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kottke.org posts about medicine

Former NFL player Aaron Hernandez had severe CTE

posted by Jason Kottke   Sep 22, 2017

Former New England Patriots player Aaron Hernandez, who was serving a life sentence for murdering a friend and who died in prison from suicide earlier this year, was found to have “a severe form” of CTE, a brain disease linked to repeated head trauma that has also been found in many other former NFL players.

Researchers who examined the brain determined it was “the most severe case they had ever seen in someone of Aaron’s age,” said a lawyer for Hernandez in announcing the result at a news conference on Thursday. Hernandez was 27.

Hernandez played three seasons in college and only three in the NFL, yet the damage to his brain was similar to “players with a median age of 67 years”. If you’re a young football player in college or the NFL right now, you have to be looking at this situation pretty hard right now.

See also: Don’t Let Kids Play Football, what the ball boy saw, I’m quitting football, NFL deliberately campaigned against science regarding head injuries, Junior Seau’s family sues NFL over concussions, how professional football might end (sooner than you think), and a message in an NFL player’s suicide.

Disturbed by on-field violence, top football TV analyst quits

posted by Jason Kottke   Aug 30, 2017

Former NFL player Ed Cunningham has resigned from his job as a college football color analyst for ABC/ESPN because of “his growing discomfort with the damage being inflicted on the players he was watching each week”.

If Ed Cunningham had not already seen enough, he would be back in a broadcast booth on Saturday afternoon, serving as the color analyst for another top college football game televised on ABC or ESPN. It is the work he has done each fall for nearly 20 years.

But Cunningham, 48, resigned from one of the top jobs in sports broadcasting because of his growing discomfort with the damage being inflicted on the players he was watching each week. The hits kept coming, right in front of him, until Cunningham said he could not, in good conscience, continue his supporting role in football’s multibillion-dollar apparatus.

Another domino falls. Unless there are big changes to the game play, sooner or later football will likely become a marginalized sport in the US.

Beating cancer is a team sport

posted by Jason Kottke   Jul 20, 2017

Senator John McCain has been diagnosed with a particularly aggressive form of brain cancer. The tumor has been removed and McCain is recovering at home with his family. I wish Senator McCain well and hope for a speedy recovery.

In the wake of his diagnosis, many of those expressing support for McCain reference his considerable personal strength in his fight against cancer. President Obama said:

John McCain is an American hero & one of the bravest fighters I’ve ever known. Cancer doesn’t know what it’s up against. Give it hell, John.

McCain’s daughter Meghan references his toughness and fearlessness in a statement released yesterday. Vice-President Joe Biden expressed similar sentiments on Twitter:

John and I have been friends for 40 years. He’s gotten through so much difficulty with so much grace. He is strong — and he will beat this.

This is the right thing to say to those going through something like this, and hearing this encouragement and having the will & energy to meet this challenge will undoubtably increase McCain’s chances of survival. But what Biden said next is perhaps more relevant:

Incredible progress in cancer research and treatment in just the last year offers new promise and new hope. You can win this fight, John.

As with polio, smallpox, measles, and countless other diseases before it, beating cancer is not something an individual can do. Being afflicted with cancer is the individual’s burden to bear but society’s responsibility to cure. In his excellent biography of cancer from 2011, The Emperor of All Maladies, Siddhartha Mukherjee talks about the progress we’ve made on cancer:

Incremental advances can add up to transformative changes. In 2005, an avalanche of papers cascading through the scientific literature converged on a remarkably consistent message — the national physiognomy of cancer had subtly but fundamentally changed. The mortality for nearly every major form of cancer — lung, breast, colon, and prostate — had continuously dropped for fifteen straight years. There had been no single, drastic turn but rather a steady and powerful attrition: mortality had declined by about 1 percent every year. The rate might sound modest, but its cumulative effect was remarkable: between 1990 and 2005, the cancer-specific death rate had dropped nearly 15 percent, a decline unprecedented in the history of the disease. The empire of cancer was still indubitably vast — more than half a million American men and women died of cancer in 2005 — but it was losing power, fraying at its borders.

What precipitated this steady decline? There was no single answer but rather a multitude. For lung cancer, the driver of decline was primarily prevention — a slow attrition in smoking sparked off by the Doll-Hill and Wynder-Graham studies, fueled by the surgeon general’s report, and brought to its full boil by a combination of political activism (the FTC action on warning labels), inventive litigation (the Banzhaf and Cipollone cases), medical advocacy, and countermarketing (the antitobacco advertisements). For colon and cervical cancer, the declines were almost certainly due to the successes of secondary prevention — cancer screening. Colon cancers were detected at earlier and earlier stages in their evolution, often in the premalignant state, and treated with relatively minor surgeries. Cervical cancer screening using Papanicolaou’s smearing technique was being offered at primary-care centers throughout the nation, and as with colon cancer, premalignant lesions were excised using relatively minor surgeries. For leukemia, lymphoma, and testicular cancer, in contrast, the declining numbers reflected the successes of chemotherapeutic treatment. In childhood ALL, cure rates of 80 percent were routinely being achieved. Hodgkin’s disease was similarly curable, and so, too, were some large-cell aggressive lymphomas. Indeed, for Hodgkin’s disease, testicular cancer, and childhood leukemias, the burning question was not how much chemotherapy was curative, but how little: trials were addressing whether milder and less toxic doses of drugs, scaled back from the original protocols, could achieve equivalent cure rates.

