Category: Health

The “Deliciously Guilty Pleasure” and “Disorienting Joy” of California Skiing in August

(p. A20) This weekend, . . . hordes of Californians are smearing pink and yellow zinc oxide on noses, shoving feet into hard plastic ski boots and gliding over to the lifts at Mammoth Mountain for yet another day on the slopes. A reminder: It’s August.

. . .

Unpredictable change is the new status quo.  . . . it can also, in a rare instance like the chance to ski in the dog days of summer, bring a disorienting joy.

. . .

In mid-July [2023], well after all the hot dogs and fireworks, I headed up to the Sierra and ran into so much lingering snow that the road through Yosemite National Park hadn’t yet opened for the season. I took an alternate route, 108 over Sonora Pass, and saw people parking in turnouts, carrying skis up dirt trails through trees, stepping onto sunny snow slopes and linking turns back down to ice chests full of cold drinks before, you know, maybe going for a swim. When I finally got to Kelly’s place, the creek on her high desert property frothed in a fabulous white and clear torrent through sage lands sparkling with superblooming yellow mule’s ear, red paintbrush and white phlox. The big peaks, meanwhile — in the dead heat of a California summer — remained so heavily blanketed in snow that I felt I was seeing them the way Indigenous people must have during the Little Ice Age, 500 years ago.

The premise of California’s secular faith in nature is that water plus sunshine equals enlightenment. In high school I was transfixed by a description on the jacket of Bank Wright’s classic “Surfing California” of “skiing Mount Baldy in the morning and surfing Hermosa Beach in the afternoon.” That struck the teenage me as the absolute perfect way of snatching healthy peace and giddy fun from the predictable maw of adult misery.

. . .

. . . when I drove to Mammoth, put on my favorite cowboy hat against the sun and sipped iced coffee while watching tiny black figures ski down blinding white slopes, the experience was perhaps best likened to the queasy adrenalized thrill of an oncoming manic episode after a long and dark depression — worrisome, yes, bound for nowhere good but, as long as we’re just talking here and now, a deliciously guilty pleasure.

For the full commentary, see:

Daniel Duane. “The Upside of Climate Chaos? Skiing in August.” The New York Times (Monday, August 7, 2023): A20.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the commentary has the date Aug. 6, 2023, and has the title “It’s August. Californians Are Still Skiing. Don’t Ask.”)

“Proud Symbol of Britain’s Welfare State” in “Deepest Crisis of Its History”

(p. A1) As it turns 75 this month, the N.H.S., a proud symbol of Britain’s welfare state, is in the deepest crisis of its history: flooded by aging, enfeebled patients; starved of investment in equipment and facilities; and understaffed by doctors and nurses, many of whom are so burned out that they are either (p. A6) joining strikes or leaving for jobs abroad.

Interviews over three months with doctors, nurses, patients, hospital administrators and medical analysts depict a system so profoundly troubled that some experts warn that the health service is at risk of collapse.

. . .

(p. A6) More than 7.4 million people in England are waiting for medical procedures, everything from hip replacements to cancer surgery. That is up from 4.1 million before the coronavirus pandemic began in 2020.

Mortality data, exacerbated by long wait times, paints a bleak picture. In 2022, the number of excess deaths rose to one of the highest levels in the last 50 years, and those numbers have kept rising, even as the pandemic has ebbed.

In the first quarter of 2023, more than half of excess deaths — that is, deaths above the five-year average mortality rate, before the pandemic — were caused by something other than Covid-19. Cardiovascular-related fatalities, which can be linked to delays in treatment, were up particularly sharply, according to Stuart McDonald, an expert on mortality data at LCP, a London-based pension and investment advisory firm.

For the full story, see:

Mark Landler. “After 75 Years, Health Service In U.K. Teeters.” The New York Times (Monday, July 17, 2023): A1 & A6-A7.

(Note: ellipsis added.)

(Note: the online version of the story has the date July 16, 2023, and has the title “A National Treasure, Tarnished: Can Britain Fix Its Health Service?”)

