I felt a little guilty about pushing my colleague John Sanford to confront his blood phobia as part of a story he was writing for Stanford Medicine magazine. I feel fine about it now, though. While writing it, John overcame the phobia! And the story turned out very well too. In fact, it was recently singled out by long-form journalism curator Longreads as a story worth reading.

Here’s how it starts:

I awoke close to midnight. It was the middle of August, in 1992, and the windows were open in the room of the Paris hostel where I was staying. The air was warm and still. My chest felt moist with — sweat? I touched the substance with an index finger and pressed it to my thumb. It felt tacky. Blood!

(That’s John in the photo, by the way. Yes, he’s holding a test tube of blood.)

Previously: New issue of Stanford Medicine magazine asks, What do we know about blood? and Programmed to fear spiders?
Photo by Erin Kunkel

“Blood is a very special juice.”

Goethe didn’t know the half of it when he penned this line for the character of Mephistopheles, in “Faust,” more than 200 years ago.

In those days people believed blood held mystical qualities and was a potent life force. No wonder Mephisto wants the contract for Faust’s soul signed in the stuff.

But what exactly does blood do?

The new issue of Stanford Medicine magazine tells blood’s story, from 17th-century attempts at blood transfusion to the workings of a modern blood bank to today’s studies of gene therapy to treat hemophilia.

Inside the issue:

• “Blood quest:” An article on Stanford’s early fight to prevent the spread of AIDS by screening blood - while other blood banks argued against testing.
• “Blood, sweat and fears:” The story of a blood phobic and his attempt to conquer the surprisingly common condition.
• “Roll up your sleeve:” An explainer on the irreplaceable resource that is human blood, and why blood donation remains so crucial.
• “Life of blood:” A visual primer on blood cells, the most numerous cells in your body.
• “Against the flow:” A feature on why blood transfusions are declining, and why that’s good news for health.
• “In his blood:” A look at growing up with hemophilia, featuring a physician with hemophilia who is dedicating his life to finding cures for the life-threatening disease.

This issue’s “Plus” section, featuring stories unrelated to the special report, includes:

• “Bubble girl:” A feature on a new treatment for severe combined immunodeficiency disease, also known as “bubble boy disease.”
• “A Nobel experience:” An insider’s view of this year’s Nobel Prize festivities.

Previously: The money crunch: Stanford Medicine magazine’s new special report and The data deluge: A report from Stanford Medicine magazine
Photo by Renphoto

As an enemy of daylight saving time I am a fan of writer /chronobiologist Bora Zivkovic’s lucid denunciation of this outmoded practice. In a new article crossposted by Scientific American and Zócalo Public Square, he spells out the madness of shifting clocks forward an hour at the start of spring (and shifting back an hour in the fall). The piece points out that daylight saving time no longer serves its original purpose - to save energy used for lights. And more concerning, it explains that the clock shift leads to increased incidence of injuries and illness. He explains:

Chronobiologists who study circadian rhythms know that for several days after the spring-forward clock resetting – and especially that first Monday – traffic accidents increase, workplace injuries go up and, perhaps most telling, incidences of heart attacks rise sharply. Cases of depression also go up.

For more details on why the rest of the world should join Russia and Belarus, both of which stopped switching the clock forward and back in 2011, give it a read. You’ll also pick up some interesting facts: Cells in our eyes adjust to the shift in about a day, while cells in our digestive systems can take weeks.

Photo by Slideshow Bruce

As the editor of Stanford Medicine, I think a lot about new research, new discoveries, new treatments. So it’s no wonder I find stories of long ago a refreshing change when I’m reading for pleasure. A look at my 10 favorites this year shows my predilection, though there’s lots of new here too. History fan or not, if you read just one, read about the immortal jellyfish! I can’t stop thinking about them.

Undead: The rabies virus remains a medical mystery, by Monica Murphy and Bill Wasik, Wired
An account of a modern attempt to cure rabies, with lots of history woven in.

Can a jellyfish unlock the secret of immortality? by Nathaniel Rich, New York Times Magazine
Including wondrous jellyfish that grow younger and a researcher who breaks the mold, and it’s told with humor and lyricism.

Two hundred years of surgery, by Atul Gawande, New England Journal of Medicine
For gems like this: “Liston operated so fast that he once accidentally amputated an assistant’s fingers along with a patient’s leg, according to Hollingham. The patient and the assistant both died of sepsis, and a spectator reportedly died of shock, resulting in the only known procedure with a 300% mortality.”

Post-Prozac nation: The science and history of treating depression, by Siddhartha Mukherjee, New York Times
Everything we knew about antidepressants like Prozac was wrong. But that’s OK.

The nature of the Knight Bus, by Chris Gunter, Story Collider
A look behind the scenes at top science journal Nature from one of the journal’s editors.