Perhaps most symbolically, the decline in breast cancer mortality epitomized the cumulative and collaborative nature of these victories — and the importance of attacking cancer using multiple independent prongs. Between 1990 and 2005, breast cancer mortality had dwindled an unprecedented 24 percent. Three interventions had potentially driven down the breast cancer death rate-mammography (screening to catch early breast cancer and thereby prevent invasive breast cancer), surgery, and adjuvant chemotherapy (chemotherapy after surgery to remove remnant cancer cells).

Understanding how to defeat cancer is an instance where America’s fierce insistence on individualism does us a disservice. Individuals with freedom to pursue their own goals are capable of a great deal, but some problems require massive collective coordination and effort. Beating cancer is a team sport; it can only be defeated by a diverse collection of people and institutions working hard toward the same goal. It will take government-funded research, privately funded research, a strong educational system, philanthropy, and government agencies from around the world working together. This effort also requires a system of healthcare that’s available to everybody, not just to those who can afford it. Although cancer is not a contagious disease like measles or smallpox, the diagnosis and treatment of each and every case brings us closer to understanding how to defeat it. We make this effort together, we spend this time, energy, and money, so that 10, 20, or 30 years from now, our children and grandchildren won’t have to suffer like our friends and family do now.

Google search data shows “a crisis of self-induced abortions”

posted by Jason Kottke   Jun 26, 2017

For his book Everybody Lies: Big Data, New Data, and What the Internet Can Tell Us About Who We Really Are, Seth Stephens-Davidowitz combed through data on Google Trends for five years, looking for data on searches that Google users “don’t tell to possibly anybody else, things they might not tell to family members, friends, anonymous surveys, or doctors”.

According to a recent interview with Stephens-Davidowitz, right now the data is showing an increase in search queries on how to perform abortions at home and, no surprise, the activity is highest in parts of the country where access to abortion is most difficult.

I’m pretty convinced that the United States has a self-induced abortion crisis right now based on the volume of search inquiries. I was blown away by how frequently people are searching for ways to do abortions themselves now. These searches are concentrated in parts of the country where it’s hard to get an abortion and they rose substantially when it became harder to get an abortion. They’re also, I calculate, missing pregnancies in these states that aren’t showing up in either abortion or birth rates.

That’s pretty disturbing and I think isn’t really being talked about. But I think, based on the data, it’s clearly going on.

What bullets do to bodies

posted by Jason Kottke   Jun 16, 2017

Emergency room doctor Leana Wen writes in the NY Times about what bullets do to human bodies.

Early in my medical training, I learned that it is not the bullet that kills you, but the damage from the bullet. A handgun bullet enters the body in a straight line. Like a knife, it damages the organs and tissues directly in its path, and then it either exits the body or is stopped by bone, tissue or skin.

This is in contrast to bullets from an assault rifle. They are three times the speed of handgun bullets. Once they enter the body, they fragment and explode, pulverizing bones, tearing blood vessels and liquefying organs.

Earlier this year, Jason Fagone wrote a much longer piece on the same topic for HuffPost.

“As a country,” Goldberg said, “we lost our teachable moment.” She started talking about the 2012 murder of 20 schoolchildren and six adults at Sandy Hook Elementary School. Goldberg said that if people had been shown the autopsy photos of the kids, the gun debate would have been transformed. “The fact that not a single one of those kids was able to be transported to a hospital, tells me that they were not just dead, but really really really really dead. Ten-year-old kids, riddled with bullets, dead as doornails.” Her voice rose. She said people have to confront the physical reality of gun violence without the polite filters. “The country won’t be ready for it, but that’s what needs to happen. That’s the only chance at all for this to ever be reversed.”

She dropped back into a softer register. “Nobody gives two shits about the black people in North Philadelphia if nobody gives two craps about the white kids in Sandy Hook. … I thought white little kids getting shot would make people care. Nope. They didn’t care. Anderson Cooper was up there. They set up shop. And then the public outrage fades.”

I think about this tweet all the time:

In retrospect Sandy Hook marked the end of the US gun control debate. Once America decided killing children was bearable, it was over.

Dylan Matthews donated a kidney to a complete stranger

posted by Jason Kottke   Apr 11, 2017

Last August, Dylan Matthews donated one of his kidneys to someone he’d never met before.

