Longer looks: Lithium in the water; controlling cancer; recovering from brain injury

Sep 19 2014

Each week, KHN's Shefali Luthra finds interesting reads from around the Web.

The New Yorker: Is It Possible To Control Cancer Without Killing It?
There are many kinds of cancer, but treatments have typically combatted them in one way only: by attempting to destroy the cancerous cells. Surgery aims to remove the entire growth from the body; chemotherapy drugs are toxic to the cancer cells; radiation generates toxic molecules that break up the cancer cells' DNA and proteins, causing their demise. A more recent approach, immunotherapy, coöpts the body's immune system into attacking and eradicating the tumor. The Agios drug, instead of killing the leukemic cells-;immature blood cells gone haywire-;coaxes them into maturing into functioning blood cells. ... at least some cancer cells might be redeemable: they still carry their original programming and can be pressed back onto a pathway to health (Dr. Jerome Groopman, 9/15).

Modern Healthcare: ACA Open Enrollment For 2015 Causing Anxiety For Plans, Providers
During the 2014 open enrollment for Obamacare coverage, Mary Denson, 21, a student at Columbia (Mo.) College, qualified for a federal premium subsidy that reduced her premium contribution for buying health insurance to less than $20 a month. But she fears that when she renews her coverage for 2015, she won't have enough income from her nanny job to reach the subsidy income threshold of 100% of the federal poverty level and continue qualifying for premium tax credits. .... The sole focus during the 2014 open enrollment period was on signing up as many people like Denson as possible in exchange and off-exchange individual-market plans. But when the three-month open enrollment period for the second year ... opens on Nov. 15, the task for health plans, insurance brokers and thousands of enrollment workers at hospitals, clinics and community organizations will be more complex (Paul Demko, 9/13).

The Washington Post: After Traumatic Brain Injury, A Young Man's Astounding Recovery
On Nov. 8, 2012, my son Dylan -; two months into his junior year at Tufts University -; was struck by a car in a crosswalk. His head punched a hole through the car's windshield, and he suffered a traumatic brain injury so severe that doctors initially warned he might be permanently disabled. ... his luck changed in time to save his life. Because the accident occurred at 8:30 p.m. rather than in the middle of Boston's rush hour, he was brought to a hospital within a half hour -; and not just any hospital. It was Massachusetts General, ... The speed of triage was impressive, but the results of that scan were devastating. Dylan's brain injury was rotational, meaning hisFortunately, Dylan's neocortex, the brain's seat of higher-level processing, was mostly uninjured. And he had one other thing going for him, doctors said: his youth (Rebecca Hubert Williams, 9/15).

The New York Times: Should We All Take A Little Bit Of Lithium?
Lithium is a naturally occurring element, not a molecule like most medications, and it is present in the United States, depending on the geographic area, [in water] at concentrations that can range widely, from undetectable to around .170 milligrams per liter. This amount is less than a thousandth of the minimum daily dose given for bipolar disorders and for depression that doesn't respond to antidepressants. ... Evidence is slowly accumulating that relatively tiny doses of lithium can have beneficial effects. They appear to decrease suicide rates significantly and may even promote brain health and improve mood (Anna Fels, 9/13). 

New York Magazine: My Year As An Abortion Doula
Women have historically supported other women through the process of childbirth, so the work of birth doulas is nothing new. But when birth doulas Lauren Mitchell and Mary Mahoney sought to bring those support practices into abortion clinics, they met immediate resistance. "To imply that women getting abortions would need something as touchy-feely as support was not accepted," Mitchell explains. Some birth doulas were reluctant to consider the needs of women terminating pregnancies as at all similar to their patients carrying them to term. And many pro-choice doulas, doctors, and nonprofits were unwilling to acknowledge how difficult and painful many women find abortion (Alex Ronan, 9/14).

Pacific Standard: Gambling With America's Health
A debate over the social and health costs of legal gambling has largely been sidelined even as availability has expanded dramatically in the last 25 years. This is not because of a lack of merit, say experts and activists, but because of the political power of the gambling industry. They allege that the industry has employed tactics in the same spirit as those of tobacco companies, which for many years misled consumers about the addictive properties of cigarettes and advertised to young people and other vulnerable consumers. According to Les Bernal, the national director of Stop Predatory Gambling, a Washington, D.C.-based non-profit, "This is one of the biggest public health issues in America today that no one has been paying attention to" (Elaine Meyer, 9/15).

Aeon Magazine: How Mathematics Can Make Epidemics History
When Ronald Ross tipped over the water tank outside his bungalow in Bangalore, it began a lifelong battle against mosquitoes. It was 1883 and Ross, only two years out of medical school, was the British Army's new garrison surgeon. Overall, he was happy with the posting – he considered the city, with its sun, gardens and villas, to be the best in southern India. He was less enthusiastic about the mosquitoes. Having arrived to find his room filled with the sound of buzzing wings, he decided to hunt down and destroy their breeding ground in pools of stagnant tank water. ... The longer Ross spent in the region, the more he began to suspect that those mosquitoes transmitted malaria .... Ross's work, which won him a Nobel Prize in 1902 and a knighthood in 1911, set the stage for a new mathematical way of thinking about disease outbreaks from bubonic plague to influenza (Adam Kucharski, 9/16).