LEIGH HOPPER

What you can't do with a Kindle

2011-03-03T07:17:00.000-08:00

I went to Africa for the first time in 1999 on the dime of the Kaiser Family Foundation. It was an incredible trip. We flew in tiny planes and landed on grassy airstrips where giraffes had just stepped out of the way. We visited a high-rise brothel in Johannesburg, accompanied by an armed private security detail. It was terrifying.

My husband joined me after the work part of the trip was over and we drove around Kruger Park in the world's smallest car, dodging mountains of elephant dung.

Anyway, shortly after takeoff on the return flight, Mark realized he'd brought nothing to read. Nothing like the prospect of 24 hours in coach class without a book to make one feel claustrophobic.

I was midway through James Michener's The Covenant, a fairly engrossing history of South Africa. Like all Michener books, this one was about 3 inches thick. I cracked the paperback at the 1-and-a-half-inch point, and spread the pages so wide you could see the binding. I took out my pocket knife (this was before 9/11) and began slicing.

"Don't do that!" my husband cried. "Why not?" I said. "Michener, any writer, would love this!"

I gave him the front half. I continued with my half. What author would object to having his or her book dismantled and devoured?

My life as a reporter, tale No. 1

2011-01-28T14:00:00.000-08:00

"You want to have a look?" he said. "Sure," I said, in a neutral voice. The former truck driver reached beneath his big belly, unzipped his pants and dropped his drawers.

It's not like you think. No, really. His wife was in the room. And this story is not a joke; it's about one of my most moving experiences as a reporter.

"Flesh-eating bacteria" was all over the news. That's tabloid-ese for necrotizing fasciitis, a fast-moving bacterial infection that travels something like an inch per hour between the layers of the skin. The only way to stop it is surgery, where you cut away everything that's infected, and then some.

The truck driver called me at the newspaper after reading an article I'd written about an unusually high number of Group A strep infections in Central Texas. (A story I broke, if I don't say so myself.) Strep and staph infections are sometimes the cause of this deadly condition.

The truck driver had survived necrotizing fasciitis, but just barely. He'd been driving his truck when he noticed a horrible pain in one of his testicles. Soon, it had swollen to the size of a football. He made it to the hospital in the nick of time.

Doctors saved his life, but he was a scarred man. What remained of his family jewels looked like two walnuts tacked on to his groin. They hurt, and he couldn't drive a truck anymore or make love to his wife.

Back at the office, my co-workers were astonished and a little tickled by what had happened. I couldn't really explain how flattered and honored I felt to be trusted so entirely by a stranger. I felt amazed. Grateful, even. Weird, huh? I wrote my article, but didn't tell the story behind the story very much. I didn't want to cheapen the memory or his trust by playing it for laughs.

What's the moral of this post? Dunno. It's not exactly something I can share at Career Day, so I'll put it here for posterity.

The hidden life of Igloos: Reporter tale #3

2011-01-28T06:56:00.000-08:00

If this had been a radio story, the opening sound would have been the scooping of ice into a 16-quart Igloo cooler. That's right, an ordinary Igloo cooler with the push-button handle and tent-shaped lid. This humble container would fly by private jet through starry skies to West Texas and return to Austin, a human heart within.

I had been wearing a pager for three months, waiting for this moment. I wanted to watch a heart transplant, from beginning to end.

I'll never forget the sight of the donor, a man who'd died suddenly and virtually painlessly from a brain aneurysm. He lay in the middle of a large, empty, all-white operating room. He was all in white, including the top of his head, only his brown face exposed. A machine breathed for him, so he didn't look dead. The scene looked like something out of Cocoon, or maybe ... Bethlehem.

It was holy.

In the hall outside the OR, the surgeon (who'd brought his own saw and other instruments), the transplant nurse, myself and a photographer, lined up with other teams who had their own Igloos filled with ice -- to carry back kidneys, the liver, the lungs. The organs had to be removed in a certain order, starting perhaps with the most fragile? I don't recall exactly. I think our group went first.

A nurse discovered me and the photographer and indignantly shooed us out into the waiting room. We weren't there long. The surgeon did his work quickly and we were out of there, leaving the others to collect the organs they'd come for.

Back on the plane, in the darkness, the surgeon suddenly jolted as if he'd forgotten something. He put his hand on the cooler and relaxed again, in relief.

In Austin, the transplant recipient's heart was removed. It was flabby and gray, like a chunk of pork tenderloin. The donor heart, red and firm as a fist, was sewn in. Later that day, the patient was sitting up, soon to take his first post-op steps.

"I can feel it," he told his wife. "It feels really strong."

An update on my book ...

2011-01-27T12:25:00.000-08:00

My writing mojo is in short supply. To motivate myself somewhat, here I post the millimeter of progress made on my book project. This scene takes place in Malawi.

Peter Kazembe felt, almost, dislike for his HIV patients. In fact, here came one now with his parents. Hadn’t he seen this child last week? Hadn’t he told the mother and father there was nothing he could do? These children took up a lot of time because there was so much wrong with them. In fact, they took away time from other patients, the ones with problems that he actually could solve. And the sicker they became, the more frequent their visits grew. These children with AIDS, he had nothing but painkillers to give them. He fought to hide his impatience from the parents. Their persistence, their questions, felt like rebukes. He hated it. They complicated his life.

Nine hundred miles away in Botswana, a diamond-rich nation that provided healthcare to all its citizens, Gabriel Anabwani watched all the public health gains over the past 30 years slip away. The Kenyan-born doctor, a specialist in pediatric cardiology, had moved to Botswana to help start a medical school. Proudly he'd watched infant mortality decline and he predicted the country's health statistics would soon match those of Western nations.

Then began the steady flow, a trickle at first, of infants arriving at the hospital with a strange pneumonia. The pediatric ward, always full, began to get crowded. Each metal-frame bed or crib held a patient or two, and beneath each bed was a pallet on the floor with another patient or two.

The death rate climbed and morale dropped low. Anabwani began taking a blood sample from each child who died with tuberculosis, pneumonia or diarrhea. Nearly every one of them was infected with HIV.

Anabwani and Kazembe were adrift on a sea of despair. They knew about the AIDS drugs that reversed the disease in wealthier parts of the world. It was unclear where they would find help.

Why did AIDS explode in Africa? Monkey virus met needles

2010-09-17T08:48:00.000-07:00

Precursor to H.I.V. Was in Monkeys for Millennia
By DONALD G. McNEIL Jr.
Published: September 16, 2010
New York Times

In a discovery that sheds new light on the history of AIDS, scientists have found evidence that the ancestor to the virus that causes the disease has been in monkeys and apes for at least 32,000 years — not just a few hundred years, as had been previously thought.

That means humans have presumably been exposed many times to S.I.V., the simian immunodeficiency virus, because people have been hunting monkeys for millenniums, risking infection every time they butcher one for food.

And that assumption in turn complicates a question that has bedeviled AIDS scientists for years: What happened in Africa in the early 20th century that let a mild monkey disease move into humans, mutate to become highly transmissible and then explode into one of history’s great killers, one that has claimed 25 million lives so far?

Among the theories different researchers have put forward are the growth of African cities and the proliferation of cheap syringes.

Confirming that the virus is very old also helps explain why it infects almost all African monkeys but does not sicken them. Over many generations, as any disease kills off vulnerable victims, the host adapts to it.

The new research, published Thursday in Science magazine, was relatively simple. Scientists tested 79 monkeys from Bioko, a volcanic island 19 miles off the West African coast. Bioko used to be the end of a peninsula attached to the mainland in what is now Cameroon, but it was cut off when sea levels rose 10,000 years ago at the end of the last ice age.

Since then, six monkey species have developed in isolation on the island, and scientists from the National Primate Research Center at Tulane University in Louisiana and other American and African universities found that four of them — drills, red-eared guenons, Preuss’s guenons and black colobuses — had members that were infected with S.I.V.

The four strains in the four species were genetically very different from one another — meaning they presumably did not come from monkeys carried over to the island by humans in the last few centuries. But each was close to the strain infecting members of the same four genuses on the mainland, meaning they must have existed before Bioko was cut off.

Knowing that all four strains were at least 10,000 years old, scientists recalculated the virus’s “molecular clock,” measuring how fast it mutates. They now believe that all the S.I.V. strains infecting monkeys and apes across Africa diverged from a common ancestor between 32,000 and 78,000 years ago.

“When we only had 25 years of data, we were dating from the tip at the end of a branch of the evolutionary tree,” said Preston A. Marx, a virologist at the Tulane primate center and an author of the paper in Science. “I knew that what we had before couldn’t be right, because the virus had spread from the Atlantic to the Indian Ocean to the southern end of the continent, and it couldn’t have done that in a couple of hundred years.”