On Monday, August 22, 2016, a surgical team at Johns Hopkins Hospital in Baltimore removed my left kidney. It was then drained of blood, flushed with a preservative solution, placed on ice, and flown to Cincinnati.

Surgeons in Cincinnati then transplanted the kidney into a recipient I’d never met and whose name I didn’t know; we didn’t correspond until this past month. The only thing I knew about him at the time was that he needed my kidney more than I did. It would let him avoid the physically draining experience of dialysis and possibly live an extra nine to 10 years, maybe more.

Why did he do it? Because he thought it was the right thing to do morally.

I’d wanted to give a kidney for years — at least since I first heard it was possible after reading Larissa MacFarquhar’s New Yorker piece on “good Samaritan” kidney donors when I was in college. It just seemed like such a simple and clear way to help someone else, through a procedure that’s very low-risk to me. I studied moral philosophy as an undergrad, and there’s a famous thought experiment about a man who walks by a shallow pond where a child is drowning and does nothing, because leaping in to save the child might muddy his clothes.

As Matthews notes, all you need to do to get started on the road to becoming a living donor is fill out this form.

An epidemic of middle-aged male loneliness

posted by Jason Kottke   Mar 10, 2017

Um…

Vivek Murthy, the surgeon general of the United States, has said many times in recent years that the most prevalent health issue in the country is not cancer or heart disease or obesity. It is isolation.

Oh.

Beginning in the 1980s, Schwartz says, study after study started showing that those who were more socially isolated were much more likely to die during a given period than their socially connected neighbors, even after you corrected for age, gender, and lifestyle choices like exercising and eating right. Loneliness has been linked to an increased risk of cardiovascular disease and stroke and the progression of Alzheimer’s. One study found that it can be as much of a long-term risk factor as smoking.

The research doesn’t get any rosier from there. In 2015, a huge study out of Brigham Young University, using data from 3.5 million people collected over 35 years, found that those who fall into the categories of loneliness, isolation, or even simply living on their own see their risk of premature death rise 26 to 32 percent.

Eep!

That fainting life

posted by Jason Kottke   Mar 10, 2017

Fainting

Isabella Rotman drew a comic for The Nib about her life as a hemophobe (someone who faints at the sight of blood).

Once at a former deli job, I passed out onto a pizza oven in response to a coworker’s particularly graphic description of a lawn mower injury. Had the oven been on, I would have suffered some pretty drastic burns.

I’m a fainter, though not at the sight of blood. After fainting a couple of times in high school, a doctor chalked it up to low blood pressure — I am the chillest mofo you know, blood pressure-wise — and urged me not to stand up too quickly after lying down. Just this morning, I did not heed that advice and almost toppled over after getting out of bed and stretching my arms above my head.

But my bigger problem, and what made Rotman’s comic resonate with me, is that medical procedures and doctor’s offices also cause me to faint. This wasn’t always the case. When I was younger, I received allergy shots up to three times a week and had no problem going into the clinic to get my shot…I even looked at the thin needle going into my arm every time. Flu shots, dentist visits, doctor’s appointments? No problem. Then when I was 17, I went to the local clinic for a mandatory physical for college. They did a blood draw, which went smoothly, but right afterwards, as I was sitting in a chair in the hallway, I fainted — probably because of my low blood pressure. Weird, but not a big deal.

Fast forward 12-15 years, during which time (because I was young and healthy and dumb and medical care is expensive) I did not visit a doctor’s office1 and somehow I had developed a phobia of needles going into my skin. I found this out when I went to get a flu shot, watched the needle sink into my arm, and promptly passed the fuck out.2 Since then, any time I’ve had to get a shot or blood drawn, I have fainted (or at least felt like I was going to).

That’s bad enough, but the problem became psychosomatic. Any trip to a doctor’s office will now trigger a faint feeling, even if I’m not the patient. Every time I take my kids to the pediatrician, there’s a possibility I’ll end up on the floor. When my wife was pregnant with our first kid, I nearly fainted at one of her ultrasound appointments and the ultrasound tech plopped me down in a nearby chair and handed me a glucose drink, telling me that becoming a father is a lot to handle for some men. (I think I nodded weakly, not even able to muster a “yeah, it’s not that”.) It’s gotten to the point where even *thinking* about it makes me feel weird. My palms have been sweaty and I’ve felt lightheaded the entire time I’ve been writing this post. The same thing happens when I tell people about it in person. It’s ridiculous and I feel stupid about it, even though it’s a stark reminder how much your subconscious thoughts can affect your body (and how little control we have over ourselves sometimes).

As Rotman did, I have been attempting exposure therapy with some success. When I went in for a physical a few months ago, I told the nurse that I might faint during the blood draw. She had me lay down on the table and just before she came over with the kit, I popped my headphones in and put on some relaxing music (Tycho I think). I broke out in a sweat and the procedure took much longer than it should have — she had to stick me *twice* because she didn’t get enough the first time — but I got through it without passing out. Progress to build on, I hope!

