First, for all of us who remember that astonishing grade-school moment when we discovered that other people could read words off the blackboard even from the back of the classroom, or see trees as a collection of individual leaves, the Guardian has a (somewhat premature) gift: “Short-sightedness gene discovery could consign glasses to history“:
… Shortsightedness is a relatively new but growing phenomena and as urbanisation and intensive education levels increase it is reaching epidemic proportions in some parts of the world.
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Around a third of people in Britain are short-sighted, but in the Far East it is an even bigger problem, possibly because use of technology at an early age is more prevalent there. In Japan, two thirds of teenagers are already myopic and in Singapore, 80 per cent of 18-year-old male army recruits are short sighted, compared with 25 per cent just 30 years ago…
Eighty percent? I can remember, back in the late 1960s, when the idea that myopia might be genetic and/or influenced by starting to read at an early age was considered nutty fringe talk from Hindu caste-defenders and American DFHs.
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I have tried, and failed, to come up with a succinct explanation of why this NYTimes article, “2 Brothers Await Broad Use of Medical E-Records”, bothers me so much.
The argument seems to be that the Doerrs’ technology package will be consistently profitable because it will save a lot of individuals time & money, and that will help bend the arc of nationwide medical spending in the right direction. But it’s only “steady business” money, not mad casino lottery-win money, so who cares? And if that’s the argument that will determine whether or not HCR… or the American medical system in general… succeeds or fails, then how truly fvcked are we?
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Paul de Kruif’s biography of Dr. Banting was among the first “grown-up” stories I can remember reading, so I was fascinated by the NYTimes’ coverage of an exhibition on “Rediscovering the First Miracle Drug“.
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And in the “Excellent Links” department, Martin Robbins, The Guardian‘s Lay Scientist, satirizes “This is a news website article about a scientific paper“. (“In the standfirst I will make a fairly obvious pun about the subject matter before posing an inane question I have no intention of really answering: is this an important scientific finding?”). Another link for my Read-Regularly bookmarks!
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El Cid
Frontiers of Tea Party Constitutional science.
Oh, wait, though — this sort of view of TeaTards is just a bunch of liberals looking down their noses and we need to find common ground, that this view expressed by this TeaHad’s founder is totally not representative of what TeaLoungists think.
JGabriel
Anne Laurie:
Genetic. I’ve been reading since 2, and I’m far-sighted. Reading from a PC screen 3 feet away or a sign a block away is fine, but for a book or anything closer than 2 feet I need glasses.
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El Cid
Physics News profiles a younger UK female nuclear fusion research physicist honored recently for her reaching out to bring understanding of the field to young students (with video interview with plasma demo). A really good role model and public intellectual. Dr. Windridge’s website here. (She’s also stunningly attractive. Sorry. Had to mention it.)
R. Porrofatto
The Robbins piece in the Guardian is hilarious. The comments too. Thanks for the link.
Scott P.
Gah, that first article’s headline is bad. There is no “short-sightedness gene” — how could there be? What evolutionary purpose would that serve? There may well be a gene with an allele that contributes to short-sightedness, but that is a very different thing. Fortunately, the article is better.
Uloborus
I worked at Kaiser when they transitioned to electronic medical records. They really are fucking awesome. A doctor without your medical records is hamstrung, and suddenly the doctors could access ALL of the patient’s records INSTANTLY. No charts getting lost. No delay waiting for a chart. No ‘the chart is at the hospital because this isn’t our regular patient’. No ‘I can’t read this other doctor’s handwriting’, which is a complaint I’ve certainly heard before. Any doctor you visit always has your medical history in front of them. And I cannot possibly stress enough what a huge difference that makes. Our doctors bitched and whined about learning to use it for two weeks, and after that they’d have murdered anyone who tried to take it away from them.
Uloborus
@Scott P.:
A short-sightedness gene could serve an evolutionary purpose. SICKLE CELL ANEMIA serves an evolutionary purpose. Evolution is bizarre. Certain genes stay in the pool because that trait is useful to certain populations.
It’s not at all difficult to imagine that there are populations of people who need to be able to see things really well up close and don’t much care about sight at a distance. I don’t know who they are, but it’s not exactly a stretch.
WyldPirate
Thanks, Anne. I haven’t gotten through all of the stuff but the Banning article was great and the Guardian parody is spit-your-coffee-on the screen funny. It’s also applicable to all journalmalism; not just science journalism.
