My new computer gave me the dreaded blue screen of death this past week. Not once but five times in a row, all within 20 minutes of start up and restarts. The block of text was as ominous and incomprehensible as the Star Wars opening.  

"A problem has been detected and Windows has shutdown to protect your computer. ....Modifications of a system code or critical data structure was detected.... Stop code 0x00000109."

The first time, I was startled. The second time perplexed. The third time, hyperventilating. The fourth time (before I could even update my status on Facebook: Anne is hyperventilating) I was a quivering mass of nail-chewing hysteria. The fifth time - ya don't wanna go there.

I had just bought the system three weeks earlier, dropping $1300 plus on the top of the line monster with 8 GB of RAM, a hard drive with enough computing capacity that would have taken up 6 city blocks of IBM mainframes in the 1970s, and an enormous flat screen monitor capable of having three documents full size, all viewed at once for editing and multitasking.

 I had a day of writing and editing to do in a busy week and a nutso month. This could not be happening.  I have all my data obsessively backed up, but I need a functional computer just to get work done.  Telling editors, clients, and art directors that you are late on a deadline because of computer problems sounds as convincing as "the dog ate my homework."

But five blue screens! This was not a computer problem, this was a meltdown. My keening moans of woe  shook the quiet 1940s Victoria apartment block where have my office.

Calm down. Rending garments does nothing. This is obviously a hardware fault on a new system. It is all under warranty. Call Future Shop.

"What is the make and model of your computer?" the clerk asked between my sobs.

“Gateway MS Pro.” 

 “Let me see… oh here. Gateway has a chat forum and email tech support on their website. Just go to www.gateway.com”

 “Calm down ma’am. You are right, email is not much use if your system is not working.  I’ll see if I can find a phone number. Hmmm. I don’t see a phone number. I will transfer you to our tech support.”

I waited while Michael Buble played. Eventually a man came on whose voice sounded completely bored and flat -- to counteract no doubt the hysterical calls he gets all day.

I could hear him sigh as he listened to my problem: “That needs to be dealt with by Gateway, Ma'am.  You are still under warranty. They have online email support and a tech support chat room….”

“Okay. Calm down ma’am. Yes I guess that is no use if you can't get online. Yes, I do have a tech support phone number but we can’t give out that phone number as that is the one we use..."

My frustration was sky high. I tried to keep my voice as even as his. What did he suggest I do with a three-week old malfunctioning system?

"Well the best thing to do is pack up your computer and bring it in here. Blue screens are hard to determine. We will run diagnostic tests. That takes four or five  business days, depending on the problem. If it is not a software problem or a virus, but a manufacturer's hardware problem -- and it sounds like hardware -- then we ship it back to Gateway. It is all under warranty.

And if it was hardware ( I knew it was hardware) how long would my computer be gone?

"One or two months at the most...

 “Well no, we don’t give a loaner…” he said.

Eventually the bored-voice man - to get the hysterical me off the phone --  found a phone number for me to call – that of Acer, the manufacturer of Gateway.

I called the 1-800 number and a pleasant, computer generated woman’s voice answered.

“Welcome to Acer. Please say as clearly as possible the issue you are calling about. You can say sales or tech support or..“

“Tech Support” I yelled.

“Okay. Tech support. What is the technical issue you are calling about?”

“Blue Screen!”

“Okay, blue screen. For operating system issues we need your 11-digit SNID number. You will find this number underneath the bar code on the side of computer. If you do not have this number handy, this automated system will wait until you find it. Say halt to look for the SNID and then say continue when you are ready to proceed.”

(Oh dang!) HALT!

I pulled the computer tower out from my desk, disentangling wires and cords. The bar code was a tiny patch and the SNID an even tinier number underneath it. It looked like this: 00083383712.

I got out my reading glasses and rummaged for a pen light. On my hands and knees under my desk I still could barely make it out. I wrote it down as best I could and then climbed  back up to the phone.