  1. Aside from a trip to the emergency room from — you guessed it! — a fainting incident when I was 24. Came to on the floor of the bathroom having slammed my mouth on the edge of the counter. It was exactly as painful as it sounds and it totally fucked up my grill.

  2. And wow, did the nurse look alarmed when I came to a few seconds later. They all look alarmed, even when I tell them ahead of time that I might faint. One of the last times, the nurse said, “I didn’t think you were actually serious.” (That fainting experience was the weirdest one I’ve ever had. According to the nurse, I was out for about 6-8 seconds but had a whole experience in my head that lasted for at least a half hour. I wasn’t near death, but it felt very real and I can definitely see how some people would interpret that as an out-of-body or religious experience.)

The best medical science images of the year

posted by Jason Kottke   Mar 06, 2017

Wellcome Images 2017

Wellcome Images 2017

Wellcome Images 2017

The Wellcome Image Awards 2017 recognize the best images related to healthcare and biomedical science taken during the past year.

The Wellcome Image Awards are Wellcome’s most eye-catching celebration of science, medicine and life. Now in their 20th year, the Awards recognise the creators of informative, striking and technically excellent images that communicate significant aspects of healthcare and biomedical science. Those featured are selected from all of the new images acquired by Wellcome Images during the preceding year. The judges are experts from medical science and science communication.

From top to bottom, there’s Mark R. Smith’s photo of a baby Hawaiian bobtail squid, neural stem cells growing on a synthetic gel photographed by Collin Edington and Iris Lee, and Scott Echols’ image of a pigeon’s blood vessel network. (via digg)

Harrowing illegal abortion stories from before Roe v. Wade

posted by Jason Kottke   Feb 21, 2017

Before the Roe v. Wade Supreme Court decision in 1973, most women seeking abortions in the US had to get them illegally. Illegal abortions were often unsafe & painful, and many women died, were injured, or were sexually assaulted by the men performing the procedures. In this video, three women who had abortions before 1973 and a woman who worked at a Brooklyn hospital in that era described their experiences.

“He said, ‘I’m not going to give you any anesthetic’ and he said ‘If you scream, they will hear you.’”

That’s how Connie described the illegal abortion she received in 1953 when she was 16 years old. Now a retired teacher, mother and grandmother, Connie said that after she received the abortion, the man who performed the procedure proceeded to sexually assault her as she lay bleeding on the table.

The Gates Foundation Annual Letter for 2017

posted by Jason Kottke   Feb 17, 2017

Each year, Bill and Melinda Gates write a letter about the work they’re doing with the Bill and Melinda Gates Foundation. In 2006, Warren Buffett donated more than billion to their foundation, which effectively doubled its available resources. This year’s letter from the Gateses is addressed to Buffett and details the return on his investment so far.

Bill: If we could show you only one number that proves how life has changed for the poorest, it would be 122 million — the number of children’s lives saved since 1990.

Melinda: Every September, the UN announces the number of children under five who died the previous year. Every year, this number breaks my heart and gives me hope. It’s tragic that so many children are dying, but every year more children live.

Bill: More children survived in 2015 than in 2014. More survived in 2014 than in 2013, and so on. If you add it all up, 122 million children under age five have been saved over the past 25 years. These are children who would have died if mortality rates had stayed where they were in 1990.

Bill calls saving children’s lives “the best deal in philanthropy”. Melinda continues:

Melinda: And if you want to know the best deal within the deal — it’s vaccines. Coverage for the basic package of childhood vaccines is now the highest it’s ever been, at 86 percent. And the gap between the richest and the poorest countries is the lowest it’s ever been. Vaccines are the biggest reason for the drop in childhood deaths.

Melinda: They’re an incredible investment. The pentavalent vaccine, which protects against five deadly infections in a single shot, now costs under a dollar.

Bill: And for every dollar spent on childhood immunizations, you get $44 in economic benefits. That includes saving the money that families lose when a child is sick and a parent can’t work.

Vaccines. And Now my kids don’t die.

A short animated history of Planned Parenthood

posted by Jason Kottke   Jan 20, 2017

From Now This, a short animated history of Planned Parenthood, the origins of which date back more than 100 years.

No woman can call herself free who does not own and control her body.

Voices in the video include Mindy Kaling, Amy Schumer, and Meryl Streep.

