Memory altering research the stuff of sci-fi, cinema and Sherlock

In the BBC’s Sherlock, the title character –played by Benedict Cumberbatch — often resorts to his “mind palace” to piece together nebulous memories.

In the film Eternal Sunshine of the Spotless Mind, a character played by Kate Winslet goes to a clinic to get  painful memories of a relationship erased.

.photoA bit of a stretch, but add Frank Booth’s gas sniffing psycho from the film Blue Velvet, and you pretty much find nods to all the research Carolyn Y. Johnson talks about in her Globe column this morning. 

In research published Wednesday in the journal PLOS ONE, McLean Hospital researchers took rats that had learned to fear a tone because it was followed by a foot shock and erased the negative memory, by having them breathe xenon gas. In a separate study, Massachusetts Institute of Technology scientists reported in the journal Nature they were able to use cutting-edge genetic tools to alter the emotional context of a memory, allowing them to replace the negative memory of receiving a mild electric shock with the pleasurable one of mingling with mice of the opposite sex.

That adds to a body of research from MIT over recent years that has shown that administering a drug can wipe out a negative memory in mice, or that it is possible to trigger an existing memory or plant a false one using genetic manipulation.

 

 

The Boston Globe series that Steward Health took to court — before the stories ran

The Globe’s narrative story about one man’s struggles with his mental health care is running this week. And the company that runs one of the hospitals where he was treated was not allowed to read it first.ssLast week:  

A Suffolk Superior Court judge ruled Thursday that Steward Health Care System has no right to review the reporting or records collected by The Boston Globe for a yet-to-be-published article about a man’s journey through the mental health care system.

Judge Jeffrey Locke said the for-profit health care company may comment broadly to the newspaper and answer limited questions on the patient’s care without violating medical privacy laws.

Steward, in a suit filed against the Globe Wednesday, asked the court to permit release of the patient’s private medical records, which the company said it needed to rebut a Globe story that is scheduled to be published this weekend.

The hospital chain also served papers to the man profiled in the story. Read the full story above a full run-down of the legal contortions hospital lawyers performed to argue that they were not going after the patient or trying to repress the story.

This is more about more than a thin-skinned story subject.  Health care reporters seeking comment or information for stories can come up against overly broad interpretations of patient privacy laws.  Worth watching.

Finally, a question: What would The Cheescake Factory do? 

 

Priorities for Comparative Effectiveness + Senate and health reform

The Institute of Medicine, a Congressional research arm, released a list of  “100 health topics  (.pdf) that should get priority attention and funding from a new national research effort to identify which health care services work best.”

Among the high priority issues: atrial fibrillation, hearing loss, fall prevention for the elderly, MRSA prevention, localized prostate cancer,  lower back pain, Alzheimer’s disease, a form of breast cancer called Ductal Carcinoma In Situ, ADHD, unintended pregnancies and obesity.    

For more on effectiveness research and the conservative objections to it see my earlier post.

If you have a cold, what should you do? Take aspirin? Vitamin C? Flush your sinuses out with a little pot that looks like a lamp a kid would rub to release a genie? (I have one of those.) What about pain from gallstones? Should you let a doctor take out your gall bladder?  (I used to have one of those.)

Among those who sat on the panel: Brigham and Women’s Hospital president Dr. Gary L. Gottlieb, Dr. JoAnn E. Manson, also of the Brigham, and head of the Women’s Health Initiative and and Dr. James N. Weinstein of the Dartmouth Institute for Health Policy and Clinical Practice, which has been leading research into the area for years.

 

 

Also, Sens. Kennedy and Dodd yesterday proposed a less expensive version of the health reform plan put forward by Senate Democrats. Kaiser Health News has a good round up of stories — including some that question the senators’ math. This from CQ Politics:

Democrats have struggled with CBO to get the agency’s cost estimates of their legislation down to a less staggering price tag. Dodd alluded to the behind-the-scenes negotiations during the Thursday conference call, at a point when he thought reporters were unable to hear him.”This is great news, staff really did a wonderful job,” he told other senators who had joined him on the call. “I talked to [CBO director] Doug Elmendorf more times over the weekend, trying to get these numbers. It got to be pretty frustrating. The results are great” 

 

Health delivery lessons from the developing world?

