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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
Contributors
Boston Globe Health and Science staff:
Scott Allen
Alice Dembner
Carey Goldberg
Liz Kowalczyk
Stephen Smith
Colin Nickerson
Beth Daley
Karen Weintraub, Deputy Health and Science Editor, and Gideon Gil, Health and Science Editor.
 Short White Coat blogger Ishani Ganguli
 Short White Coat blogger Jennifer Srygley
Week of: September 9
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« September 2, 2007 - September 8, 2007 | Main | September 16, 2007 - September 22, 2007 »

September 14, 2007

Patrick blasts restrictions on children's health insurance

By Alice Dembner, Globe Staff

Restrictions imposed by the Bush administration on a program that provides health insurance for more than 90,000 children in Massachusetts are "dumb" and should be revoked by President Bush or overturned by Congress, Governor Deval Patrick said this morning.

Patrick said the new rules for the State Children's Health Insurance Program would deny health insurance to thousands of children and hurt the state's effort to provide coverage for all its residents.

"It's a step in the wrong direction and has to be prevented," Patrick said at a news conference at the Martha Eliot Health Center in Jamaica Plain.

At the same event, Senator John Kerry announced that he and Senator Edward M. Kennedy introduced legislation yesterday to overturn the new rules. Prospects for the legislation's passage are unclear, but Kerry pledged that "we are going to get these policies turned around."

Both the Senate and House last month passed bills to expand funding for SCHIP by billions of dollars, but Bush has threatened to veto the expansion.

The new rules are designed to restrict the program to families making up to 250 percent of the federal poverty level, but Massachusetts has extended coverage to those making up to 300 percent.

September 14, 2007

Short White Coat: We learned that for a reason?

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

ishani 2.JPG

I'm back from a summer’s hiatus from medical school -- the last we’ll get until graduation. With the recent start of a second year crammed with endless classroom hours and totebags of take-home work, as well as the vaguely looming threat of next spring’s Board Exams, training has shifted into high gear.

Last spring, I wrote about learning how to talk to patients, how to use empathic words to connect with them and accumulate facts about their medical histories. In our second-year version of Patient Doctor class -- in which we'll actually touch and probe our guileless test patients -- we discovered this week that we need to know why we're asking each question. It's called taking an "informed history," and it requires steering the interview toward a shifting target diagnosis. If asking about a headache complaint, we must suspect migraine, tumor, or hemorrhage (among other options) and ask questions that will parse out the true cause.

Inherent in this new expectation, and in the courseload we have already undertaken in second year, is the notion that we should apply our cumulative knowledge from the past year or so. A fair demand, yes, especially since we’ll be treating patients as third-year students in a matter of months. But I can’t help but think I have a lot of learning -- and re-learning -- to do before I can call myself informed.

Our professors reassure us that this fear of ill-preparedness is normal at any stage of our processive march to full doctorhood. But with a year of school under my belt, I've already acquired the uneasy feeling that I’ve learned these things before, that I should know to ask if the pain always is in the same place, or if it has affected the patient's vision. No more wallowing in the ignorant bliss of first year.

Posted by Ishani Ganguli at 01:10 PM
September 14, 2007

Today's Globe: drug abuse by prescription, cooling after injury, SF healthcare for all, stents, Dr. Donald Dressler, Dr. James Longcope

zolot100.bmpThe case of Dr. Joseph Zolot (left), whose license was suspended in June, opens a window into the potential for highly profitable assembly-line prescribing, as the medical profession has become more aggressive in treating chronic pain, including putting suffering patients on narcotics.

kevi%20everett150.bmpDoctors initially said that Buffalo Bills tight end Kevin Everett (left) had little chance of walking again after his devastating spinal cord injury in last Sunday's football game against the Denver Broncos. But Everett's ongoing recovery may stem in part from an experimental cooling technique performed moments after the accident, researchers say.

An initiative known as Healthy San Francisco is the first effort by a municipality to guarantee care to all of its uninsured, and it represents the latest attempt by state and local governments to patch a broken federal system.

Patients who get the leading drug-coated stents to prop open coronary arteries rather than bare-metal stents run no higher risk of death, according to a new report by a multinational team of doctors.

donald%20dressler85.bmpDr. Donald P. Dressler (left), a physician who specialized in the treatment of burns, died of prostate cancer Sept. 5 at his home in Portsmouth, R.I. He practiced in Cambridge for many years, taught at Harvard Medical School, and was the city's acting commissioner of health and hospitals in 1978 and 1979.

