CommentPlus: pick of the papers

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

1. Forget protecting pensioner benefits. We need to prioritise real hardship (Guardian)

Older people in Britain have never been so well off, says Peter Wilby: because of their voting power, politicians are scared to upset them.

2. Resignation is not an option for the Pope (Times)

It is Benedict XVI's duty to implement worldwide the reforms already made by Catholic leaders in Britain, says William Rees-Mogg. But he cannot resign -- the last time a pope did so was in the year 1415. A resignation under pressure would not be the Church's last.

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3. Obama throws out the political rules (Financial Times)

Clive Crook discusses the passing of the US health-care bill. Elated Democrats feel they have the upper hand, but now they need to get the public behind what they have done.

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4. Parliament's wash-up's a stitch-up (Guardian)

Martin Bell argues that due democratic process is lost in the secretive pre-election horse-trading to decide which bills will survive. Electoral reform is a potential casualty.

5. Shock, horror . . . America places its own interests first (Independent)

Bruce Anderson says there is only one certainty in foreign policy: that there will be regular proclamations of the death of the special relationship, but the hearse will never arrive.

6. The special relationship has been a myth for decades (Times)

Anthony Eden wondered whether we should have taken a leaf from de Gaulle's book and treated the Americans mean to keep them keen. Better late than never, says John Charmley.

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7. Refugees for settlers is the way forward for Israel (Financial Times)

Israel is unlikely to abandon the Jewish settlements, writes Eugene Rogan. The only way forward is to put a real price on settlements that might make the Israeli government pause before expanding them -- giving right of return to Palestinian refugees.

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8. A rate for the rich (Guardian)

Twenty years after the poll-tax riots, John Andrew argues that reform is needed for council tax that benefits the wealthy. The longer the tax stays unreformed, the more unfair it will become.

9. Europe has resolved nothing over Greece (Financial Times)

Last Thursday's agreement sounded significant, says Wolfgang Münchau, but the deal was mostly smoke and mirrors -- it is hard to imagine even a hypothetical scenario in which the European Union would disburse the emergency aid.

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10. This is one utopian vision that need not be so far from reality (Independent)

Charles Leadbeater of the Young Foundation makes the case for greater citizen engagement, to create a high-energy politics based on constitutional convention which could replace the exhausted parliamentary system.

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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