“Life is a preexisting condition waiting to happen”

posted by Jason Kottke   Jan 17, 2017

I posted earlier about Atul Gawande’s piece in the New Yorker on the importance of incremental care in medicine. One of the things that the Affordable Care Act1 did was to make it illegal for insurance companies to deny coverage to people with “preexisting conditions”, which makes it difficult for those people to receive the type of incremental care Gawande touts. And who has these preexisting conditions? An estimated 27% of US adults under 65, including Gawande’s own son:

In the next few months, the worry is whether Walker and others like him will be able to have health-care coverage of any kind. His heart condition makes him, essentially, uninsurable. Until he’s twenty-six, he can stay on our family policy. But after that? In the work he’s done in his field, he’s had the status of a freelancer. Without the Affordable Care Act’s protections requiring all insurers to provide coverage to people regardless of their health history and at the same price as others their age, he’d be unable to find health insurance. Republican replacement plans threaten to weaken or drop these requirements, and leave no meaningful solution for people like him. And data indicate that twenty-seven per cent of adults under sixty-five are like him, with past health conditions that make them uninsurable without the protections.

That’s 52 million people, potentially ineligible for health insurance. And that’s not counting children. Spurred on by Gawande, people have been sharing their preexisting conditions stories on Twitter with the hashtag #the27Percent.

The 27% figure comes from a recent analysis by the Kaiser Family Foundation:

A new Kaiser Family Foundation analysis finds that 52 million adults under 65 — or 27 percent of that population — have pre-existing health conditions that would likely make them uninsurable if they applied for health coverage under medical underwriting practices that existed in most states before insurance regulation changes made by the Affordable Care Act.

In eleven states, at least three in ten non-elderly adults would have a declinable condition, according to the analysis: West Virginia (36%), Mississippi (34%), Kentucky (33%), Alabama (33%), Arkansas (32%), Tennessee (32%), Oklahoma (31%), Louisiana (30%), Missouri (30%), Indiana (30%) and Kansas (30%).

36% uninsurable in West Virginia! You’ll note that all 11 of those states voted for Trump in the recent election and in West Virginia, Trump carried the day with 68.7% of the vote, the highest percentage of any state. The states whose people need the ACA’s protection the most voted most heavily against their own interest.

Update: An earlier version of this post unfairly pinned the entire blame for the lack of coverage of those with preexisting conditions on the insurance companies.2 I removed the last paragraph because it was more or less completely wrong. Except for the part where I said we should be pissed at the Republican dickheads in Congress who want to repeal the ACA without replacing it with something better.3 And the part where we should be outraged. And the part where we regulated cars and cigarettes and food to make them safer, forced companies to build products in ways they didn’t want, and saved millions of lives. We can’t make everyone healthier and raise taxes to do it? Pathetic for what is supposedly the world’s most powerful and wealthy nation. (thx @JPVMan + many others)

  1. I hope, for the love of Pete, that everyone reading this site is aware that the Affordable Care Act (the ACA) is Obamacare. Obamacare is the derogatory name the Republicans gave to the ACA that everyone, including Obama himself, ended up using. Which is unfortunate. President Obama and his administration deserve neither all of the credit nor should shoulder all of the blame for the ACA.

    I would also like to add that I, as a (very) small business owner, rely on the protections afforded by the ACA to get insurance coverage for me and my family. Something to keep in mind if you otherwise don’t know anyone who would be affected by the ACA’s repeal. (Of course, the cushy insurance policy you get through work might be affected as well, you never know.)

  2. At the heart of the ACA is a compromise between the US government and the insurance companies. The insurance companies don’t want to sell people insurance only when people are sick…that would be prohibitively expensive. That’s where the preexisting conditions thing comes in. So, the ACA says, ok, you have to sell insurance to people with preexisting conditions and we’ll make sure that everyone has to buy insurance, whether they’re sick or not. That bargain makes sure more people are covered and gives the insurance companies a larger pool of people to draw premiums from.

    You can see why Republicans don’t like it: it forces people to buy something even if they don’t want to and it forces companies to sell things to people they would rather not sell. And as a bonus, people the Republicans don’t give a shit about — women, the poor, people of color — are disproportionately helped by the ACA. So they’ll repeal it and replace it with magic! And the only cost will be an increase in dead Americans.

  3. I am all for this, BTW. If Paul Ryan and Donald Trump come up with a plan to give better and cheaper healthcare coverage to everyone in America, let’s do it.

Slow and steady wins the healthcare race

posted by Jason Kottke   Jan 17, 2017

In a piece called The Heroism of Incremental Care for the New Yorker, surgeon Atul Gawande argues that our healthcare system is built for and celebrates heroic intensive care over the slower but more effective efforts of long-term primary care givers.

We have a certain heroic expectation of how medicine works. Following the Second World War, penicillin and then a raft of other antibiotics cured the scourge of bacterial diseases that it had been thought only God could touch. New vaccines routed polio, diphtheria, rubella, and measles. Surgeons opened the heart, transplanted organs, and removed once inoperable tumors. Heart attacks could be stopped; cancers could be cured. A single generation experienced a transformation in the treatment of human illness as no generation had before. It was like discovering that water could put out fire. We built our health-care system, accordingly, to deploy firefighters. Doctors became saviors.

But the model wasn’t quite right. If an illness is a fire, many of them require months or years to extinguish, or can be reduced only to a low-level smolder. The treatments may have side effects and complications that require yet more attention. Chronic illness has become commonplace, and we have been poorly prepared to deal with it. Much of what ails us requires a more patient kind of skill.