Perverse Medicare Pricing Incentives Drive Hospital Consolidation Inefficiency

(p. A17) Currently, Medicare pays hospital-owned facilities two to three times as much as independent physician offices for the same service, according to the Alliance for Site Neutral Payment Reform. This creates an enormous incentive for large hospital chains to acquire outpatient practices. Consolidation creates a vicious circle in which larger hospital systems can demand ever higher rates from insurers and also have the capital to buy up physician practices. Removing this perverse incentive will ensure that patients have access to trusted doctors and appropriate care at the same price regardless of treatment location and remove artificial pressure to consolidate.

These bipartisan reforms would deliver hundreds of billions in savings for families. Site-neutral payments would save taxpayers more than $153 billion in Medicare spending over the next decade and also substantially reduce premiums and cost-sharing for Medicare beneficiaries by $94 billion, according to CRFB. In total, these changes could save patients and taxpayers between $346 billion and $672 billion over the next decade.

Large hospital systems have exploited our nation’s outdated billing systems to foist gigantic bills on Americans. Bringing much-needed transparency in hospital billing will deliver more affordable care and put patients back in control.

For the full commentary, see:

Bobby Jindal and Charlie Katebi. “Doctor’s Office Care at Hospital Prices.” The Wall Street Journal (Thursday, July 27, 2023): A17.

(Note: the online version of the commentary has the date July 26, 2023, and has the same title as the print version.)

Scientists Had Political Motives for Dismissing Wuhan Lab-Based Covid Origin

(p. A17) On March 17, 2020, the journal Nature Medicine published a paper by five scientists, “The Proximal Origin of SARS-CoV-2,” that dismissed “any type of laboratory based scenario” for the origin of the pandemic. It was cited by thousands of news outlets to claim that the virus emerged naturally. But Slack messages and emails subpoenaed and released by the House Oversight Select Subcommittee on the Coronavirus Pandemic suggest that some of the authors didn’t believe their own conclusions. Before, during and even after the publication of their paper, they worried privately that Covid-19 was caused by a laboratory escape, perhaps even of a genetically engineered virus.

. . .

On April 16, a month after publication, Mr. Andersen wrote that “I’m still not fully convinced that no culture was involved” and “we also can’t fully rule out engineering”—i.e., that the virus not only was released from the lab but had been genetically manipulated there. He worried about the Wuhan lab’s research on live SARS-like viruses from bats at low biosafety levels: “it’s definitely concerning work, no question about it.”

So why did they publish a paper denying that laboratory origin was plausible? The answer may lie in their messages. In early February 2020, Mr. Rambaut wrote: “Given the s— show that would happen if anyone serious accused the Chinese of even accidental release, my feeling is we should say that given there is no evidence of a specifically engineered virus, we cannot possibly distinguish between natural evolution and escape so we are content to ascribing it to natural processes.”

Mr. Andersen replied: “I totally agree that that’s a very reasonable conclusion. Although I hate when politics is injected into science—but it’s impossible not to.”

. . .

To adjust the conclusions in a scientific paper for political reasons isn’t part of the scientific process. The world was misled with serious consequences.

For the full commentary, see:

Matt Ridley and Alina Chan. “The Covid Lab-Leak Deception.” The Wall Street Journal (Thursday, July 27, 2023): A17.

(Note: ellipses added.)

(Note: the online version of the commentary has the date July 26, 2023, and has the same title as the print version.)

Elderly Benefit Most from Air-Conditioning

(p. A18) The aging process makes older bodies generally less capable of withstanding extreme heat, doctors say.

“They’re at extremely high risk of heat stroke and death,” James H. Diaz, a professor of environmental and occupational health sciences at Louisiana State University’s School of Public Health, said of older people. “When we look at what happens with these heat waves, most of the deaths occur in the homebound elderly.”

In many communities, including in New Orleans and Houston, officials have opened cooling centers and shelters in recent weeks, with air-conditioned shuttle buses meandering through neighborhoods, picking people up. Programs are also in place to provide or repair air-conditioners or help people struggling to afford their electricity bills.

. . .

In . . . Orlando, Veronica King, 67, said she keeps her air-conditioner running even if she can’t afford to. “I have to figure out how to cover that bill,” she said, adding that she relies on machines that help her breathe. “When it’s hot, I can’t breathe.”