Beatrice H. Hahn, a virologist from the University of Alabama at Birmingham and a discoverer of the simian virus, called the study “a very nice paper,” adding, “This is what people like us have been looking for.”

Previous methods of dating the virus had concluded it was a few hundred to 2,000 years old, “and that just didn’t seem right,” Dr. Hahn said.

The ancestor virus — which, like many diseases, may have crossed into simians from another, still-unknown species — may have existed for millions of years.

That theory was given greater credence two years ago with the discovery that some Madagascar lemurs have in their genomes the remnants of a virus that was not an S.I.V., but related to it. Madagascar, a Texas-size island 250 miles off the southeastern African coast, separated from Africa 160 million years ago. It has no monkeys, but lemurs’ ancestors arrived there, possibly on floating mats of vegetation, probably more than 10 million years ago.

H.I.V., which is almost universally fatal to humans, is obviously very new to us. As Dr. Marx pointed out, if it had been in humans before the 20th century, it would have arrived in the Americas in some of the 12 million Africans kidnapped for the slave trade.

Its immediate ancestor is probably also relatively new to chimpanzees. Last year, Dr. Hahn showed that it can sicken and kill chimps, although not as quickly, meaning they have probably been adapting to it for generations.

The virus has probably crossed over from simians into humans at least five times. There are two human immunodeficiency viruses, H.I.V.-1, by far the most common, and H.I.V.-2, which is milder and rarely seen outside West Africa, and which jumped to humans from sooty mangabeys, a monkey that West Africans hunt and eat.

H.I.V.-1, in turn, has four substrains, designated M, N, O and P. The first, which has spread around the world, clearly came from chimpanzees, as did N and O. But P appears to have crossed over from a gorilla; it was discovered only last year, and in only one woman, who was from Cameroon, where lowland gorillas are hunted for meat.

It is very likely, scientists said, that a little infected monkey or ape blood got into human veins many times in history as hunters cut themselves while butchering carcasses. But even if it sickened those hunters, it probably died out with them or their immediate contacts.

The earliest confirmed H.I.V. case in humans was found in blood drawn in 1959 from a man in Kinshasa, in what was then called the Belgian Congo.

Sometime between the 1800s and 1959, something presumably allowed a human infection with a chimpanzee virus to spread widely enough to evolve into modern H.I.V.-1, which could spread easily among humans.

Dr. Marx believes that the crucial event was the introduction into Africa of millions of inexpensive, mass-produced syringes in the 1950s. Campaigns to wipe out yaws, syphilis, malaria, smallpox and polio required syringes, and many were reused, often with official approval. Traditional healers adopted them for injecting their decoctions, and they became status symbols; a study in Uganda in the 1960s found that 80 percent of families owned one.

Not everyone agrees. Michael Worobey, a virologist at the University of Arizona and another author of the Science paper, said backdating the molecular clock, which he did by comparing the 1959 blood sample with the only other known early one — a paraffin-embedded lymph node from 1960, also from Kinshasa — suggested that the virus emerged closer to 1910, when syringes were handmade, expensive and rare.

He and Dr. Hahn suspect that the growth of colonial cities is to blame. Before 1910, no Central African town had more than 10,000 people. But urban migration rose, increasing sexual contacts and leading to red-light districts.

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Med students meet cadaver's family

2010-09-14T08:48:00.000-07:00

An odd, compelling story for your reading pleasure:

Students form bond with family of a cadaver donor
By LINDSEY TANNER
The Associated Press
Monday, September 13, 2010; 2:33 AM
GARY, Ind. -- Dot Purcell always knew she would donate her body to science. Even when young, the mother of 11, a doctor's daughter, would say, "there's something good in here" that might help others.
That death talk made her doting husband squeamish, and Jim Purcell tried to talk her out of it, saying, as they aged, that her body would be too old to be useful. He didn't want to contemplate losing his beautiful, fun-loving wife, who cherished life but accepted death. But when the moment came, after 64 blissful years of marriage, and her wish was carried out, neither of them could have imagined just how much Dot's decision would help, and heal.
Every year, thousands of people donate their bodies to science, becoming an essential part of hands-on medical training. Their gift allows students to study human anatomy and the effects of age, trauma and illness in close-up detail.
Yet, despite this intimacy, usual protocol calls for some distance. Donors are anonymous, and while many U.S. schools hold memorial services to honor them, details of what goes on in the dissection lab just aren't talked about much, certainly not with the surviving family members. It's all too awkward, too indelicate, too personal.
Which is why the story of what happens at Indiana University Northwest, where Dot Purcell's body ended up, is so unusual.

At the tiny medical school, a vibrant oasis in Gary, an otherwise decaying steel town, medical students are told the donors' names, given their medical records, and encouraged to get to know their families. These cadavers are the students' first patients, with lives worth knowing, not just for humanistic reasons, but to help students better understand the bodies they dissect.
Ernest Talarico, assistant director of medical education at IU Northwest, is the brains behind the idea. When he was in school, students often gave the unidentified cadavers crude nicknames. "Salty" was the moniker given a cadaver whom Talarico helped dissect - because the man had a nude woman tattoo on his chest.
"I found that disrespectful because they had a name and a life, and we should respect that as part of the tremendous gift they give to us," Talarico said.
So last October, a year after Dot's death, Purcell got a letter from Talarico. Dot's body, donated to the state anatomical gift association, had been sent to the Gary school, just 10 miles from the family's home in Munster, and they were invited to meet with the four first-year medical students who would be working on her.
"I was not that eager to meet them," Purcell said. At 90, the retired public relations executive is still grieving for the woman who ran their busy household and made him feel whole.
Dot had been mostly healthy until she was diagnosed in early 2008 with an extremely rare type of melanoma, the most dangerous form of skin cancer.
"It was devastating to me and to everyone in the family," Purcell said with a deep, heavy sigh, "because it just came on suddenly, and then she was gone."
Dot's diagnosis came several months before she died, but after six decades together, months seem like days and life without Dot was unimaginable to Jim.
More receptive to the idea of meeting the students was his son, Mike, ninth out of the 11 kids and more like Dot - an outgoing, glass-half-full kind of guy. He gently tried to convince his dad that it might be a good idea.
"The more my dad and I thought about it, we were like, you know what, she's come home. This is great," said Mike Purcell, 46.
First-year medical student Lucas Buchler had his own trepidations about meeting Dot's family. He thought the dynamics of the whole thing were pretty weird. Here were students on an amazing high, starting medical school - for some, fulfilling a lifelong goal - and they'd be meeting with families "in grieving mode," reeling from the loss of a loved one.
"It's a fairly emotional experience," Buchler, 23, said during a recent interview, a few weeks before starting his second year.
For many students, it's the first time they'd ever seen a cadaver, and even medical students get squeamish. But also, they can be overcome by appreciation for the donors and "their ultimate gift."
"We all prepared ourselves for an awkward interaction," Buchler said.
When the day arrived, there were more than just polite handshakes. The businessman in Jim Purcell approached it like interviewing a job candidate, and he grilled the students.
"I asked them what brought them into medicine," Jim Purcell said.
For Buchler, a handsome, serious young man with a thick brown buzz cut and an almost Marine-like bearing, it was an intense interest in the human body and how it works, plus a genuine desire to help people, that made him want to be a doctor.
He found Purcell's questions welcoming, not challenging.
"I could tell by how he listened to our answers he had a genuine interest," Buchler said. "It was wonderful for us."
Throughout the semester, while working in the dissection lab, the students kept in touch with the Purcells, gaining an understanding of the family's deep grief while getting to know who Dot was.
She was an uncommon mix of elegant and practical, a buoyant blonde who met Jim while they were in college - he at Notre Dame, she at its sister school, St. Mary's College. Dorothy - everyone called her Dot - was a former teacher who loved sparkly jewelry and never left the house without her makeup just so, but wore gym shoes with everything because of chronic foot pain.
She helped design the spacious two-story house she and Jim built 50 years ago, with fancy French provincial decor and washer and dryer on the main floor instead of the basement, decades before that became fashionable, to make them more accessible.
She loved books and music, going out on the town with her husband and ice-skating with her kids. She had a great sense of humor, and taught her children to challenge everything.
Coincidentally, the music Dot's student team chose to listen to during dissections was the same kind of classical music she loved.
"We knew right away that they clicked with my mom," Mike Purcell said.
Buchler, especially, clicked with the Purcells. Since that first meeting, and even after the semester ended, he's been in weekly contact, by e-mail, phone, or personal visits, with Jim and Mike, who also lives nearby. First, it was to fill them in on what he was learning in class, now it's to keep them updated on research he's doing.
Buchler says learning about Dot the person has helped what he's learned in the lab make more sense.
Along with melanoma, Dot had a blood condition related to leukemia, and doctors had told the family that it was the cause of death. But Buchler and his team learned the melanoma, which had spread to her liver, was the true cause. It's a type of cancer that invades mucous membranes rather than other skin surfaces. There are fewer than 300 reported cases worldwide, and Buchler said research on Dot will improve understanding of risk factors for this rare cancer.
The students also discovered that Dot had a bone abnormality called Charcot foot, which explains why her feet were always so painful and swollen. Although she didn't have diabetes, the foot condition is common in that disease, and Buchler says the knowledge he's gained from Dot will help him treat future patients with diabetes.
Late in life, Dot developed unusually hard patches of skin on her calves. She never got a diagnosis. Studying tissue samples under the microscope, Buchler's team found bone tissue had developed deep inside the skin - another extremely rare condition that he will describe in a research paper.
All families involved in the program have questions. Most want general information about what killed their loved one, minus graphic details. Students give them updates, explaining that they're now working on the musculoskeletal system, for example, without getting too descriptive.
If families' queries veer into graphic territory, students steer them back "so that things aren't uncomfortable for them or us," Buchler said. "We'd say those are details we'd rather not discuss, for reasons you understand."
The Purcells just wanted to know what the students were learning and tried not to think about what goes on in dissections.
That became a challenge, though, at the end of the semester, when students hold a memorial service for the donors - in the anatomy lab, with the bodies present and loved ones invited to attend. The cold steel dissection tables where the bodies lie all semester are covered with metal hoods, draped tastefully with cloth and topped with flower bouquets, candles and donors' photos. But still.
"When I first saw that it was going to be in there," Mike Purcell says, "I had no desire to go in there."
Jim Purcell was particularly hesitant. "All he thought about was all the chopping and cutting," Mike Purcell says.
But the Purcells are glad they attended. They are Roman Catholic but never had a wake or funeral - donated bodies must be whisked away right after death to be properly preserved. The ceremony in that dissection room helped move them closer to closure.
The students read letters of appreciation to the six donors present. And a member of the clergy spoke of God and the afterlife.
Like most donor bodies, Dot's was cremated at semester's end, her remains mailed back to her family in an unmarked square box. Jim Purcell placed the box, still wrapped in postal paper, in a cabinet in the family living room, on a shelf in between two statues of angels.
The box is unopened, Mike says, reflecting his father's wishes. "He doesn't want to think of her as being reduced to that."
But in a way, she's not. The knowledge the Purcells have gained about Dot's death and how it will help these future doctors treat patients has, in a sense, revived her and kept her memory alive, in the service of science.
"They have been very thorough in telling me what happened and why, which was very comforting to me," Jim Purcell said. "They've demonstrated to us how valuable it is both to medical people and families to get answers to why your loved one dies."
Says Mike Purcell: "It's cathartic. It's great."
The Purcells' relationship with Buchler goes beyond medical science. As fans, they talk Notre Dame football, and Jim plans to have the students out to his club for dinner. He has vowed to attend their graduation from medical school in three years, God willing.
Buchler smiles broadly when Jim says Dot "would have been thrilled with the whole process. She would have loved these students."
Jim, once so opposed to the idea of donating a body to science, says now he's even considering doing the same thing.
Mike chuckles at the thought, thinking of his mother's continuing influence.
"She's still teaching us," he said.