A human-powered paper centrifuge

posted by Jason Kottke   Jan 13, 2017

Testing human blood for tropical diseases like malaria can be difficult in some parts of the world. Centrifuges used to separate the blood for testing are expensive and require electricity. Researchers from Stanford have developed an ingenious human-powered centrifuge made of paper and string inspired by a children’s toy invented 5000 years ago (paging Steven Johnson, Steven Johnson to the courtesy desk please).

In a global-health context, commercial centrifuges are expensive, bulky and electricity-powered, and thus constitute a critical bottleneck in the development of decentralized, battery-free point-of-care diagnostic devices. Here, we report an ultralow-cost (20 cents), lightweight (2 g), human-powered paper centrifuge (which we name ‘paperfuge’) designed on the basis of a theoretical model inspired by the fundamental mechanics of an ancient whirligig (or buzzer toy; 3,300 BC). The paperfuge achieves speeds of 125,000 r.p.m. (and equivalent centrifugal forces of 30,000 g), with theoretical limits predicting 1,000,000 r.p.m. We demonstrate that the paperfuge can separate pure plasma from whole blood in less than 1.5 min, and isolate malaria parasites in 15 min.

A million rpm from paper and string…that’s incredible. (via gizmodo)

“This is what happens to the bodies of the women you know”

posted by Jason Kottke   Dec 19, 2016

My friend Courtney Skott wrote an intense piece about the three miscarriages she’s had, including one just a couple of weeks ago. (Note: you may find the images disturbing, but that might also be a good thing.)

It wasn’t until after that miscarriage that I learned how common they are. But even if you know the statistics — that perhaps 20% of confirmed pregnancies miscarry — they are easy to dismiss. After all, it’s much more likely that you will be in the other 80%, isn’t it? But 1 in 5 is still pretty high, and once you start telling your friends that you had a miscarriage, all the miscarriages around you come out of the woodwork. “My sister had one. My best friend had one. I had two.”

Why didn’t I know that before?

Waaaay more people should know this — I didn’t until, well, you know. Like Courtney says, you don’t realize until you start talking to other people about it and…”out of the woodwork” is right.

Can hypothermia save lives in the trauma center?

posted by Jason Kottke   Nov 22, 2016

Nicola Twilley reports on a relatively new technique being used in a Baltimore trauma center: freezing trauma victims to give the doctors working on them more time to save their lives.

When this patient loses his pulse, the attending surgeon will, as usual, crack his chest open and clamp the descending aorta. But then, instead of trying to coax the heart back into activity, the surgeon will start pumping the body full of ice-cold saline at a rate of at least a gallon a minute. Within twenty minutes (depending on the size of the patient, the number of wounds, and the amount of blood lost), the patient’s brain temperature, measured using a probe in the ear or nose, will sink to somewhere in the low fifties Fahrenheit.

At this point, the patient, his circulatory system filled with icy salt water, will have no blood, no pulse, and no brain activity. He will remain in this state of suspended animation for up to an hour, while surgeons locate the bullet holes or stab wounds and sew them up. Then, after as much as sixty minutes without a heartbeat or a breath, the patient will be resuscitated.

Brain damage is a risk — as is, you know, dying from hypothermia — but there are many instances of people surviving even after their hearts stop for an hour or two.

AIDS and the myth of Patient Zero

posted by Jason Kottke   Oct 31, 2016

Some recent genetic testing of the blood of AIDS patients has determined that the strain of HIV responsible for the majority of the AIDS cases in the US spread from Zaire to Haiti around 1967, from Haiti to NYC around 1971, and from there to San Francisco around 1976 and that Gaétan Dugas (aka Patient Zero) was not responsible for setting the epidemic in motion.

The strain of H.I.V. responsible for almost all AIDS cases in the United States, which was carried from Zaire to Haiti around 1967, spread from there to New York City around 1971, researchers concluded in the journal Nature. From New York, it spread to San Francisco around 1976.

The new analysis shows that Mr. Dugas’s blood, sampled in 1983, contained a viral strain already infecting men in New York before he began visiting gay bars in the city after being hired by Air Canada in 1974.

The researchers also reported that originally, Mr. Dugas was not even called Patient Zero — in an early epidemiological study of cases, he was designated Patient O, for “outside Southern California,” where the study began. The ambiguous circular symbol on a chart was later read as a zero, stoking the notion that blame for the epidemic could be placed on one man.

Abnormal heartbeat EKG waves

posted by Jason Kottke   Oct 20, 2016

Abnormal EKG

This is a lovely infographic from Eleanor Lutz of a bunch of different heartbeat EKG waves, from a normal heartbeat to a flatline to ventricular fibrillation (“must be treated immediately with CPR and defibrillation”.) Prints are available.

