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International Patients, Seeking Cures in the States

December 18, 2018

Are they taking up beds that could be used for vulnerable domestic patients or are they bringing money that could be used toward other programs?

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International Patients, Seeking Cures in the States

Tuesday, December 18th, 2018

By Richard Leiter, MD

“I need you to do everything for him,” the young man told me through an Arabic interpreter.

We were at an impasse. We had many tools available to treat our patient’s pain and ease his suffering. But the young man wanted something more — a cure for his father, my patient. I backed away from the marble-topped table and left the bright, well-appointed family meeting room on the hospital’s top floor. Heading to see my other patients, I worried about what the next few days would hold for my patient.

He was a middle-aged man from a large city in Saudi Arabia. Over the course of a few months, his belly became swollen and painful. He lost weight and his skin turned a vibrant shade of yellow. He was eventually given a discouraging diagnosis: widely metastatic cholangiocarcinoma, a cancer of the gallbladder. It is an incurable disease with an average survival of only months.

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Image: By FoxDon – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=21692070

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NY Times

Why Don’t We Have Vaccines Against Everything?

November 20, 2018

Money is just the obvious obstacle. A few diseases, like H.I.V., so far have outwitted both the immune system and scientists

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Why Don’t We Have Vaccines Against Everything?

Tuesday, November 20th, 2018

11 THINGS WE’D REALLY LIKE TO KNOW

Vaccines are among the most ingenious of inventions, and among the most maddening.

Some global killers, like smallpox and polio, have been totally or nearly eradicated by products made with methods dating back to Louis Pasteur. Others, like malaria and H.I.V., utterly frustrate scientists to this day, despite astonishing new weapons like gene-editing.

We have a vaccine for Ebola that protects nearly 100 percent of its recipients, but we are lucky to get a routine flu shot that works half that well.

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NY Times

Grief as My Guide: How My Sister Made Me a Better Doctor

November 14, 2018

Even when she was gone, she was present in the patient sitting before me and in the way I was newly able to comfort and reassure her

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Grief as My Guide: How My Sister Made Me a Better Doctor

Wednesday, November 14th, 2018

The razor had a familiar thrum. Only this time, I wasn’t the one doing the shaving. I was watching as my sister’s remaining hair fell away.

She was putting on a brave face, joking with the hairdresser. Her defiant look said: “Leukemia’s not going to get me.” But in her eyes, I also saw terror. I wanted to rescue her, but there was nothing I could do.

Eighteen months younger than me, Victoria had always been there, someone I took for granted. When we played as children, she tried to keep up, to convince me she was cool and worthy of attention. We had weathered much together: a move to London, our parents’ divorce, a health crisis of my own. She always had my back. But with college, marriages, moves across the country, kids of our own, we grew apart. She became an actress; I became a neurosurgeon.

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Thumbimage via NYT/ Joseph Stern

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NY Times

Surgery in Space: Medicine’s Final Frontier

October 12, 2018

Astronauts on long-duration flights will need access to more than just routine care

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Surgery in Space: Medicine’s Final Frontier

Friday, October 12th, 2018

The concept of human space exploration of space has experienced something of a recent revival in the public consciousness. The private SpaceX and Virgin Galactic companies (and their eccentric front men) often make front-page news for their achievements and goals, which ultimately involve traveling to and colonizing distant planets. Though some decry these ambitions as extravagant fantasies, news pertaining to novel developments in extraterrestrial exploration often goes viral over digital media, reflecting genuine public interest in the topic.

Though we are technologically closer to realizing long-distance space travel than we were 50 years ago, significant engineering, financial and logistical obstacles remain. The health and well-being of participants on future exploratory or colonization missions encompasses all of the aforementioned. The medical needs of future explorers and colonists must be adequately met in the face of arguably the most adverse and unpredictable conditions humans will ever venture into.

…continue reading ‘Surgery in Space: Medicine’s Final Frontier’

Image: By Derek Springer from Los Angeles, CA, USA – Star Trek 017, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=4994823

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Scientific American

Nursing Homes Are Pushing the Dying Into Pricey Rehab

October 10, 2018

Elderly residents given intensive therapy in the last weeks of life jumped 65 percent, a study shows, raising questions about financial incentives

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Nursing Homes Are Pushing the Dying Into Pricey Rehab

Wednesday, October 10th, 2018

Nursing home residents are increasingly spending time in rehabilitation treatment during the last days of their lives, subjected to potentially unnecessary therapy that reaps significant financial benefits for cash-strapped facilities, a study shows.

The proportion of nursing home residents who received “ultrahigh intensity” rehabilitation increased by 65 percent from October 2012 to April 2016, according to research published this month by the University of Rochester. Medicare defines “very high” therapy as almost nine hours per week, and “ultrahigh” therapy as more than 12 hours per week. Some residents were found to have been treated with the highest concentration of rehabilitation during their last week of life.

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Bloomberg

The Importance of Medical Touch

October 8, 2018

It can show gentleness and compassion or carelessness and incompetence

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The Importance of Medical Touch

Monday, October 8th, 2018

It started, as it does for thousands of women every year, with a routine mammogram, and its routine process of having my breasts — like a lump of dough — manipulated by another woman’s hands and placed, albeit gently, into tight compression. It’s never comfortable, but you get used to it because you have to.

Unlike previous years, though, my next step was a biopsy, for which I lay face down, my left breast dangling through a hole in the table. Several hands reached for what’s normally a private and hidden body part and moved it with practiced ease, compressing it again into position for the radiologist’s needles, first a local anesthetic and then the probes needed to withdraw tissue for sampling.

I was fearful of the procedure and of its result and, to my embarrassment, wept quietly during the hour. A nurse gently patted my right shoulder and the male radiologist, seated to my left and working below me, stroked my left wrist to comfort me. I was deeply grateful for their compassion, even as they performed what were for them routine procedures.

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NYTimes

How Big Data Is Changing Science

October 2, 2018

New biomedical techniques, like next-generation genome sequencing, are creating vast amounts of data and transforming the scientific landscape. They’re leading to unimaginable breakthroughs – but leaving researchers racing to keep up

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How Big Data Is Changing Science

Tuesday, October 2nd, 2018

This is when I start feeling my age,” says Anne Corcoran. She’s a scientist at the Babraham Institute, a human biology research centre in Cambridge, UK. Corcoran leads a group that looks at how our genomes – the DNA coiled in almost every cell in our bodies – relate to our immune systems, and specifically to the antibodies we make to defend against infection.

She is, in her own words, an “old-school biologist”, brought up on the skills of pipettes and Petri dishes and protective goggles, the science of experiments with glassware on benches – what’s known as “wet lab” work. “I knew what a gene looked like on a gel,” she says, thinking back to her early career.

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Mosaic

‘Journalologists’ Use Scientific Methods to Study Academic Publishing

September 20, 2018

Is their work improving science? Drummond Rennie, with support from his editor-in-chief, George Lundberg, dreamed up the inaugural Peer Review Congress. He wanted to turn the lens of science onto the journals themselves

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