Some physicians in South Korea are working to understand the differences in healthcare across the DMZ and health issues North Korean defectors face, in preparation for eventual reunification — not easy when the medical tools Northern Korean physicians have are so drastically outdated and when support for reunification is dropping in the South. At Undark, Sara Talpos talks to the doctors trying to bridge these gaps.
The practice of medicine is sharply different in the two countries. In North Korea, the focus is on infectious disease and physical trauma, often caused by coal-mining injuries. Doctors learn only the basics of other diseases because specialized medicines and equipment — chemotherapy for cancer, for example — simply aren’t available.
Ko laughs when I tell him I’ve heard North Korean X-ray images are so poor that a South Korean doctor wouldn’t be able to understand them. “Yes, that’s true,” he says, sipping a cup of coffee. We’re meeting at Steff Hotdog, a fast-food restaurant located, somewhat improbably, inside Anam Hospital. “That’s because they don’t have X-ray film.” Instead, the doctor takes the patient into a dark room, where the patient stands between the X-ray machine and a translucent screen. Ko borrows my pen to illustrate. His doctor sits hunched over on a stool like Rodin’s “The Thinker.”
In the 2000 film Unbreakable, we’re introduced to two characters at opposite ends of a spectrum: an extremely frail man with a brittle bone disease played by Samuel L. Jackson, and a man with superhuman levels of strength and invulnerability played by Bruce Willis.
“However unreal it may seem, we are connected, you and I,” Jackson’s character tells Willis’. “We’re on the same curve, just on opposite ends.”
In a recent issue of Wired reporter Erika Hayasaki introduced us to another set of people on the opposite ends of a spectrum.
Steven Pete has a rare neurological condition that makes him unable to feel pain.
Pete pauses for a moment and recalls a white Washington day a few years ago. “We had thick snow, and we went inner-tubing down a hill. Well, I did a scorpion, where you take a running start and jump on the tube. You’re supposed to land on your stomach, but I hit it at the wrong angle. I face-planted on the hill, and my back legs just went straight up over my head.” Pete got up and returned to tubing, and for the next eight months he went on as usual, until he started noticing the movement in his left arm and shoulder felt off. His back felt funny too. He ended up getting an MRI. “The doctor looked at my MRI results, and he was like, ‘Have you been in a car accident? About six months ago? Were you skydiving?’ ”
“I haven’t done either,” Pete replied.
The doctor stared at his patient in disbelief. “You’ve got three fractured vertebrae.” Pete had broken his back.
Pam Costa has the opposite neurological condition — she feels pain constantly, as if her body is on fire.
Because the inflammation is exacerbated by physical contact, stress, and even the smallest elevation in surrounding temperature, Costa lives her life with great care. She wears loose-fitting clothes because fabric feels like a blowtorch against her skin. She sleeps with chilled pillows because the slightest heat makes her limbs feel like they are crackling. “Have you ever been out in the bitter, bitter cold, where your feet were ice?” she asks me. “Almost frostbite? Then you warm them up and it burns? That burning sensation: That is what it feels like all the time.”
Pete and Costa are also connected, sharing a genetic link that has helped scientists understand why we experience pain and how to treat it.
At Seattle Met, James Ross Gardner reports on the surprising social arrangements and habits of crows, who recognize and remember individual people and hold funerals to honor their dead — a phenomenon that is helping scientists like Kaeli Swift understand how intelligent creatures process death. Feed a crow and she will gift you with keys and candy as tokens of her appreciation. Treat her poorly and she and her corvid compatriots may mob you on sight.
But what if I were to tell you that the crows you spy in your yard are almost always the same individual crows? That those birds—usually two, a male and a female known as a territorial pair—don’t live there but fly in every day from 20 miles away? During the day urban crows rummage and build nests in a specific spot, in a specific neighborhood, then decamp for the evening to a massive, crowded roost outside the city—their own crow planet— and report back to the neighborhoods each morning. Like you, they commute to work.
At my house, we’d noticed the lack of bees this spring, but we’d chalked it up to the late arrival of warm weather and a rainier-than-usual season. Turns out our anecdotal data gathering isn’t entirely off — there are fewer bugs. Of all kinds.
Entomologists call it the windshield phenomenon. “If you talk to people, they have a gut feeling. They remember how insects used to smash on your windscreen,” says Wolfgang Wägele, director of the Leibniz Institute for Animal Biodiversity in Bonn, Germany. Today, drivers spend less time scraping and scrubbing. “I’m a very data-driven person,” says Scott Black, executive director of the Xerces Society for Invertebrate Conservation in Portland, Oregon. “But it is a visceral reaction when you realize you don’t see that mess anymore.”
Some people argue that cars today are more aerodynamic and therefore less deadly to insects. But Black says his pride and joy as a teenager in Nebraska was his 1969 Ford Mustang Mach 1—with some pretty sleek lines. “I used to have to wash my car all the time. It was always covered with insects.” Lately, Martin Sorg, an entomologist here, has seen the opposite: “I drive a Land Rover, with the aerodynamics of a refrigerator, and these days it stays clean.”
