May 28, 2017

No Image

Sports May 28, 2017

From NFL Player To Neurosurgeon: 'Why Can't I Do Both?'

Myron Rolle talks about his long journey from playing football at Florida State University and joining the NFL to going to Harvard medical school to start his residency in neurosurgery.

MICHEL MARTIN, HOST:

We will soon crown the latest NBA champion and in honor of that, we’ll continue our series of conversations Across the Generations with father and son ballers Rick and Canyon Barry. They’ll tell you why they tune out the haters and remain true to the underhand free throw. That’s coming up.

But first football and the brain. And when I said that I bet your mind went to all the recent stories about brain trauma and America’s most watched sport. But I’m actually talking about a former NFL player who is now training to become a neurosurgeon. Myron Rolle played at Florida State then after taking a brief detour to enjoy his Rhodes scholarship, he played for the Tennessee Titans and Pittsburgh Steelers.

Last week, though, he graduated from Florida State University’s College of Medicine. And next month, he will head to Harvard Medical School to start his residency in neurosurgery. And Dr. Myron Rolle is with us now from Orlando, Fla. Dr. Rolle, welcome. Congratulations to you.

MYRON ROLLE: Thank you very much for having me.

MARTIN: Now, you know I have to ask you when you were growing up when you were a little boy what did you want to be?

ROLLE: I actually wanted to be a neurosurgeon, believe it or not. I – also a football player, but my brother Marchant gave me this book, “Gifted Hands” by Ben Carson and put him in front of my face as somebody who looked like me, came from a similar background as me.

And as I got older, I started to learn more about neurosurgery, the brain and how it functions. And it just piqued my interest even more. And I’m glad that I am starting this journey soon and going to join the likes of someone like Dr. Carson.

MARTIN: You know, it’s funny because a lot of kids if you ask them they say – well, what do you want to be when they grow up? They’ll say I want to be a baseball player and a veterinarian. You know? When people say that people, you know, generally laugh and pat them on the head and go, yeah, that’s cute. But did people do that to you? I mean, did you ever doubt that you could actually do both?

ROLLE: No. I honestly – I never had a doubt. And I cannot take the credit. I give that to my parents. You know, we came from the islands of the Bahamas, and I left there when I was very young, ended up moving to New Jersey. And in New Jersey, my parents were prophesied to my brothers and I and speak and hardwire into our minds that just because we come from a small country, just because we have dark skin, just because we don’t have a lot of money does not mean that we cannot accomplish our goals in this country that has an abundancy (ph) of resources.

We have to develop our firm foundation of education. We have to believe in ourselves. We have to be good citizens, good leaders, stay true to our Christian principles, and these things could happen for us. So they poured the confidence in me, and I walked out of my house in New Jersey every morning thinking, yeah, why not? Why can’t I do both? Why can’t I do all things? Once I had that firm belief, it gave me, you know, the initiative to kind of go and pursue those things with all veracity.

MARTIN: I want to go back to your days as an undergrad at Florida State where you faced a difficult decision. You know, first there was your interview for the Rhodes scholarship and that – for people who, you know, this is a highly competitive award. It’s very prestigious.

People may know that, you know, Bill Clinton was a Rhodes Scholar, Cory Booker was a Rhodes, Susan Rice. So first, the interview conflicted with a game that you were scheduled to play in, and then you knew that if you did win the award that it could interfere with your chance of being a first-round draft pick in the NFL. There had to have been people talking in your ear saying you’re crazy, you know.

ROLLE: Oh, yes.

MARTIN: You get your money, and I just wondered how did you decide what to do?

ROLLE: You’re right. It was an absolutely hard decision, very, very difficult. I had been playing football since I was 6. And I chose Florida State University because I wanted to get to the NFL. That school had a pedigree of putting players into the National Football League, and I had two cousins who played in the NFL. And my daddy started the Commonwealth American Football League back home in the Bahamas, so, you know, it was – all roads were leading towards playing professional football.

And then, as you said, I was projected as a first-round draft pick. But the Rhodes committee – I – I’ll be completely frank with you. I asked them if I could postpone my Oxford experience for a little bit and go to the NFL first, and then go back to Oxford. They said no. So that made it – OK, you either take the Rhodes scholarship now or you lose it forever. I prayed about the decision. I talked to my family, but I think what really helped me make that decision was talking to young people actually, young people who looked at my story and said that they drew inspiration from it.

And the fact that I was up for something so prestigious that was academic based, it kind of gave them, you know, the motivation to pursue knowledge and to, you know, try to go for their degrees and things like that. So the fact that I was placed in this position of being a role model for young people by choosing academics and that Oxford experience over the fast money and the early draft pick in the NFL, that was big for me. So I did it. I made the decision, and I don’t regret it today.

