Tag Archives: Medicine

Why We Fight

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Has med school taught me to appreciate the complexity of the human body and the intricacy of human disease? Hell no! What has it taught me? That the human body is a freakin’ mine field. Every which way you turn there are 10 more ways stuff can go wrong with your body. Some of them are worse than others, but let’s suffice it to say, there’s a lot of bad diseases out there and a lot of ways for you to die. It sometimes makes you wonder how we’ve got so many relatively healthy people out there. I suppose at least part of that is a credit to the human body’s resilience to withstand the barrage of daily attacks on its integrity.

The thing that sucks about the body is that we only get one, and it only takes one bad event to land us in “game over” territory. It’s not like a car, where there may be a lot of ways things can go wrong, but you can replace a blown out tire or just buy a new car if things get bad enough. If you blow out your liver though, you’re taking out the major player in the regulation of your body’s biochemistry. You lose that, and you do not pass Go and collect $200. That’s not to mention all the junk that gets old and wears out just through regular use. It scares the hell out of me because I don’t want my car to break down.

So what has all this knowledge of the body taught me? People are screwed. They’re gonna get sick. I mean really sick when one of these systems breaks down. And at least some of the time, there’s not a whole lot you can do to avoid it. It’s scary, and sometimes it makes me want to curl up in a ball and not leave my room. It makes me worry about every little pain, bump, or abnormality. Is this going to be my blow out?

But then I realized that this is why I’m doing what I’m doing. I’m going to get really sick. So are you. We could both be really sick right now and not even know it. This is what the training is all about. It’s so that when someone is really sick, we’re ready for ‘em. You don’t practice and train for a sport because you like to beat yourself up. You do it so that when the time comes, you’re ready to face the challenge head-on and kick its ass with barely a thought.

The only problem is that there’s always going to be a better opponent. So we train and we fight, but ultimately it’s a losing battle. And that’s OK. The point is to do all you can, and to do that you’ve got to be well-trained. What good does it do to be scared? Being scared does nothing; neither does being ambivalent. The fight’s coming to you, whether you’ll have it or not. The best you can do is be ready and waiting for it.

Futile care

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PandaBear made a good point about the incentives for terminating futile medical care:

My third point is that there is no incentive at any level of the medical industry to use a little common sense. At the high end, physicians risk severe legal consequences for not doing exactly what the family wants no matter how unrealistic. So dangerous is the legal terrain in this area of medicine that most hospitals have an ethics committee part of whose purpose is to spread legal responsibility. In many cases, however, there is no financial incentive to withdraw care as Medicare makes no distinction between the living and the living dead. At the patient end, the families have no financial stake in any of the decisions they make. If we but charged the families a small fraction of the cost for futile care or, more diabolically, had payment garnished from the patient’s estate upon their death, the families would be looking for the plug, especially in the cases where the ICU serves as an expensive funeral home where families can meet to see the body. If the family ever says, “We want to keep Uncle Joe on the ventilator until the rest of the family can fly in from Seattle,” they should be responsible for the full cost of the additional stay. -PandaBear, M.D.

I thought it was important that he emphasized that this is futile medical care and not simply medical care for the elderly as it may seem in some of his other posts. The point being that this is wasting a lot of money!

Pieter didn’t lie

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Apparently Pieter wasn’t lying to me when he said my undergraduate thesis was on a really important topic. In yesterday’s Tribune, they dug up an apparently old piece of news that I hadn’t heard. The folks at UIUC‘s new IGB received a $7 million grant from the NIH back in April. For what? Apparently to use the technique Pieter and I (mainly Pieter, mind you) helped design for understanding and developing antibiotics.

“The genetic screening method they are using has been available to the scientific community for about three years. Metcalf considers it a powerful aid in his search because it replaces a hit-or-miss screening system in which scientists had to grow the bacteria under a variety of conditions to find out what antibiotics they could produce.”
-Chicago Tribune

Of course, this is only getting covered in the Tribune now (7 months after the grant was awarded) because of all the hype about MRSA in the high schools. Considering we specifically designed our method to promote development of new antibiotics that could kill MRSA (and do many other things), it’s no wonder someone decided it might be important around now. I just hope in a few years we hear that their work (and our technique) has paid off and that they’ve got a prospective drug candidate or two. For further reading, see my undergrad thesis below.

One problem I have with the Tribune newspaper article is that it didn’t mention the other 4 researchers. Now Prof. Metcalf may be the lead investigator, but let’s face it, mass spec is the backbone of the technique. A hat-tip to Neil or the Kelleher Group would have been nice, guys. But I guess the public really doesn’t care about the “how”, they just want to know that someone’s on the case. Well folks, the scientists are on it.

Attached:
Jonathan Blackhall’s UIUC Undergraduate Thesis