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PROTO MAGAZINE
The Cholesterol Deniers. For decades, a tiny encampment of researchers has held that statin treatment is a hoax. In a time when contrarian views roar to life on social media, how can medicine keep minority opinions from doing irreparable harm?COVID-19 ON PURPOSE
COVID-19 On Purpose. One sure-fire way to test vaccines and treatments is to deliberately infect volunteers. Once unthinkable, the idea is quickly gaining steam. Every Monday for the past four months, virologists from the United States and Europe have dialed into an afternoon conference call to discuss a delicate topic: deliberatelyinfecting
WHY DO YOUNG, HEALTHY PEOPLE DIE FROM COVID-19? In late March, a 16-year-old girl died of coronavirus in Paris. Her name was Julie, and she had no history of medical problems. Her illness started with just a cough, which she treated with over-the-counter medications. A short while later, she developed shortness of breath and was eventually taken to one of the best hospitals in the city. Within a couple of days, Julie took a turn forthe
THE CHOLESTEROL DENIERS CARDIOLOGIST STEVEN NISSEN, chief academic officer of the Heart and Vascular Institute at the Cleveland Clinic, delights in the reputation he has earned among his critics. One prized possession is a photograph digitally doctored to show him wearing a tinfoil dunce cap, with the headline, “Steven Nissen goes full quack.” The image appeared on the home page of Natural News, a website that A TURNING POINT IN THE BURNOUT CRISIS It is now possible to imagine a world recovered from COVID-19. In that future, how will medicine have changed? These 10 essays explore the technical, social and political ripples of the pandemic. The COVID-19 pandemic has only exacerbated another public health crisis that had already reached epidemic proportions. Physician burnout is a syndromecharacterized by
THE CASE AGAINST VAPING The Case Against Vaping. As COVID-19 makes lung health a national concern, experts take another look at the dangers of e-cigarettes. FARRAH KHERADMAND WAS PUZZLED by what she saw under the microscope. The slides contained lung tissue, stained purple and red, of mice that had been exposed to the aerosols produced by the “vaping” ofDEFINED: BIOCREEP
biocreep: a possible phenomenon in which so-called noninferiority trials, which compare the efficacy of new drugs with that of existing drugs, in fact allow inferior treatments to go to market. Noninferiority trials, used predominantly in cases in which testing a new drug against a placebo would be unethical, were used in a quarter of new drug tests submitted to the Food and DrugWHEN LYME LINGERS
THE IDEA THAT HE MIGHT HAVE LYME DISEASE never crossed Ethan Robert’s mind. His symptoms began in 2009 with pain in a sciatic nerve that ran down his left leg. After a month the pain went away, but the following year his shoulders and elbows hurt, and the pain migrated to different joints in his arms for about 18 months. Robert, who lives in Boston, wrote that off to overexertion at the gym SHOULD THERE BE DIFFERENT DRUGS FOR DIFFERENT RACES POINT: Race is a social construct, not a genetic indicator, says Troy Duster, professor of sociology at New York University and the University of California at Berkeley and former president of the American Sociological Association. He specializes in the sociology of science and in issues of race and ethnicity. Since at least the 1600s, scientists have grouped humans according to various racial CALMING THE EXPLOSIVE CHILD 16 17 protomag.com // fall 07 fall 07 // protomag.com Now other groups are attempting to confirm those findings. The department of psychology at Virginia Tech in Blacksburg is comparing CPS with traditional parent training in a study of 150 kids with ODD and will also consider whether CPS leads to improvement in specific skills the children maylack.
PROTO MAGAZINE
The Cholesterol Deniers. For decades, a tiny encampment of researchers has held that statin treatment is a hoax. In a time when contrarian views roar to life on social media, how can medicine keep minority opinions from doing irreparable harm?COVID-19 ON PURPOSE
COVID-19 On Purpose. One sure-fire way to test vaccines and treatments is to deliberately infect volunteers. Once unthinkable, the idea is quickly gaining steam. Every Monday for the past four months, virologists from the United States and Europe have dialed into an afternoon conference call to discuss a delicate topic: deliberatelyinfecting
WHY DO YOUNG, HEALTHY PEOPLE DIE FROM COVID-19? In late March, a 16-year-old girl died of coronavirus in Paris. Her name was Julie, and she had no history of medical problems. Her illness started with just a cough, which she treated with over-the-counter medications. A short while later, she developed shortness of breath and was eventually taken to one of the best hospitals in the city. Within a couple of days, Julie took a turn forthe
