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A Wheel

Atul Gawande at The New Yorker, The Cost of Defunding Harvard:

Sarah Fortune, a professor and the chair of the department of immunology and infectious diseases at Harvard’s school of public health, is among the world’s leading experts on tuberculosis, the No. 1 infectious cause of death globally. She had a sixty-million-dollar N.I.H. award for a seven-year moon-shot effort to unravel exactly how tuberculosis makes people sick, in order to find ways to better control the disease. It is now the beginning of the fifth year of the contract, which has supported work involving some sixty people across fourteen institutions—including Case Western Reserve University, in Ohio, the University of Pittsburgh, the University of Colorado, and clinical sites in South Africa and Uganda. That work—in humans, animals, and machine-learning models—had already revealed a pathway to a truly protective vaccine against T.B., which was previously believed impossible. The team had been conducting testing in macaques of an injectable vaccine developed by researchers at Boston Children’s Hospital.

But, on Tuesday morning, Fortune had received an e-mail with a letter from the N.I.H. ordering her to stop her research, “effective immediately.” Virtually all spending was halted. This was reminiscent of the stop-work orders and terminations at U.S.A.I.D., which ended more than eighty per cent of the agency’s programs and led to layoffs for some two hundred thousand people in the U.S. and around the world. These programs and people had saved lives by the millions. The indifference to, and even celebration of, the destruction is what is most horrifying.

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Solitary Confinement

Is long-term solitary confinement torture?

The simple truth is that public sentiment in America is the reason that solitary confinement has exploded in this country, even as other Western nations have taken steps to reduce it. This is the dark side of American exceptionalism. With little concern or demurral, we have consigned tens of thousands of our own citizens to conditions that horrified our highest court a century ago.

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Better

Just got done reading Atul Gawande’s book Better: A Surgeon’s Notes on Performance. First off, it’s a fantastic title: it reflects the simplicity of Gawande’s language and the complexity he manages to express with those words. The book explains how, through “diligence”, “doing right”, and “ingenuity”, surgeons can improve. The anecdotal essays are fascinating and well-written… and the ideas are inspiring. The idea is, the greatest gains we will see in the delivery and efficacy of healthcare lie not in the raw advances in science, but in the persistent, thoughtful efforts of those “on the ground” fighting the same problems every day. Here’s a bit where Gawande describes the thinking of a surgeon turned malpractice lawyer:

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McAllen, Texas Healthcare

In the healthcare article of the year, Dr. Atul Gawande has done some outstanding reporting: he has described the core problems of the United States’ healthcare system. He has also pointed out beacons for reform to pursue — the foremost being the Mayo Clinic right here in Rochester, Minnesota:

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Improving journalism

The 3 key parts of news stories you usually don’t get at Newsless.org makes so much sense to me. I always thought that I didn’t understand a lot of current events reporting because I wasn’t rabidly following every minor detail — that the onus was on me to put the article in context. In the aforelinked article, Matt Thompson argues that news becomes more engaging, more useful, better, when put into context. Thompson uses a recent, spectacular Atul Gawande article in the New Yorker as an example of journalism done right:

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The Quest for True Meaning

I suppose this could be considered another entry in my ‘happiness’ series, but this comes from a very different angle. I just finished a flat-out fantastic article in the New Yorker called The Way We Age Now, by Atul Gawande. What Dr. Gawande did was summarize the steeply declining geriatric profession and link it to anecdotal evidence for necessary changes in medicine’s attitude towards geriatrics.

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