Author Archives: Karen Weintraub

Cancer Patient Receives Nation’s First Penis Transplant At MGH

In this photo provided by Massachusetts General Hospital, Thomas Manning gives a thumbs up after being asked how he was feeling following the first penis transplant in the United States. (Sam Riley/Mass General Hospital via AP)

In this photo provided by Massachusetts General Hospital, Thomas Manning gives a thumbs up after being asked how he was feeling following the first penis transplant in the United States. (Sam Riley/Mass General Hospital/AP)

Back in 2012, Thomas Manning of Halifax, Massachusetts, suffered a serious groin injury when a heavy cart fell on him at work. As he was being treated for it, his doctors found an aggressive cancer growing in his penis, and amputated most of it.

“He’s really an incredible person that after that surgery, totally unprovoked, said, ‘Doc, if I can have a penile transplant, I’m your patient,’ ” Manning’s doctor, MGH urologic oncologist Adam Feldman, told reporters on Monday. “And then shortly afterward was when the program started and I said, ‘You know … there just might be something here for you.’ “

It took more than three years for all the pieces to come together, but Manning, 64, has now received the country’s first penis transplant. Surgeons in South Africa and China have performed similar operations.

The operation at Mass. General took place overnight on May 8, and lasted more than 15 hours in total. The organ came from a deceased anonymous donor whose family gave special permission for the transplant.

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MIT Researchers Aim To Create An On-Demand Pharmacy

Students and postdocs at MIT who were part of the pharmacy on demand (a small scale pharmaceutical manufacturing unit) team. (Courtesy of MIT)

Students and postdocs at MIT who were part of the pharmacy on demand (a small scale pharmaceutical manufacturing unit) team. (Courtesy of MIT)

Hundreds of thousands of bright pink, white or blue tablets and capsules in all colors of the rainbow drop into bottles on sleek conveyors every hour in a sprawling building — somewhere. Each batch of pills may take a month or more to make.

But now, in a lab near Kendall Square, a team of MIT researchers can turn out 1,000 pills in 24 hours in a device the size of your kitchen refrigerator. It’s a whole new way of making drugs.

“We’re giving them an alternative to traditional plants, and we’re reducing the time it takes to manufacture a drug,” said Allan Myerson, professor of chemical engineering at MIT.

The Defense Department is funding this project for use in various places like field hospitals serving troops, jungles to help combat a disease outbreak, and strategic spots throughout the U.S.

“These are portable units so you can put them on the back of a truck and take them anywhere,” Myerson said. “If there was an emergency, you could have these little plants located all over. You just turn them on and you start turning out different pharmaceuticals that are needed.”

Sound simple? It’s not. This mini plant represents a sea of change in both size and operation. Continue reading

Asleep At The Wheel: Drowsy Driving As A Public Health Crisis

The National Highway Transportation Safety Administration says there were more than 72,000 documented accidents involving drowsy drivers between 2009 and 2013. But that’s just from official police reports, so experts say it’s a gross under-estimate. (Jesse Costa/WBUR)

The National Highway Transportation Safety Administration says there were more than 72,000 documented accidents involving drowsy drivers between 2009 and 2013. But that’s just from official police reports, so experts say it’s a gross under-estimate. (Jesse Costa/WBUR)

It’s midafternoon and I’m fighting to keep my eyes open. It’s a matter of life and death. That’s because I’m northbound on I-93, going 65 miles an hour — with many cars passing me.

Once or twice on the monotonous two-hour drive, a jolt of adrenaline surges through my bloodstream as I suddenly realize I’ve actually drifted off for a micromoment. Thankfully I get home without killing myself or anybody else.

If you say you haven’t had the same experience behind the wheel, I don’t believe you.

The National Highway Transportation Safety Administration (NHTSA) says there were more than 72,000 documented accidents involving drowsy drivers between 2009 and 2013. But that’s just from official police reports, so experts say it’s a gross under-estimate.

After all, there’s no sleep-a-lyzer test for drowsiness like the blood alcohol-level test for drunk drivers. And it’s harder for a cop to spot a drowsy driver than one distracted by a smart phone.

“Twenty to twenty-five percent of all crashes could be fatigue-related — drowsy drivers,” says Dr. Mark Rosekind, the NHTSA administrator. “We could be looking at over a million crashes and potentially up to 8,000 lives lost.”

Rosekind made those remarks during a webcast this week sponsored by the Harvard T. H. Chan School of Public Health and The Huffington Post. The discussion included HuffPost editor-in-chief Arianna Huffington, Harvard sleep expert Charles Czeisler, and Jay Winsten, associate dean for health communication at the Harvard Chan School.

The forum is part of a national campaign against drowsy driving that’s just getting underway.

The idea is to treat drowsy driving as the public health issue that many believe it is and to bring to the campaign the same strategies that stigmatized drunk driving. Winsten master-minded that effort 28 years ago when he coined the term “designated driver” and nagged movie and TV producers to insinuate it into their scripts.