Assuaging the mental burden each person carries was a calling Dr. james%20longcope85.bmpJames Longcope (left) first heard in the 1960s when, as a Navy officer and a general practitioner, he treated those who served in Vietnam and their families in the United States. He changed his specialty to psychiatry and spent 37 years seeing patients in the Emerson Hospital community. He died of a heart attack Sept. 3 in the cottage he shared with his wife in Cedar Bay, Ontario, along Lake Erie in Canada. He was 70 and had moved to Westminster last year after living for many years in Groton, Harvard, and Acton.

Posted by Elizabeth Cooney at 06:58 AM
September 13, 2007

More get insurance

Another 10,000 people signed up for the state's subsidized insurance plan last month, bringing the total to 115,418, the Commonwealth Health Insurance Connector announced today.

The bulk of the enrollees in the Commonwealth Care program are getting full subsidies, but more than 22,000 are required to pay small premiums.

In addition, 7,164 people now have insurance through a separate, unsubsidized program, called Commonwealth Choice. Seventy percent of those people have chosen plans offered with lower than market premiums, most of which have coverage limits or high deductibles.

Posted by Elizabeth Cooney at 02:33 PM
September 13, 2007

Combining targeted drugs may work better against brain tumors, study says

Aggressive brain tumors receive more than one chemical signal telling them to grow, so more than one targeted drug should be used to shut these switches down, Dana-Farber researchers report.

Writing in the online edition of the journal Science, Dr. Ronald DePinho and his colleagues say they found many kinds of mutated cell-growth molecules sending abnormal signals at the same time, explaining why drugs such as Gleevec that target only one signaling pathway have only limited success.

The researchers were studying cells from glioblastoma multiforme, the most common kind of brain tumor and one of the most lethal forms of cancer people can have. The median survival time is about 12 months.

Testing a combination of three or more drugs, including Tarceva and Gleevec, the authors discovered they were able to block the abnormal signals and kill the cancer cells.

The authors recommend clinical trials to see if a combination of Gleevec, Tarceva and other compounds can thwart tumor cell growth. They also note that the signaling patterns they saw in brain tumors have been detected in cell lines of two other kinds of cancer with poor survival rates: lung and pancreatic.

And based on what they called proof-of-principle for personalized medicine, they suggest studying patients' tumor cells to see which switches are activated so the best drugs to block them can be used.

Posted by Elizabeth Cooney at 02:00 PM
September 13, 2007

BU names NIH official to major biolab post

By Stephen Smith, Globe Staff

Boston University today named a federal scientist who specializes in the study of the Ebola and Marburg viruses to the number two position at its controversial high-security laboratory being built in Boston's South End.

Thomas W. Geisbert will become associate director of the Biosafety Level-4 Laboratory and related facilities already rising on Albany Street. The high-security lab will allow scientists to work with the world's deadliest germs, including Ebola, anthrax, and plague.

Geisbert comes to BU from a similar position at the National Institute of Allergy and Infectious Diseases, where he helps preside over that agency's Biosafety Level-4 lab. When Geisbert joins BU on Oct. 1, he will also have direct responsibility for overseeing the handling and analysis of specimens generated by research projects in the facility, which is underwritten by a $128 million grant from the US government.

BU also announced today that Joan Geisbert, who is married to Thomas W. Geisbert, has been hired to help run the specimen lab. Joan Geisbert, who begins her job at BU on Feb. 1, has worked in Biosafety Level-4 labs for 26 years and most recently has supervised high-security labs at the US Army Medical Research Institute of Infectious Diseases in Maryland.

The BU lab, which is being built on the university's medical school campus, has generated lawsuits and street protests by opponents, who maintain that the facility has no place in a congested urban neighborhood. Foes of the lab have also charged that locating it in the South End imposes an unfair burden on a community with a significant segment of poor and minority residents.

Posted by Elizabeth Cooney at 01:37 PM
September 13, 2007

Fenway authors write book on LGBT health

fenway%20guide%20to%20lgbt%20health100.bmp

To fill a gap in clinical textbooks, doctors from Fenway Community Health have written a book about the healthcare needs of lesbian, gay, bisexual and transgender people.

The Fenway Guide to Lesbian, Gay, Bisexual and Transgender Health, to be published Sept. 30 by the American College of Physicians, is intended for physicians, other healthcare providers and educated consumers interested in specific issues related to LGBT people, co-author Dr. Harvey Makadon said in an interview.

"There is no comprehensive textbook," he said. "We try to go through what the issues are, what we know and what we don't know, and how clinicians can work with patients in a nonjudgmental way."