Though observations about splattered bugs aren’t scientific, few reliable data exist on the fate of important insect species. Scientists have tracked alarming declines in domesticated honey bees, monarch butterflies, and lightning bugs. But few have paid attention to the moths, hover flies, beetles, and countless other insects that buzz and flitter through the warm months. “We have a pretty good track record of ignoring most noncharismatic species,” which most insects are, says Joe Nocera, an ecologist at the University of New Brunswick in Canada.
What exactly does a bullet do to flesh as it careens through the body? At Highline, Jason Fagone profiles Philadelphia trauma surgeon Dr. Amy Goldberg, a woman on the front lines of gun violence as she attempts to repair the broken bodies that arrive daily at Temple University Hospital. Dr. Goldberg doesn’t only fix the damage, she’s also working to prevent it. After a patient died the third time he was shot, she worked with friend and coworker Scott Charles to create a social program, Turning Point, which has been instrumental in stopping gun violence before it starts.
More than 30,000 people die of gunshot wounds each year in America, around 75,000 more are injured, and we have no visceral sense of what physically happens inside a person when he’s shot. (Dr. Amy) Goldberg does.
“The creation of a person, you know. It’s the heart beating and the lungs bringing air. It is so miraculous.” Surgery, for Goldberg, was a way of honoring the miracle. And trauma surgery was the ultimate form of appreciation, because a surgeon in trauma experienced so much variety. She might be operating on the carotid artery in the neck, or the heart in the chest, or the large bowel or small bowel in the abdomen, or the femoral artery in the thigh, at any given moment, on any given night.
“As a country,” Goldberg said, “we lost our teachable moment.” She started talking about the 2012 murder of 20 schoolchildren and six adults at Sandy Hook Elementary School. Goldberg said that if people had been shown the autopsy photos of the kids, the gun debate would have been transformed. “The fact that not a single one of those kids was able to be transported to a hospital, tells me that they were not just dead, but really really really really dead. Ten-year-old kids, riddled with bullets, dead as doornails.”
Christian H. Cooper made his way from Appalachia to Wall Street, and from poverty to wealth. But is it because he worked harder than the family and friends still struggling in East Tennessee, or was it luck? In Nautilus, he digs into the emerging science of epigenetics to look at the way poverty actually changes our genetic expression, and therefore our physiology. If poverty has treatable physical aspects, what does that mean for economic policy, social policy, and politics? What does it mean for the American ideal of meritocracy?
Now, new evidence is emerging suggesting the changes can go even deeper—to how our bodies assemble themselves, shifting the types of cells that they are made from, and maybe even how our genetic code is expressed, playing with it like a Rubik’s cube thrown into a running washing machine. If this science holds up, it means that poverty is more than just a socioeconomic condition. It is a collection of related symptoms that are preventable, treatable—and even inheritable. In other words, the effects of poverty begin to look very much like the symptoms of a disease.
That word—disease—carries a stigma with it. By using it here, I don’t mean that the poor are (that I am) inferior or compromised. I mean that the poor are afflicted, and told by the rest of the world that their condition is a necessary, temporary, and even positive part of modern capitalism. We tell the poor that they have the chance to escape if they just work hard enough; that we are all equally invested in a system that doles out rewards and punishments in equal measure. We point at the rare rags-to-riches stories like my own, which seem to play into the standard meritocracy template.
Last Friday, I had the once-in-a-gosh-darn-lifetime opportunity to see Bill Nye—yes, the Science Guy himself—in a darkened auditorium of 1,200 people fist-pumping to his theme song and cheering for facts. He spent a significant chunk of the evening discussing climate change denial, the connection between climate change and terrorism, Donald Trump’s plan to slash funding for scientific organizations and initiatives, and the viability of Solutions Project.
“Article I, Section 8 of the Constitution makes reference to the progress of science and the useful arts,” Nye said. “It doesn’t say for the repression of science. It doesn’t say ignoring the facts discovered by the means of science.” He’s optimistic about our future and disturbed by what he call’s the United States’ “can’t-do attitude.” His number one piece of advice for advocating for climate change awareness? “Talk about it.” So that’s what I’m doing in this week’s reading list.
Author and activist Rebecca Solnit urges us to commit to love and hope, not despair, in spite of our terrifying present:
“You have to be willing to imagine a world in which we recognize that what we’re called upon to do is not necessarily to sacrifice; instead, it’s often to abandon what impoverishes and trivializes our lives: the frenzy to produce and consume in a landscape of insecurity about our individual and collective futures.”
Ten Gulfstream jets, outfitted with special engines that allow them to fly safely around the stratosphere at an altitude of 70,000 feet, take off from a runway near the Equator. Their cargo includes thousands of pounds of a chemical compound — liquid sulfur, let’s suppose—that can be sprayed as a gas from the aircraft. It is not a one-time event; the flights take place throughout the year, dispersing a load that amounts to 25,000 tons. If things go right, the gas converts to an aerosol of particles that remain aloft and scatter sunlight for two years. The payoff? A slowing of the earth’s warming—for as long as the Gulfstream flights continue.