Continue! I yelled.

“Please type in or say the 11-digit SNID number.”

I typed in the number, trying to get the zeroes, 8s and 3s in the right order.

“To confirm, the SNID you provided is: zero, zero, zero, eight, three, three, eight, three, seven, one, two.

That was what I had written down.

“Yes! ” I said.

“This is not an Acer Product. Please call the company who made your computer. Goodbye,” said the voice. The phone clicked dead.  The computerized woman hung up on me.

Shit! I pulled the computer back out, got out a magnifying glass and got back on my hands and knees. Dang!! I had an 8 and a 3 reversed.

I dialled the 1-800 number again.

“Hello,’ said the pleasant computer female. “Is this the same problem you recently called about?”

Okay, at least she is efficient. We can get right back to entering the correct SNID.

“Yes,” I said.

“This is not an Acer Product. Goodbye."

I called my husband Keith, frantic. "Find me another number for Gateway or Acer. I am being blocked by a cyber control freak." He searched websites and got a different number for customer support. I called this one. The same computerized woman's voice answered.

“Is this the same problem you recently called about?” the computer voice said.

“No!” I lied.

“Are you sure? Is this the operating system problem you called about at 10:05 am June 9, 2010,” she tested, almost HAL-like in her menacing, overly-calm tone.

“No!” I lied.

“Okay ( I could tell she didn’t believe me.)  To go any further we need your 11-digit SNID number. You will find this number underneath the bar code on the side of computer. If you do not have this number, the system will wait until you find it. Say halt to look for the SNID and then say continue when you are ready to proceed.”

I entered in the number, holding my breath that this time I would do it correctly.

"You are being transferred," the system said. Muzak played.

A human voice finally came on.

“Hello, this is Raminder, how may I help you?.”

He was in a data call centre on the outskirts of Mumbai, India.

I sputtered out my blue screen problems, the three-week old system, the whole sorry tale.

I could tell Raminder was reading from a binder. He was a lovely caring man ( I couldn't understand half of what he said, but he mumbled it in a very caring kind way.) But he was no use what-so-ever. Ultimately, his only advice: pack up computer in its box -- it was all under warranty -- and either ship it or deliver it by hand to the Gateway office in Burnaby or Toronto. It would be back in one to two months, all covered. But no, they do not give a loaner.

I was on my own.  

 (PS. Thank God for Darryl Gittins, tech writer for Boulevard and computer whiz extraordinaire. He took away my new system, hooked up an old lap top of his to let me survive for three days.  Running my new system through a series of diagnostic tests he discovered  my blue screen woes were coming from a 2GB module of RAM that had a manufacturing glitch. He pulled the RAM -- I still have 20 times more RAM than my last system. Now I am going to see if Future Shop or Gateway will reimburse the cost. I have a feeling, no, because I did not pack up the computer and send it back.)



My paternal grandmother, a pious Irish-Canadian Catholic, believed the telephone was an instrument of the devil – and that was even before her long dead sister Ella phoned one night with a warning.

The story of that spooky 1919 call and the death that Ella foretold is family legend. It goes like this: Six-year-old Gerald ( my father’s older brother in a family of 10 siblings)  cut his foot on an ice skate. It became infected, and, in the age before antibiotics, gangrenous. He was to have his leg amputated in hospital the next day. The family, all worried about the fate of the sweet young child, had finally gotten to sleep when the phone rang. It was midnight ( of course.)  My grandmother, who usually never answered this new fangled contraption, did not want everyone to awaken again.

“Mary,” the voice said. “This is Ella in Heaven. Don’t let Gerald have the operation.”

My grandmother screamed and fainted, so the story goes, and the rest of the family found her on the hallway floor,  the earpiece dangling off the hook. Stopping the operation was not an option, the leg was too far gone. But Gerald died during the procedure.

 Ghost stories like this abound in my paternal lineage, but only one of the visitations occurred via phone.

