Life After Aids

Advances in pharmacology have beaten back HIV/Aids, at least in rich countries. Deaths are “incredibly rare” in Britain. “For those diagnosed with HIV now, life expectancy is similar to someone who does not have the virus. The medical profession considers HIV a chronic disease in the same category as, for example, type 2 diabetes. As a doctor I can tell you that, medically speaking, I’d rather have HIV than diabetes” (Metered paywall) (1,130 words)

Tax The Childless

Slash taxes on parents. “As a childless professional in my mid-30s I often reflect on the sacrifices working parents make to better the lives of their children. I have come to the reluctant conclusion that I ought to pay much higher taxes so that working parents can pay much lower taxes. The willingness of parents to bear and nurture children saves us from becoming an economically moribund nation” (1,140 words)

Watching A Brain Surgeon At Work Pick of the day

Brain surgery is “like bomb disposal work”, says Henry Marsh, a British neurosurgeon; “with the crucial difference that it is only the patient’s life at risk, not the surgeon’s”. Marsh’s memoir, Do No Wrong, is “a self-lacerating document: by and large, it contains stories not of triumph, or the author’s skill and expertise, but of the emotional and psychological toll exacted when things go horribly wrong” (3,920 words)

Diary: “Sh-t, I’ve Had A Stroke” Pick of the day

On having a stroke. “I bent down to push some rubbish into the already stuffed bin. When I stood up half the world had disappeared. It had disappeared but it was still there, sort of. The kitchen wall was visible but it didn’t seem quite right. The mirror had become a window, but all that could be seen in this window was the wall on the other side of the room, behind me or behind where I used to be. Where had I gone?” (4,196 words)

The Overprotected Kid

Sensible, much-needed discussion of over-anxious parenting, part of our wider fetishising of safety over freedom. “It’s hard to absorb how much childhood norms have shifted in just one generation. Actions that would have been considered paranoid in the 1970s — walking third-graders to school, forbidding your kid to play ball in the street — are now routine. In fact, they are the markers of good, responsible parenting” (8,860 words)

Getting Cancer Wrong

Radiologist Robert Gatenby wants to model the behaviour of cancers mathematically so that their movements become “as predictable as those of a hurricane”, and easier to arrest. It’s a big job; he’s been at it for 30 years; but “complexity doesn’t mean there aren’t simple rules”, starting with those of evolution. Doctors should aim to “understand cancer with the same totality that Newton understood gravity” (4,160 words)

Not The Marrying Kind Pick of the day

A novelist tells his father, a high court judge, that he is gay: “The coming-out speech is a relatively unvarying form because the event has only two parts, a clearing of the throat to demand attention and then a simple phrase that can’t be taken back (I’m gay). After that, as it seems to the person making the declaration, the fixed points disappear. All clocks return to zero hour and the speakers have new voices issued to them” (4,360 words)

My Dementia Pick of the day

Teacher describes losing her mind to dementia, as her mother did before her. One small miracle: Her ability to write stays with her. “Persons having spent a lifetime mastering particular knowledge structures may retain access to this expertise even after becoming utterly dependent on others in living their lives”. But there is no ducking “the statistically meaningful downward migration of my IQ on the bell curve” (10,600 words)

A Mad World

Psychiatrist discusses “diagnostic creep” — the conceptualising of more and more patterns of behaviour as mental illness. “We don’t think that everyone is crazy, nor are we necessarily guilty of pathologising normal existence”. The question is always whether treatment might be useful: “A continuous view of mental illness extends into areas that might actually be normal, but still detract from optimal, day-to-day function” (2,100 words)

Zero Dark Cavity

A new chewing gum could save the US Army $100m a year by reducing tooth decay. “They’re calling it combat gum”. Dental emergencies “account for 10% of all injuries that cause soldiers to be evacuated from the battlefield”, not counting battle itself. The gum contains a “synthetic sequence of anti-microbial peptides” which mimics bacteria-killing molecules naturally found in saliva. Civilians will get it eventually (750 words)

The Behavioural Benefits Of Castration Pick of the day

A vet reflects. In a single week he has castrated “40 calves, two colts, three dogs, one cat, one ferret and a coatimundi”, mostly for “behavioural rather than medical reasons”. Dogs no longer lunge at the legs of passers-by; geldings graze peaceably in fields; rabbits fight less and cease to mate with their siblings. “Freed from desire, they appear to be contented. Brave new world! Time to sharpen the knives for Homo sapiens(690 words)

Reaching My Autistic Son Through Disney

An autistic boy learns to speak, read, write and draw by immersing himself in Disney films, identifying with their characters and borrowing their dialogue. It may be that the films, viewed many times over, provide simple, vivid paradigms — “beauty lies within, be true to yourself, love conquers all” — that the autistic mind can appropriate and use as points of reference in an otherwise confusing world (Metered paywall) (8,800 words)