THE CHOLESTEROL DENIERS CARDIOLOGIST STEVEN NISSEN, chief academic officer of the Heart and Vascular Institute at the Cleveland Clinic, delights in the reputation he has earned among his critics. One prized possession is a photograph digitally doctored to show him wearing a tinfoil dunce cap, with the headline, “Steven Nissen goes full quack.” The image appeared on the home page of Natural News, a website that A TURNING POINT IN THE BURNOUT CRISIS It is now possible to imagine a world recovered from COVID-19. In that future, how will medicine have changed? These 10 essays explore the technical, social and political ripples of the pandemic. The COVID-19 pandemic has only exacerbated another public health crisis that had already reached epidemic proportions. Physician burnout is a syndromecharacterized by
THE CASE AGAINST VAPING The Case Against Vaping. As COVID-19 makes lung health a national concern, experts take another look at the dangers of e-cigarettes. FARRAH KHERADMAND WAS PUZZLED by what she saw under the microscope. The slides contained lung tissue, stained purple and red, of mice that had been exposed to the aerosols produced by the “vaping” ofDEFINED: BIOCREEP
biocreep: a possible phenomenon in which so-called noninferiority trials, which compare the efficacy of new drugs with that of existing drugs, in fact allow inferior treatments to go to market. Noninferiority trials, used predominantly in cases in which testing a new drug against a placebo would be unethical, were used in a quarter of new drug tests submitted to the Food and DrugWHEN LYME LINGERS
THE IDEA THAT HE MIGHT HAVE LYME DISEASE never crossed Ethan Robert’s mind. His symptoms began in 2009 with pain in a sciatic nerve that ran down his left leg. After a month the pain went away, but the following year his shoulders and elbows hurt, and the pain migrated to different joints in his arms for about 18 months. Robert, who lives in Boston, wrote that off to overexertion at the gym SHOULD THERE BE DIFFERENT DRUGS FOR DIFFERENT RACES POINT: Race is a social construct, not a genetic indicator, says Troy Duster, professor of sociology at New York University and the University of California at Berkeley and former president of the American Sociological Association. He specializes in the sociology of science and in issues of race and ethnicity. Since at least the 1600s, scientists have grouped humans according to various racial CALMING THE EXPLOSIVE CHILD 16 17 protomag.com // fall 07 fall 07 // protomag.com Now other groups are attempting to confirm those findings. The department of psychology at Virginia Tech in Blacksburg is comparing CPS with traditional parent training in a study of 150 kids with ODD and will also consider whether CPS leads to improvement in specific skills the children maylack.
WHEN WILL WE GET A COVID-19 VACCINE? Vaccines have historically taken decades to develop. The urgency imposed by COVID-19 is clear and that push may be helped by two factors: advances in vaccine technology, and insights from working on other diseases. Both of these factors could boost an effort coordinated by the Ragon Institute of MGH, MIT and Harvard, one of nearly three dozen COVID-19 vaccine projects currently under wayORGANS ON ICE
Organs on Ice. If transplant organs could be kept fresher for longer, they could help thousands more on waitlists. The organ shortage is a national crisis, with 120,000 people on transplant waitlists and more than 20 people dying every day for lack of a new heart, lung or kidney. But the solution may not be to enroll more donors.THE SCARLET GENE
The Scarlet Gene. With the human genome laid bare, scientists are narrowing their search for the roots of mental illness. IN DECEMBER 1979, FAITH REIDENBACH, a Smith College sophomore, appeared at the student infirmary during exam week. Rambling and delusional, she was diagnosed with mania and sent home to Ohio to recuperate. IS SKIPPING A CHILD’S VACCINES MEDICAL NEGLECT? In May, Minnesota reached an unfortunate milestone: The state had seen more measles cases in the first five months of 2017 than the entire country had experienced in all of 2016. The number of cases was, at recent count, 79. Most of those diagnosed with measles have been children, and more than a quarter of them have required hospitalization. While no one has died during the outbreak, someTHE SALVARSAN WARS
Before 1910 the only treatment available for syphilis was about as terrible as the disease itself: the liquid metal mercury, which could cause death or organ damage. So when the first clinically tested syphilis agent debuted 100 years ago, it quickly became the most prescribed drug in the world. “People whohave shown no evidences whatever of diseasehave been begging for a dose of PUTTING THE DEAD TO REST Putting a face to unidentified remains requires both anatomical knowledge and an artistic hand. Sculptor Madison Haws began this bust with the bones of a woman who died anonymously in a home for the mentally impaired in Queens, N.Y. Haws started with a 3D-printed replica of the woman’s skull, then built up layers of clay to recreate lost muscles and tissues. CALMING THE EXPLOSIVE CHILD 16 17 protomag.com // fall 07 fall 07 // protomag.com Now other groups are attempting to confirm those findings. The department of psychology at Virginia Tech in Blacksburg is comparing CPS with traditional parent training in a study of 150 kids with ODD and will also consider whether CPS leads to improvement in specific skills the children maylack.