 Naturally Grandma thereafter refused all late night calls, saying nothing good can come from them.

I think she was onto something: I’ve been bedevilled by phones for at least two decades.

In my 20s my cat, Fauve, loved to chew through telephone cords. I’d be cut off in mid-sentence. I’d rub Bitter Apple repellent or spray her with a water gun, but it remained a game for her to wrap herself in the cord and gnaw as fast as she could whenever I talked.  Once I waited on hold for 45 minutes, motionless, to seek out training tips from the vet on a CBC call-in show. “We could be cut off at any minute. What do I do?” I asked. 

“Get a cordless phone,” he said.

But cordless phones are worse, at least in my house where no one EVER puts them back on their base. “Where’s the $#@ phone!!!?” we yell, frantically lifting couch cushions, newspapers and sports gear as we can hear it ring — somewhere.

I bought two identical phones so that one, at least, might make it back to a base. We soon learned they wouldn’t charge unless coupled with their true mate. But which went where?  It took weeks to figure it out and when we finally did I painted bright pink nail polish blazes on the upstairs set and pearly white ones on the downstairs set.  So now its: “Who put the pink phone on the pearly base!!!?”

Of course, if it stays off the base long enough the batteries die completely. We once lost the dead downstairs phone for a good four months. I scoured the house repeatedly, finally resorting to Grandma Mary’s remedy: praying to St. Anthony, Saint of lost items. (And I am not even a Catholic since my father left the fold. ) “Guess what was in the pullout couch?”  Kate announced after a sleep over. (Wow, good work St. Ant!)

I won’t tell you how many trips I’ve made to London Drugs to buy new batteries for phones so dead they won’t recharge.

Being prudent, we also got tethered phones on both floors – but they root you in place. We were a host family for a guide dog in training, a black lab puppy named Piper,  who soon learned we couldn’t move and discipline him when on a fixed phone. During the year we had Piper we put everything possible chest high or higher. Like Pavlov’s dog, Piper would hear the ring, and if he saw I was immobile, take off to find a leather shoe, washcloth, kid sock,  butter dish, hair brush, or Barbie doll to devour. “Can’t talk now,” I’d say, slamming down the phone to run after him shaking rocks in a tennis ball can, a training tip to control his ravenous appetite that failed miserably. He gnawed everything, including a telephone.

While dogs can figure out tethered phones, some modern youth can’t. My sister called a friend and got her young daughter: “Can you get your Mommy for me?” my sister asked. “Oh no,” said the girl. “This phone is attached to the wall.”

Now we hardly ever use the house phones at all. Messages left on the home answering machine can sit there for days, everyone else assuming another person in the family has lifted the receiver to listen for them.  "You have ten new messages" the computerized voice almost nags when one finally remembers to check. "What is wrong with you people?!" our former friend Michael greeted us one day this past month when we bumped into him at the Moss St. Market. Three of his messages that week had still not been heard.

These days of course each of us in the family has our own cell  phone.

But OMG, I could go on and on about the bane of cell phones: the mafia-like contracts, the frustration of companies that seductively court newbies with sweet deals but jack the prices on long-time customers; the umpteen ones lost by teens that even St. Anthony can’t help find;  the one destroyed after it was dropped in a puddle;  the exorbitant bills; the overheard irritating conversations in public venues; the tyranny of never being unavailable.

In rebellion, I refuse to use my cell phone for all but the most urgent calls. ( I do rather like texting; I am a writer after all.)

But I will take a call anytime, from Ella. There is one thing I have to know: “Ella, how did you make that call? "

Because in my heaven, there are no phones.



Today, on my Facebook page, I got into a discussion with friends about the modern dilemma of whether a facebook profile is equivalent to the sanctity of the diary.

