Longer looks: The timely trauma response in Boston; Problems with aging doctors; Transplants from donors with HIV

Apr 19 2013

Every week reporter Ankita Rao selects interesting reading from around the Web.

The New Yorker: Why Boston's Hospitals Were Ready
The bombs at the Boston Marathon were designed to maim and kill, and they did. Three people died within the first moments of the blast. More than a hundred and seventy people were injured. They had their limbs blown off, vital arteries severed, bones fractured, flesh torn open by shrapnel or scorched by the blasts' heat. Yet it now appears that every one of the wounded alive when rescuers reached them will survive. Medically speaking, this is no small accomplishment (Dr. Atul Gawande, 4/17).

The New York Times: For Trauma Surgeons, Saving Lives, If Not Legs, With No Time To Fret
So many patients arrived at once, with variations of the same gruesome leg injuries. Shattered bones, shredded tissue, nails burrowed deep beneath the flesh. The decision had to be made, over and over, with little time to deliberate. Should this leg be amputated? What about this one? ... The toll from the bombs Monday at the Boston Marathon, which killed at least three and injured more than 170, will long be felt by anyone involved with the city's iconic sporting event (Gina Kolata, Jere Longma and Mary Pilon, 4/16).

Time: How Terror Hijacks the Brain
Fear short circuits the brain, especially when it hits close to home, experts say-; making coping with events like the bombings at the Boston Marathon especially tricky. "When people are terrorized, the smartest parts of our brain tend to shut down," says Dr. Bruce Perry, Senior Fellow of the ChildTrauma Academy. (Disclosure: he and I have written books together). When the brain is under severe threat, it immediately changes the way it processes information, and starts to prioritize rapid responses (Maia Szalavitz, 4/16).

The New York World: Are Some Doctors Too Old To Practice Medicine?
While only a little over one-quarter of New York State's doctors are 60 or older, more than 40 percent of all the enforcement actions taken by the state since 2008 targeted senior doctors, according to an analysis of recently published actions by the state Office of Professional Medical Conduct. ... Specialty boards-;like orthopedic surgery and internal medicine-;do require physicians to recertify, usually about every 10 years. And hospitals by and large won't grant privileges to a doctor that doesn't have certification. But board certification is not a requirement for state licensure to practice -; meaning those that work outside of a hospital setting have no duty to remain certified. In 2010, about 1 in 5 doctors in New York State were not board certified (Curtis Skinner, 4/12).

Related KHN coverage: Aging Doctors Face Greater Scrutiny (Boodman, 12/10).

Slate: A Kidney For A Kidney
Last month, the Senate Health, Education, Labor and Pensions Committee made life a little better for people awaiting an organ transplant. It passed the HIV Organ Policy Equity (HOPE) Act, legislation designed to end the federal ban on research into organ donations from deceased HIV-positive donors to HIV-positive recipients. It would permit the Secretary of Health and Human Services to sanction such transplant operations if the research establishes their safety (Sally Satel, 4/15).

The New Yorker: How Damaged Are N.F.L. Players' Brains?
In November of 2010, a few dozen retired players from the National Football League gathered with their wives in a large living room. Snacking on appetizers and soft drinks, they listened to an informal pitch by John Hart, Jr., a neurologist at the University of Texas at Dallas. He wanted to scan their brains. Since that first meeting, Hart's team has recruited more than fifty former N.F.L. players for an ongoing study tracking their brain connections and mental health. The scientists' latest batch of data, presented at a meeting of the Cognitive Neuroscience Society in San Francisco on April 15th, shows that retired N.F.L. players are more likely to have memory problems and depression than non-athletes of the same age, and that these deficits may stem from damage in certain bundles of white matter in the brain. But the researchers were more surprised by what the study didn't show: nearly sixty per cent of the group had no mood issues, cognitive disability, or irregular brain patterns (Virginia Hughes, 4/16).

NewsHour: The Day Polio Began Losing Its Grip on America
April 12, 1955, was supposed to be Tommy Francis's day. At 10:20 a.m., the distinguished epidemiologist conducted an international press conference in Rackham Auditorium at the University of Michigan. The topic was the field trial he had just completed -- the largest of its kind ever -- evaluating the efficacy of the poliovirus vaccine developed by Dr. Jonas Salk at the University of Pittsburgh. ... By early 1953, Salk had begun campaigning relentlessly for a national field trial of his vaccine. For this critical but unglamorous task, the NFIP turned to Salk's former teacher, Thomas Francis, who had introduced Salk to the design of killed-virus vaccines at the University of Michigan School of Public Health (Dr. Howard Markel, 4/12).