SHOULD PRISONERS PARTICIPATE IN MEDICAL RESEARCH TRIALS POINT: If one respects the tenets of science and of human rights, the answer is clear, says Vera Hassner Sharav, founder of the Alliance for Human Research Protection (AHRP), which advocates responsible and ethical medical research practices. In 1973 the journalist Jessica Mitford famously summarized why prisoners were the preferred medical research subjects in the UnitedPROTOMAG
1997. Gastroenterologist Detlef Schuppan, then at the Free University of Berlin, discovered that the autoantibodies of celiac patients are directed against tissue transglutaminase (an enzyme released from the intestine’s cells when gluten passes into the mucosal layer). He introduced a simple blood-screening test for initial diagnosis.PROTOMAG
1. A Change of Heart: Unraveling the Mysteries of Cardiovascular Disease, by Daniel Levy and Susan Brink (Vintage Books, 2005). A behind-the-scenes history of the people, science, politics and culture that created one of the longest-running epidemiology studies.PROTO MAGAZINE
The Cholesterol Deniers. For decades, a tiny encampment of researchers has held that statin treatment is a hoax. In a time when contrarian views roar to life on social media, how can medicine keep minority opinions from doing irreparable harm?COVID-19 ON PURPOSE
COVID-19 On Purpose. One sure-fire way to test vaccines and treatments is to deliberately infect volunteers. Once unthinkable, the idea is quickly gaining steam. Every Monday for the past four months, virologists from the United States and Europe have dialed into an afternoon conference call to discuss a delicate topic: deliberatelyinfecting
WHY DO YOUNG, HEALTHY PEOPLE DIE FROM COVID-19? In late March, a 16-year-old girl died of coronavirus in Paris. Her name was Julie, and she had no history of medical problems. Her illness started with just a cough, which she treated with over-the-counter medications. A short while later, she developed shortness of breath and was eventually taken to one of the best hospitals in the city. Within a couple of days, Julie took a turn forthe
THE CHOLESTEROL DENIERS CARDIOLOGIST STEVEN NISSEN, chief academic officer of the Heart and Vascular Institute at the Cleveland Clinic, delights in the reputation he has earned among his critics. One prized possession is a photograph digitally doctored to show him wearing a tinfoil dunce cap, with the headline, “Steven Nissen goes full quack.” The image appeared on the home page of Natural News, a website that A TURNING POINT IN THE BURNOUT CRISIS It is now possible to imagine a world recovered from COVID-19. In that future, how will medicine have changed? These 10 essays explore the technical, social and political ripples of the pandemic. The COVID-19 pandemic has only exacerbated another public health crisis that had already reached epidemic proportions. Physician burnout is a syndromecharacterized by
THE CASE AGAINST VAPING The Case Against Vaping. As COVID-19 makes lung health a national concern, experts take another look at the dangers of e-cigarettes. FARRAH KHERADMAND WAS PUZZLED by what she saw under the microscope. The slides contained lung tissue, stained purple and red, of mice that had been exposed to the aerosols produced by the “vaping” ofDEFINED: BIOCREEP
biocreep: a possible phenomenon in which so-called noninferiority trials, which compare the efficacy of new drugs with that of existing drugs, in fact allow inferior treatments to go to market. Noninferiority trials, used predominantly in cases in which testing a new drug against a placebo would be unethical, were used in a quarter of new drug tests submitted to the Food and DrugWHEN LYME LINGERS
THE IDEA THAT HE MIGHT HAVE LYME DISEASE never crossed Ethan Robert’s mind. His symptoms began in 2009 with pain in a sciatic nerve that ran down his left leg. After a month the pain went away, but the following year his shoulders and elbows hurt, and the pain migrated to different joints in his arms for about 18 months. Robert, who lives in Boston, wrote that off to overexertion at the gym SHOULD THERE BE DIFFERENT DRUGS FOR DIFFERENT RACES POINT: Race is a social construct, not a genetic indicator, says Troy Duster, professor of sociology at New York University and the University of California at Berkeley and former president of the American Sociological Association. He specializes in the sociology of science and in issues of race and ethnicity. Since at least the 1600s, scientists have grouped humans according to various racial CALMING THE EXPLOSIVE CHILD 16 17 protomag.com // fall 07 fall 07 // protomag.com Now other groups are attempting to confirm those findings. The department of psychology at Virginia Tech in Blacksburg is comparing CPS with traditional parent training in a study of 150 kids with ODD and will also consider whether CPS leads to improvement in specific skills the children maylack.
