Longer Looks: Bacteria On The Brain; Abortion Rhetoric; Texting Therapists

The New Yorker: Bacteria On The Brain
The prognosis for glioblastoma is grim. Even with the standard treatment—surgery, radiation, and chemotherapy—the median survival time from diagnosis is little more than fourteen months. But for decades talk has circulated in the field about glioblastoma patients who, despite hospitals’ efforts to keep the O.R. free of germs, acquired a “wound infection” during surgery to remove their tumors. These patients, it was said, often lived far longer than expected. A 1999 article in Neurosurgery described four such cases: brain-tumor patients who developed postoperative infections and survived for years, cancer-free. Three of the patients were infected with Enterobacter, the fecal bacterium, and although the cases were anecdotal, and the alleged connection between the bacterium and survival was unproven, the notion became operating-room lore. One neurosurgeon, currently in private practice, told me that his former boss would joke during operations, “If I ever get a GBM, put your finger in your keister and put it in the wound.” (Emily Eakin, 11/29)

The Wall Street Journal: Second Acts: A Retired Surgeon Takes On A New Medical Mission
Leonard Glass, a retired surgeon, had an idea about who could help fill these much-needed shoes: older medical specialists. For example, many surgeons retire due to diminishing eyesight or fine-motor problems, while obstetricians often burn out in their 60s after decades of sleepless nights. Yet these doctors are still capable of providing general medical care. Dr. Glass himself retired from practicing surgery in 2005 when a neck injury began limiting his dexterity. “I kept reading about this impending doctor shortage, and I looked around at many of my retired colleagues and thought, why not get some of these doctors back to work?” says Dr. Glass, now 80. (Essick, 11/29)

The New York Times Magazine: Planned Parenthood And The Tinderbox Of Abortion Rhetoric
Before the shooting, abortion opponents like Cruz, Yoest and Fiorina weren’t advocating violence, of course. They were calling on Congress to investigate and stop funding Planned Parenthood. The group doesn’t receive federal money to pay for abortions; Congress has barred that since 1977 (except in the rare case of rape, incest or saving the life of the mother). But Planned Parenthood receives $450 million in federal funds annually, mostly from Medicaid, to provide health care like birth control and testing for sexually transmitted diseases to low-income women. Abortion opponents have every right to lobby to take the funding away, and to use whatever language they choose in doing so. The First Amendment protects them. But that doesn’t mean that the killings necessarily came from nowhere, or that no one cautioned that the recent burst of angry accusations carried a physical risk (Emily Bazelon, 11/3)

The New York Times: Could Your Healthy Diet Make Me Fat?
Some people eat as little fat as possible to lose weight and stay healthy, while others avoid carbohydrates. A vegan diet (with no animal products) and the paleo diet (with lots) both have enthusiastic devotees. One popular diet encourages intermittent fasting, another frequent small meals. Who’s right? Perhaps they all are, according to the new field of “personalized nutrition.” This month, an Israeli study of personalized nutrition was heralded by a media frenzy. “This diet study upends everything we thought we knew about ‘healthy’ food,” claimed one headline. The study suggested that dieters may be mistakenly eating a lot of some foods, like tomatoes, that are good for most people, but bad for them. And it raised the possibility that an individualized approach to nutrition could eventually supplant national guidelines meant for the entire public. (David S. Ludwig, 11/28)

52 Insights: Talking To The Dead
A shocking and little known fact: only 3% of individuals that die worldwide have an official cause of death certificate. More specifically, in India, a country of over a billion people, 80% of deaths take place outside the healthcare system. Indian-Canadian epidemiologist Prabhat Jha saw this as a serious problem and decided to fix it. In 2002, he initiated a revolutionary project, the Million Death Study, where he planned to create a cause of death index which would effectively verify data on how these millions of people had passed. An ambitious project by any measure, it has covered the length and breadth of India, with many volunteers and health care officials carrying out verbal autopsies in 2.3 million homes, on 14 million people. This is a project which has and will change global health policy for years to come. (11/26)

STAT: Psychotherapy By Emoji: Mental Health Community Wrestles With Texting
It’s not the first time the field has wrestled with technological change, experts say. For therapists to communicate with patients by phone or Skype is now far from unusual, especially in urgent situations. And texting has become a kind of native dialect for teenagers and young adults. (Eric Boodman, 11/30)

The Atlantic: Covering Transgender Care Is Good Economics For Insurance Companies
While insurers are increasingly starting to pay for gender-reassignment surgery and hormone therapy (as of 2014, the Centers for Medicare and Medicaid Services no longer ban such coverage, for example), many still do not—even though the American College of Physicians, the American Medical Association, and the American Psychological Association are just a few of the many organizations that consider gender-transition services to be medically necessary for transgender people. (Julie Beck, 12/1)

Vox: Why Doctors Overprescribe Antibiotics — Even In Cases Where They're Useless
Colds and flus are caused by viruses. Antibiotics do not treat viruses; they're designed to treat bacteria. Taking an antibiotic for your cold or flu will not work. No one should ever do it. Yet despite these very simple facts, many people continue to take antibiotics when they have a cold or flu. It's one reason behind the rise of antibiotic-resistant bacteria. (Julia Belluz, 11/27)

Pacific Standard: How Big Pharma Gave America Its Heroin Problem
This is all far in the past, but I've been thinking about my gall bladder surgery recently, as headlines of record heroin overdoses have filled the news cycle. Earlier this month, CBS's 60 Minutes ran with the theme in their piece "Heroin in the Heartland." Correspondent Bill Whitaker trotted out the usual narratives—Mexican drug cartels and bored suburbanite kids meeting up; the Mexicans getting rich; the rich kids dying. But the segment didn't go into much detail about the real cause: Americans are addicted to pain meds—legal and illegal—because the United States' medical community had redefined who needed these meds and who didn't. (Daniel McGraw, 11/30)

Aeon: The Neurofix
For leading edge baby boomers who are now well past 60, the road has flattened, the fires of ambition have been banked and, barring an unusual late career surge, whatever territory we’ve conquered is all we’re going to claim in this life. Now we’re just trying to prevent it all from slip sliding away. No amount of Botox or Pilates can stave off the loss of brain cells, a steady erosion that began, ironically, in the days when we were part of the Woodstock nation. (Linda Marsa, 11/27)