What Adam is Reading Week of 10-3-22

Week of October 3, 2022

 

Last week, flying from Nevada to Maryland, I assisted someone who became ill mid-flight.  (This occasionally happens when you travel a lot.)  Unlike other healthcare venues, the most immediate question during a flight is, "Do we need to land now?"  After that, the situation evolves into creatively delivering care in a physically and resource-constrained environment (how do I assess the patient, and what medications and tools do I have?).  It is atypical for kidney doctors to be the lead in urgent situations.  I find these events mostly anxiety-provoking and a little exciting.  Thankfully it ended well - I watched the patient walk off the plane, and, best of all, the patient was not the pilot.

 

Here is what is in the standard airplane medical kit:  https://thepointsguy.com/news/whats-inside-an-airplanes-emergency-medical-kit/

In appropriate instances, I could see asking other passengers for things like albuterol inhalers or prednisone as well.

 

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In the U.S., COVID case rates, hospitalizations, and deaths are declining in almost all states.  Last week, about 400 people died daily, with 28,000 hospitalized patients.

 

N.Y. Times Tracker

https://www.nytimes.com/interactive/2021/us/covid-cases.html

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It feels like we are in a relative lull of COVID.   And it is an excellent time to get both a bivalent booster and the flu vaccine.  Epidemiologist Katelyn Jetelina (from the University of Texas Health Science Center) offers this fantastic review of data on how safe and effective COVID-19 vaccinations are before, during, and after pregnancy.

https://yourlocalepidemiologist.substack.com/p/mrna-in-breastmilk-thats-okay-and

 

The Atlantic highlights some engrained American culture trends that are self-defeating in pandemics: "Since its founding, the [United States] has prized a strain of rugged individualism that prioritizes individual freedom and valorizes self-reliance.  According to this ethos, people are responsible for their own well-being, physical and moral strength are equated, social vulnerability results from personal weakness rather than policy failure, and handouts or advice from the government is unwelcome.  Such ideals are disastrous when handling a pandemic, for two major reasons..."

https://www.theatlantic.com/health/archive/2022/09/covid-pandemic-exposes-americas-failing-systems-future-epidemics/671608/

 

I am starting to see predictions for the coming winter's COVID surge - again emphasizing how valuable having the bivalent vaccine booster may be.  As this Science article states, "The boosters are always going to be a step behind, but the good news is that the BA.5 booster is going to be one or two steps behind the virus' evolution, instead of five steps behind."

https://www.science.org/content/article/big-covid-19-waves-may-be-coming-new-omicron-strains-suggest

 

 

Medical Trends and Technology

 

One recent conversation with a loyal reader resulted in my learning more about breath training - using devices and deep breathing to lower blood pressure.  Admittedly, I was skeptical.  But there is some interesting data and, perhaps, some sustained reductions in blood pressure.  Moreover, the risk and costs are low.  Breathe training seems like a potentially useful adjunct to standard blood pressure therapy.

https://www.npr.org/sections/health-shots/2022/09/20/1123500781/daily-breath-training-can-work-as-well-as-medicine-to-reduce-high-blood-pressure

For the doctors, here are the actual articles from the Journal of the American Heart Association

https://www.ahajournals.org/doi/10.1161/JAHA.121.022203

and

https://www.ahajournals.org/doi/10.1161/JAHA.121.020980

 

Infographics

Here is a nicely executed infographic from 2014 - "What it costs to propose at every baseball stadium in the U.S." It is thematically appropriate, conveys the cost gradient, and is concise.  I wonder how these prices have changed over time?

https://www.si.com/extra-mustard/2014/03/31/infographic-the-cost-of-a-marriage-proposal-at-every-mlb-park

 

Get to know our AI Overlords!

My opening anecdote inspired this week's AI-generated image, "a flying doctor with blood pressure cuffs as wings."  Not sure what is going on with the doctor's face, left leg, thumbs-up, or left hand.  I hope this image is not what artificial brains perceive as they read my email. 

https://labs.openai.com/s/20WlWGkeOojEya0EF38t27JD

 

 

Things I learned this week

 

British author Ian Leslie writes and consults about human behavior and psychology.  He has met Paul McCartney several times and believes Sir Paul has "a freakish memory."   I don't know if one can conclude much from Ian's anecdotal data, but his blog piece was interesting.

https://ianleslie.substack.com/p/paul-mccartneys-freakish-memory

 

 

I learned about Prisencolinensinainciusol - A song by Italian singer Adriano Celentano intended to sound to its Italian audience as if it is English.  However, the lyrics are deliberately unintelligible gibberish.  "Celentano's intention with the song was NOT to create a humorous novelty song but to explore communication barriers."  Though unintended, the whole thing is amusing.  Watch the video—a well-spent 3:39 seconds of your life.

The song

https://www.youtube.com/watch?v=-VsmF9m_Nt8

Background

https://en.wikipedia.org/wiki/Prisencolinensinainciusol

and

https://www.thelocal.it/20201126/prisencolinensinainciusol-heres-what-that-nonsensical-english-song-actually-means-in-italy/

lyrics

https://lyricstranslate.com/en/adriano-celentano-prisencolinensinainciusol-lyrics.html

 

 

As my older son is looking at colleges, our family has had several conversations about the impact of "redshirting" or holding back children to make them relatively older than others in their grades or peer groups.  My kids have August birthdays, and we did not hold them back.  As such, they are relatively young compared to their peers.  There is a fascinating  array of data on this topic:

 

Malcolm Gladwell wrote extensively about this in his book Outliers and recently revisited the topic on his podcast.

https://share.descript.com/view/VDS7PW2XdA1

Bottom line - numerous examples demonstrate that relatively older children have a higher chance of success in sports and education.

 

And, when younger kids mix with older kids, the younger kids tend to benefit (perhaps at the expense of the older kids).

https://www.newyorker.com/tech/annals-of-technology/youngest-kid-smartest-kid

 

In the context of college admissions, some advantages have nothing to do with age.

https://www.nytimes.com/2022/10/01/opinion/school-private-college.html

 

 

 

Clean hands and sharp minds,

 

Adam