Some 30,000 pairs of his spectacles have already been distributed in 15 countries, but to Silver that is very small beer. Within the next year the now-retired professor and his team plan to launch a trial in India which will, they hope, distribute 1 million pairs of glasses. The target, within a few years, is 100 million pairs annually. With the global need for basic sight-correction, by his own detailed research, estimated at more than half the world’s population, Silver sees no reason to stop at a billion.

If the scale of his ambition is dazzling, at the heart of his plan is an invention which is engagingly simple. Silver has devised a pair of glasses which rely on the principle that the fatter a lens the more powerful it becomes. Inside the device’s tough plastic lenses are two clear circular sacs filled with fluid, each of which is connected to a small syringe attached to either arm of the spectacles.

The wearer adjusts a dial on the syringe to add or reduce amount of fluid in the membrane, thus changing the power of the lens. When the wearer is happy with the strength of each lens the membrane is sealed by twisting a small screw, and the syringes removed. The principle is so simple, the team has discovered, that with very little guidance people are perfectly capable of creating glasses to their own prescription.

In truth, experts say, the developing world doesn’t need more incubators. It needs incubators that work. Over the years, thousands have been donated from rich nations, only to end up in “incubator graveyards” — most broken, some never opened. According to a 2007 study from Duke University, 96 percent of foreign-donated medical equipment fails within five years of donation — mostly because of electrical problems, like voltage surges or brownouts or broken knobs, or because of training problems, like neglecting to send user manuals along with the devices.

To compensate for this philanthropic shortsightedness, medical staffs either crank up the temperature in “incubator rooms” to 100 degrees or more, or swaddle babies in plastic to hold in body heat. Such makeshift solutions led the Boston team to ask: How can we make an incubator for the developing world that will get fixed? . . .

In his discussions with doctors who practice in impoverished settings, Dr. Rosen learned that no matter how remote the locale, there always seemed to be a Toyota 4Runner in working order. It was his “Aha!” moment, he recalled later: Why not make the incubator out of new or used car parts, and teach local auto mechanics to be medical technologists?

The larger point of my argument with your claim is that we cannot (I use the term advisedly) know what to expect of children with Down syndrome. Early-intervention programs have made such dramatic differences in their lives over the past few decades that we simply do not know what the range of functioning looks like, and therefore do not rightly know what to expect. That, Professor Singer, is the real challenge of being a parent of a child with Down syndrome: it’s not just a matter of contesting other people’s low expectations of your child, it’s a matter of recalibrating your own expectations time and time again—and not only for your own child, but for Down syndrome itself. I’ll never forget the first time I saw a young man with Down syndrome playing the violin—quite competently, at that, with delicacy and a sense of nuance. I thought I was seeing a griffin. And who could have imagined, just forty or fifty years ago, that the children we were institutionalizing and leaving to rot could in fact grow up to become actors?  Likewise, this past summer when I remarked to Jamie that time is so strange that nobody really understands it, that we can’t touch it or see it even though we watch the passing of every day, and that it only goes forward like an arrow, and Jamie replied, “except with Hermione’s Time-Turner in Harry Potter,” I was so stunned I nearly crashed the car. I take issue with your passage, then, not because I’m a sentimental fool or because I believe that one child’s surprising accomplishments suffice to win the argument, but because as we learn more about Down syndrome, we honestly—if paradoxically—don’t know what constitutes a “reasonable expectation” for a person with Down syndrome.

Non-white medical students are more likely to embrace orthodox medicine and reject therapies traditionally associated with their cultures. That is one finding from an international study that measures the attitudes of medical students toward complementary and alternative medicine (CAM). While seemingly counter-intuitive, white students view CAM more favorably than their non-white counterparts, the study authors say....

[I]n the first study, U.S. medical students wanted more courses about CAM than students in Hong Kong, for example. (The Hong Kong school was not included in the 2nd survey of fourth year students.) The second study continued to support that trend with the least interest in CAM measured in Asian and black students.