Solar geoengineering used to be akin to fringe science, perceived as weird or dangerous. David Keith, head of Harvard University’s Solar Geoengineering Research Program, remains cautiously optimistic about the potential of this fascinating field.
David Goodrich, former Director of the United National Global Climate Observing System, is the author of A Hole in the Wind: A Climate Scientist’s Bicycle Journey Across the United States. This excerpt tracks Goodrich’s trek out West, observing increased wildfires, for which “climate change is the background music.”
“Fuck inclusivity. If people who have had their land stolen from them and people who were stolen from their lands are not considered key in the economic management of their own environments, then solutions to their specific climate struggles will not be effective; they won’t address the problems at their roots. And when it comes to disaster preparedness for Black and brown people in coastal regions, staying alive is a matter of knowing their roots.”
That’s not how all hunters approach climate change. Randy Newberg, a hunter and advocate for hunting on public lands, has no qualms about acknowledging the problem. “If you spend as much time in the hills as I do, I don’t know how you could deny that climate is changing,” he says. Deniers exist, “but honestly, I call them the flat-Earth society,” he adds. Many hunters see climate change as a serious threat to the wildlife and public lands they want to protect for future generations. That’s what’s been driving the conservation movement for decades in the US, and it should not be a liberal or a conservative issues, says Newberg, who identifies as an Independent. “Maybe I’m naive and too idealistic for today’s political world,” he says, “but I struggle to understand how is it that clean air and clean water and productive lands are a partisan issue. To me, they’re an American issue.”
For now, the White House hasn’t been very responsive, but it might be just too early to tell, says Bozmoski. Some proposals coming out of Washington — like the carbon tax and the climate change resolution — seem to bode well. “It really stokes our optimism on the Eco Right, that our family has gotten bigger and more powerful,” Bozmoski says. At the same time, he says, it will take time for Republicans to come together and put forward a climate change policy — they will need to get over the divisions within their own party and develop an actual policy. That’s what groups like republicEn are there for, Bozmoski says. And he has high hopes. “The prospects for a coalition of lawmakers moving forward with a solution is better now than it has been in any point since 2010,” Bozmoski says. “There’s no more pussyfooting around climate change out of fear.”
His latest book, New York 2140, takes place not at the moment of catastrophe—in the year 2100, sea levels rise and flood New York so that a majority of the city is 50 feet underwater—but 40 years later, as most city-dwellers do what they’ve always done, and simply gotten along with it. At New York Magazine, Robinson talks with Jake Swearingen about why he made a novel about climate change with a positive outlook.
I was expecting this very dystopian, grim novel. But it’s remarkably cheerful! It’s like one of Dickens’s happier novels, or Les Misérables where it’s this exploration of a city from the sewer system up, through all these different characters. I thought of the book eventually as a comedy of coping, and to do that I picked a time, or perhaps 40 years after the disaster itself. If it was set in the midst of the catastrophic flood in 2100, the disaster would have dominated that work. It would not have been the comedy of coping — it would have been the disaster of refugee creation.
But I think, at some point, science fiction has to imagine the people who come after, when the situation will be natural, whatever it is. If that natural situation that they’re coping with is that new part of Manhattan that resembles Venice, there will be good parts to that as well as bad parts. There will be beautiful parts as well as moldy, horrible parts. So I wanted to convey that as part of the vibe of this novel.
Dr. Kodi Azari has traveled the U.S. as a lead surgeon in five hand transplants. Hand transplant recipients have usually lost their hands before surgery, but Azari laid the groundwork for a new kind of procedure:
The doctor had some hypotheses he wanted to test, provided he could find a patient with the ideal requirements: excellent health, enormous self-discipline, a positive attitude, and—rarest of all—a limb that needed to be replaced but had not yet been amputated.
Azari knew he was hoping for a long shot. Most hand transplant candidates have been injured in accidents or in battle, when a catastrophic event forces an emergency amputation. These procedures are aimed at minimizing suffering and are usually carried out to facilitate future prosthetic use. Generally that means the arm is severed closer to the elbow than the wrist, and the nerves and tendons are trimmed back and tucked inward to lessen discomfort. That creates challenges, however, if a transplant is attempted later. All those tucked-in nerves and tendons tend to merge over time into a jumble of tissues that is difficult to connect to a new hand with precision.
Wouldn’t it be great, Azari thought, if a transplant recipient’s arm could be amputated in a way that prepped it specifically to receive a new limb? How much more quickly would a patient recover if each tendon, nerve, artery, and vein were left in place and marked—labeled, like so many colored speaker wires, to be hooked up to a matching apparatus? How much more functionality would the patient gain, and how rapidly would he or she gain it? Azari believed this fantasy patient would awaken post-op, look at the new hand, and be able to move the fingers right away.
Azari found the ideal patient in Jonathan Koch, a television executive who experienced full-blown septic shock and needed several limbs amputated. Amy Wallace tells his story in Los Angeles Magazine.