Israel reacts to election results

Posted on March 17, 2015 by Gideon Gil

Tweets (in English) about the Israeli election within 50 km of Tel Aviv

Truth Claim: The Measles Vaccine

Posted on March 10, 2015 by Gideon Gil

You have done everything you can to protect your child.

You breastfed her.

You put her in a car seat.

You insisted he wear a bike helmet.

You decided not to vaccinate your child against measles because of the risk of a serious side effect.

The US Centers for Disease Control says about 1 in 3,000 people suffer a seizure after getting the shot.

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That’s similar to the risk of developing breast cancer during pregnancy, according to the American Cancer Society – a chance millions of women accept annually.

Still, since measles is uncommon in the United States and the death rate is less than 1 in 1,000, many parents decide against vaccinating their children.

That seemed like a reasonable choice — until last December. That’s when someone with measles visited Disneyland, sparking an outbreak that has now stricken 142 people in seven states. Most were unvaccinated.

Measles is more infectious than even Ebola. And unlike Ebola, it can be spread by a child who looks perfectly healthy – no sneezing, no cough, no fever, no rash. The germ can survive in the air or on surfaces for up to two hours. A child could have been infected simply by getting on a Disneyland ride after the infected visitor.

One Disneyland ride, Peter Pan’s Flight, lasts 130 seconds. In two hours, at least 50 children could have ridden on the same car as the infected person and been exposed to measles.

The vaccine is the only way to protect your child against measles.

An evening in the ER

Posted on February 23, 2015 by Gideon Gil

“Tell me what happened that brought you in here,” the doctor says, eyeballing a thin young man consigned to a bed in the corridor of a Boston hospital’s emergency room.

He has a rare disease of his intestinal tract, the patient explains softly. The doctor leans in to hear him above the chatter of passing nurses. And he came in hoping for relief of rectal pain.

Back at the nurse’s station, the doctor shows me a warning entered in the patient’s electronic medical record: “DRUG-SEEKING BEHAVIOR,” it says. It cautions against giving him a heating pad because in the past, he has used one to elevate his temperature.

I had decided to visit the emergency room to see for myself what politicians and public health officials have called an alarming crisis – a surge in deaths caused by overdoses of heroin and prescription painkillers, which are collectively known as opioids. On Thursday, the administration of Massachusetts Governor Charlie Baker released data showing that overdose deaths from opioids increased by almost half in 2013 from the year before, to almost 20 a week.

Source: Mass. Department of Public Health (Data exclude suicides.)

A few weeks earlier, the ER I visited had treated six patients for opioid overdoses in a single Friday night shift. This is not that unusual: a federal report notes that ER visits related to misuse or abuse of opioid prescription drugs jumped 183 percent nationally between 2004 and 2011, to nearly half a million.

Source: US Substance Abuse and Mental Health Services Administration

During my evening at the ER, however, no overdose cases arrive. Patients are being treated for a stroke, a head injury suffered in a fall, shortness of breath, unexplained pelvic pain, unexplained malaise, an anxiety attack, a nose bleed. The count of patients in the waiting room, displayed prominently on screens at the nursing station, steadily ticks up, from 1 to 7. “Welcome to the jungle,” the chief resident says when we meet.

But doctors are vigilant for patients who might be inflating pain complaints to feed an addiction to opioid medication, such as the young man in the corridor, with a stubbly patch of beard on his chin.

He drew their suspicion because his description of the location of his pain changed; when he arrived, he had told the triage nurse it was in his abdomen. But his doctor is sympathetic. The patient has suffered a litany of medical problems, and pain can be ambiguous – there’s no blood test or scan to diagnose it. She is reluctant to deny medication to someone who is actually in severe pain. Still, she recounts the story of a past patient who complained of severe pain but then walked out of the ER when a scan showed nothing wrong and doctors wouldn’t give him Dilaudid.

The doctor digs further. From the medical records and conversations with the patient, she learns he has visited four other Boston emergency departments in the previous few days. Three apparently sent him on his way without providing treatment. But a fourth performed a scan, and though it revealed no serious problem, gave him a prescription for an opioid pain reliever. That was only a few hours ago.

