Category: Health

While Looking for Spotted Fever, He Found the Cause of Lyme Disease

(p. A25) Willy Burgdorfer, a medical entomologist who in 1982 identified the cause of what had been a mysterious affliction, Lyme disease, died on Monday [November 17, 2014] at a hospital in Hamilton, Mont. He was 89.
. . .
In the early 1980s, Dr. Burgdorfer was analyzing deer ticks from Long Island that were suspected to have caused spotted fever when he stumbled on something unexpected under his microscope: spirochetes, disease-causing bacteria shaped like corkscrews. They were located in only one section of the ticks, the so-called midguts. He had studied spirochetes in graduate school.
“Once my eyes focused on these long, snakelike organisms, I recognized what I had seen a million times before: spirochetes,” he said in a 2001 oral history for the National Institutes of Health, which include the National Institute of Allergy and Infectious Diseases.
He had not been working on Lyme disease, but he had spoken with the doctor who helped discover it, Dr. Allen Steere of Yale. After he saw the spirochetes in the Long Island ticks, he quickly realized that the bacteria might also be in the deer ticks believed to be playing a role in Lyme disease in Connecticut and elsewhere, including Long Island.

For the full obituary, see:
WILLIAM YARDLEY. “Willy Burgdorfer, Who Found Bacteria That Cause Lyme Disease, Is Dead at 89.” The New York Times (Thurs., NOV. 20, 2014): A25.
(Note: ellipsis, and bracketed date, added.)
(Note: the online version of the obituary has the date NOV. 19, 2014.)

“Bad Ideas Die Hard, Especially Those that Flatter Our Vanity”

(p. C5) Mütter was one of the first plastic surgeons in America.
. . .
Mütter was also a pioneer of burn surgery.
. . .
Every hero needs a good antagonist and Mütter had a great one, a professor and blowhard named Charles D. Meigs who was as contrary as a Missouri mule. Meigs was a highly regarded obstetrician and one of Mütter’s colleagues at Jefferson. He rejected Mütter’s namby-pamby notions by reflex. Anesthesia? Pshaw! Men and women are put on earth to suffer. Handwashing? Humbug! The very idea that physicians could spread disease was preposterous. As Meigs wrote, “a gentleman’s hands are clean.” Unfortunately, bad ideas die hard, especially those that flatter our vanity. The fight to make medicine as humane as possible continues long after Mütter’s premature death from tuberculosis in 1859.

For the full review, see:
JOHN ROSS. “The Doctor Will See You Now.” The Wall Street Journal (Sat., Aug. 30, 2014): C5.
(Note: ellipses added.)
(Note: the online version of the review has the date Aug. 29, 2014, and has the title “Book Review: ‘Dr. Mütter’s Marvels’ by Cristin O’Keefe Aptowicz.”)

The book under review is:
Aptowicz, Cristin O’Keefe. Dr. Müt­ters Marvels: A True Tale of Intrigue and Innovation at the Dawn of Modern Medicine. New York: Gotham Books, 2014.

Embryo Stem-Cells Improve Sight in Severe Vision Loss Patients

(p. A7) Researchers have used stem cells from human embryos to treat patients suffering from severe vision loss, the first time the technique has been shown to be both safe and potentially effective in a sustained way.
. . .
. . . , Dr. Lanza and his colleagues first obtained an eight-cell embryo from a fertility clinic. (The embryo was left over from fertility treatments and was destined for destruction.)
. . .
Vision tests suggested that 10 of the 18 treated eyes had improved sight, with eight patients reading more than 15 additional letters on a reading chart in the first year after transplant. Visual acuity remained the same or improved in seven patients, though it decreased by more than ten letters in one patient.

For the full story, see:
GAUTAM NAIK. “Vision Improves in Stem-Cell Trial.” The Wall Street Journal (Weds., OCT. 15, 2014): A7.
(Note: ellipses added.)
(Note: the online version of the story has the date OCT. 14, 2014, and has the title “Stem Cells Show Potential Benefits for Eye Diseases.”)