In Houston, where the heat index could reach 107 degrees on Sunday, Ms. Lowry and her husband, Jasper, 72, have come up with a compromise. They have two cars, neither with working air-conditioning. But they figured they could at least spare the money to repair it in one of them.

For the full story, see:

Shannon Sims and Rick Rojas. “Rising Temperatures Could Bring More Than Misery for Seniors.” The New York Times, First Section (Sunday, July 9, 2023): 18.

(note: ellipses added.)

(Note: the online version of the story was updated July 12, 2023, and has the title “Rising Temperatures Threaten More Than Misery for Oldest Americans.”)

Rage That Transplant Medicine Stagnates

The essay quoted below provides one more example of why we should unbind medical entrepreneurs to allow them to bring us more and faster cures.

(p. 8) Today, I will explain to my healthy transplanted heart why, in what may be a matter of days or weeks at best, she — well, we — will die.

. . .

Organ transplantation is mired in stagnant science and antiquated, imprecise medicine that fails patients and organ donors.

. . .

Over the last almost four decades a toxic triad of immunosuppressive medicines — calcineurin inhibitors, antimetabolites, steroids — has remained essentially the same with limited exceptions. These transplant drugs (which must be taken once or twice daily for life, since rejection is an ongoing risk and the immune system will always regard a donor organ as a foreign invader) cause secondary diseases and dangerous conditions, including diabetes, uncontrollable high blood pressure, kidney damage and failure, serious infections and cancers. The negative impact on recipients is not offset by effectiveness: the current transplant medicine regimen does not work well over time to protect donor organs from immune attack and destruction.

. . .

I am speaking for my transplant cardiologist, the finest physician I have ever known, who sat across from me last month and cried into his palms when he told me I had incurable cancer.

For the full essay, see:

Amy Silverstein. “My Donor Heart And I Will Die Soon.” The New York Times, SundayOpinion Section (Sunday, April 23, 2023): 8.

(Note: ellipsis added; in the original, the word “we” in the first sentence is in italics.)

(Note: the online version of the essay has the date April 18, 2023, and has the title “My Transplanted Heart and I Will Die Soon.”)

See also:

Williams, Alex. “Amy Silverstein, Who Chronicled a Life of Three Hearts, Dies at 59.” The New York Times (Weds., May 17, 2023): A21.

Some of the issues raised in Silverstein’s essay were earlier discussed in her book:

Silverstein, Amy. Sick Girl. New York: Grove Press, 2007.

Simple Beeping Pagers Tell Patients a Doctor’s Distraction Is Work-Related

(p. A10) Pagers, those pre-cellphone, one-way devices that alert the carrier that someone is trying to reach them, can seem like something out of a time capsule.

. . .

There are people who just refuse to let their pagers go, including some doctors and bird watchers. They say pagers allow them to separate parts of their life in a way phones don’t, and that the lower-tech one-way communication of a pager is less distracting than looking at a phone full of alerts and apps.

. . .

Another advantage of the pager? It’s easy for staff to throw one in frustration instead of turning on each other, according to Dr. Colm McCarthy, an orthopedic surgeon in Fall River, Mass.

Tired during a busy on-call night once, he chucked his pager in a closet where it broke.

He gave up his pager when he got his current job, and transitioned over to the apps on his phone. Now, though, when he gets a message on his phone, it’s awkward to answer it, he says. If he’s looking at the phone, he worries patients might wonder what he’s paying attention to while with a pager, it’s obvious it’s work.

He has multiple apps on his phone. Last year, his hospital adopted the fourth app that connects him to patients. When a patient wants to reach him, he gets a message with a phone number. He then has to call that number to get a message with the patient’s phone number.

The mute function on the apps is easily overridden by alerts, so to separate work from home life, he keeps his phone on silent altogether, he says. He often misses messages from family and friends because of that.

For the full story, see:

Ariana Perez-Castells. “What the Beep? Die-Hards Refuse to Let Go of Their Pagers.” The Wall Street Journal (Monday, May 20, 2023): A1 & A10.

(Note: ellipses added.)

(Note: the online version of the story has the date May 19, 2023, and has the same title as the print version.)