The situation that prompted this discussion is that last week my 19 year old daughter used my office computer to write and print out resumes. Today, the first time in a week, I typed in www.facebook.com and instead of having my login pop up I was taken directly to her home page. At first I was confused. The first name I saw, in bold print, was a young man, a friend of Kate's whom I happen to have strong feelings against for a few egregious infractions I witnessed or was recipient of  during those awkward teen years. I have heard he has since grown up and become a decent young man, but when I saw his name front and centre on what I thought was my home page I went: WHAT? He IS NOT my Friend!!??# He's in JUVIE!!

That name shocked me into the recognition that this was not my homepage but in fact my daughter's that she had neglected to exit. I wanted my page,  so I logged her out. But in the time it took to sign on to my profile I thought: Oh dang! Wasn't that just the perfect opportunity to explore ( some might say "spy") on the life of the flesh I gave birth to? 

The role of parent is a weird one in the teen years. It is like parenting toddlers who have access to alcohol and car keys. I  believe Mother Nature has designed the relationship between teens and parents to be increasingly distant so that around age 19 both sides say: all right, time to get out and explore the world. If our children stayed as sweet and lovely as they are at 10, holding our hand as we walk to the grocery store, we would never want them to grow up and get on with their own lives.  "Live with us forever darling, no need to find a job, mate and produre a family of your own." If our children continued to look at us with those eyes of adoration and dependency that gazed at us as we tucked them into bed at age 5, they, too,  would never want to go.

And then no new generation would have babies and everything would collapse. So Mother Nature makes sure teens and parents spar and separate. The survival of the species is at stake!

So by 19, when the kid has all the answers and roles her eyes you both know: time to get some experience of your own, dearie dee.

But I miss knowing the details of their lives, their ups and downs they used to share so readily, the who- said-what-to-whom. It is natural for teens to withdraw into grunts upon being asked "how was your day?" And I am luckier than many in that my girls are still rather open with me. 

 But while both my daughters ( and many of their friends) have friended me on Facebook, both have put me on "extreme limited profile" to curb my intrusion on their space. Both have made it clear that if I should somehow get access to their unguarded face book page and read it, it would be akin to reading their diary.

I know all about diaries. I was an obsessive diary keeper from the age of about 11 to the age of about 32. I have 13 large volumes in a box in my attic. My early jotting years are largely juvenalia: " "Jennifer likes Scott, but I like him, too. And he smiled at me yesterday and I smiled back and said Hi. But Jennifer saw it and then we got in a big fight in the girls'washroom and she said she wasn't my friend anymore."

Once in my late 20s,  I read out loud my diaries from those early teen years  to my mother and a sister and we laughed so hard we had tears streaming down our faces. My excruciating recording of those awkward angst-filled years hit a chord of hilarity with  of us  -- every woman has been there in her teen years.

Though much in my 13 tomes is fogettable drek that I would happily now burn at no loss to the world of literature and letters, within those pages are hints of the writer I was to become - Holden Caulfield-like observations of hypocrisy, Thoreau-like ruminations on nature, Leacock-like ( well at least I like to think so ) riffs on life's absurdities. And there are sketches and paintings, concert stubs and snapshots,  and heart-felt revelations and honesty that still move me to read to this day. There is also some pretty racy bits -- I was single to age 30 after all -- and that content in my 20s is rather akin to the "I like Scott"  material of the early years but with way, way more at stake. 

But here is the thing. They are nothing like facebook. They are my most private and intimate thoughts on life. There is no way, in the world, I would have ever have posted my entries to share with 500 so-called friends. I would have been humilated and  mortified to have anyone -- my mother, my sisters, my friends -- read about my insecurities and bravado, my loves and likes, my insights and worries, my pratfalls and pontificating.

Now I have the dilemma: what to do with my diaries? I still am not keen to have anyone read them (i.e racy bits) least of all my husband and children who have a certain image of me. (Note to family: I will notice if anyone goes up to the attic and touches them!! Thank goodness the attic is only accessible by a long ladder hauled up from the basement and a trap door.)  And I still cringe with the thought that after I am dead, someone will read them. But I cannot burn them yet-- they still contain too much of me even though I have not read them in years.