The man who couldn't remember

2009-12-03T12:53:00.000-08:00

From a great article in the New York Times:

The man who could not remember has left scientists a gift that will provide insights for generations to come: his brain, now being dissected and digitally mapped in exquisite detail.

The man, Henry Molaison — known during his lifetime only as H.M., to protect his privacy — lost the ability to form new memories after a brain operation in 1953, and over the next half century he became the most studied patient in brain science.

He consented years ago to donate his brain for study, and last February Dr. Jacopo Annese, an assistant professor of radiology at the University of California, San Diego, traveled across the country and flew back with the brain seated next to him on Jet Blue.

Doc-owned hospitals to decline?

2009-11-20T13:25:00.000-08:00

Studies show that physician-owned hospitals drive utilization up and create financial incentives for doctor-owners to refer more patients for surgery. Some might say there's an inherent conflict of interest when doctors refer patients to hospitals where they have a financial interest.

Read an awesome article on this subject in the upstart Texas Tribune.

What do you think of new mammogram recommendations?

2009-11-18T07:12:00.000-08:00

I'm agog at a major reversal in thought about early detection of breast cancer. I'm all for common sense when it comes to avoiding medical procedures when possible. But I know too many women who had no family history yet discovered a malignant lump before the age of 40.

For example, the U.S. Preventive Services Task Force (USPSTF) now recommends against routine mammography screening for average-risk women in their 40s. Does this mean insurance will stop covering such screenings?

You don't have to feel guilty if you don't do a self-exam once a month. The government task force recommends against breast self-exams based on findings from two large studies showing the practice to have no value.

Wow.

Task force vice-chairwoman Diana B. Petitti, MD, MPH, says the new recommendations do not mean average-risk women younger than 50 and older than 74 should never be screened. Rather, they are meant to foster discussion between these women and their doctors about the risks vs. benefits of routine screening.

Potential risks include anxiety, unnecessary biopsy, and unnecessary treatment of cancers that would never become life threatening.

From a pretty good article on WebMD.

No final fashion statements on death row

2009-11-17T13:32:00.000-08:00

The Washington Post's Robin Givhan finds meaning in a death row inmate's execution-date uniform. Eloquent, fascinating, disturbing.

One of the curious details announced after the execution of convicted sniper John Allen Muhammad had to do with his attire. He was wearing prison-issue denim trousers and shirt, as well as a pair of flip-flops. This piece of information was delivered without emotion by witnesses and officials, as if it were as crucial to the historical record as the fact that he did not have any last words, demonstrate any contrition for his terrible crimes or have a spiritual adviser present.

A state-sponsored execution is filled with ritual, from the agonizing countdown to the grim hour to the prisoner's last meal. That final repast is such a curious display of compassion under the circumstances. Don't let the man die hungry, as if that would be an indication of a truly uncivilized electorate. Or is the last meal a grudging willingness to let the convicted man have the tiniest bit of control over how he will exit this world?

Read the rest of it right here.

2009-11-12T12:29:00.000-08:00

Houston
It was late and the railyard was empty,
security lights like stars, their beams diffused in the swampy sky.
Silver rails pointed out of town. The tank cars were giant pills;
story upon story of lights resembled analysed DNA.

Our headlights came to rest on a blue Victorian
tiny, with an ancient person inside
who remembered when the porch welcomed neighbors.

A tree in the yard glittered.
Cockroaches swarmed over the branches,
dripped from the leaves like rain.

What happened to kids with ADHD in the old days

2009-10-23T11:27:00.000-07:00

Some people wonder about the explosion of children diagnosed with attention deficit hyperactivity disorder and other problems. My answer to that is some of them could let out all that energy on the farm, but some were probably injured as a result of their risk-taking behavior. Others were beaten by frustrated parents and eventually ran away from home.

I'm not trying to be provocative, it's just something I've thought about.

In 1960, a woman who couldn't abide the annoying habits of her 12-year-old step-son sought the services of psychiatrist Walter Freeman. Most people, aside from his step-mother, saw Howard Dully as a normal, rambunctious child. Of course, they didn't have to live with him. He ate like a pig and enjoyed destroying the building-block structures his little brother carefully built.

The psychiatrist thought the boy would benefit from a procedure he'd developed: the transorbital "ice-pick" lobotomy.

I ran across Dully's book, "My Lobotomy," last night at Half Price Books and sat on a bench and read it entirely. Which led me to this amazing 2005 NPR production of Dully's story, narrated by the extraordinary Dully himself. Listen here.

Ian McEwan slept here. So did Peter Carey and W.S. Merwin

2009-10-20T07:27:00.000-07:00

When UT's Michener Center for Writers hosts brilliant guests, do you think the university puts them up at the Omni? No way. Instead, they stay at Verde Camp, a little compound of exquisite, vintage cottages just off S. Congress.

I met owner B.J. Heinley, a designer, at my coffee shop "office" after I overheard him on the phone confirming a reservation with a hard-of-hearing customer. B.J., a big bear of a guy, and his wife Carrie moved to Austin five years ago to raise little kids and be closer to family.

I was blown away when I visited Verde Camp, so I'm pimping it here. B.J. is an art-school grad, a designer by trade and former Yahoo! employee, and this collection of six 1930s guesthouses is surely his masterpiece.

