As a radiologist, I really appreciated this comic “A Radiologist’s Day“. You can click on the image below to see the full-sized version.
(And I bought the shirt at CafePress.)
Back in December, I answered a question about the reality of karma on Philosophy in Action Radio. If you’ve not yet heard it, you can listen to or download the relevant segment of the podcast here:
Then, some weeks ago, Robert Garmong sent me a tidbit from this article — Shock and Anger in Cambodian Village Struck With H.I.V. — relevant to karma:
The villagers’ affection for the doctor does not blunt their pain and bewilderment over the mass infection. Prum Em, Ms. Yao’s 84-year-old husband, stares with blank incomprehension when asked about the infections, which struck across three generations.
“I have done only good deeds my whole life,” he said. “It’s inconceivable that the family could have this much bad luck.”
Robert Garmong added:
There’s no specific evidence that this is what happened, but it could easily have been the case that this man’s family members intentionally took risky injections because “my family has only done good deeds, so surely the downside risk won’t happen to me.” I doubt that’s what happened, because there’s no evidence that the people even knew they were taking a risk. But the point remains. By messing with people’s rational calculations, the concept of “karma” leads in principle to self-destructive thinking.
I’ve been slightly appalled by the way that the debate over vaccination has proceeded of late — particularly in the belligerent peddling of misinformation and calls for government controls. (I’ve seen that on all sides, unfortunately.) Alas, that’s to be expected when sick kids are involved. In any case, because I’m answering a question on Sunday’s Philosophy in Action Radio about whether people have an obligation to vaccinate purely for the sake of herd immunity, I thought that I’d compile some links for reading in advance.
A word of warning, first. As you’ll see, these links are from a variety of perspectives, and I’m not vouching for them. You shouldn’t assume that I agree with them. They’re just to help inform you about the debate.
Also, I answered a question about compulsory vaccination on the 3 August 2014 episode of Philosophy in Action Radio. If you’ve not yet heard it, you should listen to or download the relevant segment of the podcast before Sunday’s broadcast. It’s here:
For more details, check out the question’s archive page.
And with that… see you on Sunday!
I’m sorry to report that my horse Phantom and I parted ways on Thursday afternoon, shortly after a ditch during cross-country schooling. She was scared and jumped it big. Immediately thereafter, I went left and she went right. I ended up unconscious on the ground, and she ran back to the trailer to her buddy Lila. (Poor Phanny didn’t mean to unseat me; she doesn’t have any meanness or screw-you in her, just fear.)
I woke up quickly, but I was pretty woozy for the rest of Thursday. (I got a CT scan that evening, and hooray, no bleeding!) So I just have a concussion. Basically, I got my bell rung, harder than I’d like. I wasn’t injured other than that, except that I bit my tongue. I was, of course, wearing a protective helmet and vest.
So now I need to take life gently for a few days. That’s not easy for me, but I’m going to work at it. I’m really eager to get on both horses again, although it was a real treat to watch Eric Horgan ride Phantom on Friday.
Anyway, the really good news is that I’ve made such good progress since that first night — to the point that I’m feeling pretty normal now. So I’m game to go ahead with Sunday’s broadcast of Philosophy in Action Radio. We’ve got some great questions on tap, and the first one is even relevant to my recent experience!
This is a horrifying story: Cancer doc admits scam, giving patients unneeded chemo. This doctor gave unnecessary chemotherapy — basically, he poisoned his patients — for money. (The profit motive is usually a tremendous force for good… but not always.)
Here’s the bright spot in this morally bleak story — the nurse who turned him in as soon as she saw (in a job interview) him doing wrong:
Angela Swantek, a chemotherapy nurse who blew the whistle on Fata to state authorities in 2010, was in the courtroom during Fata’s guilty plea. She said she was relieved to hear him admit to things she witnessed years ago in his office. “I’m numb,” she said in a court hallway. “I’m not surprised though; I wondered how his team was going to defend him. The charts don’t lie.”
