The year in review, from the editors of The Atlantic’s Health channel
Some people with potentially lethal gut infections find that the only effective treatment is an orally-administered fecal transplant. The treatment is gaining acceptance among physicians.
Read more. [Image: B*2/Flickr]
Abraham Lincoln often spoke and dreamed about being assassinated, convinced that he would not outlast the rebellion when his work would have been done. Prior to his inauguration, he received letters warning him that he would be killed before reaching Washington. After he died an envelope with eighty such letters was found among his eﬀects, and although twice while president he had his hat shot from his head by unknown assailants, he deprecated all attempts to guard his life.
Read more. [Image: Wikipedia]
On April 28, 2009, a box containing a newly isolated virus showed up at Doris Bucher’s lab. She and her colleagues at New York Medical College opened it up right away. Thousands, or perhaps millions, of lives might depend on what they did next.
The virus was a new kind of influenza, known as 2009 H1N1. It had abruptly started spreading across North America in the previous month, and was beginning to appear in countries around the world. Once scientists at the Centers for Disease Control and Prevention analyzed it, they realized that the vaccine already in production for the next flu season probably wouldn’t be effective against it. And because it was so new, people’s immune systems might also be unable to stop the virus, which meant that it could become a global outbreak—a pandemic.
No one knew how bad 2009 H1N1 might prove to be, but the experts did know that the virus had the capacity to be very bad. Flu pandemics had occurred three times in the previous century, and the worst of them, the so-called Spanish Flu of 1918–19, had killed an estimated 50 million people. It, too, was an H1N1 virus. Once researchers at the CDC got hold of the 2009 H1N1 virus, they had one urgent mission: make a new vaccine.
The first step was to send batches of the virus to a handful of vaccine experts like Bucher. As soon as she received her supply of 2009 H1N1, she got to work on creating a “seed stock” of modified viruses that could be used to produce hundreds of millions of vaccine doses. Manufacturers for the most part still make flu vaccines the way they did in World War II: in chicken eggs. Bucher had to transform the viruses, which grow very well in human airways, so that they would grow very well in eggs.
Read more. [Image: Kevin Van Aelst]
Medical treatment for elderly, chronically ill patients is costly and often ineffective. Why better care may be found outside the hospital system.
Read more. [Image: Javier Jaén Benavides]
Your birthday is an inescapable mark, one of a small number of qualities in life you can never change, that accompanies you everywhere. Think about how often you write out or speak aloud those eight digits; they are one of the core confirmations of your identity, now and forever. I’m “Elijah Wolfson,” but to many I’m also “09/20/1985.”
The immutability of one’s nativity may be why so many are drawn to astrology—according to a 2009 Harris Poll, a full 26 percent of Americans believe in astrology (less than the number of UFO believers, but more than those that accept reincarnation as truth). Astrology builds on your birthday, giving it a meaning that goes well beyond that arbitrary 24-hour period so many years ago, of which you have no functional memory. It purports to help us understand the world through a system of relationships between astrological phenomena and human experience. Today, it takes its most popular form in the horoscope, found mostly in pop culture magazine and websites, and often focusing on foretelling the reader’s future in the realms of love and money.
Read more. [Image: Wikipedia]
In some new systems where doctors are reviewed by patients, physicians unwilling to supply addicts with pain pills receive poor patient-satisfaction feedback. That is judged as poor performance by hospital administrators.
We asked leading figures in technology, science, medicine, and design for nominations. Here’s what they said.
Scientists at the National Institutes of Health, the federal agency with a $30 billion budget responsible for funding medical research across the country, probably woke up Tuesday morning with, at best, audible sighs.
First, in the spring, there was sequestration—the automatic, across the board spending cuts that lopped off 5.5 percent of your budget. Now, thanks to the government shutdown, 73 percent of NIH staff is sitting at home, furloughed—among them, some of the most brilliant scientists and medical researchers in the word—and, thanks to a Congress whose mental health is open to debate, you’ve been put in the untenable position of turning away 200 patients to the NIH Clinical Center, including 30 children, many of them cancer patients.
Read more. [Image: Jason Reed/Reuters]
"It’s been more than 100 years since Abraham Flexner proposed the current model for medical education in North America," writes Dr. Richard Schwartzstein this month in the New England Journal of Medicine. That model is a four-year program: two years of studying science in classrooms, and two years learning by seeing patients in hospitals and clinics.
Those four years are just to get the doctor of medicine degree. For centuries, a physician would go straight into practice from there. Because today there’s so much more to learn, though, and escalating demand for specialists, doctors don’t actually practice until completing a residency. That involves clinical training of three to seven more years. And then, increasingly likely, a fellowship—one to three additional years.
Read more. [Image: bertknot/Flickr]