MARTIN: Do you see yourself as having some opportunity to be influential in the issues that are so present in the NFL right now and, frankly, in the minds of the public? Frankly, some people are wondering whether it’s still ethical to be a football fan, knowing what we know about the impact of the sport on players, particularly something as consequential as brain trauma. Do you see yourself having a role in this discussion?

ROLLE: Yes, I do actually. You know, I think that I can potentially have a very strong voice in this coming from the athletic side and now from the scientific side. But neurosurgeons are doing a lot of work in it already. There are some neurosurgeons out of Stanford that are looking at some type of concussions based on the predominant symptoms – is a cognitive decline? Is at equilibrium problems? Is it ocular motor issues? Is it anxiety or depression?

And once you can kind of categorize concussions based on those symptoms, then you could have a more targeted therapy, and then there’s neuroscientists, neurologists looking at the pathophysiology of concussions and then social psychologists looking at the failure to report and physicists looking at the circular or linear rotations. So there are a lot of people taking a bite out of this issue and trying to preserve this game that I love and that we all love.

I want the game to stay, and I want it to be safe. I want it to still exist because it’s done so much for me. It’s giving me tools that I’m using now in the operating room learning how to mitigate pressure, communicating, strategizing – all these things that I did every day on the field in the weight room, I do now as a physician. So it’s a powerful sport. And, like you said, I just definitely hope to have a voice in it and keep it around.

MARTIN: That’s Dr. Myron Rolle, former NFL player. He’s about to start his residency in neurosurgery at Harvard Medical School, and he was kind enough to join us from Orlando. Dr. Rolle, thank you so much for speaking with us.

ROLLE: Thank you very much for having me. I really do appreciate this.

Copyright © 2017 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Let’s block ads! (Why?)

No Image

Business May 28, 2017

South Korean Youth Struggle To Find Jobs After Years Of Studying For Tests

Students try out a Samsung Electronics Galaxy S8 Plus smartphone at a shop in Seoul, South Korea, on April 27. Many post-college grads in South Korea spend years studying for tests in the hopes of winning a job at a company like Samsung.

Ahn Young-joon/AP

hide caption

toggle caption

Ahn Young-joon/AP

Lim Hyuk-ju lives in a tiny apartment in a bustling student neighborhood of South Korea’s capital, Seoul.

The apartment is just 30 sq. ft. — basically a walk-in closet with a toilet, shower and shared kitchen — for $400 a month.

“It’s uncomfortable, because when I lay down my legs hit the back wall,” explains Lim, 25.

She has to be quiet because the walls are thin. Lim’s neighbors are all young people like her, studying 15 hours a day for job entrance exams.

Lim graduated at the top of her high school class. She wants to be an accountant. So for now, her parents support her on a path that’s typical for young South Koreans: Study for months or years to pass exams for jobs in government, or in big family-run Korean conglomerates like Samsung, LG and Hyundai.

“All these tests, and memorizing the right answers,” says Lim, “I sometimes wonder if this is really the only way to succeed.”

Lim Hyuk-ju, 25, in her 30 sq. ft. apartment in Seoul. Lim pays $400 a month for this tiny space, where she studies 15 hours a day for job entry exams. Her path is similar to many youth in South Korea, where unemployment among 15- to 29-year-olds is nearly three times the overall rate.

Lauren Frayer/NPR

hide caption

toggle caption

Lauren Frayer/NPR

South Korea’s economy has slowed, and it appears to have hurt young people the most. Some 11.3 percent of youth aged 15 to 29 are out of work. That’s nearly three times the overall jobless rate.

A new liberal president, Moon Jae-in, won office earlier this month, with huge support from young voters. Now one of his first tasks — on top of dealing with nuclear-armed North Korea — is to improve the economic prospects for young South Koreans.

Big conglomerates, or chaebols, run South Korea’s economy. Sales revenue from the top five chaebols amounted to 58 percent of South Korea’s GDP in 2015. And it’s not only cellphones and cars. In Korea, there’s a Samsung art gallery and a Samsung amusement park. You can buy life insurance from Samsung. In the case of Hyundai, the big Korean carmaker, the company also runs a hospital in Seoul. LG, another electronics giant, also has a Korean cosmetics line — and dozens of other businesses and subsidiaries.

“They’re just giant conglomerates that control so much of the economy on a scale just not seen in a lot of the world,” says Geoffrey Cain, who trained as an anthropologist and is writing a book about Samsung.