PROTO MAGAZINE
The Cholesterol Deniers. For decades, a tiny encampment of researchers has held that statin treatment is a hoax. In a time when contrarian views roar to life on social media, how can medicine keep minority opinions from doing irreparable harm?COVID-19 ON PURPOSE
COVID-19 On Purpose. One sure-fire way to test vaccines and treatments is to deliberately infect volunteers. Once unthinkable, the idea is quickly gaining steam. Every Monday for the past four months, virologists from the United States and Europe have dialed into an afternoon conference call to discuss a delicate topic: deliberatelyinfecting
WHY DO YOUNG, HEALTHY PEOPLE DIE FROM COVID-19? In late March, a 16-year-old girl died of coronavirus in Paris. Her name was Julie, and she had no history of medical problems. Her illness started with just a cough, which she treated with over-the-counter medications. A short while later, she developed shortness of breath and was eventually taken to one of the best hospitals in the city. Within a couple of days, Julie took a turn forthe
THE CHOLESTEROL DENIERS CARDIOLOGIST STEVEN NISSEN, chief academic officer of the Heart and Vascular Institute at the Cleveland Clinic, delights in the reputation he has earned among his critics. One prized possession is a photograph digitally doctored to show him wearing a tinfoil dunce cap, with the headline, “Steven Nissen goes full quack.” The image appeared on the home page of Natural News, a website that A TURNING POINT IN THE BURNOUT CRISIS It is now possible to imagine a world recovered from COVID-19. In that future, how will medicine have changed? These 10 essays explore the technical, social and political ripples of the pandemic. The COVID-19 pandemic has only exacerbated another public health crisis that had already reached epidemic proportions. Physician burnout is a syndromecharacterized by
THE CASE AGAINST VAPING The Case Against Vaping. As COVID-19 makes lung health a national concern, experts take another look at the dangers of e-cigarettes. FARRAH KHERADMAND WAS PUZZLED by what she saw under the microscope. The slides contained lung tissue, stained purple and red, of mice that had been exposed to the aerosols produced by the “vaping” ofDEFINED: BIOCREEP
biocreep: a possible phenomenon in which so-called noninferiority trials, which compare the efficacy of new drugs with that of existing drugs, in fact allow inferior treatments to go to market. Noninferiority trials, used predominantly in cases in which testing a new drug against a placebo would be unethical, were used in a quarter of new drug tests submitted to the Food and DrugWHEN LYME LINGERS
THE IDEA THAT HE MIGHT HAVE LYME DISEASE never crossed Ethan Robert’s mind. His symptoms began in 2009 with pain in a sciatic nerve that ran down his left leg. After a month the pain went away, but the following year his shoulders and elbows hurt, and the pain migrated to different joints in his arms for about 18 months. Robert, who lives in Boston, wrote that off to overexertion at the gym SHOULD THERE BE DIFFERENT DRUGS FOR DIFFERENT RACES POINT: Race is a social construct, not a genetic indicator, says Troy Duster, professor of sociology at New York University and the University of California at Berkeley and former president of the American Sociological Association. He specializes in the sociology of science and in issues of race and ethnicity. Since at least the 1600s, scientists have grouped humans according to various racial CALMING THE EXPLOSIVE CHILD 16 17 protomag.com // fall 07 fall 07 // protomag.com Now other groups are attempting to confirm those findings. The department of psychology at Virginia Tech in Blacksburg is comparing CPS with traditional parent training in a study of 150 kids with ODD and will also consider whether CPS leads to improvement in specific skills the children maylack.
WHEN WILL WE GET A COVID-19 VACCINE? Vaccines have historically taken decades to develop. The urgency imposed by COVID-19 is clear and that push may be helped by two factors: advances in vaccine technology, and insights from working on other diseases. Both of these factors could boost an effort coordinated by the Ragon Institute of MGH, MIT and Harvard, one of nearly three dozen COVID-19 vaccine projects currently under wayORGANS ON ICE
Organs on Ice. If transplant organs could be kept fresher for longer, they could help thousands more on waitlists. The organ shortage is a national crisis, with 120,000 people on transplant waitlists and more than 20 people dying every day for lack of a new heart, lung or kidney. But the solution may not be to enroll more donors.THE SCARLET GENE
The Scarlet Gene. With the human genome laid bare, scientists are narrowing their search for the roots of mental illness. IN DECEMBER 1979, FAITH REIDENBACH, a Smith College sophomore, appeared at the student infirmary during exam week. Rambling and delusional, she was diagnosed with mania and sent home to Ohio to recuperate. IS SKIPPING A CHILD’S VACCINES MEDICAL NEGLECT? In May, Minnesota reached an unfortunate milestone: The state had seen more measles cases in the first five months of 2017 than the entire country had experienced in all of 2016. The number of cases was, at recent count, 79. Most of those diagnosed with measles have been children, and more than a quarter of them have required hospitalization. While no one has died during the outbreak, someTHE SALVARSAN WARS
Before 1910 the only treatment available for syphilis was about as terrible as the disease itself: the liquid metal mercury, which could cause death or organ damage. So when the first clinically tested syphilis agent debuted 100 years ago, it quickly became the most prescribed drug in the world. “People whohave shown no evidences whatever of diseasehave been begging for a dose of PUTTING THE DEAD TO REST Putting a face to unidentified remains requires both anatomical knowledge and an artistic hand. Sculptor Madison Haws began this bust with the bones of a woman who died anonymously in a home for the mentally impaired in Queens, N.Y. Haws started with a 3D-printed replica of the woman’s skull, then built up layers of clay to recreate lost muscles and tissues. CALMING THE EXPLOSIVE CHILD 16 17 protomag.com // fall 07 fall 07 // protomag.com Now other groups are attempting to confirm those findings. The department of psychology at Virginia Tech in Blacksburg is comparing CPS with traditional parent training in a study of 150 kids with ODD and will also consider whether CPS leads to improvement in specific skills the children maylack.