I moderated the online discussion. Here are some highlights:

The Brain Split

Czeisler, who’s the head of the division of sleep and circadian disorders at Brigham and Women’s Hospital, says the sleep-deprived brain can split itself in two. One part goes through the motions of a “highly over-learned task” such as driving. Meanwhile, cognitive centers involuntarily transition from wakefulness to sleep.

“So it’s particularly concerning that 56 million Americans a month admit that they drive when they haven’t gotten enough sleep and they’re exhausted,” Czeisler says. “Eight million of them lose the struggle to stay awake and actually admit to falling asleep at the wheel every month.”

My powerful mid-afternoon drowsiness was typical. “It used to be thought that [drowsiness-related crashes] only happened at night, but that’s because people weren’t looking,” Czeisler says. “Most sleep-deficient driving incidents happen during the daytime because there are so many more drivers on the road.”

And there’s a physiological factor. Mid-afternoon is before the brain’s internal clock “has given us a second wind to help us stay awake in the evening,” he says.

Who Falls Asleep Most?

Three groups are particularly vulnerable to falling asleep at the wheel, Czeisler says: young people, night-shift workers, and the millions of people who suffer from sleep apnea.

“Young people think that because they’re young, they’re fit, they can do anything,” the Harvard sleep researcher says. “But actually, young people are the most vulnerable. More than half of fatigue-related accidents are in people under 25 years of age.” Continue reading

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State’s Opioid Epidemic Is Vividly Seen On Boston’s ‘Methadone Mile’

On “Methadone Mile,” a one-mile stretch of Massachusetts Avenue in Boston, it is not uncommon to witness people using drugs. Here, we’ve digitally blurred this person’s face to prevent identification. (Jesse Costa/WBUR)

On “Methadone Mile,” a one-mile stretch of Massachusetts Avenue in Boston, it is not uncommon to witness people using drugs. Here, we’ve digitally blurred this person’s face to prevent identification. (Jesse Costa/WBUR)

The ravages of the state’s opioid epidemic are perhaps nowhere more visible than in an area of Boston known as “Methadone Mile” — a one-mile stretch of Massachusetts Avenue in the shadow of Boston Medical Center. Continue reading

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Emergency Mental Health Programs Called Into Question After Taunton Attack

Many questions remain about the mental health services Arthur DaRosa received in the day before he went on a deadly stabbing rampage in Taunton Tuesday evening.

On Thursday, the hospital where DaRosa went for help — Morton Hospital in Taunton — says it has banned the outside contractor that evaluates MassHealth (Medicaid) patients who come in with psychiatric emergencies.

State policy says emergency mental health evaluations of patients with MassHealth must be done by outside behavioral health vendors. They’re known as Emergency Service Programs.

On Wednesday, Morton Hospital called that policy “misguided.” It wants its own clinicians to evaluate all patients.

The Emergency Services Program the hospital is banning, known as Norton Emergency Services or Taunton/Attleboro Emergency Services, is actually run by the state Department of Mental Health.

Megan Wiechnik, the resource helpline director with the National Alliance on Mental Illness Massachusetts chapter, told WBUR’s All Things Considered host Lisa Mullins the system as it stands works — sometimes.

Earlier:

Health Care And Civic Leaders Launch Serious Illness Care Coalition

Dr. Atul Gawande, a co-chair of the Serious Illness Care coalition, is a surgeon at Brigham and Women’s Hospital and a professor at Harvard Medical School and the Harvard School of Public Health. (Courtesy)

Dr. Atul Gawande, a co-chair of the Serious Illness Care coalition, is a surgeon at Brigham and Women’s Hospital and a professor at Harvard Medical School and the Harvard School of Public Health. (Courtesy)

A group of health care and civic leaders meets at the Kennedy Library Thursday morning with a mission: ensuring that Massachusetts residents live their final weeks or months as they choose. They’re launching a new statewide effort called the Serious Illness Care coalition.

The aim of the group is to encourage patients, doctors and family members to talk about what type of care they want when facing a serious illness — the kind that could lead to death within a year.

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Opinion: Pediatrician Asks, Why Can’t I Talk To You About Guns In The Home?

A Seattle public health official demonstrates the use of a gun lock box during a news conference on Jan. 21. (Elaine Thompson/AP)

A Seattle public health official demonstrates the use of a gun lock box during a news conference on Jan. 21. (Elaine Thompson/AP)

Here’s a conversation I was in on recently between a pediatric intern and the parents of a healthy, 1-day-old baby. It occurred in the Yale-New Haven Hospital well baby nursery.

“Your daughter’s physical exam is perfect,” the intern said. “She’s eating well, peeing and pooping well. I want to talk to you a little about how to help you keep her safe and healthy.”

Next came a standard discussion about the baby’s sleeping position and whether she’s got a car seat. Then, the next question:

“Do you have any guns in the home?”

Suddenly, the genial tone changed.

“I don’t think you should ask that question,” said the child’s father.

“Should I take that as a ‘yes’?” the intern pressed.

“I just don’t think you should ask.”

