Category: Medicine

0Epidemics have been a part of mankind for thousands of years.  At some point in time, humanity has been threatened with the possibility of extinction in the form a new disease that had not yet been understood by doctors and government officials.  In the United States, there was a disease that caused widespread panic and afflicted millions of Americans before it was contained.  Its most-famous victim was former President Franklin D. Roosevelt who became known as the “Wheelchair President”.  The disease was officially designated poliomyelitis or polio for short.  To this day, it remains one of America’s deadliest epidemics next to AIDS and cancer which continues to claim lives each year.   The origins of polio are mysterious and the successful creation of a vaccine was the result of the hard work and dedication of the greatest virologists who rose to the occasion to save the nation from a deadly disease.  Today the disease is largely forgotten and taken for granted.  A diagnosis of polio is exceedingly rare and in the event it is detected, vaccines are readily available to contain the virus and give the patient a long and happy life.  However, less than sixty years ago the race to find a vaccine was hotly contested as Americans and the world lived in suspense at the possible eradication of a silent killer.  Two doctors on opposites ends of the spectrum are forever linked with the disease and the successful campaign to eliminate it;  Albert Sabin and Jonas Salk.  This is the story of polio and the two physicians that have become legends in American history. The book is presented to us by David Oshinsky, author and Pulitzer Prize winner who also published  Bellevue: Three Centuries Of Medicine And Mayhem At America’s Most Storied Hospital.  Contained within these pages is the incredible story of the monumental effort to find a cure for the disease that threatened to eliminate the population of an entire nation and struck fear in the hearts and minds of households everywhere.

Albert Sabin died in 1993 and Jonas Salk two years later in 1995.  By the time of their deaths, polio had nearly been eradicated in the United States with isolated cases appearing on occasion. If they were alive today, I believe they would both feel vindicated even more by the rare existence of the polio disease in the United States today and in most parts of the world except for countries in Africa which still continue to struggle with the deadly disease.   The true irony of Sabin and Salk as we see through the account by Oshinsky, is that although they both sought a vaccine to save people from polio, they did so from opposite ends and maintained their stances until their deaths.  Salk became the first to claim popularity through the creation of his killed virus vaccine.  Several years later, Sabin would be the hero with his live virus vaccine.  The vaccines pitted them against each other in a long and protracted battled from which they would never reconcile. Once colleagues and later adversaries, both would be vindicated years after their deaths.

Oshinksy’s research is beyond reproach and readers familiar with his other works will readily agree. The book is engaging from the start as we trace the origins of the epidemic and learn a multitude of facts about the virus that will challenge common held beliefs.   Social status, wealth, ethnicity and professional competition serve as regrettable undercurrents that on occasion caused setbacks and put the battle for a cure in a negative light.  And the actions of the Eisenhower administration towards the disease are shocking and mind-boggling.  The behind the scenes trivialities that occur serve as a premonition of the AIDS epidemic in which political ambitions and career advancements take center stage nearly overshadowing the main goal.  Thankfully, the doctors were successful and polio is no longer the killer in America that it once was.

This book is a step back into time in an era in America that would shock most readers today.  World Wars, racial and class discrimination in the early stages of the fight but the revelation of how polio affected people challenges all of the notions that were held about social status and health.   It also reinforces the point that viruses do not discriminate and epidemics claim victims across all cultures.  And in some cases, the relatives of those tasked with finding the cure are also afflicted highlighting the severity of the growing crisis.  Furthermore, the battle between the National Foundation for Infantile Paralysis and Health, Education and Warfare Department cast a dark blemish on the cause.  The scandal of Cutter Laboratories and new cases of polio following the inoculations of the vaccines nearly caused a new widespread panic.  As we know through history, the government and the doctors pressed on with Sabin’s live virus vaccine becoming the standard for over thirty years before Salk’s killed virus once again rose to prominence in 2003.  Regardless of the order of introduction or range of administration, both vaccines played a crucial role in the eradication of the disease and cemented Sabin and Salk’s legacies.  Oshinsky has done a service to both physicians in telling the story of their never-ending efforts to save America.

ISBN-10: 0195307143
ISBN-13: 97895307146

Medicine

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The evolution of medical care in the United States is as scary as it is fascinating.  Today it is hard to fathom the once draconian methods physicians used to treatment even the most common ailments.  In fact, methods were so primitive, a patient was more likely to die at a hospital than at home. Of course now, the opposite is most likely to happen. America is home for some of the best hospitals in the world and cutting edge medical care.  But the path taken to reach this point was long, torturous and in some cases, shocking beyond belief.  At the center of the development in hospital care was a facility that became an icon in New York City, Bellevue Hospital.  The hospital which is still open today, has a long history that is largely unknown.  And the patients admitted there today are most likely highly unaware of the hospital’s storied past and how it came one of the City’s leading medical facilities.

Pulitzer Prize winner David Oshinksy has compiled this incredible investigative report into the history of Bellevue.  And it is all here; the good, the bad and the extreme ugly.   Through exhaustive research, he has carefully reconstructed the history of the hospital and others in the City of New York.  And although Bellevue is the subject of the book, the provides fascinating details about the origins of other hospitals in the City, some of which are no longer in existence.  St. Vincent’s is the first to come to mind.   The founders of these hospitals and the early pioneers of treatment there have been forgotten over time but Oshinsky brings them all back to life as he examines their lives and their contributions to the field of medicine. The book feels like a step back into time to an era in which emergency care often resulted in an emergency itself.