SHOULD PRISONERS PARTICIPATE IN MEDICAL RESEARCH TRIALS POINT: If one respects the tenets of science and of human rights, the answer is clear, says Vera Hassner Sharav, founder of the Alliance for Human Research Protection (AHRP), which advocates responsible and ethical medical research practices. In 1973 the journalist Jessica Mitford famously summarized why prisoners were the preferred medical research subjects in the UnitedPROTOMAG
1997. Gastroenterologist Detlef Schuppan, then at the Free University of Berlin, discovered that the autoantibodies of celiac patients are directed against tissue transglutaminase (an enzyme released from the intestine’s cells when gluten passes into the mucosal layer). He introduced a simple blood-screening test for initial diagnosis.PROTOMAG
1. A Change of Heart: Unraveling the Mysteries of Cardiovascular Disease, by Daniel Levy and Susan Brink (Vintage Books, 2005). A behind-the-scenes history of the people, science, politics and culture that created one of the longest-running epidemiology studies.PROTO MAGAZINE
The Cholesterol Deniers. For decades, a tiny encampment of researchers has held that statin treatment is a hoax. In a time when contrarian views roar to life on social media, how can medicine keep minority opinions from doing irreparable harm?COVID-19 ON PURPOSE
COVID-19 On Purpose. One sure-fire way to test vaccines and treatments is to deliberately infect volunteers. Once unthinkable, the idea is quickly gaining steam. Every Monday for the past four months, virologists from the United States and Europe have dialed into an afternoon conference call to discuss a delicate topic: deliberatelyinfecting
WHY DO YOUNG, HEALTHY PEOPLE DIE FROM COVID-19? In late March, a 16-year-old girl died of coronavirus in Paris. Her name was Julie, and she had no history of medical problems. Her illness started with just a cough, which she treated with over-the-counter medications. A short while later, she developed shortness of breath and was eventually taken to one of the best hospitals in the city. Within a couple of days, Julie took a turn forthe
A TURNING POINT IN THE BURNOUT CRISIS It is now possible to imagine a world recovered from COVID-19. In that future, how will medicine have changed? These 10 essays explore the technical, social and political ripples of the pandemic. The COVID-19 pandemic has only exacerbated another public health crisis that had already reached epidemic proportions. Physician burnout is a syndromecharacterized by
THE CHOLESTEROL DENIERS CARDIOLOGIST STEVEN NISSEN, chief academic officer of the Heart and Vascular Institute at the Cleveland Clinic, delights in the reputation he has earned among his critics. One prized possession is a photograph digitally doctored to show him wearing a tinfoil dunce cap, with the headline, “Steven Nissen goes full quack.” The image appeared on the home page of Natural News, a website that THE CASE AGAINST VAPING The Case Against Vaping. As COVID-19 makes lung health a national concern, experts take another look at the dangers of e-cigarettes. FARRAH KHERADMAND WAS PUZZLED by what she saw under the microscope. The slides contained lung tissue, stained purple and red, of mice that had been exposed to the aerosols produced by the “vaping” ofDEFINED: BIOCREEP
biocreep: a possible phenomenon in which so-called noninferiority trials, which compare the efficacy of new drugs with that of existing drugs, in fact allow inferior treatments to go to market. Noninferiority trials, used predominantly in cases in which testing a new drug against a placebo would be unethical, were used in a quarter of new drug tests submitted to the Food and DrugWHEN LYME LINGERS
THE IDEA THAT HE MIGHT HAVE LYME DISEASE never crossed Ethan Robert’s mind. His symptoms began in 2009 with pain in a sciatic nerve that ran down his left leg. After a month the pain went away, but the following year his shoulders and elbows hurt, and the pain migrated to different joints in his arms for about 18 months. Robert, who lives in Boston, wrote that off to overexertion at the gym THE HEART OF A PRESIDENT On September 24, 1955, Paul Dudley White and his wife, Ina, were on their way to a dinner party near Boston when they heard shocking news on the car radio: President Dwight D. Eisenhower had suffered a heart attack. Within a few hours, the Surgeon General’s office tracked down White and summoned him to Eisenhower’s bedside. SHOULD THERE BE DIFFERENT DRUGS FOR DIFFERENT RACES POINT: Race is a social construct, not a genetic indicator, says Troy Duster, professor of sociology at New York University and the University of California at Berkeley and former president of the American Sociological Association. He specializes in the sociology of science and in issues of race and ethnicity. Since at least the 1600s, scientists have grouped humans according to various racialPROTO MAGAZINE
The Cholesterol Deniers. For decades, a tiny encampment of researchers has held that statin treatment is a hoax. In a time when contrarian views roar to life on social media, how can medicine keep minority opinions from doing irreparable harm?COVID-19 ON PURPOSE
COVID-19 On Purpose. One sure-fire way to test vaccines and treatments is to deliberately infect volunteers. Once unthinkable, the idea is quickly gaining steam. Every Monday for the past four months, virologists from the United States and Europe have dialed into an afternoon conference call to discuss a delicate topic: deliberatelyinfecting
WHY DO YOUNG, HEALTHY PEOPLE DIE FROM COVID-19? In late March, a 16-year-old girl died of coronavirus in Paris. Her name was Julie, and she had no history of medical problems. Her illness started with just a cough, which she treated with over-the-counter medications. A short while later, she developed shortness of breath and was eventually taken to one of the best hospitals in the city. Within a couple of days, Julie took a turn forthe
