It's not often that "breaking news" and neuroscience are linked. Health (with a capital "H"), healthcare reform and costs, and a variety of diseases appear almost daily in the news. For example, reports related to novel influenza H1N1, the availability-or not-of vaccines to prevent it and its unusual prevalence and mortality among young adults, have dominated print and electronic media since this time last year. Congressional and public debate about the possible "reform" of the U.S. healthcare system swirl endlessly in print, on local and national television, and on social-networking Web venues (President Obama "tweets" about healthcare reform regularly). We have also witnessed a very public media debate related to the revised guidelines for mammography screening for breast cancer.
Less visible, but perhaps equally important, are the local and national news stories and reports written regularly about neurologic disorders. These provide us, as neuroscience nurses, with a platform for patient and family education, with a means of supporting strategies to prevent potential neurologic disease and injury and with a public face for the care we provide for patients who are already affected by neurologic disorders. In addition, some of these reports challenge our patients' and our own long-held beliefs about neuroscience.
In October of last year, Scientific American published an insightful article-"Turbocharging the Brain" (Stix, 2009)-about the use of cognitive enhancers. The author examines the use of neuroenhancers or smart drugs that improve attention, memory, and planning ability among college students (Ritalin and Adderal) and software developers (Provigil) as well as more widespread use of medications originally developed to maintain or improve cognition function in patients with dementia. The use of neuroenhancing drugs in individuals for whom they were not prescribed raises legal issues, concerns about the risks and benefits of the drugs, their side effects and addictive potential, and ethical issues related to fairness and coercion. As neuroscience nurses, we should also take part in this debate. We care for individuals who need, and benefit from, these drugs, but we are often intimately aware of the dangers inherent in their use. Again, we have an opportunity to teach.
The Chicago Tribune, in November of last year, ran a series of reports related to autism (Tsouderos & Callahan, 2009a, 2009b). As the number of children diagnosed with autism rises and parents search for answers and optimal care for their affected children, dubious medicine emerges as a challenge to all neuroscience professionals. Children are treated with hyperbaric oxygen, heavy metal chelating agents, gluten-restricted diets, high-dose vitamins, and testosterone among other "nontraditional" treatments. Although we understand the challenges families face in caring for and providing the best education for autistic children, we can serve them best by teaching what we know about pathophysiology and pharmacology, helping them access support services, and advocating for special education.
In late December, the National Football League (NFL) suspended its study of the long-term effects of concussions in retired players. The study, initiated in 2007, was part of the NFL's handling of players who experienced play-related concussion and its efforts to improve player safety. The study was suspended, not because it drew a straight line between repeated head injuries and long-term cognitive deficits in football players but because of harsh criticism about poor statistical sampling, conflicts of interest among the researchers, and "[horizontal ellipsis] conclusions drawn before the study was concluded" (Schwarz, 2009, p. B15). Suspension of the study sends a mixed message to the more than one million youngsters who play football; they, and their parents, may conclude that if the NFL doesn't see a significant risk of play-related head injury, neither should they. We should be shocked and dismayed by these reports; they provide us with an opportunity to teach prevention-we can teach young players and their families that any head injury is potentially serious. We can't assume "it's just a concussion" and recommend taking the afternoon off (the NFL's original treatment plan). We need to teach that cerebral dysfunction can persist for at least a month after injury and that injured players require careful monitoring and follow-up care.
Finally, on a more diagnostic note, The New York Times published a "Diagnosis" column (Sanders, 2009) in which the author speculated that, with Sherlock Holmes, Sir Arthur Conan Doyle may have created the first portrayal of an individual with Asperger's syndrome decades before Hans Asperger published his work. Holmes is direct to the point of rudeness; he has detailed knowledge of many kinds of strange phenomena; he exhibits what Asperger later called autistic intelligence. Perhaps most important, Holmes has difficulty understanding what others feel and how they think. All in all, it is a thought-provoking neuroscience mystery.
The "News" is with us everyday. We are caught up in the events of the world around us. Let's try to use it to support our work and our commitment to nursing excellence.
References