Medical Topics – Page 5 – education and deconstruction.com

Koop

The Book of the Week is “Koop, The Memoirs of America’s Family Doctor” by C. Everett Koop, M.D., published in 1991.

Koop grew up in Brooklyn, New York. In the late 1920’s, when he was in his teens, the operating rooms at Columbia Presbyterian Hospital had no security, so he pretended to be a medical student in order to watch surgeries. He snuck in, thanks to his next door neighbor, who worked there. In the late 1930’s, he began to realize that he was attending the medical school that had the right environment for him– the friendly and cooperative Cornell, rather than the arrogant and competitive Columbia.

Koop’s medical training was abbreviated due to a shortage of personnel during WWII, so that he was performing advanced procedures before he was truly ready to do so. Nevertheless, he had a tough, take-charge personality which stood him in good stead in the face of medical generalists who resented being crowded out when medicine underwent more and more specialization.

For decades, Koop was a pediatric surgeon at the Children’s Hospital of Philadelphia. In 1980, newly-elected President Reagan tapped him to be Surgeon General of the United States. The nomination and confirmation processes were rigorous, as Koop’s personal life-and-death beliefs were clearly favored by conservative Republicans but opposed by liberal Democrats.

Nevertheless, Koop became famous for his anti-smoking crusade. As might be recalled, he educated the American public on the dangers of, and influenced legislation on, smoking. He explicitly wrote: “Smoking is not only dangerous for the smoker, but also dangerous for the nonsmoker who inhales environmental tobacco smoke… [Such] passive smoking causes many diseases, including cancer.” He reported that more than 50% of adults in the United States smoked in 1964; in 1981, 33%. When he resigned as Surgeon General in 1989, that figure was just over 26%.

Read the book to learn of Koop’s adventures in college, in medicine, and as a political appointee.

20 Things You Didn’t Know

The Book of the Week is “20 Things You Didn’t Know About Everything” by the editors of Discovery Magazine and Dean Christopher, published in 2008. This book briefly covers a range of topics, regaling the reader with trivia and interesting factoids.

One topic covered was airport security. As might be recalled, at this book’s writing, “The U.S. government continues to spend untold billions developing technology designed to detect weapons [which were never found in Iraq]– but extremely little on techniques and training to ferret out troublemakers at our airports.”

There are at least sixteen thousand classified species of bees. On average, bees fly at fifteen miles per hour. The honey they make can be used as an antibacterial wound-healer, because it contains certain infection-fighting substances. The chapter on mosquitoes lamented that people must learn to live with the blood-sucking bugs; however, it completely failed to mention that there exist fish that eat mosquito eggs, thus keeping the pest’s population down in certain places in the world, such as Florida and Australia.

At the book’s writing, there was a museum on the history of contraceptives in Toronto, Canada. Read the book to learn additional fun information.

Brain Rules

[SIDENOTE: Strangely, anytime, but only when this blogger writes something controversial, or about Donald Trump, WordPress crashes. Just an observation.]

The Book of the Week is “Brain Rules” by John Medina, published in 2008.

The author wrote about various factors that affect brain function, and how the brain can function better with regard to exercise, evolutionary developments, memory, driving, sleep, stress, the senses and gender.

The author claimed that studies have shown that any amount of exercise is better for the brain and body as a whole than no exercise at all. Intelligence can be maximized in work and school environments when people have a knowledge-base plus creativity. Other research showed that a simple experience of magazine-reading changed the neurons in the brain of one identical twin but not the other twin who hadn’t done magazine-reading.

Medina related a few anecdotes from his personal life to illustrate his points. A memorable incident for him occurred when a dog came out of a lake and shook water all over him. During those ten seconds, a normal human brain would “…recruit[s] hundreds of different brain regions and coordinate[s] the electrical activity of millions of neurons.”

The author cited blind gender studies in which subjects were asked their opinions of a person’s behavior; subjects held negative opinions of the person they were told was female, and positive opinions when told the person was male.

