Can comics help us heal? Graphic medicine exhibit comes to UMass Med in the fall.

A few recommendations from Noes

Also note: Noes’  The Graphic Medicine Book Discussion Kit.



Writing about ovarian cancer and missing a friend — and science writer –who died from it.

from TinkerI could not help thinking about my friend Caroline Dopyera when I was working on this story. She died in 1997 from ovarian cancer, not long after this picture was taken.  She was an energetic science writer who came to The News & Observer on a AAAS fellowship and stayed on. This picture was taken when we met up in Malaysia. She had been in Indonesia reporting on orangutans and I was in Phnom Penh on year-long stint working for the recently shuttered Cambodia Daily. We met for a few days on Tioman Island. She was diagnosed soon after returning to the states. I still miss her. She would have loved to write this story.


Professor Angela Belcher earned a MacArthur genius grant by engineering a harmless virus to form tiny wires — an insight that could lead to cheap and biodegradable batteries and solar cells. Now she’s using the same virus to perform a different trick and solve a very different problem: the grim prognosis for women with ovarian cancer.

CVS CMO outlined a plan for “complementary primary care.” You’ll be able to get it in your neighborhood drug store.

Troy Brennan spoke at an event in Boston on digital health and aging Wednesday.  He emphasized that the merger between CVS and Aetna has yet to be approved. But, he outlined the CVS plan to offer more than urgent care.

A few more from the meeting


Daily Dose archived, health blogger Kotz leaves “The Boston Globe”

Deborah Kotz,  the Globe’s Daily Dose health blogger for the past four years, has taken a buy-out and that Daily Dose will be archived.

We’ll miss Kotz. While often stuck fielding the barrage of journal studies coming out of Boston medical centers,  she always managed to avoid disease-of-the week reporting.  Some stories just confuse readers. But writers who skip them often have to face editors asking “Why didn’t we have this?”

Still, it’s the kind of reporting that wins health writers like Kotz kudos.

The Globe no longer shares content with, so that website produces its own health reports. Mostly aggregation, but a few stories. We’ll miss the science touch Kotz brought to that site before the Globe/ divorce.  We wish them well as they find their way.They seem to have taken over the @bewellboston twitter feed.


Check in here for your sort-of-weekly, but always insightful dose of local health blogging. Or check out WBUR’s CommonHealth for daily posts.

Don’t have a hot attack: Framingham Heart Study carries on

fhsWhat is up with the Framingham Heart Study? That long-running research project has been tracking the cardiac health of hundreds of local folk for decades.  (The algorithm used to estimate the 10-year risk of heart disease is called the “The Framingham Risk Score.”)

A story and a blog post recently reported woefully about a 40 percent sequester cut to the study’s National Institutes of Health funding.  Neither quoted anyone from NIH.

So, both pieces failed to note that the cut is to the study’s administrative grant from the National Heart Lung and Blood Institute, not its research grants.  According to BU, the study receives an estimated $5.4 million in NIH grants for research. This funding is not impacted by the 40 percent cut.

In other words, the cuts come from the money used to run the program – office staff, data collection and the management of study subjects, not the scientific research projects that fall under the program’s umbrella. The data collected from the locals helps researcher understand the mechanics and, more recently, the genetics of heart disease as it impacts the rest of us.

In total, NIH says it will spend $21 million this year contracts for the FHS study infrastructure – including a study looking for biomarkers for heart disease. In addition to funding the BU research, NIH says its grants cover 17 FHS related studies at eight different organizations and universities. In addition to the Heart Lung and Blood institute, that money comes from five other NIH institutes and centers, including the National Institute on Aging, The National Institute of Diabetes and Digestive and Kidney Diseases and the National Institute of Neurological Disorders and Stroke.

None of this was clear in this first, July 20 story from the Metro West Daily:

The Framingham Heart Study expects to lose $4 million in funding as part of the federal budget cuts known as sequestration, study officials confirmed Friday in a statement. The $4 million cut takes effect Aug. 1 and represents 40 percent of funding it receives from the National Heart, Lung and Blood Institute (NHLBI), a division of the National Institutes of Health, the statement said.