Bruce Walker, director of the Partners AIDS Research Center at Massachusetts General Hospital, comments in today’s Wall Street Journal story on using “simpler and less expensive treatments like those used abroad” to reduce heatlh costs here.   

 Walker “worries that imported practices — and possibly lower standards — would be adopted only for disadvantaged patients in the U.S. But Dr. Walker believes it will be too costly for the U.S. to continue to rely on current practices. “You have to find a way of changing the approach slightly while still providing outstanding care,” he says.”

 Also, Susan Milligan – who knows her way around Capitol Hill — reports on Obama’s health care forum for the Globe.  

 AP reports on his rejection of single payer.

 Obama said a government-run “single-payer” health care system works well in some countries. But it is not appropriate in the United States, he said, because so many people get insurance through their employers working with private companies.

 Kaiser Health News has the transcript

 Here’s the problem, is that the way our health care system evolved in the United States, it evolved based on employers providing health insurance to their employees through private insurers.  And so that’s still the way that the vast majority of you get your insurance.  And for us to transition completely from an employer-based system of private insurance to a single-payer system could be hugely disruptive.  And my attitude has been that we should be able to find a way to create a uniquely American solution to this problem that controls costs but preserves the innovation that is introduced in part with a free market system. 

Massachusetts June 24 State House health bill testimony

The Joint Committee on Health Care Financing held a hearing Wednesday afternoon on several bills including one on health care affordability.

Health Care for All reports on the hearings on their blog.

“Dorcas Grigg-Saito, the CEO of the Lowell Community Health Center, shared the struggles many of her clients have with the costs of health care. Grigg-Saito informed the Committee that the Lowell Community Health Center serves one-third of the population of Lowell and 93% of the patients are below 200% fpl.”

(Click here for my story on how the Lowell health center works with the Khmer community’s preference for traditional medicine.)

 

More woes for Massachusetts insurance model

From the Globe:

Overseers of Massachusetts’ trailblazing healthcare program made their first cuts yesterday, trimming $115 million, or 12 percent, from Commonwealth Care, which subsidizes premiums for needy residents and is the centerpiece of the 2006 law.

WBUR’s CommonHealth also reports

The economy is hitting the state’s free and subsidized health insurance program, Commonwealth Care, from 2 angles. First, more state residents affected by the shrinking job market are signing up. Second, the state has less money to spend on this…and hundreds of other programs.

For more on the way the state casts the plan, see the Commonwealth Connector website.

The Globe has this interview as well:
State Treasurer Timothy P. Cahill has come out strongly against the $1 billion in tax increases approved by the Legislature, proposing instead deep cuts in the state’s landmark effort at universal healthcare, calling it a luxury taxpayers can no longer afford.

As the Globe points out, Cahill has no say in this except that he’s apparently toying with the idea of running for governor.

In other news, The Washington Post has an interview with Atul Gawande, the Harvard doc whose New Yorker piece put the concept of practice pattern variation into the conversation.
 

 

Non-profit hospitals behaving badly?

I was surprised by this factoid. It was buried is Scott Allen’s fine Sunday story in the Globe on the fight for outpatient business in the suburbs. 

Beth Israel set up a taxpayer group in 2006 to oppose a proposed $13 million cancer center at Newton-Wellesley Hospital, in part because it would be less than 5 miles from a Beth Israel cancer center. Beth Israel later dropped its opposition in a settlement whose terms were not disclosed.

Paul Dreyer, state director of Health Care Safety and Quality, said hospitals commonly set up independent taxpayer organizations as a way to oppose other hospitals’ building plans. That’s because a grass-roots group with as few as 10 members can force a public hearing under state law.

There’s a name for this in policy circles – instead of grass roots organizations, these are astroturf orgs.

 A business tactic or a way to game the system?  I guess it depends on which side of the fight you’re on.