In the book Makadon and his co-authors Dr. Ken Mayer and Hilary Goldhammer of the Fenway Institute at Fenway Community Health and Dr. Jennifer Potter of Beth Israel Deaconess Medical Center discuss topics of particular concern for LGBT people. As a group they are more likely to smoke, LGBT youth are at higher risk for depression and suicide, and certain cancers are more common, such as anal carcinomas in gay men and breast cancer in lesbians.

"We realized this was an important area that wasn't being covered," Dr. Steven Weinberger, senior vice president for medical education and publishing of the American College of Physicians, said in an interview. "It has not been taught in medical school. Residents can take an elective to work in an environment where they are exposed to LGBT patietns, but it sort of falls through the cracks in terms of the standard curriculum."

In 2003 the University of Toronto Press published "Caring for Lesbian and Gay People: A Clinical Guide," by Allan D. Peterkin and Cathy Risdon, but the ACP thought it was more specific to Canadian than US healthcare, Tom Hartman of the US publisher said.

A companion web site for the Fenway book, with downloadable forms, will be available Oct. 15 at the ACP site.

Posted by Elizabeth Cooney at 11:21 AM
September 13, 2007

Getting aggressive about organ donations

Boston University bioethicist Michael Grodin says in today's Washington Post that organ donation networks can appear too zealous in their efforts to find potential donors.

"It's like they're vultures flying around the hospitals hovering over beds waiting for them to die so they can grab the organs," he told the Post. "That's the impression you get sometimes."

The story traces the more aggressive drive for organ donations to a 2003 federal campaign called the Breakthrough Collaborative. It was designed to boost the number of organs retrieved by the nation's 58 organ-procurement organizations, or OPOs, in light of a growing waiting list for kidneys, livers and other organs.

OPOs defend their practices while condemning a California case in which a surgeon is accused of hastening an organ donor's death, the story said.

"That case appears absolutely to be a case of a transplant recovery surgeon crossing a very clear line that should never be crossed," Thomas Mone, president of the Association of Organ Procurement Organization, told the Post. "Our job is to recover organs and save lives. But we have to do that sensitively, honestly and fairly, keeping the interests of the donors and families in mind. There's often a fine line there, but we make sure we never cross it."

Posted by Elizabeth Cooney at 08:00 AM
September 13, 2007

Today's Globe: insurance hikes, free care cuts, victims of violence, Fernald, US deaths, 9/11 illnesses, war amputee rehab, exercising in traffic

Massachusetts health insurers are predicting their rates will increase by about 10 percent next year for most residents covered through employer health plans, marking the eighth consecutive year of double-digit premium hikes.

Proposed reimbursement rules for hospitals that treat uninsured patients would cut millions of dollars from annual payments to Massachusetts hospitals that provide care for the majority of low-income and uninsured residents, according to new state projections.

Lawmakers are considering a bill that would establish standardized steps that healthcare workers could follow to help victims of violent crimes get social services, such as a referral to a shelter for victims of domestic abuse.

Governor Deval Patrick's administration announced yesterday that it is appealing a federal judge's decision that halted the state's plan to close the Fernald Development Center in Waltham, saying the ruling interferes with the state's ability to decide how to best care for its mentally retarded residents.

The number of deaths in the United States rose in 2005 after a sharp decline the year earlier, a disappointing reversal that suggests the 2004 numbers were a fluke.

Doctors treating sickened ground zero workers offered Congress a detailed diagnosis yesterday of the ailments still affecting thousands after the Sept. 11 attacks, but warned that there's no way to determine how many more may become afflicted with life-threatening illnesses.

War veterans who have lost a limb will relearn tasks such as shooting a weapon, driving a car, or rappelling down a cliff at a rehabilitation center opening at Walter Reed Army Medical Center.

People with heart disease should steer clear of heavy traffic when exercising or simply take their workout indoors to avoid breathing polluted air.

Posted by Elizabeth Cooney at 06:55 AM
September 12, 2007

Partners doctors group names chief medical officer

By Jeffrey Krasner, Globe Staff

Jennifer%20Daley85.bmpPartners Community HealthCare Inc. chose Dr. Jennifer Daley (left) as its new chief medical officer, filling a key position that has been vacant since February. Daley, 57, served most recently as chief medical officer for Tenet Healthcare, the large for-profit health system.

A specialist in internal medicine, Daley has deep roots in the Boston area. She trained at New England Medical Center and completed a fellowship in medicine at Harvard Medical School in 1987. She worked at Beth Israel Deaconess Medical Center, the Brockton-West Roxbury Veterans Affairs Medical Center and Massachusetts General Hospital and is a graduate of Tufts School of Medicine.