As a native New Yorker, I have passed Bellevue both on foot and by car dozens of times. In fact, my mother had a brief admission there several years ago.  However at no time was I even vaguely aware of the importance of the place in which I stood.  The history contained within the walls of the hospital is nothing short of astounding.  And having read this phenomenal work, I can exclaim that I had grateful for all of the advancements made in the field of medicine.  And I know that I do have to go to Bellevue, I will be in the care of the some of the best physicians New York City has to offer.  But as Oshinsky shows us, Bellevue also has a very dark past that often bordered on the unreal.

It will be hard for readers to imagine what medical care used to be like during a time when doctors were still learning how to treat even common conditions.  In an era before anesthesia, antibiotics and even proper sanity conditions, most patients entered the hospital and never left.   Those who did die, ran the risk of ending up in potter’s field which at the time existed in more than one location in the city.   As plagues swept through the City, the death toll mounted as doctors struggled to keep up.   Their attempts to treat the conditions and the solutions employed were beyond surreal and today they would be considered criminal.  Bellevue, while an early pioneer for above standard medical care, was not exempt and carries to this day, a fair number of its own horror stories that turned a blossoming hospital into the scorn of the City.  These stories included horrific medical practices, insufficient security and criminal neglect.  However, through every major crisis faced by the City of New York, Bellevue’s doors were always open and have remained so to this day. Even in times when ethnicity determined where you received medical treatment and mental institutions could not contain the sick, Bellevue took in all comers and that tradition has continued.

For those who are history lovers and want to know about the City of New York and in particular Bellevue hospital, this is the place to start.  Not only will you learn about Bellevue, but you will also learn about the history of the medical field in the United States and see how far society has come and how are we still have to go for the past is always prologue .

ISBN-10: 038552336X
ISBN-13: 978-0385523363

Medicine

Shilts.jpgThe announcement by former NBA star Magic Johnson that he was HIV+ shocked and devastated my friends and I.  Although we knew much about the dreaded disease that had taken the lives of thousands of people, there was still much that did not know.  Johnson would be considered one of the lucky few who survived an era in which we saw the deaths of tennis great Arthur Ashe and Real World star Pedro Zamora, among others including the author of this book, Randy Shilts.   When he died, I was a freshman in high school still trying to understand how and why society was now faced with an incurable disease.  Two years after his death, one of my uncles contracted the disease and died less than a year later.

What was becoming overwhelmingly clear was that AIDS was unlike anything we had ever seen before. And furthermore, it did not discriminate. Wreaking havoc on the immune system,  the disease crippled the infected person until their body just completely shut down.  Misunderstanding and misinformation lead to fear, discrimination and vicious rumors about anyone that was diagnosed as either HIV+ or having full-blown AIDS.   When HBO premiered ‘And The Band Played On’, my parents had my brother and I sit down and pay close attention.  HBO’s screen adaptation of Shilts’ bestselling novel is a critical film in American cinematic history. But our focus here in this masterpiece by Shilts of the origin of the AIDS crisis and the missteps along the way that helped it become an epidemic.

Today we can look back in hindsight with the knowledge that no one knows for certain exactly where HIV+ began.   The central figure here is Gaetan Dugas, the former Air Canada flight attendant who doctors believed to be the carrier of the disease. Dugas had confessed to having slept with hundreds of men without protection.   He eventually contracted the disease and died in 1984.  But for many years he was Patient Zero and the man doctors feared would continue to spread the disease in every place he traveled to.  While Dugas was a central figure,  he was not the only person to show the symptoms of the disease with doctors in New York City reporting similar cases year prior.  But Dugas was critical in understanding the spread of the disease as the crusade to identify and fight it began in San Francisco, the city that had attracted thousands of gay men during the 1970s.

The CDC becomes a part of the story as doctors continue to diagnose alarming numbers of patients with Kaposi sarcoma, an indicator of an underlying HIV infection.  As the body count increased, the CDC sprang into action as Don Francis, director of the AIDS Laboratory Activities began his journey to identify the cause of infection.  His mission to find a cure for AIDS and the battle between antagonist Robert Gallo and French doctors Françoise Barré-Sinoussi and Luc Montagnier are central to the book and highlight the behind the scenes wars raging as a deadly epidemic continued to claim lives while politicians ignored the warning bells.  Homophobia and hysteria took center stage as many sought to write of HIV and AIDS as a  “gay disease”.   As Shilts points out, Bath houses were closed and gay men demonized as having “deserved” the plague.  Washington dragged its feet with more than one president simply avoiding the crisis until it was far too late.  In fact, it was not until the disease began to affect heterosexuals that America began to take notice.

Today it is rare to hear of anyone dying from AIDS. In fact, people are now able to live for decades.   But there was a time where HIV and AIDS were a death sentence.  For gay men, it was essentially the end of their lives.  Before the century was over, it would claim the lives of Freddie Mercury, Rock Hudson, Sylvester, Anthony Perkins, Perry Ellis, Halston and Eazy-E, among millions of people worldwide.  The story to fight that disease that changed mankind is tragic, complicated and at times infuriating. The true ugliness that developed as egos clashed, politicians failed to act and the religious right found a scapegoat did more to prevent progress than it did to help.   And that is the true tragedy that can be seen here in Shilts’ words.

We have the benefit of history on our side and can look back at AIDS as a time in which hope was quickly fading.   Shilts and many others did not leave to see the tremendous progress doctors have made in treating AIDS.   Their deaths were not in vain and today HIV and AIDS are no longer the death sentence they once were.  But no matter how much progress is made, we should never forget the long struggle doctors faced in unraveling the mystery to one of mankind’s deadliest diseases.  And at the time Shilts wrote this best-selling book, the future was nowhere near as bright as it is now.  And this book is a testament to it and the best account of the beginning of the AIDS epidemic.

ISBN-10: 0312374631
ISBN-13: 978-0312374631

 

Medicine