Morning Call: pick of the comment

The ten must-read pieces from this morning's papers

1. There is more than cowardice that stands between Labour and regicide (Guardian)

Jonathan Freedland says that the lack of a clear challenger to Gordon Brown and the absence of an alternative programme mean that the Prime Minister is likely to survive again.

2. I know a man who can keep the New Labour flame burning (Independent)

John Rentoul argues that the next leader of the Labour Party should be -- and probably will be -- David Miliband.

3. General election 2010: time for the traditional bluster, bombast and lies (Daily Telegraph)

Simon Heffer says that both Labour and the Tories have duped the voters. He calls on Nick Clegg to provide an alternative to such deception.

4. Cameron will not break his vow on marriage (Times)

Daniel Finkelstein argues that David Cameron will not break his pledge to recognise marriage in the tax system. The Tory leader may introduce only a small tax break, but he regards the message as more important than the money.

5. The cause of our crises has not gone away (Financial Times)

John Kay warns that the conditions for a repeat of the financial crisis are in place and that even if there is a will to respond to the next crisis, the capacity to do so may not be there.

6. Walk of shame (Times)

A leader argues that while the Islamist march at Wootton Bassett may be deeply offensive, it should not be banned. The test of a fair society is how it deals with that which its majority finds objectionable.

7. High-speed rail will bleed us all for a few rich travellers (Guardian)

Simon Jenkins argues that the case for high-speed rail has yet to be proven. Upgrading and properly managing the existing railway may be better value for money than a project costing untold billions.

8. Great opportunities are open to the Liberal Democrats (Independent)

A leader says that Nick Clegg is right not to commit to either Labour or the Tories but that he must now prove his "seriousness of intent".

9. The eurozone's next decade will be tough (Financial Times)

Martin Wolf says that with no willing spender of last resort, the weaker members of the eurozone are unlikely to receive much help.

10. Marriage is no rose garden, and the Tory party knows it (Guardian)

Amelia Gentleman urges the Tories to look beyond marriage as a solution to societal breakdown. Cameron should spend whatever money there is on better schools and housing.

 

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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