The Indian Sanitary Pad Revolutionary Pick of the day

Heroic tale of an unschooled Indian entrepreneur who has “revolutionised menstrual health for rural women” by “inventing a simple machine they can use to make cheap sanitary pads”. He tested prototypes using goat’s blood from a friendly butcher; “everyone thought he’d gone mad”; family and friends shunned him; even his wife left him, for a time. The secret of his resilience: “Being uneducated, you have no fear of the future” (2,800 words)

Closing Time

From the LRB archives: Review of of How We Die, by Sherwin Nuland, who died this week. “The fascination of this book lies not primarily in its biology lessons for the layman but in the stories it tells of the mysterious places where we die: the insides of our bodies … We learn how sepsis comes to be the terminal event in a cancer patient’s life and why she is so thin; why Dr Livingstone, being attacked by a lion, probably felt no pain” (1,060 words)

Can’t We Talk About Something More Pleasant?

Graphic memoir about life with — and, eventually, the death of — elderly parents. “Graphic” in the sense that this is an artist’s sketchbook, not that it is particularly shocking; although it is deeply moving, and may, indeed, be a masterpiece of some kind. “I wasn’t great as a caretaker, and they weren’t great at being taken care of”

What Good Are Children?

You’d have to be an economist to ask that question; and here is an economist’s answer. “Study after study has shown that those who live with children are less satisfied with their lives than those who do not.” Should governments issue warnings to prospective parents? That depends on your perspective. “Perhaps the attractions of children are a deception necessary to keep in motion the continuation of mankind” (1,448 words)

Naked, Covered In Ram’s Blood, Feeling Pretty Good Pick of the day

Notes from a trip to Senegal, to discover how depression is treated there. The answer: With a shamanistic ceremony called an ndeup, which involves taking off your clothes, rubbing your chest with millet, and getting into a wedding bed in the town square with a ram. Next: “The poor old ram’s throat was slit, as were the throats of the two cockerels. And I was covered in the blood of the freshly slaughtered ram and cockerels” (2,640 words)

Obama’s Trauma Team Pick of the day

Another healthcare magnum opus from Brill, one year on from his acclaimed investigation of hospital billing. This time, a deep dig into the healthcare.gov fiasco, and how a team of geeks from Silicon Valley rescued the site from total failure. Beneath the tech problem, the political problem: “It is the story of an Obama Administration obsessed with healthcare reform policy but above the nitty-gritty of implementing it” (6,900 words)

Cognitive Science Explained

Brisk tour of current knowledge. There may be effective treatments for Alzheimer’s within ten years, based on catching the disease early. No evidence that any common virus is a “major cause” of neurological disorders such as autism and schizophrenia, but “gut in the bacteria is a fascinating area of research right now”. Chronic use of marijuana by adolescents “can lead to cognitive decline, especially in working memory” (1,280 words)

The Seductive Appeal Of Cultural Stereotypes

Critical review of The Triple Package, by Amy Chua and Jed Rubenfeld, which claims that the “secret to success” in America is to be raised by Jewish, Chinese, Indian or Nigerian parents. The authors avoid “the grossest racism”. But they need be held to a higher standard of evidence. Too much of their argument relies on anecdotes. “We always find stereotyping plausible. That is why it is treacherous” (740 words)

The Smart-Pill Oversell

Pills for attention-deficit disorders — usually methylphenidate or amphetamine — do calm people down and increase the ability to concentrate. These behavioural changes “make the drugs useful”. But “a growing body of evidence suggests that the benefits mainly stop there”. Medicated children don’t perform measurably better in later life. “Much beyond a year the benefits either vanish or shrink to clinically meaningless proportions” (2,570 words)

This Old Man: Life In The Nineties

“I’m ninety-three, and I’m feeling great. Well, pretty great, unless I’ve forgotten to take a couple of Tylenols in the past four or five hours. I get around with a couple of arterial stents that keep my heart chunking. My conversation may be full of holes and pauses, but I’ve learned to dispatch a private Apache scout ahead into the next sentence to see if there are any vacant names or verbs in the landscape” (5,000 words)

Your Oral Surgeon Loves You

Trigger alert: There’s a lot of dentistry in here. But if you don’t mind the scraping and sewing, a nice little story. “An implant seemed like the best option for long-term dental happiness. It would be expensive, yes. Also, very painful. And it was a nine-month process. But on the plus side, I’d have the implant for 20 years, and my jawbone would stay healthy. I decided to be brave, suck up the expense, and count my blessings” (1,230 words)

Extreme Medicine

Interview with Dr Kevin Fong, specialist in extreme-environment medicine. Topics include: doctors in space, freezing to death, drowning. “As you dive into the water, the water starts to compress the tissues of your body so that you become more dense. After you’ve gone maybe seven, eight meters from the surface you will no longer float. You become negatively buoyant, which is to say, you sink” (1,470 words)

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