Friday, September 30, 2011

The Limits of Empathy

David Brooks has had a series of excellent editorials on empathy and social justice. This is the latest. 
But if you subscribe to the New York Times it is worth reviewing his past month or two of columns on this subject.

The problem comes when we try to turn feeling into action. Empathy makes you more aware of other people’s suffering, but it’s not clear it actually motivates you to take moral action or prevents you from taking immoral action.

n the early days of the Holocaust, Nazi prison guards sometimes wept as they mowed down Jewish women and children, but they still did it. Subjects in the famous Milgram experiments felt anguish as they appeared to administer electric shocks to other research subjects, but they pressed on because some guy in a lab coat told them to.
Empathy orients you toward moral action, but it doesn’t seem to help much when that action comes at a personal cost. You may feel a pang for the homeless guy on the other side of the street, but the odds are that you are not going to cross the street to give him a dollar.
Moreover, Prinz argues, empathy often leads people astray. It influences people to care more about cute victims than ugly victims. It leads to nepotism. It subverts justice; juries give lighter sentences to defendants that show sadness. It leads us to react to shocking incidents, like a hurricane, but not longstanding conditions, like global hunger or preventable diseases.
Nobody is against empathy. Nonetheless, it’s insufficient. These days empathy has become a shortcut. It has become a way to experience delicious moral emotions without confronting the weaknesses in our nature that prevent us from actually acting upon them.
People who actually perform pro-social action don’t only feel for those who are suffering, they feel compelled to act by a sense of duty. Their lives are structured by sacred codes.

Twitter Study Tracks When We Are :)

Drawing on messages posted by more than two million people in 84 countries, researchers discovered that the emotional tone of people’s messages followed a similar pattern not only through the day but also through the week and the changing seasons. The new analysis suggests that our moods are driven in part by a shared underlying biological rhythm that transcends culture and environment.
The pair found that about 7 percent of the users qualified as “night owls,” showing peaks in upbeat-sounding messages around midnight and beyond, and about 16 percent were morning people, who showed such peaks very early in the day.
After accounting for these differences, the researchers determined that for the average user in each country, positive posts crested around breakfast time, from 6 a.m. to 9 a.m.; they fell off gradually until hitting a trough between 3 p.m. and 4 p.m., then drifted upward, rising more sharply after dinner.
To no one’s surprise, people’s overall moods were lowest at the beginning of the workweek, and rose later, peaking on the weekend. (The pattern of peak moods on days off held for countries where Saturday and Sunday are not the weekend.)
The pattern on weekend days was shifted about two hours later — the morning peak closer to 9 a.m. and the evening one past 9 p.m., most likely because people sleep in and stay up later — but the shape of the curve was the same.

Making Change Happen, on a Deadline

I like the concept of a 100 days goal!
Like many companies in AIDS-wracked Ethiopia, PreFabricated had an AIDS policy, which included extra pay for its H.I.V. positive workers so they could buy more food.  In March, 2008, the company decided to do more.  It set a goal of persuading 70 percent of its employees — 700 people — to get tested for H.I.V. in 100 days.
This was a startling idea.  “Employees do not like to get tested at work because of privacy concerns,” said Seife Mergia, the company’s head of planning and information.  Most of the employees did not work at headquarters, but were scattered around various construction sites.  They were mostly contract day laborers — a workforce few companies invest in.  Yet by day 40 the company had built a clinic. It set up a lab and hired a technician.  It gave people credible evidence that their H.I.V. status would be confidential.  At the 120-day mark, 900 people had been tested for H.I.V.
PreFabricated surpassed its goal using a strategy called Rapid Results, in which a group of people choose a project and carry it out in 100 days.  Companies in Addis that used Rapid Results got their H.I.V. testing rates up to about 75 percent — triple the norm.   The same method has been used in Nicaragua to help pig farmers raise fatter pigs and to improve dairy farms’ milk quality.
Rapid Results is an eccentric idea.  Nadim Matta, a management consultant who is president of the Rapid Results Institute in Stamford, Conn., likes to say that what’s missing to turn poor places into rich places isn’t more information, money, technology, workshops, programs, evaluation or any of the other things that development organizations normally provide.  What’s missing are motivation and confidence.
At first glance, this seems crazy —  can we cheerlead our way into the middle class?
What Matta means is that usually the obstacle to development is not that we don’t have the tools, but that we don’t use the tools we have. People drag their feet. The next step is someone else’s problem.  
The deadline creates an ethos of doing whatever it takes.  

Monday, September 26, 2011

Malaria: Epidemic On the Run

Emer also wants me to understand that contracting malaria is often just the beginning of one's troubles. Malaria might kill you. But if it doesn't, it may be the start of an endless cycle of illness and poverty. "Because kids get malaria, there is a lot of absence from school," he says. "So our kids don't do well. So they don't get good jobs, and they don't earn money. Then they have children, who also get sick, and the parents have to spend their little money on them instead of spending it on schools or other things — and they have to stay home to look after them, so they lose more money. Malaria keeps us poor."