Medina crowed about how awesome retention was when research subjects were subjected to multi-sensory presentations (such as academic lectures, as when visuals, written text and verbal communication were used) as opposed to any of these alone. He advocated minimizing the reading by subjects of large chunks of text because tests showed that it was not as effective at getting subjects to retain information as was multi-media.

It appeared that the author was promoting dumbed-down education in general; perhaps because it is in the best interest of any university professor to tow his employer’s line (and possibly the government’s) in order to continue to receive research grants and further his or her career.

Read the book to learn of more neurological studies and the author’s ideas (which he admits are fantasies) that might improve cognitive functioning at work or school.

Unsolved Science

The Book of the Week is “Unsolved Science” by Bill Price, published in 2016.

This book is a compilation of articles discussing the various areas of science that humans have still to decipher.

One reason scientific mysteries remain is that they lie in regions difficult and expensive to study, such as the deep oceans and outer space.

Although it is known that humans have roughly half of the same DNA as bananas and 99% of chimpanzees, it is unclear what accounts for the differences in intelligence and linguistics between humans and the latter.

Read the book to learn why it is so difficult to find a cure for cancer; the causes of long-term global temperature changes; the pros and cons of nuclear power; and many other mysteries of the universe.

Case Files

The Book of the Week is “Case Files, 40 Murders and Mysteries Solved by Science” by Larry Verstraete, published in 2011. This book briefly describes how science played a role in the investigations of various situations, such as homicides, discoveries of human remains, the root cause of an epidemic, astronaut deaths, art forgery, arson and many others.

The topic areas included forensic entomology, archeological anthropology, pathology, DNA fingerprinting, radiocarbon dating, video superimposition, spectroscopy, stable isotope technology, Raman microscopy, xylotomy and others.

When a dead body is found, and certain insects are present, a scientist can learn how many generations and lifespans of that insect elapsed from the time of death until the corpse’s discovery.

The gender, age and size of a murder victim can be discerned, even when the body is badly decomposed, from the bones. The nature of the teeth indicate age, and ethnicity is revealed by the skull’s features. DNA testing of various kinds is a whole other ball of wax.

Read the book to get an overview of the many ways science can provide evidence for reconstructing events to further the causes of justice, improve people’s quality of life and prevent future mishaps.

Brain Food

The Book of the Week is “Brain Food” by Dr. Brian Morgan and Roberta Morgan, published in 1987. This book discusses how diet can affect brain health, and which nutrients to consume in order to improve brain function when certain conditions are present. It covers stress, moods, appetite, PMS, learning and memory, allergies, drugs, brain development and aging.

In recent decades, there have been numerous contradictory studies sponsored by entities that wish to promote particular edibles. The authors of this book backed up their suggestions with credible scientific sources, and did not make any sensational claims about one specific substance or food.

Common sense dictates that exercise tailored to an individual is always healthy. An exercise program might call for additional protein consumption, however, as muscles require it for growth.

The brain is unable to store oxygen or energy, so it must consume a few hundred calories a day and receive a continuous blood supply. Calories that have particular nutrients, are going to optimize brain function. Here is some information on the kinds of nutrients to eat to maintain a healthy mind and body:

Vitamins B1, B6 and B12 are important for maintaining healthy neurological structure and activity. Whole grains are a source of the B vitamins.

Serotonin and dopamine are neurotransmitters that aid sleep and produce positive emotional vibes. Magnesium and vitamin B6 stimulate their production. B6 can be found in bananas, Grape Nuts, fish, liver and peanuts. Happily for some people, magnesium is found in chocolate; also– spinach and almonds.

The body is likely to be deficient in protein and calcium when it experiences stress of prolonged duration.

Studies have shown that a high-protein diet accelerates aging. Thus, protein should comprise only 13% of calories eaten. If taste buds become dulled with aging, try a zinc supplement.

Animal fat worsens artery clogging. One substance that might help is pectin, found in apples, oranges and grapefruit. Eating fish is also a mitigating factor.

High blood pressure increases with the consumption of pickled foods and cold cuts. It might decrease with potassium-filled citrus fruit, leafy greens, raisins and almonds.