The houses, all painted green, sit beneath a canopy of huge oaks (preserved from oak wilt to the tune of $50,00o!). Inside, you find wit and sophistication: an awesome Blue Dot sleeper sofa, a battered sign from a ranch and B.J.'s childhood dining table. Out back, around the firepit, are Eames-inspired chairs made from oil drums. The kitchens are farmhouse white, with porcelain sinks and white counters.

The street is nearly traffic-free, even though it's "within stumbling distance", as one guest put it, of the Continental Club.

If you've dreamed of writing a novel, you imagine it could happen here. Guests stay for a night, or for several months. Bring a bike, and you won't need a car until it's time to leave. Live on the pizza at Home Slice, tacos from Guero's, swim laps at Big Stacy Pool (always free and heated in winter), maybe even get some groceries (or fresh sushi) from HEB.

A one-bedroom that can sleep four is $140 for the night, $800-plus for the week. B.J. says the old-timers on the street like Verde Camp because they're happy to see the longtime rental property restored to its rightful glory.

(photos courtesy of B.J. Heinley)

There but for the grace of God ...

2009-10-15T07:59:00.000-07:00

A guy I know in Houston, Scott Corron, is one of my peers. By that I mean we are similar demographically in age, health, intelligence, achievement, etc. He's an avid cyclist, a photojournalist, and a big-time sales leader in cardiac diagnostic equipment.

In January, he was riding his bike around Memorial Park with a couple of friends. He started feeling nauseated. He left his friends and began pedaling toward a restroom.

While riding my bicycle at a little more than 20mph, I suffered a cardiac arrest. My heart stopped. A medical student, a 4th year at the time, Eilean Myer who is now a resident at The Mayo Clinic saw me. She ran to me and began CPR. There were no defibrillators close by. Eilean was joined by Ross Mattern, a former paramedic who was also running in the area. They both tag teamed CPR and were then joined and observed by a Memorial Hermann Cardiologist Dr. Lalitha Sunder. Houston Fire Department arrived several minutes later and eventually shocked me several times in the park on the street.

At the hospital, his heard stopped several more times. At one point, a physician wanted to give up but a nurse urged him to keep trying.

He lived. He's on a mission now to put defibrillators throughout Memorial Park.

Godspeed, Scott.

(photo by Scott Corron)

Lice haiku

2009-10-05T11:37:00.000-07:00

In Fall's bright light, lice
Hysteria among us
The smell of tea tree

-- John Snyder

The oddball that was Michael Jackson's doc

2009-09-29T09:13:00.000-07:00

From the New York Times article about Conrad Murray, MD:

By all accounts, Dr. Murray has always had a charitable streak, a soft spot for poor people like the ones he grew up with. In June 2006, he founded a cardiology clinic in the impoverished neighborhood of Houston where his father, whom he did not know as a child, had been a doctor for years.

If he is charitable, however, he is also less than reliable in his personal affairs. Dr. Murray has been plagued with unpaid debts, delinquent taxes and lawsuits from creditors, legal records show.

He has fathered at least seven children with six women over the years, most of them out of wedlock, according to a deposition he gave in a 1998 paternity suit ...

This story humanizes Murray, but it's also baffling ...

Color of prehistoric birds discovered

2009-09-15T06:52:00.000-07:00

In kids' books about dinosaurs, the creatures come in all sorts of colors. But that's all just made up; nobody knows for sure what their hides -- or feathers -- really looked like.

Until now.

Scientists, including Julia Clarke from the University of Texas, recently discovered evidence for the first time of iridescence in fossil feathers more than 40 million years old.

"The feathers produced a black background with a metallic greenish, bluish or coppery color at certain angles--much like the colors we see in starlings and grackles today," said Richard Prum, a scientist at Yale and one of the paper's authors.

Cool!

The discovery of a "color-producing nanostructure" in a fossil feather opens up the possibility that we'll someday be able to determine more colors in fossil birds, as well as in feathered dinosaurs, sez National Science Foundation paleontologist H. Richard Lane.

Found via EurekAlert! Read Carl Zimmer's article about it here.

Pregnant women priority candidates for H1N1 vaccs

2009-09-11T09:08:00.000-07:00

A pregnant friend was wondering what she should do about swine flu. Should she seek vaccination or not? She should, and here's why:

Pregnant women are priority candidates for vaccination because they accounted for 6% of deaths early in the epidemic, though they account for just 1% of the population, according to a report by the Centers for Disease Control and Prevention. During the first month of the epidemic, they were also hospitalized at a rate that was roughly four times higher than for other groups, CDC says.

Flu vaccines have long been used during pregnancy, and they are considered safe during any trimester. The vaccine contains no thimerisol, a preservative, or adjuvants, immune boosters that are widely used in other vaccines.

Since the virus in the vaccine is inactivated, it is impossible to become infected with H1N1 from the shot.

If you're pregnant, and you'd like to be vaccinated sooner than later, Scott and White Memorial Hospital and Clinic in Temple and Baylor College of Medicine in Houston are conducting clinical trials to determine what's the smallest possible dose that works (to stretch supplies further). The National Institute of Allergy and Infectious Diseases (NIAID) is the study's sponsor.

The study will involve up to 120 women 18 to 39 years of age who are in their second or third trimester of pregnancy. Volunteers will receive 15 micrograms or 30 micrograms of a 2009 H1N1 influenza vaccine made by Sanofi Pasteur to determine the most effective dose.

Women will receive two injections 21 days apart. Researchers conducting the study and an independent committee will continuously monitor the vaccine's safety. Researchers will gauge the vaccine's effectiveness by monitoring antibody levels to flu virus. They'll also collect umbilical-cord blood to measure how much antibody circulates from mother to fetus through the placenta.

From USA Today. For contact info about the vaccine trials, visit clinicaltrials.gov.

First-person accounts of living with ADHD

2009-09-10T15:29:00.000-07:00

These short interviews are enlightening. I especially like the one by a mom of a child with ADHD.

Find the link here on Tara Parker Pope's blog, Well, on the New York Times website.

Enjoy!

Parent support for ADD kids

2009-09-09T12:12:00.000-07:00

So, last night I attended my first meeting of a support group for people with attention deficit disorder or parents of children with this disabiity. I had been meaning to go for a long time, but never made the time.

After a 60 percent disastrous camping trip this weekend, I decided to go. I'd been wondering, "What is WRONG with my child?" I knew about the ADD part, but why would a campout on the river be a journey to hell?

I described this experience, and three moms in attendance nodded in recognition. The moderator, a hilarious and richly informed veteran of ADD parenting, said, "He did everything but wave a sign in your face that said, 'Mom, I'm out of my routine! Take me home!'"

CHADD meets the second Tuesday of each month at Rosedale Elementary.

Are you thinking about quitting Facebook?

2009-09-01T09:40:00.000-07:00

The New York Times says more and more people are leaving the social networking site. I guess they are "tweeting" instead. Their stated reasons are rather vague, ranging from Facebook's discontinuation of its Scrabulous app to rampant advertising on the site. Big whoop.

Me, I have nothing but love for Facebook, partly because it recently handed me a rare gem. I reconnected with a former fishing buddy and coworker. He asked about my folks, and I had to pass along the sad news that they died eight years ago. It was a terrible, unexpected thing, but I'm okay with it now, more or less. But how gratifying his response:

I can't tell you how shocked I was to read about your parents. I am so sad and so sorry. I clearly remember the BBQs over at their house with Lola Mae, and your grandmother, and their dog--the boat rides on the bayou.

I hadn't thought about that smelly little dog, Heinz (57 varieties, you know), in ages. Or those backyard cookouts with my parents and great-aunt Lola Mae. Or the meandering fishing adventures on the bayou in my friend's funny little boat ... wow. Just wow. I treasure that.

His compassion about my parents meant a lot, too. You'd be surprised (or maybe not) how uncomfortable some people are in speaking of another's profound loss. Reminds me of how, after I wrecked my Honda Civic, I went around with two black eyes for weeks. Most people averted their gaze, or pointedly ignored my raccoon face. Then I walked into a convenience store in Columbus, and the clerk exclaimed, "Honey, I hope you're okay!"

But back to the Facebook gem. Those boat rides, the backyard fishfries and crawfish boils are part of the fabric of my being. It's nice to have that back.

(photo by Banjo Jones)

Fishing Lady Bird Lake

2009-08-30T10:03:00.001-07:00

Last weekend, Mark and I and the boys loaded up folding chairs and fishing poles and picked out a shady spot under a cypress tree on Lady Bird Lake, east of I-35, near the old Holly St. power plant. A couple of feral parrots provided a tropical soundtrack while we tried catching sunfish with bread balls and dog food.

