Context, Connections, and Community
The Early Years
As any parent could tell you, one of the benefits of spending time with toddlers is that everything is new to them; seeing the world through their eyes can change one’s perspective, bringing new understanding. From newborns deprived of their parents’ touch to an 8-year-old feeling shame and guilt over her newly diagnosed diabetes, the children in these essays — along with their parents and physicians — may help readers view health and medicine through fresh eyes.
- Blame July 2, 2020 | E. Gay A sliver of light interrupts the dark and marks this room as foreign. In this hospital bed, I listen to voices that are too loud for nighttime. This room, this night, this hospital bed, feel like a punishment. The crime is clear to me: I have eaten too much sugar on Halloween.
- When All You Have Is Quality of Life October 15, 2020 | M.C. Halley The uncertainty underlying medical decisions and their effects on quality of life loom large in the context of undiagnosed disease. Indeed, in making decisions for a child with such a disease, quality of life may be a parent’s only compass.
- Peak Moments October 21, 2021 | S.D. Mallett As the new school year approaches, an immunocompromised mother faces a different risk–benefit calculus from most moms in sending her son off to kindergarten during a pandemic. But having saved up her “risk dollars,” she is ready to spend some on a return to normalcy.
- Losing Touch May 6, 2021 | K. Wu In providing surrogate incubators for babies who were born too soon, we in the NICU place painful restrictions on the most basic of human relationships, the one between parents and their child, as medical demands require parents and baby to lose touch with one another.
- The Surgeon and the Mother January 28, 2021 | H. Carmichael I did not get to hold you for the first 3 weeks of your life. I knew this would happen. I was the surgeon, and I was prepared. But slowly, over those first weeks, my surgical armor shifted, slipped, cracked, as you gradually opened your eyes and claimed me as your own.
- N Engl J Med 2022; 387:767-770
The cyberthreat to health care has never been greater. Fortunately, clinicians can protect themselves and their patients from the worst of these attacks, in part by means of precautions and preparation.
- N Engl J Med 2022; 387:770-772
State fertility-fraud laws prohibit deliberately misrepresenting the source of sperm, eggs, or embryos used to treat infertility. Such legislation could herald an expansion of informed-consent doctrine.
- N Engl J Med 2022; 387:772-774
The risks associated with alcohol consumption are well documented. Requiring new, well-designed warning labels on alcohol containers could provide information to consumers and reduce harm.
- N Engl J Med 2022; 387:775-777
For patients with rare diseases, connecting virtually with specialists across state lines can be the only option for excellent care. So why are state-licensing restrictions being enforced more aggressively than ever?
- PerspectiveAug 31, 202210.1056/NEJMp2211311
Intradermal JYNNEOS may safely provide populations that have been disproportionately affected by monkeypox with rapid access to a limited resource without sacrificing the level of immune response achieved.
- N Engl J Med 2022; 387:672-675
For the one in nine hospitalized U.S. adults who have SUD, hospital-based addiction care has critical health benefits. But most hospitals don’t offer such care.
- PerspectiveAug 24, 202210.1056/NEJMp2210192
When state laws banning abortion directly and immediately threaten the health of patients, should physicians collectively disobey them?
- N Engl J Med 2022; 387:579-581
Tecovirimat might speed resolution of monkeypox illness and improve outcomes, but how can we manage compassionate access to a drug whose safety and efficacy in humans have not been established?
- N Engl J Med 2022; 387:581-583
The long-term physical, mental, and social sequelae of traumatic injuries are substantial and have often been neglected. This burden is especially high among members of marginalized populations.
- N Engl J Med 2022; 387:577-579
Health worker burnout, exacerbated by Covid-19, is not only about long hours. It’s about the fundamental disconnect between health workers and the mission to serve that motivates them.
- N Engl J Med 2022; 387:584-585
For professionals who work with children and adolescents, policies like Florida’s “Don’t Say Gay” law have outsized cruelty — even beyond the enormous harm they will do to the young people we serve.
- N Engl J Med 2022; 387:491-493
A shortage of contrast material has made weighing value an urgent aspect of imaging decisions and provided a stark example of the consequences of low-value imaging for public health and health equity.
- N Engl J Med 2022; 387:486-488
Recent developments in health care delivery pose challenges for noncompete agreements. Practices should recognize the changing legal landscape and adjust their employment contracts accordingly.
- N Engl J Med 2022; 387:488-491
Many children born with sickle-cell disease in sub-Saharan Africa will die before their fifth birthday. Opportunities exist to expand the distribution, use, and oversight of effective medication.
- N Engl J Med 2022; 387:481-483
Explicitly including race or ethnicity as a factor in government allocation of resources raises legal concerns. Litigation related to Covid-19 treatment guidance in New York highlights these issues.
Understanding Covid Vaccine Efficacy over Time — Bridging a Gap Between Public Health and Health CareN Engl J Med 2022; 387:483-485
It’s now feasible to track, for each patient seen at a health care facility, which Covid-19 vaccine they received when and what their clinical evaluation revealed.
- N Engl J Med 2022; 387:390-393
After Dobbs, Americans may find themselves in a society where many aspects of basic health care are threatened and the law tries to turn clinicians into adversaries of their patients.