 The story quotes a spokeswoman from Boston University, which is home to the study.

The cut with “result in a reduction in workforce affecting 19 staff from a variety of clinical and administrative areas, as well as reductions in clinic exams and lab operations.”

Then it quotes from a statement about NIH cuts in general from new Sen. Ed Markey:

“Slashing critical federal investment in medical research jeopardizes the health of many Massachusetts residents, while putting at risk tens of thousands of jobs in the commonwealth’s innovation economy and the industries they support,” Markey said. 

Then it quotes from Karen LaChance, a Framingham resident and president of the Friends of the Framingham Heart Study.

“We just hate to see any cut. It delays hopefully finding whatever the magic bullet might be to prevent heart disease.

Then it doesn’t quote anyone from NIH.

In a post on the Metro West Daily story,  WBUR’s CommonHealth blog offers the headline “Famed Framingham Heart Study Faces Deep Cuts From Federal Sequester.”

It was a “Say it isn’t so” moment this morning when I saw this MetroWest Daily News headline: Framingham Heart Study Faces $4 Million Cut. “Heart disease is the country’s number 1 killer, and chances are whatever you do to prevent it or treat it was influenced by the Framingham Heart Study, a venerable epidemiological gem right here in our own Boston suburbia….”

But, you could argue that it ain’t so.

As far as the impact of the cuts, Metro West Daily quote  BU as noting that “This loss of funding will result in a reduction in workforce affecting 19 staff from a variety of clinical and administrative areas, as well as reductions in clinic exams and lab operations.”

BU tells us that approximately 80 people work at the FHS. “The affected staff will see a reduction in hours beginning Aug. 19; if alternative funding sources are not identified, a layoff would occur Nov. 1. “

The FHS site was a little clearer on all this, with note on its home page:

New Information for FHS Participants edited July 20 2013

Q. Is the FHS closing?
A. No. The current Offspring and Omni Group 1 exams are continuing to Oct. 31, 2013. Ancillary studies are continuing as planned. Medical history updates are being collected on the regular schedule. Please respond to calls for FHS participation as usual.

By Wednesday August 1, BU had posted its own story on the BU Today website with the headline: “Framingham Heart Study Carries on, Despite Budget Cuts: 65-year-old core contract loses 40 percent of funding.”

BHN Report: On MV, Berwick takes a break from his break to comment on Ryan Medicare plan, new film

Former Medicare chief Donald Berwick was present both on and off the screen for a Thursday Martha’s Vineyard showing of a new film on the health care system. Berwick, who spends part of his summer in Chilmark, was fresh off an interview with WBUR’s On Point call-in show. So, he was ready to comment on the Medicare voucher plan proposed by Republican Vice Presidential candidate Paul Ryan.

Berwick thinks the addition of Ryan to the ticket will be good for the debate over the Medicare budget.

“You see Romney trying to explain the Ryan plan. I think it will help clarify the difference in viewpoints,” between the two parties, he said.

At the same time, Berwick noted that issues surrounding Medicare are complicated – he admited that he had study up on some technicalities when he took over the national health plan for the elderly for a year.  So, voters are already hearing a lot of “irresponsible rhetoric” and one-liners, he said.

As it turns out Romney and Ryan were also in New England this week– talking about Medicare during yesterday’s campaign stop in New Hampshire. The Boston Globe reported that Ryan said he invites a debate on the plan. He characterized Obama’s approach this way:

            Mitt Romney and Paul Ryan, campaigning in a state with a median age higher than Florida’s, criticized President Obama on Monday morning for his health care law and said the Republican ticket would be more likely to put Medicare on sounder financial footing.

     “Medicare should not be a piggybank for Obamacare!” Ryan said.