Two little boys from the neighborhood told us our hooks were too big, and that corn made a better bait. We'll try again sometime soon. Fo mo info, click here.

Kennedy achieved 'good ending for myself''

2009-08-28T10:32:00.000-07:00

This is a touching article about the final days of Sen. Kennedy's life and his attitude toward his fatal disease.

Down with the cancer survivors' park!

2009-08-28T09:42:00.000-07:00

The new Austin Chronicle prints a great letter to the editor about why the city should reject the $1 million R.A. Block Cancer Survivors' Park in front of the Palmer center. Here's a taste:

Austin should not set a precedent by relinquishing control of 1.5 acres of prime public parkland to an independent organization ...

Required texts about "positive attitude" and cancer survivorship are not universally welcomed by those living with metastatic cancer or who have lost loved ones. Such didactic texts suggest you're not trying hard enough if you're not surviving ...

Why cancer? What about AIDS, multiple sclerosis, diabetes, drunken driving? Whose disease/issue is more important?

Not to mention what a god-awful project Houston's Bloch plaza is. (See photo above.)

As the letter-writer points out, we can't tell the Bloch family how to spend its money. But I have a proposal. Why not put that $1 million into making cancer treatment more easily accessible to the poor?

Or if parks are your thing, give the $1 million to Austin to xeriscape/upgrade Zilker Park, a place that can uplift spirits regardless of one's health condition.

Doc gave Michael his 'milk'

2009-08-26T13:55:00.000-07:00

"Michael Jackson was not the usual patient with the usual problems in the usual circumstances," said Murray's attorney, Edward Chernoff, in response to the court records. "Dr. Murray's overriding goal was to try to help him. . . . To place negligence on him simply because he was there, I don't think is fair."

The above comes from a good story in the LA Times. The story goes on:

At Jackson's request, Murray had been administering 50 milligrams of propofol in the six weeks prior to his death using an intravenous line, according to court records. But after weeks of use, Murray said he tried to wean the pop star off the medication. Murray told detectives that he lowered Jackson's dosage to 25 milligrams and mixed it with two other sedatives, lorazepam and midazolam. Then, on June 23, he administered those two medications and withheld the propofol -- and Jackson was able to sleep.

On June 25, the day Jackson died, Murray once again tried to induce sleep without resorting to propofol, according to the affidavit. He first gave Jackson the three alternative sedatives at 1:30 a.m., 2 a.m., 3 a.m., 5 a.m. and 7:30 a.m. But Jackson remained awake.

Finally, "after repeated demands/requests from Jackson," Murray relented and gave Jackson 25 milligrams of propofol, diluted with another sedative, records state.

The rest is history ....

'Activist' judges, now 'activist' coroners?

2009-08-26T11:43:00.000-07:00

You've heard the complaints about activist judges, but can a coroner take a stand? I'm asking because Michael Jackson's death was ruled a homicide. Which means his doctor, Conrad Murray, may face criminal charges for manslaughter. Here's what he did: gave His Strangeness a drug to help him fall asleep. Didn't work. Hours later, tried a different drug. Five attempts, same story. Finally, Murray gave Jackson propofol. Watched him for 10 min, then left for 2 minutes to go pee. Returned and -- whoops! -- Jackson's dead.

Todd Ackerman has a good story about the drugs here, in the Houston Chronicle.

Murray's guilty of stupidity, for sure, but murder? In my years as medical reporter for the Houston Chronicle, I wrote about a Texas doctor who nicked a patient's artery in the course of surgery, and said patient bled to death. A couple other patients of his died or were left severely brain-damaged. Newsflash: This happens quite often.

Another doc butchered his spinal patients, leaving them worse off than before and addicted to painkillers to boot. This is all public record, available on the Texas Medical Board's website.

The medical board, the state agency that regulates doctors, took appropriate action within its purview, in my view. But what if a criminal investigation had been launched? Could these doctors have been tried for murder, or assault and battery?

Watch what happens to Murray. Could set an interesting precedent.

The Perfect Grill ... for a Cannibal

2009-08-20T19:20:00.001-07:00

TMZ.com, the celeb-stalking website that was the first to report Michael Jackson's death, is a guilty pleasure of mine. This post made me laugh, especially the Sears' rep's comment at the end.

The Perfect Grill ... for a Cannibal

Shared via AddThis

Dave Eggers is my hero

2009-08-19T07:12:00.000-07:00

From the New York Times Book Review:

Imagine Charles Dickens, his sentimentality in check but his journalistic eyes wide open, roaming New Orleans after it was buried by Hurricane Katrina. He would find anger and pathos. A dark fable, perhaps. His villains would be evil and incompetent, even without Heckuva-Job-Brownie. In the end, though, he would not be able to constrain himself; his outrage might overwhelm the tale.

Read the full review of his latest book, Zeitoun, here. I'm going to get this book today. He's my hero because he represents truth-telling, the writing of real-life stories, at its very best.

Eeewww ...

2009-08-13T11:46:00.000-07:00

A Dallas-Ft. Worth television station has a story about a local pediatrician giving himself a good time while at work.

A Fort Worth pediatrician is being accused by his nurse of masturbating in the open spaces of his office.

Lawyers for Marilyn Stacy filed a petition Monday with the Tarrant County court stating that Dr. Lundy Eldridge Cavender would "masturbate in the open of his pediatric office" in the presence of Stacy and other employees.

Stacy additionally claimed that Lundy would make "obscene noises" and even touch her during the act.

On July 22, Stacy said she was making copies when Lundy reached out to touch her on the shoulder during one of his self-
indulgent sessions. Stacy said she screamed when she caught him "red-handed."

Furthermore, Stacy said the doctor made obscene statements of a sexual nature in regard to her 13-year-old daughter.

Stacy said she has been unable to return to work since the incidents, which recently started happening. Stacy said she has worked for the doctor for a number of years.

"Frankly, this is frightening and outrageous conduct for any human being, not to mention a pediatrician," the petition reads.

According to the petition filed with the Tarrant County court on Monday, Cavender has been censured for previous offensive conduct by state medical boards.

Stacy is seeking compensatory damages for mental anguish, loss of earnings and embarrassment.

Now said doctor's wife is saying the accusing nurse and said doc were having an affair. Sordid stuff!

My life as a reporter, tale No. 2 (a sad one)

2009-08-12T10:19:00.000-07:00

"I don't think I'll ever be happy again," he said, weeping. We were sitting at a picnic table in the shade of an oak. Tears were running down my face, too. They made dark spots on the table and smeared the ink in my notebook.

He was bearded, middle-aged, solidly built. He and his new wife had married recently, having found love later in life. How cruel to have it snatched away so soon. They were driving down an empty highway outside Austin when a church van packed with teen-agers pulled directly into their path. The truck T-boned the van, the man's bride was killed, as were something like eight kids. Horrific.

A few days later I was covering the teen-agers' funeral. I found their parents cheerful -- the kids were in a better place, after all. No, they had not yet called the pickup driver to express condolences over his loss, even though one of their own had caused the accident. I think the parents can be forgiven for that oversight.

I am delighted and awed to encounter people of strong faith. My tiny great-aunt, Lola Mae, was such a person. A tree-trimmer high in the pecan in my backyard was too. I asked him if he wore a safety harness like a rock-climber. He said he used to, but stopped "after I put my trust in Jesus Christ." I was so surprised I laughed!

But the parents in the church group who'd just lost their young people were plain weird. Maybe they were in the sway of a messianic pastor, I don't know. But I don't think God wants us to be happy no matter what ... we're meant to experience the fullness of life, which includes death as well as grief.

After my interview with the widower, we hugged. I've no idea whether he found happiness again, but I bet he did, eventually.

Sick of reading parenting books

2009-08-11T11:36:00.000-07:00

If I lay eyes on another, I think I'll scream. I've read and re-read many, and truly admired and been inspired by a few of them. And yet ...

If you are a parent of a, ahem, spirited child (now there's a euphemism!), then you've probably trolled the internet for advice and come upon programs that promise results, programs you have to pay for. And they aren't cheap.

Anyway, a friend recently pointed me to a website called Think:Kids. Think:Kids is a program in the Department of Psychiatry of Massachusetts General Hospital. That's Harvard, people.

The program, dedicated to "rethinking challenging kids," talks about three ways parents deal with problem behavior. 1) Imposition of adult will (not gonna work) 2) Changing your expectations (okay, so don't brush your teeth) 3) Working with said kid to solve the problem.

