Author Archives: Rachel Zimmerman

Blogger, CommonHealth Rachel Zimmerman worked as a staff reporter for The Wall Street Journal for 10 years in Seattle, New York and in Boston as a health and medicine reporter. Rachel has also written for The New York Times, the (now-defunct) Seattle Post-Intelligencer and the alternative newspaper Willamette Week, in Portland, Ore., among other publications. Rachel co-wrote a book about birth, published by Bantam/Random House, and spent 2008 as a Knight Science Journalism Fellow at MIT. Rachel lives in Cambridge with her husband and two daughters.

Welcome, Attorney General Healey. What Are You Going To Do About Partners?

It’s swearing in day for Maura Healey, Attorney General. (Steven Senne/AP)

It’s swearing in day for Maura Healey, Attorney General. (Steven Senne/AP)

Maura Healey will inherit several thorny issues Wednesday as she becomes the next state attorney general. Near the top of her list: the agreement that would let Partners HealthCare acquire at least three more hospitals in exchange for some limits on price and staff increases.

During the campaign, Healey raised questions about whether the deal was enough, both in scope and in duration.

So now that she’s in charge, will she urge Judge Janet Sanders to approve the agreement, suggest changes, or start over? In an interview before her swearing-in, WBUR’s Bob Oakes put these questions to Healey. Here’s the sum total of her response:

This is a matter that I’m reviewing and being briefed on now. The perspective I come from, as attorney general, is to drive down health care costs. So I’m considering my options. Right now, the matter is before the court, as you say. There was a proposed consent judgement filed, and we’ll just have to see on that.

In short, stay tuned.

Sanders suggested back in November, at the last hearing on the Partners deal, that she’d like to speak to Healey before issuing a ruling. She may also be waiting for Partners to name a new CEO, a decision some sources expect in the next four or five weeks. Sanders could call the parties in for a status conference at any time. Healey and Partners have that option as well.

Who will make the next move? Any bets?

You can hear all of Bob’s conversation with the new AG here.

Related:

In Wake Of Brigham And Women’s Shooting, A Look At Area Hospitals’ Safety Protocols

Police outside the Shapiro building at Brigham and Women's Hospital after Tuesday's shooting. (Steven Senne/AP)

Police outside the Shapiro building at Brigham and Women’s Hospital after Tuesday’s shooting. (Steven Senne/AP)

Brigham and Women’s Hospital in Boston said it’ll review its safety measures and protocols Wednesday after the fatal shooting of a doctor there Tuesday. The doctor, Michael Davidson, 44, was pronounced dead late Tuesday.

Investigators say the gunman, identified by police as 55-year-old Stephen Pasceri, of Millbury, deliberately targeted Davidson. Police say Pasceri died from an apparent self-inflicted gunshot wound.

It’s the type of situation the hospital’s chief operating officer, Dr. Ron Walls, says all hospital staff have been carefully trained to address.

“There is no amount of preparation anyone can do that completely eliminates the prospect of this kind of tragic event happening,” Walls said. “But we do believe we have a responsibility, and we’re working hard to meet that responsibility to have all of our people completely prepared in the best way we can so that when something like this happens — if it happens, and whatever happens– our staff is able to respond.”

John Erwin, the executive director of the Conference of Boston Teaching Hospitals, joins Morning Edition to discuss safety measures at area hospitals.

To hear the full interview with Erwin, click on the audio player above.

Related:

Doctor Shot At Brigham & Women’s Hospital Has Died

This post has been updated.

WBUR reports that the doctor shot at Brigham & Women’s Hospital yesterday has died:

A cardiac surgeon was shot inside Boston’s Brigham and Women’s Hospital Tuesday and later succumbed to his injuries, police said, and the suspected shooter was found dead in an examination room from an apparent self-inflicted gunshot wound.

Dr. Michael Davidson (Courtesy of Brigham and Women's Hospital)

“This evening, Dr. Michael J. Davidson, director of Endovascular Cardiac Surgery at Brigham and Women’s Hospital, has tragically died as a result of the gunshot wounds he sustained this morning during the shooting event at the Shapiro Cardiovascular Center,” the hospital said in a statement late Tuesday.