Cain says South Korea’s conglomerates are so pervasive, they squeeze out smaller businesses.

“They can basically tell a small business to supply them a part and just pay them whatever they want, and then pay them whenever they want, and give them a terrible contract,” he says.

Small businesses struggle to grow.

“So that’s what creates so few job opportunities,” Cain says.

For many Korean youth, it’s the dream of a job-for-life with a big conglomerate — or nothing at all. As the economy slows, there aren’t enough jobs for all the college graduates here. So many turn to test-taking, as competition rises.

Like Lim in her tiny apartment, many Koreans study for years. Hyundai requires a six-hour exam, just to get your foot in the door. Samsung has its own version of the SAT.

President Moon won office May 9 in part on a promise to ease youth unemployment by creating more public sector jobs. But some economists say that’s only a short-term fix.

“Job creation should be [by] business, not the government,” says Kim Gwang-Suk, an economist and professor at Seoul’s Hanyang University. “In the long term, all the government should do is make an environment in which companies can invest more.”

Kim says the new president should help small businesses, boost entrepreneurship, and reform the conglomerates. On the campaign trail, Moon promised to do just that. But the conglomerates remain the backbone of the Korean economy. It’s unclear whether he really has the will or ability to change them.

In the test prep section of a big Seoul bookstore, young people sit on the floor, pouring over test materials on a Saturday morning.

“As the economy goes bad, there aren’t many good jobs, and the competition is fierce,” says Baek Eui-hyun.

He’s 28 and still unemployed, after studying for two years for a public administration exam. He failed twice, and is browsing for other tests he might take. He says young Koreans are frustrated.

“Of course they don’t want to spend their time being stuck in a tiny room studying books for exams,” he says. “But there aren’t any alternatives.”

The President Moon’s success may be measured not only in how he deals with North Korea, but in the alternatives he offers some of his youngest voters.

Let’s block ads! (Why?)

No Image

Health May 28, 2017

In The Age Of Digital Medicine, The Humble Reflex Hammer Hangs On

The good old reflex hammer (like this Taylor model) might seem like an outdated medical device, but its role in diagnosing disease is still as important as ever.

Meredith Rizzo/NPR

hide caption

toggle caption

Meredith Rizzo/NPR

Receiving a diagnosis in 2017 — at least one made at a medical center outfitted with the latest clinical gadgetry — might include a scan that divides your body into a bread loaf of high-resolution digital slices. Your DNA might be fed through a gene sequencer that spits out your mortal code in a matter of hours. Even your smartphone might soon be used to uncover health problems.

Yet nearly 130 years since its inception — after decades of science has mapped out our neuronal pathways — a simple knob of rubber with a metal handle remains one of medicine’s most essential tools. I’m referring to the cheap, portable, easy-to-use reflex hammer.

This unassuming device can be invaluable in diagnosing nervous and muscular disorders, and in determining whether a patient’s pathology lies in the brain or elsewhere in the body. It can also help curtail healthcare spending by preventing unnecessary, often expensive testing. Yet like so many major medical and scientific discoveries, the reflex hammer has humble origins, in this case: the basement of a Viennese hotel.

The inn was run by the father of Leopold Auenbrugger, an 18th century doctor who is considered to be among the founders of modern medicine. To gauge how much wine was left for customers, hotel employees would thump casks with their hands and listen for a dull thud or hollow tympany. Auenbrugger realized that the same technique — now called “percussing” — could be applied to the human torso to, say, determine how much fluid had built up around a diseased heart. He wrote as much in his 1761 paper New invention to detect diseases hidden deep within the chest.

Leopold Auenbrugger (here with his wife, Marianne) is regarded as one of the founders of modern medicine, having applied the idea of detecting disease by sound.

Wellcome Library, London

hide caption

toggle caption

Wellcome Library, London

Relflex hammer warfare

Thought to be more accurate than the human hand, it wasn’t long before percussion hammers were being designed to more precisely diagnose disease. Competition ensued.

Scottish physician Sir David Barry’s model, released in the 1820s, was the first. German doctor Max A. Wintrich’s came shortly after and was more popular, but was not without its critics: “[Wintrich’s hammer] is inconvenient to hold, it is rigid … it required education to use it, and even then it does not fulfill its purposes,” a rival inventor commented.

As neurologist Dr. Douglas J. Lanksa wrote in a 1989 paper on the many types of reflex hammers, “Some were T-shaped or L-shaped, others resembled battle axes, tomahawks, or even magic wands.” He adds that no material was off limits: wood, ebony, whale bone, brass, lead, even “velvet-covered worsted” (a type of yarn).

As percussion hammer warfare waged on, doctors and scientists were also beginning to understand the concept of reflexes, or involuntary, near-immediate responses to stimuli that occur before any sensory information reaches the brain. Muscular jerks. Blinking. Sneezing. Gagging. All of these are automatic feedback loops between sensory and motor neurons that help us navigate our environment and protect us from danger.

In 1875, German neurologists Drs. Heinrich Erb and Carl Friedrich Otto Westphal were among the first to realize that eliciting a reflex by briskly tapping the tendons of major muscles might be useful. They felt the knee jerk — or “patellar-tendon” reflex — in particular could help assess nerve function.

Anton Wintrich introduced this percussion hammer model in 1841.

Wellcome Library, London

hide caption

toggle caption

Wellcome Library, London

Hammers specifically suited to test reflexes were soon developed, the first of which had the now classic shape we’re accustomed to — a thin metal handle with a triangular rubber head. Designed by American physician John Madison Taylor in Philadelphia in 1888 — and modified ever since by many — the simple device was heavy enough to elicit reflexes, and had round edges to ease impact. An entry level model runs just $2.25 on Amazon.

The Krauss hammer, developed by German-American physician William Christopher Krauss, was designed around the same time. It had two rounded heads: a large one for knees and a smaller one for biceps. Dr. Ernst L.O. Trömner’s did too, but it also tapered to a thin end to assess skin reflexes. There were also the Queen Square hammer, the Babinski hammer, the Buck hammer and the Berliner hammer. The Stookey hammer flaunted a camel hair brush to get a better sense of touch sensation. The list goes on.

Past to present

Daniella C. Sisniega is a third year medical student at the Boston University School of Medicine. Last month at the American Academy of Neurology’s annual meeting, she presented a poster explicating the reflex hammer’s past.

“I’m fascinated by how the reflex hammer started out as a percussion hammer, but was [then] adapted to elicit reflexes and has been in every neurologist’s tool box ever since,” she told NPR. “I also did not know that the little rubber triangle was the first reflex hammer. I feel like I owe it an apology!”

Sisniega jokes about the lackluster quality of the inexpensive Taylors.

“The little tomahawk is included in the kit everyone receives when they enter medical school,” she recalls. “The rubber is cheap and very light, while the other hammers are heavier on the head so that you can use the ‘swing’ of the hammer as opposed to the strength of the strike to test the reflex.”

While attending the AAN conference myself, I asked multiple sclerosis expert Dr. Stephen Krieger about the role of the reflex hammer in modern medical diagnosis.

“We could argue about the nuances of the hammer — the Queens Square, the Tomahawk, plastic handle, metal handle, weighted, flexible or rigid — but the hammer itself is always in the hand. Reflexes tell the story of neurologic diseases of all sorts,” he says.

Krieger explains how disorders of the brain, like a stroke or brain tumor, result in hyperactive reflexes, while conditions affecting muscles and peripheral nerves usually result in reduced or non-existent reflexes. Reduced reflexes are, for example, a common symptom of back pain due to degenerative disk disease.

Dr. Andrew Wilner, an assistant professor of neurology at the Mayo Clinic, recounted the story of one of his patients, who had back pain, weakness and numbness of the legs. Wilner was leaning toward a diagnosis of either Guillain-Barre Syndrome (GBS) — an autoimmune disorder of peripheral nerves — or a myelopathy, an injury of some kind to the spinal cord. Both conditions can lead to medical emergencies, but each requires drastically different treatment.

“The reflex hammer was arguably our most important tool in narrowing down the differential diagnosis,” he says. “Had we found diminished or absent deep tendon reflexes, GBS would have been more likely. As it turned out, the patient had brisk pathological knee jerks, pointing to a lesion in the brain or spinal cord.”

Based on these findings, Wilner ordered an imaging study of the patient’s spinal cord, where a lesion was found — as opposed to pursuing the costly tests involved in a GBS diagnosis.

Wilner feels that the simple art of interviewing and examining a patient can get overshadowed by the myriad new diagnostic technologies. When it comes to clinical tools, he feels, sometimes basic is better.

“Technology is glorious,” admits Krieger, “and [it] will teach us things about patients that we could never have known or imagined. But the simple, elegant, inexpensive almost plebeian swing of the reflex hammer has a cost/benefit ratio that I think no advanced technology will likely ever match.”

Bret Stetka is a writer based in New York and an editorial director at Medscape. His work has appeared in Wired and Scientific American, and on The Atlantic.com. He graduated from the University of Virginia School of Medicine in 2005. He’s also on Twitter: @BretStetka

Let’s block ads! (Why?)