Health

A LITTLE PAIN NEVER HURT ANYBODY:

A New Way to Treat Back Pain (Sumathi Reddy, Dec. 21, 2023, WSJ)

What if the best way to treat your chronic back pain is by retraining your brain?

That’s the premise of a novel approach to chronic pain. Many people feel pain even after a physical injury has healed or when doctors can’t find a physical cause. The approach, called “pain reprocessing therapy,” tries to train the brain not to send false pain signals. Some early results are promising.

In a study published last year in JAMA Psychiatry, 66% of a group of people who did the therapy for a month were pain-free or nearly pain-free up to a year later.

IT’S ALL IN YOUR HEAD:

An unhealthy obsession with sickness increases risk of dying, study says (Kyle Melnick, December 25, 2023, Washington Post)

The study, published this month in the JAMA Psychiatry journal, found that people diagnosed with hypochondriasis were 84 percent more likely than people without the disorder to die of dozens of conditions, especially heart, blood and lung diseases, as well as suicide.

ABOVE AVERAGE IS OVER:

Digital algorithm shown to significantly reduce antibiotic prescription (Paul McClure, December 19, 2023, New Atlas)

A new study has found that using a digital support algorithm to guide diagnosis and treatment by healthcare providers significantly reduced the number of antibiotic prescriptions given to acutely sick children, without affecting treatment success or causing harm.

Optimally, AI can serve the purpose of “death committees”

IT’S ALL IN YOUR HEAD:

You Know It’s a Placebo. So Why Does It Still Work? (Tom Vanderbilt, 12/19/23, Wired)

You might think that having a positive attitude about the nothing-pill is what transforms it into a something-pill. Perhaps OLPs are a sort of meta-placebo, a testament to how much we believe in our power of belief. But the real driving impulse for many patients who enroll in clinical trials isn’t positive expectation. It seems to be a more uncertain emotion: hope. As the 2017 study puts it, “Hope is a paradoxical combination of opposites, balancing despair and the counterfactual notion that things can improve—a kind of ‘tragic optimism.’” A patient who has suffered for years from some condition, taken drugs, undergone procedures, and gotten no relief may think: A sugar pill probably won’t help, but what the heck, let’s see what happens. As a 2016 paper in the journal Pain puts it, “Engendering hope when participants feel hopeless about their condition can be therapeutic.”

THE DOCTOR WILL SCAN YOU NOW:

Underestimating AI in Healthcare (Daisy Wolf, Adela Tomsejova, Jay Rughani, and Vijay Pande, December 13, 2023, Andreesen horowitz)

In the 2000s, technology radically changed not just how stocks were traded, but the decision behind which stocks to trade. Firms like Citadel, DE Shaw, and Two Sigma started to employ High Frequency Trading, computer algorithms capable of executing thousands of trades per second.

Quants, the algorithm writers, overtook master traders, who manually studied companies. Algorithms overtook hunches. The quant funds who led the pack raked in hundreds of billions of dollars.

100% of stock trades used to be made by humans. Today, 80% are made by computer algorithms.

AI is about to bring a similar revolution to healthcare.

Over the next few decades, at least half of the $4.3 trillion dollar American healthcare industry will be AI-driven.

AI will drive drug discovery, proposing medicines not yet dreamed up by man. AI will play a key role in diagnosis, helping humans know what’s wrong sooner so they can get access to life-saving treatments. AI will change how care is delivered, as every human will have a world-class AI doctor in their pocket. And AI will eliminate a lot of the infuriating back office minutia in healthcare.

The markets are significantly undervaluing this opportunity.

IT’S IMPOSSIBLE TO OVERSTATE DEFLATIONARY PRESSURES:

New AI-powered doctor’s office allows patients to draw blood, take vitals (Jennifer A. Kingson, 12/11/23, Axios)

Now coming to a mall, gym or office building near you: A self-contained doctor’s office, powered by artificial intelligence, where you — the patient — draw your own blood and take your own vitals.

FEAR ITSELF:

Curing cancerphobia: How the psychology of fear distorts our view of cancer (David Ropeik, 11/29/23, Big Think)

Fighting the entrenched misbelief that “everything causes cancer” is hard. The highly respected Cancer Research UK tried, calling the study factually incorrect and misleading, as well as directly addressing the psychological factors of control and less fear of what is natural than what is human-made, saying, “It can be tempting to worry about our cancer risk from external things like pollution and chemicals more than from things we can control, like our lifestyles. But decades of research have shown that lifestyle factors — such as not smoking, keeping a healthy weight, limiting alcohol, getting enough exercise, and avoiding sunburn — have an important effect on cancer risk. In contrast, the evidence that pollution and industrialization has a widespread role in UK cancer rates is weak.”

The belief that cancer is mostly caused by human-made substances explains why any mention of the word “chemicals” or “radiation” sets off alarms. (Magnetic resonance imaging was originally called nuclear magnetic resonance imaging. The “nuclear” was dropped to avoid the frightening allusion to weapons and radiation.) And it explains why scientists frustrated by “chemophobia” and “radiophobia,” corollaries of cancerphobia, try to reduce those fears by arguing, “All of nature is made out of chemicals,” and, “If we’re worried about nuclear power we should also worry about natural sources of radiation like the sun and bananas.”

NO MAN IS A FAILURE WHO HAS FRIENDS:

Friendship as Soulcraft: How I made friends in my thirties. (Matt Dinan, Fall 2023, Hedgehog Review)

As Aristotle points out, even if one had every other good, one would still choose to have friends. This recognition is what led me to make friends in my thirties: I came to see that because you don’t need friends, and they don’t need you, you must seek them out. And an insufficient understanding of how this makes friendship different from other forms of love is one of the primary roadblocks to finding friendship in our time and place.

There is security in the messy neediness of love, the occult magnetic fields that attract and repel. Passion means to suffer, to be set upon. This is not to speak ill of love, but only to observe that since friendship is more freely chosen, it rests on unstable ground. Romantic love holds us together through mutual awareness of our neediness, but friendship does not arise from any need. Filial love is so powerful because it is, ideally without caveat, the sort of belonging one can neither earn nor lose. Some of the deepest hurts in human life consequently arise when we do lose that love, when the familiar becomes estranged. Family members, even those in a family you have some choice in forming, are the same type—“kin.” But the friend is some “other,” a stranger I have come to prefer.

HE WAS NOT ON TO NOTHING:

Understanding Sigmund Freud’s Id, Ego and Superego (Emilie Le Beau Lucchesi, Nov 9, 2023, Discover)

Exploring the Id
The first part, the id, was both innate and unconscious. Freud saw it as the driving force behind a person’s impulse to satiate their desires. The id wasn’t conceptualized as something that regulated or judged a person’s needs or wants. Rather, the id was the animalistic compulsion to seek pleasure and satisfy impulses.

The Development of the Ego
The ego began to develop within the first few years of a child’s life, Freud argued. The ego was the person’s sense of self, and it had to negotiate between the id’s impulses and the superego’s cautious urgings to not act in ways that would be socially unacceptable.

Understanding the Superego
Around the age of six, Freud theorized that a person’s superego began to form. Freud saw the superego as a guardian that pressured the ego to resist the id’s impulses in order to fit social norms.

Perhaps best thought of this way: The id is pure desire; the ego is the personal limitation on acting out those desires; and, the supego is the societal limitations. The rest is bunk.

IT’S IMPOSSIBLE TO OVERSTATE DEFLATIONARY PRESSURES:

The Medical-Robotics Revolution (Jonathan Shaw, Apr. 6th, 2022, Harvard Magazine)

What if a cardiac surgeon could operate on a beating heart without opening the patient’s chest? Or a flexible robot could navigate the delicate branching of blood vessels, or bronchi in the lungs, and then stiffen to perform surgery at its tip? Or a magnetic field could be engineered to drive a plaque-clearing robot inside a person’s arteries?

These kinds of innovations are already in the vanguard of the field of medical robotics, says professor of surgery Pierre Dupont, a leading designer of robotic systems for use in healthcare. “I thought of going into medicine instead of engineering,” he admits, “so when I had the chance to combine the two, it was a fantastic opportunity.” The field encompasses precision instruments that can be deployed by doctors inside the human body for visualization, diagnosis, and treatment, but also patient-focused inventions, from handheld devices that let diabetics control their blood sugar to wearable robots that help stroke patients walk again.

Not all these achievements will make it from the lab. But gradual trends are emerging: toward increasing autonomy for the robots themselves, and greater personalization for users, whether as patients or providers of healthcare.

Above average is over.