Longer Looks: The Dangers To Manicurists; Tom Brokaw’s Battle With Cancer; Nurse Confessions

The New York Times: Perfect Nails, Poisoned Workers
[S]tories of illness and tragedy abound at nail salons across the country, of children born slow or “special,” of miscarriages and cancers, of coughs that will not go away and painful skin afflictions. The stories have become so common that older manicurists warn women of child-bearing age away from the business, with its potent brew of polishes, solvents, hardeners and glues that nail workers handle daily. A growing body of medical research shows a link between the chemicals that make nail and beauty products useful — the ingredients that make them chip-resistant and pliable, quick to dry and brightly colored, for example — and serious health problems. (Sarah Maslin Nir, 5/8)

The New Yorker: Anatomy Of Error: A Surgeon Remembers His Mistakes
[Henry] Marsh, who is now sixty-five, is one of Britain’s foremost neurosurgeons. He is a senior consultant at St. George’s Hospital, in London, and he helped to pioneer a kind of surgery in which patients are kept awake, under local anesthesia, so that they can converse with their surgeons while they operate, allowing them to avoid damaging what neurosurgeons call “eloquent,” or useful, parts of the brain. Marsh has been the subject of two documentary films. Still, he writes, “As I approach the end of my career I feel an increasing obligation to bear witness to past mistakes I have made.” A few years ago, he prepared a lecture called “All My Worst Mistakes.” For months, he lay awake in the mornings, remembering the patients he had failed. “The more I thought about the past,” he recalls in his book, “the more mistakes rose to the surface, like poisonous methane stirred up from a stagnant pond.” (Joshua Rothman, 5/13)

NBC News: Tom Brokaw On Cancer Diagnosis: 'I Didn't Know What I Was In For'
Tom Brokaw was diagnosed with multiple myeloma, a treatable but incurable blood cancer, in August 2013. Through months of specialized treatment, he is in remission and he is opening up about his battle with the disease: "One of the things that I learned, and I had really good doctors, as individuals sometimes it wasn't as collective as I wanted it to be. So one of the things that you have to learn, even if you don't have the kind of advantage that I do — with the high profile and the access — you have to learn to manage your case. You have to take an active role in it. You either do it yourself, or you do it in conjunction with another physician, who's a friend, who's kind of wise counsel, who's there off to the side saying, 'You know, there may be another way of looking at this,' or there's 'I'm not happy with the protocol that they've come up with.' " (Tom Brokaw and Tim Uehlinger, 5/8)

Politico: Nurse Confessions: Don’t Get Sick In July
Many nurses call their profession—3.5 million strong in the United States and more than 20 million worldwide—a “secret club.” In the years I spent going behind the scenes in hospitals, I learned why. Their experiences are so novel, their jobs so intimate and occasionally horrifying, their combination of compassion and desensitization so peculiar, that nobody else could possibly understand what it is like to work in their once-white shoes. “Doctors breeze in and out. They do not share the most intimate moments with the patients, but they are the ‘important’ ones who get the media accolades,” a New Jersey nurse practitioner told me. “It is the nurse who holds the hand of a patient without a family, who talks to them while they take their last breaths. It is the nurse who cleans the patient’s body, wipes away the blood and fluids, and who says goodbye to the patient for the last time.” (Alexandra Robbins, 5/12)

Stanford Medicine: Hacking The Biological Clock
Cells in the human body follow cycles that repeat anywhere from once a second, in the case of a heartbeat, to once a month, for the female reproductive cycle. Living organisms have biological cycles that span all sorts of other time frames — the fastest-replicating bacterial cells duplicate every 15 minutes, bears hibernate annually, some cicada species emerge from the ground only once every 17 years, and many bamboo plants go for more than 60 years without flowering. Scientists have watched these cycles with awe, asking what keeps these clocks ticking. Slowly, they’ve revealed many of the molecular gears that let cells stay on schedule. And even among disparate species — and between cycles with drastically different periods — they have uncovered commonalities. ... With that knowledge in mind, scientists have now turned to a new type of question: How can we take advantage of what we know about the clock? (Sarah C.P. Williams, Spring 2015)

Health Affairs: The Fall: Aligning The Best Care With Standards Of Care At The End Of Life
As the former CEO of Denver Health, a large safety-net health care system in Colorado, where I also served as chief medical officer for most of my twenty-year tenure as CEO, I was a vigorous proponent of using the best available data to create standards of care. I embraced this as an essential pathway to reduce care variation and improve quality. Since a majority of our patients were members of minority communities, creating evidence-based standard care pathways for every person also seemed a way to reduce disparity. Clearly, I was a believer in a standardized approach to care. But when my ninety-four-year-old mother sustained a fall, my strong commitment to standards waned. (Patricia Gabow, 5/4)

Modern Healthcare: Herding Academic Cats: Engaging Doctors Is Key To Teaching Hospital Reforms
It's a tough challenge to engage academic physicians in managing the health of an enrolled patient population. Doctors traditionally have been trained to deal with the patient in front of them. Changing their focus to population health requires a different mindset. That's even more true for academic medical center doctors, who are steeped in teaching hospital traditions, or who may see clinical operations merely as a backup funding source for their research and education missions. But some academic medical center leaders are finding innovative ways of working with their doctors to make their organizations more competitive in today's cost-conscious healthcare market. They are also getting their faculty physicians to collaborate with community-based doctors in new payment and delivery models such as accountable care organizations. (Andis Robeznieks, 5/9)

Marketplace: 'Instagram For Doctors' Is Grisly And Useful
While you’re on Instagram looking at puppies, artisan desserts and celebrity selfies, some doctors are on a different photo sharing app, looking at gangrene, gallstones and rashes. ... It might seem like a strange thing to appreciate, but hundreds of thousands of people have created an account on Figure 1. Most are doctors, like [first-year emergency medicine resident John] Corker, who join the service to learn about medical conditions and share the occasionally gruesome photo. The x-rays, lesions, tumors and gunshot wounds are categorized by anatomy and specialty. Corker says in the emergency room, access like this is invaluable. (Lauren Silverman, 5/13)