Swantek, 45, of Royal Oak, said she went to Fata’s office for a job interview in 2010 when she saw patients getting chemotherapy in a manner that wasn’t correct. “I left after an hour and half. I thought this is insane,” she said. That same day, Swantek went home and wrote a letter to the state and suggested they investigate him.
According to Swantek, the state did nothing and notified her in 2011 that they had found no wrongdoing. “I handed them Dr. Fata on a platter in 2010 and they did absolutely nothing,” said Swantek, noting she was elated when she learned the federal government charged Fata in 2013.
“I started crying,” she said. “I thought about all of the patients he took care of and harmed.”
Kudos to her for reporting him to the authorities, rather than just walking away. If only those authorities had done their job…
Monica Hughes recently gave an excellent talk on, “The Transformation of American Healthcare: Lessons from the Veterans Administration and Existing FDA Standards of Care” to Liberty On The Rocks at Flatirons.
Her talk is now available on YouTube (3 parts).
Disclaimer and synopsis:
DISCLAIMER: The speaker is not a medical doctor or health care practitioner. The ideas in this video are not intended as a substitute for the advice of a trained health professional. All matters regarding your health require medical supervision. Consult your physician and/or health care professional before adopting any nutritional, exercise, or medical protocol, as well as about any condition that may require diagnosis or medical attention. In addition, statements regarding certain products and services represent the views of the speaker alone and do not constitute a recommendation or endorsement or any product or service.
Synopsis: In January 2014, Robb was diagnosed with glioblastoma multiforme (GBM), one of the deadliest brain cancers in existence. Nicknamed “The Terminator” the median survival time is around 11 months. Robb had brain surgery on January 16, which was performed by a team of surgeons while Robb was awake. The surgery was a success.
Monica’s research into the post-surgery treatments that worked best for other survivors showed that they were not approved by the Food and Drug Administration, so they’d have to go to a cancer center that sprouted up in Tijuana, Mexico for treatment which included a 100 year-old immune system booster called Coley’s Vaccine.
Bio: Monica Hughes has bachelor’s, master’s, and PhD degrees in biology and has taught college biology since 2006. Previously, Monica served as a medical writer for National Jewish Health, a premier research hospital for respiratory and immune disorders, and is now a patient advocate specializing in literature research.
Robb LeChevalier has served in the Air Force and has a bachelor’s degree in electrical engineering. He designed his own home situated in the foothills outside of Denver, and currently develops high speed electronics for his own company, Astronix Research. He has been an Objectivist for 40 years.
More: Robb was given 2 months to live without surgery, a maximum of 6 months to live with surgery only, and an unspecified amount of time with additional therapy due to the unusually aggressive nature of his particular tumor. He and his wife Monica faced seemingly insurmountable hurdles by the Veterans Administration along the way, including timely care from the VA and a delay of emergency surgery that could have cost Robb his life had they not pushed for a special dispensation from a panel of VA doctors within the 48 hours leading up to his scheduled surgery. They are currently contesting 58 claims denials by the VA totaling nearly $250,000 in unpaid medical bills.
In the days following Robb’s surgery, they discovered that immunotherapy held the best chance of long-term and quality survival for this cancer. Historical 3 year survival with FDA-approved standard of care for GBM is around 7%. 3-5 year survival for some GBM patients in clinical trials using cancer vaccines is between 20%-50%, depending on the vaccine. Yet they discovered that due to FDA regulations, it is impossible to enter these clinical trials without first or concurrently undergoing FDA-approved standard of care, and that such care would greatly reduce his likelihood of responding to immunotherapy, if he was lucky enough to meet the criteria for the study and be placed in the treatment arm of such a trial.
Given these poor odds, Robb chose to forego all standard of care therapy after surgery, and opted for an immunotherapy protocol abroad that, according to current MRI results, has left him without evidence of disease. As of June 10, 2014, their new low deductible PPO health insurance policy, purchased on the Obamacare exchange, has not paid out a single penny of reimbursement for Robb’s cancer treatment.
(Note: I also discussed their case in my 5/28/2014 Forbes piece, “VA Denies Coverage For US Air Force Veteran With Malignant Brain Tumor“.)
