Issue 59
Drinking around the world, the meaning of "superbug," and the dark history of a life-saving treatment.
Dec. 30, 2018
Hello friend! Welcome to Scrap Facts.
I'm a reporter covering health and science with insatiable curiosity. I love everything I learn, not all of which gets its own story. Each week, I'll bring you some of my favorite facts that I picked up on the job or while out living life.
Archives from Tinyletter can be found here.
Standard drinks are not so standard globally.
Found while reporting: What we learned about drinking alcohol in 2018.
If you were confused by all the studies that came out about alcohol, don’t worry—you weren’t alone. In this deep dive, we explain the reasoning behind some of those scary headlines you may have seen, and why they don’t tell the whole story.
While I was reporting this story, I came across something odd: There is no specific definition of a “drink.” Countries (and not every one) have a rough estimate of the number of grams per alcohol that constitute a drink—which means it’s even harder to figure out what people mean when they say they have “seven drinks per week.” In the US, it’s 14 grams of alcohol per beverage, which is roughly a beer or a wine. In the UK, one unit is 8 grams, but per the National Health Service, typical glasses of wine or beers are 2 units. In Austria and Bulgaria, it’s 20 grams of alcohol. Of course, in actual drinks, the alcoholic content varies, adding another layer of confusion.
You can read through all those that are available here, courtesy of the World Health Organization (you’ll have to download a CVS file).
We actually don’t create all the drug-resistant bacteria out there.
Found while reporting: A report by the NIH Clinical Center shows how stealthy multi-drug-resistant bacteria can be
I read a paper this week in which researchers from the US National Institutes of Health described how they found a drug-resistant type of bacteria was found living in the sinks that lead to patients’ rooms in their Clinical Center. Unfortunately, this strain of bacteria ended up causing three deaths—although these patients had all had stem-cell transplants, and were also suffering from other infections, so it’s impossible to say that these infections caused their deaths.
When I hear (read) “multi-drug-resistant bacteria” I think “superbug.” And in a sense, this is correct. Superbugs are bacteria that have become resistant to multiple types of antibiotics. Ramanan Laxminarayan, an economist who runs the Center for Disease Dynamics, Economics & Policy, a public-health research organization in Washington DC, once told me “You have to think of it as a new disease which can’t be treated with any drugs that we have.”
However, I learned this week that a crucial definition of superbugs (and there is no real one, because it’s a term made up for non-scientists), is that they are made as a result of swapping genes that make them resistant to antibiotics. Some bacteria, like Sphingomonas koreensis, are just naturally immune to a lot of antibiotics, and don’t aid in the problem of growing drug resistance. They’re still nasty, though.
The procedure to cure intractable epilepsy has a dark history.
Found while reading Beneath the Skin.
The thing about being a human is that we think we’re in charge of ourselves, but that’s not totally true. On a conscious level, we may be able to decide what we want to do with our bodies. But subconsciously, we’re on a team with our organs. When everyone’s pulling their weight, we feel great. But when one player is struggling, our whole lives go out of whack, sometimes in horrible ways.
Beneath the Skin is a collection of essays by some of the world’s best writers about each of these players. The liver, the skin, the kidneys. (It was originally a radio series called “Body of Essays” but I suppose that was too cliche for the book title.) Some of them are better than others, but the one I liked the most had to do with the history of anterior temporal lobectomy—that awesome surgery I wrote about in my Thanksgiving edition this year that is used to treat patients with temporal lobe epilepsy.
The origins of anterior temporal lobectomy, or ATLs, is actually from lobotomies, which you’ve almost surely heard of. Lobotomies were possibly some of the cruelest and most disastrous procedures in medicine. They involved lightly sedating (no anesthesia) a patient, and then cutting open her skull and chipping away at her frontal lobe with what writer Philip Kerr calls “an ice pick.” The instrument was probably a little more sophisticated than this, but not much. The first lobotomy was performed in 1935, and the lead surgeon, António Egas Moniz was awarded a Nobel Prize for Medicine 14 years later for finding “the therapeutic value of lobotomy for certain psychosis.”
Neurosurgeons were essentially flying blind and fast—some surgeons reportedly performed 25 in a single day (for context, an ATL today can take eight hours.) There were no CT or PET scans back then, so often these surgeries were lethal, or severely debilitating. That didn’t stop them from performing 20,000 lobotomies in the US over the next 16 years, Kerr writes. They were used to a number of conditions including:
schizophrenia
chronic headaches
migraines
post-partum depression
manic depression
PTSD. A bunch of WWII vets received lobotomies.
“mild behavioral disorders,” which was likely Rosemary Kennedy’s (JFK’s sister) diagnosis when she received one at the age of 23. She was reportedly rebellious, and her father ordered the procedure that left her with the mental capacities of a toddler. Another boy Kerr found received one for the similar reason that “his mother didn’t like him.”
Fortunately, the first drugs for mental illness were invented around the 50s, and although these were not perfect, they made lobotomies pretty much obsolete. However, imaging technology and surgical tools improved, as did neuroscience as a whole. Scientists kept with it, and eventually developed ATLs (technically high-tech lobotomies), which can help patients with temporal epilepsy 80% to 90% of the time.
Stuff I learned from others:
For all the bad stuff that happened this year, there were some major developments that improved the quality of life of people as a whole, from Elijah Wolfson for Quartz. As my colleague Akshat Rathi says, “it’s still the best time to be alive as a human.”
Streaming services are not doing right by artists at all, from Ephrat Livini for Quartz.
Physicians of color are good for medicine, according to economics. One of the best economics papers of 2018 (according to a prominent economist) showed that African American men were more likely to listen to African American doctors, from Dan Kopf, for Quartz. For what it’s worth, physicians I have spoken to for other projects have expressed this same sentiment, and in general I’d say more diversity in medicine is a good thing.
Animal of the week: Hippopotamuses. This year like every year, I wanted a hippopotamus for Christmas, but alas, another year has gone by and all I got were new running shoes. Again.
I’m kidding. I love running shoes, and I most definitely would be unable to care for a hippopotamus. They are MASSIVE. This week, the Cincinnati Zoo celebrated the fact that Fiona, a premature hippo, finally hit 1,000 pounds. As an adult, she could weigh up to 3,000 pounds.
Hippos are mammals with ever-growing canine teeth. Known to be aggressive, and in the wild the males solve disputes within groups by chomping at each other with their 20-inch teeth. They also secret this cool red mucous-like substance that keeps their skin nice and hydrated under the hot sun, and in protected in the water. Great animals to admire from afar.
Not Fiona, but a very good baby hippo.
Long read of the week: My colleague Alex Ossola went to Guam, and saw first hand the tensions that come when the US military is the entity in charge of the local ecology. She wrote about it for National Geographic.
Thanks for learning with me this year, friend, and I hope the new year brings you peace and delightful tidbits. This newsletter is a labor of love—it takes up a decent chunk of free time. If it’s been worth something to you this year, consider sending me a tip through my Venmo. If that’s something that doesn’t work for you, love on any internet platform of your choice is great, too.
That’s all for now. Stay curious, friend! <3
If you love Scrap Facts, consider sending it to a friend. Wanna keep in touch outside of this newsletter? Follow me on Twitter and Instagram. Top image by E. Y. Smith.