The 44-year-old from Wellesley was shot twice, Boston Police Commissioner William Evans said in a midday news conference, before Davidson died.

“Dr. Davidson was a wonderful and inspiring cardiac surgeon who devoted his career to saving lives and improving the quality of life of every patient he cared for,” the hospital statement added. “It is truly devastating that his own life was taken in this horrible manner.”

A former Brigham & Women’s cardiologist who worked with Davidson often called him “a dynamic and energetic thought leader in cardiovascular medicine.”

Police are seen outside the Brigham and Women’s Hospital in Boston Tuesday, where one person was shot. (Robin Lubbock/WBUR)

Police are seen outside the Brigham and Women’s Hospital in Boston Tuesday, where one person was shot. (Robin Lubbock/WBUR)

Hospital employees had been well-drilled for this disturbing eventuality.

In November 2013 we reported that about 1,200 Brigham doctors, nurses and other staff viewed the hospital’s new “Active Shooter Preparedness Training” video, which offers a step-by-step guide on how to handle a hospital shooter, which in some cases is called a “Code Silver.” Continue reading

Appreciating The Nature In Your Medicine Cabinet

By James Morris
Guest contributor

One of the the most exciting aspects of the recent discovery of the new antibiotic teixobactic was the way scientists discovered it — and where.

The antibiotic comes from a bacterium that was found in a sample of soil from Maine. To uncover it, scientists used a new technique that allowed them to screen bacteria for antibiotics without growing them in culture, opening the door to finding newer, more potent and less resistant antibiotics in the future.

It’s worth noting that teixobactic is not the only antibiotic that comes from a bacterium. In fact, many of our antibiotics come from bacteria and other microbes, and many of our medicines come from nature. It’s one of the benefits of biodiversity.

Recently, I was teaching a class on biodiversity to college students. To get them thinking about how we benefit from species richness, I asked the class to name a couple of medicines that derive from nature.

I thought this would be an easy question. To my surprise, the class (of 250 students) was silent. This was unusual — I usually have more trouble keeping them quiet. Finally, after maybe 20 seconds (a long time in a large lecture hall), a hand shot up. “Marijuana!” one student proudly exclaimed.

I was taken aback. Not because weed was mentioned in a college classroom. And not because the student was incorrect — she was of course correct. Marijuana comes from the plant Cannabis and it has some useful medicinal properties, for example to treat nausea caused by cancer chemotherapy, and fatigue, appetite loss and pain associated with AIDS. There is continued debate over its use, but that’s not the point.

The point is that while the class was hard-pressed to come up with more than one medicine derived from nature, the reality is just the opposite: It’s difficult to think of a medicine that doesn’t ultimately come from nature.

If apples and carrots are nature’s toothbrush, grapes are nature’s jellybeans, and raisins are nature’s candy, then certainly plants, animals, fungi, and microbes are nature’s medicine cabinet.

Perhaps the most famous example is penicillin. Continue reading

That Extra Slice: Study Finds When Kids Eat Pizza, They Eat More Calories

Pizza birthday party (Flickr Creative Commons)

Pizza birthday party (Flickr Creative Commons)

By Alvin Tran
Guest contributor

Parents, if you want to prevent your kids from eating too many extra calories, you might want to think twice about letting them have that “just one more” slice of chewy dough, tangy tomato sauce and glistening melted cheese.

In a new study, published Monday in the journal Pediatrics, researchers found that pizza contributed to children and adolescents consuming more calories, saturated fat, and sodium in their usual diet.

“They’re taking in substantially more nutrients we really want to be thinking about limiting,” said Lisa Powell, PhD, a University of Illinois at Chicago professor of health policy and administration and the study’s lead author.

Powell’s study, which analyzed 24-hour dietary recalls of more than 12,000 kids over a 7-year period, found that children between the ages of 2 and 11 consumed an extra 84 calories on the days they ate pizza, while adolescents consumed an extra 230 calories.

