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I won’t drag out that crusty joke about having to go to the airport to find a good surgeon in Las Vegas (nyark nyark!), but it seems to elbow itself into the conversation any time you talk about the state of health care in Nevada. Every time I ever heard it, the telling of it was always cynical and strangely gloaty, like the jokester was unconsciously reveling in our state’s troubled health-care system. If humor relies on a little bit of truculent accuracy for its impact (we’ve all winced at the punch line that lands too close to home, too near the bone), I’m not so sure that joke’s funny anymore. Because (after the fake-patriot pageant of closet racists and posturing gun-lobby molls subsided), the Nevada Legislature managed to move the state ahead on health care. One of the signature pieces of legislation that emerged from this session was launch-pad funding, about $27 million, for a medical school in Southern Nevada. (Heidi Kyser reports on the numbers, and what they mean, on page 23.) With added oomph by private donor money and additional backing to support graduate medical programs — the magic glue that encourages doctors to stay and practice and make a home in Nevada — the school is aiming to accept its first class as early as 2017. That not only holds the promise of alleviating our doctor shortage, stopping our medical brain-drain and introducing some badly needed specialty practices to Southern Nevada; it also translates into billions of dollars of medical spending that circulates in the state. Perhaps just as noteworthy is how we got to this point: with refreshingly tantrum-free collaboration between Northern Nevada and Southern Nevada, entities that haven’t always kumbayaed in the process of divvying up state revenue. Call me a Pollyanna, but when University of Nevada School of Medicine Dean Tom Schwenk says this legislation reflects a statewide vision for improving health care — and not, instead, a case of bickering siblings being momentarily pacified — I want to believe him. But whether this is the fruit of community-minded fraternity or backroom dealing, we’re undeniable winners.

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That promising development serves as a nice news peg for our health and medicine issue, and new emerges as a theme elsewhere, such as in “The next frontier” (p. 93). In this feature, we profile five new medical technologies — from cutting-edge nerve surgery techniques to cancer treatments that seem to come straight out of a sci-fi movie — that are offering patients renewed hope and health. And, back by popular demand, we’ve got Best Doctors 2015-2016 (p. 75) and topDentists (p. 83) to help you make health-care decisions with a list of the best medical and dental professionals in the Las Vegas Valley.

Anyone who thinks laughter is the best medicine probably never heard “The Aristocrats” joke. If you have heard it, sure, you’ve laughed — but you’ve also gasped and grimaced, too, and probably also made some strange feral, moaning noise to convey your mounting bafflement and frightened confusion. On the anniversary of the cult documentary about this legendarily offensive and shocking joke — really, less a joke than a sort of cathartic exercise that maps the edges of our fears and fantasies — we’ve got an oral history of the 2005 film (p. 106) produced by Penn Jillette and Paul Provenza. Not all jokes are funny, to be sure, but sometimes the point is not in the punch line, but in the telling.

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KNPR's State of Nevada
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