Partners Community HealthCare is the physicians group for doctors that work for Partners HealthCare. Daley will head medical affairs for the group, and will work to improve quality, safety and efficiency provided by the 4,900 Partners doctors.

September 12, 2007

Dry summer has been bad news for mosquitoes

By Stephen Smith, Globe Staff

A dry summer has yielded at least one benefit: fewer mosquitoes carrying highly lethal Eastern equine encephalitis.

A state health report presented today shows that through Friday, disease trackers had found only 22 pools of mosquitoes carrying the virus. That compares with 121 pools of infected mosquitoes through the same period last year.

Dr. Alfred DeMaria, the state's director of communicable disease control, attributed the decline to the lack of rainfall, which is necessary for mosquitoes to breed robustly. The lack of rain, DeMaria said, has been most pronounced in the southeastern corner of the state, long recognized as a hotbed of Eastern equine activity.

Another mosquito-borne ailment, West Nile virus, appears to be at a level similar to last year, DeMaria said.

Eastern equine is the deadliest of all ailments spread by mosquitoes, killing one-third to one-half of people who contract the illness. No human cases of Eastern equine have been reported in Massachusetts this year.

Three cases of West Nile have been documented in the state, but investigators said they do not believe any of those infections was acquired in Massachusetts. Two of the people with the disease were visiting Massachusetts and appear to have contracted the virus before arriving in the Bay State. Investigators said the third patient, a Boston man, was exposed while in Montana.

To avoid contact with infected mosquitoes, the Massachusetts Department of Public Health recommends limiting outdoor activities from dusk to dawn, peak biting times for mosquitoes. Otherwise, wear as much clothing as comfortable and apply insect repellent such as DEET, permethrin, picaridin, or oil of lemon eucalyptus.

DEET should not be used on infants under the age of 2 months and should be used in concentrations of 30 percent or less on older children. Oil of lemon eucalyptus should not be used on children under 3 years old.

Posted by Karen Weintraub at 02:15 PM
September 12, 2007

Ban proposed on toy jewelry containing lead

By Stephen Smith, Globe Staff

State health regulators this morning called for a ban on necklaces, bracelets, and other toy jewelry containing dangerously high levels of lead.

Tests performed by the state Department of Public Health found that some of the trinkets, which investigators purchased in stores across Massachusetts, possessed lead levels thousands of times higher than permitted. High lead levels in children have been linked to learning problems and other medical conditions.

State law forbids lead in paint applied to toys and jewelry but neither Massachusetts nor federal regulations cover lead in the metal and plastic contents of toy jewelry, leaving children vulnerable, Suzanne Condon, director of the state's Bureau of Environmental Health, said during a meeting of the state Public Health Council.

"I can remember as a child putting my necklace in my mouth," Condon said. "It's a rare thing if you don't see children with these things in their mouth."

Condon said 79 pieces of toy jewelry were tested and more than 10 percent had high rates of lead. That finding led health regulators to draft the proposed ban, which must be approved by the Public Health Council.

Members of the panel this morning expressed enthusiasm for the prohibition and suggested that regulators consider expanding it to other products potentially containing lead. If the ban is adopted, the state plans regular spot checks to make sure dangerous products aren't being sold, Condon said.

September 12, 2007

Hearing put off in nursing mother's suit against medical exam board

By Felicia Mello, Globe Correspondent

The case of a Brookline woman who is suing for extra break time to pump breast milk during the licensing exam to become a doctor has been removed to federal court, meaning a previously scheduled state court hearing this afternoon will not take place.

A hearing has been set for tomorrow at 2 p.m. to decide whether the federal court will hear the case before Sophie Currier, 33, is scheduled to take the test September 24 and 25.

Currier, a Harvard Medical School student who is breastfeeding her 4-month-old daughter, filed suit against the National Board of Medical Examiners in state court last week, saying the 45 minutes of free time allowed over the course of the nine-hour exam was not enough for her to expel milk in addition to eating and using the restroom.

The board has refused to grant Currier the extra time but has offered to supply her with a private room in which to pump the milk during scheduled breaks.

The case was transferred to the US District Court at the request of lawyers for the medical board.

Christine Smith Collins, Currier’s attorney, said the removal "could be viewed as a delay tactic by the board trying to push off a decision until after she's taken the exam, so she can’t get the relief that she’s seeking."

But medical board attorney Joseph Savage said he made the request because Currier’s major argument was that her civil rights had been violated, a claim more appropriately heard by a federal judge.

Currier, a Brookline resident, has started a blog, called Support Nursing Moms, in hopes of reaching other women in similar circumstances.

