Week of July 24, 2023
My typical office visit opening patient question is, "Since our last appointment, have you had any hospitalizations, illnesses, medication changes, or alien abductions?" I like asking mildly absurd and provocative questions - it lightens the tone and helps gauge the patient's attention and cognition. To the abduction question, the usual response is a quiet smile or an "I'm still waiting" answer. Recently, a patient responded that they had resisted an abduction attempt. Despite an alien coming to take the patient from their bedroom on multiple nights, the patient argued that childcare responsibilities were more important than space exploration. The patient and the alien parted ways, having "agreed to disagree." Healthcare opens the door to a wide range of conversations - I can now add the value of debating work/life balance with extraterrestrials to the list of things patients have taught me.
My opening question may be teaching me practical tactics:
https://www.newsnationnow.com/space/ufo/luna-house-oversight-hearing-uaps-uly-26/
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Hospitalizations are still decreasing, but wastewater monitoring indicates an increasing infection rate.
The N.Y. Times COVID Tracker contains only CDC-gathered hospital data as a surrogate (lagging) indicator.
https://www.nytimes.com/interactive/2023/us/covid-cases.html
Wastewater monitoring is more of a LEADING indicator.
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COVID articles
Tulane Professor Mike Hoerger offers a fantastic analysis of wastewater vs. other types of COVID incidence data. Without the full spectrum of monitoring (reported tests, real-time hospitalizations, ICU admissions, and deaths), we have a narrow understanding of what is happening.
https://twitter.com/michael_hoerger/status/1682257993608380417
Here is another COVID forecast for the next few weeks - another case spike, but probably less than last summer.
https://twitter.com/jpweiland/status/1682167805553041408
Medical Trends and Technology
StatNews offered a well-written description of how variations in HLA type (the proteins on the outside of cells that, amongst other things, identify us to our immune systems) impact the likelihood of having asymptomatic COVID infections. The article summarizes a recent Nature article in which the immune systems of those with specific HLA types robustly responded to coronaviruses, especially when they have prior (non-COVID) coronavirus exposure. "Individuals with this B*15:01 [HLA protein] mutation who [also] have [an existing exposure to coronaviruses] seem to be particularly effective[...] at [clearing] the virus before experiencing any symptoms."
https://www.statnews.com/2023/07/19/why-people-catch-covid-but-never-get-sick/
and
https://www.nature.com/articles/s41586-023-06331-x
Exercise is good for cardiovascular health, even if you only work out on the weekends. A recent study in JAMA demonstrated that "Physical activity [even if] concentrated in 1 to 2 days was associated with [a] similar [reduced] risk of cardiovascular outcomes [compared to] more evenly distributed [physical] activity."
https://jamanetwork.com/journals/jama/article-abstract/2807286
"Participants who exercised moderately or vigorously as little as 2 hours per week had lower rates of atrial fibrillation (a heart rhythm which can be dangerous), heart attacks, heart failure, and strokes. The study followed nearly 90,000 volunteers (with an average age of just north of 60) for around 6 years, on average." Dr. Jeremy Faust offered an analysis of this study, which utilized health trackers (like Fitbit) to obtain data.
https://insidemedicine.substack.com/p/weekend-warriors-vs-daily-gym-rats
Here is an excellent example of how scientific writing gets translated into consumer media:
A group of professors writes about known and unknown problems of embryo development in low-gravity environments, especially in light of the emerging consumer space programs. While not humanity's most pressing scientific issue, the authors highlight the open series of questions surrounding the unknowns of human reproduction in zero gravity.
Sex in Space: Consideration of uncontrolled human conception in emerging space tourism
https://zenodo.org/record/7852203
and commentary
The U.K.'s Daily Mail picks this up: "Scientists call for urgent research on the consequences of joining the 'Karman line club' – as they claim intercourse will happen between space tourists within 10 years." Based on this headline, we will need "study couples" to urgently launch for immediate research - similar to "blow up the asteroid about to hit the Earth" movies.
Infographics
I did not realize how common it was to describe the relative sizes of our nearby planets as fruit. It is a wonderful example of communicating and relating scale using commonly understood sizes.
https://cdn.foodbeast.com/content/uploads/2014/11/space-fruit.jpg
from
https://www.foodbeast.com/news/planets-relative-to-fruit-sizes/
Things I learned this week
Dr. James Barry was an accomplished Irish surgeon who graduated medical school in Edinburgh in 1809, rising through the British military medical ranks. He was a highly skilled surgeon, performed the first successful cesarean section, and was a vocal advocate for sanitation and public health. Upon his death in 1865, Dr. Barry was found to be a woman. She had passed as a man for his entire medical career in the military. What a remarkable and challenging life.
https://sciencehistory.org/stories/magazine/how-history-keeps-ignoring-james-barry/
and (shorter version)
https://www.history.com/news/the-extraordinary-secret-life-of-dr-james-barry
The gender of young gorillas is hard to determine, even though they don't wear pants.
https://nypost.com/2023/07/22/gorilla-believed-to-be-a-boy-gives-birth-at-ohio-zoo/
Living with A.I.
Google will offer A.I. that writes news stories. Perhaps it will do better than the Daily Mail headlines regarding the urgent need for space sex research.
https://techcrunch.com/2023/07/20/google-reportedly-testing-ai-tool-write-news-articles/
Dr. Leana Wen, a G.W. University epidemiologist, published a comprehensive overview of how healthcare organizations use A.I. While not as exciting as the hype, cautious optimism abounds.
https://www.washingtonpost.com/opinions/2023/07/20/ai-health-care-epidemics-diagnosis/
A.I. art of the week
"Postage stamp from Fiji celebrating aliens coming to the bedroom of a woman wearing a nightgown and hair rollers"
Clean hands and sharp minds,
Adam
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