Dalai Lama Will Name Succesor at 90 (he is 76)

All will be clear when the Dalai Lama is around 90 years old. That was the message from the exiled Tibetan spiritual leader over the weekend, as he convened a conference of various Tibetan Buddhist sects in the Indian hill station of Dharamsala. Although the Nobel Peace Prize laureate, 76, is in good health, the issue of what will happen to the Tibetan struggle once he dies looms in many minds. Tibetans believe that he will be reincarnated; after all, the current Dalai Lama is considered the 14th incarnation of the Tibetan god of compassion. But how—and if—this will happen will only be revealed in “clear written instructions” that the Tibetan leader promises to release when he reaches his ninth decade.

Saudi Women Get the Vote but Real Power is Elusive

On Sunday, Saudi Arabia's King Abdullah granted women the right to vote and run in the next set of municipal elections, scheduled for 2015. That's good news. But not as good as you might think.

Monday, September 19, 2011

Researchers Announce a Breakthrough on HIV/AIDS Treatment

A technique that alters T cells has been shown to reduce the amount of virus in infected people.

Sangamo's approach is based on the observation that some people have a naturally occurring mutation in the CCR5 gene that protects them against HIV. Ordinarily, humans have two copies of every gene. It turns out that individuals with a mutation in both copies of the CCR5 gene cannot be infected by the most common HIV strains. In people with the so-called Delta-32 mutation in just one copy of the gene, infection rarely progresses to AIDS. In the U.S., about 1 percent of the population is thought to carry the helpful mutation, which some researchers believe arose as protection against the Black Death.
Previous evidence existed showing that CCR5-negative cells could help AIDS patients. In 2007, an American man with AIDS and lymphoma received, as treatment for the cancer, a bone-marrow transplant from a person with the CCR5 mutation. The marrow recipient has been free of both AIDS and cancer since then. Sangamo's method treats a patient's own cells, with less risk than a marrow transplant.

Sunday, September 18, 2011

For The Dying, A Chance To Rewrite Life

The idea that we all tell ourselves about ourselves and our lives is a concept that has resonated. I ...the idea of using narrative as a way to create a denoument to one's life at the end seems to be a good one..
NPR explores this here.

Saturday, September 17, 2011

Reno Air Races

Reno is still recovering from the devastating crash of the 51 Mustang airplane into the crowd at the Reno Air Races yesterday...
Reno Gazette Journal link here.
New York Times link here.
I would like to commend REMSA,my fellow ophthalmologists, trauma surgeons and ER physicians, as well as ancilliary personnel who responded professionally and are continuing to care for the many patients.

My heart goes out to those who died and were injured along with their families.

Tuesday, September 13, 2011

Good News About Malaria

Good News About Malaria via Doc Gurley

A report by the RBM (Roll Back Malaria) agency in Geneva, Switzerland says that globally deaths from malaria have fallen by 20% in the past decade, from 984,000 in the year 2000 to 781,000 in 2009. In addition, three countries have been added to the list of those certified as malaria-free; Morocco, United Arab Emirates and Turkmenistan. The agency credits the steep ride in funding for the fight against malaria, particularly from the Bill and Melinda Gates Foundation and the Global Fund to fight AIDS, Tuberculosis and Malaria. Funding to fight malaria has increased by 15 times since 2003 and is credited with the progress that has been made.
The increase in funding has led to a huge increase in the distribution of insecticide treated malaria nets in dub-Saharan Africa where 80% of global malaria cases arise.

Personalizing Your Hotel Search

SEARCHING for a hotel online has long been limited to plugging in your travel dates and destination and then sifting through star ratings and prices. But there are other factors involved. Is the hotel in a convenient location? Is it child friendly? Will the room have a view of a brick wall or the sea?

Now, a number of Web sites are attempting to answer these questions with tools including photo-based searches and maps that show where a town’s hot spots are.

Monday, September 12, 2011

iExaminer for iPhone 4 Liberates Fundus Exams

Ophthalmoscopes are widely used to help diagnose a variety of conditions, but much like traditional microscopes they can only be used by one person at a time and sharing what one sees requires, as the old saying goes, a thousand words.
The iExaminer from Intuitive Medical Technologies in Shreveport, Louisiana is a simple iPhone 4 attachment for the popular Welch Allyn PanOptic ophthalmoscope that lets you do fundus exams and share videos and images right from the iPhone.

Low-Hassle Ways To Cloud-ify Your Work

Want your files accessible online, but don't like the idea of not keeping a local copy? These tools let you sync and collaborate, but also give you offline copies and peace of mind.

Friday, September 09, 2011

Cost Savings of Genentech's Avastin Gets Closer Look

The irony here is that while the President and members of Congress bemoan physician fees, they did not recognize how much money retina specialists saved the U.S. government.
 Ironically,  the fee for injection of Avastin was halved last year. 

