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Precision Medicine Is Crushing Once-Untreatable Cancers–But There’s a Catch

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For tens of thousands of patients, precision medicine is rewriting their cancer stories. But only a fraction of patients benefit. Can medicine close the gap?

From my cover story in the July 26, 2019, Newsweek

Linda Boyed, an energetic 52-year-old occupational therapist, was thrilled to be on vacation with her family in Hawaii, hitting the beaches and taking long walks. But she couldn’t shake a constant feeling of fatigue. When she returned home, her doctor delivered the bad news: Cancer of the bile ducts in her liver had already spread too far for chemotherapy or surgery to do any good. He offered to help keep her comfortable for her final few months.

But then Boyed’s husband found a doctor at Ohio State’s cancer center who was running studies of experimental drugs for gastrointestinal cancers. That doctor gave her an experimental drug called BGJ398. Boyed’s symptoms cleared up, the tumors stopped growing, and she regained the weight she had lost….Read more

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The Worst Patients in the World

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Americans are hypochondriacs, yet we skip our checkups. We demand drugs we don’t need, and fail to take the ones we do. No wonder the U.S. leads the world in health spending.

From my article in the July 2019 issue of The Atlantic

I was standing two feet away when my 74-year-old father slugged an emergency-room doctor who was trying to get a blood-pressure cuff around his arm. I wasn’t totally surprised: An accomplished scientist who was sharp as a tack right to the end, my father had nothing but disdain for the entire U.S. health-care system, which he believed piled on tests and treatments intended to benefit its bottom line rather than his health. He typically limited himself to berating or rolling his eyes at the unlucky clinicians tasked with ministering to him, but more than once I could tell he was itching to escalate….Read more

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With a Simple Twist, a ‘Magic’ Material Is Now the Big Thing in Physics

QuantaGrapheneImage2The stunning emergence of a new type of superconductivity with the mere twist of a carbon sheet has left physicists giddy, and its discoverer nearly overwhelmed.

From my April 30, 2019, article in Quanta Magazine (also published in Wired)

Pablo Jarillo-Herrero is channeling some of his copious energy into a morning run, dodging startled pedestrians as he zips along, gradually disappearing into the distance. He’d doubtlessly be moving even faster if he weren’t dressed in a sports coat, slacks and dress shoes, and confined to one of the many weirdly long corridors that crisscross the campus of the Massachusetts Institute of Technology.

Jarillo-Herrero has never been a slacker, but his activity has jumped several levels since his dramatic announcement in March 2018 that his lab at MIT had found superconductivity in twisted bilayer graphene — a one-atom-thick sheet of carbon crystal dropped on another one, and then rotated to leave the two layers slightly askew….Read more

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How to Almost Learn Italian

Language apps like Duolingo are addictive—but not particularly effective.

From my article in the December 2018 issue of The Atlantic

Late one chilly evening last September, I excused myself from a small group huddled around a campfire to peck at and mumble into my phone.

No way was a camping trip going to make me miss my Italian lesson.

For most of the preceding year, I had religiously attended to my 15-minute-or-so daily encounters with the language-learning app Duolingo. I used it on trains, while walking across town, during previews at the movie theater. I was planning a trip to Rome in the late spring, and I’ve always been of the mind that to properly visit a country, you’ve got to give the language a shot.

But I had another reason for sticking with it: Duolingo is addictive….Read more

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Health Care’s ‘Upstream’ Conundrum

When it comes to the long-term health of the country, findings now show the big problem might not be health care at all—it might be everything else. Can researchers get politicians to pay attention?

From my article in January 2018 in Politico

At the heart of America’s vaunted health care system is a frustrating puzzle. The United States pays three times as much per citizen as the average of other wealthy nations—far more than even the second-highest spender, Switzerland, adding up to $3 trillion a year. Yet for all that enormous expenditure, we come in dead last among those nations in lifespan. And as the bills climb, our life expectancy is actually shrinking.

What’s going so wrong? If our national health care were a corporation, that return on investment would get its CEO immediately fired. Plenty of experts are ready to point fingers at various causes: our lack of universal health care, industrialized food system, PoliticoUpstreamsuburban lifestyles, and profit-driven tangle of insurers and drug companies and hospitals. Surely those play a role. And yet other countries face each of these, and other challenges as well, and still manage to spend less and enjoy better health overall.

Looming over the American conversation about public health is a growing suspicion that there’s a bigger reason for our uniquely poor showing, one that has been staring us in the face for years. It’s an explanation rooted in one simple statistic: While we pay more for health care than any other country in the world, when it comes to spending on social services—education, subsidized housing, food assistance and more—we rank in the bottom 10 among developed countries.

It’s easy to think of “health” as just another category of social-service spending. But a great deal of modern research suggests that it might be more accurate to think of it as the payoff of all the other services put together. Elizabeth Bradley, president of Vassar College and a former Yale researcher widely seen as the world’s foremost expert in the relationship between social services and health, has documented how the ratio of a country’s social-service spending to health care spending is highly correlated with health outcomes around the world. “The right question for our political agenda is, ‘What’s going to give us the most bang for the buck in health outcomes?'” says Bradley. “What our work has shown is that the answer is spending on social services.” Read more

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The War on Stupid People

American society increasingly mistakes intelligence for human worth

From my article in the July/August 2016 issue of The Atlantic

As recently as the 1950s, possessing only middling intelligence was not likely to severely limit your life’s trajectory. IQ wasn’t a big factor in whom you married, where you lived, or what others thought of you. The qualifications for a good job, whether on an assembly line or behind a desk, mostly revolved around integrity, work ethic, and a knack forAtlStupid getting along—bosses didn’t routinely expect college degrees, much less ask to see SAT scores. As one account of the era put it, hiring decisions were “based on a candidate having a critical skill or two and on soft factors such as eagerness, appearance, family background, and physical characteristics.”

