Doctor’s Orders: Don’t Stay Alone in a Hospital

Question: How can a person be a better patient?

Atul Gawande: It's a good question, because I think it is -- there are two things about it. Number one is there's no straightforward recipe. But there are things that we recognize we can do. I think number one is to understand that making the system work well is something that we're only starting to grapple with. Medicine has been about parts; it's been about having a great drug, a great doctor. It has only in the last few years started to become about making all of that fit together as well as possible. And the most important role, I think, that patients play is, they're the only ones that see when things are falling through the cracks. You see one specialist and then another specialist, but they don't talk to each other, and what they're telling you doesn't make sense or fit together. A third of patients by the end of their life have 10 or more specialists in their care. And we're not very good at knitting all of that together.

And so I think the most important part the patient plays is not being passive about their part on the team. They are -- we're not great at drawing out the patient; we've wanted the patient to be passive and not so involved, just do what we say. But the more we have different people involved, what we tell people is contradictory. It doesn't always help them the way it should. And as we get our act together, I think what we're learning is, the patients play a key role.

Question: How can family members help?

Atul Gawande : One thing that I tell people is, if you have a sick family member, don't leave them alone in the hospital. Even when there are visiting hours where you're supposed to go home, I'll tell people, find any way you can to stay anyway, because when you're sick is the last moment when, as a patient, you're able to fend for yourself.

And the family member is often the person, as shifts change and different people come and go, who will be the ones to convey, you know, my dad actually seems sicker than he did yesterday. You'll be surprised about the extent to which just having those kinds of eyes and ears are missing with the slew of people coming and going. So I know it can be unnerving. It's sort of like when the effort to trap terrorists falls through, and the passenger has to be the one to tackle the terrorist trying to light the bomb on the plane. In a certain sense, for an extremely complex system of care to work well, we all have to be part of the equation. We in medicine have to be willing to hear from patients who have challenges. We sometimes have to be willing to push back and say, actually on that one, here's the reason why we're doing it this way. But it's becoming a group effort in order to get things right.

If you’re a hospital patient, advises surgeon Atul Gawande, make sure a family member is always with you.

China's "artificial sun" sets new record for fusion power

China has reached a new record for nuclear fusion at 120 million degrees Celsius.

Credit: STR via Getty Images
Technology & Innovation

This article was originally published on our sister site, Freethink.

China wants to build a mini-star on Earth and house it in a reactor. Many teams across the globe have this same bold goal --- which would create unlimited clean energy via nuclear fusion.

But according to Chinese state media, New Atlas reports, the team at the Experimental Advanced Superconducting Tokamak (EAST) has set a new world record: temperatures of 120 million degrees Celsius for 101 seconds.

Yeah, that's hot. So what? Nuclear fusion reactions require an insane amount of heat and pressure --- a temperature environment similar to the sun, which is approximately 150 million degrees C.

If scientists can essentially build a sun on Earth, they can create endless energy by mimicking how the sun does it.

If scientists can essentially build a sun on Earth, they can create endless energy by mimicking how the sun does it. In nuclear fusion, the extreme heat and pressure create a plasma. Then, within that plasma, two or more hydrogen nuclei crash together, merge into a heavier atom, and release a ton of energy in the process.

Nuclear fusion milestones: The team at EAST built a giant metal torus (similar in shape to a giant donut) with a series of magnetic coils. The coils hold hot plasma where the reactions occur. They've reached many milestones along the way.

According to New Atlas, in 2016, the scientists at EAST could heat hydrogen plasma to roughly 50 million degrees C for 102 seconds. Two years later, they reached 100 million degrees for 10 seconds.

The temperatures are impressive, but the short reaction times, and lack of pressure are another obstacle. Fusion is simple for the sun, because stars are massive and gravity provides even pressure all over the surface. The pressure squeezes hydrogen gas in the sun's core so immensely that several nuclei combine to form one atom, releasing energy.

But on Earth, we have to supply all of the pressure to keep the reaction going, and it has to be perfectly even. It's hard to do this for any length of time, and it uses a ton of energy. So the reactions usually fizzle out in minutes or seconds.

Still, the latest record of 120 million degrees and 101 seconds is one more step toward sustaining longer and hotter reactions.

Why does this matter? No one denies that humankind needs a clean, unlimited source of energy.

We all recognize that oil and gas are limited resources. But even wind and solar power --- renewable energies --- are fundamentally limited. They are dependent upon a breezy day or a cloudless sky, which we can't always count on.

Nuclear fusion is clean, safe, and environmentally sustainable --- its fuel is a nearly limitless resource since it is simply hydrogen (which can be easily made from water).

With each new milestone, we are creeping closer and closer to a breakthrough for unlimited, clean energy.

The science of sex, love, attraction, and obsession

The symbol for love is the heart, but the brain may be more accurate.

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Golden blood: The rarest blood in the world

We explore the history of blood types and how they are classified to find out what makes the Rh-null type important to science and dangerous for those who live with it.

Abid Katib/Getty Images
Surprising Science
  • Fewer than 50 people worldwide have 'golden blood' — or Rh-null.
  • Blood is considered Rh-null if it lacks all of the 61 possible antigens in the Rh system.
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There never was a male fertility crisis

A new study suggests that reports of the impending infertility of the human male are greatly exaggerated.

Sex & Relationships
  • A new review of a famous study on declining sperm counts finds several flaws.
  • The old report makes unfounded assumptions, has faulty data, and tends toward panic.
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