According to the authors, the key to peak intellectual performance is sufficient iron– found in liver, Grape Nuts, beef, carrots, lamb and raisins. Memory can be improved with lecithin supplements. Don’t forget to eat wheat germ, peanuts and ham. Another important nutrient is vitamin E, found in leafy greens, other vegetables and whole grains.

Of course, all of the above should be done in moderation and the reader should consult his or her doctor before a radical diet is started. Read the book to learn a wealth of additional information on the substances to put in your body to stay happy and healthy.

The Inheritor’s Powder

The Book of the Week is “The Inheritor’s Powder” by Sandra Hemple, published in 2013. This book recounts the advances made in investigating homicide by poisoning in England in the early to mid 1800’s, and describes one 1833 case that shows why killing via arsenic was so common at the time, and why it became even moreso. One reason was that 1840’s popular reading matter, novels and newspapers, piqued readers’ morbid curiosity by featuring stories on poisoning, which could serve as instructions.

In 1754, the founding of the Society of the Arts saw the launching of “… a series of competitions for inventions, discoveries and artistic endeavors with prizes in the form of medals and money.” This prompted chemists and dispensers of medical treatments to engage in research to improve their practices. The year 1814 saw the first extensive textbook on toxicology.

One scientific advance in the mid-1830’s was made by James Marsh, who developed a method to test for arsenic in human organs rather than stomach contents. Hugo Reinsch developed a different test that mixed arsenic with other substances. Both methods had their flaws.

Usually, money was the motive for murder by poisoning. The killer poisoned a member of his or her household and/or family– because he or she stood to inherit and/or collect on an insurance policy. There were many controversial cases that pitted scientists against each other over the toxicology test results. It will never be known how many people were sent to the gallows due to bungled tests.

Read the book to learn of the fate of the prime suspect in the aforesaid 1833 case, and whether the more likely perpetrator– whose past criminal history allegedly included a felony, jailing, illegitimate children and attempted murder, not to mention extortion in later years– was ever brought to justice.

The View From the Vue

The Book of the Week is “The View From the Vue” by Larry Karp, originally published in 1977. This is the personal account of a medical intern at Bellevue Hospital in New York City in the 1960’s. The place had a reputation for treating poor, mentally ill patients, as well as the medical facility to which lazy doctors from other facilities transferred poor patients.

The author related a series of anecdotes of the kinds of patients who frequented the hospital and the experience he received in diagnosing their sometimes then-rare ailments, such as abdominal pregnancy, and common ailments– J-O Rat Paste and lead poisonings. He also related a few interesting factoids of that bygone era, like “In these days, the name cards on the foot of each bed were color-coded according to the religion of the patient. Blue was the Jewish color.”

Read the book to learn of how his wife was allowed to assist him in his work as an unpaid intern of sorts (a situation that would never exist these days), and what transpired when he developed sleep-deprivation syndrome.

The Antidote

The Book of the Week is “The Antidote” by Barry Werth, published in 2014. This suspenseful saga is about the public drug company, Vertex.

Vertex has created the core substances in drugs that treat niche diseases, such as hepatitis C and cystic fibrosis. It has partnered with various other drug companies to use their resources.

Unconventionally, in the 1990’s, Vertex’s employees were organized into teams working on protein targets rather than those working on different diseases. The company’s teams were demoralized when they failed month after month to come up with a successful molecule.

The cost of American drugs is so high not just because the drugmakers are greedy, but because their employees feel entitled to a large reward for creating an effective product that does minimal harm to patients. They take tremendous risks– acquire pricey, extensive educations in organic chemistry and such, working long daily hours, suffer loads of stress from dealing with grant applications, patent disputes, licensing issues, doctor-insurer issues, undergoing the rigorous process of seeking FDA approval after laboring months or years on a drug substance– possibly applying for approval at the same time as another company with a competing product, and face the possibility of being laid off anytime. This is why life-saving, life-prolonging medicines are astronomically expensive. However, the drugs would not exist, but for the necessary evil of a greed machine that raises the funds to pay for the price of creating them.