A TURNING POINT IN THE BURNOUT CRISIS It is now possible to imagine a world recovered from COVID-19. In that future, how will medicine have changed? These 10 essays explore the technical, social and political ripples of the pandemic. The COVID-19 pandemic has only exacerbated another public health crisis that had already reached epidemic proportions. Physician burnout is a syndromecharacterized by
THE CHOLESTEROL DENIERS CARDIOLOGIST STEVEN NISSEN, chief academic officer of the Heart and Vascular Institute at the Cleveland Clinic, delights in the reputation he has earned among his critics. One prized possession is a photograph digitally doctored to show him wearing a tinfoil dunce cap, with the headline, “Steven Nissen goes full quack.” The image appeared on the home page of Natural News, a website that THE CASE AGAINST VAPING The Case Against Vaping. As COVID-19 makes lung health a national concern, experts take another look at the dangers of e-cigarettes. FARRAH KHERADMAND WAS PUZZLED by what she saw under the microscope. The slides contained lung tissue, stained purple and red, of mice that had been exposed to the aerosols produced by the “vaping” ofDEFINED: BIOCREEP
biocreep: a possible phenomenon in which so-called noninferiority trials, which compare the efficacy of new drugs with that of existing drugs, in fact allow inferior treatments to go to market. Noninferiority trials, used predominantly in cases in which testing a new drug against a placebo would be unethical, were used in a quarter of new drug tests submitted to the Food and DrugWHEN LYME LINGERS
THE IDEA THAT HE MIGHT HAVE LYME DISEASE never crossed Ethan Robert’s mind. His symptoms began in 2009 with pain in a sciatic nerve that ran down his left leg. After a month the pain went away, but the following year his shoulders and elbows hurt, and the pain migrated to different joints in his arms for about 18 months. Robert, who lives in Boston, wrote that off to overexertion at the gym THE HEART OF A PRESIDENT On September 24, 1955, Paul Dudley White and his wife, Ina, were on their way to a dinner party near Boston when they heard shocking news on the car radio: President Dwight D. Eisenhower had suffered a heart attack. Within a few hours, the Surgeon General’s office tracked down White and summoned him to Eisenhower’s bedside. SHOULD THERE BE DIFFERENT DRUGS FOR DIFFERENT RACES POINT: Race is a social construct, not a genetic indicator, says Troy Duster, professor of sociology at New York University and the University of California at Berkeley and former president of the American Sociological Association. He specializes in the sociology of science and in issues of race and ethnicity. Since at least the 1600s, scientists have grouped humans according to various racial A TURNING POINT IN THE BURNOUT CRISIS It is now possible to imagine a world recovered from COVID-19. In that future, how will medicine have changed? These 10 essays explore the technical, social and political ripples of the pandemic. The COVID-19 pandemic has only exacerbated another public health crisis that had already reached epidemic proportions. Physician burnout is a syndromecharacterized by
FIGHTING COVID-19 WITH THE BODY’S CLOCK Even as the COVID-19 vaccines roll out, current cases of the disease remain on the rise. Better ways to treat the infected are still sorely needed, and that holds especially true for countries where resources are limited and vaccinations are likely to move more slowly. So it is with interest that many are considering a resource as free as the rising and setting of the sun. THE AWAKENING OF OLIVER SACKS Medical writing owes a debt to Oliver Sacks, whose books bring readers nose to nose with great neurological puzzles. The British physician is best known for capturing detailed, narrative case histories that convey a human experience of disease. And while Sacks has more than 40 years of published work, he may be best remembered for his first successful book, which chronicled an enigma SHOULD THERE BE DIFFERENT DRUGS FOR DIFFERENT RACES POINT: Race is a social construct, not a genetic indicator, says Troy Duster, professor of sociology at New York University and the University of California at Berkeley and former president of the American Sociological Association. He specializes in the sociology of science and in issues of race and ethnicity. Since at least the 1600s, scientists have grouped humans according to various racial WHEN PUBERTY STRIKES FOR 27 YEARS, UNTIL HIS DEATH IN 1750, JOHANN SEBASTIAN BACH led three male choirs in Leipzig. Most of the singers were teenagers, almost all of them musical prodigies. By the standards of the time, German school officials kept excellent records on each student, including his date of birth, academic performance and family history. More than two centuries later, an enterprising THE PILL AND THE PESSARY The Pill and the Pessary. Margaret Sanger was a lifelong pioneer for birth control—and drove major innovations in the devices that made it possible. by Wyatt Marshall. One hundred years ago this October, Margaret Sanger opened the first family-planning clinic in the United States. During its first 10 days, Sanger and her younger sister, nurseORGANS ON ICE
Organs on Ice. If transplant organs could be kept fresher for longer, they could help thousands more on waitlists. The organ shortage is a national crisis, with 120,000 people on transplant waitlists and more than 20 people dying every day for lack of a new heart, lung or kidney. But the solution may not be to enroll more donors.GUT FEELINGS