Forssmann’s Courage Rewarded with “Professional Criticism and Scorn”

(p. 197) Forssmann’s report in the leading German medical journal garnered him not hosannas but instead fierce professional criticism and scorn. In response to a senior physician who claimed undocumented priority for the procedure, the twenty-five-year-old Forssmann was forced to provide an addendum to his publication one month later. Rigid dogmatism and an authoritarian hierarchy characterized the German medicine of that day. The human heart, as the center of life, was considered inviolable by instrumentation and surgery.

Source:
Meyers, Morton A. Happy Accidents: Serendipity in Modern Medical Breakthroughs. New York: Arcade Publishing, 2007.

Denied Approval to Catheterize Hearts, Forssmann Catheterized His Own

(p. 195) Forssmann received his medical degree from the University of Berlin in 1929. That year, he interned at a small hospital northwest of Berlin, the Auguste-Viktoria-Heim in Eberswalde. He pleaded with his superiors for approval to try a new procedure–to inject drugs directly into the heart–but was unable to persuade them of his new concept’s validity. Undaunted, Forssmann proceeded on his own. His goal was to improve upon the administration of drugs into the central circulation during emergency operations.
The circumstances of the incident on November 5, 1929, revealed by Forssmann in his autobiography, could hardly have been (p. 196) more dramatic. The account reflects Forssmann’s dogged determination, willpower, and extraordinary courage. He gained the trust of the surgical nurse who provided access to the necessary instruments. So carried away by Forssmann’s vision, she volunteered herself to undergo the experiment. Pretending to go along with her, Forssmann strapped her down to the table in a small operating room while his colleagues took their afternoon naps. When she wasn’t looking, he anesthetized his own left elbow crease. Once the local anesthetic took effect, Forssmann quickly performed a surgical cutdown to expose his vein and boldly manipulated a flexible ureteral catheter 30 cm toward his heart. This thin sterile rubber tubing used by urologists to drain urine from the kidney was 65 cm long (about 26 inches). He then released the angry nurse.
They walked down two flights of stairs to the X-ray department, where he fearlessly advanced the catheter into the upper chamber (atrium) on the right side of his heart, following its course on a fluoroscopic screen with the aid of a mirror held by the nurse. (Fluoroscopy is an X-ray technique whereby movement of a body organ, an introduced dye, or a catheter within the body can be followed in real time.) He documented his experiment with an X-ray film. Forssmann was oblivious to the danger of abnormal, potentially fatal heart rhythms that can be provoked when anything touches the sensitive endocardium, the inside lining of the heart chambers.

Source:
Meyers, Morton A. Happy Accidents: Serendipity in Modern Medical Breakthroughs. New York: Arcade Publishing, 2007.

Major Cancer Drugs Have Come from Unexpected Sources

(p. 182) Starting in the last decades of the twentieth century, last decades of the twentieth century, sophisticated genetics and molecular biology have been aimed toward a more precise understanding of the cell’s mechanisms. Yet, even here, chance has continued to be a big factor. Surprising discoveries led to uncovering cancer-inducing genes (oncogenes) and tumor-suppressing genes, both of which are normal cellular genes that, when mutated, can induce a biological effect that predisposes the cell to cancer development. A search for blood substitutes led to anti-angiogenesis drugs. Veterinary medicine led to oncogenes and vaccine preparations to tumor-suppressor genes. In one of the greatest serendipitous discoveries of (p. 183) modern medicine, stem cells were stumbled upon during research on radiation effects on the blood.
Experience has clearly shown that major cancer drugs have been discovered by independent, thoughtful, and self-motivated researchers–the cancer war’s “guerrillas,” to use the reigning metaphor–from unexpected sources: from chemical warfare (nitrogen mustard), nutritional research (methotrexate), medicinal folklore (the vinca alkaloids), bacteriologic research (cisplatin), biochemistry research (sex hormones), blood storage research (angiogenic inhibitors), clinical observations (COX-2 inhibitors), and embryology (thalidomide).

Source:
Meyers, Morton A. Happy Accidents: Serendipity in Modern Medical Breakthroughs. New York: Arcade Publishing, 2007.

