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In honor of Martin Luther King, Jr. and the holiday we celebrate today, I am reposting my two cents, first published June 13, 2008.
43 Ye have heard that it hath been said, Thou shalt love thy neighbour, and hate thine enemy.
44 But I say unto you, Love your enemies, bless them that curse you, do good to them that hate you, and pray for them which despitefully use you, and persecute you;
What would the world be like if Christianity as a whole really took this seriously?
While these words certainly sound nice, and few disagree in Sunday School, it seems to me that very few actually live these words. Our nation was touched and somewhat perplexed at the compassion of the Amish a couple of years ago after a gunman killed 5 small Amish girls before killing himself. The entire community forgave him, turned up in droves to his funeral, offered his widow condolences and the Nation generally approved. I wonder if there was any controversy within the Amish community themselves. Five years earlier, a cowardly civilian attack performed by hijacking airplanes and flying them into skyscrapers launched a cry of retribution leading to two wars with millions of casualties, the relaxing of civil rights and Geneva convention protocols, and lifting the torture ban regarding prisoners.
When other countries asked not to jump into war, to slow down, we derided them. When Singers spoke out against the idea of war they quickly became Pariahs and were decried as unpatriotic, complete with burning of albums and death threats. In short, most of America acted the way the natural man does, we returned violence and intolerance for violence and intolerance, loving our neighbor and hating our enemy. At my own peril, I am going to take a journey down into politics and war, a subject fraught with contentious traps, and explore the possibilities of nonviolence and loving our enemies.
First Published May23,2008
We hear a lot on-line about everything that is wrong is medicine. Improvement should always be our aim and this is healthy. I think it does us all a little good to take a step back and realize just what we have. There are some things medicine has done for us I don’t think you could put any price tag on. While most are intensely aware of shortcomings, here is a reminder of just what how powerful modern medicine has been.
1. Antiseptics– In the mid 18th century, around the same time, Oliver Wendell Holmes and a Hungarian physician, Ignaz Semmelweiss, both noticed that when obstetricians washed their hands, it drastically cut the number of mothers who died of fever afterward. Semmelwies reported this observation and was roundly chastised, discredited, and ridiculed. Holmes had actually published this same finding in a medical journal a few years earlier, even advocating disinfectants, where it was uniformly ignored.
Holmes turned prophet when the germ theory of disease emerged two decades later. Joseph Lister learned about the discovery of microbes as the cause of fermentation from Pasteur, theorized they could be the cause of wound infections and developed sterile operating technique with phenol. Infections rates plummeted, Lister’s fame soared, and the mouthwash named after him remains in use to this day.
2. Smallpox eradication– This disease killed an estimated 400,000 people in Europe every year in the 18th century, including 4 sitting monarchs. The mortality rate was 30% and it left survivors scarred for life wherever the sores developed. Sores on the eyes made it the #1 cause of blindness. Edward Jenner discovered the principle of vaccination in 1796, some efforts to organize campaigns to vaccinate were made as early as 1803 by the Spanish, however it took time to accept this wacky idea of injecting disease to get rid of disease.
Inoculation was banned in England in 1842. Over the next ten years the course reversed completely and vaccination was mandated in 1853. By 1900, Smallpox was virtually eradicated in the US and Britain, by 1978, it was eradicated from planet earth except in the freezer at the CDC for some suspect reason.
3. The polio vaccine– In the 1920’s Poliomyelitis was a scourge and a plague that everyone lived in fear of. The initial infection was as common and pretty identical to the common cold or influenza. Most people got, spread it and recovered. However, 10% of those infected had weakness, 1 in 10 of these developed permanent paralysis as the motor neurons in the spinal cord were destroyed.
Vaccination was first developed in the 18th century, and scientists fought to develop the vaccine for over fifty years. It took time to realize there were three different polioviruses, each pretty stable over time. In 1949, Dr. Jonas Salk made a breakthrough when he developed a technique to grow poliovirus in culture, rather than in live monkey brains. He then found a way to weaken the virus and the one of the most massive clinical trials in history was begun. People rushed their children to the doctor and proudly displayed buttons they were polio pioneers.
Today, polio has been eradicated in the Americas and tragically, only exists in very poor nations with poor vaccination rates. The WHO has long held a goal for complete eradication, which is theoretically possible and humans are the only host for the virus.
4. Anesthesia– Humphry Davy reported anesthetic properties of nitrous oxide in a paper in 1800. However, chemists decided it was much more fun as a recreational drug, until it was used in the first painless tooth extraction in 1846. Four years earlier, a surgeon by the name of Crawford Long had discovered diethyl ether had similar effects on the body as nitrous oxide and used it to anesthetize a patient before removing a neck tumor. Ether had this problem of flammability and tendency to explode leading to the development of several other inhaled anesthetics and now many IV anesthetics, which are much easier to administer reliably. This development, more than any other, is what allowed the advent of modern surgery.
5. Antibiotics- Though bread mold had been used to treat wounds by the Egyptians, and several other scientists had documented the penicillium molds ability to kill off bacteria in 1897-1914, the discovery of Penicillin is credited to Sir Alexander Fleming, who discovered the bacteria killer in 1928, just because he had the strange habit of playing around with fungus to see how it beat the bacteria off. He did not believe it would last long enough in the human body to kill bacteria and dropped the study in 1931. It remained for others to develop it for use as a drug and the US government went into large scale production during World War II. As sulfa, streptomycin and many others have been added to the arsenal, bacterial disease has never been the same since, pretty much uniformly sinking like a rock on the list of the top causes of mortality in the developed world.
