Not a Choice: Reflections on Political Folly

Across the country, even globally, the mad rush is on by politicians to indulge the public mood and eliminate COVID restrictions. I think it a mistake and that it comes too soon.

At home, nearly a million Americans have perished and our medical grid buckles as COVID patients, the vast majority unvaccinated, take up hospital beds. Meanwhile, many needing cancer screening, surgery or follow-up are turned aside. New research reveals its devastating consequences.

Long term COVID can be dehabilitating, even for those vaccinated. Recently, I had conversation with a man from Louisville, a home physical therapist. He shared he had come down with the virus six months ago, was placed on a ventilator, then developed pneumonia. He still doesn’t feel right. He’s married with four children and just 29. He told me—I didn’t need convincing—that he’d not be here at, all had he not been vaccinated.

Yes, omicron infections have been plummeting, but they still highly exceed the number of infections before the Delta impact, then averaging between 12,000 and 16,000 daily cases. In contrast, “the U. S. daily average of cases and hospitalizations on 16 February was about 124,000 and 81,000” (NYT).

As Vanderbilt University School of Medicine infectious disease expert William Schaffner cautions, “Some governors think we are almost there – they are dropping mask mandates – and my response is: good luck to you. My fingers are crossed on your behalf.”

I believe strongly in Biden’s mandates to ensure public safety, sadly thwarted by the courts under the auspices of the First Amendment and public non-compliance. Good government that seeks the welfare of its citizens fulfills government’s proper role without nullifying the tenets of our Constitution.

Observing COVID protocol is not a personal choice. It’s a necessity.

—rj

Intolerance: Medicine’s Nemesis

Medical Statue at Semmelweiss Medical Museum
Medical Statue at Semmelweiss Medical Museum (Photo credit: Curious Expeditions)

I had grown up thinking medicine was free of the prejudices, if not sheer ignorance, rampant in the everyday world where resistance to anything new seems a given.  Let’s face it:  we humans don’t like having the security of our assumptions challenged.  The truth is that the history of medicine shows the same proclivity for stubbornness or subordination to the weight of custom as elsewhere.

In his riveting study, Doctors: The Biography of Medicine, physician Sherwin Nulan recounts the story of Ignac Semmelweiss, a young Viennese physician in the 1840s, who observed that women delivering their babies in hospitals died of puerperal, or bed fever, considerably more frequently than those delivering at home.  He did his own research to find out why, ultimately discovering a link between medical student routine and maternal deaths.

Each day,  students and profs would examine cadavers in between visiting patients. Although they didn’t have any notion of germs back then, Semmelweiss ultimately concluded that “invisible cadaver particles” on the hands of students and attending physicians was the source.  In short, he had discovered the role of infection in promoting illness.  

Instituting a protocol of his students’ washing their hands in a chlorine solution, he saw a dramatic drop-off in mortality.  His colleagues, however weren’t amused by this young upstart, whose research implicated them in so many deaths.  Consequently, Semmelweiss didn’t publish his research for fifteen years.

Dr. Joseph Lister
Dr. Joseph Lister

By the 1860s,  Louis Pasteur’s germ theory had entered into medicine, though it initially wasn’t widely accepted.  In Britain, Dr. Joseph Lister decided to apply the notion to post surgical infections, which were nearly always fatal.  Discovering that a neighbor city had poured carbolic acid down its drains to eliminate a potent sewer stench, he concluded that the acid had killed microorganisms similar to those Pasteur had identified.  Applying this concept to surgery, he employed wound dressings saturated in carbolic acid.  Later, he added spraying the entire surgical area with the solution.  Ultimately, he expanded the solution to washing his hands and instruments.  Lister published his successful results in 1867, inaugurating the formal beginnings of antisepsis.  It would be another generation, however, before Lister’s innovations became universal.

It was only in the 1880s that doctors had finally moved beyond a solely antiseptic solution to changing their clothes and boiling their instruments, sutures, towels, and sponges and adopting a ritual of vigorous hand washing.  In 1893,  Dr. William Halsted  became the first surgeon to wear a surgical mask.  In the 1920s, white garments and linens became universal, though the former now seems to be giving way to darker shades again.

Infection still remains a serious threat and the shorter your hospital stay, the better your odds.  Each year, nearly 2 million patients experience infection and 100,000 die.

Even with today’s antibiotics, infection looms as a serious menace, complicated by the increasing rise of resistant, highly contagious bacteria strains.

The bottom line in medicine is that what we don’t know often governs more than what we know.   After several thousand years, we overwhelmingly treat symptoms, not causes.  Now and then, however, a Semmelweiss or Lister appears like some new Columbus, charting a vastly different terrain leading to a New World.  Thus, it behooves medicine to be open to self-scrutiny, forfeit vested authority, tradition, and prejudice.  Only in this way can we find the breakthroughs that advance our safety, promote our healing, and perhaps offer sovereignty over some of our most chronic diseases like cancer.

–rj

.

%d bloggers like this: