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Finding joy in the PICU at Christmas

December 24, 2023
Editor, First Opinion

I'm a weeper. I cry at movies and TV shows, at books, when I'm frustrated and when I'm angry and when I'm sad — and, sometimes, when I edit First Opinion essays.

And I cried at least twice while editing Maria Kefalas' gorgeous piece on her daughter Cal, who often found herself in the pediatric intensive care unit around Christmas because of a rare degenerative disorder called leukodystrophy. "For families like mine, the PICU can be a respite, especially during Christmas," she writes. "The nurses decorate the floors in an effort to make a place filled with monitors, ventilators, and hospital beds festive. No one believes in Santa in the PICU, but the nurses and doctors try to pretend magic and miracles are real. These efforts might seem futile, but the patients and their parents indulge this." Maria's touching essay celebrates Cal and everyone who helped her at the Children's Hospital of Philadelphia: the volunteers, the custodians, the doctors, the child life specialists, the therapy dogs. It's well worth the read, but be sure to have a tissue nearby.

Also in First Opinion this week: Ezekiel J. Emanuel has an answer to a question that has puzzled many: Why aren't health care costs rising faster than inflation? Addiction medicine physician Cara Poland, who lost her brother to suicide after his struggle with alcoholism, argues that raising the federal excise tax on alcohol would save lives. The Census option "some other race," selected by almost 50 million Americans in 2020, is a public health crisis. Pepper Bio CEO Jon Hu argues that patient advocacy needs to be redirected. And on the final episode of this season of the "First Opinion Podcast," I spoke with De-Shaine Murray about his recent essay on racism in neuroscience, past, present, and future.

Recommendation of the week: I love medical historical fiction, and Audrey Blake's "The Girl in His Shadow" really scratches that itch. It's the story of an orphan raised by an eccentric physician in mid-19th century London, where she develops medical skills that alarm the establishment. Oh, and there's a bit of romance, too. I also devoured the sequel, "The Surgeon's Daughter."

Last week I asked for some favorite life science-related books, movies, podcasts, and TV shows. I didn't get quite enough recommendations to make the newsletter, which I'll chalk up to end-of-year-itis. But if you have something worth sharing with the rest of the class, please post it on STAT+ Connect, our subscriber-only platform, where you can also find my colleague Adam Feuerstein's favorite books of the year.)

The First Opinion newsletter will be taking next Sunday off. Have a very happy new year.

Cal smiles on her 8th birthday, just before Christmas, after being extubated.
Courtesy Maria Kefalas

The unique pain and joy of celebrating Christmas with a child in the pediatric intensive care unit

For families like mine, the pediatric intensive care unit can be something of a respite, especially during Christmas.

By Maria Kefalas


Why haven't health care cost increases exceeded inflation? There's a very good reason

Since 2010, the mindset of American physicians has changed, from ignoring costs to trying to cut them. It's working.

By Ezekiel J. Emanuel


The U.S. must raise federal alcohol taxes to address the alarming rise in alcohol use

Research shows that raising federal excise taxes on alcohol can deter alcohol use while also funding treatment programs.

By Cara Poland



Racism infects neuroscience's past and present. What about its future?

Neuroscience has a long history of racism. Neurotechnologist De-Shaine Murray doesn't want that to be its future, too.

By Torie Bosch


There's a public health crisis lurking in our data: the Census option 'some other race'

Nearly 50 million people in the 2020 Census chose "some other race." That imprecise data is hurting public health.

By Juan Carlos Gonzalez Jr.


Alzheimer's drug approvals show we need a reevaluation of patient advocacy

The structure of patient advocacy groups and the haphazard manner in which they wield their immense power can get in the way of good science.

By Jon Hu


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