Dennis SGMM
@Uloborus:
St. Jude Heritage is our provider. They went to electronic records around four years ago and the quality of care that we get from them went from damned good to great. I recently needed some surgery and I was surprised to see that my Xrays and MRI had even gone into the system.
thomas Levenson
@Uloborus: What you say. I’m not a doctor, nor do I work in healthcare, but everything I’ve read and all the folks I’ve talked to about this say that something as mundane – seeming as electronic record keeping is an enormous two-fer win. It cuts costs — by more than you’d think, because I’m not sure anyone who hasn’t spent time digging in this area pretty deeply knows how much effort is wasted through poor access to all kinds of records. And it improves outcomes, as access to comprehensive records does all kinds of good things for patient management. (See the reference in the article for the application of this stuff to diabetes care, e.g.)
And it probably has a deeper long term effect than just improving matters at the practice by practice level. One somewhat hidden theme of Atul Gawande’s important article on health care cost differences between two towns in Texas was how hard it was for people to get that information readily, just to see the fact that one area was spending enormously more for no measurable benefit. And it’s not just cost. Different areas have different standards of care. (Long ago, when I was dealing with a horrible case of Hep A, I found, late in the game, that they dealt with my particular presentation of the problem in Miami very differently than they did in Boston. Which was better? No one knew.)
Once you get more uniform standards of data entry and structures, maybe, at long last, we can get some of that cool stuff they call science working on issues like this.
Record keeping is boring. It’s also the foundation of a lot of what we need to do.
thomas Levenson
Here’s the Gawande link I omitted in the comment above.
Comrade Mary
I’m working on a documentation/training project for an American company that provides an electronic patient registry for all kinds of physician organizations. It’s a pretty damned sweet little application, too.
My childhood! I learned to read upside down because I gave up on the blackboard, even in the first row, while I was still in elementary school. Reading what the student across the table was writing was much, much easier.
And I got my first glasses from a Bloor St. shop when I was 15. My first impression was the same: “Trees! LEAVES!” My second impression was sensory overload as Honest Ed’s was just across the street.
Uloborus
@thomas Levenson: and @Dennis SGMM:
Oh, yeah. And *less people die* because any doctor can, say, look at your records and say ‘This looks like a virus, but your history makes me wonder if you have diabetes. Let’s run some blood tests to be sure.’
That’s also probably pretty important. Electronic medical records really are all that and a bag of chips.
McWaffle
That EMR one is also funny, because if that’s all they’ve got to show after this long in the industry, that really isn’t that great. It isn’t bad, but certainly not be front-page exciting. Commenters on HISTalk (an industry blog) seemed to agree.
Oh, and @Uloborus: You’re welcome
Don K
@Dennis SGMM:
Henry Ford here in the Detroit area went electronic years ago, and for someone like my partner, who has MS and diabetes, and sees an internist, neurologist, ophthamologist, and neurosurgeon on a regular basis (and other specialties from time to time), it’s great. Every doctor can see what every other doctor is saying. A doctor can get a line chart of a time series of test results to track trends. X-rays skip film now, are taken digitally, and show up in the record instantly.
As an added bonus, the doctor can send scrips electronically to a pharmacy so when you stop by the pharmacy on the way home, there’s a chance it’s waiting for you. Because scrips are entered on the screen, the system has a record of every scrip being taken and can check for interactions. For a while now, HFHS docs have been prohibited from writing handwritten scrips. The only thing missing is a search function. Presently doctors and nurses have to scroll through potentially hundreds of entries to find what they’re looking for.
There’s an interesting generational difference in use of the system. Younger docs (like an endocrinologist he saw a few times) are used to taking notes directly on the keyboard because that’s how they’ve done things at school. Older docs still take notes by hand and depend on them being transcribed at a later time. Not optimal, but at least the notes get into the system at some point.
Redshift
@Uloborus: I remember reading in some popular-science book about a tribe who lived in very dense forest and never saw things more than a few feet away. The particular scene described was that a member went out of the forest with researchers, and was shocked to see an animal “grow” as they approached it from a distance. (Apparently he adjusted pretty quickly after that, indicating that distance perception is hard-wired, but even so, in their usual environment, being very nearsighted would probably be an evolutionary advantage.)
Dennis SGMM
@Comrade Mary:
I didn’t even know that I was nearsighted (How could I?) until I went from A’s to F’s when a reshuffle in one of my sixth grade classes moved me from the front of the room to the back. My teacher (Gods rest his soul) caught it right away and sent me home with a note. Two weeks later I was sporting a pair of very heavy 1960 glasses (It was 1960) and getting good grades again.