I would argue that there should have been incentives to retina physicians who, based on fairly good evidence, knew that avastin was equivalent to Lucentis in terms of efficacy, and who were saving the government a phenomenal amount of money by using Avastin. Not only did the government save money, so did patients. To make it more interesting retina doctors who used Lucentis were actually more profitable in this regards, than those who exclusively used Avastin.

WASHINGTON—Medicare could have saved more than $1 billion and Medicare patients $275 million over two years if doctors treated a serious eye disease with Genentech's Avastin instead of the company's similar but more expensive drug Lucentis, according to a new government audit.

Thursday, September 08, 2011

End Malaria Project

For those of you who contributed to Seth Godin's End Malaria Project as outlined in the post below, you already received an email from Seth Godin, noting that the book "End Malaria"became an instant worldwide bestseller.

Wednesday, September 07, 2011

That buzzing in my ear didn't mean I was about to die

Seth Godin gets it...Today is End Malaria Day and he is making an impassioned plea for us all to do something to help saving lives (in many cases children's lives). It's as simple as buying a bed net. For anyone who has spent any amount of time in Africa, South East Asia or any other malaria infested areas, you know how crucial bed nets are, not only for a good night's sleep, but also for disease prevention from mosquitoes!

Six weeks ago, at midnight, I found myself awake but wiped out from jet lag. I was in a lumpy bed, in the dark, in an obscure, $20 a night, John-Waters'-esque former country club. I was in Kitale, Kenya, near the Ugandan border.
A mosquito was buzzing in my ear. (Why do they buzz in your ear?). I had meds, of course, but what if I didn't? What if, like so many who live here, I had kids and no money for medicine?
Try to imagine that for a second before you click onto the next thing you've got on your agenda for today.
Today is End Malaria Day.
Right this minute, right now, please do three things:
  1. Buy two copies of End Malaria, an astonishing new book by more thansixty of your favorite authors. In a minute, I will explain why this might be the most important book you buy this year (not the best book, of course, just the most important one). You should buy one in paperbacktoo so you can evangelize a copy to a colleague.
  2. Tweet or like this post, or email it to ten friends (It only takes a second.)
  3. And, visit the End Malaria Day website and share it as well.
What would happen if you did that? What would happen if you stepped up and spent a few dollars?
Here's what would happen: someone wouldn't die.

Adjusting, More M.D.’s Add M.B.A.

Under heavy pressure from government regulators and insurance companies, more and more physicians across the country are learning to think like entrepreneur.

Sandy Huffaker for The New York Times
Dr. James Kuo is nonexecutive chairman of a company headed by his wife, Dr. Geraldine Kuo.

Tuesday, September 06, 2011

2011's Top Do-Good Design: Yves Béhar's Glasses For The Poor

I thought the one Laptop per Child XO computer was a great concept and participated in it along with many family and friends...I always wondered where the green color came from...a nd now I now--Mr. Behar. His latest effort is similarly awe inspiring!
For the second time, San Francisco industrial designer Yves Béhar has won the INDEX Award, a 100,000 Euro prize given to five life-improving design projects by a Danish nonprofit. This year, Béhar's program "See Better to Learn Better," a system for delivering attractive, affordable eyeglasses to school-age children, has been presented with one of the awards. Béhar previously won for the One Laptop Per Child XO computer in 2007.
With the winnings, Béhar plans to expand See Better to Learn Better to other locations, including a pilot program in Indonesia with the Sumba Foundation and another project that will take place in San Francisco in partnership with the nonprofit Tipping Point. Béhar cautions that providing proper eye care to young people is not an issue relegated to impoverished nations. "The need is everywhere, in both developing countries and the developed ones," Béhar tells Co.Design. "Getting over the stigma that kids feel when having to wear glasses is something that design, participation, and choice can do."
In fact, Béhar sees correcting vision as a vital global issue that could radically improve the state of the planet, akin to eradicating a disease. "500,000 new kids entering school every year in Mexico need eyeglasses. Now let’s multiply this number by every country, and the numbers are staggering," he says. "That such a minute investment can change the education level of a population is a no-brainer to governments everywhere. For less than $10 -- the cost of the eye exam, custom lenses, frames, and shipping -- a child’s education level can change radically." In fact, according to a study by the University of Aguascalientes, a child that receives lenses immediately improves their reading and comprehension by 100%.

Monday, September 05, 2011

Somalia famine: UN warns of 750,000 deaths

As many as 750,000 people could die as Somalia's drought worsens in the coming months, the UN has warned, declaring a famine in a new area.

BuckEye Surgeon

Some of the most compelling medical blogging on the internet comes from Jeffrey Parks, aka" Buckeye Surgeon"

Here is an example of his poignant, thought provoking writing:  Irrational Death.

Kevin Md

Kevin MD is a good source for medical blog posts---Here are a couple of the most recent:

Your 10 minute office visit needs 8 people and 45 minutes of work


How malpractice hurts doctors and their future patients

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