"I am fighting because I don't have a choice," she said today, "but I feel passionate about it because I feel I could influence how other nursing mothers are treated as well."

September 12, 2007

Berwick and Herr win Heinz awards

Two Cambridge innovators are among five winners of $250,000 awards from the Heinz Family Foundation for their achievements in medicine and science, the foundation said today.

donald%20berwick%20100.bmpDr. Donald Berwick (left), co-founder of the Institute for Healthcare Improvement and a professor of pediatrics at Harvard Medical School, won in the public policy arena. His organization has been central in the movement to increase patient safety through efforts to make healthcare systems work better. The 100,000 Lives campaign, followed by the 5 Million Lives effort, set goals to improve care in hospitals.

hugh%20herr100%202.bmpHugh Herr (left), MIT professor and director of biomechatronics at the MIT Media Lab, won in the technology, the economy and employment category. He studies human movement, how it is controlled and how to engineer human-like structures, including prostheses for amputees and wrap-around devices for people who have suffered strokes.

"My philosophy is that there are no disabled people in the world. There are only technologies that haven't been invented yet or technologies that don't work," Herr said in an interview yesterday. He calls himself an end-user because both his legs were amputated. "We should not accept disability and society should always continue to work toward technological interventions that bring us closer to being sure no one has to live with a disability, whether cognitive or physical."

Yesterday Berwick said he might use his grant to advance IHI's work in developing countries, where the organization has been applying the same principles that work to reduce infections in hospital ICUs to ways that keep women from dying in childbirth in remote villages in Malawi.

"We take very good science around public health and then empower local groups to implement that science," he said. "The same improvement methods that are getting traction in wealthy countries can have tremendous effects in developing countries."

The other winners of the Heinz awards, named for Senator John Heinz of Pennsylvania and selected by the foundation chaired by his widow, Teresa Heinz, are:

Dr. David L. Heymann of Geneva, assistant director general of the World Health Organization, in the human condition category

Dave Eggers, San Francisco author and founder of the 826 Valencia writing laboratories, in the arts and humanities category

Bernard Amadei of Boulder, Colo., founder of Engineers Without Borders -- USA and -- International, and Susan Seacrest of Lincoln, Neb., founder of the Groundwater Foundation. They are co-recipients in the environment category

Posted by Elizabeth Cooney at 07:35 AM
September 12, 2007

Today's Globe: diabetes drug, prescription drug deaths, nursing home segregation, Russian 'day of conception,' cholera in Iraq, health insurance costs, anemia drug doses, medical errors

The widely used diabetes pill Actos appears to lower a patient's chances of death, heart attack, or stroke, unlike its beleaguered chief rival, Avandia, a new analysis shows. It also carries an increased risk of nonfatal heart failure, the analysis showed, confirming earlier studies.

Reports of dangerous side effects and deaths from widely used medicines almost tripled between 1998 and 2005, an analysis of US drug data found.

Elderly and ill blacks in the United States are more likely to live in poor-quality nursing homes, researchers said yesterday in a study showing that clear patterns of segregation persist.

Governor Sergei Morozov of Ulyanovsk in central Russia has decreed Sept. 12 a Day of Conception and is giving couples time off from work to procreate. Couples who give birth nine months later on Russia's national day, June 12, will receive money, cars, or other prizes.

A cholera epidemic in northern Iraq has infected approximately 7,000 people and could reach Baghdad within weeks as the disease spreads through the country's decrepit and unsanitary water system, Iraqi health officials said yesterday.

The increasing cost of health insurance is putting coverage out of reach for many small to midsize companies and their workers, even though the rise in premiums this year was the lowest increase in eight years.

Amgen Inc. and Johnson & Johnson's anemia drugs don't need changes in recommended doses to protect the safety of kidney patients, US advisers said.

Legislation to require public reporting of medical errors that will be heard by the Legislature's Public Health Committee today should be revised so that providers are not allowed to bill for the extra costs of treating preventable errors, injuries, and infections that occur in hospitals, Richard Lord, president and CEO of Associated Industries of Massachusetts, and Dr. Marylou Buyse, a practicing primary care physician and president of the Massachusetts Association of Health Plans, write on the op-ed page.

Posted by Elizabeth Cooney at 06:53 AM
September 11, 2007

BU immunology lecture to honor 9/11 victim

Boston University School of Medicine will remember one of its own who died in the Sept. 11, 2001, attacks.

A lecture at noon Friday will honor Sue Kim Hanson, a researcher in the medical school's pulmonary center before she died along with her husband and daughter on the second plane that struck the World Trade Center.