The island where people forget to die, by Dan Buettner, New York Times Magazine
On mellowing out on a Greek island to live to 100. It got me thinking about how to bring more mellowness into my life.

Fear fans flames for chemical makers, by Patricia Callahan and Sam Roe, Chicago Tribune
A great investigation into a chemical industry-funded front group’s deceptive campaign that fueled demand for flame retardants in furniture, electronics and baby products among many other items. The whole four-part series is worth reading. It also explains that the chemicals have been linked to cancer, neurological deficits, developmental problems and impaired fertility — and not only that, but they don’t work.

The measured man, by Mark Bowden, The Atlantic
On one man’s effort to use big data as a tool to guide him to better health. This is either insane, the future, or both.

A family learns the true meaning of the vow ‘in sickness and in health’, Washington Post Magazine
A heartrending, inspiring read for me, though not for all - as evident by the comments.

Previously: My top medical reads of 2011 (aside from those I edited)

From Dec. 24 to Jan. 7, Scope will be on a limited holiday publishing schedule. During that time, it may also take longer than usual for comments to be approved.

A list for lovers of medical writing and things Stanford: The 10 most popular Stanford Medicine magazine stories published in 2012 (as determined by pageviews on our website).

1. Positive charge – New technology to treat depression – by Ruthann Richter
2. Against the odds – A band of rebels fights to save health care – by Kris Newby
3. Neuroscience of need - Understanding the addicted mind – by Bruce Goldman
4. Transition point – The unmet medical needs of transgender people – by Tracie White
5. Big data – What it means for health and the future of medical research – by Krista Conger
6. Statistically significant – Biostatistics is blooming – by Kristin Sainani
7. Brain power – Psychiatry turns to neuroscience – by Jonathan Rabinovitz
8. King of the mountain – Digging data for a healthier world – by Bruce Goldman
9. Cancer roundhouse – Evidence mounts that a single antibody could knock out many cancers – by Chris Vaughan
10. Autism answers – Parents run experiments to see what works – by Erin Digitale

And, as a bonus, a story (from Ruthann Richter) on cancer screenings that really resonated with readers.

Previously: Stanford Medicine magazine’s big reads of 2011

From Dec. 24 to Jan. 7, Scope will be on a limited holiday publishing schedule. During that time, it may also take longer than usual for comments to be approved.

If you don’t have your health, you don’t have anything. Unfortunately, in the United States protecting this most precious asset is breaking the proverbial bank. As I edited the new issue of Stanford Medicine magazine, which includes a report on the medical world’s money crunch, I came across harrowing statistic after harrowing statistic.

Among them:

• U.S. health-care spending neared $2.6 trillion in 2010, which is 17.9 percent of the nation’s gross domestic product. This translates to $8,402 per person.
• More than 75 percent of U.S. health-care spending is due to chronic conditions, which are expected to become even more prevalent as the baby boomer generation ages. In 2000, 125 million people suffered from chronic conditions; by 2020, that number is projected to reach 157 million.
• Competition for biomedical research funding has become cutthroat. At the National Institutes of Health, the world’s biggest funder, requests for dollars rose from 3.6 times the supply in 1998 to 6.5 times the supply in 2011.

What’s behind the crisis? How can we dig ourselves out of this predicament? The new issue offers some answers and poses more questions. Inside the report:

“The competition”: A feature on the intense competition for funding for biomedical research — competition that has reached an all-time high.

“Against the odds”: A story about a young oncologist’s experience as member of a small band of physicians, engineers and management scientists training to battle the waste and perverse financial incentives in America’s medical system. She is part of Stanford’s Clinical Excellence Research Center, led by Arnold Milstein, MD, a major national force in medical service innovation.

“Melinda Gates on family matters”: A Q&A with philanthropist Melinda Gates on her campaign to expand access to contraception.

“Testing testing”: A piece on the dangerous and costly problem of overscreening for medical conditions, focusing on the seemingly intractable debate over prostate cancer screening.

“Giving well”: Interviews with four major Stanford financial supporters about why they give.

In addition to the special report, this issue includes a feature, “Marathon man,” on the career of Stanford medical school’s dean, Philip Pizzo, MD, a pioneer in pediatric HIV research as well as an academic leader, who is stepping down from the position after 12 years.

Previously: The data deluge: A report from Stanford Medicine magazine; The future of psychiatry: A report from Stanford Medicine magazine and Cancer’s next stage: A report from Stanford Medicine magazine
Illustration by Brian Rea

I love this: Here’s a way anyone reading this blog - assuming you’re at least 18 and are a U.S. citizen or permanent resident - can compete for $3,000 of federal research funding plus a chance to chart the course of vision research. The National Eye Institute is holding a contest to identify audacious goals in vision research, and specifically encourages the general public to take part.