But as I said on my Facebook profile, a daughter's face book page is not really like a diary at all, it is like a teen party with no adult supervision in which there is no expectation among friends of privacy. All is shared -- every last camera angle and thought. It is life lived as if on stage, knowing, hoping, all are watching.

I do hope they are finding a quiet time for pause,reflection and rumination somewhere, somehow. I think it is good for the soul and for the maturation of an adult.  Facebook does not provide it.

But I will give them their privacy on FB, because like a closed door in teenage years, they seem to really want and need it.

But it ain't no diary.

The last two weeks have seen a flurry of comments about the merits of screening mammography for women under the age of 50. There is nothing new here. This debate has been going on for more than 20 years now. Evidence has existed for years, that in population terms, screening younger women does not save lives from breast cancer and probably harms more woman than it helps. The US has chosen for years to ignore this, while the rest of the western world generally does not promote screening to women under 50.

Before we get into the details let me make two things perfectly clear:

• Screening versus diagnostic mammograms: the general public often doesn't understand the difference between screening and diagnostic mammograms. Screening takes a healthy population of women with absolutely no symptoms and tests them with regular mammograms. A diagnostic mammogram, on the other hand, is done when there is a detectable lump, a discharge,  a change or puckering in the skin or when a woman is found or suspected by family history to carry BRCA-1 or BRCA-2 genes. The debate about mammograms is around screening healthy women with no symptoms or genetic risk and its value in saving lives. If you or a loved one at any time has any symptoms  or carry the gene for breast cancer, get a diagnostic mammogram as fast as you can. In the same way, screening breast self exams -- which means teaching healthy symptomless women how to check their breasts in a routine way at the same time ever month -- has not been found to help. That is completely different from the need for all women to simply know her breasts and notice any change -- a lump, a puckering, a discharge or thickening of the skin. As soon as you have a symptom, get into the doctor right away.
• The need for clear informed consent and personal decision-making:  A woman  must be the master of her own body. If, with her family doctor, a woman at any age is fully aware of the pros and cons of mammograms and decides she needs one or wants one, and the doctor agrees, she should be able to get one. But as I will detail below, there has been a lack of clear informed consent around mammograms. Only the benefits, and none of the downsides, are widely promoted in the invitations to screening programs. But, if a woman knows the pros and cons and decides to get one, I absolutely support that right. I personally know many women who chose screening and had early cancers, mostly DCIS,  found. They firmly believe this saved their lives and I support their right to believe that and make that choice. More informed consent is needed.

Now that those two things are clear, let me tell you a story. Back in 1987, when I was medical reporter at the Vancouver Sun, I got a call from the BC Cancer Agency that the Canadian National Breast Cancer Screening Study was comparing the outcomes of women screened to women not screened in huge numbers -- more than 90,000 Canadian women. But there was a problem - not enough women knew about the study and so not enough were signing up to take part. I wrote a story about a woman whose breast cancer was found on a screening mammogram, and how grateful she was. And I urged women to take part in this important study. The Cancer Agency had so many calls in the week after my story ran -- more than 3,000 -- that they had to put in extra phone lines. The BC arm made its target number for the study in part based on my promotion of it. I firmly believed early detection was the way to go.

But then, around 1988/89, I began to hear concerning rumors among my sources that results of the study were astonishing and confounding. In the 40 to 49 age group, more women were dying in the screened group than were dying in the control group. This did not make sense. We all believed so firmly that early detection would save lives, and that the earlier that screening was started, and a cancer detected, the better. No one wanted to believe that finding it earlier might in fact be harmful.  Canadian lead researcher Dr. Cornelia Baines says the data about worse outcomes in screening in younger women started showing as early as 1983, but by the early 1990s, with more than 90,000 women studied,  it was clear - the young mammography group had more deaths, more false positives and more overdiagnosis ( treatment of harmless cancers) than the control group. When Baines et al published the results in 1992 they were roundly criticized, their study methods were faulted (there was nothing wrong with the study) and the Canadian team's credibility was assaulted. It was shocking to see how ideology trumped the research. The message was ignored and the messengers shot instead.