It’s not a good idea to eat pizza as a snack.
– Lisa Powell, PhD

They also consumed significantly more sodium and saturated fat, which nutrition and health experts often dub the “bad fat.”

There is a silver lining, however. Children’s overall caloric intake from pizza declined by 25 percent over the course of the study. The study’s adolescent population, which ranged from ages 12 and 19, also demonstrated similar trends: its caloric intake from pizza fell by 22 percent.

But while the number of calories that adolescents consumed dropped, their overall consumption, on average, did not significantly change over the course of the study. According to Powell and her co-authors, this may be due to a slight increase in pizza consumption.

“The average adolescent takes in 620 calories of pizza. By showing that they consume this extra 230 calories, that means that on days they consume pizza, they’re not adequately adjusting the caloric intake and other things they take in that day,” Powell said. “They may be eating pizza but they’re having this additional 230 calories that they’re taking in.”


Overall, pizza consumption remained highly prevalent across both groups. In 2009 to 2010, 20 percent of children and 23 percent of adolescents consumed pizza on a given day.

Powell and her colleagues also found that consuming pizza as a snack or from fast-food restaurants were the two greatest culprits influencing both children and adolescents’ overall daily calorie intake.

“It’s not a good idea to eat pizza as a snack. That’s one thing that teens and parents should keep in mind,” Powell said. Continue reading

White Coats For Black Lives: Toward Racial Equality In Health Care

Kaitlyn Veto/flickr

Kaitlyn Veto/flickr

Acknowledging the public health impact of racism and deep disparities in the quality and accessibility of medical care for patients of color, a national organization, White Coats for Black Lives, says it’s launching a new effort today, in celebration of Martin Luther King, Jr.

Dorothy Charles, one of the group’s organizers and a first year medical student at the University of Pennsylvania’s Perelman School of Medicine, offers some context in an email:

Racism profoundly impacts people of color: the black-white mortality gap in 2002, for example, accounted for 83,570 excess deaths. As future physicians, we are responsible for addressing the perpetuation of racism by medical institutions and seek policy change to eliminate disparities in outcomes.

Here’s a statement from the White Coats for Black Lives National Steering Committee:

Upon matriculating in medical school, students recite the Hippocratic Oath, declaring their commitment to promoting the health and well-being of their communities. On December 10, 2014, students from over 80 medical schools across the United States acted in the spirit of that oath as we participated in a “die in” to protest racism and police brutality. In our action, we called attention to grim facts about the public health consequences of racism, acknowledged the complicity of the medical profession in sustaining racial inequality, and challenged a system of medical care that denies necessary treatment to patients unable to pay for it, disproportionately patients of color.

Today, in celebration of the legacy of Dr. Martin Luther King Jr., we announce the founding of a national medical student organization, White Coats for Black Lives. This organization brings together medical students from across the country to pursue three primary goals:


1. To eliminate racism as a public health hazard

Racism has a devastating impact on the health and well-being of people of color. Tremendous disparities in housing, education, and job opportunities cut short the average Black life by four years. Physicians, physician organizations, and medical institutions must therefore publicly recognize and fight against the significant adverse effects of racism on public health. We additionally advocate for increased funding and promotion of research on the health effects of racism.

2. To end racial discrimination in medical care

We recognize that insurance status serves in our healthcare system as a “colorblind” means of racial discrimination. While it is illegal to turn patients away from a hospital or practice because of their race, patients across the country are frequently denied care because they have public insurance or lack health insurance. We support the creation of a single payer national health insurance system that would give all Americans equal access to the healthcare they need. Such a system would create a payment structure that reflects the fact that “Black lives matter.” Moreover, ample evidence suggests that patients of color receive inferior care even when they are able to see a doctor or nurse; we therefore advocate for the allocation of funding for research on unconscious bias and racism in the delivery of medical care. Continue reading

Trying To Turn Up Heat On Health Cost Control In Mass.

Updated Jan. 17, 2015, 4:15 p.m.

BOSTON — In 2012, Massachusetts became the first state in the country to set a goal to cut health care spending.