Should we use CRISPR to engineer mosquitoes incapable of transmitting malaria?

posted by Jason Kottke   Sep 21, 2016

Thousands of people die every day from malaria, a disease that is transmitted to humans solely through mosquitoes. With CRISPR, scientists can easily genetically engineer mosquitoes incapable of transmitting malaria and using a technique called gene drive, they can force that genetic change into the native mosquito population. So, should we do it?

100 objects that shaped public health

posted by Jason Kottke   Sep 15, 2016

From the School of Public Health at Johns Hopkins comes this list of 100 things that have “made their mark on public health”, good and bad. Here’s a sampling of the objects:

Horseshoe crab. We all owe a debt of gratitude to the helmet-shaped horseshoe crab, whose ancestors date back 450 million years. From vaccines to needles to pacemakers, any IV drug or medical equipment that will come in contact with the human body must first be safety-checked using a test that comes from a clotting compound in the crab’s blood. This compound can detect even the smallest amount of deadly bacteria and is sensitive enough to isolate a threat equivalent to the size of a grain of sand in a swimming pool.

Vaccines. Immunization is one of the most important public health achievements in human history. Vaccines helped eradicate smallpox globally and eliminate polio in the United States. The introduction of effective vaccines has also drastically reduced deaths from measles, diphtheria, rubella, pertussis (“whooping cough”) and other diseases that sickened hundreds of thousands of Americans in the early 20th century.

American Cheese. Food processing was actually developed to make food safer. Milk is pasteurized to kill harmful organisms, and canning and freezing foods such as meats, fruits and vegetables helps them last longer. But the food industry has taken processing well beyond these early origins. Often, to extend a food’s shelf life, manufacturers increase fats, sugars, and salt and add in chemical flavorings, emulsifiers, and other additives — taking foods that could have been healthy and making them much less so.

Pap smear. Since its introduction in 1955, the Pap smear has reduced death from cervical cancer by more than 60 percent. Invented by Dr. Georgios Papanikolaou, the Pap smear is a diagnostic procedure in which a health-care professional swabs a cell sample from the cervix and sends it to a lab to see if any of the cells are malignant. Before the invention of the Pap smear, cervical cancer was one of the leading causes of death for women of childbearing age in the United States. Today, it comes in at number 14 on the list of cancers found in women.

Spittoons. Spittoons were developed centuries ago as receptacles for spitting — think ashtrays for saliva. These brass or even porcelain repositories were everywhere: In homes, train stations, saloons and even the U.S. Congress. They were meant for men to dispose their chewing tobacco and the abundant phlegm that accompanied the habit. Convenience turned to concern in the late 19th century when a global tuberculosis epidemic took hold and scientists realized that spittoons might actually spread diseases. Some argued that when people spat in the general direction of a spittoon and missed the target, they caused a greater health threat than if the spittoon hadn’t been there at all.

Vaccines. And now my kids don’t die.

If Our Bodies Could Talk, a FAQ for human bodies

posted by Jason Kottke   Sep 02, 2016

If Our Bodies Could Talk

James Hamblin, the dishy brainiac doctor who does those entertaining and informative videos for The Atlantic, is coming out with a book in December called If Our Bodies Could Talk. He calls it “a FAQ about human bodies”.

Now, in this original and entertaining book, Hamblin explores the stories behind health questions that never seem to go away — and which tend to be mischaracterized and oversimplified by marketing and news media. He covers topics such as sleep, aging, diet, and much more:

Can I “boost” my immune system?
Does caffeine make me live longer?
Do we still not know if cell phones cause cancer?
How much sleep do I actually need?
Is there any harm in taking a multivitamin?
Is life long enough?

The coming CRISPR revolution

posted by Jason Kottke   Aug 11, 2016

Perfect eyesight. Curing cancer. Designer babies. Super-soldiers. Because of CRISPR, genetic engineering might make tinkering with life as easy as playing with Lego.

Imagine you were alive back in the 1980’s, and were told that computers would soon take over everything — from shopping, to dating, and the stock market, that billions of people would be connected via a kind of web, that you would own a handheld device orders of magnitudes more powerful than supercomputers.

It would seem absurd, but then all of it happened. Science fiction became our reality and we don’t even think about it. We’re at a similar point today with genetic engineering. So let’s talk about it.

Relatedly, I’m finishing up Neal Stephenson’s Seveneves right now and while it starts out as space science fiction, much of the book is concerned with the sort of genetic engineering issues discussed in the video.

The trippy past and scientific future of psychedelics

posted by Jason Kottke   May 17, 2016

After The Man freaked out back in the 60s, LSD and other psychedelics were banned and criminalized. But slowly, scientists are experimenting with psychedelics to treat depression, anxiety, and other ailments.

In the 1960s, a psychologist and former Harvard teacher named Timothy Leary coined the phrase ‘Turn on. Tune in. Drop out.’ The slogan was inspired by advertising jingles, but Leary wasn’t pushing a product, he was promoting a drug: LSD.

