Friday, August 27, 2010

Tainted Eggs and Scrambled Tubing

Tainted Eggs and Scrambled Tubes
Two recent news stories caught my eye. Both are fairly common stories of public health hazards, but the results and reaction to both are stunningly different. Where do the real dangers lie? You decide.
Recall expands to more than half a billion eggs
“Investigation of nationwide salmonella outbreak expands to 2nd Iowa farm
A half-billion eggs have been recalled in the nationwide investigation of a salmonella outbreak that Friday expanded to include a second Iowa farm. More than 1,000 people have already been sickened and the toll of illnesses is expected to increase.” (so far, no deaths)
How many times have we heard this story of a ‘nationwide salmonella outbreak; be it hamburger meat, tomatoes, spinach, and now eggs? In any event, the response to this public health hazard, where occasionally a few people die and many are made ill, is swift, decisive and far-reaching. The meat-packing plant and/or farm producer is shut down, and there are massive nationwide recalls of the suspected tainted animal or plant product.
Headline #2: NYTimes 08-20-2010, by Gardiner Harris
U.S. Inaction Lets Look-Alike Tubes Kill Patients
“Thirty-five weeks pregnant, Robin Rodgers was vomiting and losing weight, so her doctor hospitalized her and ordered that she be fed through a tube until the birth of her daughter.
But in a mistake that stemmed from years of lax federal oversight of medical devices, the hospital mixed up the tubes. Instead of snaking a tube through Ms. Rodgers’s nose and into her stomach, the nurse instead coupled the liquid-food bag to a tube that entered a vein.
Putting such food directly into the bloodstream is like pouring concrete down a drain. Ms. Rodgers was soon in agony. They soon learned that the baby had died…And then Robin Rodgers — 24 years old and already the mother of a 3-year-old boy — died on July 18, 2006, as well.
Their deaths were among hundreds of deaths or serious injuries that researchers have traced to tube mix-ups. But no one knows the real toll, because this kind of mistake, like medication errors in general, is rarely reported(*1). A 2006 survey of hospitals found that 16 percent had experienced a feeding tube mix-up.
Experts and standards groups have advocated since 1996 that tubes for different functions be made incompatible — just as different nozzles at gas stations prevent drivers from using the wrong fuel. But action has been delayed by resistance from the medical-device industry and an approval process at the Food and Drug Administration that can discourage safety-related changes."
How many times have we heard this story of doctor/treatment-induced (iatrogenic) patient death; be it from unnecessary surgery, to hospital-acquired infections, to adverse drug reactions, and medical tubing mix-ups, among others?
However, contrary to salmonella outbreaks where many are sickened and few, if any die, medical mishaps, which are ‘rarely reported,’ are killing people, an estimated 800,000 people per year, and are, by far, the leading cause of death and injury in the U.S. To be fair, ‘to err is human,’ and many presenting patients are seriously ill requiring drastic measures that raise all risks. However, even if 800,000 deaths per year is a gross exaggeration by a factor of four, 200,000 (*2) deaths per year by medical error would still be one of the leading causes of death.
There just is no comparison between illness and death caused by salmonella and those caused by medical error.
However, unlike the reaction to a salmonella scare, the response to chronic widespread, systemic medical mishaps is dismissal, denial and obstructionism by the AMA, the pharmaceutical companies, manufacturers of medical devices, and the FDA.
They have us afraid of the wrong things.
Important Notes:
(*1) "More than 250,000 side effects linked to prescription drugs, including injuries and deaths, are reported each year. And those "adverse-event" reports by doctors and others are only filed voluntarily. Experts, including Strom, believe the reports represent as few as 1% to 10% of all such events. "There's no incentive at all for a physician to report [an adverse drug reaction]," said Strom, who has documented the phenomenon. "The underreporting is vast."
(*2) JAMA. 12-21-1994 Error in medicine: "180,00 people die each year partly as a result of iatrogenic injury, the equivalent of three jumbo-jets crashes every 2 days." This is what was acknowledged in 1994. In light of note (*1) above..."the under-reporting is vast," 180,000 represents only a fraction of the problem, perhaps as little as 1% to 10%. And, the problem has only gotten worse since then.

Monday, August 9, 2010

Redefining Quackery

Redefining Quackery
Medicine is the science and art of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness.” A noble standard, if only it was true.
Medicine, like so much in our society, has lost its way. And, in its wake, like that of the financial institutions that rig the markets and steal, and corporations that pollute our environment and our bodies, there is a very human toll.
But medicine, a business purportedly centered on ‘maintaining and restoring human health,’ as such, and unlike financial institutions and corporations, requires higher standards.
But, sadly, so much of its practice has devolved into pure ‘quackery’ (to borrow a word so often brandished by the AMA, in their never-ending war for market dominance).
Quackery is a derogatory term used to describe the promotion of unproven or fraudulent medical practices. The word "quack" derives from the archaic word "quacksalver," of Dutch origin, meaning "boaster who applies a salve." In the Middle Ages the word quack meant "shouting". The quacksalvers sold their wares on the market shouting in a loud voice.”
On TV, on any given evening, on any channel, the drug companies are ‘boasting’ their life-saving health elixirs that promise anything from safe 3+hour erections to thicker and longer eyelashes; from legal uppers and downers, to sleep aids, from prescription skin rejuvenators to prescription fish oils, to fast-acting pre-meal heartburn and upset stomach pills that encourage us to eat whatever we want, especially foods our bodies would otherwise reject.
All of these elixirs and more have several things in common: little, to nothing, to do with ‘restoring health or preventing disease’, all have side-effects, ranging from mild to lethal, all are generating huge profits for Big Pharma, and all require a prescription and a visit to the pharmaceutical companies’ sanctioned retailers and legal drug dealers, doctors.
Add to that medical quackery in the form of cosmetic surgery: lip and breast augmentations, vaginal labia reductions, hair implants and laser hair removal; not-to-mention, abdominal implants and ‘sketching’ for men.
Clearly these are drugs and procedures in search of markets and have virtually nothing to do with medicine, ‘as the art and science of healing.’ It is all part of a far broader problem, the medicalization of life: the expanding of diagnoses and narrowing of the definition of normal, using constant repetition and playing on our fears and insecurities, to convince us that our bodies are inadequate, and that every possible symptom, from headache, to shyness, sadness to stomach ache, anything and everything, are conditions that require cure, instead of say, introspection and change.
Combine all of that with the fact that only an estimated 15% of everything that doctors do is backed by hard scientific evidence. Most of the rest is supported by anecdotal evidence, perpetuated mythology (ie: chemical imbalances in the brain, cholesterol), or self-serving, fraudulent corporate-sponsored science fiction. Consider only the field of invasive cardiology: “the data from clinical trials are clear: Except in a minority of patients with severe disease, bypass operations don’t prolong life or prevent future heart attacks; nor does angioplasty.” And yet, as of 2005, cardiologists performed about 400,000 bypass surgeries and over 1 million angioplasties per year. In fact, the evidence, by far, supports lifestyle changes of a healthy diet and exercise to significantly decrease the risk, not only of heart attack, but of all diseases. But, doctors, hospitals and drug companies do not make money on patient health.
A model of health that shamelessly promotes disease and passive medical consumerism, creating lifetime career patients, is not only quackery; it is dangerous to our health, producing untold numbers of patient victims of that care.