Longreads

A man with blood phobia discovers an effective treatment for his condition:

"He tells me to close my eyes as he puts a new image on the screen of the computer. It is a red dot. I tense my muscles. No problem. And so it goes, until I am looking at blood dripping off the cuticle of a nail. Still, no problem. 'I love treating phobics,' Taylor says, grinning. 'It’s so wonderful to see people do these exercises and get better quickly. It's so effective.'"

A group of young doctors from the Clinical Excellence Research Center at the Stanford School of Medicine are looking for new models to make health care better and more affordable:

"Patel was second up in the presentation, a little nervous and barely tall enough to be seen behind the podium. She stated the problem in her target area: Cancer is the second-leading cause of death in the United States, with costs estimated to be $173 billion by 2020. These rising costs are unsustainable.

"And what do many poor-prognosis cancer patients get for all the money spent? 'Horrible treatment,' she said, citing a statistic that silenced the room: Seventy-three percent of terminal cancer patients never have an end-of-life discussion with their oncologists. 'Many patients are rushed off to chemotherapy without understanding the big picture. And when predictable treatment side effects happen at night and on weekends, patients who are unable to reach their oncologist end up in misery in emergency rooms and hospitals. Later in their illness, many die painfully in intensive-care facilities that bankrupt their families emotionally – and sometimes financially.'

"During her presentation, Patel’s eyes became dark pools that threatened to overflow. A few people in the audience wept silently, perhaps remembering loved ones who had similarly suffered.

"'Overall, these added services improve the quality of life of patients, giving them what they need and want without delay,' she added after describing her model. 'And best of all, we lower health insurance costs … simply by doing the right thing.'"

Examining the unmet medical needs for transgender people in the United States:

"The problem is that in the United States, most physicians don’t exactly know what treatment for the transgender patient entails. For an untrained professional, it’s a challenge to provide care to a patient with a penis who wants a vagina, or to a patient who has been tortured emotionally by being told she’s a boy when she knows she’s a girl. General practitioners — the majority of doctors who treat patients in the United States — are equally unprepared to care for those transgender patients after they have begun to take hormones and undergone genital-reconstruction surgery. The lack of medical education on the topic, a near-total absence of research on transgender health issues and the resulting paucity of evidence-based treatment guidelines leave many at a loss."

“See you below,” he yelled to Deborah as he flew through the air. Five seconds into his fall, the static line engaged his chute, which opened above. Randy clutched the handles around his shoulders, terror in his throat, resolving never to skydive again. He landed in the drop zone at the Antioch, Calif., airfield with a thud when he heard screams and turned to see Deborah, her partially opened white chute wrapped around her like a shroud as she streaked toward the ground. Her main chute had never opened, and she was frantically clawing her way to her reserve chute.

The medical establishment, facing a huge shortage of organs, needs new sources for transplantation. One solution has been a return to procuring organs from patients who die of heart failure. Before dying, these patients are likely to have been in a coma, sustained by a ventilator, with very minimal brain function — a hopeless distance from what we mean by consciousness. Still, many people, including some physicians, consider this type of organ donation, known as “donation after cardiac death” or DCD, as akin to murder.