Communists Want Us to Forget the 1.6 Million Chinese They Murdered in Cultural Revolution

(p. A23) It would seem impossible to forget or minimize the Cultural Revolution in China, which lasted from 1966 to 1976, resulted in an estimated 1.6 million to two million deaths and scarred a generation and its descendants. The movement, which under Mao Zedong’s leadership sought to purge Chinese society of all remaining non-Communist elements, upended nearly every hallowed institution and custom. Teachers and schools long held in esteem were denounced. Books were burned and banned, museums ransacked, private art collections destroyed. Intellectuals were tortured.

But in China, a country where information is often suppressed and history is constantly rewritten — witness recent government censorship of Covid research and the obscuring of Hong Kong’s British colonial past in new school textbooks — the memory of the Cultural Revolution risks being forgotten, sanitized and abused, to the detriment of the nation’s future.

The Chinese government has never been particularly eager to preserve the memory of that sordid decade. When I spent six weeks traveling in China in 1994 — a slightly more open time in the country — I encountered few public acknowledgments of the Cultural Revolution. Museum placards and catalogs often simply skipped a decade in their timelines or provided brief references in the passive voice along the lines of “historical events that took place.”

But in her new book, “Red Memory: The Afterlives of China’s Cultural Revolution,” the journalist Tania Branigan notes that under Xi Jinping, China’s top leader, efforts to suppress this history have intensified — with troubling implications for the political health of the country at a time when it looms larger than ever on the world stage. “When you’ve had a collective trauma, you really need a collective response,” she told me recently. “I can see why the Communist Party wants to avoid the rancor and bitterness, but when you don’t have that kind of acknowledgment, you can move on — but you can’t really recover.”

For the full commentary, see:

Pamela Paul. “The Decade That China Cannot Delete.” The New York Times (Friday, May 19, 2023): A23.

(Note: the online version of the commentary has the date May 18, 2023, and has the title “The Decade That Cannot Be Deleted.”)

The book on the cultural revolution mentioned above is:

Branigan, Tania. Red Memory: The Afterlives of China’s Cultural Revolution. New York: W. W. Norton & Company, 2023.

Mice on Taurine Lived 10% Longer and Looked Healthier

(p. A3) Scientists are exploring a new biological link to longer life.

Boosting levels of an amino acid called taurine made mice and worms live longer, according to research published Thursday [June 7, 2023] in the journal Science. Middle-aged monkeys given taurine supplements became healthier, researchers said. In humans, lower levels of taurine were associated with age-related problems.

“This is a very promising molecule,” said Vijay Yadav, an assistant professor of genetics and development at Columbia University, who co-wrote the paper.

People have been searching for life-extending substances for millennia. Other recent studies have explored antiaging properties of compounds including resveratrol, found in red wine, and the immunosuppressive drug rapamycin. Yadav said he first suspected taurine’s connection with aging over a decade ago when his lab compared the contents of blood drawn from people of different ages.

. . .

Researchers gave daily doses of taurine to hundreds of 14-month-old mice, considered middle-aged, and compared their average lifespans to mice that didn’t get extra taurine. The female mice given taurine lived 12% longer on average and male mice that got taurine lived 10% longer, researchers said.

Mice that received taurine also appeared to be healthier.

For the full story, see:

Dominique Mosbergen. “Amino Acid Found To Slow Down Aging.” The Wall Street Journal (Friday, June 9, 2023): A3.

(Note: ellipsis, and bracketed date, added. The online version is longer, but the passages quoted above appear in both versions.)

(Note: the online version of the story was updated June 9, 2023, and has the title “Is Taurine the Key to Longer Life? It Made Monkeys Healthier.”)