Alessio Fasano, chief of pediatric gastroenterology at MassGeneral Hospital for Children, thought he had celiac disease all figured out. It’s an autoimmune disease in which the body destroys its own cells—in this case, the cells lining the intestines—which causes digestive problems and sometimes leads to malnutrition and other serious health issues. As described in “Celiac Disease THE PROBLEM WITH BIOMARKERS IN JUNE, THE NEW YORK TIMES MAGAZINE TOUTED Eva Redei’s discovery—of 18 genetic markers in the blood that appear to identify major depression and anxiety in adolescents—as an innovation “that will change your tomorrow.” It could certainly help solve an acute problem. Only a quarter of depressed and anxious young people get treated, many self-medicate with drugs and alcohol, andPROTOMAG
1997. Gastroenterologist Detlef Schuppan, then at the Free University of Berlin, discovered that the autoantibodies of celiac patients are directed against tissue transglutaminase (an enzyme released from the intestine’s cells when gluten passes into the mucosal layer). He introduced a simple blood-screening test for initial diagnosis. Skip to main content Stay on the Frontiers of Medicine. Sign up for a free subscription to Proto.Follow Us
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Privacy Statement/Terms of use Search Results for "" See more Close searchIN FOCUS
AN EPOCHAL CHANGE IN CARE DELIVERY During the lockdowns, virtual care took a giant step forward. Can it surmount the obstacles ahead? _It is now possible to imagine a world recovered from COVID-19. In that future, how will medicine have changed? These 10 essaysexplore the
technical, social and political ripples of the pandemic._ During the Great Plague of the 17th century, nobles and the wealthyretreated...
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IN DEPTH
THE CHOLESTEROL DENIERS For decades, a tiny encampment of researchers has held that statin treatment is a hoax. In a time when contrarian views roar to life on social media, how can medicine keep minority opinions from doingirreparable harm?
TELEMEDICINE AND ITS DISCONTENTS Not everyone stands to benefit from digital care. How can we changethat?
THE CRACKS IN WALLS THAT DIVIDE US In the COVID-19 crisis, rival institutions joined forces. Can those collaborations endure? HARD LESSONS IN HEALTH CARE ECONOMICS The economic pinch weakened hospitals and providers. How can we buildthem up again?
A TURNED PAGE ON RACIALIZED MEDICINE Bias gets baked into algorithms that guide medical care. Rooting it out will take patience and cooperation. A FUTURE INFORMED BY GENDER-AFFIRMING CARE The transgender community is quietly reinventing the medical paradigm. A RECKONING FOR NURSES AND NURSING In the isolation of the COVID-19 wards, nurses were a lifeline. Hospitals stand to benefit from their insight. A TURNING POINT IN THE BURNOUT CRISIS Mental health treatment for medical practitioners will never be thesame.
MEDICAL EDUCATION WILL BE TRANSFORMED Dozens of pandemic-era innovations, and the experience of teaching during a crisis, have all left an indelible mark. OUR CALL TO COMMUNICATE THE TRUTH Science and public health have been under steady attack. It is up to medical professionals to fight back. TWO TAKES ON A PANDEMIC Every nation has had its own experience of COVID-19. The stories of Denmark, a model of socialized care, and Rwanda, a bright spot among developing nations, both hold wider lessons for the world. CHAPTER 1: IN THE PATH OF THE PANDEMIC A novel coronavirus would come to affect every ward, clinician, researcher and patient at Massachusetts General Hospital. CHAPTER 2: THE VIRTUES OF NECESSITY As the first COVID-19 patients arrived, pressure mounted to discover how the disease worked and how it could be beaten back. CHAPTER 3: THE FIGHT THAT LIES AHEAD When the caseload began to ease, clinicians came to grips with the new normal as researchers set their sights on ending the pandemic forgood.
THE CASE AGAINST VAPING As COVID-19 makes lung health a national concern, experts take another look at the dangers of e-cigarettes.See More
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DISPATCHES
SHOULD WE INSIST ON SHOTS? Massachusetts broke ground on mandatory vaccination in 1905. History may repeat itself with COVID-19. CLINICIAN VIOLENCE MOVES ONLINE As practice goes digital, so too does a brutal workplace hazard.THE RAGE ROOM
A woman finds therapeutic value in sledgehammers and broken plates. THE YEAR OF THE NURSE The World Health Organization gave Elizabeth Iro the job of advocating for nurses everywhere.THE DOSES LEFT OVER
Is there any hope for saving wasted medications? RACISM IN THE BLACK BODY For decades, researchers have looked at social factors to explain the greater presence of disease in Black populations. But the stress of experiencing racism causes great harm, too. IS HEALTH CARE’S RACISM TREATABLE? In the wake of a landmark year of activism, medical schools, hospitals and the research establishment are seeking to excise racial discrimination. How well have they done?MADE TO BE INVADED
Mini gut models give scientists a front row seat to some of the most puzzling pathogen behaviors. FATHERS-TO-BE, TAKE NOTE A wave of research shows how a pregnancy can be put at risk by drinking, diet and exposures to toxins—on the part of the male. PODCAST: DO BETTER BY DISABLED PATIENTS People who live with a disability are no stranger to overcoming obstacles. But the bias of a clinician shouldn’t be one of them. WHAT MAKES A KID CLUMSY? More research into coordination disorders shows why some children are more prone to trip, fumble and spill the milk.EYES IN THE SKY
Satellite data can be used to assess the health impact of dust storms and the spread of mosquito-borne diseases. Additional applications could be on the horizon. COULD THIS ONE CHANGE HELP CURB THE OPIOID CRISIS? To prescribe an effective bridge to addiction treatment, emergency physicians must get special training and receive a waiver. Making that process easier—or eliminating the requirement altogether—couldmake a big impact.
