Five of the Best

The top five comment pieces from today's papers

In the Washington Post, Fareed Zakaria says that Obama should reject General McChrystal's demand for a troop surge in Afghanistan:

Why has security gotten worse? Largely because Hamid Karzai's government is ineffective and corrupt and has alienated large numbers of Pashtuns, who have migrated to the Taliban. It is not clear that this problem can be solved by force, even using a smart counterinsurgency strategy. In fact, more troops injected into the current climate could provoke an anti-government or nationalist backlash.

On the day the London Evening Standard goes free, the Times's Libby Purves argues that the days of free online content are over:

It's been fun: like a jammed fruit machine spewing free tokens or a whisky-galore shipwreck. But it's got to stop. Content -- whether music, films, pictures, news or prose -- can't be free and flourish. The music and movie industries are fighting: journalism, after the ego trip of gaining millions of online readers, is following. It has to. There is no alternative.

The Guardian's Jackie Ashley writes that the quality of prospective MPs gives cause for optimism as the expenses scandal returns:

[T]his is the good news: that parliamentary politics really is being cleaned up. If MPs behave badly, out they will go. Most ordinary parliamentarians work very hard, and for less money than they could get elsewhere. There are rotten apples and overripe plums; but there are some good ones too. You can't improve parliament without encouraging a fresh wave of keen, principled and determined outsiders to breach its walls. Now this is going to happen.

The New York Times's Paul Krugman warns that an obsessive fear of inflation threatens to prevent a full economic recovery:

What's even more extraordinary, however, is the idea that raising rates would make sense any time soon. After all, the unemployment rate is a horrifying 9.8 per cent and still rising, while inflation is running well below the Fed's long-term target. This suggests that the Fed should be in no hurry to tighten -- in fact, standard policy rules of thumb suggest that interest rates should be left on hold for the next two years or more, or until the unemployment rate has fallen to around 7 per cent.

In the Independent, Paul Collier says that the economic crisis has led to a damaging flight of finance from Africa:

Why does this matter? It matters because Africa desperately needs more investment. For decades Africa has been investing only around 20 per cent of national income, whereas Asia is investing around 40 per cent. At these rates, almost regardless of returns, Africa will continue to fall further behind the emerging-market economies. Yet Africa simply cannot afford to finance a substantial increase in investment from its internal resources. A domestically financed increase in investment could only come at the expense of consumption.

 

George Eaton is political editor of the New Statesman.

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A swimming pool and a bleeding toe put my medical competency in doubt

Doctors are used to contending with Google. Sometimes the search engine wins. 

The brutal heatwave affecting southern Europe this summer has become known among locals as “Lucifer”. Having just returned from Italy, I fully understand the nickname. An early excursion caused the beginnings of sunstroke, so we abandoned plans to explore the cultural heritage of the Amalfi region and strayed no further than five metres from the hotel pool for the rest of the week.

The children were delighted, particularly my 12-year-old stepdaughter, Gracie, who proceeded to spend hours at a time playing in the water. Towelling herself after one long session, she noticed something odd.

“What’s happened there?” she asked, holding her foot aloft in front of my face.

I inspected the proffered appendage: on the underside of her big toe was an oblong area of glistening red flesh that looked like a chunk of raw steak.

“Did you injure it?”

She shook her head. “It doesn’t hurt at all.”

I shrugged and said she must have grazed it. She wasn’t convinced, pointing out that she would remember if she had done that. She has great faith in plasters, though, and once it was dressed she forgot all about it. I dismissed it, too, assuming it was one of those things.

By the end of the next day, the pulp on the underside of all of her toes looked the same. As the doctor in the family, I felt under some pressure to come up with an explanation. I made up something about burns from the hot paving slabs around the pool. Gracie didn’t say as much, but her look suggested a dawning scepticism over my claims to hold a medical degree.

The next day, Gracie and her new-found holiday playmate, Eve, abruptly terminated a marathon piggy-in-the-middle session in the pool with Eve’s dad. “Our feet are bleeding,” they announced, somewhat incredulously. Sure enough, bright-red blood was flowing, apparently painlessly, from the bottoms of their big toes.

Doctors are used to contending with Google. Often, what patients discover on the internet causes them undue alarm, and our role is to provide context and reassurance. But not infrequently, people come across information that outstrips our knowledge. On my return from our room with fresh supplies of plasters, my wife looked up from her sun lounger with an air of quiet amusement.

“It’s called ‘pool toe’,” she said, handing me her iPhone. The page she had tracked down described the girls’ situation exactly: friction burns, most commonly seen in children, caused by repetitive hopping about on the abrasive floors of swimming pools. Doctors practising in hot countries must see it all the time. I doubt it presents often to British GPs.

I remained puzzled about the lack of pain. The injuries looked bad, but neither Gracie nor Eve was particularly bothered. Here the internet drew a blank, but I suspect it has to do with the “pruning” of our skin that we’re all familiar with after a soak in the bath. This only occurs over the pulps of our fingers and toes. It was once thought to be caused by water diffusing into skin cells, making them swell, but the truth is far more fascinating.

The wrinkling is an active process, triggered by immersion, in which the blood supply to the pulp regions is switched off, causing the skin there to shrink and pucker. This creates the biological equivalent of tyre treads on our fingers and toes and markedly improves our grip – of great evolutionary advantage when grasping slippery fish in a river, or if trying to maintain balance on slick wet rocks.

The flip side of this is much greater friction, leading to abrasion of the skin through repeated micro-trauma. And the lack of blood flow causes nerves to shut down, depriving us of the pain that would otherwise alert us to the ongoing tissue damage. An adaptation that helped our ancestors hunt in rivers proves considerably less use on a modern summer holiday.

I may not have seen much of the local heritage, but the trip to Italy taught me something new all the same. 

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear