Gems of the Times

Gawande and Williams

Gems of the Times

Gawande and Williams

Gems of the Times
An email conversation about the news of the day.
March 15 1999 3:28 PM

Gawande and Williams

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Dear Marjorie:

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You raise all kinds of good stuff. For starters, as fun as the Monday papers might be, I've always thought of Saturdays as having the hidden gems. As an outsider, it seems to me that the papers never took Saturday editions all that seriously and so let all kinds of goofy stuff creep in. This Saturday was a case in point, with the Times running stories like "A Professor in Nanjing Takes Up Jewish Studies," a front-page retelling of the whole Whitey Bulger mobster saga (a Boston-Irish mafia story replete with crafty cons and FBI bungling that has kept us entertained up here for years), and an odd little piece about the surge of popularity for books about math (I learned that three authors now have advances for books on the concept of zero).

I, too, was puzzled by the shallowness of the Times piece about the Watson-Watkins killings. And, as for the smallpox story, you'd think I'd jump all over it. However, I'm afraid I didn't catch that one.

But God love the whole term-limits story. Seems to me I've been reading this one for a couple of years now, but you can never get enough of skewering hypocritical demagogues. The only bummer is that the politicians who are about to renege on their pledges to abandon office can't come up with a more creative argument than the one pushed by the guys they ousted from office: Seniority has its benefits for constituents.

Two stories caught my interest today. First was the Times' story about the blue pike, a species now feared extinct, that an Ohio barber had in his freezer since he caught it in 1962. What makes this story so marvelous is its marriage of the high-tech DNA typing that will sort out whether some recently sighted fish elsewhere might in fact be true blue pike and the story of this small-town guy who just couldn't stop talking about "the blue pike generation" to his customers. Not to mention that it holds the possibility of resurrecting a species once thought to be long gone (Jurassic Park it's not, though).

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The other was a story that struck me as a true disservice. The Times had a front-page piece raising concern that a "tide of injuries" is inevitable in young computer users. Repetitive stress injury has now claimed some 20 million adults, but the coverage ignores basic facts about the condition that has puzzled researchers: 1) The likelihood of developing chronic hand/arm disability does not seem to be proportional to the amount of repetition in one's job. 2) The likelihood is proportional to job dissatisfaction and availability of social supports (for example, being married). 3) Fearmongering publicity about RSI in Australia actually seemed to spur an epidemic of the condition, which has since died away there.

Having an expectation that an acute pain (like a writer's cramp) will turn into a chronic pain (like RSI) seems to increase the likelihood that the transformation will indeed occur. (Isn't pain a weird beast?) Certainly, there's been a fierce debate in the scientific community about whether ergonomic changes to "fit" people to their computers are a waste of money or even make matters worse. By unquestioningly predicting a tide of children disabled by their computers, the Times may be spurring a self-fulfilling prophecy.

But enough about this hobbyhorse of mine. I'll try not to get off on too many medical tangents tomorrow.

Yours,

Atul

Atul Gawande has written about medicine for The New Yorker and Slate, is a surgical resident in Boston, and is a fellow at the Harvard School of Public Health. Marjorie Williams is a contributing editor at Vanity Fair.