As the institute explains on its website (where you can find the complete entry details):

The challenge calls for submission of audacious goals in any area relevant to NEI’s mission to conduct and support research, training, health information dissemination, and other programs with respect to blinding eye diseases, visual disorders, mechanisms of visual function, preservation of sight, and the special health problems and requirements of the blind.

What an audacious idea. Though it would be even more audacious if young people and non-U.S. residents could enter too! The more audacious ideas the better.

(Submission period ends November 12, 2012)

Photo by Mike_Cantwell

I fell in love with the art of data visualization while working on Stanford Medicine magazine’s new special report on the medical data deluge and how it’s changing research and health care. When I put out word that I was gathering images to possibly illustrate our report, in came this one from Purvesh Khatri, PhD, who works with Atul Butte, MD, PhD, medical data-mining maven.

The figure represents biological networks interacting with each other during kidney transplant rejection. Each circle indicates a cell signaling pathway, with the dots making up the circle representing genes in the pathway and the lines between the dots showing interactions between those genes. Yellow, orange and red lines mark one gene activating the other; green lines mark one repressing the other. The black lines show crosstalk between pathways. Khatri created the image with data from the NCI-Nature Pathway Interaction Database.

Previously: The data deluge: A report from Stanford Medicine magazine
Image by Purvesh Khatri

Just as people leave digital trails these days, so do our cells, and they’ve been doing so for decades as a result of biomedical research. The huge challenge of mastering this biomedical “big data” deluge, a goldmine for research and drug development, is the theme of a special report in the new issue of Stanford Medicine magazine.

In the report:

“B!g data:” the lead article on the data deluge in biomedicine, told through the story of genetics professor Michael Snyder, PhD, who made himself the subject of his own big data project, allowing the world to watch as his health took a nose dive.

“A singularity sensation:” a Q&A with science fiction author Vernor Vinge, five-time winner of the Hugo Award, whose stories explore themes including deep space and the singularity, a term he coined for the emergence of a greater-than-human intelligence brought about by the advance of technology.

“King of the mountain:” a profile of a wildly successful medical data miner Atul Butte, MD, PhD, who’s urging other researchers to dig in.

“On the records:” a piece on the creation of a research database built on medical records from Stanford and Lucile Packard Children’s hospitals.

“Statistically significant:” an article on the rise in importance of biostatistics: Suddenly the “stodgy” old field of statistics is where the action is.

This issue’s “Plus” section, featuring stories unrelated to the special report, includes:

“Cancer roundhouse:” a feature on the mounting evidence that a single antibody, known as anti-CD47, could knock out many cancers.

“Game on:” a story on using gamification — with a computer game called Septris — to teach residents and doctors how to recognize when patients have sepsis, and how to treat them.

Previously: The future of psychiatry: A report from Stanford Medicine magazine, Cancer’s next stage: A report from Stanford Medicine magazine, and Surviving survival: The new Stanford Medicine magazine is out
Photo by Dwight Eschliman

In a story online today, I describe how a team led by Stanford’s Carlos Bustamante, PhD, and Sean Myles, PhD, discovered that the gene for blond hair arose independently in the South Pacific nation of the Solomon Islands. The researchers identified the islanders’ “blond” gene and discovered it’s not the same gene that causes blond hair in Europeans.

Reporting the story was so much fun. I learned from Myles, who spent a month there gathering the data, how important it is to get the village chief on board when doing genetic research in the Solomon Islands, that Solomon Islanders’ saliva (which he collected for the study) is often bright red from chewing betel nut, and that on one of the islands (with an active volcano) you can cook by simply burying the food in the hot ground for a while. “The beaches are pristine, water super blue. You can hear the fish jumping in the water. It’s what a lot of people would think of as paradise,” he told me. Wow, what a trip.

The genetic finding, published in the May 4 issue of Science, has a certain “wow” appeal too, and the researchers say there’s a serious message that comes along with it. As Bustamante told me, the finding underscores the importance of genetic studies on isolated populations like the Solomon Islanders:

If we’re going to be designing the next generation of medical treatments using genetic information and we don’t have a really broad spectrum of populations included, you could disproportionately benefit some populations and harm others.

Myles, now an assistant professor at Nova Scotia Agricultural College, expands on this on his lab’s website:

Our result is therefore a call for action. We must take steps now to ensure that the benefits of current genomics research extend beyond privileged populations and provide an increase in well-being for people everywhere. Humanity’s natural genetic diversity is vast and fascinating – we should be measuring and assessing it all! The same applies for genomics research in agriculture. A continued focus on a small number of elite individuals in plant and animal breeding is myopic and dangerous. An immense amount of existing genetic diversity that is essential to our future well-being is being ignored. Whether it’s us or our food that we research, our aim is to cultivate an appreciation for natural genetic diversity. Our future depends on it.

Photo of a child from the Solomon Islands by Sean Myles