Next, his doctor enters his name into a state database, called the Prescription Monitoring Program. It lists all prescriptions filled by pharmacies in Massachusetts and can be used to spot patients who have a history of apparent doctor-shopping – obtaining narcotics from multiple doctors in a short period of time. In 2013, the program flagged more than 10,000 people as “individuals with activity of concern.” Nearly three-quarters of a million residents received an opioid prescription that year — 11 percent of the state’s population.

All physicians are supposed to check the list whenever they are prescribing narcotics to a patient for the first time. But only two-thirds of doctors are enrolled in the program, and even those don’t always comply, citing the time it takes.

The ER doctor has forgotten her password and searches her e-mail to find it. But in little more than a minute, the prescription data on her patient fills the computer screen:

In the past 12 months, he had obtained more than 20 prescriptions for narcotics from 10 doctors.

There is now no question he is attempting to feed an addiction.

What to do now? “You never want to blame,” the doctor says to me. “He’s just had the bad luck of having lots of illnesses.”

She pages a hospital social worker, but doesn’t hear back. She goes to see the patient, who has now been given a room in the ER. She tells him she can’t give him any medication, but offers to make him an appointment with the surgeon who operated on his intestines at another hospital. Worried he won’t keep the appointment, she calls one of the patient’s friends. There’s no answer.

He asks for a heating pad.

Gideon’s Media Diary

Posted on February 17, 2015 by Gideon Gil

I”was”shoveling”another”foot”of”snow”off”my”driveway”Sunday”morning”when”a” passing”car”slowed”to”a crawl.”Suddenly,”two”objects,”flung”from”the”driver’s”side” window, arced”high”over”the”car’s”roof like”Kareem”Abdul”Jabbar”hook”shots. The”Boston”Globe”and”New”York”Times”had”arrived.”In”print. Despite”the”blizzard. I”was”so”overjoyed,”I”highHfived”Waldemar,”the”delivery”driver.” Sunday”is”the”one”day”of”the”week”that I”am”still”able”to”enjoy”the”ritual”of”reading” newspapers,”unadulterated”by”apps,”social”media,”and”other”digitalHage”johnnysH comeHlately. Keeping”a”media”diary revealed”to”me”how”much”my”media” consumption”habits”have”changed”the”rest”of”the”week.”While”I”still”rely”heavily”on” newspapers”for”my”news”those”other”mornings”– both”in”print”and”online”– I”multiH task”over”breakfast,”clicking”on”links”delivered”via”Twitter”and”daily”eHmail” newsletters,”and”tweeting”and”retweeting”stories”that”interest”me.”I”consume”more” news”during”my”commute”– NPR”and”the”BBC”over”the”car”radio,”Twitter,”Facebook, and”eHmail”while”riding”the”bus”or”T.” Perhaps”the”biggest”change,”though,”is”that”I”already”know”many”of”the”morning” headlines”the”night”before,”thanks”to”newspaper”websites,”breaking”news”alerts”on” my”phone,”and”social”media.”So”in”the”morning,”I”look”for”context”and”explanatory” stories. Times”Media”Critic”David”Carr’s”untimely”death”was”a”case”in”point: I”got”the”news”from”an alert”sent”to”my”phone”Thursday”night”by”the”Times.”I” immediately”opened”the”NYT”Now”app”to”read”the”short”item”posted”there.”During” the”evening,”I”checked”Twitter”periodically”and”followed”the”torrent”of”140H character”tributes.”Before”bed,”I”read”the”full”obit”on”the NYT”website. On”Saturday” morning,”I”read”two”Globe”stories”in”print,”an”interview”with”Carr”just”before”his” death”and”a”story”about”his”first”semester”teaching”at”BU.”Finally,”I”read”The”Media” Equation”column”in”Monday’s”Times”(again”in”print),”Carr’s”old”column,”which”also” focused”on”his”teaching. This”exercise”also”showed”me”that”I”still”get”most”of”my”information”from”words,” written”or”spoken.”The”main”exception”this”week:”maps”showing”expected”snowfall.” I”watched”only”one”video”–”of”my”nephew”and”his”cat”playing”the”piano.”” Here is a breakdown of my media consumption:

Future of News and Participatory Media

Treating newsgathering as an engineering problem… since 2012!

Author Archives: Gideon Gil

Israel reacts to election results

Truth Claim: The Measles Vaccine

An evening in the ER

Gideon’s Media Diary