Same reaction: leaves on trees? Trees on mountains? It made me an instant Buddhist: “To see the world with new eyes.”
Don K
Sounds like I’m a classic case of nearsightedness: reading when I was 4, reading to the class in kindergarten, bored stiff in 1st grade when the other kids were struggling with Dick and Jane (yes, this was a long time ago), wearing glasses when I was 9.
My biggest memory is of when I realized there was something wrong with my vision. I was in the car with my parents coming back from visiting some relatives. When we were about to the exit we needed on the Pennsy Turnpike, my dad read from the sign announcing the exit. I asked where he was reading from, and he said it was on the sign. I guess up till that time I thought the signs were just decorative objects placed there by the Turnpike Commission. We made an appointment with the optometrist for the next week, and I had my glasses shortly after.
Looking back, I suppose being nearsighted and not corrected explains why I couldn’t judge a fly ball or play catch successfully, and why I didn’t worry about staying between the lines when coloring – trees and houses are supposed to look fuzzy, aren’t they?
Mnemosyne
I have to say, I have absolutely no memories of there being a difference between the world without glasses and the world with glasses, but I got them younger than most of the people here: I think I had them at age 6 by about the middle of first grade.
morzer
I discovered I needed glasses for short-sightedness at an early age precisely through sitting at the back of the class. I had always just copied from my neighbor, and assumed this was the normal procedure. My grades were excellent (which is largely a tribute to his literacy and penmanship) until the day when he was absent with some sort of illness. My version of what should have been on the board was so creative that the teacher suspected I had gone mad. One visit to a properly certified (as opposed to simply certifiable) optician later, and the world took on a new and intriguing configuration.
A scene from A Funny Thing Happened On The Way To The Forum:
Officer (handing Pseudolus a scroll):
Do you know what this is?
Pseudolus (concealing illiteracy, but indignant):
Of course I know what this is. This is writing!
morzer
A point of order:
Anne Laurie, your first link goes to the Telegraph, not the Guardian.
Just sayin’.
DBrown
“I don’t know who they are, but it’s not exactly a stretch.” (question relative to short sighted gene)
Answer: try nearly a million years of our evolution – the need to chip stones to make cutting tools. That not only made us human but was the key to start our brain growth. This is NOT a disadvantage but a huge advantage for some in a group. That is how evolution for groups works.
Kay
@Mnemosyne:
I got them at 6 too, and I absolutely remember the newly-distinct leaves on trees, walking out of the building.
I also remember the first time I was out in a driving rain in contact lenses, and realized I could still see.
Maude
I got glasses for near sightedness at 21. I noticed that print looked darker and the street lights weren’t fuzzzy.
Wear dollar glasses for computer.
Mnemosyne
@Kay:
If I got them at the time of year in Chicago that I recall I did, there wouldn’t have been any leaves on the trees to see and the world would have been an undifferentiated mass of white with glasses on or off. So that may be why. ;-)
I do remember being freshly fascinated by the optician’s carpet every time I got a new pair of glasses.
EIGRP
Last year my son was complaining of not being able to see the blackboard at school. A trip to the opthomologist (optomologist?) and he was told to wear reading glasses for regular reading/homework/”close up” activities which he could see fine anyway.
Turns out that all the close up work was preventing his eye muscles from being able to focus on the blackboard.
His eyes are fine now, glasses aren’t needed although we pester him to use reading glasses every once-in-a-while.
I think that was probably my problem as a kid too. 5th grade and I had glasses. 20 years later, LASIK solved the glasses problem.
Eric
Comrade Sock Puppet of the Great Satan
“I worked at Kaiser when they transitioned to electronic medical records. They really are fucking awesome. A doctor without your medical records is hamstrung, and suddenly the doctors could access ALL of the patient’s records INSTANTLY.”
Kaiser’s IT is slick, slick, slick. I remember being sent by a doctor to get an X-ray. I went, got the X-ray (four floors down), and the doctor had accessed and read it before I got back up the four floors to his office.
It is stupendously dumb that except for exceptions like Kaiser and the Mayo Clinic, medicine in the U.S. is still practiced on the individual-practioner cottage-industry model. For something that’s 18% of the economy, that’s a fuckload of inefficiency.
Comrade Sock Puppet of the Great Satan
My myopia grew progressively worse as I grew up.
I remember looking forward to getting new glasses each year so I could see the leaves on trees again.
Uloborus
@DBrown:
Yep. All it has to do is be an advantage for SOMEONE and it will remain in the population, waiting.