The 2010s, in contrast, are a terrible time to not be brainy. Those who consider themselves bright openly mock others for being less so. Even in this age of rampant concern over microaggressions and victimization, we maintain open season on the nonsmart. People who’d swerve off a cliff rather than use a pejorative for race, religion, physical appearance, or disability are all too happy to drop the s‑bomb: Indeed, degrading others for being “stupid” has become nearly automatic in all forms of disagreement. Read more

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How Junk Food Can End Obesity

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Demonizing processed food may be dooming many to obesity and disease. Could embracing the drive-thru make us all healthier?

From my cover story in the July/August issue of The Atlantic 

Late last year, in a small health-food eatery called Cafe Sprouts in Oberlin, Ohio, I had what may well have been the most wholesome beverage of my life. The friendly server patiently guided me to an apple-blueberry-kale-carrot smoothie-juice combination, which she spent the next several minutes preparing, mostly by shepherding farm-fresh produce into machinery. The result was tasty, but at 300 calories (by my rough calculation) in a 16-ounce cup, it was more than my diet could regularly absorb without consequences, nor was I about to make a habit of $9 shakes, healthy or not.

Inspired by the experience nonetheless, I tried again two months later at L.A.’s Real Food Daily, a popular vegan restaurant near Hollywood. I was initially wary of a low-calorie juice made almost entirely from green vegetables, but the server assured me it was a popular treat. I like to brag that I can eat anything, and I scarf down all sorts of raw vegetables like candy, but I could stomach only about a third…read more.

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Survival of the wrongest

januaryfebruary2013cover_300x400How personal-health journalism ignores the fundamental pitfalls baked into all scientific research and serves up a daily diet of unreliable information.

From my cover story in the January/February issue of the Columbia Journalism Review

In late 2011, in a nearly 6,000-word article in The New York Times Magazine, health writer Tara Parker-Pope laid out the scientific evidence that maintaining weight loss is a nearly impossible task—something that, in the words of one obesity scientist she quotes, only “rare individuals” can accomplish. Parker-Pope cites a number of studies that reveal the various biological mechanisms that align against people who’ve lost weight, ensuring that the weight comes back. These findings, she notes, produce a consistent and compelling picture by “adding to a growing body of evidence that challenges conventional thinking about obesity, weight loss, and willpower. For years, the advice to the overweight and obese has been that we simply need to eat less and exercise more. While there is truth to this guidance, it fails to take into account that the human body continues to fight against weight loss long after dieting has stopped. This translates into…read more.

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How to Fix the Obesity Crisis

 

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Although science has revealed a lot about metabolic processes that influence our weight, the key to success may lie elsewhere

From my cover story in the February 2011 issue of Scientific American

Obesity is a national health crisis—that  much we know. If current trends continue, it will soon surpass smoking in the U.S. as the biggest single factor in early death, reduced quality of life and added health care costs.
Why are extra pounds so difficult to shed and keep off? It doesn’t seem as though it should be so hard. The basic formula for weight loss is simple and widely known: consume fewer calories than you expend. And yet….almost everybody who tries to diet seems to fail in the long run—a review in 2007 by the American Psychological Association of 31 diet studies found that as many as two thirds of dieters end up two years later

weighing more than they did before their diet.
   Maybe someday biology will provide us with a pill that readjusts our metabolism so we burn more calories or resets our built-in cravings so we prefer broccoli to burgers. But until then, the best approach may simply be to build on reliable behavioral psychology methods developed over 50 years and proved to work in hundreds of studies. These tried-and-true techniques, which are being refined with new research that should make them more effective with a wider range of individuals, are gaining new attention. As the NIH puts it in its proposed strategic plan for obesity research: “Research findings are yielding new and important insights about social and behavioral factors that influence diet, physical activity, and sedentary behavior….” read more (Subscription or payment to Scientific American needed to read full article at the site, but you can read a copy here)

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Lies, Damned Lies, and Medical Science

Much of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong. So why are doctors—to a striking extent—still drawing upon misinformation in their everyday practice? Dr. John Ioannidis has spent his career challenging his peers by exposing their bad science.

From my article in the November 2010 issue of The Atlantic


 
In 2001, RUMORS were circulating in Greek hospitals that surgery residents, eager to rack up scalpel time, were falsely diagnosing hapless Albanian immigrants with appendicitis. At the University of Ioannina medical school’s teaching hospital, a newly minted doctor named Athina Tatsioni was discussing the rumors with colleagues when a professor who had overheard asked her if she’d like to try to prove whether they were true—he seemed to be almost daring her. She accepted the challenge and, with the professor’s and other colleagues’ help, eventually produced a formal study showing that, for whatever reason, the appendices removed from patients with Albanian names in six Greek hospitals were more than three times as likely to be perfectly healthy as those removed from patients with Greek names….read more

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