Morning Call: pick of the papers

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

1. Cameron’s incurable European headache (Financial Times)

This is where the irresistible force of rising Tory europhobia meets the immovable object of geopolitical reality, writes Philip Stephens.

2. It’s too early for the Tories to assume defeat is inevitable in 2015 (Daily Telegraph)

David Cameron could be a transformative leader if he had more faith in his power to change minds, says Fraser Nelson.

3. Algeria spills more blood (Guardian)

The violent end to this standoff is only the start of a new chapter in the country's savage history, writes Nabila Ramdani.

4. Don’t reject a referendum, Ed. Fast-track it (Times) (£)

The Labour leader should seize his chance to appeal to British business and voters, says Philip Collins. He must offer an in-out vote now.

5. Mali is not a global conflict. It doesn't require a global response (Independent)

The notion of a global threat from a revived al-Qa'ida should be familiar by now; it's the same flawed reasoning the led the US to launch its "war against terror", says Adrian Hamilton.

6. A living wage, or a much higher minimum wage, is worth paying (Daily Telegraph)

As City profits soar, the low-skilled, service areas of the economy continue to suffer a fall in income, writes Jeremy Warner. Radical action might avoid a social catastrophe.

7. A funny way of firing up the locomotive (Financial Times)

Now and in the interwar period, austerity policies have often failed in their own terms as they have made deficits worse, writes Samuel Brittan.

8. Mr Cameron and the speech that never was (Daily Mail)

The Prime Minister is confronting one of the most crucial issues of our times while Ed Miliband has nothing useful to say, argues a Daily Mail editorial.

9. Hugh Gaitskell: New Labour's old roots (Guardian)

Tony Blair never acknowledged the influence of his most like-minded predecessor, who died 50 years ago this week, says a Guardian editorial.

10. Why today’s American presidents need a third term (Independent)

There are compelling reasons why two four-year terms may not be enough for a competent and popular US president today, writes Mary Dejevsky.

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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