But two otherr large European controlled studies found exactly the same result -- women under 50 had more deaths.  UK surgeon and breast cancer expert Dr. Michael Baum, who in in the 1980s was the strongest proponent in that country for mammography and set up its national screening program, has become one of its strongest and most vocal critics. Baum is particularly concerned by the huge increase in ductal carcinoma in situ ( DCIS) found in women under 50 who have mammograms.

Here is what Dr. Baum has said widely in various interviews, including to me in an article I did on DCIS in spring 2008 Best Health, about his theory about what is occurring:

" Ductal carcinoma in situ is probably not a good word, and we should call it latent cancer. These latent cancers, particularly in premenopausal women, are grossly over-represented in women given mammograms--something like five times more, compared to what you would expect. This suggests that if left to their own devices, these latent cancers might never trouble a woman. But if you identify these latent cancers and biopsy them, you have traumatized the area. You immediately trigger the natural healing mechanisms, and natural healing mechanisms involve angiogenesis ( formation of new blood vessels.) So, effectively, the biopsy could be considered an angiogenic switch. You take a latent cancer that would never hurt a woman, biopsy it, turn on the angiogenic switch, and it ceases to be latent. A latent disease becomes an aggressive disease."

This theory of angiogenesis is highly controversial and you won't hear it discussed much, but it is strongly supported Michael Retsky, PhD, a researcher at Harvard Medial School and the late, famed researcher Judah Folkman, also of Harvard, who is credited as the father of angiogenesis research in many disease processes including cancer. Another interesting finding that might support the theory that mammography may somehow help turn on a switch making some breast cancers more aggressive. For years researchers have known about "interval cancers"  -- breast cancer that shows up, suddenly between the screening as a felt lump in women who have been having mammograms every year or two.  There is no evidence of a cancer at all on the screen, but then one suddenly grows rapidly before the next scheduled mammogram. Interval cancers are usally more aggressive than those found at the time of screening or those found in women who have never undergone screening. They don't know why interval cancers are particularly nasty, but Baum theorizes that perhaps radiation or the intense squeezing of the breast during the screen may switch on the healing response of angiogenisis that also spurs a cancer growth.

Baum resigned from the UK screening program in the 1990s when it refused to share the pros and cons with all women taking part in screening as a necessary discussion about informed consent. He believes that fully informed women over the age of 50 should choose for themselves as there is evidence past age 50 it saves lives, but he is on the record saying: "To promote screening mammography to women under the age of 50 is absolutely unethical."

But let's take a closer look at that age of 50 -- that age is chosen because the median age of menopause in western women is around 49.  Onset of menopause ranges from the early 40s to the late 50s. Some women do not experience menopause ( a full year without a menstrual period) until age 58 or 59. The evidence is that it is likely menopause not age, that is the defining factor of whether screening mammograms are helpful.  ( It could again be angiogenesis and the menstrual cycle, some theorize.) The evidence is convincing enough for me that I have decided I will not undergo a screening mammogram until I have had one full year of cessation of menstruation. The best results for screening is among women aged 60 to 69, likely because all women by that age are menopausal.

Here is another fact that more women should know. The huge drop in the use of hormone replacement therapy corresponds exactly, with a lag time, with a significant drop in breast cancer incidence. In fact, more lives may be saved by not doing HRT than from screening.  There was a 13 per cent drop in hormone receptor positive breast cancer between 2001 and 2004 and an 8 per cent drop in a single year ( 2002/2003) that tracks exactly to the sudden stop of HRT by millions of women following the 2001 results of the Women's Health Initiative, that found HRT was harming women.

