CommentPlus: pick of the papers

The ten must-read pieces from the Sunday papers.

1. Don't destroy our universities. Our future depends on them (Observer)

With knowledge-intensive work growing ever more important, Will Hutton argues that the government must rethink its stance on university cuts. The inevitable further budget reductions will cause deep damage.

2. The new university challenge is to unravel Labour's mess (Sunday Times)

Minette Marrin looks at Labour's legacy to education -- a disastrous combination of inflation and devaluation. The Blair-Brown years have demonstrated that it is quite easy to bring down standards.

3. For Cable as chancellor, vote Labour (Independent on Sunday)

John Rentoul explores the possibilities of a hung parliament. With such a clunky mechanism, the Lib Dems need Brown to do well if they are to enter a power-sharing deal.

4. Budget 2010: David Cameron prepares for 48-hour trench warfare (Sunday Telegraph)

Labour's last-ditch Budget will herald an artillery battle over Britain's future, says Matthew d'Ancona. Cameron and George Osborne must be honest and detailed in their responses.

5. Do the right thing before you go, Alistair Darling (Sunday Times)

Dominic Lawson agrees that the Chancellor is preparing Wednesday's Budget statement with an eye to posterity. He is a mild-mannered man; if he were more abrasive, he might harangue the public-sector unions picketing the Treasury.

6. Why all these emails from Barack Obama make me feel cheap (Observer)

Andrew Rawnsley says that the internet is undermining old-fashioned campaign models and killing conventional forms of propaganda.

7. Cut off the cash and Israel might behave (Independent on Sunday)

Binyamin Netanyahu is undermining US interests, says Avi Shlaim. The sooner Barack Obama makes his support conditional, the better.

8. Care for the eldely: One question that all our politicians are agreed on (Sunday Telegraph)

Alasdair Palmer wonders how we will fund care for the elderly over the next 20 years -- neither Labour nor the Conservatives has suggested a viable way to fill the funding shortfall.

9. Saying sorry is not enough. The Church has got to change (Observer)

The paper's editorial says Pope Benedict XVI's letter to the Catholics of Ireland was inadequate, and adds to the woes of those his Church has wronged.

10. Health-care reform enters its endgame (Independent on Sunday)

Failure on health-care reform will not break Obama's presidency, says the leading article, but it could alter the political calculus.

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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