Vertex posted a “profit” of more than $2 million in the fourth quarter of 1993, even though it had yet to sell even one pill. Its financial arrangements with its partners allowed it to claim that its income exceeded its expenses. By the end of the 1990’s, however, there were still no actual drugs produced, and the company was likely many years and hundreds of millions of dollars from the market. It was thus a likely takeover target. Some of Vertex’s scientists and lawyers became avid day-traders of the company’s stock in the autumn of 2000, after a deal with Novartis.

Trading rumors fly all the time, and one influential analyst at a big-name investment bank might downgrade a drug company’s stock, causing a selloff. In the early 2000’s, there was an SEC accusation of insider trading against Vertex’s house counsel. Ironically, it is common practice for panel members of the FDA to receive financial support in research-funding from many pharmaceutical companies.

Those companies that are public must answer to Wall Street. Unsurprisingly, at numerous medical conferences, their executives spout cliches such as “…We believe it’s a matter of time before we break this disease wide open and make a really big difference for a lot of people.”

Read the book to learn about actions Vertex took in research, development and finance in order to stay in business twenty years while accumulating losses of more than $1.5 billion; the causes of its high turnover of executives; how it became more geared toward finding commercial applications with its research results, and how it had fared product-wise and financially by autumn 2013.

Genius on the Edge – Bonus Post

This blogger skimmed “Genius on the Edge” by Gerald Imber, MD, published in 2010. This long book describes the career of Dr. William Halsted.

Halsted was born in 1852 in New York City. There was still much ignorance about medicine in his generation. Fatal diseases, such as malaria, yellow fever and tuberculosis were rampant. He developed a passion for medicine at Yale University. The most prominent doctors of his age included Pasteur, Lister, Morse, Hunter, Wells, Koch, Morton, Young and Warren. They spurred progress in sanitation, anaesthesia, and the collection of new information and techniques for treating patients.

In the 1870’s, Columbia College, Physicians and Surgeons didn’t require undergraduate degrees for entry because it was seeking revenue from student tuition. The three-year program was all lectures– no labs, no interaction with patients. In the 1870’s, during Halsted’s internship at Bellevue Hospital, many personnel didn’t wash their hands before operating, and smoked.

In late 1884, Halsted started using cocaine as a local anaesthetic in dentistry. He displayed, “…hyperactivity, rambling speech, inattention, and suspended decision-making ability.” Medical students and their teachers started using cocaine as a pick-me-up. They became addicted. “The drug was readily available in Europe, through Merck, and there was no stigma associated with its purchase.” In late 1886, Halsted went to work at Johns Hopkins Pathological– the “Bell Labs” of medicine. He went to Baltimore because his addiction had wrecked his career in New York. He substituted morphine for cocaine.

It is unclear how much better Halsted could have performed were it not for his addiction. He did have a brilliant career, but there were bouts of irresponsibility, socially and teaching-wise. He missed classes, started surgery at 10am instead of 8 after a while, failed to show up for meetings, and retreated to his country home for almost half the year. One positive side effect of his addiction was that Halsted delegated complete patient care to residents when he had morphine withdrawal symptoms. So the residents got a golden opportunity they would not have had otherwise, to learn their craft.

Side Note (There’s nothing new under the sun.): “As a group, they [nurses] felt themselves underpaid and overworked.” The Training School taught them to cook and clean. They were required to wear brown Oxford shoes.

Halsted experimented on dogs on and off for a couple of years, between months-long stints in drug rehab. He began seeing human patients for surgery in early 1889. He pioneered the medical-school residency program. He instituted the training of surgeons to train other surgeons. Three other doctors at Johns Hopkins who wrought major change in medicine in the U.S. were William Osler, William Welch, and Howard Kelly. Halsted specialized in surgery for breast cancer and inguinal hernia.

Johns Hopkins wanted to remain on the cutting edge of medicine by opening a medical school but it needed money to do so. Female heirs of prominent, wealthy families raised the money and placed conditions on the school’s opening, requiring gender equality. After much controversy, it opened in the fall of 1893.

Read the book to learn how medicine in America changed through the years of the late 19th into the 20th century, and how, according to this book, Johns Hopkins led the way.