I've read all about choice #3 and tried it sporadically. But what's nice is there are seven YouTube videos showing how it's done. Sorta like mini Super Nanny episodes. Check 'em out.

The twin within

2009-08-08T07:24:00.000-07:00

For some reason my son was asking me about human chimeras. Human whats you ask? A friend of ours told us a story about this he'd once heard on NPR.

A woman applying for welfare underwent genetic testing to prove her children were hers. The results of the tests showed the children were related to each other and to their father, but not to her. They didn't share her DNA. How could this be? She gave birth to them, for cryin' out loud. Social workers suspected she was some kind of imposter and she nearly lost her kids.

Fortunately for her, the woman's lawyer had heard about this medical mystery before. The answer to the puzzle was that the woman possessed two sets of DNA -- one in her blood, and another in some other part of her body. That's because she was really two people -- the person she saw in the mirror, and a twin who had been absorbed and incorporated into her body when they were just a pair of embryos in their mother's womb.

Read more about Lydia Fairchild here or listen here.

What does Lance do ... when he's gotta GO?

2009-08-05T11:57:00.000-07:00

Here's the answer:

The husband of one of my co-workers is a professional bicycle rider, sponsored by a pharmaceutical company that distributes insulin. His job is to ride in as many bicycle racing events as he can during the year wearing the company logo. During those intense races, I asked him what happens if he needs to pee. I thought it was a good question. I assumed the he stopped at a portable potty and did his thing, but NO! What he told me next both shocked and troubled me.

Without stopping, or even slowing down, he is able to pee on the run! How can this be done, especially when wearing those tight spandex pants? Practice. Practice. Practice. Apparently, Chris has it down to a fine art of whizzing while whizzing by on his bike. He said that during televised races, a camera may zoom in on the act in progress, but will quickly pan out. Apparently, all (or most) bicycle racers have developed this unusual skill.

Source: All Ears

A new way to get throat cancer ...

2009-08-04T20:16:00.000-07:00

Smoking and alcohol abuse were once considered the only major risk factors for these cancers, but this is no longer the case. Increasing rates of HPV infection, spread through oral sex, is largely driving the rapid rise in oropharyngeal cancers, which include tumors of the throat, tonsils, and base of the tongue, said Scott Lippman, MD, who chairs the thoracic department at the University of Texas M.D. Anderson Cancer Center

As many as half of the oropharyngeal cancers diagnosed today appear to be caused by HPV infection.

"Changing sexual practices over the last 20 years, especially as they relate to oral sex, are increasing the rate of head and neck cancers and may be increasing the rates of other cancers as well,” he said.

He added that there is some evidence that oral HPV infection is also a risk factor for a type of cancer of the esophagus.

“The paradigm is changing,” Lippman said. “The types of patients we are seeing now with oropharyngeal cancers are not the patients we have classically seen who were older, smokers, and have lots of other problems. These are young people, executives, a whole different population.”

Read more on Web MD. I'm just tellin' ya.

Too little of the "sunshine vitamin"

2009-07-31T10:46:00.000-07:00

This week I was driving a golf cart around a friend's mini-ranch in Manor, and came upon a gorgeous bird I later id'd as a Bullock's Oriole. On this same day my son got an awful sunburn on his back from crouching next to the cowpond and netting perch.

Last fall, I wrote about the sunshine vitamin in the Boston Globe. This turned out to be way more interesting than I expected. Especially the hypothesis that people with darker skins living at cloudier latitudes than their ancient ancestors may be at greater risk of cancer, heart disease, etc etc.

We synthesize vitamin D in our skin, with the help of sunshine. Babies get it from their mother's milk or the sun. People with darker skin synthesize it at a slower rate, and that fact, combined with people wearing sunscreen or staying indoors more of the time, leads to vitamin D deficiency. Docs run across it in emergency rooms sometimes in the form of rickets, of all things.

And yet, because we're living so dad-gum long, we can't rely on sunshine only for vitamin D because we'll develop skin cancer. Or worse, wrinkles. That's why you should be chugalugging cod liver oil, or at least swallowing capsules.

How much is enough? For babies and kids, 400 IU a day. For grownups, it should be at least double that, and studies show doses of 10,000 IU are well-tolerated. Stay tuned for more info. Or check out this National Institutes of Health info sheet.

Can journalists participate in clinical trials?

2009-07-29T20:55:00.000-07:00

One of my old bosses encouraged me to "develop sources" inside Houston's major public hospital, so when bird flu hit I'd be able to report the story up close and personal. Little did he know that if the pandemic struck, I'd be AWOL so fast there'd be a weird sucking sensation in the newsroom, like a door opening on an airplane mid-flight.

Nevertheless, I began to get prepared. I signed up for a bird flu vaccine trial at Baylor College of Medicine, a study designed to see how small the dose could be and still be effective. In exchange for letting my arm get pricked a few times, and showing up for a handful of followup visits, I was to be compensated $300.

Another one of my bosses was horrified by this. He took me aside and said there was no way I could participate -- taking money from Baylor College of Medicine would compromise me as a journalist. To me, this was nonsense. I mean, I wasn't taking money from BCM, I was getting paid by the National Institutes of Health, which bankrolls many such studies. I'm a taxpayer. I'm donating a bit of my body for science. What's the problem?

Furthermore, the $300 was part of a carefully worked out formula designed to level the playing field. I'm giving something to them, they're giving something to me. Not so different from the way journalism usually works.

So what do you think I did? First correct answer wins a box of Kleenex.

All of which is to say, when the H1N1 vaccines come out, look for me and my kids at the front of the line.

Salud, the Austin American-Statesman's health blog:

In the current pandemic, no one knows whether swine flu, or the H1N1 flu, will mutate into a worse virus this fall. Experts expect the virus to be circulating along with regular flu this fall, and a swine flu vaccine probably won’t be available until October. Health authorities are recommending that people get regular flu shots and once a swine flu vaccine is available, the Centers for Disease Control and Prevention has suggested that children, health care workers, pregnant women and other people at risk of complications get it first.

Problem is, one in six public health workers -- that's the shot givers -- plan to stay home during the pandemic, according to a new study online in PLoS.

Jacko's doc: Asleep on the job?

2009-07-28T18:27:00.000-07:00

It's a little beside the point for DEA agents to go after Michael Jackson's enabler, Dr. Conrad Murray, for administering the surgical anesthesia drug Propofol that probably killed Jackson.

For what it's worth, the Texas Medical Board hasn't taken any action against Murray, who has a practice in Houston.

As I wrote earlier, Jackson was having such problems sleeping that he had doctors put him under -- like you would to undergo, say, plastic surgery -- using drugs never intended for use outside a hospital. To do so constitutes malpractice, IMHO.

But the DEA seems shocked, shocked, that a drug addict and his supplier screwed up with fatal consequences. This happens all the time. Hydrocodone, Diazapam and Xanax and other meds were combined in Heath Ledger's accidental death. Apparently they were obtained through "proper channels" and all, but really, is there much difference?
The main difference here, to my mind, is that the surgical anesthesia drugs require constant monitoring. The New York Daily News reported that the room where Jackson was found contained three oxygen tanks, a porcelain doll atop the bed, and an IV drip. But no EKG machine, TMZ.com reported. A person knocked out on propofol should always have one.

Here's the zinger: Authorities think Murray may have fallen asleep and awakened to find Jackson already dead from heart failure. What a bad feeling. Like crashing a train while you were texting.

Malpractice, stupidity -- Murray's admitted as much. But homicide? Nah. A vast Propofol conspiracy? Please.

A just-written bit from my book ...

2009-07-27T13:24:00.000-07:00

Some children simply gave up. Others remained bright-eyed, in love with life. Those were the ones who really disturbed him. One such patient, a girl, died just before the International AIDS Conference of 1996, the one at which new drugs were introduced that would complete the lifesaving AIDS drug “cocktail.” If she’d lasted two more months she would have been in the group rescued by the drug combination known as highly active antiretroviral therapy, or HAART. All of those other kids are alive today and she probably would be too.
Her mother had died of lymphoma about a year earlier. Dr. Mark Kline loved this family. When the mother, who also had AIDS, fell ill with the blood cancer Kline knew she had only a little time left. He went to see her in hospice, where she showed Kline a drawing her daughter had made depicting mom as a guardian angel, looking down from heaven. Kline and the woman admired the picture together for a moment, then the woman turned to him.
“You’re really her guardian angel,” she said. “You’ve got to promise me that you’ll take care of her.”
But they both died anyway. By early 1996, Kline was attending a patient funeral every week.

A flu hospital? It could get that bad

2009-07-23T18:49:00.000-07:00

Mary Ann Roser in the Statesman:

Westlake High School student Ashley Payne started feeling nauseated, weak and feverish the day before her church camp ended at South Padre Island last week.