A while back, I had to look up the spelling of Dr. Mengele’s name, and as a result, I came across this horrifying article: Why One Auschwitz Survivor Avoided Doctors for 65 Years.
The transport to Auschwitz took two weeks. His sick father died on the journey. Upon arrival, they had to strip and submit to an inspection. Ganon’s mother and five siblings were then sent to the gas chambers.
Yitzhak Ganon was taken to the Auschwitz-Birkenau hospital, where Josef Mengele, the so-called “Angel of Death,” conducted grisly experiments on Jewish prisoners.
Ganon had to lie down on a table and was tied down. Without any anesthetics, Mengele cut him open and removed his kidney. “I saw the kidney pulsing in his hand and cried like a crazy man,” Ganon says. “I screamed the ‘Shema Yisrael.’ I begged for death, to stop the suffering.”
After the “operation,” he had to work in the Auschwitz sewing room without painkillers. Among other things, he had to clean bloody medical instruments. Once, he had to spend the whole night in a bath of ice-cold water because Mengele wanted to “test” his lung function. Altogether, Ganon spent six and a half months in the concentration camp’s hospital.
Although I read a slew of books on the Holocaust last year, I avoided reading about the gruesome experiments of Nazi doctors. For someone to deliberately inflict suffering worse than death on innocent people, including children. As much as I want to recognize the historical facts and honor the victims, it’s far, far too horrifying imagine.
This USA Today article — Dangerous MRSA bacteria expand into communities — is a good bit of journalism. It begins:
Eric Allen went to bed March 1, thinking he had a light flu. By the time he staggered into the hospital in London, Ky., the next day, he was coughing up bits of lung tissue. Within hours, organs failing, he was in a coma.
Tests showed that Allen, 39, had a ravaging pneumonia caused by methicillin-resistant Staphylococcus aureus, or MRSA, an antibiotic-resistant bacteria once confined to hospitals and other health care facilities. Allen hadn’t been near a doctor or a hospital.
Same with the next victim, a 54-year-old man, who came in days later and died within hours. And the victim after that, a 28-year-old woman, dead on arrival.
The doctors were alarmed.
“What really bothered me was the rapidity of their deterioration, a matter of hours,” says Muhammad Iqbal, a pulmonologist who chairs the infection control committee at Saint Joseph-London hospital. “We were worried that something was spreading across the community.”
Indeed, a deadly form of MRSA had sprung from nowhere, picking off otherwise healthy people. The cases thrust Iqbal and his colleagues to the front lines of modern medicine’s struggle against antibiotic resistant bacteria – perhaps the nation’s most daunting public health threat. No drug-defying bug has proved more persistent than MRSA, none has caused more frustration and none has spread more widely. In recent years, new MRSA strains have emerged to strike in community settings, reaching far beyond hospitals to infect schoolchildren, soldiers, prison inmates, even NFL players.
A USA TODAY examination finds that MRSA infections, particularly outside of health care facilities, are much more common than government statistics suggest. They sicken hundreds of thousands of Americans each year in various ways, from minor skin boils to deadly pneumonia, claiming upward of 20,000 lives. The inability to detect or track cases is confounding efforts by public health officials to develop prevention strategies and keep the bacteria from threatening vast new swaths of the population.
Now… go read the whole thing: Dangerous MRSA bacteria expand into communities. It’s well-worth a few minutes of your time!
I was intrigued by the hypothesis that MRSA is carried by a certain low percentage of the population, then strikes when its host is weakened by flu or other illness. However MRSA is spread, the prospect of life in a post-antibiotic world is damn scary.
As it happens, I answered a question about antibiotic resistance in a free society on the 17 February 2013 episode of Philosophy in Action Radio that might be of interest. If you’ve not yet heard it, you can listen to or download the relevant segment of the podcast here:
For more details, check out the question’s archive page.
Chris Land posted this to Facebook yesterday, and it’s too awesome not to share:
Announcing the AFFORDABLE RELATIONSHIP PROTECTION ACT
Looking for a romantic partner takes time, energy and money. Sadly, many American adults are currently unrelationshipped. Who can they turn to in need? To whichever institution is in the best position to help, that’s who!
