So this event was massive. Lovely story. Thanks for joining me. That's all for today's Woman's Hour.

Join us again next time. In December 1969, Muriel Mackay vanished from her London home. If you have your wife, it will cost you a million pounds to get her back. Two men, toggling Rupert Murdoch's wife, Anna, had abducted Muriel

by mistake. It was the first high-profile kidnapping in British history, and the tabloid press were hooked. Was she alive? Was she dead? The police were baffled. It's the most hideous crime, kidnapping. It's worse than just a straight murder. And Muriel's family was thrown into a nightmare that continues to this day. I just want to find my mother's body.

I'm Jane McSorley and this is Intrigue. Worse than murder. Listen on BBC Sounds. I'm Sarah Trelevan, and for over a year, I've been working on one of the most complex stories I've ever covered. There was somebody out there who was faking pregnancies. I started, like, warning everybody. Every doula that I know. It was fake. No pregnancy.

And the deeper I dig, the more questions I unearth. How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's Baby. It's a long story, settle in. Available now.