But today, scientists are studying psychedelics once again, in the latest twist in the long, strange story of LSD.

Even outside of a therapeutic setting, many people extolled the beneficial effects of psychedelics. Former Apple CEO Steve Jobs recalled in his biography by Walter Isaacson:

Taking LSD was a profound experience, one of the most important things in my life. LSD shows you that there’s another side to the coin, and you can’t remember it when it wears off, but you know it. It reinforced my sense of what was important — creating great things instead of making money, putting things back into the stream of history and of human consciousness as much as I could.

Check out the NY Times companion piece and the archival footage of LSD experiments on cats, spiders, and goats.

The Demon in the Freezer

posted by Jason Kottke   May 17, 2016

Errol Morris has made a short film about the world’s remaining stocks of smallpox virus 1 and the debate between those who want to eliminate the virus forever and those who want to keep it around.

In the story from classical Greece, Pandora was warned: Don’t open the box. She opens it anyway. The various pestilences are unleashed on the world but Hope remains at the very bottom of the box. Today there are microbiologists who want to continue to research smallpox. If they are given a free hand, what might they unleash?

There are those who insist that these residual stocks of smallpox should not be destroyed because some ruthless super-criminal or rogue government might be working on a new smallpox, even more virulent than existing strains of the virus. We may need existing stocks to produce new vaccines to counteract the new viruses. New viruses, new vaccines. New vaccines, new viruses. An escalating arms race with germs.

Keep this video in mind when you read about the latest advances with CRISPR.

  1. I’m going to embed the video here, even though it seems like every time I embed a video from anywhere but YouTube or Vimeo, it either autoplays or, even worse, autoplays with the sound on. Also, while I was watching on the Times’ site, the video was glitchy and stopped twice, prompting two reloads. I get why the Times (and other media outlets) want to develop their own embeddable media, but until they get it right, they should leave it to Vimeo and YouTube, the only two sites who have actually gotten it right.

Superbugs, the antibiotic apocalypse explained

posted by Jason Kottke   Mar 16, 2016

The latest video from Kurzgesagt is an explainer on antibiotics and superbugs (drug resistant bacteria).

What would you say if we told you that humanity is currently making a collaborative effort to engineer the perfect superbug, a bug that could kill hundreds of millions of people?

DIY orthodontics

posted by Jason Kottke   Mar 14, 2016

Diy Braces

Amos Dudley wanted to improve his smile but didn’t want to pay thousands of dollars for Invisalign, so he 3D printed his own orthodontic aligners.

I took a mold of my teeth with some cheap alginate powder, Permastone, and a 3d printed impression tray, to get a better picture of what was really going on. Notice LI-r (right lateral incisor) projected outward, and CI-r (right central incisor) depressed inward and overlapping.

At the time of writing this, I’m an undergrad, which means that a) I’m broke, and b) I have access to expensive digital fabrication tools - definitely an unusual dichotomy. I was researching [name brand clear-aligner treatment], and I ran across a photo that caught my eye.

Those look like the layer striations from a 3D print!

What is to stop someone, who has access to a 3D printer, from making their own orthodontic aligners?

Update: Unsurprisingly, orthodontists feel that DIY dentistry is not such a great idea.

Belli notes, “He moved these teeth in only 16 weeks. You can cause a lot of problems with that. If you move a tooth too fast, you can actually cause damage to the bone and gums. And if you don’t put the tooth in the right position, you could throw off your bite,” leading to additional damage and wear on the teeth.

“By the time you read this, I’ll be dead”

posted by Jason Kottke   Mar 05, 2016

John Hofsess helped eight people die and just before he died late last month at an assisted death facility in Switzerland, he wrote this piece.

I was horrified anew in 1999 when the gifted conductor Georg Tintner, who was dying from a rare form of melanoma, jumped from the balcony of his 11th-floor apartment in Halifax to end his agony. Many Canadians would hear such news, shake their heads, utter a few sympathetic platitudes and move on. But I couldn’t just sit back and wring my hands. That year, I went from advocating for assisted suicides to facilitating them. Let’s not mince words: I killed people who wanted to die.

(via nextdraft)

John Oliver takes on crazy US abortion laws

posted by Jason Kottke   Feb 22, 2016

On the most recent episode of Last Week Tonight, John Oliver argues against many US states’ anti-abortion laws. This was super funny and also made me really angry.

Inside the mosquito factory

posted by Jason Kottke   Feb 17, 2016

In an all-white room, mosquitoes are mated and the resulting larvae divided by sex. Workers whisk at stray mosquitoes with electrified tennis rackets — the kind you see in novelty stores, but which have sold out in mosquito-obsessed Brazil.

MIT Tech Review takes you inside the mosquito factory that could stop Zika and other diseases. (Add “working in a mosquito factory” to the list of jobs I’m glad I don’t have…)