A few years after the passage of the Affordable Relationship Protection Act, the website YourLoveMatch.gov will go live. Unrelationshipped adults can then create an online profile with the help of specially funded Coaches. Based on your individual selection criteria, an exciting new partner will be assigned in 4-6 weeks. Love at last!
To provide the necessary funding, all adults will be required to set up an account or face a small penalty (this is not a tax unless it needs to be for legal reasons). Those already in a relationship will be required to register that relationship. Government is what we do together.
IF YOU LIKE YOUR PARTNER, YOU CAN KEEP YOUR PARTNER. Any significant changes (like change of job or residence or a new tattoo) will require re-registration. Approval will be routine unless you’ve selected a substandard partner. In those rare cases, your new partner will be a big improvement!
Sure there will be a few bugs to work out. A few kinks, some bumps in the road. But let’s all keep the end goal – happy relationships for everyone! – firmly in mind. Anyone against this WANTS people to be unhappy. Stride forward, comrades! Forward to the future!
I’m looking forward to upgrading my substandard partner soon! Sure, I’ll have to pay a bit more, but I’ll get something much better, right? Right?!?
PJ Media has just published my latest column, “Will Tomorrow’s Medical Innovations Be There When You Need Them?”
My basic theme is that we must protect the freedoms necessary for the advancement of medical technology.
I start with a pair of vignettes:
How much has American medicine changed in the past 30 years?
Let’s turn the clock back to 1983. A middle-aged man, Dan, is crossing the street on a busy midday Monday. An inattentive driver runs a red light and plows into Dan at 45 mph, sending him flying across the pavement. Bystanders immediately call for help. An ambulance rushes Dan to the nearest hospital. In the ER, the doctors can’t stabilize his falling blood pressure. They prep him for emergency surgery. The trauma surgeon tries desperately to stop the internal bleeding from his badly fractured pelvis but is unsuccessful. Dan dies on the operating table.
The surgeon gives Dan’s wife the sad news: “I’m sorry, but your husband’s injuries were too severe. We did everything we could. But we weren’t able to save him.”
Fast forward to 2013. Dan’s now-grown son Don suffers the same accident. But within minutes of his arrival in the ER, he’s sent for a rapid trauma body CT scan that shows the extent of the pelvic fractures — and more importantly, shows two badly torn blood vessels that can’t be easily reached with surgery.
An interventional radiologist inserts a catheter into the femoral artery in Don’s right leg. Watching live on the fluoroscopy screen, the radiologist skillfully guides the catheter through the various twists and turns of the arterial system and positions it at the first of the two “bleeders.” From within the blood vessel, he injects specially designed “microcoils” into the torn artery and stops the bleeding. He then guides the catheter to the second bleeder and repeats the procedure. Don’s blood pressure recovers. The surgeons now have time to repair Don’s pelvic fractures and other internal injuries.
The surgeons give Don’s wife the good news: “Your husband’s injuries were pretty bad. But we were able to fix everything. He’ll still have to go through recovery and physical therapy. But he should be back to normal in six months”…
For more, read the full text of “Will Tomorrow’s Medical Innovations Be There When You Need Them?”
(The material for the opening vignettes was drawn from two excellent presented last month at the 2013 annual meeting of the American Society of Emergency Radiology. )
Update #1: A great example of medical innovation coming from unexpected places was this 11/14/2013 New York Times article describing how an Argentinian car mechanic saw a Youtube video on how to extract a stuck cork from a wine bottle and realized it could also be used to help extract babies stuck in the birth canal.
His idea will be manufactured by Becton, Dickinson and Company and has already undergone initial successful safety testing in humans. It could save the lives of many babies in Third World countries and also reduce the need for Caesarean section in industralized countries. (Via Gus Van Horn.)
Update #2: For those interested in the real-life technology used in the fictional scenario I discussed, here’s a nice medical slideshow from UCLA interventional radiologist Dr. Justin McWilliams, “Life-saving Embolizations: Trauma and GI bleeding“.