The Science paper on taurine mentioned above is:

Singh, Parminder, Kishore Gollapalli, Stefano Mangiola, Daniela Schranner, Mohd Aslam Yusuf, Manish Chamoli, Sting L. Shi, Bruno Lopes Bastos, Tripti Nair, Annett Riermeier, Elena M. Vayndorf, Judy Z. Wu, Aishwarya Nilakhe, Christina Q. Nguyen, Michael Muir, Michael G. Kiflezghi, Anna Foulger, Alex Junker, Jack Devine, Kunal Sharan, Shankar J. Chinta, Swati Rajput, Anand Rane, Philipp Baumert, Martin Schönfelder, Francescopaolo Iavarone, Giorgia di Lorenzo, Swati Kumari, Alka Gupta, Rajesh Sarkar, Costerwell Khyriem, Amanpreet S. Chawla, Ankur Sharma, Nazan Sarper, Naibedya Chattopadhyay, Bichitra K. Biswal, Carmine Settembre, Perumal Nagarajan, Kimara L. Targoff, Martin Picard, Sarika Gupta, Vidya Velagapudi, Anthony T. Papenfuss, Alaattin Kaya, Miguel Godinho Ferreira, Brian K. Kennedy, Julie K. Andersen, Gordon J. Lithgow, Abdullah Mahmood Ali, Arnab Mukhopadhyay, Aarno Palotie, Gabi Kastenmüller, Matt Kaeberlein, Henning Wackerhage, Bhupinder Pal, and Vijay K. Yadav. “Taurine Deficiency as a Driver of Aging.” Science 380, no. 6649 (June 9, 2023): eabn9257.

So-Called “Inflation Reduction Act” Mandates Pharma Firms Dishonestly Say They Voluntarily Negotiated Prices

(p. A15) The pharmaceutical company Merck claims in a lawsuit filed this week that the “Drug Price Negotiation Program for Medicare,” part of last summer’s Inflation Reduction Act, is an unconstitutional taking of company’s property and a violation of the company’s freedom of speech. If successful, this lawsuit will prevent the unconstitutional practice of forcing drug companies to sell drugs to the U.S. government at a government-determined price.

To make the provision of the 2022 law constitutional, Congress could have imposed price controls, or it could have bargained with pharmaceutical companies using the massive marketing power of Medicare, which accounts for some half of all American drug spending. Instead, Congress tried to prevent pharmaceutical companies from walking away from any potential deal. Under the act, secret negotiations force pharmaceutical companies to agree to government-determined prices amounting to massive discounts off market-based prices, under the threat of crippling taxes and penalties.

Americans tend to support pharmaceutical “price negotiations,” but oppose “price controls.” Knowing this, Congress set up a ruse.

. . .

. . ., the law essentially requires a company to communicate that it agreed to the set price—compelled speech that is prohibited by the First Amendment. Time and again, the Supreme Court has declared forced speech beyond the power of the government. The government’s only seeming interest is to pretend that a system of unilateral price controls and mandated sales is actually a system of voluntary negotiations.

For the full commentary, see:

Daniel E. Troy. “An Unconstitutional Offer Drug Companies Can’t Refuse.” The Wall Street Journal (Friday, June 9, 2023): A15.

(Note: ellipses added.)

(Note: the online version of the commentary has the date June 8, 2023, and has the same title as the print version.)

Man Died When Pharmacist Refused to Give Him EpiPen Without the Mandated Prescription

(p. A15) Rates of hospital admissions for asthma, nut allergies in children, and prescriptions for EpiPens (used to treat extreme reactions) have all tripled in recent decades. Not only are food allergies now more common in children, but they are less likely to be outgrown with age than in years past.

The causes and consequences of this epidemic are the subject of “Allergic,” an important and deeply researched book by Theresa MacPhail, a medical anthropologist who memorably portrays the human face of disease.   . . .   Ms. MacPhail . . . has a personal connection to this subject: Her father died after being stung by a bee on the main street of the New Hampshire town where she grew up. (His girlfriend drove him to a drugstore instead of a hospital; even though he was in extremis, the pharmacist refused to dispense an EpiPen without a prescription.)

For the full review, see:

John J. Ross. “BOOKSHELF; Runny Noses, Itchy Eyes.” The Wall Street Journal (Wednesday, May 24, 2023): A15.

(Note: ellipses added.)

(Note: the online version of the review has the date May 23, 2023, and has the title “BOOKSHELF; ‘Allergic’ Review: Runny Noses, Itchy Eyes.”)

The book under review is:

MacPhail, Theresa. Allergic: Our Irritated Bodies in a Changing World. New York: Random House, 2023.