That is why the Great Plague of 1665 has been largely understood as a London phenomenon. The sites of old plague pits are now pointed out with understandable pride. Richard Barnett reveals that the escalator at Camden Town Underground station passes through a vast grave for plague victims, and that a “massive plague pit” is responsible for the low ceiling of the basement of Harvey Nichols. It would be fair to say that he takes a certain, rather morbid, pleasure in compiling this Baedeker of disease and suffering. But why not? This is London’s real heritage. Together with this volume are a glossary and six maps, so that the reader can make his or her way down the various roads to oblivion. If you wish to follow the course of tropical disease as it ate its way to the heart of the metropolis, you can do so; you can follow the route of the plague, or the life of an 18th-century medical student. All human life, and human death, is here.

Does the nature of psychotic delusions change over the centuries? Or are “crazy” people crazy in the same ways regardless of where and when they lived and died?

Slovenian researchers analyzed more than 120 years’ worth of patient reports from the Ljubljana mental hospital, and their findings suggest that psychotic delusions are profoundly shaped by contemporary society, with the technology of the day—be it the telegraph or the television—playing a prominent role. The researchers also found that the “persecution delusion” (a paranoid narrative in which the subject feels hounded by evildoers) is a relatively modern phenomenon: a reaction to the possibility of nuclear war and to Cold War conspiracy flicks like The Manchurian Candidate. In this sense, schizophrenic delusions are a twisted mirror to the world we live in.

Late in the book, when Kidder begins — and very skillfully too — to draw together the threads of his narrative and to sum up (as best he can) his understanding of Farmer, he notes Farmer’s fondness for a particular phrase: “the long defeat.” At one point Farmer says to Kidder,

“I have fought the long defeat and brought other people on to fight the long defeat, and I’m not going to stop because we keep losing. Now I actually think sometimes we may win. I don’t dislike victory. ... You know, people from our background — like you, like most PIH-ers, like me — we’re used to being on a victory team, and actually what we’re really trying to do in PIH is to make common cause with the losers. Those are two very different things. We want to be on the winning team, but at the risk of turning our backs on the losers, no, it’s not worth it. So you fight the long defeat.”

In an interview Kidder gave earlier this year about the book, he commented on the phrase, and says that Farmer “probably picked [it] up from reading Camus.” But that’s not right: he got it from what we learn in Mountains Beyond Mountains is his favorite book: The Lord of the Rings. Galadriel says it: “Through the ages of the world we have fought the long defeat.” And Tolkien himself, in letters, adopted and endorsed the phrase: “I am a Christian, and indeed a Roman Catholic, so that I do not expect ‘history’ to be anything but a ‘long defeat’ — though it contains (and in a legend may contain more clearly and movingly) some samples or glimpses of final victory.”

It seems to me that this philosophy of history, if we may call it that, is the ideal one for anyone who has exceptionally difficult, frustrating, even agonizing, but nevertheless vitally important work to do. For such people, the expectation of victory can be a terrible thing — it can raise hopes in (relatively) good times only to shatter them when the inevitable downturn comes. Conversely, the one who fights the long defeat can be all the more thankful for victories, even small ones, precisely because (as St. Augustine said about ecstatic religious experiences) he or she does not expect them and is prepared to live without them.

I watch Grey’s Anatomy for the fast-paced gore and the overblown personal dramas. I watch its spin-off, Private Practice, for all that along with its thoughtful treatment of bioethical dramas – the same dramas we’re seeing in real-life hospitals and public debate.

The bioethics debate isn’t just a clinical and scientific debate or an abstract and philosophical one. It’s a debate about how to best fulfill the human longings for long life, good life, health and family. There’s all sorts of humanity mixed up in it - competing human longings and fallible human judgment deciding human life’s creation and existence. While philosophers and politicians squabble, doctors practice bioethics every day; and they don’t always have the time for debate when human life is at stake and the ethical choice isn’t clear.

Medicine | A medical journal says a vast amount of cancer research is never published, perhaps because clinical trials show the drugs or treatments didn’t work. That deprives other researchers of valuable knowledge. Why this happens: scientists, medical journals and drug firms all have an interest in touting breakthroughs and not failure. [Business Week, Oncologist]

The proportion of viewers who were aware that, with the proper treatment, there is more than a 90% chance of an HIV-positive woman having a healthy baby increased by 46 percentage points after the episode aired (from 15% to 61%). This includes 17% of respondents in the post-show survey who volunteered the specific response that the woman has a 98% chance of having a healthy baby—the statistic that was repeated several times on the show.