6. Cracking the human genome– In 1950, A mysterious molecule called deoxyribonucleic acid had long been known to sit in the center of cells innocuously, not doing much. This changed in 1952 when Alfred Hershey and Martha Chase proved that DNA was the genetic material for the T2 bacteriophage virus. James Watson and Frances Crick then discovered the structure of deoxyribonucleic acid (DNA) and the way it could vary with 4 base pairs. This allowed Crick in 1957 to hypothesize the relationship of DNA, RNA , and protein in 1957. He would be vindicated as other scientists cracked the genetic code a few years later. Fast forward forty some odd years and the entire genome of mankind has been sequenced. Our understanding of inherited diseases has skyrocketed, with new information gained every day, multiplying exponentially both new ethical dilemmas and the possibility to treat the untreatable.
7. Medical imaging– In 1895, Wilhelm Conrad Roentgen was playing around with a myterious new “x-ray” he had discovered when he stopped in front of his ray detector and caught a glimpse of the shadow of his own skeleton. Two weeks later he took a picture of his wife’s hand and started us down the road to the entire field of Radiology. X-rays are vital to diagnose and treat bone problems and pneumonias, to name a few. Real time x-ray movies, or fluoroscopy is used routinely in surgery, CT scans gave us the first view of soft tissues, vastly improving the ability to visualize tumors, abscesses. This was followed by MRI, which my specialty is particularly fond of, giving us a chance for the first time to see detailed brain anatomy without radiating or cracking open the skulls of patients. Procedures such and functional MRI and PET are unlocking function and physiology secrets in living patients without laying a finger on them.
8. Acute lymphocytic leukemia– There are 4000 cases of ALL in the US annually, 3000 of these occur in children at a peak age of 2 to 5 years old, making it the most common childhood cancer. 30 years ago it had 100%mortality and was a death sentence. Since then, the development of Bone Marrow transplantation, umbilical cord blood stem cell transplantation and a National registry allowing clinical trials on a massive scale, have lowered that mortality to 20% in five years, for the most common type, 90% go into complete remission with about 60% cured.
9. HIV/AIDS antiretrovirals– Just when you thought we were done with all the major advances these days, along comes a new and deadly plague with knocking out the bodies defenses causing 100% mortality. Intensive study into the human immunodefieciency virus has led to antiretroviral medications that can knock HIV to undetectable levels. While we are still looking for a permanent cure, the current state of the art is bright. Unfortunately, Africa and Asia are in the throes of crisis and the developed/undeveloped gap has reared it’s ugly head, just as it did in the past with vaccines and antibiotics. Here’s hoping for another smallpox type resolution, rather than measles or polio.
10. Insulin- In 1889, Oscar Minkowski and Joseph von Mering decided to remove a dog’s pancreas to test the organ’s role in digestion. The animals keeper noticed afterward that swarms of flies were attracted to the dog’s urine. Thus they demonstrated the first link between the pancreas and diabetes, leading to the discovery of the insulin as the hormone all higher lifeforms use to metabolize sugar from the blood.
Type I diabetes was 100% fatal whenever it hit prior to this discovery, and became treatable for the first time. First the hormone was derived from animals, now gene splicing has enabled the production of genetically engineered human insulin, delivery systems are advancing all the time with the ultimate dream envisioned of the artificial pancreas, or perhaps pancreas insulin producing cell transplantation. Many, many years of life have now been added to both type I and II diabetics around the world.
So the next time you read about diminishing returns of medicine in improving our health, take a good look at just where medicine has taken us. I don’t think many people would want to go back. While learning to control costs and improve efficiency, and wise use of technology will be critical to sustaining healthcare in the future, it is hard to overestimate the benefits of modern medicine. What do you think? Did I leave anything out?
I won’t be posting anything for the next couple of days, and probably won’t be writing anything new the next couple of weeks. January 8th will mark this blog’s first anniversary. While my traffic is modest, it has roughly quadrupled what I had in the beginning, so I thought I would share what I consider some of my best writing that you may have missed from the archives, daily until then to celebrate and to give myself a vacation.
In the meantime, I just thought I would share some of the more interesting podcasts listen to habitually, as my Christmas gift to you. If you are like me and love to know stuff, they should be great for occupying your time and feeding your brain over the holidays. Read the rest of this entry »
The blogosphere is one place where you will never find any shortage of opinions and punditry. The recent election has been rife with partisan bickering and and all or nothing thinking. The healthcare debate online suffers from much of the same problem. It is fascinating to me how perceptions can vary from one person to another regarding the same reality.
Through it all, I cling to the idea that the vast majority of people are basically good. At the same time, a look at history or the news makes quite clear that even good people are capable of doing some pretty horrible things. Jonah Lehrer at Frontal Cortex recently shared a personal experience with one way that people with good intentions can make the world worse, the Just World Phenomenon. Read the rest of this entry »
It’s here again and back on schedule. This week I’ve got emotion, fear and stigmatization on the mind, parables, heaven and hell and success for the soul and whoopee cushions, spleens and lots and lots of protein for the body, to name just a few. So without further delay I present especially for you, the reader, the creme de la creme of the internet I happened to have stumbled across surfing the internets- Read the rest of this entry »
” We have learned by sad experience that it is the nature and disposition of almost all men, as soon as they get a little authority, as they suppose, they will immediately begin to exercise unrighteous dominion.”
Few things in life distort the relationship of communities and society more than power and politics. The American revolution and the revolution in France introduced democracy to both America and Europe in roughly the same time period. The French revolution ended up much more violent and tumultuous than the former, described by Charles Dickens as “the best of times” and “the worst of times” simultaneously. The French revolution was an extremely violent and intolerant uprising. It led to mass beheading and guillotining of the aristocracy. It led to the rise of the first of the modern despots in Napoleon, who enthralled the recently empowered majority, was voted into power which he refused to release and unleashed upon the rest of Europe, as the revolution ran off its rails.