Other campers also got sick, including eight of Ashley's friends, said her mom, Nicole Gaulden.

As Ashley, 16, recovered at home this week from a mild bout of what the camp doctor called a probable swine flu case, many camps in the United States have dealt with similar outbreaks this summer. Some simply closed, some sent sick kids home and others toughed it out with ailing campers and liberal distribution of hand sanitizer.

The summertime flu may be an unfamiliar experience for many camps and campers because the novel H1N1 virus, or swine flu, has not faded along with seasonal flu. Now Central Texas communities are bracing for what could be an even bigger challenge: starting school next month with swine flu still circulating.

The article goes on:

The World Health Organization said Tuesday that some countries might want to consider delaying school to slow its spread after deaths doubled this month to more than 700 worldwide.

"We tried closing schools to contain the flu" when the H1N1 virus hit this spring, Texas Education Agency spokeswoman Debbie Ratcliffe said Wednesday. "That really did not work very well."

Furloughed school kids swapped germs in malls, movie theaters and friends' houses.

And on:

Temple-based Scott & White is seeing eight to 10 swine flu cases a day and is considering designating certain clinics for flu patients only and perhaps even a hospital — the former King's Daughters in Temple — as a "flu hospital," said Gail VanZyl, chief nurse executive for Scott & White Healthcare.

A flu hospital!
Swapping germs in the mall!
Camp closures!

Folks, this is serious! A fascinating fact: The average age of serious cases requiring hospitalization is the mid-30s. Reason why, oldsters (50 and up) are thought to have encountered similar germs along the way and harbor lingering resistance.

School supplies: pencils, paper, swine flu face masks

2009-07-23T12:11:00.000-07:00

At this time, the World Health Organization considers the overall severity of the influenza pandemic to be moderate. This assessment is based on scientific evidence available to WHO, as well as input from its Member States on the pandemic's impact on their health systems, and their social and economic functioning.

The moderate assessment reflects that:

1.Most people recover from infection without the need for hospitalization or medical care.
2.Overall, national levels of severe illness from influenza A(H1N1) appear similar to levels seen during local seasonal influenza periods, although high levels of disease have occurred in some local areas and institutions.
3.Overall, hospitals and health care systems in most countries have been able to cope with the numbers of people seeking care, although some facilities and systems have been stressed in some localities.

Okay, so should you be worried? Should you stock up on canned food and bottled water in the event that society collapses?

Me, I'm keeping an eye on this, folks. Prediction is this bug will come roaring back as soon as school starts.

Effect Measure, an authoritative flu blog (yes there is such a thing)quotes Lawrence Altman in the NY Times, reporting that in Mexico

Many people suffering from swine influenza, even those who are severely ill, do not have fever, an odd feature of the new virus that could increase the difficulty of controlling the epidemic, said a leading American infectious-disease expert who examined cases in Mexico last week.
Fever is a hallmark of influenza, often rising abruptly to 104 degrees at the onset of illness. Because many infectious-disease experts consider fever the most important sign of the disease, the presence of fever is a critical part of screening patients.

Instead of fever, they have terrible gastrointestinal symptoms. A comment posted to Effect Measure related that

my son (at University) had a week-long bout of severe GI trouble of the which-end-gets-the-toilet-first variety, combined with similarly severe muscle aches etc -- but no fever. School NP didn't even screen him. A few days later his roommate had high fever and other flu-like symptoms and was isolated on policy.

Meanwhile the cow-orkers have been reporting a lot of GI upsets making the rounds in their families. No telling whether this is flu or something else, could just be coincidence.

The fact that we don't have any kind of surveillance set up to even detect the difference, however, should be a worry to us all.

Interesting times, people.

Ka-ching!!

2009-07-22T09:15:00.000-07:00

My blog has earned $3.12 so far! I am thrilled, actually. Thanks to all who have clicked on those little ads down the side, even if you don't really need to lose weight or conduct a background check on anybody. (I'm working on getting classier ads on the site.)

Survival of the sexiest

2009-07-21T17:45:00.000-07:00

One Mark Henricks of Austin writes in a letter to the Statesman:

I sort of understand why Derrick Z. Jackson's column, "Lost in the drama of high-profile sex scandals: the children," focused on famous fathers harming children with their family fracturing misdeeds. Still, behind those headlines lurks a more important and less-recognized truth. Mothers fracture many more families than fathers and for reasons that may be even less defensible. Wives instigate more than two of every three divorces, most commonly citing not abuse or infidelity but poor communication and feeling unloved ...

Jackson could better help kids by explaining why so many women seek divorce so frequently, and for such nebulous reasons rather than issuing another missandrist monologue.

Wow. Just ... wow.

Henrick's letter is one of those that inadvertently shed more light on the writer than on the issue. Here's a sample of Jackson's thoughtful column:

Once, just once, could a guy like Sanford anticipate his own press clippings and decide that his "soul mate" in Argentina was not worth tearing a piece out of the souls of his boys? He can call his sons "absolute jewels and blessings," as he did at his stranger-than-truth press conference last month, but when he later said, "I knew the cost" of the affair and the cost was worth it because "I will be able to die knowing that I had met my soul mate," you just get the feeling he doesn't get it. The children just end up as cheap collateral damage.

According to letter-writer Henricks, infidelity is grounds for divorce whereas "feeling unloved" is something to be endured (at least if there are children to be considered). Henrick's statistics are interesting, and what interests me is what they say about differing priorities in sexual selection.

Evolutionary biologists say traits such as "good communication" have played an important role in human evolution. In The Mating Mind, author Geoffrey Miller explains how the human mind has developed the sophistication of a peacock's tail to encourage sexual choice, a powerful force that has refined art, morality, music, and literature, ie, human civilization.

Which goes to show that one man's "nebulous reason" is another woman's instinct to survive.

Dentists gone bad, allegedly

2009-07-20T12:35:00.000-07:00

Statesman reporter Mary Ann Roser has a great story about the light regulation of dentists in Texas. The story also quotes two other friends, Donald Patrick, the former exec director of the Texas Medical Board, as well as lawyer Louis Leichter, who happens to be a talented chef.

It's time for the dental board to get disciplinary actions online, asap, like, yesterday! Follow this link to the Texas Medical Board, type in your doctor's name, and see what you find. You'll see how far behind dental regulators are.

Cicada tacos, and other summer delights

2009-07-19T10:58:00.000-07:00

Outdoor writer Mike Leggett has a cool article in today's Statesman about cicadas, which we called locusts when I was a kid growing up in Brazoria County. Here's a bit:

Back in East Texas, we plucked discarded cicada exoskeletons from the trees and walked around with them stuck to our clothes or ball caps.

Nobody ever said we were smart.

Alive, they could be held in your hand for a buzz, tied to sewing thread for your own helicopter or thrust down the back of someone's shirt for the loudest, funniest hallway screams ever invented.

These aren't the famous 17-year cicadas, Leggett writes, which lay eggs in trees, and then the larvae drop to the ground and burrow down where they live on liquid from tree roots for 17 years before emerging.

These are called giant cicadas, and they have a 4- to 5-year underground lifespan. Apparently, they are relatively new to Central Texas (though their sound is so inextricably linked to childhood summers in my brain I didn't notice them as "new")

Leggett reports that their main predator is the cicada killer, a large wasp that looks like a yellow jacket on steroids. Lizards and other reptiles might feed on them when they've just emerged and are still soft. Some cicadas have been spotted spiked on fences and mesquite thorns by butcher birds. (Italics mine, for emphasis.

And now, let me point you toward a recipe for cicada tacos. Deep-fried, I can imagine them tasting a little like fried-shrimp tacos. Mike, you let me know how they taste, okay?

El Chirper Tacos

Ingredients:

2 tablespoons butter or peanut oil
1/2 pound newly emerged cicadas
2 serrano chilies, raw, finely chopped
1 tomato, finely chopped
1 onion, finely chopped
1/2 tsp ground pepper or to taste
1/2 tsp cumin
3 tsp taco seasoning mix
1 handful cilantro, chopped
Taco shells, to serve
Sour cream
Shredded cheddar cheese
Shredded lettuce

Directions

1. Heat the butter or oil in a frying pan and fry the cicadas for 10 minuts, or until cooked through.
2. Remove from pan and roughly chop into 1/4-inch cubes/ Place back in pan.
3. Add the chopped onions, chilies and tomato, season with salt, and fry for another 5 minutes on medium-low heat.
4. Sprinkle with ground pepper, cumin and oregano to taste.
5. Serve in taco shells and garnish with cilantro, sour cream, lettuce and cheddar cheese.