Six weeks after the episode aired, the proportion who gave the correct response had dropped to 45%, but was still substantially higher (by 30 percentage points) than it had been prior to the show. This time around, however, only 3% volunteered the specific fact that the woman would have a 98% chance of having a healthy baby.

Armchair philosophers sometimes defend the purity of “Science” by distinguishing it from technology or applied science, a move resembling hip America’s affection for the idea of soccer, but not the game itself. Separate scientists from tools and applications, and what’s left? A feeble enterprise, a succession of conjectures.

When applied, science sometimes delivers but always—always—graces humanity with unexpected consequences. Nothing infuriates my literature and medicine students as much as Wendell Berry’s observation that “medicine is an exact science until applied,” and nothing they learn in their four years of medical school is more urgent and more true.

Upwards of 85 percent of parents who receive a prenatal diagnosis of Down Syndrome elect to terminate the pregnancy, according to several studies in the peer-reviewed journal Prenatal Diagnosis. A 1999 British study in that journal found the termination rate to be between 91 and 93 percent. When I was a teenager in the 1980s, I remember seeing many people my age and younger who had the distinctive facial and behavioral characteristics of Down children. These days I rarely see a Down Syndrome child at all.

What is peculiar about Down Syndrome as a reason for termination is that, plainly put, you rarely meet a Down Syndrome “sufferer” who is notably unhappy. The condition has a range of manifestations, some more disabling than others, but many, many persons with Down Syndrome thrive as children and adults, even if they may not have the same range of capabilities as you or I do.

The fact that this syndrome has become a reason for termination is evidence of the terrible power of culture. A culturally neutral artifact (prenatal diagnosis of congenital diseases) combined with a culturally tragic artifact (elective abortion) begins to make it plausible that parents should avoid the challenges and risks of a Down pregnancy by ending it. The decreasing number of children born with the condition begins to make it more difficult to imagine that “normal” families can absorb the stresses of raising such a child, and undermines public support for public programs that support families who have made that decision. Which, over time, makes carrying a Down Syndrome baby to term ever more inconceivable, leading to increased rates of termination, leading to decreasing plausibility . . . until one day the burden of bringing a Down Syndrome child into the world is seen as so grave that less than 10 percent of parents take the risk.

But Sarah and Todd Palin have done it. I cannot think of any other public figures in my adult life, at least of the prominence they are about to enjoy or endure, who have made this decision. They will cause many, many families to reconsider the horizons of the possible. Their public example could very well lead to a cultural sea change—a dramatic shift in the “horizons of the possible.” That phrase from my book is no metaphor. Those horizons are so real that, for a future generation of children and their parents, they are quite literally a matter of life and death. For this reason, which utterly transcends politics and this year’s election, the sudden prominence of the Palins is, in the deepest sense, an extraordinary act of public service.

Our idea is that Coca-Cola could use their distribution channels (which are amazing in developing countries) to distribute rehydration salts to the people that need them desperately. Maybe by dedicating one compartment in every 10 crates as ‘the life saving’ compartment?

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Decades of war and internal strife have left Cambodia with one of the highest proportions of people disabled by land mines in the world. The country’s only professional sports league is the Cambodian National Volleyball League (Disabled), a network of volleyball teams whose players once fought against each other in times of civil war and now face each other on the court. They also sponsor a wheelchair racing program which empowers women who would traditionally be confined to their homes. Currently, the national volleyball team is ranked number three in the world, and regularly defeats non-disabled teams including an Australian navy squad which has tasted defeat three years running. These national heroes may have lost limbs to land mines, but they’ll still whoop you in volleyball.

Kate Benson in the Sydney Morning Herald:

When Mehdi Jaffari was told his left carotid artery was so severely blocked he faced the risk of an imminent stroke, he turned the clock back to medieval times.

The 52-year-old counsellor, from Chatswood, bought more than 35 leeches from a Victorian farmer and applied them to his body daily. Within five days, a CT angiogram showed the artery had cleared, stunning staff at Royal North Shore Hospital and his family.

Leech therapy, first documented in Greece more than 4000 years ago, is not new in Sydney. More than 50 Richardsonianus australis leeches are kept in a tank at Liverpool Hospital for use on patients who have had skin grafts or severed digits because their saliva contains hirudin, a chemical that acts as a powerful anticoagulant and vasodilator.

More here.  [Thanks to Susan Anthony.]