In 2013, the state beat the goal. Spending grew 2.3 percent, well below the gross state product (GSP), 3.6 percent.

Now, at the start of 2015, the state’s largest employer group says good, time to set a more aggressive goal.

We should “congratulate ourselves for being successful in year one,” says Rick Lord, president and CEO at Associated Industries of Massachusetts (AIM), and “set a target that’s more aggressive.”

AIM is backing legislation filed by House Minority Leader Brad Jones that would lower the benchmark from straight GSP to GSP minus 2 points starting next year and continuing through 2022. After that, the cap would go back to even with GSP.

Continue reading

Miralax Dilemma: As Common Laxative Studied, Parents Ask, ‘Is It Safe?’

Miralax is seen on a store shelf. (Robin Lubbock/WBUR)

Miralax is seen on a store shelf. (Robin Lubbock/WBUR)

By Ricki Morell

If you, like millions of parents, routinely give your child Miralax for constipation, recent reports that the Food and Drug Administration is studying a possible link between the common laxative and neuropsychiatric problems probably sounded scary.

After years of complaints from activists, two Children’s Hospital of Philadelphia researchers are now leading an FDA study of the ingredient — polyethylene glycol 3350, or PEG 3350 — to see how it affects children.

“We’re pleased that they’re going to be looking at behavior changes because that’s never been done before,” said Carol Chittenden, co-director of The Empire State Consumer Project, a nonprofit consumer group in Rochester, New York, that pushed the FDA to embark on the study. “Parents are feeling anxious but also validated because they’ve been telling their doctors for years about these symptoms.”

Just because the FDA is doing a study, doesn’t make it dangerous.
– Dr. Samuel Nurko

Miralax is sold over the counter as an adult laxative, but pediatricians and gastroenterologists routinely prescribe it to infants, toddlers and older children. And they often prescribe it for long-term daily use for chronic constipation, even though the label says it should be used for no more than seven days “unless advised by your doctor.”

Dr. Samuel Nurko, director of the Center for Motility and Functional and Gastrointestinal Disorders at Boston Children’s Hospital, said parents have little reason to worry. Dr. Nurko, who was involved in previous studies of Miralax, some partially funded by the drug company that used to own Miralax, argues that the drug isn’t approved for children because of the technicalities surrounding the FDA study process. He believes Miralax is safe for children.

“Just because the FDA is doing a study, doesn’t make it dangerous,” Dr. Nurko said. “From my perspective, the risk of not treating constipation is worse. Do you think the FDA would leave it on the market if it were dangerous? I think it’s an overreaction but I’m glad that they are studying it.”

About 5 percent of children suffer from constipation, according to the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, which has guidelines for long-term use of Miralax among other constipation treatments.

FDA spokesperson Andrea Fischer said in an email that the agency is funding the $325,000 study to explore pediatric safety concerns even though “the FDA has not determined that there is enough data to warrant additional warnings regarding these products, or to issue specific warnings about pediatric use of the drugs at this time.”

The FDA first tested Miralax in 2008 and found small amounts of ethylene glycol and diethylene glycol, toxic ingredients also found in antifreeze. In subsequent tests in 2013, it found no detectable levels of those ingredients.

Chittenden says any hint that PEG can lead to side effects known to be associated with ethylene glycol or diethylene glycol toxicity is disturbing. According to a 2009 FDA drug oversight report, neuropsychiatric side effects “may include seizures, tremors, tics, headache, anxiety, lethargy, sedation, aggression, rages, obsessive-compulsive behaviors including repetitive chewing and sucking, paranoia and mood swings.”

Diethylene glycol toxicity can also cause “metabolic acidosis,” or too much acid in the blood, which, in severe cases, can lead to shock or death.

But Fischer emphasized that the link between these side effects and Miralax is so far unproven. Continue reading

How Art Can Re-Order A Harsh, ‘Deformed’ Childhood

Artist Evelyn Berde was born with congenital scoliosis in 1950 and spent many years in and out of Massachusetts General Hospital, confined to a bed for months at a time.