ONE THING LEADS TO THE NEXT Robert Lefkowitz is best known for revealing the mechanism behind hundreds of drugs in use today. But he thinks of himself as a storyteller first and has a new book out to make his case. PODCAST: THE RESEARCH YEAR THAT WAS Medical research labs have faced a difficult stretch of closed buildings and competing priorities. Yet they have also produced milestone discoveries—and not only on COVID-19.See More
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FROM MASS GENERAL
WHAT A HOSPITAL IS BUILT FOR As COVID-19 first swept through Boston, the people of Massachusetts General Hospital responded. Their efforts offer a portrait of medicinein motion.
OUR RESPONSE TO A PANDEMIC Peter L. Slavin and Timothy G. Ferris discuss how Massachusetts General Hospital is tackling COVID-19. THE CHANGING LANDSCAPE OF PRIMARY CARE Peter L. Slavin and Timothy G. Ferris discuss a shortage of primary care physicians and how to address the problem. A SAFE AND CONTROVERSIAL PLACE Physician Mark Eisenberg discusses the furor over (and the desperate need for) safer injection sites. NEXT-GENERATION VACCINES Peter L. Slavin and Timothy G. Ferris discuss the revolution of rational vaccine design. A REVOLUTION IN CANCER TREATMENT Peter L. Slavin and Timothy G. Ferris discuss the promise of CAR T cell therapy for solid tumors. CLIMATE CHANGE MEETS AN AGING POPULATION The most common victims of extreme weather events are older people. New research looks into how the health system fails them, and how itcan be fixed.
SINGULAR EXCEPTIONS
Should primary care physicians be trained to spot unusual, medicallyimportant cases?
SILENT NO MORE
Peter L. Slavin and Timothy G. Ferris discuss the need to end workplace violence in health care. AN EXTRA PAIR OF (A)IS Machine intelligence takes a big step into the clinic, with a technology that helps identify patients with an elevated risk ofbreast cancer.
DOCTORING ON A SCREEN Telemedicine made its first broadcast 50 years ago in an airportclinic.
ENDING THE AIDS EPIDEMIC Since the early 1980s, AIDS has killed more than 35 million people worldwide. But researchers are determined to find better treatments, cures and preventions that many finally put an end to theepidemic.
FOR SOME CLOTS, IT TAKES A VILLAGE Treatment of pulmonary embolisms may benefit from a team approach. But that model faces obstacles inside and outside the hospital. SHINING A LIGHT ON DEPRESSION Peter L. Slavin and Timothy G. Ferris highlight the need for new approaches to treating depression. A (SMALL) CAUSE OF BIG PAIN Neurologist Anne Louise Oaklander investigates a cause of chronic pain that is treatable without opioids.See More
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CHARTS & DATA
WHAT IS A COLLABORATIVE COMMUNITY? An unconventional new model makes industry meetups a key part of medical device regulation.THE BODY ON CHIPS
An engineered model of human physiology hits an important milestone. HOW TO GREEN A HOSPITAL Health care leaders look for ways to scale back an outsized carbonfootprint.
THE NEW ANATOMY
Parts of the body are constantly being proposed or discovered. Wheredo they come from?
ANATOMY OF A HASHTAG Public health messaging online yields beautiful—but sometimesworrying—data.
HOW DID COVID-19 GET HERE? Genomic analysis details how SARS-CoV-2 spread through Boston. THE VILLAGE WITHOUT MEMORY In France, a home for people with dementia is designed from the groundup.
TO CHOOSE DEATH
Oregon’s Death With Dignity Act crosses the 20-year mark.IN PASSING
How does a hospital keep patient details from getting lost in theshuffle?
TO CATCH A PROTEIN
The world of protein imaging undergoes a chilly revolution.THE NEXT ZIKA
Vaccines are most helpful before an epidemic hits. So which diseases should researchers prepare for next?RESEARCHKIT
A software platform from Apple is helping medical researchers collect health data from any iPhone userWHITE COATS
The standard garb of the physician comes with surprising risks andbenefits.
UNSOUND THE ALARM
Hundreds of alarms compete for a clinician's attention. Can less noisemean better care?
BABEL IN THE ICU
Machines in an ICU can't speak to one another—but what if theycould?
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