“Sir, we ask because we want to make sure that your baby is as safe as she can be, making sure you keep any guns locked up and away from her.”

“It’s none of your business.”

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Opinion: Pending Mass. Paid Leave Bill Targets An Issue Of ‘Human Dignity Violated’

Author Kate Mitchell with her newborn son, Mateo (Courtesy)

Author Kate Mitchell with her newborn son, Mateo (Courtesy)

Ten days after giving birth to my son, Mateo, I was able to walk, but not much more than a few careful steps from couch to bathroom.

I was still bleeding. I was fighting mastitis, a breast infection that delivered a high fever and the worst chills I have ever experienced. Did I mention I was breastfeeding nearly every 45 minutes around the clock? I was totally in love, and completely exhausted.

Luckily for me, I didn’t have to go back to work right after Mateo’s birth. But the same is not true for far too many American women. In fact, about one quarter of mothers in the United States have no choice but to return to work within 10 days of having a baby — many of them still bleeding, still trying to establish breastfeeding, completely exhausted, and often traumatized by leaving their newborns at a time when they need their mothers most.

“At times I feel deeply disappointed that I couldn’t manage to fight harder for what every mother, including me, deserves: time and space to heal and to bond with her new baby.”

– Katey Zeh

In an effort to learn more about the issue, I put together an informal survey that I shared on Facebook and Twitter. One respondent, Katey Zeh, a maternal health advocate with the United Methodist Church, shared her story of lacking access to family leave: In 2014, she gave birth on a Monday, returned to work emails on a Friday, and fully returned to work the following Monday.

Paid parental leave is “partially about economic justice, but it’s also about my parenting — and my family — being affirmed by our society,” Zeh said. In a blog post, she describes in a bit more detail what the lack of leave meant to her:

Now that my daughter is six months old I look back on that time with a lot of regret. If I couldn’t advocate for myself, what kind of advocate was I anyway? If I couldn’t advocate for my kid, what kind of mother did that make me? At times I feel deeply disappointed that I couldn’t manage to fight harder for what every mother, including me, deserves: time and space to heal and to bond with her new baby.

Another respondent, a Catholic school teacher from Ohio who asked that her name not be published, said she loved her work but knew she would not be ready to return to its long hours only four weeks after giving birth — the amount of partial pay leave her employer offered. She also knew that her husband’s work would not allow him to share the home responsibilities, as his job required even longer hours and offered no paternity leave benefits. She left the job she loved. Continue reading

Judge Rejects Injunction To Stop Construction On Children’s Hospital Healing Garden

Visitors relax in the Prouty Garden in this file photo. (Robin Lubbock/WBUR)

Visitors relax in the Prouty Garden in this file photo. (Robin Lubbock/WBUR)

A Suffolk Superior Court judge has denied a request for a preliminary injunction that would have stopped Boston Children’s Hospital from continuing any construction-related work on the site of its planned new clinical building. The plans call for the demolition of Prouty Garden, a healing garden that was bestowed to the hospital 60 years ago.

A group of people opposed to the development project — plaintiffs include family members of patients who’ve used Prouty Garden and physicians — had asked the judge to issue the injunction, saying the hospital has illegally started work on the site before the state Department of Public Health issues its approval.

The judge ruled the plaintiffs didn’t meet the burden of proving they’re likely to succeed in a lawsuit, but can still press forward with a suit challenging the project. Continue reading

Earlier:

Policies For Transgender High School Athletes Vary From State To State

Justin Bonoyer stands in the athletic fields at Ponaganset High School in North Scituate, Rhode Island. Justin was Elise to his coaches until a few weeks ago. (Jesse Costa/WBUR)

Justin Bonoyer stands in the athletic fields at Ponaganset High School in North Scituate, Rhode Island. Justin was Elise to his coaches until a few weeks ago. (Jesse Costa/WBUR)

Crack. A bright pink aluminum bat connects with a fluorescent yellow softball, sending it toward woods that border Ponaganset High School in northwest Rhode Island. The left fielder runs in and makes the catch.

“Two down ladies, two down,” a player calls.

This is home field for Ponaganset’s Lady Chieftains, except, it seems, the team is not all ladies.

Justin Bonoyer, a stocky 5-foot-5-inch player with a shock of blonde hair, plays right field. Justin was Elise to his coaches until a few weeks ago, although he’d already come out as transgender to most of his teammates.

“I’m a guy,” Justin says. “It’s the same as if a guy who’s not trans went and played on a girl’s softball team.”

Well, sort of. There are separate rules for transgender athletes. Rules so different from state to state that some high school athletes like Justin can try out for any team they choose while others need sex reassignment surgery before they can sign up.

There’s a lot of attention on bathrooms in the debate about transgender rights. The next battleground may be locker rooms, basketball courts and soccer fields. For high school students, the debate centers on Title IX, the federal law that bans discrimination based on gender. Does it also ban discrimination based on gender identity?

We’ll lay out the arguments in a minute. First, a little more about Justin. Continue reading