Her art, she says, is informed by her experience living with her “deformity,” as it was referred to back then, and her childhood growing up in the old West End of Boston, a low-income neighborhood near MGH and the Charles River, which was razed in the late 1950s, displacing many residents.

It wasn’t an easy childhood: Alcoholism ran in the family and Evelyn’s brother drowned in the Charles River when he was nine and she was just six. Evelyn was subjected to numerous surgeries and procedures for her scoliosis — some that now seem barbaric.

But art, she says, “has the ability to lift us out of one place and take us to another.”

Here, you can listen to Evelyn talk about five of her paintings and tell the stories that helped shape them.

Artist Evelyn Berde's "Shame" (Courtesy Berde)

Artist Evelyn Berde’s “Shame” (Courtesy Berde)

Artist Evelyn Berde's "July 12, 1956" (Courtesy Berde)

Artist Evelyn Berde’s “July 12, 1956″ (Courtesy Berde)

Continue reading

Diaper Power: Expanding Gel Could Help Scientists See Brain Workings

If this were a glam-genius movie along the lines of “The Imitation Game,” we’d see an exhausted, stymied scientist changing the over-wet diaper of his cranky baby, then suddenly straightening up and gasping in the throes of a revelation: “What if — what if — we don’t try to improve the microscope? What if we just make the thing we’re trying to see bigger? We could expand it just like the gel in this huge wet diaper!”

Sadly, it didn’t happen that way. So the moral of this story is not that scientists should change more diapers. But a report just out in the journal Science does point the way to a promising new scientific tool that could prove helpful in the monumental efforts under way to map the brain. And yes, it involves diapers — or rather, the polymer gel that makes disposable diapers expand so rapidly when wet.

Turns out, with some chemical tweaking, that gel can be used to expand brain tissue without distorting its structure, so it may allow scientists to map the nano-scale 3-D connections between neurons — even potentially to get a full picture of how information flows in small animal brains or parts of the human organ.

I spoke with neuro-engineer Ed Boyden of MIT’s Media Lab and McGovern Institute for Brain Research, senior author on the new study in Science, co-authored with MIT grad students Fei Chen and Paul Tillberg. Our conversation, lightly edited:

How would you sum up what you report in this “Science” paper?

Over the last several hundred years, microscopists have been imaging life. The way they do it is they use a glass lens to magnify the light coming out of the biological sample. This has been very, very powerful, and untold numbers of insights have emerged from it, but there’s a problem: How can you image a large, 3-D object with nano-scale precision? Light cannot go down to very, very fine precision because light is sort of finite in size, you could say. It has a wavelength that’s really large compared to single molecules.

What we’ve found is that, in contrast to lens-based magnification, you can physically magnify an object and make it bigger. So that was the first key finding: We can physically magnify an object.
The second key finding is that we have engineered a chemical system that lets you do this very, very precisely and with good resolution.

And a third take-home message from the paper is that we have now shown that the chemical process we developed is very isotropic — that is, it’s very smooth and even, and doesn’t introduce distortion, all the way down to the nanoscale.

Why does being able to analyze brain tissue at this nanoscale resolution matter?

If you want to understand the brain, well, brain circuits are quite large. The individual cells in the brain could be millimeters or centimeters in size in terms of their length. But the actual things that organize the brain — the connections called synapses — are nanoscale. So if you want to understand how a brain circuit funnels information or processes information, you need to be able to map a large, 3-D object with nanoscale precision, and that’s something our technology is enabling.

What could be done with it?

In neuroscience, we’re excited by the possibility that you could try to map an entire small brain, in organisms like flies or worms. We think it’s possible you could expand the entire nervous system or the entire brain and then see the whole thing.

That would be very exciting because you could try to follow the pathways that lead in from the sensory organs — like the eyes — all the way to the motor outputs — to the muscles, and look at all the stuff in between: What makes decisions? What makes memories? And then map that.

One could imagine that at some time in the future you could try to load up these molecular maps of a neural circuit into a computer and then try to simulate a brain in a computer.

What about human brains? Continue reading