Look at these two graphs from the New England Journal of Medicine and note the  drop  corresponds to the sudden decline in prescriptions for HRT. Although the issue is still being debated, a similar decline was seen in Canada, Spain and the UK, and a special study by regions in California also showed the same result. Click to enlarge the thumbnail to better read the graph, from New England Journal, Berry et al, April 19, 2007 

For those of you wanting more references, here are a few ones to start. The literature is huge. Just google pubmed and go to the National Library of Medicine data base. You could be reading for hours. I am citing the British Medical Journal and European journals primarily because there seems to be a more open discussion of the pros and cons over the last decade in Europe than in North America,  which may be interesting to Canadian women. Here in North America we still shoot the messenger, as has been seen by the coverage of the past week. Thus, I am wearing my flak jacket.

H Gilbert Welch. Overdiagnosis and mammography screening.

BMJ 2009 339: b1425. [Extract] [Full Text]

Zackrisson S, Andersson I, Janzon L, Manjer J, Garne JP. Rate of over-diagnosis of breast cancer 15 years after end of Malmö mammographic screening trial: follow-up study. BMJ 2006;332: 689-91.[Abstract/Free Full Text]

Duffy SW. Some current issues in breast cancer screening. J Med Screen 2005;12: 128-33.[Medline]

Moller B, Weedon-Fekjaer H, Hakulinen T, Tryggvadottir L, Storm HH, Talback M, et al. The influence of mammographic screening on national trends in breast cancer incidence. Eur J Cancer Prev 2005;14: 117-28.[CrossRef][ISI][Medline]

H Gilbert Welch, Lisa M Schwartz, and Steven Woloshin. Ramifications of screening for breast cancer: 1 in 4 cancers detected by mammography are pseudocancers
BMJ 2006 332: 727. [Extract] [Full Text]

 Michael Baum. Ramifications of screening for breast cancer: Consent for screening BMJ 2006 332: 728. [Extract] [Full Text]

• I've had differing reactions to my blog on peanut bans, one of which was that young allergic children cannot be charged with keeping themselves safe. I totally agree and I did not want to give that impression. Risk management must have responsible adults oversee it. Adults ensure safe processes are followed. It means that teachers or cafeteria staff must enforce the rules that everyone sits in place and eats their food, with no food sharing. It means that the adult asks who has an allergenic food that day, and that kids are separated in a way that no one feels bad, or singled out or isolated. It means the adult oversees the safe and effective clean up - "Johnny, you missed that spot there, wipe it up again." or " Dylan, don't throw that wash cloth, walk over to the sink and rinse it out." Without a process that all agree to, responsible adults to monitor the process and consequences if the process is not followed, the allergic child is left to fend for his or her self and risk management is equally unsafe as peanut bans or no plan at all.
• An interesting article on HPV vaccination appeared in the Nov 5 New England Journal of Medicine. Instead of using the vaccine to prevent infection with HPV -- as it is being used now -- Dutch doctors created a variant of the HPV-16 vaccine and gave it to 19 women with early precancerous lesions of the vulva. Typically these women would have had to undergone an invasive course of repeated ablations with a carbon dioxide laser ( burning) or wide excision via surgery ( cutting) of their vulva to remove these lesions to stop them progressing to cancer. Recurrence is almost universal. So instead the Dutch doctors gave the vaccine to prime the women's immune systems to fight the HPV strain themselves. Of the 19, 15 had a marked improvement of symptoms  and 9 women completely cleared the lesion and remained lesion free 2 years later. The use of immune modulating to fight early cancer is a fascinating and hugely important area of medicine. The HPV vaccine and the Hepatitis B vaccine are both proving that some future cancers can be prevented by immunization. Now new evidence is emerging that early cancer may one day be widely treated by the same means. I believe the viral role in cancer will be an area of explosive research in the decade ahead. Some are suggesting that viral causes of prostate cancer and some forms of  breast cancer may also be revealed.