Word: wilderness
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...over the world are now living in Berlin and, some nights, they all seemed to end up on my living-room sofa," says Jeffrey Eugenides, the American Pulitzer Prize-winning novelist who lived in Berlin from 1999 to 2003 and goes back every summer. "It's a much wilder place than New York City. There are all kinds of trapdoors you can fall through. It's a bit dangerous, but estimable. The dinner conversation is always serious and never about real estate...
...been a similarly frustrating situation for Wilder. "All we can say to parents, at the moment, is that you shouldn't do unnecessary procedures on kids - but we knew that already," he says. (Read "The Year in Medicine 2008: From...
...decline" after coming out of anesthesia, the condition is not limited to elderly patients, and it could be the result of inflammation or other stress responses to major surgery, rather than the anesthetic.) The only research to associate surgical anesthesia in infancy to cognitive impairment later in life was Wilder's study earlier this year, but the literature on the whole in this area remains inconclusive. So far, the bulk of the evidence comes from studies in lab animals, rather than the human population. "The animal data is convincing," says Wilder. "But we need further studies...
...Every doctor interviewed for this article urged patients not to avoid necessary surgery or forgo required anesthesia. To understand the consequences of going without anesthesia, Wilder points to certain surgical trends in the 1960s. Believing that babies were still too underdeveloped to feel pain, many doctors at the time advocated only light anesthesia or none at all for infants undergoing surgery. "The morbidity and indeed mortality levels were much higher [in these babies]. The stress response to the pain of the surgery proved dangerous," Wilder explains. It is also important to remember how primitive surgical painkilling mechanisms were before...
...Several large population studies into anesthetics are now under way among both young children and elderly patients. Wilder anticipates that "we are about five years away from getting to the bottom of this." If anesthetics do prove to be neurotoxic, it could be a regulatory and ethical nightmare to decide how best to continue using them. For Xie's part, he thinks researchers must come up with alternative drugs for vulnerable patients if such a scenario unfolds. "Science doesn't always tell us what we want to hear. If certain drugs are dangerous to use, then we should...