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Genetic Frontiers

Angie Heeded the Call

Pool image by Alistair Grant; via Getty

Treatments still lag far behind the crystal ball provided by genetic tests, but Angelina Jolie was right to take action after discovering she had the faulty BRCA gene. Dr. Kent Sepkowitz on medicine’s remarkable achievement.

Angelina Jolie made news Tuesday with her sober, nontheatrical, and informative revelation that she had undergone a bilateral mastectomy to prevent development of breast cancer.However radical-seeming the intervention, the medical evidence for bilateral preventive mastectomy is extremely sound. According to the National Cancer Institute, the reduction in risk of breast cancer among women at medium and high risk for breast cancer is about 90 percent, though the procedure is not a guarantee that no breast cancer will occur.


We Can't Win With The Pill

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A new study says that your low-hormone pill could leave you screaming during sex for all the wrong reasons. Lizzie Crocker reports.

Ah, the birth control pill, that magical feat of science that allows us to have as much sex as we want without getting pregnant, basically by tricking our bodies into thinking we already are. Today’s pill is a reliable, convenient and relatively safe form of contraception, which explains why more than 99 percent of sexually active women in the U.S. have used it at some point in their lives. When the pill first became available in 1960, it came with a high dose of estrogen that may have been responsible for an alarming deluge of blood clots, along with doubling the size of women’s breasts in some cases.

Keep it Off

What’s Lap-Band Surgery?

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Chris Christie revealed he secretly underwent a weight-loss surgery in February known as the lap band—and has dropped roughly 40 pounds since. Lizzie Crocker on whether you should have a titanium band wrapped around your stomach.

In February, Chris Christie, the notoriously heavyweight New Jersey governor, underwent a 40-minute lap-band weight-loss surgery, the description of which is enough to make anyone lose his appetite. (Note to readers: we don’t recommend reading the below before breakfast. Or immediately after, for that matter.)Christie revealed his secret surgery to the New York Post this week, saying he “agreed to the operation at the urging of family and friends after turning 50 last September.

Sex Superbug

Worse Than AIDS? Nope.

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Drug-resistant gonorrhea, the so-called sex superbug found in Hawaii, is no killer on par with AIDS, as some reports suggest. It’s hardly even a killer. Dr. Kent Sepkowitz on our addiction to superbug stories.

It’s been a busy year for the world of infectious diseases. Close on the heels of carbapenemase-resistant Enterobacteriaceae, H7N9 avian flu in China, and SARS junior in Saudi Arabia are reports of highly drug-resistant gonorrhea in Hawaii. The strain, dubbed HO41 has landed just two years after first identification in Japan in 2011.Even if doctors and the public health world are not quite prepared, the press certainly is. Ready and eager, too.


Spider Bite Didn’t Kill Slayer

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The spider bite that’s been blamed for his untimely death may have masked a more common culprit, writes Doctor Kent Sepkowitz

Jeff Hanneman, lead guitarist of the seminal thrash-metal group Slayer, died this week of liver failure. Without exception, the somber coverage of his death has included mention of the nearly fatal infection Hanneman had sustained in 2011 when he developed necrotizing fasciitis, a.k.a. flesh-eating bacteria, of his right arm. Even a representative of the band, which Hanneman had played in since its founding in 1981, suggested the bite that seemingly led to the devastating infection may have played a role in his early death.

Visual Thinking

Temple Grandin: My Big Idea

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The animal-science pioneer and autistic activist looks inside her own brain to learn about the latest research on autism—and discovers that she’s quite face-blind.

What’s your big idea?That there are three kinds of thinking. The traditional way of describing different kinds of minds is to say that some people think visually and some people think verbally. But “visual thinker” doesn’t really describe that part of the population well. I think in pictures, but I found that other visual thinkers don’t think like me at all. They think spatially. The more I asked people how they think, the more convinced I became that picture/object thinking and pattern/spatial thinking were as distinct from each other as the old visual and verbal categories.

Medical Opinion

The Horror of Force Feeding

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Hunger strikers at Guantánamo Bay will have tubes shoved up their noses, down their throats, and into their stomachs. It’s grisly, excruciating, and ethically dubious. By Kent Sepkowitz.

A very complicated ethical debate has arisen from the mess that is the Guantánamo Bay detention camp.About 100 men are in the midst of a life-threatening hunger strike to bring world attention to their plight. In response, the U.S. has sent 40 medical personnel to “force feed” the prisoners sufficient calories to prevent their starving to death—and with the action surely has brought the prisoners a large amount of global attention.Leaving aside for moment the substantial legal, moral, and political issue at hand, some might wonder just how a person can be force fed.

Medical Mystery

Are Ultrasounds Causing Autism?

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Scientists are uncovering disturbing evidence that those sneak peeks at baby could damage a developing brain.

Toward the end of my first pregnancy, a doctor ordered an “emergency” ultrasound because she believed I was measuring small. She turned to go to her next client before I could talk to her about it, muttering that she suspected “intrauterine growth retardation.” My husband and I sat in the waiting room, flooded with anxiety. The scan showed the baby was fine. It wasn’t until years later when I started researching and writing about pregnancy that I learned that ultrasound scans have not been shown to be any more effective in predicting intrauterine growth restriction (doctors these days try to avoid using the word retardation) than palpation of the pregnant woman’s abdomen by an experienced clinician.


Big Idea: Farming Treats Cancer?

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You know labels like ‘organic,’ ‘free range,’ or ‘non GMO,’ but what exactly do they mean? Physician Daphne Miller, who teaches family medicine at UC San Francisco, sought to learn more about where our food is grown in ‘Farmacology,’ and finds that innovative farming can teach us new lessons about our health—a vineyard’s pest management strategy, for instance, offers a new take on cancer care.

What is your big idea?We are more connected to the farm than we think.Recently I began to take time away from my medical practice to visit sustainable farms and see what went on there. As I journeyed across the country, milking cows, gathering eggs, weeding brassicas, laying irrigation pipe and hawking produce at farm stands, I discovered that good medicine and good farming had much in common. In fact, I began to see family farmers as healers whose jobs were more complicated than mine, since they were responsible for the health of an entire eco-system (soil, soil creatures, animals, plants, water, air, people, and so on) while I was expected to care for just one member of that eco-system (people).

Meningitis Scare

It’s Not a ‘Gay Disease,’ Got It?

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If a deadly strain of meningitis hits gay men in New York, and then a gay man gets meningitis in L.A., what’s a public health official to do? Kent Sepkowitz on the tricky politics of diseases that discriminate.

The slow-motion meningitis outbreak among gay men in New York City took a possibly frightening turn this weekend when a rapidly fatal case of the disease was seen in a previously healthy young gay lawyer in Los Angeles.  The facts are still emerging, but the basics are as follows: last fall, just before a fungal meningitis scare popped up in five mostly Southern states, a cluster of cases caused by meningococcus, a bacterium, was seen in NYC among gay men, some of whom were HIV-infected.

5 Secrets for Better Health Care

Johns Hopkins Hospital surgeon Marty Makary shares the five insider tips to getting top-notch medical care. First stop? The internet.

  1. Why Is the Penis Shaped Like That? Play

    Why Is the Penis Shaped Like That?

  2. The Number: $5.7 Billion Play

    The Number: $5.7 Billion

  3. The War on Waxing? Play

    The War on Waxing?


Healthy Reads

The Happiness Project

The Happiness Project

The famous Grant Study tracked hundreds of Harvard men from youth to death to determine what predicts contentment.


Has the War on Cancer Failed?

Unlikely Cures

An Epidemic of Absence

A Selfish Read

What Richard Dawkins Reads


How to Be Ethical