Look here, for cicada pizza and cicada sushi recipes.

Dirty bathtub rings at city pools

2009-07-18T20:26:00.000-07:00

Anyone besides me notice the ring of scum around Deep Eddy pool? My hairdresser said his bathingsuit was actually sticking to it when he leaned up against the side. I know it's only sunscreen, flakes of skin and and soggy band-aids, but yuck.

I'm thinking, this is only going to get worse. With 104-degree Austin summers here to stay, all of our fair city's pools, cricks and swimmin' holes will get more and more crowded. At Dick Nichols pool, by the end of the day, if you sweep your arm through the water it will snag strands of hair. Back in the day, you could swim laps after 9 p.m. at Barton Springs in a relatively empty pool. No more.

It's time to do something. If you care about Austin's swimming spots, get involved with Friends of Barton Springs. Be a friend of Deep Eddy by clicking the link above.

I'm trying to figure out if Stacy Pool in Travis Heights has a friend, because it sure needs one. This beloved lap-swimmng spot could use some TLC. While no one was paying attention, the most god-awful wheelchair-accessible dressing room was built -- it seems specially designed to ferment and emanate bad smells.

Anyone interested in starting a Friends of Stacy Pool?

For the record, re Jacko ...

2009-07-17T18:53:00.000-07:00

My longtime colleague Banjo Jones, pictured left, author of the blog The Brazosport News, emailed me a polite correction. Michael Jackson wasn't going to tour 50 cities, as I wrote. He was going to do 50 shows in London. Apparently his handlers agreed to it even though he insisted he only wanted to do 10 shows, but he was on the verge of going broke and they agreed to the 40 extra shows. Perhaps they wanted to make sure they got paid.

One theory regarding MJ's untimely death, according to Banjo, is that Jacko wanted to get himself hospitalized which is why he asked his personal doc to spend the night with him. To make sure he wouldn't die. The hospitalization would have triggered a clause in his London contract to get him out of the 50 show deal.

True? Sure -- didn't you just read about it on the Internet?

Momflesh, with jiggling jowls

2009-07-16T12:04:00.000-07:00

This morning, hauling my 130-something pounds of momflesh around Lady Bird Lake, I locked eyes with a baby in a stroller going the opposite way. Look at him, I thought, those cute little baby jowls jiggling as he bounces along! Then I wondered, Are my jowls jiggling? At least he's going to grow into those cheeks. For me, things will only get worse.

Those signs of aging, too numerous and subtle to really fight -- the earlobes, the tip of the nose drooping slightly -- all are on their way. It would be nice to age gracefully into a Georgia O'Keefe or one of those "mature" models whose only nod to age is the gray hair. I'm probably destined to end up looking like my father's sister, whom he called Sister. I'm told she looked just like me as a girl. When I knew her, however, she had a sallow face and cottony hair stained by cigarette smoke. Her mouth reminded me of a nutcracker.

A couple of years ago I attended a fund-raiser luncheon in Houston. I sat near a table of society mavens, all shellacked, tucked, bleached, bejewelled and dressed in little couture luncheon suits. "Guess what? They're all actually in their 80s!" I whispered. "Yes," said the doctor beside me, "but what gives them away is their hands."

All of which is to say is I'm grateful for the dermatologist who zapped away a couple of spots on my neck and two spots on my face yesterday. Already I'm looking younger. Hanging out at Surfside Beach in the 1970s, we'd never heard of skin cancer. Pass me the baby oil, I want to "lay out" and work on my tan.

What have I been doing?!

2009-07-15T11:04:00.000-07:00

When I left my medical reporting gig at the Houston Chronicle in January 2007 to follow my husband to Austin, my goal was to work on a book. Well, folks, it's been slow going. For now, let's leave it at that. What follows is an excerpt from what I'm writing.

Pediatric infectious disease was a wonderful specialty for optimists -- before AIDS came along.

Intellectually, it was exciting, a bit like playing detective. Bug bites, exotic infections picked up from food or animals -- nearly all of it could be conquered with medication. A child with something as serious as bacterial meningitis could be brought back from the brink.

James Oleske, a pediatrician in Newark, New Jersey, “expected to treat and cure even his very sick patients.”*

All of us went into pediatrics, I think, because we loved kids -- or certainly most of us. And certainly we didn't go into pediatrics because we wanted to take care of dying kids, except for those few who went into oncology.

... Then I (began) seeing kids that I tried to save; they'd just die, poor mostly, mostly minority, from families that were pretty fractured by poverty and drug use ... I was scared. I was frightened by the fact that kids were sick and dying.

Doctors had a hard time grasping that a disease of gay men and drug addicts might be showing up in children as well. Personal prejudice colored perception of the disease as dirty, distasteful. When Oleske submitted a paper about AIDS in infants to a scientific journal, his peers were incredulous. Are you sure it’s not sickle cell disease? Are you sure this isn’t a cluster of congenital immune deficiency? They were more willing to believe in an epidemic of a rare immunological syndrome than in AIDS.

In infectious disease, when something “new” happens, the new thing is generally a bacterium suddenly resistant to antibiotics, or perhaps a virus never seen in the United States imported by a traveler. Strange cases were appearing, children sick with something completely different from anything ever seen before. They had unusual, recurring infections and collapsed immune systems. AIDS turned people into human petri dishes in which bacteria, viruses, fungi, parasites and cancers raged unchecked.

This growing unease was eloquently put by Randy Shilts in his history of the early AIDS epidemic, And the Band Played On:

It was Nov. 1980, the beginning of a month in which single frames of tragedy in this and that corner of the world would begin to flicker fast enough to reveal the movement of something new and horrible rising slowly from the earth's biological landscape.

Shilts gives me the shivers. You?

*From AIDS Doctors: Voices from the Epidemic by Bayer and Oppenheimer

"A mummy with two nostril holes"

2009-07-14T11:58:00.001-07:00

Michael Jackson's death made me feel so nostalgic for his music, and surprisingly (to myself) forgiving of the unsavory aspects of his life. Michael Corcoran really nailed it in the Austin American Statesman:

It's been a long time since the focus on Michael Jackson's life has been on the great entertainer he was and not the human freakshow they called Wacko
Jacko. There is great power in death to emphasize the good and so as the self-proclaimed "King of Pop" is remembered, we go back to the time when the weirdest thing about Jackson was that he wore a lone sequined glove.

But the burning question on my mind was What was the deal with his nose? While I was searching the web to figure it out, I came across Maureen Orth's series of articles for Vanity Fair about the allegations against Jackson for molesting boys. Talk about a nostalgia-killer. These articles deserve a second look, especially by a certain Congresswoman whose initials are Sheila Jackson Lee.

In 1993, police in California investigated claims that he had molested a 13-year-old boy, whose silence Jackson bought for $25 million. Another boy, the son of one of his former maids, has now testified that Jackson started groping him when he was seven. The boy's mother received $2.4 million for their silence.

Oh, and I did find what I was looking for, regarding The Nose. The tip of it is a prosthesis, Orth reported in 2003. She writes, "One person who has seen him without the device says he resembles a mummy with two nostril holes."

Jacko: From oxygen chamber to anesthesia drugs

2009-07-14T11:25:00.000-07:00

Twenty years ago, Michael Jackson sometimes slept in a pressurized oxygen chamber. So it's not surprising that he turned to surgical anesthesia drugs when he was desperate for sleep. Jackson, who complained of insomnia while he was preparing for a 50-city tour at the time of his death, must have yearned for that deep sleep of the operating room. Let the IV drugs drip, and wake up renewed.

Propofol, also known as Diprivan, was found at Jackson's rented Los Angeles home after his death. Lidocaine, also found at his home, is used to alleviate a burning sensation Propofol sometimes causes. Doctors are incredulous that the singer might have used these drugs as a sleep aide. "It's like giving someone chemotherapy so they don't have to shave their head," said one.

People, this is just not done.

A while back, I investigated the death of a Baylor College of Medicine anesthesiology resident found dead in a hospital bathroom. This is not as rare of an occurance as you'd like to think. He was addicted to fentanyl, another powerful (and oft-abused) drug used in operating rooms. The high of fentanyl is described as heavenly, whereas Propofol doesn't do anything but knock you out in 30 seconds. In surgery, it halts your breathing -- that's why patients are put on mechanical ventilation.

The young doctor died from a Propofol injection he gave himself; he'd been trying to ween himself from Fentanyl. His doctor wife told me the autopsy showed his heart continued to beat for a while after his lungs quit working.

So did Jackson die because he stopped breathing, and 5 minutes later his heart stopped? If so, how were the people around him trying to help him?