Affordable Care Act Reduces GDP, Employment and Labor Income

(p. A17) Whether the Affordable Care Act lives up to its name depends on how, or whether, you consider its consequences for the wider economy.
. . .
I estimate that the ACA’s long-term impact will include about 3% less weekly employment, 3% fewer aggregate work hours, 2% less GDP and 2% less labor income. These effects will be visible and obvious by 2017, if not before. The employment and hours estimates are based on the combined amount of the law’s new taxes and disincentives and on historical research on the aggregate effects of each dollar of taxation. The GDP and income estimates reflect lower amounts of labor as well as the law’s effects on the productivity of each hour of labor.
. . .
The Affordable Care Act is weakening the economy. And for the large number of families and individuals who continue to pay for their own health care, health care is now less affordable.

For the full commentary, see:
CASEY B. MULLIGAN. “OPINION; The Myth of ObamaCare’s Affordability; The law’s perverse incentives will have the nation working fewer hours, and working those hours less productively.” The Wall Street Journal (Tues., SEPTEMBER 9, 2014): A17.
(Note: ellipses added.)
(Note: the online version of the commentary has the date SEPTEMBER 8, 2014.)

Mulligan’s research on the effects of Obamacare is detailed in his Kindle e-book:
Mulligan, Casey B. Side Effects: The Economic Consequences of the Health Reform. Flossmoor, IL: JMJ Economics, 2014.

Cancer Gains Have Not Come from “Centralized Direction”

(p. 180) The truth remains that over the course of the twentieth century, the greatest gains in the battle against cancer came from independent research that was not under any sort of centralized direction and that did not have vast resources at its disposal. As we have seen, such research led to momentous chance discoveries in cancer chemotherapy and a greater understanding of the mechanisms of the disease that have resulted in exciting new therapeutic approaches.

Source:
Meyers, Morton A. Happy Accidents: Serendipity in Modern Medical Breakthroughs. New York: Arcade Publishing, 2007.

War on Cancer Was “Profoundly Misconceived”

(p. 179) Following the testing of nearly half a million drugs, the number of useful anticancer agents remains disappointingly small. Expressions of discontent with the methodology of research and of research and the appalling paucity of results were, over the years, largely restricted to the professional literature. However, in 2001 they broke through to the popular media. In an impassioned article in the New Yorker magazine entitled “The Thirty Years’ War: Have We Been Fighting Cancer the Wrong Way?” Jerome Groopman, a respected clinical oncologist and cancer researcher at Harvard Medical School in Boston, fired a devastating broadside. “The war on cancer,” he wrote, “turned out to be profoundly misconceived–both in its rhetoric and in its execution. The high expectations of the early seventies seem almost willfully naïve.” Regarding many of the three-phased clinical trials, with their toxic effects, he marveled at “how little scientific basis there was and how much sensationalism surrounded them.” Groopman concluded that hope for progress resided in the “uncertainty inherent in scientific discovery.”

Source:
Meyers, Morton A. Happy Accidents: Serendipity in Modern Medical Breakthroughs. New York: Arcade Publishing, 2007.
(Note: italics in original.)

In 1971 Nixon “Launched an All-Out War on Cancer”

(p. 173) In 1971 the U.S. government finally launched an all-out “war on cancer.” In his State of the Union address in January 1971, President Richard Nixon declared: “The time has come in America when the same kind of concerted effort that split the atom and took man to the moon should be turned toward conquering this dread disease. Let us make a total national commitment to achieve this goal.”
As the country debated a bill known as the National Cancer Act, the air was filled with feverish excitement and heady optimism. Popular magazines again trumpeted the imminent conquest of cancer. However, some members of the committee of the Institute of Medicine, a part of the National Academy of Sciences, which was asked by the NCI to review the cancer plan envisioned by the act, expressed concern regarding the centralization of planning of research and that “the lines of research… could turn out to be the wrong leads.” The plan fails, the reviewers said in their confidential report, because

It leaves the impression that all shots can be called from a national headquarters; that all, or nearly all, of the really important ideas are already in hand, and that given the right kind of administration and organization, the hard problems can be solved. It fails to allow for the surprises which must surely lie ahead if we are really going to gain an understanding of cancer.

Source:
Meyers, Morton A. Happy Accidents: Serendipity in Modern Medical Breakthroughs. New York: Arcade Publishing, 2007.
(Note: ellipsis in original.)