Tom Maniatis, a Harvard professor of molecular and cellular biology, will deliver the sixth annual Sue Kim Hanson Lecture in Immunology. His topic is how innate immune cells respond to viral infections by directing how antiviral proteins are made.

Kim Hanson earned a master's degree in medical sciences from BU in 1992, after which she joined the pulmonary center and enrolled in a PhD program in pathology and laboratory medicine. Her doctorate was awarded posthumously.

Posted by Elizabeth Cooney at 03:27 PM
September 11, 2007

Questionnaire intended to help doctors treat older adults

Older adults have different concerns than younger people when they come to their doctors' offices, so a Boston coalition has created a free tool to help primary care physicians recognize and meet their needs.

The Boston Partnership for Older Adults, funded by the Robert Wood Johnson Foundation, has designed a two-page questionnaire to guide primary care physicians, who give most older people their care. The group is made up of 200 organizations and individuals concerned about the needs of older people in the city.

The focus is function, said Clare Wohlgemuth, nursing director of the Boston University Geriatric Services at Boston Medical Center and chair of the partnership's health committee.

"Those of us who work in geriatrics know that for older folks, their function is totally equivalent to how they perceive their health," she said in an interview. "What we set about doing was to develop a geriatrician cheat sheet for other primary care providers to think in a functional way."

Function for older people means how well they are managing a household, what their quality of life is and whether they have a support network. Common geriatric problems a patient might not raise in an office visit are falls, urinary incontinence, sexual activity, or the burden of care they might be providing for someone else, Wohlgemth said. A companion questionnaire, without the code numbers for billing purposes that appear on the physician version, is meant to help patients raise these issues with their doctors.

The tool also refers physicians and patients to Boston ElderInfo for information on other services.

The tool is not a substitute for seeing a geriatrician, Wohlgemuth said, but that might not always be neccessary.

"Not everyone needs a geriatrician or geriatric trained nurse, but every good primary care provider needs to have sensitivity to what the special needs of older people are," she said.

Posted by Elizabeth Cooney at 03:18 PM
September 11, 2007

Teaching brain pathology by hand

joseph%20and%20student85.bmpThe advent of magnetic resonance imaging means neurologists in training no longer spend hours dissecting spinal cords and brains, psychiatrist Dr. Elissa Ely writes in today's New York Times. And she thinks that will be a loss.

"From a distance, brain autopsies seem an afterthought on life. Insurance does not cover them. They serve no lucrative purpose, so hospitals have a financial disincentive to do them," she writes. "As a result, the field of neuropathology is shrinking and its atrophy may diminish the entire field of neurology."

Dr. Jeffrey T. Joseph (at right in bottom photo with first-year resident Dr. Scott Wenson) has conducted a weekly neuropathology seminar at Beth Israel Deaconess Medical Center for 12 years, but he's leaving in the fall for the University of Calgary in Alberta, the story says.

"It's part diagnosis, part entertainment," he says about the seminars in the story. "I like to make them look. The brain is like a geode -- you don't know what's inside."

Posted by Elizabeth Cooney at 12:53 PM
September 11, 2007

Today's Globe: carbon footprint, digestible labels, gifted parrot, designs on a cure

Customers buying Timberland shoes now have something to think about other than style, comfort, and price -- global warming. The shoe maker is among a growing number of companies seeking to capitalize on consumers' growing concern about climate change by developing "carbon labels" for everything from shoes to shampoo.

labels85.bmpNext month, General Mills Inc. and Kellogg Co. will begin labeling their cereals with symbols that summarize complex nutritional information - part of the growing use of logos to steer harried grocery shoppers toward healthier choices.

Brandeis scientist Irene Pepperberg knew that Alex, an African gray parrot whose advanced language and recognition skills shattered science's understanding of the avian brain, would not be around forever to greet her in her lab each morning. But his sudden death Thursday after 30 years of research has left Pepperberg and fellow researchers shocked, scrambling to piece together the remaining data from their latest work with the bird, and feeling as if they had lost a colleague.

fashion%20doctors150.bmpBreast cancer survivors Dr. Carolyn Kaelin (second from left) and Dr. Julie Silver (right) modeled fashions by designer Sara Campbell (second from right) during a runway show in Boston's Fashion Week to benefit the Breast Cancer Research Foundation. WCVB's Kelley Tuthill (left), also a breast cancer survivor, was the event's MC.

Posted by Elizabeth Cooney at 06:57 AM
September 10, 2007

Levy and SEIU tangle again on union drive

What does "free and fair" mean?