Romney and Ryan charge that the health reform law takes $750 billion from Medicare to pay for the new health law.  Berwick said that’s “not really true.” The changes in payment are designed to promote changes in the way care is delivered, he said. “It doesn’t take a nickel away from beneficiaries. The Ryan plan is the one that takes money away from beneficiaries by putting them at risk. “

      The Ryan plan cuts Medicare by setting up a voucher system, he said. Instead of a guaranteed benefit, the approach would become a guaranteed payment in the form of a voucher. It cuts the budget, Berwick noted, by telling beneficiaries – “It’s your problem now.”

Interest in the topic drew a full house to see Escape Fire: The Fight to Rescue American Health Care in a small viewing room in Edgartown’s Harbor View Hotel. (The title refers to a method firefighters use to avoid being burned by a wildfire.) The movie offers a beginner’s overview of the problems facing the health system, as well as three engaging stories of people coping with them.   The subjects – interspersed between talking heads — include a doctor, a soldier and a victim of grossly excessive treatment for heart disease. Judging from the gasps from members of the audience, familiar facts about problems like medical errors were new to them.  “Disturbing,” one woman leaned over and whispered to her companion.

Besides Berwick and Steve Nissen of the Cleveland Clinic, those commenting in the  film did not represent the usual suspects. Most people associate Andrew Weil and Dean Ornish with healthy lifestyles, not systemic change. Still, they spoke to the need from more preventative care. The audience seemed to agree. A heart attack patient opening a can of Vienna sausages and smoking a cigarette generated the loudest groans.

Berwick also offered something different. Instead of demonizing doctors and drug companies, he notes that they just are working within the system as it stands.

“They’re just doing what makes sense,” he said. “We have to change what makes sense.”

What are #Harvard docs and #medical school students reading? Countway tweets tell all #library

The Countway Library at Harvard Medical School has a twitter account listing the books Harvard students, docs and profs return. Here are a few samples.  “Cooper:Therapy dog” seems popular, as do books by Paul Farmer of Partners in Health. For more see @HMSreturns.

History, memoir and colons

Medieval technology and social change by  Lynn Townsend White

Alfalfa to ivy : Memoir of a Harvard Medical School dean by  Joseph B. Martin

Alice Hamilton: Pioneer doctor in industrial medicine by  Madeleine P. (Madeleine Parker) Grant

The puzzle people : Memoirs of a transplant surgeon by  Thomas E. (Thomas Earl) Starzl

The mentally ill in America : A history of their care and treatment from colonial times by  Albert Deutsch

Power, sex, suicide : Mitochondria and the meaning of life by  Nick Lane

On the pill : A social history of oral contraceptives, 1950-1970 by  Elizabeth Siegel Watkins

Subjected to science : Human experimentation in America before the Second World War by  Susan E Lederer


Ophthalmology secrets in color

Trauma secrets

Dental secrets

Med School

Assessment measures in medical school, residency, and practice : the connections

So you want to be a brain surgeon?

The Washington manual internship survival guide by  Grace A Lin

Iserson’s getting into a residency : a guide for medical students by  Kenneth V Iserson


Shattering culture : American medicine responds to cultural diversity

Health issues in Latino males : a social and structural approach

Race, ethnicity, and health : a public health reader

Not too medical

Gold: recovery, properties, and applications by  Edmund M. (Edmund Merriman) Wise

Hair transplantation


[Cooper : therapy dog]

Better than well : American medicine meets the American dream by  Carl Elliott

How to

Electroconvulsive therapy : a guide for professionals and their patients by  Max Fink

Schmidek & Sweet operative neurosurgical techniques : indications, methods, and results

Fundamentals of clinical trials by  Lawrence M. Friedman

Pocket medicine

Introduction to anesthesia; the principles of safe practice by  Robert Dunning Dripps

Janeway’s immunobiology by  Kenneth (Kenneth M.) Murphy

Good general practice

Next generation microarray bioinformatics : methods and protocols

Bethesda handbook of clinical oncology

The breath, and the diseases which give it a fetid odor : with directions for treatment by  Joseph W. (Joseph William)

Sapira’s art & science of bedside diagnosis by  Jane M Orient


Callous disregard : autism and vaccines — the truth behind a tragedy by  Andrew J Wakefield