When it comes to union elections, Beth Israel Deaconess Medical Center CEO Paul Levy and the Service Employees International Union don't appear to be on the same page.

They have been at odds at least since November, when on his blog Running a Hospital, Levy warned of the union's "aggressive tactics to discredit the management and the boards of hospitals who don't give in." Seven months later the union alleged the hospital had higher emergency care costs than other major Boston hospitals, and made greater use of a state pool to be reimbursed for free care it provides uninsured patients.

This time Levy is responding to letters SEIU sent to Beth Israel Deaconess physicians. In the Aug. 21 messages, the union says it has asked the hospital to promise not to spend patient-care funds on anti-union activity, as part of a "free and fair election code of conduct" during its campaign to represent health-care workers.

"While it is awkward to impute another's motivation, it appears that the letter has three purposes," Levy wrote in his Friday night post. "First, to obfuscate the statements made by management of hospitals about this issue. Second, to present a revisionist view of what the union itself has said in other forums -- like in the US Congress, where it has strenuously argued for an elimination of elections. Third, to attempt to drive a wedge between the management and a hospital's physicians by using these mischaracterizations and appealing to the doctors' underlying sense of fairness and fondness for the workers in the hospital."

Levy says that the election process is already governed by National Labor Relations Board rules as well as hospital guidelines that support "a free and fair election," posting the hospital policy on union activities. He also refers to union efforts to replace secret ballot elections with a card-check process, in which workers would sign a card to certify a union.

The union responded this afternoon, saying Levy "continues to parrot the Bush Administration's talking points in the way he mischaracterizes Senator Kennedy's ... bill, which was not the subject of our letter."

"Despite Mr. Levy's attempts to obfuscate what many hospital workers throughout Boston are actually asking for, our message is clear," SEIU executive vice president Mike Fadel said in an e-mail. "Hospital workers across the city are calling for free and fair union secret ballot elections, which include a code of conduct agreed to by employers to ensure their right to vote is not interfered with by hospital management."

Posted by Elizabeth Cooney at 06:46 PM
September 10, 2007

Halamka not worried by report linking microchips to tumors

halamka%20150.bmpDr. John Halamka (left) is used to fielding questions about the radio frequency identification chip embedded in his arm, and not just when he sets off security alarms at Home Depot.

The chief information officer at Beth Israel Deaconess Medical Center, who had the microchip containing his medical data implanted in 2004, says he isn't worried by an Associated Press report that the US Food and Drug Administration ignored studies linking the chips to cancer in mice when it approved the devices.

"The chip is ceramic, surrounded by medical-grade glass that is, to my knowledge, invisible to the immune system," he said in an e-mail today. "Thus, I cannot imagine how a chip could induce tumors."

Halamka said he has talked to veterinarians who have implanted thousands of the chips into dogs and cats, with no side effects. He suspects that the studies of mice are not applicable to humans because mice are predisposed to developing tumors at the site of any injection.

"I've had no side effects or tumors," he said. "Should I ever develop any issues with my implanted chip, you'll be the first to know!"

Posted by Elizabeth Cooney at 04:12 PM
September 10, 2007

Nursing mother files suit against medical exam board

By Carey Goldberg, Globe Staff

Sophie Currier, the Harvard MD-PhD and nursing mother who was denied extra time to pump her breasts during an all-day exam of medical knowledge, has filed suit against the board that administers the exam.

Her case is currently scheduled to be heard this Wednesday at 2 p.m. in Norfolk Superior Court in Dedham, said her lawyer, Christine Collins, but that timing is still under negotiation.

Collins is asking the judge for an immediate order requiring the National Board of Medical Examiners to provide extra time and an appropriate place for pumping. Currier plans to take the clinical knowledge exam on Sept. 24 and 25th.

The board of medical examiners, the non-profit group that runs national medical exams, has said that it can provide accommodations only for disabilities covered by the federal Americans with Disabilities Act, and breastfeeding does not qualify.

Currier, 33, is not claiming that breastfeeding is a disability. But it is a demanding biological reality, she argues, and one that -- medical authorities agree -- is important for the health of her 4-month-old daughter, who is still exclusively breastfeeding.

Nursing mothers who go for hours without breastfeeding or pumping risk painfully hard breasts, plugged milk ducts and possible infection, as well as a possible reduction in milk supply.

Collins argues that it is a woman's constitutional right to breastfeed, and that denying Currier extra time to pump amounts to discrimination on the basis of sex. A member of the firm Bowditch & Dewey of Boston, Worcester and Framingham, Collins has taken Currier's case pro bono.

Dr. Ruth Hoppe, chair of the governing board that oversees the tests, said she could not comment directly on Currier's case.

But she said that the board tries to keep the tests as fair and uniform as possible in order to safeguard the American public and ensure the competence of its doctors. At the same time, she said, it tries to accommodate test-takers with personal difficulties that do not qualify as full-fledged disabilities, such as breast-feeding, bone fractures, back pain and bowel problems.

"We try to do the best job we can do to balance those priorities," she said.

Given the questions raised about breastfeeding, she said, she expects the board to re-examine its policy on lactation within the next year.

Currier's case, which was first reported on the Globe's front page, is in the New York Times today.

Posted by Karen Weintraub at 04:00 PM
September 10, 2007

Today's Health|Science: under the sea, skulls and bones, computers in the exam room

Over the next five years, scientists at the Woods Hole Oceanographic Institution will join researchers from around the world to design and build a global network of underwater laboratories, including one in the Atlantic Ocean off the south coast of Massachusetts, that capitalizes on advances in satellite, Internet, and sound wave technology.

harper100.bmpAlbert Harper (left), forensic anthropologist for the state of Connecticut, has been getting attention recently for his work on some very old cases - what he calls archeoforensics -- including one involving the remains of an Inca warrior, with small holes at the front and back of his skull, that was found by archeologists near the site of a 1536 battle with Spanish conquistadors in Peru.

stethoscope%20on%20keyboard85.bmpAlthough the computerized medical record system has proven to be a huge help, I have confronted an unexpected challenge: Despite repositioning the computer in every imaginable way, I often find myself making more eye contact with the screen than I do with my patients, Dr. Michael Hochman, a resident at Cambridge Health Alliance writes.

tai%20chi85.bmpAlso in Health|Science, food additives and hyperactivity, can a falling penny punch through a person and are there any health benefits from tai chi (left) exercises?

Posted by Elizabeth Cooney at 06:56 AM
September 10, 2007

Also in today's Globe: campus birth control cost, FDA testing debate, TB case report, Dr. Robert E. Flynn, Jane Tomlinson

An increase in the price for prescription birth control obtained at campus health centers has some college officials worried that students will be at greater risk for unwanted pregnancies.

A prominent New England researcher has rekindled a debate about the standards the Food and Drug Administration uses to speed approval of life-saving drugs, arguing that federal officials should insist on more rigorous proof that the drugs save lives and improve patients' health.

A congressional investigation into officials' inability to stop a tuberculosis patient from leaving the country found significant security gaps, heightening concern about vulnerability to potential cases of pandemic flu or smallpox.

dr%20robert%20e.%20flynn85%202.bmpDr. Robert E. Flynn (left), an architect behind the Caritas Christi Health Care system and former chairman of the Massachusetts Hospital Association, died Sept. 3 at his Mattapoisett home of complications from Alzheimer's disease. He was 83.

jane%20tomlinson100.bmpBriton Jane Tomlinson (right), hailed as an inspiration for defying terminal cancer to run marathons, cycle across the United States, and raise $2 1/2 million for charity, has died at the age of 43. A family spokesman said the mother of three died Sept. 3, some seven years after she was diagnosed with incurable cancer and told she would not survive more than six months.

Posted by Elizabeth Cooney at 06:54 AM
September 10, 2007

In case you missed Sunday's Globe: fighting for brain-injured soldiers, waiting for women veterans' clinic in Brockton, Edward Brandt

mannions%20150.bmpFamilies of severely brain-injured soldiers, including Maura Mannion Brodeur (with her son Vincent Mannion, left), are demanding specialized care for them in private facilities outside the military and veterans healthcare system -- a system that many families of veterans, and some leading medical specialists, view as badly overtaxed and no match for the nation's best rehabilitative hospitals.

brockton%20VA150.bmpLast January, the VA Boston Healthcare System held a ribbon-cutting ceremony at the Brockton VA campus (left) to celebrate a new treatment center for female veterans suffering from post-traumatic stress and substance abuse disorders. As of last week - nine months after the ribbon-cutting - the center is still not open. And the women's clinic at the Brockton VA campus, which serves 500 patients from across Southeastern Massachusetts, recently closed temporarily. VA officials say finding adequate staffing is the problem in both cases.

edward%20brandt85.bmpDr. Edward N. Brandt Jr. (left), a physician who oversaw the federal government's first response to the AIDS epidemic and who initiated requirements for tamper-proof drug packaging after highly publicized Tylenol poisonings, died Aug. 26 at his home in Oklahoma City.

Posted by Elizabeth Cooney at 06:05 AM
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